Medical Matters: A column on dental matters is long overdue. So a note from Dr Peter Cowan, dean of the faculty of dentistry at the Royal College of Surgeons in Ireland, telling me about an international conference on implant dentistry in Dublin this week, has prompted this piece about dental implants.
Things have come a long way from the "gum-stripping" dentures of 30 years ago. Older readers will remember the complete sets of upper and lower false teeth that were relatively common in the days before preventive dentistry.
Extractions were routine and complete clearance of teeth not uncommon. Advertisements for fixatives were a testimony to ill-fitting and socially embarrassing false teeth.
Now patients who have lost either a single tooth or several teeth have another option. A dental implant is an artificial tooth root placed into the jaw to hold a replacement tooth or bridge. Unlike traditional bridgework it is entirely independent and does not rely on neighbouring teeth for support.
Cowan says a dental implant is essentially composed of two parts, the implant itself, which is secured in the patient's bone, and the crown, which is cemented to the implant in much the same way that a standard crown is cemented to a tooth.
"In other words," he says, "the implant is like a new root which supports the replacement crown."
The scientific basis for dental implants is the concept of osseointegration. Defined as a direct structural and functional connection between living bone and the surface of a load-carrying implant, the technique has evolved over four decades of research.
And the father of dental implants, a Swedish scientist called Dr Per-Ingvar Branemark, will be in Dublin this week to discuss the latest developments in the technique that he pioneered during the 1960s.
While carrying out research early in his career into tissue injury and repair, Prof Branemark discovered that bone could be persuaded to accept a foreign material, titanium, if it was placed under the right conditions.
He then designed the first oral implants and placed them in humans. Despite initial doubts among fellow scientists, the results of properly designed clinical trials bore out his initial findings and the concept of osseointegration was accepted by dentists worldwide.
The implantation process takes place in two or three phases, depending on the implant system being used. In the first phase a careful assessment is carried out, including a detailed history, and a thorough clinical examination, which may include a number of special tests, including X-rays.
If a patient is considered suitable for implant treatment, he or she is scheduled for surgery in order to place the implant in the mouth. The operation is usually carried out under local anaesthesia, with or without sedation, in the dentist's surgery. It is a completely painless procedure.
Occasionally it may be necessary to consider general anaesthesia for more complex cases, but the majority of implants are done in the dentist's surgery.
Following a suitable healing period, which in general takes from three to six months, a second, more minor procedure is carried out under local anaesthesia to change components in the implant and to confirm that healing has been successful.
In the third phase, the patient is seen by the restorative dentist, who constructs the final crown. There is a 90-95 per cent success rate for dental implantation, provided the patient meets the assessment criteria and is able to maintain the replacement teeth to a high standard.
What makes someone a good candidate for dental implants? Ideally you are in good general and oral health and have healthy gums free of periodontal disease. You must also have adequate bone in your jaw to support the implants' integration into your mouth.
The Branemark technique is taught worldwide; one of the training centres is in Dublin. Hundreds of thousands of patients have been treated globally, and dental implants are rapidly becoming the ideal solution in many instances.
People sick of dentures or with gaps in their teeth could do worse than ask their dentist about dental implants. You could end up smiling and chewing with renewed confidence.
You can e-mail Dr Muiris Houston at mhouston@irish-times.ie. He regrets he cannot answer individual queries