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Critical Health Issues

Dr. Kevin Neshat, an oral and maxillofacial surgeon at the Dental Implant Center of North Carolina, makes a compelling case that for many people, how they eat is every bit as important as what they eat.

“Carolyn, a woman in her mid-70’s who came to us a short time ago, is a good example of a condition that is not at all uncommon,” he says.

“She was having a serious problem eating solid foods of any kind, she had lost a great deal of weight, wasn’t sleeping well, and generally felt miserable. The root cause of her misery was rapidly deteriorating oral health.”

“When I examined this woman, I found that her lower jaw was extremely fragile. Most of her lower teeth were missing, and those that remained were infected and full of decay and had to be extracted. Her upper teeth were in place and were able to serve her reasonably well-but they had little to bite against.”

“Carolyn’s lower jaw bone had resorbed over time. Our wonderful brains constantly play out the fact that form follows function. When there are no teeth that need to be held in place, the jaw bone steadily recedes or resorbs over time, responding to a cell-level message that it is no longer needed.”

“This is a huge problem for scores of older people who have full dentures. Their jawbones continue to resorb, to become thinner and more fragile because their brains receive no signals that there is a need for jaw bone to hold teeth in place. Dentures send no such signal.”

“The consequence of resorbing bone is that a great majority of people find that their dentures become increasingly loose over time, greatly affecting their ability to eat the full range of foods they desire and need. And there are often health consequences. Sometimes their speech is less articulate. A great many of dentists, responding to their patient’s requests, tighten dentures or fashion new ones, and the cycle of resorbing jawbone continues.”

“Then there’s the problem of appearance. Beyond this limited ability to eat foods of their choice, the jawbone resorbs over time. Since the area between nose and lips becomes shorter, many patients feel they look older. Meanwhile, the chin appears closer to the tip of the nose. We’ve all seen this “collapsed” look that results for patients who are dealing with the related problems of resorbing bone and loose fitting dentures.”

“For Carolyn and many others with a similar problem, we can offer an excellent remedy-surgically placing titanium dental implants in the jaw. Titanium is broadly used for this purpose because of its biological compatibility with the human body.”

“Carolyn’s jaw was so thin-less than a centimeter thick-that in this instance we had to place small implants in her lower jaw. Nonetheless, we were able to provide sufficient support with these implants so that she now has a very stable, secure full denture on the lower jaw, anchored to these tiny implants, and she is now back on the path to eating a variety of good foods and enjoying good health.”

“So we know from long experience that titanium dental implants are terrific in serving as anchors for dentures, providing stability and functionality it’s impossible to achieve, long-term, in any other way. Implants are also the gold standard for replacing one or more teeth without affecting bordering teeth, and in supporting a bridge and thus eliminating the need for a removable partial denture.”


Implants come in different sizes to serve different purposes, Dr. Neshat points out.

“Think of these as small titanium fixtures that take the place of the natural root of the tooth,” he explains. “Gently implanted into the bone, these very tiny titanium roots bond or integrate with a patient’s bone, more securely than a natural root would. And of great importance, these implants send a signal to the brain that says, ‘Hey! We’re the root of a tooth, and we need support!’ Over many years of use, there’s good evidence that after using dental implants, resorbing of jawbone either stop entirely or is greatly diminished.”

A natural tooth consists of a root and a crown. The part of the tooth that you see and eat with is called the crown. “When you lose a tooth, you lose both the root and the crown,” Dr. Neshat points out. “The dental implant is a new root, fitted in a socket that we create in the patient’s jaw, replacing the lost root of the natural tooth.”

“Once an implant has been placed in the jaw, the bone around the implant needs to heal for some period. The next step is placing a support post called an abutment into the implant itself, and then a new crown, or replacement tooth, is placed on top. It fits right on the abutment. If the purpose is to anchor a denture, as it was with Carolyn, we proceed differently. Our goal then is to anchor the dentures to the implants, so that it just clicks into place and is very firm and stable-long tern.”

“Now, depending on the location of the tooth in the mouth, we can do the extraction and in the same procedure place the implant posts in the jaw bone and some cases we can place temporary teeth at the same time, so the patient is never left without a tooth.”

Such a significant step forward is possible, says Dr. Neshat, “because of greatly increased understanding of how the bone and the body heal around an implant, because our surgical technique is much improved, and because implant companies have made great strides in their products. Added together, this all means we are enjoying success with dental implants at the 95% level or higher, with patients well into their 80s and older.” –visit for more information.