Fixing a Fractured Front Tooth – Tim’s story

By: Dr. Elizabeth Eggert

How did this start?

Tim broke his front tooth while playing football at the community center on the weekend. His father called our office emergency line and described what had happened. It sounded like the tooth was still in his mouth, but a large portion of it was broken off. Dr. Elizabeth asked Tim’s father to put the fragments they could find in some water and meet her at our office. She was able to meet Tim and his father within an hour to assess and address the situation.

What was involved?

Upon examination it was noted 2/3 of Tim’s natural tooth was broken off. The tooth was slightly mobile, but there was minimal bleeding. He was having minimal pain, except when the tooth touched cold water or air, and there were not any cuts in his mouth or face. Although the fracture was substantial, it luckily did not go into the nerve of the tooth.

The fractured part was in 3 pieces, but using her dental skills, Dr. Elizabeth was able to piece them back together like a jigsaw puzzle. Using filling material, she was able to bond the pieces back together, making it look almost as if the tooth had never been broken.

It was recommended that Tim take ibuprofen for the first few days to reduce any inflammation inside the tooth and the tissues surrounding it. He was also instructed to have a softer diet for a few weeks and to not use that tooth for biting into things.

As you can see from the after photos, the tooth pieces fit back together extremely well. The tooth does naturally stick out slightly, which could have contributed to it fracturing when it was hit. Tim has been following up with an orthodontist to develop a plan to move the teeth into a more ideal position and therefore keep them safer from potential future trauma.

After a trauma like this, it is important to follow the tooth over time. Depending on the injury it is typical to reevaluate the tooth over a period of weeks and months to make sure that complications aren’t developing. Even though the tooth nerve didn’t seem to be irreversibly damaged after the accident, it can sometimes deteriorate over time and eventually need a root canal.

It has been over 2 years since Tim’s accident and his tooth is still doing well. Because of how large the fracture was, the repair won’t last forever, and the tooth will likely need to be repaired again, probably multiple times, during Tim’s life with more filling material or even a crown or an implant. However, the longer the initial repair lasts, the better it will be for the tooth long term.

Tim and his dad were very appreciative of how quickly he was able to get in right when this trauma occurred and get it repaired. Great job by them remaining calm and gathering all the pieces, and great job by Dr. Elizabeth putting them back together again.

Identical Twin Expansion: Zack and Ryan’s Story

By: Dr. Elizabeth Eggert

When Did this Start?

Zack and Ryan are identical twins and started seeing Dr. Elizabeth for their dental care in August 2019 at age 9. During their first examination, Dr. Elizabeth noticed that their maxillary arches were narrow and that both boys exhibited some acid erosion on their teeth. Acid erosion is a classic sign of a possible airway problem. When a narrow arch is present, the airway is more constricted. Zack and Ryan both had their tonsils and adenoids out at age 5 due to snoring and recurrent strep and tonsillitis. Since having their tonsils out, their snoring decreased and they both were sleeping better but Dr. Elizabeth knew she could help make things better for their airway and their bite by referring both boys to an orthodontist for a consult for dental expansion. It is important to note that the ideal time for expansion is before the bone and cartilage at the roof of the mouth solidifies and hardens. This usually happens around puberty.

Zack Before
Ryan Before

What Was Involved?

Zack and Ryan went to Dr. Wahl’s orthodontic office in New Brighton (Village Orthodontics) for an orthodontic consultation in June, 2020. Dr. Wahl agreed with Dr. Elizabeth’s assessment and proposed palatal expander treatment. An expander is a metal device that is placed on the roof of the mouth and connects to the upper back teeth. In the middle of the expander there is a hole that allows for a metal key to be placed. Zack and Ryan would have their mom turn the key once a day in the beginning of their expansion. Dr. Wahl checked their expansion progression on a monthly basis and decided how often their expander needed to be turned. Zack and Ryan’s expansion process lasted from June to December, 2020.

In the beginning of their treatment, both boys complained of soreness while the expansion was in progress. Children’s Tylenol was successful in easing their discomfort. After the turning process was over, the boys still had the expander on the roof of their mouth, but no longer needed to have the key turned. They were in a holding pattern for a few months. They could tell that the shape of their arches had changed from a narrow square-shaped arch to a widened U-shaped arch. Zack and Ryan had their expanders removed December, 2020 and had retainers made to hold the space that was created. They will still need braces in a couple of years for Phase 2 of their orthodontic treatment when all of their permanent teeth are erupted.

Zack After Expansion
Ryan After Expansion

What Do Zack and Ryan Think?

Dental expansion for Zack and Ryan was successful! Dr. Wahl was able to widen their upper arches in a short period of time. At their periodic exam with Dr. Elizabeth, she checked the width of their maxillary arch with a cotton roll. With successful expansion, the upper arch should be able to fit the length of the cotton roll. They both passed the test. Zack and Ryan’s mom stated that they wake up more well rested than before expansion – a clear sign that they must be sleeping better due to increased airway space. Both boys agree that the expansion treatment was worth the small amount of discomfort they experienced. Expansion not only improved their airway but also set them up for successful phase 2 orthodontic treatment. Zack and Ryan are both excited for braces to begin soon!

Zack during retention phase, note there is room
for his permanent teeth to erupt!
Ryan during retention phase, note there is room
for his permanent teeth to erupt!

How Even Limited Treatment Can Have a Big Impact – Gloria’s Story

By: Dr. Elizabeth Eggert

How did this start?

Gloria has been a patient of Dr. Elizabeth Eggert for over 15 years. She loves to smile and is the kind of person with a spectacular “twinkle in her eye!” Recently, at one of her recare visits, she wanted to talk about her overlapping teeth. She noticed that a large filling she had on one of her front teeth was loose. She wondered if it had come loose because it was at such an angle? She and Dr. Elizabeth talked about how the angulation of her right front tooth and the crowding of her lower front teeth, caused all her anterior teeth to work against each other in an unharmonious manner when she eats and talks. The existing filling was very large and was at the limit of how composite filling material can work when subjected to such heavy forces.

She and Dr. Elizabeth talked about moving to a stronger restorative material, like porcelain, and how if she was willing to work on changing both of her front teeth, the angulation could be improved to create the illusion of straighter teeth.

What was involved?

Gloria was interested in sticking to only working on the two front teeth. She understood that she had other options like orthodontics to move her teeth, but she figured doing only two full coverage porcelain crowns could help improve her smile enough for her satisfaction and could be done much more quickly than undergoing orthodontic treatment.

Gloria’s two front teeth were prepared for full coverage crowns. Dr. Elizabeth worked through a mock-up with her before hand to discuss her midline (center line between the two teeth), tooth size, shape, and symmetry. Gloria was so happy with the temporary crowns based on her mock-up, she commented “if the temporaries feel and look this great, I am so excited to see how the final crowns will be.”

After the two weeks it took to get her crowns back from the dental laboratory, Gloria’s crowns were tried in her mouth. Before cementing the crowns, Gloria looked in the mirror and with an enormous smile, exclaimed, “I like these a lot. The color is perfect and they look really good on me.”

What does Gloria think?

In her final interview, Gloria was asked how she had made the decision to crown her two front teeth? She responded, “My front tooth, the right one, had a huge filling that was too big to stay put. Dr. Elizabeth helped me understand better options for that tooth. After thinking it over, I knew that my other front tooth, the left one, would eventually need a crown too, so having them done at the same time AND being able to change how crowded they looked really appealed to me. It really sounded like a great idea. I was also excited that the color could be evened out with my other teeth. I always thought that right front tooth looked too dark.”

Overall, Gloria is really happy about the outcome of her treatment and would recommend to others considering this procedure to “just do it.” “It was such a successful treatment for me, and I would love for others to experience such great results.”

One thing Gloria would like to pass along about getting crowns done with Eggert Family Dentistry is “Don’t worry about it, trust the process and Dr. Eggert because the results are wonderful.”

Gloria’s story is just one of many others who have also experienced magnificent results with Dr. Eggert. Crowns can yield beautiful and predictable results for accomplishing an improved smile. At Eggert Family Dentistry, we love providing Dentistry for a Lifetime of Smiles – thanks Gloria for trusting us to help you continue to smile big and confidently!

After

Fixing a Chipped Front Tooth – LK’s story

By: Dr. Elizabeth Eggert

How did this start?

Patient LK (this patient asked that we only use her initials) started her anterior restoration treatment with us after she chipped a filling out of one of her front teeth. LK had previously chipped this same filling, mostly because of how her bite comes together, and she was looking for a more permanent option. She also did not like the black triangles that were visible between her teeth when she smiled.

What was involved?

Upon examination it was noted that LK’s teeth had worn significantly at the edges which made her teeth look shorter. It was recommended that she undergo the records process to determine ideal treatment and what potential alternatives she had.

Through the records process with Dr. Elizabeth Eggert, LK’s treatment plan was developed. The records process involves an evaluation of muscles, jaw function, teeth, and their relationships with each other. Photos are taken of the mouth to help in visualizing how everything fits together and moves. Impressions are also made in order to create a 3D modeling of the patient’s teeth.

Through the analysis of the records process, it was recommended that LK consider doing orthodontic treatment in order to move teeth into a more functional position and prevent further breakdown of her teeth and potential restorations. It was also recommended that LK veneer her eight front teeth. Four on the upper arch and four on the lower arch. The analysis showed that the reason LK’s filling kept coming out was because her teeth are hitting too heavy against each other. The orthodontic tooth movement and 8 veneers would be able to create better functional harmony as well as redesign the teeth to correct the wear that had occurred.

What did LK want?

During the consult appointment, LK noted that she was not interested in orthodontic treatment and she planned to veneer only her two front anterior teeth. LK was willing to take the risk that her new restorations may not last long-term due the disharmony in her currently functioning system. Since LK would not be doing orthodontics, Dr. Elizabeth Eggert let her know that using a splint to protect her new veneers would be critical in order to improve our chances for success.

LK was concerned that it would be hard to get a good color match but when she saw our assortment of colors she was less concerned. LK thought about bleaching her teeth, but was worried they would be sensitive. She had tried over-the-counter products in the past, but had sensitivity issues. After reviewing her bleaching options, LK decided she would match her new veneers to her current color so she would not have to maintain the color long-term. Dr. Elizabeth was able to improve the esthetics of LK’s front teeth by restoring them to their original size and appearance. LK was very pleased with the result and stated, “It was like Christmas!” Thanks for putting your trust in us LK, it is always a pleasure working with you!

A Full Mouth Reconstruction – Mike’s Story

By: Dr. Elizabeth Eggert

How Did this Start?

Mike had been a long-term patient of Dr. Furey when Dr. Elizabeth took over his care in 2016. Up to that point, Mike had talked with Dr. Furey about the need to restore his mouth due to the severe erosion that was occurring throughout. Starting in 2016, his canines were starting to decay in addition to the erosion weakening the tooth structure. Mike was also starting to have pain on a lower left tooth due to an infection in his tooth. Mike’s case had a lot involved because we were not only dealing with erosion, but his bite and jaw anatomy have likely been contributing to the erosion on his teeth. This meant that the most predictable way to restore him back to health would involve jaw surgery and restoring all his teeth.

Mike had long been functioning with a deep bite meaning that his tongue and airway were working with space restrictions. It is thought that oftentimes deep bites will increase acid production in the mouth and be a source for erosion. Mike had previously been diagnosed with sleep apnea and had been using a CPAP machine for many years. Sleep apnea is often caused, at least in part, by a restricted airway.

What Did Mike Want?

Mike stated his goals for his teeth were “that they work and I don’t lose them.” He was noticing jagged edges and that his upper canines were especially worn. He thought the wear was due to the fact that he caught himself grinding his teeth during the day and night. He didn’t realize that the erosion may be part of a larger whole health issue. Mike had many options to consider and while he understood that jaw surgery may be the best way to improve his overall airway, in the end he decided against surgery. This meant that Mike needed to open up his deep bite and complete restorations on all of his teeth.

What Was Involved?

In order to open up Mike’s bite, a laboratory wax-up was completed. This helped create a “blueprint” of how the teeth would look with the new restorations. After Mike approved the wax-up, he started by getting his infected tooth extracted. This allowed some time for healing before an implant was placed in that same area. Mike’s progress was slowed up somewhat due to complications he had with his heart and having to undergo surgery, as well as the COVID shut-down, however, after 4 years, Mike was finally on his way to protecting his teeth with new restorations.

All of his teeth were worked on and prepared for crowns or veneers. Mike underwent preparations of the upper teeth one day and of the lower teeth another day. He spent time in temporary crowns and had to start getting used to his new bite. At first, he said “it feels kind of like a mouth full of marbles.” But, then as his muscle adjusted, he thought his bite felt good.

What Does Mike Think?

Before he started his treatment Mike stated he was “apprehensive about it.” The work in general made him apprehensive. It was a big decision, but he understood that his teeth were at severe risk if nothing was done. He did not want to “lose all those teeth.” Mike reports now he is “very happy with the results and I like them a lot!” He likes having the smooth surfaces of his new crowns rather than the rough, sharp edges from the erosive wear pattern on his natural teeth. He admits that he wishes he would have done the work sooner and that it hadn’t taken him so long to make a decision. If talking to someone considering getting this type of treatment done, he would tell them to “do it sooner than later. Be patient and follow the recommendations given by Dr. Elizabeth.”

Mike’s final results are an improvement in that he doesn’t have such a deep and restricted bite and the enamel that was eroded away has been replaced by strong porcelain. Unfortunately, without undergoing jaw surgery, Mike’s teeth will still be at risk due to jaw movements Mike makes to keep his airway more patent. Mike will still have to maintain his treatments for sleep apnea and he will likely still have dental work to do in the future should his teeth break down the road. Mike’s case is a good example of why we like to take time with kids and teenagers, making sure they are developing adequate room in the mouth for a good airway and skeletal structures, trying to prevent compromise before it occurs!

Journey to a Confident Smile – Lia’s Story Continued

By: Dr. Elizabeth Eggert

Lia’s story started with us a few years ago when she replaced a congenitally missing tooth.  She knew that was just the beginning of her journey and she had years of multiple treatments ahead.

Lia before

We are happy to show you the final results as we take you through Lia’s story once again!

Lia After

Lia was a beautiful 16 year old when her journey started.  Dr. Elizabeth bonded composite where tooth #7 was missing.  Lia decided to replace the missing tooth with composite until her skeletal growth was complete and was ready for a more permanent solution.  Lia recently had an implant placed at the site where her composite bonding was. Knowing the implant was a more permanent solution, and Lia now entering her college years, she took this opportunity to brighten her smile like she always wanted to do.

Lia After

In Lia’s case, we chose to create her beautiful smile by adding 3 veneers to match her new implant crown.  Lia always wanted a big, confident smile.  She now has a smile she loves to show off!

 

Orofacial Myofunctional Disorder – Lizzie’s Story

By: Dr. Elizabeth Eggert

How did this start?

Lizzie’s parents are longtime patients of Dr. Elizabeth and brought Lizzie in for her first visit when she was a year old. As Lizzie grew older, Dr. Elizabeth began to notice signs of what she suspected to be Orofacial Myofunctional Disorder. Orofacial Myofunctional Disorder (OMD) is a disorder characterized by improper tongue, jaw, and lip positioning during swallowing, feeding, and speaking.
Patients with OMD often have signs like malocclusion, mouth-breathing, tongue thrust, and airway obstruction. They may also have symptoms like headaches, malaise, fatigue, anxiety/depression, and pain. Dr. Elizabeth noticed that Lizzie was developing an open bite and had a non-tongue based swallowing pattern (she often uses her lips and teeth for swallowing). Dr. Elizabeth talked with the parents about helping to remind Lizzie to put her tongue up to the roof of her mouth to swallow and to keep her lip and teeth away from each other when swallowing. As Lizzie got older, it was still difficult for her to swallow with her tongue up. Dr. Elizabeth recommended that she start Myobrace® treatment and myofunctional therapy to address her symptoms.

patient highlight

Figure 1: Lizzie’s open bite: her tongue sits forward. She is developing a narrow upper arch.

What was involved?

Lizzie’s Myobrace® treatment will involve moving through a series of oral appliances that each function to address different aspects of OMDs, including habit correction, arch development, and dental alignment. Before starting her Myobrace® treatment, Lizzie came in for a short appointment with Dr. Elizabeth to take initial photos and learn how to wear her appliance. Dr. Elizabeth talked with Lizzie about the importance of wearing her appliance every night while she sleeps and for at least two hours each day. In addition to wearing the Myobrace® appliance, Lizzie has undergone myofunctional therapy with us to further correct some of the habits contributing to her OMD. During these sessions, which we offer both in-office and via Zoom, our hygienist Lea showed Lizzie different exercises to help her retrain her orofacial muscles so she can achieve a normal resting position for her tongue, lips, and jaw.

What have Lizzie’s results been?

Lizzie is still in the early stages of her treatment. She has been striving to keep her Myobrace® in at night and has been working through myofunctional exercises. She feels that her nose breathing is improving and is confident she will continue to put forth the effort for her treatment. Oftentimes, Myobrace® therapy takes many months or even years. The theory is that the slow training and continuous practice of positioning the muscles allows the facial structures to develop naturally and stay that way. We are excited to see where Lizzie will go through this journey with us.

See what our patients have to say!

Perry Nelson

“You care about your patients (listen,responsive, full of grace) From doctor to front desk.”

Chris Kline

“Very courteous and professional staff.”

Sharon Burtness

“I came in as an emergency appointment because my original dentist was out of town. All in the office were very welcoming. They did what was needed at that and I was so happy they were able to help me fix my front teeth.”

Tom Relling

“Thorough cleaning by Joanna and exam by Dr. Eggert.”

Anonymous

“Eggert Family Dentistry is friendly, professional and efficient. I doubt that any dental practice could make a visit to the dentist any more pleasant than Eggert does.”

Corinne Graham

“Thanks for explaining your Covid process clearly. And the dental procedures as well. I appreciate your educational approach so I can be confident in decisions around my oral health.”

Peggy Dissmeyer

“Receptionist has awesome personality – emails are great. Cassie did an excellent job with cleaning my teeth! Doctor Jeff is always great too.”

Shanaijah Selby

“Lea was gentle, I was able to take a nap.”

Les Raney

“I highly recommend Eggert Family Dentistry. The most pleasant dental experience. Shelly is a wonderful hygienist. Friendly, knowledgeable and professional. Dr Elizabeth is a wonderful Dentist. She is gentle, friendly, and amazing, using the latest technology for tooth restoration and other treatments.”

Adam Pickens

“Very friendly and great service when going to Eggert Family Dentistry. The team is always professional and has taken the need precautions during the pandemic to ensure everyone’s safety.”

Teri Waldvogel

“I’ve been a patient for 20 yrs. I have never had a bad experience with my treatments, procedures. The staff is great, very friendly. I’ve untrusted Dr. E with a lot of work, and she does not disappoint.”

James Knutson

“Everything was great. The Covid-19 prodigal in place were exceptional. Felt safe. Teeth cleaning was fast and thorough.”

Read more patient reviews here.

Alicia Adducci-Hassan

“Always so helpful and very nice.”

Michelle Prytz

“I am a new client to Eggert Dentistry and the service I’ve received so far has exceeded my expectations in every way. I have never had a Dentist take so much time and care with me; I highly, highly recommend them!”

Robert Hudson

“Great experience, and took the time to explain everything.”

Marcella Manivel

“I was worried about going to my appointment because of the global pandemic, but even before I got to the appointment, it was clear that they are taking precautions very seriously. My hygienist took my temperature before I entered the building, everyone uses hand sanitizer and wears masks where possible, and I still felt the high quality, personal care that I have always received at Eggert Family Dentistry.”

Tom Jennings

“All very good! Very efficient. Very personable. Enjoy going to the dentist – imagine that.”

John Eggert

“They take great care of their patients.”

James Miller

“Welcoming, staff.. efficient operation under present circumstances… very professional treatment of client… very helpful advice offered patient….”

Susan Schoon

“I so appreciate Eggert Dentistry. During this season of COVID they did a tremendous job being thorough with cleanliness and distancing when needed. My Dental Hygienist was kind, patient and great with knowledge, ‘touch in my mouth and with my teeth’ and extremely thorough. Dr Elizabeth always takes a generous amount of time with my exam, questions that I might I have from information given and on what to expect down the road. I am blessed with their services.”

Dennis Nelson

“I have been going here for awhile (10 yrs?) & have always felt comfortable and relaxed. Everyone has been super nice and friendly. They listen when I ask questions & treat me like family not just another patient.

I felt very safe during my visit. Weird thing for me is, I tend to relax at most of my visits. You have a warm, friendly & calming atmosphere. I am glad I made you my dentist.”

Delaney Finn

“All the staff is very kind and knowledgeable! They take their time during every visit. They are dedicated to getting me the best care and results possible!”

Google Review

 

Invisalign® – Kyle’s Story

By: Dr. Elizabeth Eggert

Where did Kyle start?

During one of his routine recare visits, Kyle mentioned to Dr. Elizabeth that he had frequently noticed himself clenching his teeth throughout the day which was causing jaw pain and tooth sensitivity. Kyle also mentioned he was interested in doing Invisalign® to help fix some minor crowding of his front teeth. Dr. Elizabeth discussed the importance of stabilizing his bite prior to doing any orthodontic treatment to help ensure the best results through splint therapy.

What was involved?

Kyle began his treatment with splint therapy. He wore a TMJ splint approximately 20 hours a day and came in multiple times to see Dr. Elizabeth and re-evaluate his progress. After wearing his splint consistently for about three months, Kyle noticed significant improvement in his symptoms and Dr. Elizabeth determined he was ready to move forward with Invisalign®.

We sent impressions, photos, and x-rays of Kyle’s teeth to Invisalign® where they created a 3D simulation, called a Clincheck, to show how his teeth could move with Invisalign® treatment. Kyle was very happy with the simulation, which showed a significant improvement to his crowding, and decided to move forward with Invisalign®.

Kyle’s case was expected to consist of 18 aligners that he would wear for one to two weeks at a time. As part of his Invisalign® treatment, Dr. Elizabeth slenderized some of Kyle’s teeth to create more space for his teeth to better alleviate his crowding. Kyle was very consistent in wearing his aligners as instructed, but as he progressed through his treatment Dr. Elizabeth noticed that some of his upper teeth weren’t moving as quickly as his Clincheck had projected. Dr. Elizabeth discussed this with Kyle and he opted to send his case back in for a refinement, which ended up extending his treatment by an additional 22 aligners. After his Invisalign® treatment was complete, Dr. Elizabeth made minor alterations to the biting surface of some of Kyle’s teeth to remove interferences and even out his bite. This process is called equilibration and will help to prevent Kyle’s new smile from further wear.

What does Kyle think?

Kyle had very realistic expectations about his treatment beforehand and understood that correcting his bite wouldn’t be a quick process. Although his treatment ended up taking longer than initially expected, Kyle said the results were well worth it. In addition to the cosmetic improvements to his smile, Kyle noted his bite feels better as well, saying “I don’t have any pain now that my teeth are in the right spot.”

Two Amazing Implant Stories! Candy and Joan’s Stories

By: Dr. Elizabeth Eggert

This month we are excited to share two amazing implant stories. We have been waiting patiently for both of these cases to finish over the course of a few years, but it’s been worth the wait. We want to thank Candy and Joan for allowing us to share their stories!

How Did This Start?

Both Joan and Candy came to us with a history of trying to do the right thing for their dental care, but they had both experienced at least one dental trauma years before. Joan was involved in a motor cycle accident in 1968 where she lost one of her front teeth and started down a path of needing multiple dental interventions. When we started this process with her in 2015, she told us “I hate my teeth. I hate how they aren’t in the right position. I hate how yellow they are. I hate the recession around my bridge. I like to smile, but not the look of my teeth.” She described wanting nicer looking teeth that are strong and allow her to eat without a problem. She wanted the self-confidence that comes with a beautiful smile.

Candy started her journey at age 10 when, unfortunately, she underwent her first tooth trauma, breaking a front tooth. After a series of other injuries and dental treatments done to try to save her teeth, she came to us in 2013 with multiple root canal treated teeth and some teeth that had been replaced by bridges. Candy was very concerned with the recession of her gums and that kept her from smiling too broadly. She also thought that her current dental restorations were too long, she wanted to see them a different shape.

What Was Involved?

For Joan, there were many teeth we could save, but due to the accident, she had lost a lot of bone supporting the teeth holding an existing bridge and those teeth could no longer be saved. We needed to figure out a way to “grow” bone. While bone grafting has come a long way over the years, getting vertical growth of bone with grafting alone isn’t predictable. Therefore, Joan underwent orthodontic treatment. Dr. Brian DeVoe, her orthodontist, was able to change her bone levels by orthodontically moving the front teeth down, therefore, in a sense, “growing bone.” Orthodontic tooth movement also helped straighten Joan’s previously crowded teeth.

When Joan was finished with her orthodontic treatment, Dr. Karl Andreasen, her oral surgeon, bulked up the bone horizontally with a bone graft, before placing implants a few months later. During this interim time, Joan wore both a retainer filled with fake teeth and a temporary implant bridge.

Candy had some difficult decisions to make. Because of the history of trauma to many of her teeth, the teeth were getting more and more unpredictable to save. She had to decide if putting more time, energy, and money into the teeth themselves was going to give her an outcome she would be happy with. Candy originally thought she wanted to save all the teeth that were possible to save. However, after consulting with Dr. DeVoe, an orthodontist, Dr. Dylla, a periodontist, Edgar Jimenez, a dental lab technician, and Dr. Andreasen, an oral surgeon, she and Dr. Elizabeth decided that implants would be a more predictable way to provide the function and esthetics she desired and would likely be a longer-lasting solution, as one of her goals was to “not have to deal with these teeth again.”

Candy worked with Dr. Andreasen first and prepared for the All-On-4 technique in which all of her upper teeth were removed and 4 implants were placed the same day, along with a transitional fixed plastic prosthesis.

While her implants were integrating, Candy elected to undergo Invisalign for her lower teeth to help improve their stability as well. Her Invisalign treatment took 6 months and, in the end, her lower teeth were in a better position as the planning started for her final All-On-4 prosthesis.

What Do They Think Now?

Joan is so happy with her outcome. Her teeth never stop her from smiling anymore. And, as an added bonus, she used to get a headache almost daily, but after her orthodontic treatment, she rarely is affected. Joan told us she knew it would be a lot of effort to get her to her final result, but it was worth it. She told us if she was talking to someone else who was thinking of going through a similar treatment, she would tell them “Do it! Even though it is hard and it takes a lot of effort, even if it’s a pain along the way, it’s worth it, every second of it!”

Candy thought her transitional prosthesis looked ok, but she was excited about the prospect of having complete control over how her final prosthesis would look. She and Dr. Elizabeth had many conversations about what she wanted and all this was conveyed to the lab technicians working on her case. She got to choose the color, the shape, the width, the length, and the arch form of her new smile. It took a couple try-in appointments where the teeth were set in wax and could be adjusted to meet Candy’s ideal specifications, but in the end, the lab was able to provide just what she was asking for.

Candy is happy to be finished with her treatment and says “I am happy with the outcome for sure!” Candy’s treatment took longer than expected due to some minor complications with the tissue surrounding her implants and the need for tissue grafting. Her interim prosthesis held up well though. Candy knew it would be an investment in time and money, but would tell others thinking about going this route “it’s worth it and I’m glad I did it.”