Not Enough Bone

Jawbone loss: what causes it, and can it be stopped?

In everyday speech, 'bone loss' can mean this or osteoporosis; they are two separate processes and should not be confused

If a dentist looking at your X-ray has told you that your jawbone has shrunk, osteoporosis is probably the first thing that springs to mind. Yet the most common cause of bone loss in the jaw is something else entirely: a missing tooth, a denture worn for a long time or advanced gum disease. On this page we explain why the jawbone shrinks, when this can be stopped, when the loss is permanent and how it differs from osteoporosis.

Short answer

Jawbone loss (bone resorption) is a reduction in the volume of the jawbone, most often as a result of tooth loss, wearing a denture for a long time or advanced gum disease. Bone starts to shrink once it loses the chewing load it carries. This is a local process specific to the jaw, different from osteoporosis (which people also call bone loss), a disease that affects the whole skeleton. Bone loss caused by missing teeth does not stop on its own, but it can be stopped by loading the area again with an implant or by treating gum disease. Bone that has been lost does not come back on its own.

Often confused with osteoporosis, but: A separate process: usually the result of tooth loss
Most common cause: The gap carrying no load after an extraction or tooth loss
What stops the loss: Loading the area with an implant, or treating the inflammation
Does it stop on its own?: No, it continues for as long as there is no load

Medically reviewed by Bilge Ilgın, Dentist · ImplantologyLast reviewed 2026-09-13

Why the jawbone shrinks

The part of the jawbone that holds the teeth is not a fixed block; it is living tissue that constantly renews itself under the load of chewing. When this tissue loses the load placed on it, it has no reason to keep its mass, and over time it diminishes. You can think of it like a muscle: just as a muscle that is not used gets thinner, bone that carries no load shrinks. This is the common mechanism behind jawbone loss.

The most common cause is tooth loss itself. When a tooth is extracted or falls out, the bone around its root no longer takes the force of chewing. The loss progresses quickly in the first months, then slows down but does not stop; over the years it can start from a few millimetres and reach a significant volume. A review that examined these changes after tooth extraction shows that the greatest loss of bone volume happens within the first year, but that it continues, if at a slower rate.

The second cause is wearing a denture for a long time. A removable denture sits on the gum, but unlike a root it does not transmit force into the bone; what is more, uneven pressure can build up over time in the areas the denture presses on. The result, in many people who wear dentures, is that the ridge of the jaw becomes noticeably flatter over the years. This does not mean the denture was 'badly made'; it is a limitation built into what a denture is.

The third cause is gum disease, and its mechanism is different from the ones above. Here the bone is lost not because of a lack of load but because of inflammation triggered by bacteria; even if the tooth is still in the mouth and still chewing, the bone holding its root diminishes as the inflammation goes on. At an early stage (gingivitis) this can be reversed; at an advanced stage (periodontitis) the bone that has been lost does not come back on its own.

Less common causes include cysts in the jaw, previous fractures or surgery, radiotherapy to the head and neck area, and chronic, untreated gum inflammation that goes on for many years. All of these affect bone tissue directly or indirectly, but in terms of how often they occur they lag far behind tooth loss and gum disease.

An important distinction needs to be made clear here: the 'jawbone loss' on this page and the 'bone loss' people mean when they talk about osteoporosis are not the same thing. Osteoporosis is a systemic disease that affects the whole skeleton and is linked to age and hormonal change; it is diagnosed with a bone density scan and treated with medication. The bone loss in the jaw that we describe here, on the other hand, is a local process: its source is usually tooth loss or gum disease. Someone whose bone density is completely normal and who does not have osteoporosis can still have significant jawbone loss simply because of missing teeth. Osteoporosis can be a background that speeds this picture up, and the link between some of the medicines used for it and dental treatment is assessed on its own; we cover this on a separate page.

Lost bone has another, hidden cost: the jawbone also supports the lower part of the face. In areas that have been without teeth for a long time, the loss of lip support and the face taking on a sunken look are really this bone loss showing on the outside. It is often noticed only when the appearance changes or the denture becomes loose; yet the process started quietly years earlier.

When the loss can be stopped, and when it is permanent

The breakdown below is a general framework. An examination, with X-rays when needed, shows which one applies to you.

The tooth can be saved

If early gum inflammation is treatedIf the inflammation affects only the gum (gingivitis), it reverses completely with treatment and bone loss never starts.
If an implant is placed in the gapAn implant transfers the chewing load directly to the bone and largely stops the loss in that area.
If gum disease is caught before it advancesPeriodontitis can be stopped at an early stage; the bone that has been lost does not come back, but the bone that remains is preserved.
If the denture is checked and relined regularlyA denture that no longer fits well can speed up bone loss; regular check-ups reduce this effect but do not remove it completely.

Saving it is unlikely to hold

Volume lost in the first months after an extractionBone lost during this period does not come back on its own; if needed, it can be added with a graft.
Bone lost to advanced periodontitisEven if the inflammation is stopped, the bone that has been lost up to that point does not come back on its own.
Bone loss under a denture worn for yearsA denture does not stop the loss; it only changes the surface it rests on. The loss builds up over the years.
If loss speeding up while you take osteoporosis medication is a concernThis needs a separate assessment; you need to tell us which medicine you take and for how long.

How to tell how far the loss has progressed

The sequence below is for assessment, not treatment. The aim is to pin down the cause and extent of the bone loss.

1
History and examination
We ask how long you have had missing teeth or worn a denture, about any gum symptoms and about your general health. A history of gum disease and smoking directly affect how fast the bone is lost.
2
Gum measurements
If you have teeth remaining, a small instrument is used to measure how well the gum is attached to the bone. This measurement shows whether the inflammation is active.
3
Panoramic X-ray
This image is used to assess the overall appearance of the jaw and the bone level. It gives the first idea of where the bone has been lost and how much.
4
A 3D CBCT scan if needed
If an implant is being planned, the thickness of the bone and the condition of the hard outer layer cannot be seen on a panoramic X-ray; that distinction needs a CBCT scan.
5
Assessing the denture and your habits
If you wear a denture, we look at how well it fits, how many years you have worn it and when it was last replaced.
6
The plan in writing
The steps aimed at stopping the bone loss (treating inflammation, an implant, relining the denture) and any need for a graft are shared in writing.

Options for stopping or slowing the loss

Which one suits you depends on the cause and extent of the bone loss. The options do not rule each other out; they are often used together.

Treating gum disease

The source of the inflammation is cleaned away, with surgery if needed. This stops the loss but does not bring back bone that has already been lost.

An implant in the gap

By transferring the chewing load directly to the bone, it largely stops the loss. If there is not enough bone, a CBCT scan shows which method is suitable.

Bone graft

Lost volume can be made up with your own bone or with a bone substitute material. We explain what this material is and how it is used on a separate page.

Relining or replacing the denture regularly

As the shape of the jaw changes, a gap opens up under the denture; relining at regular intervals keeps the fit but does not stop the loss.

Coordinated follow-up if you take osteoporosis medication

The type of medicine and how long it has been taken can affect dental treatment; in this case a separate assessment is needed.

What happens if the loss progresses

We are not writing this to frighten you, but to show why an early assessment matters.

The lower part of the face loses support

As the volume of bone that supports the lips and cheeks diminishes, the face takes on a more noticeably sunken look.

The denture becomes looser and looser

As the base the denture sits on gets smaller, the denture stops staying in place and needs frequent relining or replacement.

The remaining teeth may lose support

If the bone loss is caused by gum disease, the bone around the roots of the neighbouring teeth is affected by the same process.

Implant planning becomes more complicated later on

The more volume is lost, the greater the need for a graft and the longer the treatment; an early assessment can lead to a simpler plan.

Chewing becomes less efficient

As bone support diminishes, the load that both natural teeth and a denture can carry goes down; this can change your eating habits.

What to expect after the assessment

The course below varies depending on the route chosen. What they have in common is that lost bone does not come back, and the real aim is to preserve what remains.

If gum inflammation has been treated
The inflammation settles within a few weeks and the bone loss stops. The part that has been lost does not come back, but the remaining bone is preserved.
If an implant has been planned
The process depends on whether there is enough bone; in some jaws treatment goes ahead without a graft, while in others there is a wait for the volume to be built up first.
If you keep wearing a denture
The shape of the jaw changes noticeably every few years; the denture needs to be relined or replaced at regular intervals.
Long-term follow-up
The bone level and gum health are monitored at a yearly check-up. This is the only way to see early on whether the bone loss has started to speed up again.

Message us right away if

Your denture keeps getting looser or falls out often. This is a sign that the shape of your jaw has changed and that it is time for relining or replacement.
You have bleeding, redness or a bad smell from your gums. It may be a sign of active inflammation; early treatment limits bone loss.
You have noticed the lower part of your face looking sunken. This may be advanced bone loss showing on the outside; it needs an assessment.
Your remaining teeth have started to feel loose. It may show that bone support has diminished; have it checked without delay.

What determines the assessment and treatment

There are no figures on this page; the scope becomes clear after an examination and imaging. These are the deciding factors:

The degree and location of the loss: Mild bone loss in a limited area and advanced bone loss covering most of the jaw call for assessments of a different scope.
Whether gum disease treatment is needed: If there is active inflammation, it is treated first; this can be the first, and sometimes the only, step the plan needs.
Imaging method: A panoramic X-ray is enough for an initial assessment, but a 3D CBCT scan is needed if an implant is being planned.
Whether a graft is needed, if an implant is planned: If there is enough bone left, a graft does not come into it; if there is not, an extra operation and extra time are added.

Frequently asked questions

Are jawbone loss and bone loss (osteoporosis) the same thing?

No. Jawbone loss is a local process that usually progresses with tooth loss, wearing a denture or gum disease. Osteoporosis, on the other hand, is a systemic disease that affects the whole skeleton and is linked to age and hormonal change. Someone who does not have osteoporosis can have significant jawbone loss simply because of missing teeth, and in someone who does have osteoporosis, it can speed this loss up. The two can be related, but they are not the same disease.

Does jawbone loss stop on its own?

No. Bone loss caused by missing teeth continues for as long as the area does not carry a load again; it is fast in the first year and continues more slowly after that. The way to stop it is either to load the area with an implant or, if the cause is gum disease, to treat the inflammation.

How long after a tooth is taken out does the bone start to shrink?

The loss starts in the first weeks after the extraction, and the fastest loss happens within the first year. That is why putting off for a long time the decision about when, and with what, to close the gap can narrow your options later on.

I wear a denture. Will that stop the bone loss?

No. A denture sits on the gum, but unlike a root it does not transmit force to the bone; that is why the bone under a denture also diminishes over time. Relining or replacing the denture at regular intervals keeps the fit but does not stop the loss.

I have gum disease. Will the bone I have lost come back?

Bone that has been lost does not come back on its own. Once the inflammation is treated, the loss stops and the remaining bone is preserved; in some limited cases a certain amount of volume can be added with a graft, but that is the exception, not the rule.

Can I still have implants if my jawbone has shrunk?

In most cases, yes. The amount of remaining bone and the condition of the hard outer layer are assessed with a 3D CBCT scan; this makes it clear which option is suitable: a conventional implant, an implant with a graft or a strategic implant.

I have noticed my face looking sunken. Could this be caused by bone loss?

It could. The jawbone also supports the lower part of the face; the loss of lip support in areas that have been without teeth for a long time can be this bone loss showing on the outside. An examination establishes the exact cause.

I take osteoporosis medication. Does it affect my jawbone too?

The type of medicine you take, how you take it and for how long can all be relevant to dental treatment. Rather than skimming over this with a general sentence, we have covered it in detail on a separate page; you need to tell us the name of your medicine.

I smoke. Is my jawbone shrinking faster?

Smoking is a known factor that speeds up the progression of gum disease and weakens the response to treatment, and this can increase the rate of bone loss. Because it also slows healing after an extraction or surgery, cutting down or stopping smoking is part of every step aimed at stopping bone loss.

Sources

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Next step

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