Hôm qua, trong một buổi tiệc do một số bạn bè tổ chức, bà Lan khi ăn vô tình cắn phải một mảnh xương trong thức ăn. Bà cảm thấy đau nhói ở vùng răng cửa và đầu lưỡi của bà chạm phải một khoảng trống.  Thôi chết rồi! Bị gãy chiếc răng giả làm sao bây giờ? Sau đó trong suốt buổi tiệc, bà không nói một lời nào và cảm giác rất là xấu hổ vì bị mất răng cửa. Ngày hôm sau bà phải lập tức xin nghỉ để đi nha sĩ chữa khẩn cấp cho chiếc răng gẫy.

Trên đây là một thí dụ cho thấy  ảnh hưởng của sự mất răng đối với vấn đề thẩm mỹ mà chúng ta ai cũng đều  biết. Sự mất hoặc gãy răng cửa được coi như một trường hợp cần phải điều trị khẩn cấp trong nha khoa vì những tiêu chuẩn về thẩm mỹ và giao tế xã hội khiến cho nhiều người không thể chấp nhận việc mình bị hở răng cửa. Sự ảnh hưởng này rất trầm trọng và không thể chấp nhận được vì “mọi người cứ nhìn chằm chặp vào chiếc răng gẫy của tôi”.

Những hậu quả của sự mất răng có thể thay đổi tùy tình trạng mất một vài răng hoặc mất toàn bộ các răng.

Tình trạng mất một vài răng:

Mất một vài răng có thể gây ra sự teo xương sau khi mất răng.  Xương ổ răng là một phần của xương hàm bao bọc xung quanh chân răng. Phần xương này có hình thể đầy đặn khi răng còn hiện diện trên hàm. Xương ổ răng chỉ tồn tại khi còn răng. Khi răng bị mất đi thì xương ổ răng sẽ dần dần teo lại vì bị thoái hoá do không còn tác dụng để nâng đỡ răng nữa. Khi bị mất xương, răng hàm bị teo lại và môi không được nâng đỡ sẽ bị hóp vào.

Trên phương diện thẩm mỹ, răng và xương ổ răng có tác dụng nâng đỡ cho má và môi để tạo một hình dáng đầy đặn, trẻ trung của khuôn mặt.  Giờ đây, răng và xương ổ đã bị mất, má trở nên tóp hơn, các nếp gấp trên mặt trở nên sâu hơn và sự già cỗi đến rất nhanh trên khuôn mặt. Ðể phục hồi lại tình trạng “răng rụng má hóp” này chúng ta phải mang răng giả và cả nướu giả để bù đắùp lại phần răng và xương đã bị mất.

Sự mọc trồi răng đối diện sau khi bị mất răng:

Bình thường bộ răng của chúng ta ở trạng thái cân bằng nhờ các hàm răng trên và răng hàm dưới ăn khớp với nhau khi nhai hoặc khi nuốt. Sự ăn khớp này giữ cho các răng không bị trồi lên. Tuy nhiên khi một vài chiếc răng bị mất, răng đối diện không còn điểm chận sẽ dần dần mọc trồi lên (nếu là răng hàm dưới) hoặc trồi xuống (nếu là răng hàm trên).Hiện tượng mọc trồi răng là một cơ chế tự nhiên và có lợi để giữ cho chiều cao của khuôn mặt được ổn định dù bề mặt răng có bị mòn đi với thời gian do sự cọ xát khi ăn nhai.  Tuy nhiên khi một hoặc vài răng bị mất mà không được phục hồi bằng răng giả thì sự trồi răng sẽ trở nên có hại, nó làm xáo trộn sự ăn khớp của hàm răng. Ngoài ra sự trồi răng có thể nhiều đến mức độ làm cho răng thòng dài mất thẩm mỹ và răng trồi sẽ cọ sát vào vùng xương hàm mất răng đối diện, gây xây xát niêm mạc nướu. Cuối cùng răng bị trồi đó phải bị nhổ đi để không gây chấn thương cho nướu răng và xương hàm.

Một hiện tượng thứ ba xảy ra sau khi bị mất răng đó là sự hở các kẽ răng và sự di chuyển lệch lạc của răng:

Bình thường các răng tựa vào nhau như các viên gạch trên một cái cổng vòm. Khi bị mất một răng thì sự ổn định đó không còn nữa và các răng có khuynh hướng bị di chuyển và làm cho các răng còn lại bị hở kẽ hoặc nghiêng ngả tương tự như sự sụp đổ của chiếc cổng vòm xây bằng gạch khi mất đi một viên gạch.

Sự nghiêng ngả hoặc hở kẽ răng gây ra một sự mất thẩm mỹ rất trầm trọng và đôi khi không thể phục hồi bằng biện pháp làm răng giả thông thường. Ðôi khi cần phải có sự kết hợp điều trị của bác sĩ niềng răng (orthodontist) để kéo răng ngay ngắn trở lại vị trí ban đầu rồi sau đó mới làm răng giả.

Tình trạng mất toàn bộ các răng:

Do ảnh hưởng của bệnh sâu răng hoặc bệnh nướu răng, các răng bị nhổ hoặc rụng dần dần cho đến khi không còn chiếc răng nào trên cung hàm. Tình trạng mất răng toàn bộ thường gây ra nhiều hiện tượng có ảnh hưởng trầm trọng đến diện mạo và thẩm mỹ của khuôn mặt.

Hiện tượng thứ nhất là sự giảm chiều cao của khuôn mặt làm cho khuôn mặt bị mất cân đối và hàm dưới thường có khuynh hướng đưa ra trước mỗi khi bệnh nhân ăn nhai.

Khuôn mặt gồm có ba tầng A, B, C, các tầng này tương đối bằng nhau ở một người bình thường.

Hiện tượng thứ hai xảy ra khi mất toàn bộ răng. Ðó là sự tiêu mòn của xương hàm. Như đã nói ở phần trên, xương ổ răng là một phần của xương hàm, khi răng mất đi thì xương ổ răng sẽ bị thoái hoá và teo dần đi. Sự tiêu xương do mất răng sẽ kéo dài suốt đời, nó không chỉ giới hạn ở phần xương ổ răng mà còn lan rộng và làm teo cả phần xương hàm. Hàm dưới có mức độ tiêu xương nhanh gấp bốn lần hàm trên. Sự tiêu xương này khiến cho việc mang hàm giả trở nên khó khăn vì gờ xương bị hạ thấp làm cho hàm giả không còn vững; hay trượt tới, trượt lui khi nhai. Có những yếu tố làm cho sự tiêu xương hàm tiến triển nhanh hơn.  Ðó là sự nhai nghiền thức ăn trực tiếp bằng sóng hàm (xảy ra ở người mất răng mà không được phục hồi bằng hàm giả), hoặc ở những trường hợp hàm giả quá lỏng lẻo không được đệm nền thường xuyên. Các sự va chạm vào xương hàm do sự nhai nghiền trực tiếp bằng sóng hàm hoặc sự va chạm do hàm giả lỏng lẻo “nhảy lên nhảy xuống”, các sự va chạm bất lợi này làm “gia tốc” mức độ tiêu xương hàm.

Ðặc biệt ơœ hàm dưới, sự tiêu xương làm hạ thấp sóng hàm và làm cho lỗ thần kinh cằm bị lộ ra trên đỉnh sóng hàm. Vùng đỉnh sóng hàm là vùng chịu nhiều áp lực khi nhai, do đó thần kinh cằm bị đè ép sẽ gây ra sự đau đớn mỗi khi nhai.

Hiện tượng thứ ba xảy ra khi bị mất răng, đó là sự phát triển phì đại của các bộ phận ở vùng miệng như má và lưỡi. Khi không còn răng để nhai, má và lưỡi phải làm việc nhiều hơn trong việc nghiền thức ăn, với thời gian sự “tập thể dục” bất đắc dĩ này làm cho lưỡi phì lớn ra và chiếm cả thể tích của hốc miệng.  Khi đó việc mang răng giả trở nên vô cùng khó khăn vì hàm răng thường xuyên bị lưỡi đẩy ra.  Hiện tượng phì đại cuœa má và lưỡi thường xảy ra ở người mất răng mà không mang hàm giả.

Làm thế nào để khi bị mất răng mà không bị mất thẩm mỹ.  Câu trả lời có vẻ đơn giản: làm răng giả để thay thế răng mất.  Tuy nhiên, trên thực tế vẫn có nhiều người phải chịu đựng những hậu quả kể trên. Lý do đơn giản là vì thời gian kéo dài từ khi mất răng đến khi được làm răng giả. Thời gian này càng dài thì sự phục hồi thẩm mỹ càng trở nên khó khăn hơn. Trong điều kiện lý tưởng, sự phục hồi bằng răng giả nên được làm ngay sau khi nhổ răng. Nếu có phải trì hoãn thì cũng không nên để lâu hơn ba tháng. Sau thời gian này xương hàm và các răng còn lại đã bắt đầu có những sự thay đổi bất lợi cho sự thẩm mỹ, thí dụ như các răng bị hở kẽ, xương hàm bị tiêu, v.v..

Cuối cùng trong bài viết này, chúng tôi muốn nhấn mạnh sự chăm sóc răng vô cùng quan trọng nếu quý vị muốn có một khuôn mặt thẩm mỹ. Cái răng cái tóc là góc con người phải không thưa quý vị? Hãy chăm sóc răng đầy đủ hơn và giữ cho răng đừng bị mất.


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