This kind of sunken cheeked “look” as seen in the attacker referenced in this [newspaper article](delmarvanow.com: Man in Fruitland machete attack is unconscious). What causes this? You often see this facial look in addicts, alcoholics and people on the margins. Is there something dental going on?
I think you just have a case of confirmation bias. There are so many more addicts out there than you realize, but if they don’t "look like it’, you never know.
Addicts like this exist solely to get their next fix. Taking care of oneself, like eating or brushing teeth or going to the doctor stops almost completely. Its malnourishment as a side effect of their addiction.
Looking at mugshot collections some people, men especially, in various stages go drug and alcohol decay and living at the margins often have surprisingly lush and full heads of hair.
drug abuse and malnutrition reduce testosterone levels and thus the deadly effect of testosterone on the hair follicles is prevented.
During normal aging, the fat pads under the cheeks are often lost causing facial hollowing. Any kind of stress such as severe drug abuse or getting divorced can accelerate this effect.
Well I guess that’s one reason why I think it might not so much be about teeth, because when people get clean and sober, their face starts to look better again (they lose the “sunken look”), and I don’t think it’s because they’re getting dentures or implants for lost teeth. I think it’s because their skin is recuperating, and they’re regaining lost weight.