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Dental Implants

Why they’re worth the time and expense

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— David Arky

Thanks to fluoridation of public water and dental-care improvements, Americans under 50 have excellent odds of keeping their teeth. But the picture is not so rosy for most boomers and their elders. Today an astonishing one-fourth of U.S. adults over 65 are completely toothless, according to the Centers for Disease Control and Prevention. And the National Institute of Dental and Craniofacial Research reports that 58 percent of Americans 50 and over have fewer than 21 teeth (out of the usual 32).

Lost teeth can lead to poor nutrition as people avoid vegetables, nuts, and other healthy foods in favor of softer processed fare. And the traditional treatment — dentures — is problematic: They tend to shift, rubbing tissues ragged. Even well-made dentures can withstand only one-sixth the chewing force that healthy teeth tolerate. With less stimulation, jawbones erode. My friend Sally, a retired teacher from Cleveland, told me her father lost so much bone by his 70s he could no longer get a decent fit for his dentures. "He always had a clicking sound as he talked," she recalls.

Sally long feared she would share this fate. In 1993 she lost all but six of her teeth to periodontal disease. Dentures helped her live normally, but the disadvantages bothered her. Her upper palate was covered, which reduced her ability to taste food. Her dentures also tended to slip, particularly when she raised her voice — a liability for a fourth-grade teacher.

Eventually Sally heard of an alternative: titanium dental implants. When inserted into the jaw, these metal posts bond with healthy bone, creating artificial roots for false teeth. Sally underwent a multistage process that resulted in 12 titanium implants, each capped with a porcelain tooth. "It was a long ordeal," she says, " but I am really glad I had it done. I have the straight teeth I always wanted, I can eat healthy foods again, and I don't have to worry about losing my teeth during a swim — and having to dive to the bottom to retrieve them!"

Based on several such endorsements, I make an appointment at the University of Pittsburgh's Multi ­ disciplinary Implant Center.

The stretched-out "panoramic radiograph" is pinned to the light box. To this layman, it looks like the X-ray of a gorilla's mouth. Steven J. Kukunas, D.M.D., Pitt's director of implant prosthodontics, assures me the mouth in question is owned by a much smaller primate, namely me. He and his colleagues will rely on X-rays and a plaster model of my mouth to assess my suitability for titanium screwing.

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