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Volume 33 , Issue 5
September/October 2018

Page 953

Editorial: Edentulism Redefined

Steven E. Eckert, DDS, MS

DOI: 10.11607/jomi.2018.5.e

It may be hard to believe, but I recently found myself in a debate with a colleague over the definition, and intended meaning, of edentulism. It wasn’t that the term itself was vague or ill-defined; instead, it was surprising that it was a topic that would engender discussion. Of course, this was an oversight on my part, for the defi nition is relatively precise.

For me, as with most professional terminology, I go to published sources of defined terms. Realizing that this is the recommendation that I make to someone who asks about a definition, it seems appropriate that terms should not be left to personal interpretation. Instead, an accepted dictionary should be used, or, in the case of scientific languag , an accepted glossary.

The term “edentulous” has existed for quite a while. In fact, it can be traced back to the 18th century, according to the Glossary of Prosthodontic Terms.1 That term is defined as “without teeth, lacking teeth.” When we look at the related term “edentulism,” we find that the definition is “the state of being edentulous; without natural teeth”.1

If we link the two together, using one term that is derived from the other, we could probably say that the state of edentulism would present as being without teeth, or lacking teeth, with the further caveat that it is the natural teeth that are missing. Thinking about these words, it would appear that once edentulism occurs, it could not, by definition, be reversed unless natural teeth could be implanted or regenerated. Although both options are on the horizon, neither appears to be poised to arrive soon.

Since you are reading a dental implant journal, one may make the assumption that you have an interest in such devices. That interest could be existential, purely related to a need to understand things. Dental implants exist, and since they do, it might be nice to understand them. This might be analogous to wanting to understand how an internal combustion engine works. If we drive a car, it might be nice to know how and why the engine works rather than getting in, putting on the seat belt, turning the key, and going blissfully forward without a concern for either the how or the why.

We understand that some people are inquisitive by nature and like to understand all that is around them, but, my assumption is, the majority of people who are reading this journal have an interest specifically in dental implants, and that interest takes you into the deeper understanding of the topic.

How “natural” does the description of teeth have to be to qualify as not exhibiting edentulism? Is it only natural if we look at an arch of teeth with nothing but intact roots and crowns? Not to be too rhetorical, but having natural teeth alone would be unlikely to be considered as equivalent to being dentate since teeth are just one part of the stomatognathic system. After all, one could have all of the natural teeth in a box, but without bone, muscles, connective tissue, and the like, that patient would surely still be edentulous.

Perhaps our definition of edentulism should be reconsidered. Would we consider missing natural and/or permanently restored and replaced teeth as part of an alternative definition, being termed as dentate? I think that the patients that we see for dental implant treatment consider their opportunity to receive fixed definitive implant restorations as a third set of teeth, albeit not a 100% return of nature, but still effectively close to what nature had provided.

A permanently restored dentition, whether it would be roots or implants that support the definitive prosthesis, would nearly return the patient to the original level of function, comfort, and esthetics. Although the patient, using the current definition would still be termed edentulous, one would have to wonder if that description is a bit too restrictive.

As we think to the future, one might suggest that the term edentulism should be one that is undergoing obsolescence. Although the disease entity itself is one of the world’s most common, it is one for which a cure, or at least eff ective treatment, already exists. Indeed, we are closer to the solution for edentulism than we are to a cure for cancer, heart disease, diabetes, and myriad of other diseases. Given the choice, wouldn’t people choose to have all bodily systems, either by nature or by reconstruction, functioning as nature intended? This is certainly the goal that appeals to me.

Steven E. Eckert, DDS, MS



1. The Glossary of Prosthodontic Terms: Ninth Edition. J Prosthet Dent 2017;117:e1–e105.

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