Dental Part 14
Early in this journey before I had established a happy truce with Invisalign, I left a v/m for one of my brothers asking him to remind me why I did this. His chuckling return v/m suggested I had done it because my vanity is completely out of control. Ouch! 
While the primary goal is to fix my bite and avoid unthinkable dental work, as my brother correctly surmised, one does not have to scratch the surface too deeply to discover aesthetic motives.
First, straight teeth look better than snaggle teeth and let’s be honest snaggle teeth don’t age well. They just continue their march toward yellowed chaos. Of course when my teeth are straight, they will still be unattractive due to the chips, black triangles and varied lengths. But once overcrowding has been eliminated and the bite corrected, this opens the door for my talented dentist to work her magic. I can’t imagine what she will recommend but it does seem a bit silly to do all this and skip the pretty part.
It was pain in the crowded area that landed me in the periodontist’s chair initially. I asked the periodontist what happens if the pain converts from intermittent to constant. I was horrified to learn that the offending tooth would have to be extracted. In addition to a million other questions, how do you make that look good??? My substantial vanity could not possibly tolerate that.
Before proceeding, I did not fully grasp a significant aesthetic benefit. I was concerned that expanding the arch to make room for straightening the teeth would impact my appearance negatively. The periodontist assured me that the impact would be subtle and positive. I accepted this and moved on to the next question. For this article however I delved more thoroughly into this question and discovered that dental bone loss wreaks havoc both functionally and aesthetically. If function has declined, form has already been compromised. Rather than making your head spin with the details, will sum it up as simply as possible:
- Your outer facial appearance is a function of the underlying bone structure.
- If your bones change, so does your appearance.
- Healthy stable bone is maintained by the activity of healthy stable teeth.
- A bad bite and/or poor dental hygiene results in gum disease, unstable teeth and bone loss.
- Unmitigated bone loss results in tooth loss.
- Tooth loss without immediate implants results in a truly alarming rate of bone loss. Btw, just say no to dentures.
- Bone loss causes the lips and cheeks to recede, ie skinny Irish lips disappear and one gets a Wicked Witch of the West chin.
I had 360 degree bone loss as a result of years of a bad bite and early gum disease. I was delighted to discover that by addressing my bite and bone loss I also stopped sunken old lady mouth in its tracks. Yes indeedy I am very good with that.
And an important side note to consider. When looking up at a 10,000’ mountain it looks much larger when standing at sea level than it does at 5,000’. So it goes with your nose. If your lips recede, guess what is going to appear bigger? For those of us with prominent noses, this is totally unacceptable.
The moral of the story is to go to an accomplished periodontist in your 30s and periodically thereafter to monitor the status of bone health and gum disease. Chances are the dentist who is cleaning your teeth will fail to explain the details. Even if you follow all the dentist’s instructions about dental hygiene as I did, bone loss can still occur. And if vanity is of no concern, healthy teeth and a good bite have long term positive impacts on general health.
For the Curious and/or Vain
In my research, I read many articles on aesthetics and bone loss. The following article, while specifically addressing facial bone loss after tooth extraction, explains general consequences of bone loss quite well. Below is an excerpt. Now I know why I instinctively want to hang on to my own body parts. https://drkhazian.com/dentures-facial-bone-loss-premature-aging
“A well-shaped, symmetrical face with healthy looking facial skin needs an intact and healthy underlying bone structure. This is demonstrated well in young adults with intact boney structures. The same is observed in middle aged or even old individuals who have been able to maintain their facial structure. It might be called graceful aging but it is not an accidental phenomenon or due to luck. It is directly related to the state of their oral and dental health. A 65-year-old individual who has been able to maintain all his or her teeth looks much younger than the same age individual who has lost teeth and wears dentures.”
To understand how poor dental hygiene can cause periodontal disease and bone loss, read the following.
https://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm#canPeriodontal
Even with excellent dental hygiene, bone loss can occur as evidenced by my situation. Finding a succinct, non-technical article explaining why has proved difficult. Will continue the search and include upon discovery.