Being toothless is nothing to laugh about
By Eveline Gan, TODAY | Posted: 17 November 2009 1255 hrs

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SINGAPORE - A toothless grin may look cute on a child, but a few missing teeth is no laughing matter for adults.

Besides altering your appearance, missing teeth can also lead to a host of unexpected health problems, according to dental experts TODAY spoke to.

One of the key problems is the way it affects self-esteem, said Dr Hui Chee Wah, a dental surgeon and periodontist at Flozz Dental Surgery. This is especially so if you're missing a few pearly whites in front.

Aesthetically, more than one missing tooth can also alter one's facial appearance.

"When you have missing front teeth, your lip loses support and falls inside the mouth, giving you a wrinkled appearance. If you have no teeth at all, your facial profile will be completely changed, as the lack of support forces the skin to sag, creating a sunken appearance in the cheeks," said Dr Chong Kai Chuan, director of Q&M Dental Group.

More than just a pretty smile

Even if you don't mind how you look, consider the harmful health problems that may arise. For the elderly, missing teeth can have a serious effect on nutrition.

"Insufficient chewing can cause one not to eat well. For the elderly or disabled, it can lead to malnutrition," said Assistant Professor Victor Fan, a consultant of the department of oral and maxillofacial surgery at the University Dental Cluster, National University Hospital.

A missing tooth may also be the start of a vicious cycle of more tooth losses.

Dr Chong explained that this is because teeth have the ability to drift and move.

"Once a tooth is lost, the surrounding teeth will start to tilt into the space. This creates spaces between teeth. With spaces comes more food traps, and these result in gum disease and tooth decay," he said.

Interestingly, it is also not unusual for people with missing teeth to experience seemingly unrelated ailments such as muscle aches and sinus problems.

Explaining why missing teeth may be linked to neck and shoulder pain, Asst Prof Fan said: "For those with a few teeth missing on one side, their chewing pattern may be abnormal as they would have to chew more on the other side. The excess strain on one side puts stress on the jaw joint, which may end up affecting the neck and shoulder."

Dr Chong explained that sinus problems can sometimes occur when the upper back teeth, which are very close to the sinuses, are extracted.

Filling the void

That's why it is important to "fill the gaps" after losing a tooth or two.

"Dental implants are one of the closest replacements for missing teeth. One can also have dentures and dental bridges to replace the gaps," Asst Prof Fan said.

However, many patients delay getting teeth replacements after extractions either because of fear of seeing the dentist, lack of time or financial reasons, said Dr Chong.

Some also end up not doing anything because they're not aware of the problems missing teeth can lead to in the long run.

According Dr Hui, the process of losing the bone surrounding the tooth starts the moment the bad tooth is extracted.

"Over time, the loss of bone may affect your plans to use dental implants. By the time patients are ready for them - dental implants need to be surgically placed into the jaw bone - we find that many patients are lacking in these bone," he added.

Bone loss can now be reduced with a procedure known as socket preservation.

According to Dr Hui, the "relatively painless" procedure includes inserting a bone graft or bone scaffold into the tooth socket after the tooth have been extracted. This helps to preserve the tooth socket until the patient is ready for a tooth replacement. - TODAY/ar