Dentures are removable replacements for missing teeth that significantly change a person’s facial appearance. These prosthetic devices restore function and aesthetics, often creating immediate positive changes by reversing the effects of tooth loss. However, due to underlying biological processes, dentures can also contribute to long-term negative changes in facial structure.
The Anatomical Effects of Missing Teeth
The loss of natural teeth structurally alters the face, even before a denture is worn. The jawbone, specifically the alveolar ridge, begins to deteriorate because it no longer receives stimulation from chewing. This process, known as bone resorption, causes the bone to shrink and be reabsorbed by the body.
As bony support diminishes, the soft tissues of the face lose their foundation and collapse inward. This shortens the vertical dimension of the lower third of the face, making the chin appear closer to the nose. The lack of support causes the cheeks to appear sunken or hollowed, and deepens the lines that run from the nose to the corners of the mouth, known as the nasolabial folds. The lower jaw can also rotate slightly upward and forward as the bone recedes, which makes the chin look more pointed, sometimes referred to as a “witch’s chin.” These characteristics contribute to an aged appearance linked to the absence of teeth.
Restoring Facial Aesthetics and Profile
A properly designed and fitted denture provides an immediate reversal of the collapsed facial appearance caused by tooth loss. By replacing the volume of missing teeth and lost gum tissue, the denture acts as an internal scaffold. This support pushes the lips and cheeks outward, restoring the natural contour of the profile and smoothing wrinkles around the mouth.
The restoration of the correct occlusal vertical dimension is a primary aesthetic improvement. This is the precise distance between the upper and lower jaws when the mouth is closed, which is diminished when teeth are lost. The denture re-establishes this distance, lengthening the lower third of the face and correcting the appearance of the chin being too close to the nose. This increase in facial height and improved support for the soft tissues contributes to a more youthful and balanced facial profile.
Managing Long-Term Bone Resorption and Fit
While conventional dentures offer aesthetic restoration, they do not halt the underlying process of bone resorption. Traditional dentures rest on the gum tissue and the residual alveolar ridge. They fail to provide the mechanical stimulation the jawbone needs to maintain its density, and the pressure exerted during chewing can sometimes accelerate bone loss.
The gradual shrinking of the jawbone means the shape of the mouth changes, causing the denture to become progressively loose and unstable. A loose fit can lead to discomfort, difficulty eating, and a return to the negative facial aesthetics the denture initially corrected. As the bone recedes, the unsupported soft tissues begin to sag again, and the face takes on a gaunt or hollowed look. To maintain facial structure and function, dentures require regular attention, such as relining, rebasing, or complete replacement to compensate for the lost bone volume. Implant-supported dentures offer a structural advantage, as the implants are anchored in the jawbone, providing the necessary stimulation to help preserve bone volume.