Understanding Alveolar Bone Loss After Tooth Extraction

What Our Bromley Dental Patients Need to Know

Dr O Dadashian

When a tooth is extracted, a fascinating but complex process of bone remodelling begins in your jaw. This natural phenomenon, while perfectly normal, can have significant implications for your oral health and future dental treatment options. Let’s dive deep into understanding what happens to your jawbone after tooth extraction.

The Natural Process of Post-Extraction Bone Loss

Your jawbone, specifically the alveolar bone, exists primarily to support your teeth. When a tooth is removed, the bone that once surrounded it undergoes a remarkable transformation. This process, known as post-extraction dimensional changes, begins almost immediately after the tooth extraction and continues over several months.

The Timeline of Change

The most significant changes occur during the first three months after extraction. Research has shown that without any intervention, the alveolar ridge (the part of the jawbone that holds your teeth) undergoes both horizontal and vertical reduction:

• Horizontal Changes: The width of the bone can decrease by approximately 2.7-3.6mm, with more substantial changes often seen in molar areas
• Vertical Changes: The height of the bone typically reduces by 1.4-1.7mm on both the outer (facial) and inner (lingual) aspects of the ridge

Why Does This Matter?

These dimensional changes can have several implications:

• Future Implant Placement: Reduced bone volume may complicate dental implant placement
• Aesthetic Concerns: Bone loss can affect the appearance of your smile and facial structure
• Adjacent Teeth: The stability of neighbouring teeth might be affected
• Prosthetic Considerations: The fit and function of future dental prosthetics could be impacted

Factors Influencing Bone Loss

• Several factors can affect the extent of bone loss:
• Location of the extracted tooth
• Size of the extraction socket
• Thickness of the surrounding bone walls
• Presence of any infection
• Individual healing capacity
• Smoking status
• Overall health conditions

Modern Prevention Strategies

Fortunately, dental science has developed several strategies to minimise post-extraction bone loss:

• Alveolar Ridge Preservation (ARP): Using bone grafting materials immediately after extraction can significantly reduce dimensional changes
• Immediate Implant Placement: In suitable cases, placing an implant at the time of extraction can help maintain bone volume
• Advanced Surgical Techniques: Minimally invasive extractions and careful soft tissue management can optimise healing

The Role of Professional Care

While some degree of bone loss is inevitable following tooth extraction, working with your local dental professional to develop an appropriate treatment plan is crucial. Recent studies have shown that proper intervention can reduce horizontal bone loss by up to 1.88mm and vertical bone loss by up to 2.27mm compared to unassisted healing.

Looking Ahead

Understanding these biological processes helps both patients and practitioners make informed decisions about post-extraction care. Whether you’re planning for an immediate replacement or considering future restoration options, knowledge about post-extraction bone changes can guide better treatment choices.

Remember, every patient’s situation is unique, and what works best for one person may not be ideal for another. Always consult with your dental professional to determine the most appropriate approach for your specific case.

References:

1. Couso-Queiruga E, Stuhr S, Tattan M, Chambrone L, Avila-Ortiz G. Post-extraction dimensional changes: A systematic review and meta-analysis. J Clin Periodontol. 2021;48(1):126-144.

2. Gaddale R, Chowdhary R, Mishra SK, Sagar K. Soft and hard tissue changes following immediate implant placement and immediate loading in aesthetic zone-a systematic review and meta-analysis. Evid Based Dent. 2024 Dec 2. 3. Apaza-Bedoya K, Magrin GL, Romandini M, Blanco-Carrión J, Benfatti CAM. Efficacy of alveolar ridge preservation with xenografts and resorbable socket sealing materials in the esthetic region: A systematic review with meta-analyses. Clin Implant Dent Relat Res. 2024;26(1):4-14.