A great smile requires more than just healthy teeth. It also requires healthy gums and a healthy jaw bone.
The jaw bones hold the teeth in place. If a tooth is missing either due to periodontal (gum) disease or caries (decay), the jaw bone will begin to recede. Why is that a problem? You need the jaw bone intact to replace the missing tooth or teeth with a dental implant, a denture, or a partial.
Bone grafting is the common procedure that reconstructs the bone so that you can fill the extracted socket from the missing tooth in order to maintain the width and the height of the alveolar ridge. The alveolar ridge is also known as the gum ridge and is one of the two jaw ridges either on the roof of the mouth between the upper teeth and the hard palate or on the bottom of the mouth behind the lower teeth. There are a few different circumstances where bone grafting is performed:
Bone Grafting After An Extraction
If you’re having a tooth extracted, then your general dentist typically can do a simple bone graft to fill the extraction site and preserve the bone from resorbing during the same visit. The dentist will pack the empty tooth socket with freeze-dried human bone granules that look a little like sand and may choose to cover the area with a thin membrane and a few sutures to hold it in place. In this case, the bone grafting procedure takes about a half-hour. Your dentist may ask you to come back the next day for a post – op check-up, and then will have you return for another check-up about a week later. It takes about four to six weeks for the site to heal, and then a dentist can start the initial treatment for complete or partial dentures. If you prefer to go with the more natural-looking and long-lasting dental implant, then the restorative treatment will start about 4 to 6 months later.
Bone Grafting After Mild Bone Loss
If a tooth has been missing for a while, then the bone may have already resorbed. In this scenario, a dentist will need to replace a larger bony defect. For such circumstances, a portion of the patient’s own bone from another section of your mouth or body is taken along with the freeze dried bone and placed into the site that needs to be rebuilt. Your dentist may cover it with a membrane and then suture it to hold it in place while it heals. Since the dentist is just taking your own bone (which is called as an autogenous bone graft) from one place to another, your body typically will accept it, as long as you’re on an antibiotic to fend off infection. The downside is that the dentist needs to make two incisions, one at the donor site and one at the recipient site.
Bone Grafting After Extensive Bone Loss
If you have extensive bone loss from either periodontal disease or because you have had teeth missing for a long time, then you’ll require a much larger bone graft. Your dentist can use a combination of materials to build up the jaw bone, including your own bone, freeze-dried bone taken from someone else, an animal bone, or a synthetic bone substitute. The graft creates a framework that works like a scaffold so the bone graft can attach and generate new bone cells. The amount of time it takes to heal depends on how much bone grafting is needed and how many areas are involved. Once the area is completely healed, your dentist or a specialist can place the implants or fabricate dentures and restore your smile.
Bone Grafting Benefits
Rebuilding the jaw bone to its former height and width gives you more options on how you want to replace a missing tooth. Even if just one tooth is lost, your appearance can drastically change as the surrounding teeth drift out of position and change the bite. Not replacing a tooth could lead to occlusion (bite) problems, caries (cavities), and periodontal disease.
If you choose to replace the missing tooth with a dental implant, it can last a lifetime. A dental implant topped with a crown looks and feels just like a natural tooth. It helps preserve the bone and maintain the jaw frame so that it doesn’t sag and make you look older. Dental implants can also be used to support a bridge to fill a void or to secure a denture so you can eat and talk more easily.
Bone grafting can also build up the alveolar ridge so that a denture, even without implants, fits more snugly. Ill-fitting dentures can be painful. Bone grafting can ensure you have a restoration that looks, fits and feels beautiful.
Divya Peddireddy, DDS, MHA, has been providing comprehensive dental services to families for more than a decade. She earned her Bachelor of Dental Surgery degree in India in 2005, and then moved to California where she earned her Master of Science degree in Health Care Administration at California State University Long Beach, and her Doctor of Dental Surgery degree at the University of Southern California, Ostrow School of Dentistry. She is accepting new patients at SmileCare Bakersfield and at SmileCare Lancaster.
Written by: Beth Gaddis
Reviewed by: Divya Peddireddy, DDS
Reviewed by: Cindy Roark, DMD