Kapitel
How Tooth Wear Ages Your Face
[00:00:23 – 00:01:47]
Tooth wear is not merely a dental concern — it is a facial ageing issue. Grinding, acid erosion and general wear gradually reduce tooth height, particularly in the back teeth that support the bite. When this support is lost, the lower third of the face collapses slightly, leading to a sunken appearance, deeper smile lines and an overall tired look.
Research in prosthodontics confirms a strong relationship between tooth height and facial proportion. Even modest losses in vertical height can visibly alter the face in ways that cosmetic procedures such as facelifts or laser peels cannot address on their own.
Loss of Vertical Dimension and Wrinkle Formation
[00:01:47 – 00:02:58]
Vertical dimension refers to the natural height between the upper and lower jaw when the teeth are in contact, and it is primarily determined by the back teeth. When teeth are lost or heavily worn, the jaw closes further than it should, moving the chin closer to the nose and shortening the lower face.
This over-closure deepens the creases around the mouth and contributes to jowling and a folded facial appearance. Restoring vertical dimension through dental rehabilitation softens these wrinkles and improves overall facial harmony — a functional reconstruction with genuine aesthetic benefits.
Building Up the Back Teeth to Lift the Face
[00:02:58 – 00:03:36]
Restoring the height of the back teeth creates more space for the surrounding muscles and soft tissue, producing a lifting effect along the jaw. Whilst this differs from a surgical facelift — which involves repositioning skin — the outcomes can be remarkably similar.
In some cases, dental restoration and surgical techniques can be used together to achieve even more pronounced results.
Veneers and Composite Bonding as a Natural Alternative to Lip Fillers
[00:03:38 – 00:04:40]
The lips rest directly against the front teeth, so when those teeth are worn, thin or set too far back, the lips lose their internal support and appear flatter. Restoring proper tooth length and contour with Furniere or injection-moulded composite bonding provides a natural scaffolding for the lips.
This delivers a subtle, balanced fullness by restoring what was lost rather than adding volume artificially. Patients who have had lip fillers to compensate for small or worn teeth may find the result appears fine with a closed mouth, but the underlying problem becomes apparent when speaking or smiling.
Why Teeth Yellow With Age — and the Case for Whitening
[00:04:40 – 00:07:58]
As we age, tooth enamel thins and the underlying dentine becomes more visible. Dentine is naturally darker and more yellow, which gives teeth an aged appearance. Lifelong exposure to staining substances — including tea, coffee, red wine, turmeric and fizzy drinks — compounds this effect considerably.
Tooth whitening is one of the most effective and non-invasive ways to achieve a more youthful appearance. Whiter teeth are consistently associated with perceptions of health and vitality, though whitening works best as part of a broader treatment plan rather than in isolation.
A comprehensive approach at OptiSmile follows an ABC sequence: Aligning with Invisalign, Bleaching with take-home or in-aligner whitening trays, and then Composite bonding using injection moulding to restore shape and length.
The Buccal Corridor and Smile Width
[00:07:59 – 00:09:17]
The buccal corridor is the dark shadow visible at the corners of the smile, between the teeth and the cheeks. As teeth wear or collapse inwards, these shadows become more prominent and the smile appears narrower and more aged. Many patients — particularly women in their late twenties to late thirties — seek treatment specifically to address this.
Widening the smile arch through Invisalign, composite bonding or other restorations reduces these shadows and creates a fuller, more youthful appearance. Research in smile aesthetics confirms that reducing the buccal corridors significantly improves perceived attractiveness.
The “Witch’s Chin” and Jaw Over-Closure
[00:09:18 – 00:10:47]
Extreme bite collapse — often seen in patients who have lost many teeth or have not worn a lower denture for years — can cause the chin to rotate upward and forward in what is sometimes called a “witch’s chin” appearance. In severe cases, the chin nearly touches the nose.
Restoring proper bite height through restorative dentistry corrects this over-closure, repositioning the jaw and improving the profile without the need for surgery in the vast majority of cases.
Conservative Treatment: No Surgery Required
[00:10:47 – 00:12:13]
Most dental facelifts are carried out conservatively using composite bonding, Onlays, crowns or aligners. Treatment is carefully staged to test comfort, function and adaptation at each step. Surgery is reserved for specific jaw discrepancies and is not a routine part of managing age-related wear.
Bite height can typically be opened by four to five millimetres without requiring a trial period, as most patients tolerate the change well. Where any uncertainty exists, temporary restorations can be worn for a few weeks to allow the patient to adapt before final restorations are placed.
Why This Is a Functional Facelift, Not a Cosmetic One
[00:12:14 – 00:12:58]
Das primäre Ziel von a Zahn-Facelift is to restore function: chewing efficiency, jaw comfort, bite stability and the preservation of remaining tooth structure. Aesthetic improvements are often a natural by-product of returning the face to its properly supported position.
Unlike a purely cosmetic facelift, dental rehabilitation improves health, function and longevity — not just appearance. This makes it a form of anti-ageing grounded in biology rather than vanity.
Abschrift
Eon Engelbrecht (0:04) Welcome back to Save Your Money, Save Your Teeth, and today we’re diving into a topic that bridges dentistry and anti-ageing. It’s the dental facelift. I’m joined once again by Dr Clifford Yudelman from OptiSmile. Welcome back, Doctor.
Dr Clifford Yudelman (0:21) Thank you, thanks for having me back.
Eon Engelbrecht (0:23) Now let’s get straight into the questions that I have here for you this week. Firstly, how does wearing down our teeth make our faces look older?
Dr Clifford Yudelman (0:34) Tooth wear is not just a dental issue, it’s a facial ageing issue. Over time, grinding, acid erosion and general wear will shorten your teeth, especially your back teeth that support the bite. When the teeth lose height, the lower third of the face collapses slightly, and this reduces facial support for the lips and cheeks and can lead to a sunken appearance, deeper smile lines and an overall tired look.
We did do a podcast on a similar subject, but from a different angle, about opening your bite. This is more general, but it does overlap with that. Studies in prosthodontics show a strong relationship between tooth height and facial proportion, and even small losses in vertical height can change the way your face looks. Basically, wearing down your teeth accelerates facial ageing in a way that just getting a facelift or a laser peel can’t fix.
Eon Engelbrecht (1:47) I believe there’s something called a loss of vertical dimension. Can you explain that to us, and also how does it actually cause wrinkles?
Dr Clifford Yudelman (1:56) The vertical dimension is the natural height between the upper and the lower jaw when your teeth are in contact, and it’s mainly determined by the back teeth. When you’ve lost teeth or you’ve worn your teeth down, the jaw closes further than it should. We did call it in the previous podcast a collapsed bite. This causes your chin to move closer to your nose, shortening that lower third of your face, and then it deepens the creases around your mouth and contributes to more jowls and a folded facial appearance.
Not only research, but in our own experience, we’ve seen that when we restore this vertical dimension, it softens the wrinkles and improves facial harmony. People just look different after they get their bite opened and their teeth fixed up, and it’s not cosmetic guesswork. It’s actually functional reconstruction with aesthetic benefits.
Eon Engelbrecht (2:58) Can building up the back teeth actually lift sagging skin around the jaw?
Dr Clifford Yudelman (3:05) Yes. When we build these up, it gives the skin or the muscles more space, because you’ve actually opened up the space. While it’s not the same as a surgical facelift — where you’re pulling the skin from behind the ears or from behind the hairline — it can have a similar effect, and sometimes the two can be used together. As I said earlier, the results can be really amazing.
Eon Engelbrecht (3:38) Can veneers or bonding actually plump up your lips and give you that look, but without fillers?
Dr Clifford Yudelman (3:45) Yes, and in many cases it’s so much better, because your lips rest against the front teeth, and if these teeth are worn or thin or set too far back, your lips don’t get that support and they appear flatter. By restoring proper tooth length and contour with veneers, or in our case injection moulded composite bonding — which we do a lot of — it provides an internal scaffolding for the lips, and this gives a natural fullness without injecting foreign substances. The effect is subtle, balanced and proportionate, because it restores what was lost rather than adding excess volume.
Actually, in many cases I’ve seen patients who had lip fillers because their teeth were too small or worn down. The lips might look fine when the mouth is closed, but then when they speak or smile it’s hard to even see their teeth. It actually makes the problem even worse.
Eon Engelbrecht (4:40) Okay, Doctor, why do teeth turn yellow or even grey as we age, and does whitening actually make us look younger?
Dr Clifford Yudelman (4:52) Yes. For people who are just getting onto these podcasts now, we’ve done six or seven teeth whitening podcasts about in-chair, take-home and so on, but this is a great place for this question. The enamel thins as we age, and the underlying dentine becomes more visible. The dentine is naturally darker and more yellow, and it gives the teeth a more aged appearance. In addition, lifelong exposure to staining foods and drinks compounds the effect — like Coca-Cola, tea, coffee, turmeric, curries and red wine. All of these things can make your teeth go yellow or grey as you get older.
A lot of the studies have shown, and certainly clinically we see, that tooth whitening is one of the most effective and non-invasive ways to get a more youthful appearance. Whiter teeth are associated with perceptions of health, vitality and youthfulness. Whitening should be part of a broader plan, not just a standalone for worn teeth. We often whiten the teeth, straighten them with Invisalign to change the position, bring them out, give the lips more support and line them up, whiten them with take-home trays or in your aligners, and then build the teeth up with composite bonding. The ABC: aligning, bleaching or whitening, and then composite bonding using injection moulding. That’s where OptiSmile gets its ABC treatment.
Eon Engelbrecht (6:42) Oh yes, the Jacksons, of course, that song. Okay, good one.
Dr Clifford Yudelman (6:47) Don’t make me sing it. ABC 123, you’re going to sing along. That’s all I know as well. I think he was about eight.
Eon Engelbrecht (7:00) Oh yes, you’re right. That’s in his new documentary film. They also show us where he sings that song with the actor who plays him when he was much younger.
Dr Clifford Yudelman (7:09) Have you seen it? It was amazing. I loved it.
Eon Engelbrecht (7:12) Yes, I also saw it. Hectic. I never knew his father was so evil and so greedy.
Dr Clifford Yudelman (7:19) It was crazy, yeah. I actually was at his concert — I think it was Bad. I was in LA. I moved to San Diego in ’86, and I think that was in ’88. I remember driving up to LA, and there were thousands of limos. And then I actually saw him do Thriller live.
Eon Engelbrecht (7:40) That must have been amazing.
Dr Clifford Yudelman (7:42) Wow, yeah. And also, recently I was in New York and managed to get tickets to the Michael Jackson Broadway show, which was fairly similar to the movie, but different.
Eon Engelbrecht (7:55) I’m so jealous.
Dr Clifford Yudelman (7:56) I think we’re getting completely off subject.
Eon Engelbrecht (7:59) What is the buccal corridor, and how does widening the smile help aesthetics?
Dr Clifford Yudelman (8:07) That’s the dark space that’s visible at the corners of the smile, between the teeth and the cheeks. As the teeth wear or collapse inwards, these dark spaces become more prominent. We see that a lot. We get a lot of mainly females in their late twenties to late thirties wanting a broader smile, where they don’t like that shadow, where the teeth sort of disappear into the back of the mouth.
When we widen the smile it makes a real difference, because when it’s narrow it looks more aged. Between orthodontics, Invisalign, bonding or other restorations, we get that proper arch width and we can reduce these shadows and create a fuller, more youthful smile. Research in smile aesthetics shows that a moderate reduction of the buccal corridors gives people a much higher attractiveness rating.
Eon Engelbrecht (9:18) Okay. And can fixing a bite reduce the appearance of the so-called witch’s chin?
Dr Clifford Yudelman (9:30) The so-called witch’s chin comes from over-closure of the jaw. That’s usually when it’s extreme — when you’ve lost a lot of teeth and your upper and lower teeth literally cross over, the bite is completely collapsed, and the chin is rotated upward and forward, so it’s literally pointing forwards. Now that you’re calling it a witch’s chin, I think it’s a very good name.
Often it means a patient has a lower denture or hasn’t worn a lower denture in years, and then the chin almost touches the nose. It doesn’t look very pretty.
Eon Engelbrecht (10:37) Okay, so is this a surgical procedure, or can it be done with restorative dentistry alone?
Dr Clifford Yudelman (10:47) Most of these dental facelifts are done very conservatively, just by bonding. We do onlays or crowns, we use aligners, we re-injection mould. Treatment is always staged very carefully, and we test the comfort, the function and the adaptation. Surgery is reserved for very specific jaw discrepancies, but it’s not routine for ageing-related wear. A conservative approach minimises the risk while maximising the benefits. So it’s really something to look into if you feel like your smile is not helping your youthful appearance.
Eon Engelbrecht (11:28) And how do you test if a patient can tolerate a new bite height?
Dr Clifford Yudelman (11:34) We used to worry about that a lot more. Now we find you can open the bite four or five millimetres without even having to test it, because everybody can tolerate it. There’s something called freeway space. If you’re worried, you can make temporary restorations that patients wear for a few weeks or a month to check on comfort while they get used to speaking and chewing, and also the jaw joints. But, as I said, a lot of the time nowadays we can go straight to opening the bite and patients tolerate it very well.
Eon Engelbrecht (12:14) Okay, and then just one more question for today: why is this considered a functional facelift and not just cosmetic?
Dr Clifford Yudelman (12:23) It’s because the primary goal is to restore function — your chewing efficiency, your jaw comfort, preserving and building up your teeth, and bite stability. The aesthetic improvements are sometimes just a by-product of returning the face to its natural, supported position. Unlike a cosmetic facelift, a dental rehabilitation improves the health, the function and the longevity, not just the appearance. This is anti-ageing rooted in biology, not just vanity.
Eon Engelbrecht (12:59) Fascinating insights once again, Dr Yudelman. Thank you so much, we really enjoyed it today. And thank you for clarifying the difference between a functional and a cosmetic facelift.
Dr Clifford Yudelman (13:12) My pleasure, thank you. And looking forward to seeing you next time. Look after yourself, and thanks again for this amazing podcast. I know we always have a lot of fun recording them, and it’s great that we’re able to help people, and that we’ve got so many people now listening to the podcasts on YouTube, Spotify, Apple Podcasts and CastBox. Thanks for putting them out there. Next week we’ll be talking about building your own dental emergency kit, and the following week will be how to read your own X-rays.
Eon Engelbrecht (14:02) Okay, wow. I like it, it’s going into the DIY direction now. Love it. Thank you so much, Dr Yudelman, we appreciate it. And to our listeners, thanks so much for joining us. We’ll say to you: same time, same place next week.
Announcer (14:40) Discover the world of dental excellence with OptiSmile. Join us for a weekly podcast featuring Dr Clifford Yudelman, a seasoned expert with 40 years of dental experience across four continents. Gain unique insights and expert dental advice by visiting OptiSmile.co.za for articles that illuminate the path to optimal oral health. If you’re seeking unparalleled dental care in Cape Town, get in touch with OptiSmile or book directly online on OptiSmile.co.za. OptiSmile, where global expertise meets local care.
Haftungsausschluss: Der Inhalt dieses Podcasts „Save Your Money Save Your Teeth“ an Medical Mondays dient ausschließlich Informations- und Bildungszwecken. Es ist nicht als zahnärztliche oder medizinische Beratung gedacht. Die von Dr. Clifford Yudelman und etwaigen Gästen geäußerten Erkenntnisse und Meinungen sollen ein besseres Verständnis der Zahngesundheit, vorbeugender Maßnahmen und des allgemeinen Wohlbefindens fördern, sollten jedoch nicht als professionelle zahnärztliche oder medizinische Empfehlungen interpretiert werden.Dr. Clifford Yudelman diagnostiziert, behandelt oder bietet Präventionsstrategien für Gesundheitszustände nicht direkt über diesen Podcast an. Diese Plattform ist kein Ersatz für die persönliche Betreuung und Beratung durch einen zugelassenen Zahnarzt oder Arzt. Wir empfehlen unseren Zuhörern dringend, sich mit ihren eigenen Zahnärzten in Verbindung zu setzen, um individuelle Zahngesundheitsbedürfnisse und -probleme zu berücksichtigen. Die hier geteilten Informationen zielen darauf ab, den Zuhörern Wissen über Zahngesundheit zu vermitteln, dürfen jedoch nicht als Grundlage für gesundheitsbezogene Entscheidungen ohne Zahngesundheit verwendet werden professionelle Anleitung. Ihr Zahnarzt ist die beste Quelle für Ratschläge zu Ihrer Zahn- und allgemeinen Gesundheit. Bitte lassen Sie sich bei Fragen oder Bedenken bezüglich Ihrer Zahngesundheit immer von Ihrem Zahnarzt oder anderen qualifizierten medizinischen Fachkräften beraten.
