Edentulism is the word used for the state of being toothless. While some organisms are naturally edentulous, others may naturally have teeth but lose them and become edentulous. In these dentate species, edentulism is a complex condition that affects the jaws and tissues of the periodontium, which are dynamic; each structure affects the others and they change over time. When periodontitis is present, one of the primary characteristics is clinical attachment loss, which is characterized by the teeth becoming detached from the alveolar bone due to a proliferation of bacterial plaque and calculus. Clinical attachment loss can lead to edentulism; edentulism can then lead to resorption of the alveolar bone into the body. Clinical attachment loss also creates pockets in the gums, and these pockets serve as breeding grounds for greater amounts of bacterial plaque, which lead to more symptoms of periodontitis. This dynamic system is also affected by the host’s immune system and the ways it interacts with bacteria and other organisms, like yeasts, that occupy the oral cavity, contributing to a variety of periodontal pathologies including dental caries and gingivitis.

Of course, teeth are important; we need them to chew and enjoy delicious food! It turns out they serve a lot of other purposes, though. Without teeth in the mouth, the lips and cheeks can appear sunken and drawn; as the bones of the jaw resorb, this may become exaggerated. The teeth help people’s jaws remain properly aligned, too, supporting the vertical dimension of occlusion. They are instrumental in the effective pronunciation of multiple sounds, used in conjunction with the tongue and the lips. Losing one’s teeth can have a profound effect on a person’s quality of life, self-esteem, and well-being, leading some to stop smiling or talking and adversely affecting nutritional intake, and enjoyment, for many. Preventing edentulism is, for these reasons and others, the primary goal of many dental health practitioners, and this is practiced through prevention, education, and, when necessary, treatment.

In rare cases, a member of a dentate species may be born without the ability to develop teeth, a condition called anodontia. More often, however, edentulism results from the permanent teeth being extracted from an adult’s mouth -- though the teeth may also fall out on their own, in some cases. In people under 45, the primary cause of edentulism is tooth decay, while in older people, periodontal disease contributes to most cases of edentulism. Fortunately, there are many options available for people seeking to replace all or some of their natural teeth. Bridges are used to replace a minimal number of teeth and are supported by the remaining adjacent teeth. Dentures, which may be partial or complete, feature prosthetic teeth built onto an acrylic frame. While less expensive, dentures can be very uncomfortable and unstable; for this reason, many patients choose dental implants, which can be used to support individual prosthetic teeth, or entire bridges of crowns. Implants provide comfortable, stable support for replacement teeth, and they serve the added benefit of stimulating the alveolar bone and encouraging the growth and stability of new bone. They are among the more expensive replacement options, but they are considered permanent and, for many patients, are an excellent investment in their health and happiness.