Complete edentulous. Adentia in children - causes and treatment. Types of adentia in children
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The term "edentia" means the complete or partial absence of teeth. And although the unusual name is often confusing, the problem itself is not so uncommon.
Moreover, some scientists argue that a modern person does not need such a number of teeth that was vital for his ancestors, so adentia is not an accidental pathology, but the result of evolution, which took care that “extra” teeth simply did not appear.
But what nevertheless leads to such unpleasant and unaesthetic consequences as the loss of teeth?
ICD-10 code
K00.0 Adentia
Causes of adentia
Although, in general, adentia is not well understood, it is generally accepted that its cause is the resorption of the follicle. The reason for this, according to scientists, a number of factors: inflammatory processes, common diseases, hereditary predisposition.
Deviations in the formation of the rudiments of teeth, in addition, arise due to diseases of the endocrine system. Parents, on the other hand, need to carefully monitor the health of their children's milk teeth, because their diseases, with untimely diagnosis and unscrupulous treatment, can lead to extremely negative consequences, up to the loss of permanent teeth. However, in adults, various diseases of the oral cavity (caries, periodontitis, periodontal disease) cause adentia. Injuries lead to the same deplorable results.
Symptoms of adentia
The symptoms of this disease are quite obvious. A person may be missing all or some teeth, there may be gaps between the teeth, a crooked bite, uneven teeth, wrinkles in the mouth area. Due to the loss of one or more front teeth in the upper jaw, the upper lip may sink, and due to the absence of lateral teeth, the lips and cheeks. There may be problems with diction.
Any of these symptoms must be treated with attention, because even the smallest of them can later cause serious problems. For example, gum disease occurs due to the banal loss of only one tooth. This, at first glance, insignificant factor leads to other negative consequences.
Partial adentia
The difference between partial and complete edentulous lies in the degree of prevalence of the disease.
As mentioned above, partial adentia means the absence or loss of several teeth. Along with caries, periodontal disease and periodontitis, it is one of the most common diseases of the oral cavity. It affects about two-thirds of the world's population. But, unfortunately, precisely because, at first glance, the problem is insignificant, many people often do not pay much attention to the absence of one or two teeth. But the absence of incisors, fangs leads to tangible problems with speech, biting off food, which is extremely unpleasant for both the patient and those around him, splashing saliva, and the absence of chewing teeth - to a violation of the act of chewing.
Full edentulous
The complete absence of teeth is the meaning of this term. The most severe psychological pressure from this pathology is accompanied by more significant difficulties. The patient's speech and face shape change dramatically, a network of deep wrinkles appears around the mouth. The bone tissue becomes thinner due to the lack of the necessary load. The changes, of course, affect the diet in the most significant way, since patients have to give up solid food, and digestion. As a result, health problems appear, as the body lacks vitamins.
There is also the concept of "relative complete adentia", which means that the patient's mouth still has teeth, but they are so destroyed that they can only be removed.
Primary adentia
Depending on the nature of the occurrence, adentia is distinguished primary, or congenital, and secondary, or acquired.
Primary adentia is called the congenital absence of the follicle. It is due to a violation of the development of the fetus or heredity. In the case of complete primary adentia, the teeth do not erupt at all, while partial implies the absence of the rudiments of only some permanent teeth. Complete primary adentia is often accompanied by serious changes in the facial skeleton and disturbances in the functioning of the oral mucosa. Initially, partial primary adentia poses a threat specifically to milk teeth. Interestingly, in this case, the rudiments of the teeth are not visible even on x-rays, and large gaps appear between the teeth that have already erupted. This adentia also includes disorders that occur during teething, which leads to the formation of an unerupted tooth, hidden in the jawbone or covered by the gum.
Separately, a few words should be said about congenital adentia of the lateral incisors. The problem is quite common, the whole complexity lies in its specificity and complexity of treatment. The solution is to save room for the tooth in the dentition, if there is one, or to create one if it is not. For this purpose, they resort to special therapy, and at a later age, bridges are used or implants are implanted. Modern advances in orthodontics even make it possible to replace missing lateral incisors with existing teeth, but this method has certain age restrictions.
Secondary adentia
Acquired pathology, which occurs due to the complete or partial loss of teeth or their rudiments, is called secondary adentia. This disease affects both milk and permanent teeth. The most common cause is caries and its complications (for example, periodontitis and pulpitis), as well as periodontitis. Often, incorrect or untimely treatment leads to tooth loss, which usually results in inflammatory processes. Another reason is trauma to the teeth and jaws. Unlike primary, secondary adentia is a fairly common phenomenon.
Due to complete secondary adentia, the patient has no teeth at all in the mouth, which most significantly affects his appearance - up to a change in the shape of the facial skeleton. The chewing function is disturbed, even biting and chewing food becomes very difficult. Diction worsens. All this, of course, leads to serious problems in social life, which, ultimately, negatively affects the mental health of the patient.
This adentia is quite rare, and most often it is caused by an accident (various injuries) or age-related changes, because, as is well known, tooth loss is a problem most common for older people.
Partial secondary adentia, of course, does not poison the life of patients as much as complete. But this is the most common type of adentia, and people tend to underestimate it. After all, due to the loss of even one tooth, a shift in the already formed dentition can occur. The teeth begin to diverge, and in the process of chewing, the load on them increases. In the same place where the tooth is missing, insufficient load causes depletion of bone tissue. This pathology also has negative consequences for tooth enamel - the hard tissues of the tooth are erased, and the patient has to limit himself in the choice of food, since hot and cold food begins to cause him very painful sensations. The cause of partial secondary adentia, most often, is advanced caries and periodontal disease.
Dental adentia in children
Separately, we should talk about adentia in children, including the treatment of this disease. Often such adentia is caused by a disruption in the endocrine system (while the child may look completely healthy outwardly) or an infectious disease.
Parents should remember that optimally, up to three years, a child should grow twenty milk teeth, and after three or four years, the process of replacing them with permanent teeth begins. Therefore, if deviations from the norm are noticeable, milk or permanent teeth do not erupt in time, it is necessary to consult a dentist. With the help of an x-ray, it will be possible to establish for sure whether there are rudiments of a tooth in the gum. If the result is positive, the doctor will prescribe a course of treatment aimed at teething, or, in extreme cases, will resort to cutting the gums or special braces that stimulate teething. If the tooth germ is not found in the gum, it will be necessary to save the milk tooth or install an implant to compensate for the gap formed in the dentition and prevent bite distortion. It is possible to consider prosthetics as an option only after the eruption of the seventh permanent teeth in a child.
Prosthetics in case of detection of complete primary adentia in children can be resorted to not earlier than the child reaches three or four years of age. But this option is also not a panacea, since the prostheses put a lot of pressure on the jaw and can lead to disruption of its growth, so these children should be regularly monitored by a specialist.
Diagnosis of adentia
In order to diagnose this pathology, the dentist must first examine the oral cavity, and also establish what kind of adentia they have to deal with. Further, as mentioned above, it is necessary to make an x-ray of both the lower and upper jaws, which is especially important if there is a suspicion of primary adentia, because otherwise there is no way to find out if there are no follicles. When examining children, the method of panoramic radiography is recommended, which allows obtaining additional information about the structure of the roots of the teeth and the jaw bone.
Diagnosis should be carried out very carefully, because even before prosthetics it is important to establish whether adverse factors are present. For example, whether the patient suffers from any diseases of the oral mucosa or inflammatory processes, whether unremoved roots are preserved, covered with a mucous membrane, etc. If such factors are found, they must be eliminated before the start of prosthetics.
Treatment of adentia
It is quite obvious that this disease, due to its specificity, suggests that orthopedic treatment will be the main method of treatment.
In the case of partial adentia, the solution to the problem is prosthetics, and it is better to give preference to dental implants, because, unlike removable and fixed bridges, they perfectly distribute the load on the bone and do not harm adjacent teeth. Of course, it is easier to apply the prosthetic method if only one tooth is missing. It is more difficult to compensate for the lack of several teeth or to install prostheses in case of malocclusion. Then you have to resort to the use of orthopedic structures.
However, in the case of secondary adentia, doctors do not always have to use prosthetics - if an even arrangement of teeth and a uniform load on the patient's jaws can be achieved by removing one tooth.
Dental prosthetics with complete adentia has its own specifics. The primary tasks for the specialist in this case are the restoration of the functionality of the dentoalveolar system, the prevention of the development of pathologies and complications, and, only in the last place, prosthetics. In this case, we are talking exclusively about prostheses of the false jaw - removable (lamellar) or non-removable. The former can be used to treat secondary complete edentulism, they are generally very suitable for older people, although they require care: they must be removed at bedtime and constantly cleaned. They are easily attached to the gums. Such prostheses are cheap, aesthetic, but they also have disadvantages: they are not always well fixed, cause certain inconveniences, change speech, and lead to atrophy of bone tissue. In addition, it is often clearly visible that these are not real teeth.
Some dental problems significantly affect the patient's well-being, and also have a very negative effect on appearance. Dental adentia refers to one of these diseases.
Pathology is the absence of one or more teeth and can occur in different forms. Adentia is diagnosed at the appointment with a dentist. To make a diagnosis, the doctor conducts a visual examination using palpation and dental instruments, as well as auxiliary methods, which include x-rays and orthopantomography.
Removable or non-removable prostheses or dental implantation are usually used as therapeutic measures.
Congenital adentia with the absence of all teeth is considered a rare occurrence. More often, a situation arises when several dental units are missing. Often the disease is accompanied by emotional disorders associated with physical and psychological discomfort.
Adentia is of two main types:
- Congenital (primary).
- Acquired (secondary).
The disease can spread to milk and permanent teeth. Congenital adentia is called true in the case of the complete absence of the rudiments of teeth. A complicated form of the disease may be accompanied by incorrect eruption or fusion of two adjacent teeth.
This image shows complete and partial adentia - complete and partial absence of teeth in the dentition.
Different forms of the disease have their own characteristic features:
- Primary form. This option is the least common. It is caused most often by pathologies of embryonic development. With this form of the disease, the rudiments of teeth in a person may be completely or partially absent.
- secondary form. Such adentia develops with the age of the patient and reaches a maximum by the elderly. The absence of teeth in this case is explained by various diseases, as well as their gradual mechanical destruction.
- Complete edentulous. Completely missing teeth are quite rare, although sometimes the dentist may recommend removing them due to the nature of the upcoming prosthetics.
- Partial absence of teeth. This type of pathology is the most common. It occurs in children during the change of teeth to permanent ones, as well as in adults as a result of insufficient attention to oral health and due to the development of dental diseases.
The scale of the pathology is determined by the number of missing dental units.
Important! With complete adentia, teeth are completely absent in the mouth, and with partial loss of one or more is noted.
If more than 10 pieces are missing, then the form of the disease is multiple.
If up to 15 teeth are missing on the lower or upper jaw, then adentia is called partial secondary. This form of pathology has its own classification:
- The first class is distinguished by a bilateral end defect.
- The second class characterizes a one-sided end defect.
- In the third class, the presence of a unilateral included defect is noted.
- The fourth class implies the absence of a front row, which is called an included frontal type defect.
Classes can be combined with each other. Adentia can also be symmetrical or asymmetrical and not belong to any of the listed classes.
Adentia is the complete or partial absence of teeth, which occurs as a result of their loss or anomalies in the development of the dentoalveolar system. It is characterized by a violation of the continuity of the dentition, the function of chewing and speech, as well as a cosmetic defect.
Causes of adentia
The primary form of the disease refers to partially studied pathologies, so it is often impossible to fully identify the true root cause of the condition. According to one version, adentia occurs even during the period of embryonic development, when the rudiments of the future teeth of the child are formed.
Attention! Sometimes the disease is inherited from parents or develops as a result of various intrauterine pathologies.
Secondary adentia is observed much more often and has different manifestations. Partial or complete loss of teeth usually occurs for the following reasons:
- advanced forms of carious lesions;
- severe forms of periodontal disease in the absence of the necessary treatment;
- common diseases that are not related to dentistry, but worsen the condition of the oral cavity;
- the elderly age of the patient, upon reaching which the condition of the oral cavity and teeth naturally gradually worsens;
- injuries and other mechanical impacts that led to the complete destruction or loss of the tooth;
- hereditary adentia.
Adentia of teeth occurs as a result of vital activity, this is caused by a deep carious lesion of the dentition, leading to complete destruction of the teeth.
Symptoms of various forms of the disease
Diagnosis is usually not difficult even at home, since the absence of a tooth is noticeable to the naked eye. Additional signs of adentia are bite defects, irregularities, and an increase in interdental spaces. In the absence of front teeth, the cheek or lip sinks inward. In parallel, speech therapy problems may appear.
Various forms of the disease are marked by their characteristic features:
![](https://i2.wp.com/zubneboley.ru/wp-content/uploads/lechenie-adentii-zubov8.jpg)
Diagnosis of the disease
Diagnosis of adentia should be carried out exclusively by a specialist in a dental clinic, using various auxiliary techniques. This problem is dealt with by dentists-therapists, periodontists, surgeons, orthodontists, orthopedists and implantologists.
Diagnostic measures are visual examination, palpation methods, X-ray diagnostics, history taking and comparison of all the information received.
If the disease is multiple, then a full panoramic x-ray of both jaws is assigned. If necessary, orthopantomography or CT (computed tomography) is used.
X-ray examination allows you to detect the absence of the rudiments of teeth, to detect roots covered by the gums, tumors of the oral cavity, to assess the condition of the tissue of the alveolar process, signs of inflammation, etc.
Current trends in treatment
For the treatment of adentia, methods are used using removable and non-removable prostheses, as well as implantation technologies.
Important! Prosthetics is one of the most common ways to correct adentia. With the help of prosthetics, defects are corrected in the absence of one tooth or the consequences of multiple adentia are eliminated.
When a large number of dental units are missing, more complex prosthesis designs must be used.
With complete adentia, different treatment options are also possible. A removable prosthesis is used by itself without the use of additional support. Fixed structures must be fixed differently, and for these purposes, implants are used that perform a supporting function.
Treatment of adentia requires complete professional oral hygiene: treatment of caries, pulpitis, periodontitis, removal of roots and teeth that cannot be preserved, in order to make removable and non-removable dentures.
With a complete secondary form of adentia, removable plastic plates are used. Usually this technique is used in elderly patients. The plates are convenient, since care for them is quite simple and can be carried out after removing the structure from the oral cavity. Prosthetics can also be prescribed in childhood, however, it has its own characteristics and can cause pathologies in the formation of bone tissue. In any case, these activities are carried out no earlier than 4 years of the child.
Some circumstances can significantly complicate the implementation of prosthetic procedures.
If the bone tissue has thinned, then it will be more difficult to fix the prosthesis. Concomitant therapeutic measures may be required to increase the required volume of tissues.
It is also possible the occurrence of an allergic reaction to those materials with which treatment and prosthetics are carried out. In such cases, it is necessary to adjust the applied methods. Implant technologies are often used.
When there are no second incisors, treatment begins with the installation of a bracket system, which allows the future implant to be provided with the space necessary for it.
Implantation is performed in one of several ways:
![](https://i0.wp.com/zubneboley.ru/wp-content/uploads/lechenie-adentii-zubov7.jpg)
Prevention of tooth loss
To prevent congenital adenia, it is necessary to carefully monitor the health of the expectant mother and baby even before his birth. It is during this period that the rudiments of future teeth are laid. In a newborn child, it is necessary to monitor the timing of eruption of milk teeth, and also not to neglect regular visits to a pediatric dentist. A preventive appointment with a doctor is recommended at least twice a year.
Secondary tooth decay can be prevented by following the rules of daily oral care and promptly contacting a doctor for the necessary treatment. In case of loss of a tooth, prosthetics should not be postponed, as it allows you to maintain the correct bite and a uniform load on the jaw, which directly affects the health of neighboring teeth.
One of the least pleasant dental diseases is adentia. Many people may not even know about its existence, but still some people face this nuisance in their lives. Adentia is the partial or complete absence of teeth. It can manifest itself in both children and adults.
General symptoms and types of adentia
There are such types of adentia:
- full or partial;
- milk or permanent teeth;
- primary or secondary (congenital or acquired).
Depending on whether there is a partial absence of teeth or no teeth at all, some external signs of the disease are observed. With complete adentia of the teeth, the facial skeleton is deformed, there is a violation of speech, biting and chewing food. In the oral part, the muscles are sluggish, the soft tissues of the face sink, wrinkles form.
Sometimes one of the jaws or half of it lags behind in growth, which leads to various deformities: a deep or cross bite. The absence of teeth in the upper jaw is often accompanied by a progenic ratio of the dentition. There are also deviations in the functioning of the temporomandibular joint.
With partial adentia, shortening or narrowing of the dentition, displacement of displaced teeth, and the formation of gaps between them are often observed. Due to the lack of chewing load, bone tissue decreases.
Despite the fact that a person may not feel changes in chewing due to the loss of one or two teeth, significant changes occur in the body:
- there is a displacement of the entire row of teeth;
- the secretory function of the salivary glands, stomach is disturbed;
- food evacuation slows down;
- intestinal peristalsis slows down;
- the intensity of tooth mineralization decreases;
- disharmonized protein metabolism.
As a result, this leads to problems of the gastrointestinal tract. Such a complex disease as complete adentia also leads to mental disorders due to problems with social adaptation.
Diagnosis of adentia
In order to identify adentia, the dentist conducts a clinical examination. In a child, the doctor checks for the presence of rudiments of teeth, feeling the gums. Specialists also make panoramic radiography for children, which shows the structure of the roots, tissues of the alveolar process.
Complete secondary adentia is also diagnosed by collecting an anamnesis. It is necessary in order to determine the factors that may prevent prosthetics (which is included in the treatment program). The reasons why prosthetics cannot begin immediately after the diagnosis is made may be as follows:
- inflammatory processes;
- mucosal diseases;
- exostoses;
- tumor-like diseases (benign and malignant);
- the presence of roots under the mucous membrane.
Causes of missing teeth
The origin of the disease is not known for sure. An important role in its manifestation is played by heredity. For example, the cause may be anhydrotic ectodermal dysplasia - underdevelopment of the rudiments of the teeth. Sometimes adentia occurs due to problems during fetal development - a violation of the embryogenesis of tooth tissues.
Often the cause of adentia appears before birth.
In the absence of third molars and lateral incisors, phylogenetic tooth reduction takes place. Partial absence of teeth also occurs due to complications due to caries, pulpitis, trauma, periodontal disease. They, in turn, arise due to pathological processes in periodontal tissues.
There are suggestions that adentia appears as a result of resorption of the follicle under the influence of various diseases, inflammatory processes.
Primary adentia
Distinguish between complete and partial primary adentia. Let's consider them in more detail.
Complete primary
Complete primary adentia is a rare congenital phenomenon. It implies the absence of tooth rudiments, as well as a violation of the development of the facial skeleton. The lower oval of the face is reduced, the alveolar processes of the jaws are underdeveloped, pallor and dryness of the mucous membrane are noted. The patient can only eat soft and liquid food, diction is disturbed.
With complete adentia in children, there is also a weak development of the scalp, there are no eyebrows and eyelashes, the fontanel does not overgrow, and the nails are underdeveloped. The maxillofacial bones, the sutures of the bones of the skull do not fuse, the palate is flat.
Signs of violation of the facial skeleton:
- shortened upper lip;
- reduction of the gnathic region of the face;
- pronounced supramental fold;
- reduced face height;
- abnormal development of the alveolar processes.
Partial primary
Partial adentia of the congenital type occurs during the milk bite, i.e., some milk teeth simply do not erupt. Their rudiments are not determined either by touch, or even by X-ray examination.
X-ray examination is not able to detect partial primary adentia.
If there is a partial absence of teeth, then gaps are formed between the teeth, which lead to a shift in the row. However, if a significant number of teeth are missing, underdevelopment of the jaws may occur.
During the period of interchangeable dentition (when milk teeth are replaced by permanent ones), a part of both milk and permanent teeth is missing. In cases of complications, loosening of the supporting teeth is observed, the integrity of the enamel is violated.
It is rather difficult to determine the cause of such a disease. The rudiments of teeth can be resorbed under toxic effects, for example. Partial adentia of the first type may occur as a result of inflammatory processes associated with milk teeth.
Secondary adentia
Like primary, secondary adentia is complete and partial. Consider the features of diseases.
Complete secondary
Complete secondary adentia, unlike primary, is not congenital, but acquired. In this case, teeth are completely missing on the upper and lower rows (does not matter whether milk or permanent) due to any reasons. Children's secondary adentia occurs when children initially grow teeth, but over time the child loses them. The reasons for the loss can be:
- dropping out;
- removal based on the advanced stage of caries;
- surgical removal (for oncology).
In this case, the alveolar processes atrophy, and the lower jaw is close to the nose. Secondary adentia begins with a popular symptom: hard tissues of the teeth are erased, pain occurs when the teeth are closed, when exposed to thermal or chemical stimuli.
Partial secondary
Partial secondary adentia is a common occurrence. According to statistics, 75% of the world's population has experienced this problem. Most often, teeth are removed due to advanced caries, inflammation of the dental pulp (pulpitis).
Unlike primary adentia, in this case, the alveolar processes develop normally. The displacement of the teeth depends on the time period that has passed since their removal. When baby teeth are replaced by permanent teeth, there may not be enough room for the growth of "adult" teeth as a result of the displacement. Therefore, it is important to pay attention to the eruption delay in time and take appropriate measures.
Partial absence of teeth can lead to the development of a direct or reflected traumatic node. This process is also called the Popov-Godon phenomenon. It lies in the fact that inflammation begins in the gum, then the destruction of bone tissue, as a result of which pathological pockets develop in the area of the teeth.
The result of the influence of the Popov-Godon phenomenon.
In the absence of frontal teeth on the upper jaw, the upper lip “sinks”, and if several lateral teeth are missing, the soft tissues of the cheeks “sink”. Partial secondary adentia is also characterized by dislocation or subluxation of the temporomandibular joint.
Treatment of adentia
Treatment of adentia depends on the type of disease. Popular methods are:
- tab prosthetics;
- tooth implantation;
- installation of an adhesive bridge;
- installation of a prosthesis (removable or non-removable).
When receiving casts, which is performed at the first stage of prosthetics, the anatomical features of the patient are taken into account. Otherwise, there is a risk of pressure sores, dropping the prosthesis. For example, when adentia of the upper teeth is observed, the specialist pays attention to the type of jaws:
- slight atrophy of the alveolar processes, tubercles, high arch of the sky;
- the average degree of atrophy of the processes, also a high arch of the palate, while the frenulum of the tongue, lips and transitional fold are closer to the tops of the processes;
- significant atrophy of the processes, the palate is flat, the frenulum and fold are on the same level with the processes.
During prosthetics, both removable and non-removable prostheses can be prescribed. This should be decided by a specialist, based on the clinic of the disease. In the second case, the implantation of the teeth is carried out first, in order to then fix the prosthesis on the implants.
Removable dentures are also installed at an early age. They help to improve the function of chewing, the aesthetics of the dentition is restored. Until the age of 17-18, it is not recommended to install fixed prostheses, since the final formation of the jaw has not yet taken place.
Partial absence of teeth can be compensated by dental implants. In contrast, they correctly distribute the load on the jawbone without injuring adjacent teeth.
Sometimes the teeth in children, although with a significant delay, still grow if there are their rudiments. In order to prevent the development of a curved bite during this time, a removable prosthesis is applied without. After 5-6 months, it needs to be corrected or removed. When the jaw is formed, significant gaps can be closed using bridges.
Features of the treatment of primary adentia
In case of primary adentia, a pre-orthodontic trainer is prescribed, the choice of which takes into account the age of the patient. Treatment in children is based on the stimulation of proper teething. Only after seven permanent teeth have erupted, you can proceed to replace the missing ones.
If the patient has already formed a permanent bite and there is a partial absence of teeth, he should first undergo orthodontic preparation, and then prosthetics. There are several ways to restore missing teeth:
- implantation;
- installation of ceramic-metal tabs;
- use of crowns based on zirconium oxide;
- adhesive bridge.
Treatment of complete adentia with milk bite in children involves prosthetics from 3-4 years of age. However, due to the pressure of the prostheses, there may be a delay in the growth of the jaw in a child.
Features of the treatment of secondary adentia
Secondary adentia involves the complete absence of teeth, so the treatment is carried out in a complex way:
- restoration of the psycho-emotional state;
- restoration of the functionality of the dental system;
- prevention of pathological consequences;
- improving the quality of life.
In order to prevent pathology that may develop as a result of long-term treatment, immediate prostheses are used. Before the prosthesis is made, a functional cast is made, as well as an allergic reaction to the materials from which the prosthesis is made. Then the patient undergoes a fitting and installation.
During the control, it is also possible to adjust the prosthesis, the use of soft linings. Partial secondary adentia, like the first, is treated with implants and bridges.
The type of prosthetics is appointed after a detailed examination and determination of clinical conditions by a competent specialist. Complete or partial absence of teeth should be treated without fail. Not only the aesthetics of the oral cavity depends on this, but also the functioning of digestion, the work of the speech apparatus, and psychological comfort.
Today we will tell you what causes adentia of the teeth, and describe the main methods of its treatment. You will get acquainted with the types of the disease: partial, primary, complete and secondary adentia.
We will describe the main symptoms of the disease, methods of prevention, and also talk about the possible consequences.
What is adentia?
Adentia is the absence of individual teeth in the oral cavity. The disease refers to anomalies and is quite common in dentistry. It disrupts the functions of speech and chewing in humans.
Also, the absence of teeth in the oral cavity is not beautiful and not aesthetically pleasing, therefore, in many patients, the disease causes the development of complexes.
Classification
The main types of adentia of teeth:
- primary - appears from birth;
- secondary - acquired throughout life;
- partial - some teeth are missing;
- complete - absolutely all teeth are missing.
The disease can be of 2 types at the same time. For example, there is a partial secondary lack of teeth. There is congenital partial adentia - the absence of up to 10 teeth from the moment of birth.
- The primary form of the disease in full form - appears in milk, and even in permanent teeth. Such adentia eventually breaks the symmetry of the face. The alveolar processes in the jaw do not develop properly, and the roots of the teeth are completely absent in the oral cavity. To determine the absence of the rudiments of milk teeth, you need to take an x-ray and palpate the jaw. Also, the patient's lower jaw will appear much smaller. The disease of permanent teeth is similarly determined by x-ray. Only it needs to be done after a complete change of milk teeth.
- With a primary disease of a partial type - several teeth are completely missing, it is much more common in dentistry. The doctor can see small gaps between erupted teeth on x-rays. This is the first sign of the primary disease. The disease can be in a symmetrical arrangement and, conversely, in an asymmetric form. In the first case, there are not enough teeth on the right and left, completely in the same places. And in the asymmetric one, you can observe the absence of completely different teeth.
- A secondary disease with a partial view is the absence of some milk or adult teeth. Gradually, the hard tissues of the teeth begin to wear out, and hyperesthesia sets in. Due to illness, a person cannot eat solid and too hot food.
- The secondary view of the complete type is the absence of absolutely all teeth in the oral cavity. This is an acquired disease that gradually develops and progresses. It affects both milk and permanent teeth. Secondary adentia leads to a change in the shape of the jaw, it is very close to the nose, and all tissues in the oral region begin to sink. This leads to the fact that a person cannot chew even the softest food. At the same time, it is difficult for the patient to pronounce certain sounds, the function of speech is impaired. Secondary complete disease occurs after the loss of teeth or after their removal.
Causes
Let's figure out why the primary form of adentia appears:
- Complete loss of the main tooth germ.
- Heredity.
- A certain influence of factors during the development of the dental plate in the fetus.
Causes of the complete congenital form:
- manifestation of hypothyroidism;
- pituitary dwarfism occurs;
- ichthyosis disease;
- any infectious diseases;
- violation of developmental functions in the womb;
- endocrine disruptions;
- dysplasia, which is caused by heredity;
But because of what secondary adentia occurs:
- dental trauma;
- manifestation of caries;
- periodontitis occurs;
- dental removal of the root or the tooth itself;
- periostitis occurs;
- manifestation of an abscess;
- periogdontitis;
- odontogenic disease;
- erroneous dental treatment;
It is worth noting that the treatment of a secondary disease should begin immediately. Otherwise, the disease can progress and lead to the loss of all teeth.
Symptoms
Let us first note the main symptoms of the primary form:
- violation in the development of the skeleton. There are no rudiments of teeth in the oral cavity. This is evidenced by a too flat palate, a small size of the lower part of the face, pronounced folds, underdevelopment of the jaw;
- some bones of the skull or jaw do not fuse;
- Eyelashes and eyebrows may be missing. The skin begins to age and dry out early;
- inability to eat solid food. The patient can eat only soft and liquid food;
- nasal-oral breathing is disturbed due to improper development of the jaw;
- speech impairment, difficulty in pronouncing dental sounds;
- distances between the teeth are clearly visible. Neighboring teeth begin to move into these holes. It is during this process that the jaw begins to develop abnormally.
Signs of secondary adentia:
- pronounced displacement of the jaw to the nose;
- the formation of many wrinkles on the face;
- tissues of the oral region begin to sink inward;
- bony protrusions form on the jaw;
- the quality of speech suffers;
- teeth gradually shift and diverge in different directions;
- bone tissue is destroyed;
- severe pain when closing teeth;
- incisors and upper deuces begin to gradually wear out;
- small pockets appear in the gums or bones;
- dislocation of the temporal joint occurs.
Diagnostics
A complete diagnosis of adentia is carried out by various specialists. The survey takes place in several stages:
- Collection of anamnesis.
- Clinical examination.
- Palpation examination.
- Intraoral radiography - to clarify the diagnosis of a particular tooth.
- - for examining several teeth at once. It is carried out with full edentulous.
- Special casts of teeth are taken.
- Examination of the model of the jaw of a particular patient.
All examinations allow assessing the condition of the teeth, detecting tumors in the mouth and the main signs of inflammation. Thanks to the results of the diagnosis, specialists will be able to prescribe competent treatment for a particular patient.
After diagnosing and determining adentia, the doctor is obliged to prescribe prosthetics to the patient. However, there are some factors that do not allow you to immediately carry out this type of treatment. The specialist should pay great attention to such diseases:
- tumors and inflammatory processes in the mouth;
- the presence of exostoses;
- diseases in the shell of the mouth;
- unremoved tooth roots that are covered by the mucous membrane.
First you need to eliminate these factors and only then proceed to treatment.
Adentia and its treatment
For the treatment of the disease, it is important to use prosthetics. For him, they use: removable dentures (clasp or plate), as well as fixed structures (bridges).
The doctor prescribes treatment only after a complete examination and takes into account all the structural features of the patient's jaw.
- with a full type of adentia, fixed prosthetics are most often prescribed - the doctor installs special implants in the oral cavity, on which the structure with prostheses will be attached;
- with a partial form, the specialist no longer installs implants. Healed native teeth are used as a basis;
- with the manifestation of complete secondary adentia, it is important to initially restore all the main functions of the jaw system. The doctor must prevent the manifestation of complications and pathology. Only after that you can proceed to prosthetics;
- children with a congenital disease need to start treatment from the age of 3 years. Toddlers with complete adentia are fitted with platinum dentures. Note that they need to be changed every two years, as the child's body is gradually growing;
- children with a partial form are given a special prosthesis that can be removed at any time. As soon as the child's jaw stops growing, the prosthesis can be replaced with a permanent one (bridge);
- A child with partial primary edentulism needs to correctly guide the teeth so that they erupt in the right place. If the specialist does everything carefully and correctly, then the patient's jaw will not be deformed. When the child's last seventh teeth erupt, you can begin a full-fledged treatment. The doctor must understand exactly how many teeth are missing and what methods of prosthetics can be used. It is recommended to place implants for the missing teeth of the child, it is also possible to install ceramic special crowns or inlays.
After the installation of prostheses, some side effects may occur: prosthetic stomatitis appears, there may be an allergy to some prosthesis materials or dyes, the appearance of bedsores in the gum tissues.
Before starting treatment, you need to follow a few recommendations:
As you can see, adentia greatly spoils the quality of life and limits many functions. Therefore, it is so important to start treatment already at the first manifestations of the disease. At the initial stage, you can influence the disease and prevent dangerous consequences.
Preventive measures
To prevent the appearance of adentia, you need to be attentive to the health of your teeth in advance. Follow some simple tips:
- visit the dentist regularly and undergo an examination for prevention;
- In case of any dental disease, immediately contact competent treatment. Visit the doctor in the first days;
- in case of loss of several teeth, immediately switch to prosthetics. Then you can stop the progression of the disease;
- to prevent congenital adentia in a baby, it is necessary to create the best possible conditions for the development of the fetus. Eliminate any risks and do not eat dangerous foods.
If your child is not teething, contact your pediatrician immediately.
Additional questions
ICD-10 code
According to the international classification of diseases, dental adentia has the code K00.0.
Such a concept as adentia in children is considered quite rare and is not heard by a large number of people.
Many hear this term for the first time and have no idea what it is.
Despite this, each parent should have a minimum understanding of this disease, at least in order to, if necessary, take the maximum possible measures to correct this pathology in their child if it occurs.
In addition, having an understanding of the causes of the disease, it is much easier to prevent it by observing the basic preventive measures.
The concept of children's adentia
Adentia Adentia of teeth in children is a disease of the oral cavity, characterized by a complete or partial absence of dental units.
The causes of adentia can be both anomalies in the development of teeth and jaws, and their direct loss. This disease leads to a violation of the formation of the speech and chewing apparatus in a child, the development of cosmetic defects of the face, as well as further disruption of the functioning of the gastrointestinal tract.
Terms of milk bite formation
However, it is worth considering the likelihood of later teething in children. In some cases, they may appear later than physiological terms. Often this phenomenon is observed in the absence of the necessary space in the dentition. In this situation, consultation with a specialist and prompt orthodontic care is also indicated, preventing the development of more serious defects.
Parents should know the main terms of eruption of milk teeth in children.
If there are any deviations from the norm and the teeth do not erupt in due time and later, it is necessary to seek advice from a pediatric dentist.
Disease classification
Adentia in children can be classified depending on the following factors.
Causes of occurrence:
- Primary- characterized by the absence of a dental follicle (tooth germ). Most often, primary adentia is a consequence of anhydrotic ectodermal dysplasia. It can be both congenital and acquired. In the first case, teething is not observed at all, and in the second, the pathological process is a consequence of previous traumatization of the tooth germs or some endocrine diseases. With this form, the development of asymmetric facial features and a violation of the formation of the alveolar processes of the jaws are observed.
- Secondary- this form is much more common than the primary one and is the result of a complete or partial loss of the rudiments of teeth or the dental units themselves. The main causes of secondary adentia are neglected dental diseases, including untreated caries, pulpitis, periodontitis, as well as previous injuries of the oral cavity and jaws.
Number of missing teeth:
- Complete- it is characterized by the absence of all units in the dentition. There is a radical change and incorrect formation of the speech apparatus, serious psychological problems, facial deformity, problems with chewing and digestion of food.
- Partial- Multiple missing teeth. With this form, the child is faced with the problem of the correct formation of speech, as well as with inadequate chewing and digestion of food.
Primary partial adentia can, in turn, be divided into: symmetrical (it is characterized by the absence of fangs or twos) and asymmetric (the disease affects not only paired dental units).
Missing bottom tooth
Secondary partial adentia - characterized by the absence of several teeth in one row. The pathological process affects one or more masticatory organs.
Practicing orthopedists widely use the Kennedy classification. It applies only to secondary partial edentulism. According to this classification, it is customary to distinguish 4 defective classes:
- there is a bilateral end defect (distally unlimited);
- there is a unilateral end defect (distally unlimited);
- unilateral included defect (there is a distal restriction);
- frontal included defect (there are no anterior dental units).
Loss of teeth is associated not only with aesthetic defects, but also negatively affects the condition of the jaw. - a common pathology in adults.
Symptoms and signs of angular stomatitis are described.
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Reasons for the development of the disease
Due to the incomplete knowledge of the disease, it is still impossible to name reliable reasons for its development, however, there are a number of factors that may predispose to the development of this pathology.
The development of childhood adentia can be caused by the following provoking factors:
- endocrine diseases;
- infectious diseases in history;
- toxic effects on the body in history;
- hereditary predisposition;
- diseases of the oral cavity, including the dental apparatus: caries, pulpitis, periodontitis, periodontal disease, periodontitis, odontogenic osteomyelitis, etc.;
- previous traumatic impact on the teeth, jaws, oral cavity as a whole.
Knowing the causes of adentia in children, it is advisable to take all possible measures to prevent the development and progression of this condition.
Symptoms of adentia in childhood
You can suspect the presence of adentia in a child in the event of one or more of the following listed signs:
- lack of timely teething;
- after eruption, the absence of one or more dental units;
- formation of malocclusion;
- uneven setting of dental units in the holes;
- large gaps between existing teeth;
- the formation of exostoses of the jaws - bone formations on the jaws in the form of spikes, tubercles, ridges;
- skin changes in the area of the nasolabial triangle: retraction of one or both cheeks, retraction of the upper lip, formation of wrinkles;
- incorrect formation of the speech apparatus and impaired diction;
- improper formation and functioning of the temporomandibular joints;
- the appearance of hyperesthesia, pain when closing the teeth;
- the formation of pathological bone and gum pockets;
- mental disorders and violation of social adaptation in children's groups;
- development of diseases of the digestive tract associated with impaired chewing and digestion of food: gastropathy, peptic ulcer of the stomach and duodenum, colitis, etc.
The clinical picture of adentia depends directly on the form of the disease (primary or secondary, complete or partial, as well as on the severity and progression of the pathological process).
Diagnosis of the disease
The primary stage of diagnosis is a detailed examination of the oral cavity and the collection of an anamnesis from the parents, as well as complaints that made them seek help from a pediatric dentist.
The second mandatory step in the detection of the disease is the conduct of X-ray diagnostics, which allows you to accurately answer the question of the time of occurrence of adentia: is it congenital or acquired.
Panoramic x-ray of teeth
In children, panoramic radiography or orthopantomogram is widely used, which allows you to study in detail the complete pattern of the jaw and the direct structure of the bone tissue of the child.
Only on the basis of the data obtained, it is possible to accurately determine the type of disease and select the most rational treatment for each specific case.
Treatment of adentia in children
The method of treating children's adentia is determined by a qualified specialist after a thorough examination, anamnesis and additional methods for examining the child's teeth.
The most popular and effective methods of treating this disease are the following:
- Prosthetics with removable and fixed prostheses. Fixed dentures are more rational, as they are designed for further growth of the child's bones. When they are set, preliminary implantation of dental units is shown, on which prostheses will be attached in the future. It should be remembered that with partial adentia, such a treatment method as prosthetics is possible only after the seventh permanent teeth erupt. For the treatment of adentia with removable dentures, plate and clasp varieties are used.
- Installation of crowns and / or metal inlays in places where there are no teeth.
- Formation of an adhesive bridge.
If we are talking about secondary adentia, then in addition to treating this disease, it is necessary to pay close attention to the cause that directly caused it. If it still exists, it should be removed as soon as possible. In addition, it is important to carry out depulpation of teeth with secondary partial adentia, which is accompanied by hyperesthesia.
Adhesive bridge
In case of partial adentia with an incorrectly formed bite, before prosthetics of the missing dental units, the bite is corrected with the help of braces and other specialized equipment.
After the treatment, it is extremely important to regularly visit the dentist in order to dynamically monitor and determine the pressure exerted by the prosthesis on other teeth.
Treatment of adentia in a child by prosthetics is possible only when he reaches 3-4 years of age.
Possible complications of adentia treatment
Treatment of the disease does not give a 100% guarantee that after it there will be no problems with the chewing or speech apparatus.
Like any other intervention, the treatment of adentia can lead to the development of a number of complications and side effects, the most common of which are:
- The development of inflammation at the site of intervention.
- Incorrect formation of the maxillofacial apparatus.
- Loosening and subsequent loss of a dental implant.
- The development of an allergic reaction to the materials used for prosthetics.
- The appearance of bedsores in the gum tissue.
Preventive actions
The basis for the prevention of the congenital form of adentia is the observance by the pregnant woman of the therapeutic and protective regimen and all the instructions of the obstetrician-gynecologist, including the creation of favorable conditions for the intrauterine development of the unborn child. In case of a delay in the established terms of teething units in a baby, it is necessary to contact a dentist.
Prevention of the secondary form of adentia consists in regular visits to the dentist, treatment of defects and pathological processes that have formed, as well as compliance with basic hygiene measures for oral care.
It is preventive measures that will help to avoid such a disease of the oral cavity as adentia, and will also contribute to the normal development of the speech and chewing apparatus in a child, which will further prevent the appearance of other diseases, including pathologies of the digestive system.
In addition, the prevention of adentia is the prevention of the correct formation of aesthetic forms of the face and the preservation of a healthy mental sphere of the child.
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