Jaw shrinkage and facial change | Van Hoften Tandprothetiek

After the loss of teeth, the jaw changes. The bone that used to support the tooth roots is less stressed and gradually decreases in height and width. This is called jaw shrinkage or bone resorption. It is a natural process, but the speed and consequences vary greatly from person to person.

Jaw shrinkage is different from normal skin aging. Both processes can simultaneously affect the mouth, lips and lower half of the face. A well-fitting denture can provide support, but cannot completely stop the natural aging or shrinking of the jaw.

Why does a toothless jaw shrink?

Tooth roots provide stimuli to the jawbone via chewing forces. After pulling, these roots disappear and the load changes. The body adapts the bone to the new situation. This causes the jaw to slowly become lower and narrower.

The change is usually most rapid in the first period after pulling.
Then the process slows down, but it doesn't stop completely.
Over time, the lower jaw can change more than the upper jaw.
A poorly fitting prosthesis can distribute the pressure unevenly and worsen complaints.

Age, general health, bone quality, smoking, diet, medication, duration of toothlessness and the load on the prosthesis can have an influence. From the outside, it is impossible to predict how quickly someone's jaw will change.

What do you notice about jaw shrinkage?

The change is often so gradual that you do not notice it at first. Possible signals are:

the prosthesis comes loose more easily when eating, talking or laughing;
food gets under the prosthesis more often;
you use more and more adhesive paste;
there are recurring pressure points or wounds;
the lower denture feels smaller, more mobile or more difficult to control;
the teeth seem to meet differently when you close your mouth;
your chewing power or clarity of speech decreases;
the prosthesis chatters or tilts;
the corners of the mouth become more sensitive or irritated.

A prosthesis itself remains the same size. When the jaw changes, space is created between the prosthesis and the mucous membrane. This reduces the hold and the chewing pressure is less evenly distributed.

What changes can be seen in the face?

Teeth, jawbone and dentures together support the lips and cheeks. If the jaw shrinks or the denture becomes worn and too low, the proportion of the lower half of the face can change.

Possible changes are:

less support of the upper or lower lip;
deeper folds around mouth and nose;
corners of the mouth that appear to be more downward;
a shorter distance between the nose and chin when the bite height is reduced;
a chin that appears to be more prominent;
sunken cheeks or a more concave mouth area;
fewer visible teeth during talking and laughing.

Not every change is due to the prosthesis. Skin, muscle, fatty tissue and general aging also play a role. That is why we always assess the face together with the mouth, the bite, the fit and the age of the prosthesis.

The role of bite height

Bite height is the distance between the upper and lower jaws when you close your mouth. This height can decrease as artificial teeth wear, the jaw shrinks or the fit changes. This may affect facial appearance, the corners of the mouth, speech, chewing and sometimes the chewing muscles.

A lower bite height cannot be safely corrected by placing material under the prosthesis yourself. First it must be examined whether relining is sufficient or whether the teeth, bite or complete denture also need to be replaced.

Can good dentures prevent jaw shrinkage?

A well-fitting prosthesis can better distribute the load and helps to limit pressure points and overload. However, a normal removable denture cannot completely prevent jaw shrinkage.

If some healthy roots can be preserved, an overdenture can provide the bone with more local support. Implants can also stabilize the prosthesis and slow down shrinkage around the implants. Implant-retained removable dentures do not stop every form of bone or facial change and are not automatically the best solution for everyone. This requires examination and a personal treatment plan.

What can we do with a changed jaw?

Depending on the fit, bite, age and condition of the prosthesis, different solutions are possible:

A temporary soft layer

In case of wound healing or sensitive mucous membrane, a soft layer can be applied temporarily. This solution is intended to bridge a variable phase and must be monitored.

Relining or relining

With good tooth position and bite, the inside can sometimes be refitted with a new layer of plastic. This is called relining. The prosthesis then fits better into the jaw again.

Adjusting the bite

When teeth make uneven contact, targeted adjustments may be necessary to better distribute pressure. This is always carefully checked in the mouth.

A new prosthesis

If the artificial teeth are worn out, the bite height has changed significantly or the prosthesis can no longer be technically adjusted properly, a new prosthesis may be more sensible.

Examination of implant-retained removable dentures

In the case of a severely shrunken jaw and insufficient support, examination into implants and implant-retained removable dentures can be discussed. Medical suitability, bone supply, oral hygiene, expectations and reimbursement are taken into account.

What can you do yourself?

Have the prosthesis and mouth checked periodically, even without complaints.
Clean denture and mouth carefully every day.
Do not wear an ill-fitting denture for years without assessment.
Do not use adhesive to cover up a worsening fit.
Have recurring pressure points corrected in a timely manner.
Eat a varied diet and discuss unintentional weight loss with your doctor.
Don't smoke; smoking is unfavorable for oral mucosa, wound healing and implant care.
Keep old prostheses as a spare, but do not change them continuously without consultation.

What should you not do yourself?

reline the inside with material from the drugstore or the Internet;
filing away edges or grinding down artificial teeth;
place cotton wool, gauze or paper under the denture;
continuing to wear a loose-fitting denture with increasing amounts of adhesive paste;
deciding for yourself that a change in facial appearance can only be addressed with a new denture.

When to contact us?

Make an appointment if the denture becomes looser, the bite changes, pressure points return, eating or speaking becomes more difficult or you notice changes in the corners of the mouth and face. Via appointment and contact you can request a review.

Frequently Asked Questions

Is jaw shrinkage a fault of the prosthesis?

No. Jaw shrinking is a biological process after tooth loss. A poor fit can distribute the pressure unfavorably, making assessment important.

Can my face become exactly as it was before?

A new or modified prosthesis can better support the lips, bite and lower half of the face. Natural aging and missing jawbone cannot always be completely reversed. We therefore discuss realistic options in advance.

Do implant-retained removable dentures help against a sunken face?

Implant-retained removable dentures can improve hold and function and implants can help preserve local bone. It is not a general treatment for facial aging. The shape and tooth position of the prosthesis continue to determine the support.

How do I know whether relining is enough?

This is only possible after examining the fit, edges, bite, artificial teeth and oral mucosa. Sometimes relining is appropriate; sometimes a new prosthesis is better.

Resources and further information

This page provides general information. During a personal check-up we assess which changes are caused by the jaw, the prosthesis, the bite or normal aging.

Jaw shrinkage and facial changes