How Your Smile Changes As You Age — It's Not Just About Whitening

It’s time to update your oral care routine.

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There’s a laundry list of things to worry about as you get older, with some (like your overall health and general wellbeing) carrying a little more weight than others. But for the aesthetically minded, when you reach your 40s, 50s, and beyond, things like skin sagging, fine lines, thinning hair, and more tend to creep into casual conversations with your friends. All fine and dandy if you want to consult a few professionals to learn how to confront these signs of aging, but of the many many things that can change with age the one that is a bit more unexpected is your smile.

Sure, you may have come a long way from those trips to see your orthodontist as a teen, but that doesn’t mean you can simply wear your retainer every third week of the month and hope your smile will age gracefully — additional effort is required. In fact, if you’re concerned about premature signs of aging past your early 20s, it might be time to kick your oral care routine into overdrive. “The teeth are one of the first areas on our body that show signs of aging,” says cosmetic dentist and owner of Cosmetic Dental Studios Dr. Victoria Veytsman. “They will chip just due to wear and tear, they will definitely stain, they shift around, [they] get a little bit more crowded, and they lose volume in every dimension.”

If that list includes a few more surprises than just a few crooked incisors and some mild coffee stains, you’re not alone. Says Dr. Veytsman, “I think what patients are seeing and aren't able to pinpoint is the lack of harmony sometimes with the features of the face. We have patients that come in and say [things] like, ‘My smile just looks different’ or, ‘My smile doesn't match my face.’ [At my practice] we do what we call dentofacial aesthetics, a combination of teeth and face — trying to harmonize everything and make sure everything flows [when] the smile’s starting to show early signs of aging.”

Keeping your teeth healthy is obviously the foundation of any good oral health plan, but understanding the multiple factors that affect an aging smile is equally important. Here’s what the pros say you need to pay attention to to keep your smile looking its best throughout your life.

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Teeth Structure & Alignment

“Teeth are always moving [as] they are not secured in bone,” says Dr. Wesam Shafee, DMD, aesthetic dentist and founder of Smile Care Dental Group in Paramus, NJ. “They sit in a periodontal ligament and they can move. If we don't want teeth to move into a non-desired position, we have to wear retainers.”

While your teeth might not revert back to their position when you were younger, the shifting does tend to follow a similar pattern as you age. Dr. Amanda Lewis, DMD, explains, “As far as shifting, [the teeth] tip inwards [which can] make the smile look narrower, and move towards the midline which causes crowding.” This can lead to some of those almost imperceptible changes in the shape of your smile.

But it’s not only the position of your teeth that is changing — they actually get shorter with age. This might not seem that major, but as your skin starts to lose laxity (more on that soon), having less surface area to support the skin around your mouth can contribute to a more aged appearance. Says Dr. Veytsman, “Structurally, the teeth really support the lower third of the face, and as the teeth start to get shorter and move inward, that height [in the lower part of the face] starts to shorten as well. The skin [won’t] have as much support, [so] that's where you get a little bit of sagging, too.”

Orthodontic options like braces and aligners (or in some cases a permanent retainer) can help to not only correct the misalignment of your teeth but reestablish the underlying structure for the skin around your mouth and jaw. However, like anything else in the cosmetic treatment space, using these consistently is the only way to maintain proper tooth position for years to come.


Given that teeth whitening is a $45 billion global industry, millions of people already know that teeth yellow and stain with age. “Color changes occur as the outer protective enamel wears away exposing the underlying dentin, whose natural yellow color becomes more yellow, as we age,” says Dr. E. Lisa Reid, DMD, of Integrated Aesthetic Dentistry. “The enamel itself gets stained by coffee, tea, red wine, and tobacco over time.” Professional in-office treatments can address deeper stains more effectively, but maintenance with an at-home whitening system is an accessible (and much more affordable) option.

Dr. Shafee adds that, “drinking a lot of water, especially for coffee and tea drinkers, is a good idea because [it] will help cleanse the mouth and reduce the effects of staining that happens from colorful drinks.” Using a straw can also help to minimize stains from coffee or tea (wine too if you’re feeling up for it).

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Gums & Bone Density

Gum recession is easy to spot with the naked eye, and can become more prominent with age. “Bone loss is inevitable as we get older,” explains Dr. Reid. “The gum is attached to the bone, so when [this] occurs, gum recession is the result.” Osteoporosis, especially in post-menopausal women, can lead to gum recession due to bone loss. Conditions like diabetes (which also becomes more prevalent with age), are also a cause of gum recession in older adults.

Teeth grinding and clenching — often a result of stress, which can obviously get worse as you get older — also wear away at your enamel over time. “If you're a grinder, a lot of times patients will get Botox in their masseter [muscles] to calm that down, so they're not putting so much force on their teeth,” says Dr. Veytsman. “Night guards are also a preventative measure to do at home. When people grind or clench their teeth, they're more apt to chip,” which leaves your smile looking damaged and weathered. Are they the sexiest thing to wear to bed? Certainly not — but your smile will definitely reap the benefits of a night guard.

Skin Laxity & Muscle Tone

For as much obsessed as everyone seems to be with sharpening their jawlines lately, the skin around your mouth deserves an equal amount of attention in your anti-aging regimen. Dr. Reid explains that as collagen levels drop, the skin loses its firmness and begins to sag with age (aka skin laxity). She adds that there is also a reduction in your cheeks’ fat deposits, which, when coupled with the diminishing size of your teeth and overall “reduction of presence” of the jawbone, leaves an excess of skin. That means you’ll see less of your teeth when you smile as you grow older (a nearly imperceptible change over many years). Dr. Shafee adds that this is often the most surprising change for patients who are unhappy with their smile.

Additionally, with the collagen loss that accompanies age, “the groove on the midline between the base of your nose and the margin of your upper lip (the philtrum) begins to flatten,” says Dr. Reid. “And muscle tone can decrease by as much as 20% to 25% as we age, leading to decreased chewing efficiency. Weakening muscle strength also cause the lips to bend downward and elongate.”

When Can You Expect To See These Changes?

These dental professionals assert that everyone’s smile is different, but there is a general timeframe for when you might see some of these alterations. As Dr. Veytsman says, “Genetics, environment, oral hygiene,” all play a part in how your smile ages. “Right around when you start to see the aging of the face in your 30s,” is when you might spot a difference in your smile.

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Dr. Shafee typically sees patients in their 30s and 40s requesting whitening, fixing crowding or spacing, repairing old or discolored fillings, or veneers for uneven teeth. After that, he says that the 50s and 60s are when more advanced treatments come into play, especially for patients that did not address some of these signs of aging earlier. This can include, “full mouth reconstruction when we change or fix most of the teeth in order to achieve that youthful beautiful smile of their younger years, or the smile they never had but have always dreamed of,” he says.

However, just because you hit a new decade doesn’t necessarily signal that your smile is going to transform overnight. Says Dr. Veytsman, “We don't treat patients based on their age — we treat them based on their symptoms and what they present with as it can vary a lot. We typically treat patients with the goals they [have], not the number. You can be 25 and present with an aged smile — I see this all the time.”

While it’s important to keep these things in mind as you grow older, it might be wiser to concentrate on maintenance, rather than preparing to ask your dentist for a total transformation once you hit 40, 50, or beyond. Healthy habits, like regular brushing, flossing, and seeing your dentist at least twice a year will go a long way in the overall look of your smile. As Dr. Reid says, “I always tell my patients that ‘an ounce of prevention is worth a pound of cure.’”

Consider this a sign to take that retainer out of storage and book your next annual dental checkup.