July 18, 2019

Dental implant with bone graft isolated on orange backgroundImagine this scenario and tell me that you wouldn’t be shocked and understandably a bit frustrated…

For quite some time you’ve been dreaming of filling a hole in your smile with a dental implant. It has taken some time to save up for the procedure; you’re ready to book a consultation and move forward with the treatment. You are so close to getting that new tooth and to restore your beautiful smile!

You have found a periodontist that you trust to book an exam to assess the site of the missing tooth. An essential part of this exam is taking an x-ray. X-rays provide the doctor a comprehensive snapshot of the teeth, nerves and the supporting bone structures of the tooth. If you want to learn more about dental x-rays, check out our blog on why they’re so critical and important.

The doctor returns to your operatory, opens your x-ray on her screen and begins to speak to the levels of bone beneath the gums where the teeth are rooted. She brings your awareness to an auspicious dip in the level of jawbone where your tooth has been missing for the past two years.

“You are definitely a candidate for a dental implant” she begins, “although first, an implant is only successful when there is an ample amount of healthy bone for the implant to anchor into. Before getting the implant you will need a bone graft to restore the bone at the site of the missing tooth.”

What!? Another unsuspected cost?! Bone graft?! What is that and why would I need it?

If you are someone who likes to garden or grow food you will know that to grow healthy plants it is essential that there is healthy soil in your garden. In the mouth – healthy and stable teeth are dependent upon a healthy jawbone and tight, supple gums.


The most common cause of bone loss is shrinkage in the gums and in the underlying bone that begins almost as soon as the tooth previously occupying the site is removed or lost. This type of disuse atrophy can cause the jawbone to be reduced in height, in width or a combination of the two.

The rate that the jawbone’s height is lost following tooth loss seems to be genetically regulated. There is no way to tell how quickly the bone will be lost. The best way to gauge the rate of bone loss in your mouth is to observe the jawbone at the site of any previous tooth extraction. The longer it has been since the tooth was lost: the worse the bone loss generally is.

There is an additional type of bone loss that takes place in the upper back teeth that is addition to that which causes the decreases in width and height. This type of bone loss is called sinus pnuematization (expansion). Again, this process starts almost as soon as a tooth is extracted and continues over time. It reduces the height of bone available for an implant from the root tip end of the site. As with the other type of physiological gum/bone atrophy it appears to be genetically determined and there is no way to tell how fast it will progress. The only way to predict how fast sinus pneumatization will occur is to observe how long it took at another site in the same individual.

Infections of the teeth or gums can also commonly cause massive bone loss. It can take place very rapidly or more slowly over time. The speed of the bone loss due to infection depends on whether it is an acute (highly active) or chronic (slow and progressive) infection. If you have an infected tooth it is important to get it treated immediately to avoid bone loss.

Gum diseases are many and varied but generally lead to bone loss – whether it is slowly progressive, rapidly progressive or anything in between. Again, the bone loss incurred through gum disease is permanent and may render a site unsuitable for implant placement. Early detection and treatment is the key to minimize bone loss when it comes to gum diseases. For more information on gum disease, visit our blog “How can I tell if I have gum disease?”

Lastly, bone can be lost through trauma. It would be no surprise that a blow to the mouth that causes teeth to be lost may also involve the loss of large segments of bone as well. Some of the largest bone defects we have ever seen have occurred secondary to facial trauma from accidents of various kinds.

Of the various causes of bone loss the most preventable is that which follows tooth extraction. This type of bone loss is completely preventable. Talk to your dentist or periodontist about what strategies can be employed to avoid this type of preventable bone loss before the tooth is extracted.

Bell Harbour Dental & PerioInnovations is a family owned, patient-first dental practice in the heart of Downtown, Seattle. Check us on out Facebook, Twitter, and Instagram, or contact us today to assist you in taking initiative towards vibrant dental health!

©2024 Bell Harbour Dental | Privacy Policy | Web Design, Digital Marketing & SEO By Adit