Edentulism is the condition of being without teeth. Loss of some teeth results in partial edentulism, whereas loss of all teeth results in complete edentulism.
Edentulism is more than just the simple absence of teeth because the teeth, jaws, and oral mucosa change over time. Processes such as bone remodelling in the jaws and inflammation of soft tissue in response to the oral microbiota are clinically important for edentulous people. The jaw in an edentulous area undergoes further resorption even after the teeth are gone; and insertion of dental implants can elicit new bone formation.
Causes of edentulism:
- Extraction of non-restorable teeth by a dentist.
- Periodontal disease: While the teeth may remain completely decay-free, the bone surrounding the teeth may resorb and disappear, giving rise to tooth mobility and eventual tooth loss.
Teeth serve to:
- Support the lips and cheeks thereby providing a fuller and more aesthetically pleasing appearance.
- Maintain vertical dimension of occlusion and maintain alveolar ridge height.
- Along with the tongue and lips, help in pronunciation.
- Cut, grind, and chew food.
Impact of Edentulism on Oral Health:
1. Modifier of Normal Physiology
Edentulism has a significant effect on residual ridge resorption, which leads to a reduction in the height of alveolar bone and the size of the denture bearing area that affects face height and facial appearance, which are altered following total tooth loss. The loss of alveolar bone height and width also leads to changes in the soft-tissue profile, such as protrusion of lower lip and chin.
2. Risk Factor for Impaired Mastication
An important indicator for masticatory efficiency is the number of functional tooth units. According to a systematic review evaluating the relationship between oral function and dentition, tooth numbers below a minimum of 20 teeth, with nine to 10 pairs of contacting units, are associated with impaired masticatory efficiency, performance, and masticatory ability.
Moreover, the thickness of the masseter muscle is decreased in edentulous patients, thus decreasing bite force and there is difficulty in chewing hard foods.
3. Determinant of Oral Health
Edentulism can be accompanied by functional and sensory deficiencies of the oral mucosa, oral musculature, and the salivary glands. Decreased tissue regeneration and decreased tissue resistance are expected in the edentulous population, which can impair the protective function of the oral mucosa. Stomatitis and angular cheilitis increase approximately three-fold in denture wearers.
Edentulism may induce an oral dyskinesia that is purposeless orofacial movements.
Impact of Edentulism on General Health:
According to several studies, tooth loss can affect general health in several ways as indicated:
1. Lower intake of fruits, vegetables and fiber and increased cholesterol and saturated fats, in addition to a higher prevalence of obesity, can increase the risk of cardiovascular diseases and gastrointestinal disorders.
2. Increased risk of chronic kidney disease.
3. Association between edentulism and sleep-disordered breathing, including obstructive sleep apnea.
Impact of Edentulism on the Quality of Life:
Edentulism may lead to poorer quality of life (e.g. impaired mastication, denture trauma, aesthetic concerns, or negative self-perception). Teeth have an important role in facial appearance, speech, and eating ability. Edentulism negatively influences not only oral function, but also social life and day-to-day activities.
