Tooth loss and facial disfiguration

Most people worry about how their smile will change, but tooth loss has even more serious consequences for how we look.

The first thing most people think of when it comes to tooth loss is how it will affect their smile. And while this makes sense as an obvious initial thought when it comes to the negative aesthetic effects of this condition, there are in fact far more serious concerns relating to tooth loss and your appearance.

Just what are we talking about here? Quite simply, we are referring to perhaps the most serious effect of tooth loss: Facial disfiguration.

It sounds scary, but before we go into detail, the good news is that thanks to developments in implant dentistry – and more specifically in the specialities of oral maxillofacial surgery and prosthodontic dentistry – there are quick and effective solutions. While tooth loss can have a dramatic effect on your facial balance, it is not something you have to live with anymore.

And this is important. Because while we do not all need to look like movie stars in order to be happy, retaining our appearance – looking in the mirror with that feeling of ‘Yes, that’s me‘ and that is how I should look – touches on important issues of identity, self-esteem, and self-confidence. When tooth loss changes the way you look, the problem affects your happiness.

It is key to address tooth loss immediately. The longer it is left untreated, the more damage is caused and the greater the change to your facial symmetry. So acting quickly and decisively is crucial, and that all starts with visiting a specialist.

Now let’s look at what exactly happens when you lose a tooth.

Tooth loss and bone loss

In short, we can say that untreated tooth loss sets off a vicious cycle. In a healthy mouth, the tooth and the (alveolar) bone which it is attached to are constantly making contact with each other. Think of the bone as the socket which the tooth sits in. This stimulation from the tooth helps keep the bone healthy – the more the bone is stimulated, the more it is renewed and strengthened.

So what happens when the tooth is no longer there?

Well, since the bone has the task of retaining teeth we find that something quite dramatic happens once it no longer has that job to do. It starts a process called “resorption”, which essentially means it begins to break down and decrease quickly in both height and width. In the first year after losing that tooth, the bone loss is approximately 25%.

That is indeed a significant change.

From there, we find that the bone in the jaw and palate (known as the maxilla) starts its process of resorption in one direction, while the lower jaw (the mandible) resorbs in the other direction. In other words, their movement changes the proportion between our nose, lips and chin.

Yes, it is that scary, and this is where we get into how bone loss actually changes how we look.

Changes to facial structure

Teeth are busy. They are constantly moving. And they perform multiple jobs for us that in fact go well beyond just eating. One of the key tasks in fact is to provide vital support and balance to the face. So think of teeth as the outposts of your appearance, helping keep everything in place and – importantly – keeping everything in proportion.

With tooth loss and the resulting bone loss, therefore, there are changes which become more and more pronounced with time. One of the first things noticed is sunken cheeks due to the mouth “over-closing” because of reduced bone. This is a facial characteristic generally associated with an older person.

In addition, because the cheeks and lips no longer benefit from the support that the teeth normally provide, the whole face takes on a less full, more aged look.

Perhaps the biggest change, though, occurs because the bone loss alters the proportions of our face, with the lower part appearing smaller in relation to the upper part.

If you were to look at a person who was suffering from this, it would seem that the bottom part of the face is shrinking, and because of the different directions of resorption in maxilla and mandible (i.e., the different directions in which they are each receding), it looks almost as though the tips of the chin and nose are bending towards each other. This unfortunately creates a look which is often used to depict witches in children’s stories.

How bone loss affects your daily life

Tooth loss, bone loss, and the resulting changes to the shape of our faces understandably have a major effect on how we view ourselves. This is an entire subject in itself, but there are some important factors to keep in mind.

Aging is a natural part of life, but to witness an accelerated process of our face changing shape in ways normally associated with a much older person can be alarming. It is this combination of our jawbone, teeth, lips, and cheeks which make up vital parts of our facial structure, and bone loss has an effect on all these areas.

This of course can have a knock-on effect in our personal lives as well as our work lives. Whenever we are in contact with people, if we are viewing ourselves in a negative way it starts to become a serious problem in terms of how we speak to others and how we act in front of them.

What you can do

In the past, these were problems that people simply had to live with. Thankfully that has changed now and highly-skilled oral maxillofacial dental surgeons and prosthodontists are at the cutting edge of developments with implant dentistry, ensuring that the general public has the option to retain the normal characteristics of their appearance despite tooth loss.

In other words, they can look in the mirror and still say: ‘Yep, that’s me.’