My Father Was a Dentist. So How Did He Lose So Many Teeth at 90?

My father is 90 years old and a retired general dentist. Recently, he has gone through multiple root canals and extractions. In the past year alone, he lost several lower teeth, including teeth he depended on to chew.

Whenever we talked about it, he would tell me:

“I’m old. This is what happens when you get old.”

But I kept thinking:

Does it have to?

You were a dentist. You took meticulous care of your teeth. You didn't have a mouth full of cavities. You didn't have significant periodontal disease. You were an impeccable flosser.

So how did you get to 90 and lose so many teeth?

I see older patients who still have remarkably healthy natural teeth. Some reach their 80s and 90s with most—or even all—of their teeth.

Why do some mouths seem to hold up so well while others experience repeated fractures, restorations, root canals, and eventually tooth loss?

There are many possible factors: decay, periodontal disease, genetics, hygiene, medical conditions, trauma, previous dental work, and simply decades of use.

But as an orthodontist, there is another factor I can't help looking at:

the bite.

My Father Spent a Career Fixing Teeth

There is something particularly interesting about having a father who was a dentist.

His professional life was devoted to saving teeth.

When a tooth developed a problem, he fixed it.

A cavity? Restore it.

A fractured tooth? Repair it or place a crown.

A damaged or infected nerve? Perform a root canal.

A tooth that could no longer be saved? Extract it and replace it.

That is what dentists are trained to do, and those treatments save millions of teeth.

But orthodontists are trained to look at the mouth through a slightly different lens.

Instead of looking only at the tooth that failed, we also step back and ask:

Why did this particular tooth fail?

How are all the teeth fitting together?

Where do they contact when the patient bites?

Where are the forces going every time that person chews?

Are a few teeth doing much more work than the others?

And if we beautifully restore one damaged tooth but don't address an unfavorable force pattern, what happens to that restoration—or to the next tooth—over the next 10 or 20 years?

Then I Looked at My Dad's Deep Bite

My father had a very deep bite.

His front teeth overlapped significantly, creating a bite in which forces were not distributed as ideally as I would want them to be.

Suddenly, I wasn't looking at his dental history as a collection of unrelated teeth.

I was looking at the entire system.

That doesn't mean his bite caused every dental problem he experienced. Teeth can fail for many reasons.

But it made me wonder whether we sometimes spend too much time repairing the consequences and not enough time asking about the forces that may be contributing to them.

A crown can repair a fractured tooth.

A root canal can save a compromised tooth.

An implant can replace a missing tooth.

But none of those treatments, by itself, changes the way the remaining teeth come together.

Sometimes we need to fix the tooth. Sometimes we also need to ask why that tooth was under so much stress in the first place.

The Wisdom Tooth He Never Removed

There was another irony in my father's story.

As a dentist, he removed wisdom teeth from countless patients.

But he chose to keep his own.

For decades, that decision seemed perfectly fine. Nothing happened.

Then, when he was about 85, one of those wisdom teeth changed position and damaged the root of the second molar in front of it. Ultimately, he lost that molar.

I found that fascinating—and frustrating—because it challenged another assumption many of us have about our teeth:

If nothing has changed for decades, we assume nothing will.

But our mouths are not frozen in time.

Teeth can shift. Bone and periodontal support can change. Old restorations age. Our chewing patterns and dental needs evolve. Something that was stable at 50 or 60 may not necessarily remain unchanged at 80 or 90.

We readily accept this concept elsewhere in medicine. Women, for example, are taught to expect significant biological changes around menopause and to pay attention to things such as bone health as they age.

But we don't always think about our mouths in the same way.

My father's experience reminded me that dental health deserves a lifetime perspective too.

Reaching a certain age without a problem doesn't mean we should stop looking.

Sometimes it means we need to start looking differently.

My Mother Taught Me the Opposite Lesson: The Open Bite

My mother had almost the opposite bite problem.

She had an open bite.

Instead of excessive overlap in the front, only a limited number of her back teeth made significant contact.

Think about what that means mechanically.

Every time she bit down and every time she chewed, a relatively small number of teeth had to absorb much of the load.

Over time, I watched those teeth wear. Some became painful, and the supporting structures around certain teeth became increasingly compromised.

That scared me.

Because replacing a tooth doesn't necessarily eliminate the forces that may have contributed to the problem.

Even an implant still has to function within the patient's bite.

So I treated my mother's open bite.

For me, it wasn't primarily about making her teeth look straighter.

I wanted more teeth sharing the work.

Straight Teeth and a Healthy Bite Are Not the Same Thing

This is something I wish more patients understood about orthodontics.

We tend to think of orthodontic treatment as cosmetic:

My teeth are crooked. I want them straight.

And aesthetics absolutely matter. A beautiful smile can have a tremendous effect on confidence.

But straight teeth are only part of what orthodontists think about.

We're also looking at how the upper and lower teeth fit together, how the jaws relate, where forces are concentrated, whether teeth are wearing, and how the bite is likely to function over time.

A smile can look beautiful from the front and still have an unfavorable bite.

And conversely, some of the most important things we accomplish during orthodontic treatment may be things nobody else ever notices.

At 50, I Think About My Own Teeth Differently

This has made me think about my own dental health too.

At this stage of my life, I generally go to my dentist for routine examinations and cleanings rather than repeated restorative treatment.

Of course, I can't know exactly what my teeth will look like when I'm 90.

But watching my parents has made my goal very clear:

I want to keep my natural teeth for as long as I possibly can.

And that is increasingly how I think about my patients.

When an adult comes into my office and points to one crooked tooth, of course I look at that tooth.

But then I step back.

Where does the bite hit?

Which teeth are carrying the load?

Where is there wear?

Are there fractures or recession?

How do the jaws relate?

What dental work has already been done?

And most importantly:

What do I want this patient's mouth to look like 10, 20, or 30 years from now?

Orthodontics Is About More Than the Smile We Finish With

Watching my parents age has changed the way I think about my profession.

My father spent his career saving individual teeth.

I spend mine thinking about how all of those teeth work together.

Neither perspective replaces the other.

We need both.

Restorative dentistry repairs and preserves teeth when problems arise. Orthodontics can help address how the teeth fit together and how forces are distributed across the bite.

That is why, after more than 20 years as an orthodontist, I am less interested in simply making teeth straight.

I want the smile to be beautiful.

I want the bite to function.

I want the result to be stable.

And I want to think beyond the day we remove the braces or deliver the final aligner.

Because the best orthodontic result isn't just a smile that looks good when treatment ends.

It's a smile—and a bite—designed with the decades ahead in mind.

Frequently Asked Questions

Does your bite really change as you get older?

It can. Teeth can shift throughout life, and changes in periodontal support, bone, tooth wear, restorations, tooth loss, and other factors can alter how the teeth fit together. That's one reason dental and orthodontic evaluation remains important as we age.

What is a deep bite, and why does it matter?

A deep bite occurs when the upper front teeth excessively overlap the lower front teeth. Depending on the individual, a significant deep bite can be associated with tooth wear, soft-tissue trauma, functional problems, or unfavorable tooth contacts. An orthodontist can determine whether a deep bite is simply an anatomical variation or something that would benefit from treatment.

What is an open bite?

An open bite occurs when some of the upper and lower teeth don't contact when the mouth is closed. In some patients, this means a smaller number of teeth are sharing the chewing forces. Treatment depends on the cause, severity, skeletal pattern, age, and other individual factors.

Can adult orthodontic treatment prevent future tooth loss?

No treatment can guarantee that a person will keep every tooth for life. Tooth loss can result from decay, periodontal disease, fractures, trauma, medical factors, and many other causes. But when an unfavorable bite is contributing to excessive or poorly distributed forces, orthodontic treatment may help create a more functional and balanced bite as part of a broader long-term dental plan.

Should I remove my wisdom teeth if they haven't caused problems?

Not automatically. Some wisdom teeth can remain healthy and functional for life, while others may create problems with the neighboring teeth or surrounding tissues. The important lesson from my father's experience is not that everyone should have their wisdom teeth removed—it is that retained wisdom teeth should continue to be evaluated rather than assuming that decades without symptoms guarantee they will never cause a problem.