Home Blog Ask The Dentist Medicaid Polls Procedure Descriptions FAQ's Consultants News Schools Directories Research


 

Dental Health Photo Library

Bad Teeth: Severe Gum Disease and Bone - Tooth Loss


Gum Disease Stages

Our Most Popular Gum Tissue Videos:

Determining Extent of Diseased Gums
Jaw Lock
PerioLase for Reattaching Loose Teeth
Flossing Pain
All New Teeth One Appointment
Gum Disease Teeth
Click Images To Start - Stop Videos
Bonding to Fix Loose Teeth?
Video: Prevent - Control Gum Disease

As discussed elsewhere on this website, a majority of the adult population have some form of gum disease.

Diagnosed and treated early with effectively with a large choice of products and services (Perio Protect, Perio Lase, PerioWave, PerioChip, Arestin, etc), mild cases of gum disease (gingivitis) can be successfully managed.

Severe cases of advanced gum disease, commonly known as Periodontitis, can be quite devastating and cause loss of critical bone structure and mass .... causing eventual loosening and/or loss of teeth.

A variety of interventions, nonetheless, can be performed in many cases where infected hard and soft tissues are removed and treated with different types of grafting products. Temporary implants and prosthetic products can be integrated into treatment that enables patients to NOT be without teeth during healing.

Watch two different videos showing successful periodontitis treatments that involved multiple extractions yet did not force patients to be toothless during healing.

The pictures below reflect varying degrees of advanced perio disease, associated with numerous other treatment needs.



Egads... imagine kissing something like this! It is likely that all teeth will require extraction. The amount of bone and soft tissue damange won't be fully realized until everything is removed.

See the photo below to get an interior view of the mandible (lower jaw) to an understanding how how extreme accumulations can become.


Gum Disease Rampant Wisconsin
Here is an interior view of the oral cavity of the patient pictured above.

While these extreme accumulations strikingly show how devastating gum disease can be, it also shows how gum disease favors live tissue structures over areas that have been partially restored with man made products.

Notice how the crowns in the left lower jaw seem to be relatively unaffected.



Severe calculus tartar debris deposits
Calculus - Tartar - Debris Accumulation
Dr. Rick Winter, Milwaukee WI


OK .... the question of the day is which came first? ..... Advanced Gum Disease or Severe Orthodontic Issues? It is amazing that this patient hasn't had MORE significant tissue damage and loss of teeth over the years.

Unfortunately, treatment options are probably limited to total edentulation (removal of all teeth) and replacements with non removable or removable prosthetics (bridgework vs dentures)


Gum Disease Orthodontics
Orthodontic - Periodontitis Issues
Dr. Rick Winter, Milwaukee WI


Adult gum disease, when untreated for too long, can cause extreme losses of gum tissue and underlying bone. Individual tooth loss can also be inevitable for some patients. Today's advanced technologies provide several different methods of tooth replacement which, in many cases, can be achieved in one treatment session.

Treatment options can include multiple extractions, socket grafts, multiple implant surgeries, mini implants, hybrid implants, acrylic vs porcelain teeth, teeth-in-one-day, locator attachments (for removable prosthetics) and fixed bridge tooth replacements.


Gum Disease Affordable Teeth Replacement
Active Gum Disease - Tooth Loss
Ara Nazarian, DDS, Troy, MI


Untreated orthodontic issues and adult onset periodontal disease have caused a situation where unwanted teeth movement continues, along with bone loss and gum loss. This middle aged adult is now at the point where treatment is necessary to normalize bite dynamics and to restore teeth positioning that eliminates lateral (sideways) forces on both arches of teeth.

Treatment options can include limited orthodontic treatments and/or reconstructive dentistry that might incorporate tooth replacements, crowns, limited use of veneers, bridgework or denture prosthetics.


Moving Teeth
Profile View: Moving - Flaring Teeth
Corinne Scalzitti, DMD, MAGD, Austin, TX


Although not a case of rampant, severe gum disease, this photo represents what can happen when crowned teeth are not "looked after" properly or on a timely basis. Long term accumulation of gum recession effects and bone loss can destroy the cosmetic and functional goals that were, at one time, an intelligent use of restorative procedures.

Restoration or reconstructive possibilities can include implant reconstruction, custom bridgework, selective gum grafting procedures, crown replacements, removable prosthetics and denture partials.


Gum Recession Crowns
Long Term Tissue Loss
Christopher McFarland DMD, Atlanta, GA


Accumulation of bacteria, debris, calculus and tartar can accelerate when patients don't respond to advanced levels of the early stages of gum disease. A spiraling effect of initial denial, possible issues with treatment costs, eventual pain, discomfort, bleeding ... more avoidance.... and so on.

Luckily, this patient did initiate treatment at the time this photo was taken. A BioLase laser was used in conjunction with ultrasonic periodontal instruments to begin the clean up and removal of all accumulations and diseased tissue.


Tartar Calculus Gum Disease Byproduct
Extreme Accumulation
Marie Schweinebraten, DMD, Atlanta, GA


For the patients out there who know they have gum disease and are doing their best to maintain their procrastination.... this picture shows what can happen when pre-existing occlusal issues can quickly and seriously compromise overall bone health. Malocclusion can operate around the clock through normal eating, chewing and biting. Then, during sleep... night time bruxism or teeth clenching can further compromise teeth that some patients hope to save.

Extractions would be required, along with treatment to arrest the disease process and restabilize overall oral health. Tooth replacement options might include selective bone grafts (chin block, ramus, pulverized bone matrix, ridge splitting), selective placement of implants, choice of fixed bridge or removable denture prosthetics.

Flaring Shifting Teeth Destroys Bone
Malocclusion and Periodontitis - Teeth Flaring
Edward Brant, DDS, MS, Long Island, NY


It looks like calculus and tartar are keeping the lower anterior teeth from falling out. The extent of concentrated bone loss is reflected in how well we can see the patient's tongue. By the time the lower teeth fall out or are extracted, there won't be much bone there to work with.

This patient could probably be a good candidate for chin block or ramus block grafting to fill in the anterior portion of the mandible. Once healed prospects would be good for more choices of tooth replacement treatments that could go beyond common denture products. The use of dental implants would assure preservation of the new bone tissue.

Mandible Bone Block Graft Candidate
Anterior Bone Graft Candidate
Paul Sussman, DMD


Delaying treatment for too long can not only cause the loss of soft tissue and teeth... it can actually make a jaw incapable of supporting a normal denture product. The lower posterior areas of this patient's lower jawbone have vanished.

There is however a good chunk of bone in the front (anterior) area that can be used well but will now REQUIRE some type of implant solution to keep prosthetic teeth in place and will increase treatment costs substantially. The upper arch can be prepared for fixed bridge products or denture products.


Forced Lower Jaw Implants
Vanishing Mandibular Ridge
Edward Brant, DDS, MS, Long Island, NY


A good view of how ugly the accumulation of calculus and plaque can become along with all of the byproducts of advanced gum disease. Up to the point of where the patient actively consults with a dentist for treatment, it is an understatement that denial is a powerful force. Most, if not all, of the teeth will require extraction.

Restorative (actually reconstructive) treatments could include selective bone augmentation (chin block, ramus, pulverized bone matrix, ridge splitting), selective placement of implants, choice of fixed bridge or removable denture prosthetics.

Periodontitis
Severe Periodontitis
Ron Briglia, DDS, West Chester PA


Which condition caused what? This patient has orthodontic issues, bone loss issues, super eruption, gum loss and bone loss. Complacency in even some of the most basic oral health care habits got the best of this patient. Gingivitis developed into Periodontitis leading to bone loss, soft tissue loss and radical movement of tooth structures.

Total extractions of remaining teeth is required. Treatments to eradicate remaining diseased tissue will follow. Choices for tooth replacement with reasonable function and cosmetics might include selective bone grafts (chin block, ramus, pulverized bone matrix), selective placement of implants, choice of fixed bridge or removable denture prosthetics.

Severe tissue tooth loss
Redefining a Worst Case Scenario
Dr. Rick Winter, Milwaukee WI


This is about as bad as it gets.... rampant periodontitis causes wholesale destruction of bone, connective and soft tissues at an alarming rate... in this case the lower jaw more severe than the upper. Notice the near total loss of all mandibular bone. The patient is only 40 years old.

Total extractions of remaining teeth is required. Treatments to eradicate remaining diseased tissue will follow. Choices for tooth replacement with reasonable function and cosmetics might include selective bone grafts (chin block, ramus, pulverized bone matrix), selective placement of implants or mini implants (if possible, after grafting), choice of fixed bridge, denture prosthetics.

Severe bone tooth loss
Disregarding Tell-Tale Signs
Dr. Paul Sussman, Rochester New York


Gum disease can progress quickly... and it can move slowly. For many adults the process can take years to accumulate, causing changes in dentition and bite almost unnoticeably until one day it is significantly apparent. Flared teeth, excessive Diastemas, disturbed occlusion, supererupted teeth that shift into bad bite areas of the upper jaw.

Treatment options would include extractions of teeth with all degrees of periodontitis or resorption, bone grafting (chin block, ramus, pulverized bone matrix),, traditional implants, mini implants, fixed bridge, denture and partial products, teeth in an hour.

Slow gum disease bite failure
Cumulative Gum Disease - Destroyed Bite
Dr. Rick Winter, Milwaukee WI


An extreme example of how powerful avoidance behavior can be when symptoms involves beginning stages of gingivitis that can be effectively treated with antibacterial rinses... but aren't. Left untreated long enough... mild forms of gum disease will, without fail, develop into what is seen here in this photo. Soft tissue loss, bone tissue loss and multiple tooth failures.

Treatment to effectively manage the disease state will require several extractions, or perhaps more. Bone grafts may be an option (synthetic, chin block graft, ramus, cadaver based, etc) along with tissue grafting. Depending on the amount and location of sound bone mass and density, a variety of different implant solutions may permit the fitting of a fixed bridge or denture prosthesis.


Disregarding Tell-Tale Signs
Dr. Paul Sussman, Rochester New York


Significant oral disease issues left untreated for too long. Rampant tooth decay and loss of entire tooth structures. Treatment will require traditional perio treatments for all four quadrants. Extractions of unsalvagable teeth will also be required to eradicate active areas of infection.

Restorative and reconstructive procedures may include implants, crowns, dentures, partials, bridgework or implant supported prosthetics.

Rotting teeth
Prolonged Disease and Decay
Dr. Corinne Scalzitti, Austin Texas


Significant untreated tooth decay both under failed restorations and at gum lines requiring non surgical gum treatment. Dental Bonding requires exact precision on every step of the treatment procedure. The patient was neglectful because the patient could obviously see that damage being done over a period of years and just did not see a dentist. There was so much internal decay to the tooth structure that root canals, crown build-ups and posts were necessary before the porcelain crowns could be placed.

Untreated Decay - Active Disease at Gum Line
Dr. Sam


Advanced Periodontal Disease, Lost dental papillae, Periodontal Pockets, Drifting Teeth, Gum Recession, Bone Loss, Tooth Abrasion, Tooth Erosion, inadequate attached gingiva, diastema, bad bite, bad occlusion

Severe Gum Disease - Bone Loss
Dr. Sam


History of untreated gum disease, gum recession, bone loss, tooth abrasion, tooth erosion, black Lines at the gums from old style porcelain crowns done with cheap metal that oxidizes. Bad Bite, deep overbite, rotated teeth, porcelain crowns that do not match in color or size, dentistry done in segments rather than one organized procedure.

Bone Loss - Gum Disease - Oxidizing Crowns
Dr. Sam


Gum Disease with calculus stuck to the lower front teeth, bone loss, tooth drifting and rotating or moving, supereruption of lower front teeth, bad bite, poor occlusion, old amalgam fillings decaying, the upper two front teeth are removable, they can just flip out obviously called a "flipper". The dental acrylic on the removable partial denture has stained and looks dirty or brown. It is just old and can be replaced. Lower teeth have to be extracted, bone graft on implants or a fixed or removable dental bridge.

Gum Disease - Bone Loss - Super Eruption
Dr. Sam


Lower teeth supererupted, deep overbite, missing congenitally the upper lateral incisors and back molar teeth, gum recession and tooth erosion, teeth are drifting, bite is not stable, tooth abrasion, bruxism and heavy tooth wear as the angles on the lower front teeth are from clenching and tooth grinding or bruxism

Super Eruption - Missing Incisors
Dr. Sam


Teeth flaring caused by gum disease and bone loss, tongue thrusting is pushing the teeth forward which causes the spaces to open wider and wider. The process is so slow, it takes years but suddenly after the teeth tip a little too far, the process moves much faster. Speech is affected and patient now has to use tongue to speak. Speech is slurred. The lips appear bigger and bigger as the teeth tip more forward.

Bone Loss Flared Teeth
Dr. Sam


Severe bone loss, tissue loss, tooth loss. Rampant disease process necessitates removal and/or treatment of remaining teeth and supportive tissue. Soft and hard tissue (bone) grafting anticipated after extractions are completed.

Treatment recommendations for regaining dental function could include combinations of dentures, implant supported dentures and/or fixed bridges, depending upon the amount of healthy jawbone available for incorporating miniature or traditional dental implants..

Uncontrolled Periodontitis
Total Tooth Loss - Periodontitis
Dr. Richard Winter, Milwaukee Wisconsin


Rampant, uncontrolled growth of bacteria has caused bone loss, tissue loss, tooth loss. Removal and/or treatment of remaining teeth and supportive tissue required.

Treatment recommendations for could include combinations of dentures, implant supported dentures and/or fixed bridges, depending upon the amount of healthy jawbone available for incorporating miniature or traditional dental implants..

Uncontrolled Periodontitis
Total Tooth Loss - Periodontitis
Dr. Edward Leventhal, Baltimore Maryland


Gum disease and poor oral health habits have already caused loss of teeth and bone loss. Calculus and plaque build up quite evident. Following standard perio treatments to eradicate diseased tissues necessary for regaining control, reconstructive and restorative procedures are possible.

Choices for restoring dental function and aesthetics could include combinations of dentures, implant supported dentures and/or fixed bridges, depending upon the availability of healthy jawbone that can accommodate traditional dental implants.

Bad Oral Health Habits
Total Tooth Loss - Periodontitis
Dr. Edward Leventhal, Baltimore Maryland


Gum disease,excessive tooth extractions, poor oral hygiene, malocclusion, bone deterioration, bone loss, collapsed bite. Cumulative conditions of an older adult who practiced patchwork or crisis oriented dentistry... which can be fairly common.

Treatment recommendations could include treatment for halting active disease process, multiple extractions, bone grafting, dentures, partials, implant supported prosthetics, mini implant supported dentures, multiple individual implants.

Cumulative Damage
Cumulative Damage - Periodontitis
Ara Nazarian, DDS, Troy Michigan


Gum disease, poor oral health habits, food preferences, long term avoidance of routine dental care, tooth chipping, breakage, collapsing bite. Cumulative conditions of a fairly young female adult.

Treatment recommendations could include treatment for halting active disease process, multiple extractions, bone grafting, dentures, partials, implant supported prosthetics, mini implant supported dentures, multiple individual implants.

Severe Disease
Cumulative Damage - Poor Oral Health Habits
Ara Nazarian, DDS, Troy Michigan




Ask a Question


Page copy protected against web site content infringement by Copyscape


[Home]   [Ask The Dentist]   [FAQ's]   [Polls]   [Consultants]   [Directories]   [Articles]  
Contact the Editor
Technical Treatment Protocol Diagnosis Error Assessment
Free No Cost Dentist Advice
Featured in
Part of the Dental Network
Bad Health Issues in Dentistry
Gingivitis Periodontitis Pictures
Diagnosis Prevention Treatment
All rights reserved - 1999-2013
Google
Powered by DentMedHost
webmaster@dental--health.com
Dental Pros and Cons


Videos
Pictures Photos
New Products
Bad Teeth Gums Gallery