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Healthy Bone is Essential to a Beautiful Smile

In the news we hear about osteoporosis and bone loss in our body. Indeed this disorder, which affects 28 million Americans, is a health concern as we all get older and live longer. What we hear about less often is the bone loss in your mouth. According to the Academy of General Dentistry (AGD), osteoporosis also increases risk factors for tooth loss, bone loss and periodontal (gum) disease. Even those without osteoporosis need to be aware of the issues of tooth loss, periodontal disease and its affect on the bone levels. It is important to preserve the oral bone levels we have now so that ideal dental health can be achieved over our lifetime.

Preventing Bone Loss Keeps Your Smile Bright

The bone in your jaw is the actual foundation to your teeth and gums, and therefore essential to having a healthy smile. Decreased levels of bone may lead to insufficient support for teeth, resulting in shifting, loose or mobile teeth. At a certain point these teeth may be unable to be saved and must be extracted. Furthermore, missing teeth or bone loss may have consequences that are more far reaching than the ability to chew and the look of your smile. It can also affect your overall facial appearance as significant bone loss in the mouth may leave a concavity on your face in that area.

Many factors affect oral bone levels. A tooth merely having its root embedded in the bone stimulates the growth of bone and keeps it at an optimal height. If a tooth is extracted the bone may heal at a lower or sunken level and may even continue to recede. If the surrounding gums are affected by periodontal or gum disease, that may eventually contribute to gum tissue and bone loss. According to the American Dental Association (ADA), after age 35 about three out of four adults are affected by some form of gum disease. Periodontitis or advanced gum disease is the number one reason adults lose teeth.

Misconceptions Regarding Tooth Loss

Sometimes misinformation may lead people to make dental choices that negatively affect their oral bone level. Some people seem to be under the impression that if their tooth requires root canal therapy due to an infected or dead pulp, they have a choice of either having the root canal therapy or having the tooth pulled. The two choices have drastically different outcomes for your future dental health. A tooth which has had root canal therapy is still able to stimulate the growth of bone around the root; the result of a tooth extraction can lead to multiple tooth, gum and bone problems.

Another misconception is about the importance of their back teeth or molars. Some may decide they don’t have to take care of the back teeth or won’t miss them if they need to be extracted, as they can’t be seen as much as the front teeth. The molars function as the all-important chewing surfaces of our teeth, therefore absent molars may require a restriction to a softer food diet, which is undesirable to most people. In addition, as mentioned before, the bone in the area where teeth are missing may heal at a sunken level and continue to recede.

A third misconception is an ill-fitting denture can’t be fixed and must be accepted as is. There is a dangerous downward spiral linked to this belief. Maybe someone’s denture is not fitting as well for whatever reason, but they decide not to go back to their dentist to have it addressed. This poorly fitting denture will often accelerate bone loss leading to an even more poorly fitting denture and decreased bone heights.

Advances in Dentistry Help Keep Your Smile Beautiful

Fortunately, advances in restorative dentistry continue to address bone preservation. Dental implants over the past decades have revolutionized dentistry. Years ago restorations for missing teeth were limited because there was no method to anchor a crown or denture. Dental implants are titanium alloy screws that are inserted directly in the bone, allowing an extremely stable foundation on which to place a crown, bridge or denture. The implant stimulates normal bone growth similar to a natural tooth. Keep in mind that although dental implants help preserve bone, they also initially require sufficient bone levels to be able to be placed.

Preserving bone in every area of the mouth is so important that there is now state-of-the-art procedure that should be performed with any tooth extraction to maintain bone levels. If you do need to have a tooth extracted due to a severe tooth fracture or another reason, a “bone graft” can be inserted in the place of the missing tooth. This bone graft may be from various sources such as human or synthetic bone. It allows the bone surrounding the extraction site to heal at the highest position. Otherwise there may be 30 to 40% additional loss with the bone healing in a sunken position. Over time, without any such treatment, the bone will tend to recede away from the gums.

If someone has extensive bone loss but still wants to have implants placed, there are bone replacement surgeries available. Some of these bone regeneration surgeries can be complex, invasive and expensive procedures where bone is obtained from a hip surgery by an orthopedic surgeon then grafted to the jaw bone and left to heal and grow. It is much easier and simpler to prevent bone loss in the first place.

If you have any dental concerns mentioned in this article, such as missing teeth or an ill-fitting denture, discuss them with your restorative dentist on a timely basis. Not doing anything puts you at a disadvantage, as you may miss treatment or preventive opportunities. Natural teeth and implants must be able to have a firm foundation in the bone. By taking steps to preserve the bone levels in your mouth, you are making great strides in preserving your smile for your lifetime.


Dr. Wynn Okuda is an award winning international leader in cosmetic dentistry. He is one of only 280 dentists in the world to be accredited by the American Academy of Cosmetic Dentistry (AACD). Dr. Okuda turned the dental profession on its head nearly a decade ago , replacing pain, fear, & discomfort with the Dental Day Spa system. His offices for cosmetic, restorative and implant dentistry are located in Honolulu, Hawaii.
Dr. Okuda has been featured in the New York Times, Wall Street Journal, Reader’s Digest, American Spa, Shape Magazine, Better Homes & Garden, Health & Fitness Sports Magazine, New Woman, and dozens more!