The Real Causes of Tooth Loss and How to Prevent Them


Tooth loss is unpleasant but common. Most Americans aged between 20 and 34 have lost 5 or 6 teeth and roughly 1 in 50 have lost all of them. The older you are, the more likely you are to experience tooth loss as the risk factors just keep piling up.

It’s not an inevitability though. In fact, most causes of tooth loss are predictable and preventable, and by making a few small adjustments in your life, you could keep those pearly whites long into your old age.

Causes of Tooth Loss

The reason tooth loss is so common is that there are so many causes. It’s also something that happens gradually. You don’t necessarily notice the damage straight away, and so it’s easy to adopt an attitude of, “I’ll deal with it later.”

For instance, not brushing your teeth for one day probably won’t do you any harm, right? But what happens when one day turns into two or three. What happens when a week of skipped flossing turns into a month? Not only are you going to have some pretty nasty breath, but you’ll be damaging your teeth and gums and potentially reducing their lifespan.

Gum disease is one of the biggest causes of tooth loss and as far as many Americans are concerned, it’s the only one. But there are numerous other causes, some less obvious than others. These include:

Trauma

Trauma is one of the most unpredictable and scary ways to lose a tooth but it’s not always as instant and clear-cut as you might think.

Take sport as an example. In the United States, you could be forgiven for thinking that football and boxing caused the most incidents of tooth loss and a few years ago, you might have been right. Today, it’s a completely different story.

In the 1950s, over half of all football injuries involved dental issues. Players suffered cracked and chipped teeth, tooth loss, and even damage to the bone that supports the teeth.

Today, dental injuries account for around 2% of all wounds sustained in the NFL. The tackles are just as hard and the players are even stronger, but they also wear resilient helmets and mouthguards and their teeth are protected better than ever.

It’s a similar story with boxing. Not only do fighters wear mouthguards when they fight and head guards when they train, but the heavy boxing gloves help to spread the impact and reduce the risk of tooth loss.

Wresting is more of a problem. The combatants don’t strike each other with the same regularity as seen in boxing and MMA, but it’s not unusual for a stray elbow, fist, or foot to connect, and because it’s not encased in a 10lb glove, that force is more focused.

But believe it or not, basketball is by far the most dangerous sport where tooth loss is concerned. Players don’t wear helmets or gloves and while some have taken to wearing mouthguards, they are the exception.

Basketball is technically a non-combat sport, but as any player will tell you, that’s rarely the case. Elbows fly, fists are thrown, and injuries are common. For much the same reason, dental injuries are also relatively common in soccer. We found an entire YouTube video with incidents of professional soccer players losing their teeth during a competitive match.

And if you’re thinking that those players are amateurs and the games are the rough-and-tumble affairs found in grassroots soccer, think again. The list includes World Cup winners and some of the biggest leagues in the world. Even Lionel Messi, often considered to be the best player in the world, is on that list!

One of the most surprising things about trauma-associated tooth loss is that’s it’s not always instant. Lionel Messi spat his tooth out soon after the injury occurred, but many don’t experience tooth loss until months and even years after the event.

In 2010, a study was published on the effects of dentoalveolar trauma over the course of many years. Researchers looked at 41 participants who had experienced this specific kind of trauma (which involves the teeth and supporting bone, known as the alveolar bone) before the age of 10.

They recorded a total of 68 traumatized teeth and found that just 7.4% were lost immediately after trauma. Many years later, when the subjects were at least 16 years old, they found that 35.6% of the traumatized teeth had been lost.

That’s an increase of 481%, suggesting that the damage isn’t always instant or immediately obvious, especially in cases where the alveolar bone has been damaged.

Smoking and Chewing Tobacco

Most people know that smoking is bad for their dental health, but they don’t always understand why. The general assumption is that the tar from cigarettes sticks to the teeth, leaving them black and prone to decay.

It certainly explains why many smokers have black and rotten teeth.

But while discoloration can play a role, it’s not the biggest oral health problem that smokers face.

Smoking reduces the flow of oxygen and inhibits the body’s ability to heal. This hastens the spread of gum disease and makes tooth loss more likely. Smokers are more likely to suffer from cavities, stained teeth, and receding gums, and if you smoke for your entire adult life, even the best dental hygiene routine won’t protect you from tooth loss.

Smokers also suffer from halitosis and bleeding gums more than non-smokers.

It’s not just smokers, either, as you’ll experience many of the same issues from chewing tobacco. You’re still ingesting nicotine and you’re also exposing your mouth and teeth to a host of harmful chemicals.

Other Diseases

Some chronic diseases like high blood pressure and diabetes increase your chances of developing gum disease and experiencing tooth loss.

The American Dental Association conducted research on how diabetes impacts dental health and found that patients with this disease had 10 fewer teeth on average, compared to just 7 missing teeth for those without diabetes. 28% had lost all of their teeth.

The ADA suggested that higher blood sugar was impacting nutrient delivery, and increasing the prevalence of gum disease, cavities, and other dental health issues.

As for high blood pressure, also known as hypertension, the connection is a little less clear but it’s definitely there. It has also been said that patients with missing teeth are more likely to suffer from cardiovascular problems, including heart attacks and strokes. This has led some individuals to state that not flossing or failing to brush twice a day increases the risk of stroke.

It’s a frightening statistic and enough to make you reach for the floss, but it’s also not as clear or as obvious as these statements would suggest.

Many of these studies found that sufferers of strokes and heart attacks are more likely to be missing teeth, have gum disease, and/or have poor dental hygiene routines when compared to otherwise healthy people.

But there’s an element of correlation vs causation at play here. In other words, just because a stroke victim has fewer teeth and terrible oral health, doesn’t mean the missing teeth and bad oral health was the cause of that stroke.

It could be argued that stroke/heart attack victims are less likely to eat well, exercise often, and care for their health, which means they are also less likely to care for their dental health, thus experiencing tooth loss.

The same could be true for the link between high blood pressure and tooth loss, but when it comes to diabetes and osteoporosis, a disease that impacts bone health, including the bone that supports your teeth, the link is a little clearer and more defined.

Poor Nutrition

A diet rich in sugar and simple starch increases your risk of developing cavities and if these are left untreated, they can spread and cause tooth loss. What’s more, your teeth won’t just wobble and then fall; they won’t signal when they are ready to be removed and then leave your gums willingly.

The cavity will eat into your nerves, leading to excruciating and consistent pain and eventually requiring surgical extraction. Just because the tooth is unhealthy, doesn’t mean it will be easy to remove. In fact, as long as the gums are healthy, the tooth will still cling to them and require some force and even surgical intervention.

Cavities are caused by plaque, a sticky substance that attaches itself to the surface of your teeth. Plaque is formed when the bacteria in your mouth mix with sugar and trigger the release of harmful acids. If you consume these foods throughout the day and don’t take the time to brush, your teeth will be hit with a constant barrage of harmful acids and will gradually be eaten away.

You can remedy this by limiting your intake of sugar and starchy foods and making sure you brush your teeth after eating. If you’re not able to brush immediately, try rinsing your mouth with water.

Studies suggest that a thorough rinse can drastically reduce the levels of bacteria in your mouth. It’s a great alternative for those times you can’t brush (such as when you’re at work or at a restaurant) and will limit the risk of plaque forming on your teeth.

Mouthwash offers the same benefits and you can also just chew gum, providing it is sugar-free. Gum helps to stimulate the flow of saliva, which neutralizes those harmful acids. It will also loosen any small bits of food that have become lodged in between your teeth.

While a diet rich in sugars and starches is harmful for your teeth, a diet with lots of fresh fruit and vegetables has the opposite effect.

Fibrous foods like apples and celery have a natural cleaning effect and are also full of water, which helps to keep your mouth moist.

Not Brushing Regularly

The American Dental Association recommends twice-daily brushing for two minutes at a time. Research suggests that close to 70% of Americans follow this advice, but that still leaves 30% that don’t. In fact, we found one dental study that suggested approximately 2% don’t brush at all!

Electric toothbrushes tend to be more effective than manual ones, as they offer more coverage and mechanisms of action, but the toothbrush that you use is less important than whether you actually brush or not.

It’s better to brush twice a day with a manual than once a day with an electric, so if you can’t afford electronic toothbrushes or just don’t like using them, there’s nothing wrong with the manual option.

The type of toothpaste you use is also important. Americans are hooked on whitening toothpaste, which uses highly abrasive substances to scrape that plaque away. But what consumers don’t realize is that these products are not designed to replace traditional toothpaste and shouldn’t be used all year round.

Your teeth need fluoride. This mineral ensures that your enamel remains strong and healthy and helps to undo some of the damage done by oral bacteria and the acids they produce.

It’s also why most dentists warn against rinsing after you brush. The fluoride needs time to work, and if you’re rinsing soon after brushing, you’re just washing it all away. Instead, you should floss and rinse your mouth before you brush, as that will help to remove any trapped bits of food.

Brushing twice a day and for at least 2 minutes at a time increases your chances of getting every last scrap of plaque in your mouth, thus preventing it from causing decay, gum disease, and tooth loss.

Don’t just focus on your teeth, either. Pay special attention to the gum line, give your gums a light brush, and use a scraper to clear any bacteria that has accumulated on your tongue.

Not Flossing

In a previous article that looked at celebrity denture wearers, we spoke about Steve-o, a Jackass star who made a name for himself doing things you can only watch with your hands in front of your eyes.

Steve-o has spoken candidly about his dental issues and noted that repeat incidents of trauma, along with a reluctance to brush, has led him to several sets of fake teeth, mostly in the form of crowns and veneers (as noted in our article, he doesn’t actually wear dentures).

But throughout all of this, he notes that one of his biggest mistakes is not flossing. In fact, he calls this his biggest regret, and that’s saying something for a daredevil who has spent years putting his life on the line.

He notes that his reluctance to floss gave him atrociously bad breath and hastened the decay of his teeth. It also led to gum disease, as the bacteria literally began to eat away at his gums.

Steve-o’s story is not unique. It’s a story told by millions of people all over the world and it’s one that emphasizes the importance of regular flossing.

Bacteria don’t just cling to the surface of your teeth, waiting to be rinsed or brushed away. It attaches itself to the nooks and crevices; it hides in the places that your brush can’t reach.

If you don’t floss away those errant pieces of food, the bacteria will spread and multiply. And unless they are cleaned quickly and completely, they will turn into tartar and begin eating away at your enamel and gums.

Some people have more of an issue than others. It all comes down to your diet and the structure of your teeth. However, unless you are missing every other tooth and, therefore, don’t have any gaps that your brush can’t reach, you need to floss!

Water flossers can help with this, but they don’t always provide the complete clean that you need. More often than not, they just blast away the food particles and leave the resilient plaque, so you need a little floss to provide a deeper clean.

They do help to simplify the process, though, and they can be used in combination with regular dental floss.

Avoiding the Causes of Tooth Loss

Most of the causes of tooth loss are preventable. If you stay away from cigarettes, maintain a good dental hygiene routine, and avoid excessive consumption of chips and candy, your chances of keeping your teeth increase significantly.

There are some things you can’t legislate for, such as disease and medication, but most causes of tooth loss are directly or indirectly related to habits or hygiene. So, keep this in mind the next time you skip flossing or leave your mouthguard at home when you go to basketball practice.

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