Edentulism

Edentulism (or edentulousness) means absence of dentition and can have a significant impact on a patient's quality of life in addition to the negative cosmetic effects.

Terminology

When edentulism is used as a standalone term it usually means that all the teeth are absent, i.e. complete edentulism. However, sometimes it is used for partial loss of teeth (partial edentulism). The adjectival form is edentulous, e.g. an edentulous mandible.

Epidemiology

As many as 30% of Americans may be edentulous .

Clinical presentation

Lacking all teeth can have a marked deleterious effect on an individual's wellbeing:

• cosmetic
• dietary deficiencies
  • secondary to dysfunctional mastication, loss of taste
• altered phonation
• psychological effects
  • loss of self confidence due to one or more of the above

Pathology

Severe periodontal disease, caries, and pain may all lead to loss of the teeth via pathological loss and/or planned extractions.

Loss of teeth leads to a loss of normal mechanical stresses on the maxillary and mandibular alveolar processes which gradually resorb. This may be exacerbated by osteopenia/osteoporosis.

Radiographic features

Other than the obvious lack of visible dentition, the most striking finding is the gradual loss of the normal morphology of the maxilla and mandible. This is due to the resorption and attenuation of each alveolus secondary to loss of the normal stresses exerted by chewing.

Treatment and prognosis

Dentures (false teeth) are the main treatment for edentulism.