Edentulous refers to the quality of having no teeth, or few teeth. In humans, tooth loss is usually due to disease, accident, the aging process, or dental decay. Some animals, however, are meant to be edentulous, such as anteaters, sloths, aardvarks, and other members of the Xenartha, or former Edentata, order. In animals that require teeth, however, edentulism can have many adverse effects.
Humans may lose teeth for various reasons, most often as a result of poor dental hygiene. Common causes include periodontitis, or gum disease, dental caries, or tooth decay, and trauma to the mouth. Because routine access to dental care is a key method of preventing tooth loss, the rate of edentulism increases with lower socioeconomic status, lower income, and lower education level. This is likely correlated to the inability of many impoverished people to afford dental insurance, which inhibits their ability to practice proper dental hygiene. Other risk factors for becoming edentulous include advancing age, being female, smoking, poor health, chewing tobacco, and poor diet.
Becoming edentulous can pose several problems, functionally and cosmetically. Teeth are central to pronunciation of speech. Some sounds may require the tongue and teeth to contact, such as the sound of “s” or “t” in the English language. People missing teeth may also have trouble pronouncing English letter sounds such as “f” or “v,” which require the lips to touch the teeth. Tooth loss can also pose patients with difficulty chewing.
Teeth also perform several roles in maintaining the structural integrity of the face. The vertical dimension of occlusion, or the height of the bite formed by the contact of the upper and lower rows of teeth, determines the shape and length of the cheeks. When a patient becomes edentulous, the mouth closes too fully with no teeth to separate the jaws, thus contributing to a sunken in appearance of the cheeks. Without teeth, the cheeks tend to wrinkle, the angle between the nose and the lips changes, the ridges that hold the teeth flatten, and the tongue may splay out to fill the open mouth space. These changed features, in concert with the aesthetic problem of exhibiting no teeth when smiling, talking, or chewing, can also lead to emotional insecurities.
Treatment for edentulous patients may vary depending on how long the patient has been missing his teeth and whether the patient is partially or completely toothless. Traditionally, edentulous patients are fitted with a row of removable artificial teeth called dentures. Partial dentures contain some false teeth to replace a portion of missing teeth, while complete dentures replace all the teeth in the upper or lower arch of mouth. Dentures, however, can exacerbate the weakening and flattening out of the alveolar ridge, or the hard gum ridge in which the teeth are implanted.
To solve this problem, dental implants are now available to edentulous patients. A dental implant is an artificial material, such as titanium, that is surgically implanted through the alveolar ridge into the jawbone to replace the tooth root and support fake teeth. A denture or artificial tooth can then be fused on top of the implant. This procedure is far more successful when the alveolar ridge has not undergone severe degradation and may be combined with other reconstructive surgeries to fix the facial abnormalities that may result from edentulism.