Dentures do not change your face shape on their own; losing the teeth and the jawbone that held your lips out does that, and a denture either replaces the lost support well or, as it wears and the bone beneath it shrinks, lets the lower face fold in. So when patients ask "do dentures change your face shape", the change starts with tooth loss and the denture decides how much of it shows. The American Dental Association's consumer site notes that when all the teeth are lost the facial muscles can sag, which can make a person look older, and that dentures can help fill out the face and profile. The patients I see with this worry usually have a well made denture that is now ten or fifteen years old.
Written by Dr James Tran, BDent (University of Sydney), MICOI, GradDip (Oral Implants), general dentist at Lumi Dental in Melrose Park.
The short version
- Teeth and bone hold the lips out and set the height of the lower face; losing them lets the lips fall in and the chin rotate up.
- The jawbone keeps shrinking under a denture, around four times faster in the lower jaw; see why the jaw shrinks under dentures.
- A well made denture supports the lips with its flange and tooth position and restores bite height; research has measured a taller upper lip and a lifted nasolabial fold after new dentures.
- An old denture with worn teeth lets the bite over-close: deeper folds, drooping or cracked corners, a more prominent chin.
- A reline does not restore lost height; a new denture can. Implants load the bone and can carry a denture or a fixed bridge.
- Nothing reverses bone already gone, and no denture is a facelift.
What holds your face up: teeth, bone and the height of your bite
Three things set the shape of the lower third of the face: the front teeth and the bone they sit in, which hold the lips forward from inside; the height of the bite, what dentists call the occlusal vertical dimension, the distance between nose and chin with the teeth together; and the muscle and skin draped over both. Take out the teeth, the bone resorbs, and support and height go with it.
A study in the journal Medicina Oral, Patologia Oral y Cirugia Bucal measured standardised photographs of 31 people with no teeth, at rest and then with complete dentures in. The authors describe the toothless face as tending towards a shorter lower face, a more prominent chin, a forward lower jaw, and lips with a collapsed look because the inner support has gone.
Why the lower face keeps changing under a denture
Bone needs load through a tooth root to stay; once the teeth are gone the ridge shrinks and a denture does not stop it. A systematic review in the International Journal of Implant Dentistry summarises the pattern: loss is fastest in the first six months after extraction and the following two years, then continues more slowly for life; annual bone loss in the lower jaw is around four times that in the upper; and in a long-term study of complete denture wearers the front of the lower jaw lost the most height.
So the lower lip and chin change more than the upper lip, and lower dentures loosen sooner; see why lower dentures fit worse than upper dentures.
What a well made denture does for the face
The pink acrylic flange under the lip stands in for lost bone and carries the lip forward, and the teeth are set at a height that re-opens the bite to the person's own resting dimension and in a position that supports the upper lip.
The photographic study above measured the result. With dentures in, the mouth looked narrower relative to the eyes because the tissue around it was supported again; the upper lip became taller, especially its red portion; and the lower face gained height as the jaw rotated down. The authors describe the nasolabial fold being raised towards a more natural position. The lower lip changed less. Those are group averages; how much one face changes depends on the bone left, how long the teeth have been missing, and the skin. I tell patients that a new denture can give back support, not bone.
The signs an old denture is letting your face fall in
Acrylic denture teeth lose a little height each year, and as the ridge shrinks the denture settles deeper onto the gum. Both lower the bite. The signs patients describe, often without connecting them to the denture, are:
- deeper folds from the nose to the corners of the mouth
- corners of the mouth turning down
- cracked, red or sore skin at the corners, which the Better Health Channel lists among denture problems needing a dental check; dentists call it angular cheilitis, and an over-closed bite that creases the skin is one cause
- thinner-looking lips and a lip line that has rolled inward
- a chin that looks more prominent in profile, because the jaw has rotated up to meet shorter teeth
- less tooth showing when speaking or smiling.
None of these means the denture was badly made; the mouth has changed and the denture has not. The Better Health Channel notes that dentures may need relining or remaking as the gums and bone shrink with age.
What helps, and what each option cannot do
| Feature of the face | What causes the change | What a new denture can do | What implants add |
|---|---|---|---|
| Thin or folded-in lips | Lost front teeth and bone; worn denture teeth | Flange and tooth position restore support | A fixed bridge has no flange; an overdenture keeps one |
| Deeper folds beside the mouth | Lost bite height and lip support | Restoring height can lift the fold, not remove set creases | Stability, not skin change |
| Drooping or cracked corners | Over-closed bite creasing the skin | Re-opening the bite often helps; a reline does not | Same effect through tooth height |
| Shrinkage year after year | Ridge resorbing without roots | Nothing | Implants load the bone; research reports some ridge preservation |
A new denture, not a reline, when height has gone
A reline adds acrylic to the fitting surface so the denture sits snugly on the shrunken ridge. It improves fit but does not replace worn teeth, re-open the bite or reshape the flange. The single rule I give patients: if your lips have started to fold in and your denture is more than five or so years old, ask for an assessment of bite height and lip support before you ask for a reline. See denture relines versus new dentures.
Implant overdenture or fixed full arch
Two to four implants can clip a denture in place: it keeps its flange, stops moving, and the implants load the bone. A fixed full-arch bridge (the full-arch service at Lumi Dental is called All-on-X) is screwed to four or more implants. Because it must be cleanable from underneath it has no deep flange, so lip support comes from the contour of the bridge; where a great deal of bone has gone, an overdenture may support the lip better. The review above reports some bone preservation around implants, with the extent uncertain. Our guide to dentures versus All-on-X full-arch implants compares the two. Neither regrows resorbed bone, tightens skin or changes the nose or chin.
When a new denture can look too full
Support can be overdone. A flange that is too thick or front teeth set too far forward make the upper lip bulge and flatten the groove under the nose. Too much bite height is worse: the teeth click in speech and the jaw muscles ache. The right amount is judged at the try-in, with the wax teeth in and the patient talking and smiling; I would rather make three small changes then than finish a denture a millimetre too tall.
How we approach this at Lumi Dental
At Lumi Dental in Melrose Park a denture consultation begins with a dentist's examination and a look at how far the existing denture has worn. In-house 3D intraoral scanning and 3D X-ray (OPG or CBCT) show how much ridge remains, which decides whether a new denture, an implant-retained overdenture or a fixed full arch is realistic. The practice provides dentures and relines, single and full-arch implants, and IV sedation for longer surgical appointments; read more about All-on-X full-arch implants at Lumi Dental.
Questions patients ask
Do dentures make you look older?
Tooth loss can; the ADA's consumer site notes that facial muscles can sag once the teeth are gone. A well fitted denture that restores lip support and bite height can offset part of that; a worn denture that has let the bite collapse can add to it.
Can a denture fix sunken lips?
It can restore support from the inside, which often improves folded-in lips and the folds beside the mouth. It cannot replace lost bone or change the skin.
Will my face change again after new dentures?
Yes, slowly, because the ridge keeps shrinking, more in the lower jaw. A yearly check picks up wear before it shows. Implants are the only option that loads the bone; see our guide to implant-retained overdentures.
Should I get lip filler before or after a new denture?
Dental support first. Filler works on the lip from outside and cannot replace lost bite height; see lip filler, anti-wrinkle injections and dental work timing.
Do implants stop the face from changing?
They slow bone loss around them, but they do not stop ageing of skin and muscle, and bone away from the implants can still shrink.
Noticed your face changing with dentures? Complimentary implant consult in Melrose Park
If your denture has let your lips fold in or the corners of your mouth crack, the team at Lumi Dental in Melrose Park can examine the fit, the bite height and the bone that remains. Contact Lumi Dental to book, or read about dental implants at the practice. Patients visit from Ryde, Parramatta, Ermington, Rydalmere and nearby suburbs.
Sources
- Better Health Channel: Dentures
- MouthHealthy (American Dental Association): Dentures
- PMC (Medicina Oral, Patologia Oral y Cirugia Bucal): Wearing complete dental prostheses, effects on perioral morphology
- PMC (International Journal of Implant Dentistry): To what extent residual alveolar ridge can be preserved by implant? A systematic review
About the author
Dr James Tran is a general dentist at Lumi Dental in Melrose Park. He holds a BDent from the University of Sydney and a Graduate Diploma in Oral Implants, and is a Member of the International Congress of Oral Implantologists (MICOI).
This article is general information only and is not a substitute for an examination and individual advice from a registered dental practitioner. Suitability for any treatment varies from person to person.
