Sex, age, education, and certain illnesses do not explain the association between cognition and chewing ability. Whether elderly persons chew with natural teeth or prostheses may not contribute significantly to cognitive impairment as long as they have no chewing difficulty. The results add to the evidence of the association between chewing ability and cognitive impairment in elderly persons.

summary  Natural teeth are equipped with periodontal mechanoreceptors that signal information about tooth loads. In the present review, the basic force‐encoding properties of human periodontal receptors will be presented along with a discussion about their likely functional role in the control of human mastication. Microneurographic recordings from single nerve fibres reveal that human periodontal receptors adapt slowly to maintained tooth loads. Most receptors are broadly tuned to the direction of force application, and about half respond to forces applied to more than one tooth. Populations of periodontal receptors, nevertheless, reliably encode information about both the teeth stimulated, and the direction of forces applied to the individual teeth. Information about the magnitude of tooth loads is made available in the mean firing rate response of periodontal receptors. Most receptors exhibit a markedly curved relationship between discharge rate and force amplitude, featuring the highest sensitivity to changes in tooth load at very low force levels (below 1 N for anterior teeth and 4 N for posterior teeth). Thus, periodontal receptors efficiently encode tooth load when subjects contact and gently manipulate food using the teeth. It is demonstrated that signals from periodontal receptors are used in the fine motor control of the jaw and it is clear from studies of various patient groups (e.g. patients with dental implants) that important sensory‐motor functions are lost or impaired when these receptors are removed during the extraction of teeth.

The limited scientific evidence available suggests that guided placement has at least as good implant survival as conventional protocols. However, several unexpected procedure-linked adverse events during guided implant placement indicate that the clinical demands on the surgeon were no less than those during conventional placement. A clinical advantage with flapless guided surgery is that the technique is likely to decrease pain and discomfort in the immediate postoperative period.

The feasibility of adopting the microneurography technique (Vallbo and Hagbarth 1968) as a tool to investigate the mechanoreceptive innervation of peri- and intra-oral tissues was explored. Multi-unit activity and impulses in single nerve fibers were recorded from the infraorbital nerve in healthy volunteers. The innervation territories of individual nerve fascicles were mapped. These varied considerably but most fascicle fields comprised the corner of the mouth. Twenty-four single mechanoreceptive units were recorded. Eighteen innervated the skin of the face, and six innervated the mucous membranes of the lips or cheeks. A majority of the mechanoreceptive afferent units were slowly adapting with small and well defined receptive fields. It is suggested that the various slowly adapting responses may originate from two different types of afferent units. No afferents showed response properties similar to typical Pacinian-corpuscle afferents.

Intrafascicular multiunit activity and impulses in single mechanoreceptive afferents were recorded from the human lingual nerve with permucosally inserted tungsten microelectrodes. Nylon filaments and blunt glass probes were used for mechanical stimulation of the mucosa of the dorsal surface of the tongue. The innervation territories of nine nerve fascicles were mapped during multiunit recordings. All fascicle fields included the tip of the tongue, suggesting a particularly high innervation density for this area. Thirty-three single mechanoreceptive afferents were isolated and studied. Of these afferents, 22 were characterized by very small mucosal receptive fields (range: 1-19.6 mm2; geometric mean: 2.4 mm2) and responded to extremely low mechanical forces (force threshold range: 0.03-2 mN; geometric mean: 0.15 mN). As such, it was concluded that these "superficial" units terminated near the surface of the tongue. The remaining 11 units responded to probing of large areas of the tongue (> 200 mm2) and exhibited high force thresholds (> or = 4 mN). It was concluded that these "deep" units terminated in the muscle mass of the tongue. Fourteen of the superficial units were classified as rapidly adapting and resembled the fast-adapting type I afferents described for the glabrous skin of the human hand. The rapidly adapting units responded both during the application and removal of, but not during maintenance of, the mechanical stimuli on the receptive field. Two types of slowly adapting responses were observed. One type (characteristic of only 2 units) was characterized by a pronounced sensitivity to force change during the application and removal of the mechanical stimuli and an irregular static discharge during maintenance of the stimulus on the receptive field. In contrast, the other six units exhibited a weak sensitivity to force change, a highly regular static discharge, and spontaneous activity. As such, these two types of slowly adapting units resembled the slowly adapting I and II afferents, respectively, described for the hand. All 11 deep units were slowly adapting, and 7 were, in addition, spontaneously active. The units were not equally sensitive to the application and removal of the mechanical stimuli, suggesting at least two different modes of termination in tongue muscle. The deep units reliably encoded information about tongue movements in the absence of direct contact with the receptive field. In contrast, the superficial units responded vigorously when the tongue was moved to bring the receptive field into physical contact with other intraoral structures.