Total edentulism is the clinical situation that occurs after all teeth have been lost from the dental arches.
The causes of tooth loss can be multifactorial and the age at which total edentulousness occurs is usually older, but it is not uncommon in middle-aged patients.
There are obvious changes in the oral mucosa, the integuments and the bone in an edentulous patient.
Causes
There are many causes of tooth loss, the most common of which are:
Periodontal disease – is generally responsible for the loss of a large number of teeth.
The onset of periodontal disease is always marked by the presence of gingival inflammation, which in turn is manifested by the appearance of bleeding. Untreated, this gingivitis progresses and will affect the ligaments and then the alveolar bone, becoming periodontitis.
Periodontal disease may be localized to a small number of teeth or it may be generalized, the latter being responsible for the development of total edentulism.
Tooth decay– if the patient does not follow a strict hygiene protocol and is not consistent in its application, tooth decay occurs.
Usually, caries occurs preferentially towards the interdental areas or those areas that are shielded from the action of salivary flow.
In order for the patient to become totally edentulous, the carious processes should be extended to the totality of the teeth.
Usually, general diseases or those that are accompanied by defects in bone structures or enamel can lead to the rapid spread of caries to all dental units.
Dental trauma– in most cases, dental trauma is responsible for the loss of teeth in a specific region, particularly the anterior region, which is more exposed in case of impact.
Therefore, the association of total edentulism with trauma is somewhat impossible.
Features
The totally edentulous patient presents some difficulties, both functional and psychological. However, some features are characteristic of the totally edentulous condition:
Physiognomic disorders– the lower floor of a patient who has lost all teeth is much undersized and the lips tend to be sucked into the oral cavity.
Also, the natural grooves of the perioral region are accentuated and the so-called old man appearance is present.
Phonation disorders –in pronouncing certain consonants, the tongue rests on the teeth and the air coming out of the oral cavity is controlled by the teeth and lips.
If the dental units are lost, the tongue cannot adapt to produce the sounds and they will be distorted, unclear or hissing.
Chewing disorders –the teeth play a vital role in grinding food.
Without them, food skips the first stage, the shredding stage, so over time gastric disorders can occur. The gums are not designed to withstand the forces of mastication so they either keratinize or ulcerate through trauma, both of which are undesirable if the patient wishes to have dentures.
Psychological disordersdeserve a special place because they stigmatize the patient, even leading to depression.
All these problems can be solved by seeing a dentist.
Ideally, oral hygiene should be maintained within normal parameters and the patient should see the dentist regularly to prevent tooth loss.
If this event has already occurred, conventional or implant-supported dentures are the only way to replace lost teeth.
