Adentia

The term "edentia" means a complete or partial absence of teeth. And although the unusual name often confuses, the problem itself is not so rare.

Moreover, some scientists argue that modern humans do not need the number of teeth that was vital for their ancestors, so adentia is not an accidental pathology, but the result of evolution, which ensured that “extra” teeth simply did not appear.

But what actually leads to such unpleasant and unaesthetic consequences as tooth loss?

Causes of adentia

Although, in general, adentia has not been sufficiently studied, it is generally accepted that its cause is the resorption of the follicle. According to scientists, a number of factors are to blame: inflammatory processes, general diseases, hereditary predisposition.

Deviations in the formation of tooth rudiments also occur due to diseases of the endocrine system. Parents must carefully monitor the health of their children's baby teeth, because their diseases, if not diagnosed in time and treated improperly, can lead to extremely negative consequences, including the loss of permanent teeth. However, in adults, various diseases of the oral cavity (caries, periodontitis, periodontosis) cause adentia. Injuries also lead to the same deplorable results.

Symptoms of adentia

The signs of this disease are quite obvious. A person may be missing all or some teeth, there may be gaps between the teeth, a crooked bite, uneven teeth, wrinkles in the mouth area. Due to the loss of one or more front teeth in the upper jaw, the upper lip may sink in, and due to the absence of side teeth, the lips and cheeks. Diction problems may arise.

Any of the listed symptoms should be treated with attention, because even the most insignificant of them can subsequently cause serious problems. For example, gum inflammation occurs due to the banal loss of just one tooth. This same, at first glance, insignificant factor leads to other negative consequences.

Partial edentia

The difference between partial and complete edentia lies in the degree of prevalence of the disease.

As mentioned above, partial adentia means the absence or loss of several teeth. Along with caries, periodontal disease and periodontitis, it is one of the most common diseases of the oral cavity. About two thirds of the world's population suffers from it. But, unfortunately, precisely because the problem is insignificant at first glance, many people often do not pay much attention to the absence of one or two teeth. But the absence of incisors and canines leads to noticeable problems with speech, biting off food, extremely unpleasant splashing of saliva for both the patient and those around him, while the absence of chewing teeth leads to a violation of the act of chewing.

Complete edentia

Complete absence of teeth – that is the meaning of this term. The severe psychological pressure from this pathology is accompanied by more significant difficulties. The patient's speech and face shape change dramatically, a network of deep wrinkles appears around the mouth. Bone tissue becomes thinner due to the lack of necessary load. The changes, of course, affect the diet in the most significant way, since patients have to give up solid food, and digestion. As a result, health problems arise, since the body lacks vitamins.

There is also the concept of “relative complete adentia”, which means that the patient still has teeth in his mouth, but they are so destroyed that they can only be removed.

Primary adentia

Depending on the nature of its occurrence, a distinction is made between primary, or congenital, and secondary, or acquired, adentia.

Primary adentia is the congenital absence of a follicle. It is caused by a developmental disorder of the fetus or heredity. In the case of complete primary adentia, teeth do not erupt at all, while partial adentia implies the absence of the rudiments of only some permanent teeth. Complete primary adentia is often accompanied by serious changes in the facial skeleton and disorders in the functioning of the oral mucosa. Initially, partial primary adentia poses a threat to baby teeth. It is interesting that in this case, the rudiments of teeth are not visible even on an X-ray, and large gaps appear between the already erupted teeth. This adentia also includes disorders that occur during the process of teething, which leads to the formation of an unerupted tooth hidden in the jawbone or covered by the gum.

Separately, a few words should be said about congenital adentia of lateral incisors. The problem is quite common, the whole difficulty lies in its specificity and complexity of treatment. The solution is to preserve space for the tooth in the dental row, if there is one, or to create it, if it is missing. For this purpose, they resort to special therapy, and at a later age, bridge prostheses are used or implants are implanted. Modern achievements in the field of orthodontics even allow replacing missing lateral incisors with existing teeth, but this method has certain age restrictions.

Secondary adentia

Acquired pathology that occurs due to complete or partial loss of teeth or their rudiments is called secondary adentia. This disease harms both baby and permanent teeth. The most common cause is caries and its complications (for example, periodontitis and pulpitis), as well as periodontitis. Often, tooth loss is caused by incorrect or untimely treatment, which usually results in inflammatory processes. Another reason is trauma to the teeth and jaws. Unlike primary, secondary adentia is a fairly common phenomenon.

Due to complete secondary adentia, the patient has no teeth at all in the mouth, which has a significant impact on his appearance - up to and including a change in the shape of the facial skeleton. The chewing function is impaired, even biting and chewing food becomes very difficult. Diction deteriorates. All this, naturally, leads to serious problems in social life, which, ultimately, negatively affects the patient's mental health.

This type of adentia is quite rare, and most often it is caused by an accident (various injuries) or age-related changes, because, as is well known, tooth loss is a problem that is most typical for older people.

Partial secondary adentia, of course, does not poison the lives of patients as much as complete adentia. But this is the most common type of adentia, and people tend to underestimate it. After all, due to the loss of even one tooth, a shift in the already formed dental row can occur. The teeth begin to diverge, and during chewing, the load on them increases. In the place where the tooth is missing, insufficient load causes depletion of bone tissue. This pathology also has negative consequences for tooth enamel - hard tooth tissues wear out, and the patient has to limit himself in the choice of food, since hot and cold food begins to cause him very painful sensations. The cause of partial secondary adentia, most often, is advanced caries and periodontal diseases.

Adentia of teeth in children

Adentia in children should be discussed separately, including the treatment of this disease. Often, such adentia is caused by a malfunction of the endocrine system (while the child may look completely healthy) or an infectious disease.

Parents should remember that a child should have twenty baby teeth by the age of three, and after three or four years, the process of replacing them with permanent teeth begins. Therefore, if deviations from the norm are noticeable, baby or permanent teeth do not erupt on time, you should consult a dentist. An X-ray will help determine for sure whether there are tooth rudiments in the gum. If the result is positive, the doctor will prescribe a course of treatment aimed at tooth eruption, or, as a last resort, will resort to cutting the gum or special braces that stimulate eruption. If a tooth rudiment is not found in the gum, you will have to save the baby tooth or install an implant to compensate for the gap formed in the dental row and prevent a bite curvature. Prosthetics can be considered as an option only after the child's seventh permanent teeth have erupted.

Prosthetics in children with complete primary adentia can be used no earlier than when the child reaches three or four years of age. But this option is also not a panacea, since prosthetics exert a lot of pressure on the jaw and can lead to disruption of its growth, so such children should be regularly monitored by a specialist.

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Diagnosis of adentia

In order to diagnose this pathology, the dentist must first examine the oral cavity and determine what kind of adentia is being dealt with. Then, as mentioned above, it is necessary to take an X-ray of both the lower and upper jaw, which is especially important if there is a suspicion of primary adentia, because otherwise it is impossible to find out whether follicles are absent. When examining children, the panoramic radiography method is recommended, which allows obtaining additional information about the structure of the roots of the teeth and the bone tissue of the jaw.

Diagnostics should be carried out very carefully, because even before prosthetics it is important to establish whether there are any unfavorable factors. For example, whether the patient suffers from any diseases of the oral mucosa or inflammatory processes, whether there are any roots that have not been removed and are covered by the mucous membrane, etc. If such factors are detected, they must be eliminated before prosthetics.

Treatment of adentia

It is quite obvious that this disease, due to its specificity, suggests that the main method of treatment will be orthopedic treatment.

In the case of partial adentia, the solution to the problem is prosthetics, and it is better to give preference to dental implants, because, unlike removable and fixed bridge prostheses, they distribute the load on the bone perfectly and do not harm the adjacent teeth. Of course, it is easier to use the prosthetics method if only one tooth is missing. It is more difficult to compensate for the lack of several teeth or install prostheses in case of malocclusion. Then you have to resort to the use of orthopedic structures.

However, in the case of secondary adentia, doctors do not always have to use prosthetics - if the even arrangement of teeth and uniform load on the patient's jaws can be achieved by removing one tooth.

Dental prosthetics in case of complete edentia has its own specifics. The primary tasks for a specialist in this case are to restore the functionality of the dental system, prevent the development of pathologies and complications and, only lastly, prosthetics. In this case, we are talking exclusively about dentures of the denture jaw - removable (plate) or non-removable. The former can be used to treat secondary complete edentia, they are generally very well suited for elderly people, although they require care: they must be removed before bed and constantly cleaned. They are easily fixed on the gums. Such dentures are cheap, aesthetic, but they also have disadvantages: they are not always well fixed, cause certain inconveniences, change speech, lead to bone tissue atrophy. In addition, it is often clearly visible that these are not real teeth.

The installation of fixed dentures in case of complete edentia requires preliminary implantation of teeth into bone tissue so that the implanted teeth serve as a kind of support for them. The advantages of implants are convenience, excellent fixation, restoration of bone tissue, aesthetic appearance, durability.

In general, the prosthetic method is quite successful, but it is still necessary to remember a number of factors that can lead to complications. Among them:

• jaw atrophy (impairs normal fixation of the prosthesis);
• inflammatory processes;
• the presence of an allergic reaction to dental prosthetic materials, in particular to the polymer.

Prevention of edentia

Prevention of adentia in childhood consists of regular dental check-ups, stimulation of teeth eruption and prevention of dental arch deformation.

However, adults should also take their visit to the dentist very seriously. It is neglected caries or periodontal diseases that are not properly treated that lead to tooth loss. Therefore, it is necessary to visit the dentist regularly, once a year, or better yet, every six months. The necessary attention should also be paid to oral hygiene.

All these measures, as well as timely treatment, will help prevent tooth loss, and if the fact of adentia has already been recorded, then reduce tooth loss to a minimum.

Prognosis of edentia

Of course, adentia is an extremely difficult and unpleasant disease. But despite all sorts of complications and the obvious complexity of its treatment, the prognosis in most cases will be favorable. This is equally true for both partial and complete adentia. Timely and professional treatment (primarily, we are talking about installing dentures) will allow the patient to return to a normal, full-fledged lifestyle, get rid of psychological discomfort, painful sensations and digestive problems associated with adentia, and communicate calmly with other people.