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In severe cases, holes (perforations) can develop in the roof of the mouth Soft Tissue Changes Decreased blood flow causes tissue death and muscle wasting Chronic inflammation leads to changes in facial fat distribution Accelerated aging of skin and underlying tissues alters facial contours Muscle tension from repeated clenching/grinding can enlarge jaw muscles Long-term Structural Impacts Loss of teeth and bone density in the jaw from poor nutrition and reduced blood flow Changes to facial symmetry from uneven tissue damage Development of permanent hollows in cheeks and under eyes Altered bone structure from chronic inflammation and reduced blood supply Premature aging that can permanently change facial proportions and features Can Cocaine Cause Skin Problems