How Does Missing Teeth Change Face Shape and Jawbone

Single tooth loss

Missing one or two molars doesn’t seem like a big deal because it is not visible in the esthetic zone (the teeth that show when you smile); however, it can trigger a domino effect on your other teeth which can be detrimental, including changes in your face shape and face sagging from missing teeth. For example, missing teeth change face shape because the adjacent teeth may shift into the empty space. This shifting could also result in a decreased ability to chew if the surfaces of your upper and lower teeth don’t match up. Good oral hygiene can be difficult due to the hard-to-reach spaces created by the tilting teeth. As a result, you might notice the following missing teeth change face shape consequences: bleeding gums, exposed roots, space between your existing teeth, and the possibility of losing your teeth over time.

As you can see, teeth change face shape problems are magnified if multiple areas of your mouth have one or more missing teeth. Meals may take longer to eat because you don’t have adequate teeth that meet up for chewing; food gets stuck in unwanted spaces, thus, causing you to have bad breath, and face sagging from missing teeth change face shape. Eventually, your smile doesn’t look and feel the same as you notice your teeth are not straight and your lips are not supported as they once were.

A simple solution to help prevent face sagging from missing teeth as well as teeth change face shape issues is to replace it with an implant and crown as an optimal treatment option versus a removable partial (flipper) or a traditional fixed bridge. First, an implant functions like a natural tooth root in your bone. Under function, it stimulates bone turnover (growth) and maintains bone level. Second, it allows you to preserve your natural teeth in the adjacent area by not cutting them down to fit a replacement bridge. Once restored, an implant tooth functions and feels like a natural tooth. The success rate of an implant ranges from 95-98%. On the other hand, the flipper is just a temporary replacement solution, and it doesn’t prevent bone loss, face sagging from missing teeth, teeth change face shape, or improve chewing ability.

Edentulism: Complete Loss of All Natural Teeth

In most cases, the recommendation to remove all the remaining teeth is either due to severe periodontal disease or a combination of decay, infections, and non-restorable teeth. The purpose is to help restore oral health in the mouth by eliminating existing dental conditions. Immediately after removing all the teeth, there are physical changes in the facial appearance. A collapsed facial appearance happens because the teeth are absent to support the facial muscles. Without the roots, bone turnover will diminish, and the jawbone will shrink in thickness and height over time. The upper jaw resorption pattern is upward and inward, whereas the lower jaw is downward and outward. In addition, the resorption rate of your lower jaw is four times faster than your upper jawbone. Gradually, a denture wearer will develop face sagging from missing teeth, including facial appearance of a prominent chin.

Besides missing teeth change face shape issues, edentulous patients also experience limitations in chewing ability. Replacing all missing teeth with dentures is a traditional, but outdated, treatment option. Dentures can offer a chewing capacity of only 25% of natural teeth. Most patients perform reasonably well with an upper denture; however, one main complaint of the upper denture is the plastic covering the roof of the mouth, which severely impedes the ability to taste food and changes the speech significantly. Many patients cannot tolerate a lower denture. The lower ridge is horseshoe-shaped with very little structure to resist movements. In the presence of the moving tongue, jaw, and lip, the lower denture tends to move around during speech and function, thus causing sore spots and discomfort. Most patients find their lower denture uncomfortable.

One of the best available treatments to replace an edentulous arch is an implant-supported permanent set of teeth, called a fixed full-arch treatment. The location of the maxillary sinuses, the cranial nerves, the amount of bone available, and the size of the arch influence the decision on how many implants to place. Often, patients have been missing back teeth for a long time leading to severe bone loss that impedes the implant placement in the first molar areas. Therefore, fixed full-arch involves angled rear implants, accommodating the limited bone scenario in the upper and lower arches.

Also, a fixed full-arch procedure eliminates unnecessary (and sometimes painful) rebuilding of the bone, a procedure known as a “sinus lift” for the upper arch and “block graft” for the lower arch. Ideally, this treatment should occur on the same day as removing unhealthy teeth to minimize or eliminate the uncomfortable healing experience in a denture. Patients who have been missing teeth for a long time but still have enough bone to receive this procedure will experience instant gratification avoiding the struggles of a complete denture.

The above fixed full-arch treatment allows our patients to re-establish an everyday life with a positive influence on self-esteem, better overall health, and self-confidence to achieve a better life for themselves and their families and lessen the risk of teeth change face shape issues and face sagging from missing teeth.

The ClearChoice Way is to provide our patients with the best care possible and to help transform your quality of life in a positive, and meaningful way. We aim to help you achieve optimal dental health and are committed to improving the lives of those suffering with failing teeth by providing the best care possible to transform your life in a positive, meaningful way. If you have additional questions about how missing teeth change face shape or to learn more about permanent teeth replacement options, schedule a free consultation at your local ClearChoice center today.

By Lisa Hoang, DMD
Prosthodontist, ClearChoice Maitland

Dr. Lisa Hoang graduated from the University of Western Ontario with a Bachelor of Science degree in Chemistry. In 2008, she earned her Doctorate degree at the University of Pennsylvania School of Dental Medicine and was the recipient of the Dean’s Scholarship (2004-2008). Following graduation, she completed an Advanced Education in General Dentistry residency at the University of Florida College of Dentistry.