Many of my patients ask about changes in their facial appearance when they begin to wear dentures. Some patients see changes as their lower face begins to sag giving the appearance of jowls around the chin and neck. Other patients mention that their lips fold inward leading to what is described as ‘sunken cheek’ appearance.
First off, these changes are not consistent with all denture wearers.
What we recognize is that your facial structure depends on a full complement of teeth and facial bones. And with teeth loss and bone absorption there are facial changes.
How teeth help build the bone in facial structure.
The teeth play an interesting role in bone growth. What has often been described as ‘stimulating bone growth’ is in fact the teeth making hundreds of short contacts with each other day and night. These contacts are effectively small stresses transmitting through what it is called the periodontal ligament that hold the teeth in place. The bone in turn is prompted by this teeth ‘chattering’ to be in a continuous phase of re-building.
When even a single tooth is lost, there is a break in the stimulation which leads to a loss of the alveolar bone found in the mouth. In some cases it can be quite extreme up to a 25% decrease in width of bone during the first year after tooth loss and an overall 4 millimetres decrease in height over the next few years. For denturists, that’s a lot of bone.
As bone loss continues so does the gum tissue gradually decreases. The loss of gum affects the ability to chew, speak and in some cases hold dentures. As the alveolar bone begins to recede it in turns affects the bone beneath it. The basal or jawbone begins to resorb or reduce in size which gives the look of sunken cheeks.
Do exercises prevent facial sagging? There’s no evidence to suggest that it does because the sagging isn’t caused by relaxed muscles but degenerative tooth and bone loss. While the bone recedes your facial muscles, skin and fat don’t.
Will doing the exercises hurt? No but they won’t be beneficial is there isn't anything to support the muscles. A word of caution, exercises that involve clenching your teeth may put unnecessary pressure on your dentures and gums.
How to dental implants help?
One method to help reduce bone loss is to consider dental implant supported dentures. Two to four implants are placed in the jawbone and then an arch of dentures is affixed to implants.
An interesting discovery is the bone-growing properties of the titanium found in implants. The implants ‘trick’ the body into thinking that is a tooth root and not only prevent bone loss but stimulate growth keeping the bone intact along with the jaw and facial structure.
Dental implant-supported dentures are more stable and are the closest replacement for natural teeth that we have in our arsenal.
Young or old, dental implant-supported dentures are one of the best ways to restore your smile.