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Bone loss of the face is a normal part of aging, right? If you are like most people, you rarely ever open wide and bite into something that provides significant resistance. You eat soft foods and have never thought about the health consequences of that. Worse yet, perhaps you have an open bite. That means your upper and lower teeth in the front don’t touch each other when you close your mouth. In this article, we’re going to talk about why these things are a problem and what you can do about it. 

Why Are Soft Foods A Problem?  

Gravity plays a strong role in bone health and density. We know from astronauts that gravity helps keep our bones strong. Astronauts in space lose significant muscle mass and bone density in space. So much so that they may be too weak to even walk after returning from a space mission. Gymnasts and runners tend to have stronger bones from the impact their bones and joints endure. 

But what about the face? Bone density in the head and face does not simply come from the same forces that strengthen the bones in the legs. Luckily, nature designed our bodies intelligently with an ingenious solution for this. 

The solution was chewing strongly. We were made to have strong jaws, open wide, and bite strongly into foods around our environment. Our modern lifestyle has completely changed that. From the moment we are born, we eat pureed, soft foods. We complain if a portion of food is tough to chew. People fear that eating tough foods will cause them to have TMJ issues. Biting with force seems to have negative connotations for many people. 

The Scientific Mechanism For Strong Chewing

Believe it or not, teeth can move slightly. They are anchored into the jaw bone by ligaments called “periodontal ligaments” that limit their motion. Whenever you chew, the resistance of the food you are biting will cause your teeth to move ever so slightly. 

Stem cells are abundantly embedded within these periodontal ligaments and within the teeth. More so, when we’re younger than when we are older. These particular stem cells stimulate bone growth and strengthen teeth. This means our faces rely on mechanical forces to stimulate appropriate bone growth of the jaw and face. 

The interesting thing about stem cells is that they respond to mechanical forces. Part of the reason for this is that stem cells are activated by damaged tissues to regenerate. So the amount of mechanical forces is also proportional to the stem cell activation. We know that mechanical forces have effects directly into the DNA affecting gene expression. The stronger the force, the stronger the stem cell stimulation. 

But it is not just about the amount of force. The direction of the force is also responsible for where there is bone growth and strengthening. This is an important concept to understand. 

Otherwise one could argue that sleep-related bruxism (jaw clenching and grinding) is sufficient to keep our upper and lower jaws healthy. Knowing that the amount and direction of the force on the stem cells trigger them to stimulate bone growth, we end up with the overdevelopment of bone in certain areas.  

The overgrowth of bones in the upper and lower jaw is called “tori.” Mandibular tori are generally seen on the inner surface of the jaw towards the front. The bone juts out into the oral cavity. In the palate, it’s commonly seen along the midline where the maxillary bones come together. Tori can affect breathing and many people have them removed who struggle with breathing at night. 

The effects of clenching and grinding are examples of improper bone growth and strengthening. Understanding how bone growth and strengthening of the bone and teeth in the face happens, we can now understand more clearly how bone loss in the face can occur. 

In summary, there are stem cells embedded around and within the teeth that help keep you bone and teeth strong. They are activated by the direction and magnitude of mechanical forces placed on them. 

What Causes Bone Loss Of The Face? 

At this point, you should understand that eating soft foods is detrimental to your health and could cause bone loss and tooth weakness of the face over time. Foods that don’t provide much resistance to your teeth throughout your jaw range of motion can over time cause bone loss of the face. But what other factors could cause bone loss of the face? 

Open Bites

This should make sense based on everything we have discussed so far. If your teeth don’t touch and you eat soft foods, then the stem cells may not be activated enough to maintain proper facial structure. Open bites with the front teeth are worrisome because we rarely use our front teeth anymore to “grip and rip” food. Much of the function of the front teeth have been replaced by utensils. 

Braces

We now know that someone who has been in braces for 6 months will have a 24% bone loss. In the research article, the authors suggest that the bone loss from braces is caused by chronic inflammation. I do not fully agree with this. I believe a larger factor for the bone loss caused by braces is immobility. 

The result of braces is to move and realign teeth, but braces fixate each tooth to the ones around it. They provide a constant fixed tension to achieve their goal. They prevent a constant regular motion. Without changes in tension, the stem cells are not stimulated to grow bone and strengthen teeth. 

Removing Teeth

Dentists now commonly remove teeth in people who have overcrowded teeth, especially in younger people with developing jaws. This is seen as a “cosmetic” problem, but it is a sign of a much bigger problem. It is a sign of underdeveloped jaws. 

The problem with this approach is that when teeth are removed, especially in a developing jaw, the jaw no longer has the stem cells to develop bone growth around it. What this means is that the jaw is then ensured to underdevelop even more than if the teeth were left in place potentially causing airway problems in the future. 

Lately, misguided articles are being written suggesting that we are “evolving” into smaller jaws and losing our wisdom teeth. Except that our genes are not changing, so there is another factor causing this. Geneticists know that these changes are happening too fast to be explained by changes in our genetics. 

These changes are more likely explained through epigenetics. That means the way our genes are expressed outwardly. This means that the smaller jaws and absence of wisdom teeth are because of environmental factors rather than changing genes.  

Botox

People have commonly been getting botox to their masseter muscles often for pain, TMJ dysfunctions, and other reasons. Not surprisingly, research is starting to come out showing that botox leads to bone loss of the jaw. This is not surprising knowing that mechanical forces stimulate bone formation. Therefore sustained weakened jaw muscles can lead to bone loss. We now have to be more mindful about injecting botox into jaw muscles. 

Can Bone Loss Of The Face Reverse? 

The good news is that if you still have your teeth, bone loss of the face can theoretically be reversed. As far as I know, research has not been done on this. The principles are the same as in other parts of the body. Except that rather than using gravity, the face uses the teeth and jaw muscles to help maintain strong bone density. 

The simple solution would be to open the jaw wide and bite into something that provides resistance through the range of motion. These days it is difficult to find foods that do this, but some tools can do this for you consistently. One is marketed as a face strengthening device called Jawzrsize

This tool is like weight lifting or gravity for your face. It provides resistance for your front teeth. I like the tool but used the way it is designed, it only provides compression stimulation to the stem cells of the front teeth, which by itself is an improvement. 

Some modifications can stimulate the stem cells in other directions besides compressive forces, but they do not provide resistance to the teeth further back. Other tools are needed for that. I’ll discuss those in another post. 

Conclusion

A missing piece for activating the stem cells of the teeth is mechanical activation. Supplements such as vitamins D, A, K2, and ubiquinol can help strengthen bones and teeth, but they are not nearly as effective without mechanical activation. 

When we add this piece to bone growth and stimulation, we would have everyone with a developing jaw chew on strong foods or tools to prevent underdevelopment of the jaw. Adults, too, should chew on strong foods to prevent bone loss as they get older. 

We need to start looking at facial fitness as part of our overall health. 

Daniel Lopez, D.O.

Author Daniel Lopez, D.O.

Daniel Lopez, D.O. grew up with a lot of pain trying many things that did not help. Realizing that if he could not help himself, he would be unable to help others effectively, he dedicated himself to finding real answers. Since that time, Dr. Lopez has found a unique but powerful style where he has patients from around the country and the world that travel to see him for headaches, TMJ issues, eye issues, neck pain, back pain, and more. Daniel Lopez, D.O. is an osteopathic physician with Osteopathic Integrative Medicine. Prior to that he had a private practice in NYC for 6 years. He is the author of the Amazon best seller "Unwinding the Body and Decoding the Messages of Pain: An In-Depth Look into the World of Osteopathic Physicians and How They 'Magically' Use Their Hands for Healing." He lives in Aurora, CO with his wife and daughters.

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