Lingual bone dehiscence is a dental condition affecting the bone supporting teeth. It involves bone loss around a tooth, which can lead to various symptoms and, if left unaddressed, may impact the affected tooth’s stability and longevity.
What is Lingual Bone Dehiscence?
Lingual bone dehiscence involves the alveolar bone, which supports tooth roots. “Lingual” refers to the tongue-facing side of a tooth or jawbone. “Dehiscence” describes a thinning or complete absence of this bone.
Lingual bone dehiscence means the bone on the tongue-facing side of a tooth root, most often in the lower jaw, has receded or is missing. Normally, alveolar bone encases the tooth root, providing structural support and protection. When dehiscence occurs, the tooth root becomes exposed, no longer fully covered by bone. This can leave the root surface vulnerable and lead to issues with the surrounding gum tissue.
Why It Occurs and How It Feels
Several factors can contribute to lingual bone dehiscence. Anatomical variations, such as naturally thin bone plates or tooth roots that are unusually prominent, can predispose individuals to this condition. Trauma, including aggressive tooth brushing or certain dental procedures, can also break down bone and gum tissue. Orthodontic tooth movement, especially when teeth are pushed beyond existing bone boundaries, is another cause. Periodontal disease, involving inflammation and infection of the gums and supporting bone, can also lead to bone loss.
Individuals experiencing lingual bone dehiscence may notice a range of symptoms. Increased tooth sensitivity is a common complaint, particularly to hot or cold temperatures, or light touch. Localized pain or discomfort around the affected tooth can also occur. As the bone recedes, gum recession on the tongue side of the tooth often becomes apparent, as the gum tissue pulls away from the tooth surface. In more pronounced cases, the exposed tooth root surface might be visible, or in severe instances, the underlying bone itself may become exposed.
Identifying and Addressing the Condition
Dental professionals identify lingual bone dehiscence through a combination of methods. A clinical examination involves visually inspecting the affected area and gently probing around the tooth to assess gum health and bone levels. Dental imaging is also used to visualize the bone structure surrounding the tooth roots. Traditional X-rays provide some information, but advanced 3D scans, such as Cone Beam Computed Tomography (CBCT), offer a detailed, three-dimensional view of the bone, allowing for a more precise diagnosis.
Management of lingual bone dehiscence varies depending on its severity and underlying causes. Consulting a dental professional is important for an accurate diagnosis and personalized treatment plan. For milder cases, conservative approaches may be recommended, including improved oral hygiene techniques, desensitizing agents to alleviate sensitivity, and fluoride applications to strengthen exposed root surfaces. More significant cases may require surgical intervention. Bone grafting can rebuild lost bone tissue, while soft tissue grafting (gum grafts) can cover exposed root surfaces and provide protection. Addressing the root cause of the dehiscence, such as adjusting orthodontic forces or treating active periodontal disease, is also part of comprehensive care to prevent further progression.