Loss of Vertical Dimension

Vertical dimension is the space between the upper and lower jaws. In a normal occlusion with a full dentition the space is ideal with the teeth and jaw working in harmony. Over time, especially in older patients this space can diminish if the natural teeth are worn down  from bruxism or lost due to decay or periodontal disease.

This loss of vertical dimension or bite collapse can result in damage to the jaw joints, severe pain or dysfunction in the jaw joints, frequent muscle tension headaches, tooth fractures and tooth loss, and aggravation of periodontal disease if present. Other resulting issues are shortening of the lower face height, an inverted smile (corners of the mouth sag), a toothless smile, frequent cracking or chapping at the corners of the mouth (angular cheilitis), and problems chewing.

Restoring the proper vertical dimension and associated cosmetic and functional problems can be obtained by proper treatment planning. In the case of a full dentition with worn teeth, the teeth can be crowned and returned to their natural size. For partial or fully edentulous patients implants can be utilized along with removable or hybrid appliances. Below are some before and after pictures depicting loss of vertical dimension and its correction.

by Dr. H. Kopel, DDS



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