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Jawbone changes after tooth loss

The bone that held a tooth shrinks after the tooth is removed, most in width and most in the first 3 to 6 months. The amount of remaining bone shapes implant planning and whether grafting is needed.

What happens to the bone

The ridge of bone that held a tooth gets smaller after the tooth is removed.1 AAOMS states that the part of the jawbone that supported a lost tooth can deteriorate or be resorbed.2

How much and how fast

A systematic review of 20 human studies measured the changes over the first year after extraction.1

Measure at 6 monthsChange
Width (horizontal)29 to 63 percent loss
Height (vertical)11 to 22 percent loss
Mean width loss3.79 mm
Mean height loss, cheek side1.24 mm

Width loss was larger than height loss.1 The gum over the ridge gained 0.4 to 0.5 mm of thickness on the cheek and tongue sides at 6 months.1 Studies that measured plaster models found width changes ranging from 0.1 to 6.1 mm of loss.1 Most of the change happened in the first 3 to 6 months, followed by slower change afterward.1

Why it matters for implants

AAOMS states that implants require sufficient bone mass and density for a stable base.2 The AAP lists periodontal disease, wearing dentures, developmental defects and injury as causes of jaw deformities that leave too little bone for implants.3

Options that address bone loss

  • Socket preservation. Grafting the socket at the time of extraction. A meta-analysis of randomized trials found it reduced width loss by about 2 mm compared with extraction alone.4
  • Ridge augmentation. Rebuilding a narrow or short ridge with graft material before or during implant placement.3
  • Sinus lift. Adding bone under the sinus floor in the upper back jaw.5

The FDA lists helping to keep the jawbone from shrinking as a benefit of dental implants.6

General information about dental implants. Treatment decisions are made with a licensed dentist.

Sources

  1. Tan WL et al. Post-extraction alveolar hard and soft tissue dimensional changes: systematic review. Clin Oral Implants Res 2012. pubmed.ncbi.nlm.nih.gov
  2. AAOMS (MyOMS.org): Preserving Bone for Dental Implants. myoms.org
  3. American Academy of Periodontology: Ridge Modification. perio.org
  4. Avila-Ortiz G et al. Alveolar ridge preservation: systematic review and meta-analysis. J Clin Periodontol 2019. pubmed.ncbi.nlm.nih.gov
  5. American Academy of Periodontology: Sinus Augmentation. perio.org
  6. U.S. FDA: Dental Implants, What You Should Know. fda.gov

Evidence

Sourced facts

Each line links to the study or the specialty body it comes from.

  1. A systematic review of 20 studies found horizontal bone loss of 29 to 63 percent and vertical bone loss of 11 to 22 percent 6 months after tooth extraction.

    Tan WL et al. Systematic review of post-extraction alveolar hard and soft tissue dimensional changes. Clin Oral Implants Res 2012 · checked October 2, 2026

  2. The same review measured mean horizontal reduction of 3.79 mm and buccal vertical reduction of 1.24 mm at 6 months.

    Tan WL et al. Systematic review of post-extraction alveolar hard and soft tissue dimensional changes. Clin Oral Implants Res 2012 · checked October 2, 2026

  3. Most dimensional loss occurred in the first 3 to 6 months, followed by gradual reduction afterward.

    Tan WL et al. Systematic review of post-extraction alveolar hard and soft tissue dimensional changes. Clin Oral Implants Res 2012 · checked October 2, 2026

  4. AAOMS states that after a tooth is lost, the part of the jawbone that supported it can deteriorate or be resorbed.

    AAOMS (MyOMS.org): Preserving Bone for Dental Implants · checked October 2, 2026

  5. The FDA lists helping to keep the jawbone from shrinking as a benefit of dental implants.

    U.S. FDA: Dental Implants, What You Should Know · checked October 2, 2026

  6. The AAP lists periodontal disease, wearing dentures, developmental defects and injury as causes of too little bone for implants.

    American Academy of Periodontology: Ridge Modification · checked October 2, 2026

  7. A meta-analysis of randomized trials found socket grafting prevented about 2 mm of horizontal bone loss compared with extraction alone.

    Avila-Ortiz G et al. Effect of alveolar ridge preservation after tooth extraction: systematic review and meta-analysis. J Clin Periodontol 2019 · checked October 2, 2026

  8. The AAP describes sinus augmentation as a way to add bone in the upper back jaw, where bone is often limited.

    American Academy of Periodontology: Sinus Augmentation · checked October 2, 2026

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Dr. Michael Pawlus
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Dr. Michael Pawlus

Periodontist · Sarasota

ICOI Fellow, ICOI Diplomate · AAP member

Doctor page(941) 923-2288
Featured doctorDr. Michael Pawlus · Sarasota