Throughout your life, your bones constantly remodel themselves — removing old bones (resorption) and adding new ones (ossification) where needed. This is a natural process that’s important for your health and well-being.

However, when resorption happens at a higher rate than it can be replaced, it can lead to a decrease in your bone mass and put you at higher risk for fractures and breakage. In your mouth, your jawbone is most likely to be affected by this phenomenon.

HOW DOES BONE REMODELLING WORK?

Your bones have two kinds of cells that do the work to remodel your skeleton, as needed. Osteoclasts break down old bone and deliver it into your bloodstream (resorption), and osteoblasts build your bone where it needs reinforcement (ossification).

When you’re a child, you create bone faster, but the process slows as you age. When you were in your first year of life, almost 100 per cent of your skeleton was replaced, and as an adult, your bones remodel themselves at a rate of about 10 per cent per year.

Bone remodelling is an important process for a lot of dental work. When orthodontists realign your teeth with braces, clear aligners, or other devices, resorption and ossification are what allow for the movement and strengthening of your teeth in a new position. If you need dental implants, bone growth around the metal gives you stable support on par with your actual teeth.

SYMPTOMS OF JAWBONE LOSS

You may not notice the early stages of bone loss in your jaw. As bone resorption increases, you may notice one or more of the following symptoms:

• Changes in your bite and facial structure;

• Discomfort when you chew;

• Wrinkles begin to form around your mouth;

• Shifting or loosening of your teeth;

• Lips begin to sink inward;

• Wrinkled skin around your mouth;

• Headaches, facial pain, and jaw pain;

• Increased difficulty speaking; and

• If you wear dentures, changes in the fit and comfort of your replacement teeth.

WHAT CAUSES BONE LOSS IN THE JAW?

Bones are reinforced through osseointegration, where they are used the most. For your jawbone, when you chew and bite, the force you exert through your teeth into your jaws sends signals to osteoblasts to keep that bone strong.

If you’re missing a tooth due to tooth extraction, gum disease, or injury, the jawbone in the area of loss no longer receives stimuli, osteoclasts will begin to break down the jawbone, and osteoblasts will no longer prioritise rebuilding the bone structure there. New bone will still form, but at a slower rate than the bone that is being destroyed. Wearing dentures may increase the rate at which the bone deteriorates. If you wear dentures and they’ve become loose, it may be a result of bone loss, and they may require refitting.

Some other causes of bone loss in the jaw include:

• Gum disease, particularly periodontitis (severe gum disease);

• Osteoporosis, a condition that makes bones in your body weak and brittle. It can also affect your jawbone;

• Orthodontic treatment has been shown to decrease bone density around the teeth that have been moved. Fortunately, for healthy individuals, the bone usually recovers to its original strength in the months after treatment.

WHAT ARE THE EFFECTS OF JAWBONE LOSS?

In addition to the symptoms noted above, jawbone loss can cause you to lose teeth and make it difficult or impossible to give you replacement teeth (implants, removable bridges, or dentures) without an oral surgeon first performing a bone graft.

Jawbone loss can also lead to facial collapse, in which your mouth seems to fall back into your face, your chin becomes more pointed, and your facial muscles weaken. This will cause premature wrinkling around your mouth and a thinning of your lips. All of these changes tend to make you appear older than your actual age.

WHAT ARE THE TREATMENT OPTIONS FOR JAWBONE LOSS?

If you’re experiencing bone loss in your jaw, your treatment will largely depend on what’s causing it, and your dental professional is best positioned to help you determine the source of the abnormal resorption. If you have one or more missing teeth and still have enough bone density, it may be recommended that you get dental implants. Implants not only replace teeth but also stimulate the bone and can restore the natural balance of osseointegration and resorption in your jaw.

If you’ve already experienced significant bone loss, bone grafting may be necessary before your dental professional can place an implant in your jaw. If your bone loss isn’t related to tooth loss, bone grafting is still a treatment that can do more than replace bone, but stimulate bone growth, too.

If your high level of resorption is due to a condition like osteoporosis, your health-care professional and dental professional may need to collaborate on treatment for you. It’s noted that bone loss caused by osteoporosis can be treated with various medications or hormone therapies depending on your age, gender, and whether or not you have other medical conditions.

Bone loss in your jawbone can seem frightening, but no matter what’s causing your resorption, your dental professional can work with you to develop the best approach for treatment. Don’t hesitate to make an appointment so they can help you get back to a level of oral health that will keep you smiling.

Dr Sharon Robinson, DDS has offices at Dental Place Cosmetix Spa, located at shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 876-630-4710. Like their Facebook page, Dental Place Cosmetix Spa.