By: Dr. Elizabeth Eggert
How did this start?
Back-to-school season is all about fresh starts, new classes, new routines, and adventures. For Justin this year, it also means a new reason to smile!
Meet Justin, one of Dr. Jeff Eggert’s young patients. In fact, he was only in middle school when he and Dr. Jeff met. Justin came into the practice as his family transitioned to our office. He was already undergoing orthodontic treatment with Dr. Brian DeVoe at the time. At Justin’s new patient exam, Dr. Jeff noticed a large defect on one of Justin’s teeth so he took an x-ray to investigate.
Unfortunately, Justin’s tooth was dissolving from the inside, a process called internal root resorption. With root resorption, the body’s own cells begin breaking down the inside of a tooth’s root. Dr. Jeff sent Justin to Dr. Jeff Ryan of Endodontics Associates Limited, an endodontist that Dr. Jeff and Dr. Elizabeth work with closely and who is conveniently located in our same building. Dr. Jeff Eggert, Dr. Jeff Ryan, and Dr. Brian DeVoe worked together to develop a plan designed to preserve the tooth and its root for as long as possible while also preserving the surrounding bone for a future implant if one eventually became necessary. In Justin’s case, the goal was not simply to address the immediate problem. Dr. Jeff and the specialists needed to think about Justin’s his long-term dental health and what would be best for him as he continued to grow.

What was recommended?
For a young patient like Justin, who was only 13 at the time, planning for the future is especially important. An implant isn’t a good option when a patient is still growing because the facial bones will continue to change so much, it will make the implant, which is locked into place after placement, look out of place in the adult face. Therefore, implant placement is contraindicated for males until they are well into their 20’s.
It was decided to complete a root canal and buildup the missing tooth structure with a post and composite filling material, finish the orthodontic treatment to perfect the bite for Justin’s other teeth, and slowly move Justin’s “sick” tooth out of the bone, a process called orthodontic extrusion.
Orthodontic extrusion would help preserve the bone and it was able to expose more root structure so Dr. Jeff could better seal up the buildup material to the root because he was hoping to help Justin keep this tooth until he was much older.
What did he want?
As a young child, Justin’s biggest concern was to be pain free and to have a tooth for his smile. He wanted to maintain a natural-looking smile to help him feel confident as he continued growing. Luckily, Justin’s tooth lasted this way for over 4 years. But, then one day he was eating a granola bar and noticed something just didn’t feel right. He had loosened the composite buildup material and post of his weak tooth. He also noticed that it was a little painful and his gums were always so irritated around that tooth. When Dr. Jeff took another x-ray, he saw signs of infection and knew this tooth wasn’t going to be able to last any longer for Justin.

What was involved then?
After working to preserve the tooth for several years, everyone needed to accept a new plan because Justin was only 17 years old when his tooth finally had to be extracted. It is never healthy to leave an infected tooth in the mouth. Unfortunately, Justin wasn’t old enough to have an implant placed. It was important to Justin that he still be able to smile with all teeth present as well as have something that would stay in his mouth. He didn’t like the idea of a retainer that could hold a tooth in place when in the mouth, but that would show a missing tooth when it was out of the mouth.
In trying to be as conservative as possible, Dr. Jeff, Justin, and his parents all agreed to design a bonded pontic (or “fake tooth”) that would bond on to another of Justin’s teeth, holding a replacement tooth where there now was one missing. Therefore, Justin could continue to have a natural-looking appearance, finish his growing, and move into adulthood.

After Justin had his tooth extracted, he did wear a retainer for about 8 weeks that also had a fake tooth. This was necessary to allow his gums and tooth extraction site to heal. The tissue healed up really well after his “sick” tooth was out his mouth. Once he was healed up, Dr. Jeff scanned his teeth and a dental lab designed his fake porcelain pontic tooth. Dr. Jeff bonded the tooth in place which made it easier for Justin to smile again!
What does he think?
When we asked Justin what he would tell someone considering a similar procedure, Justin didn’t hesitate: “Definitely do it. It fixes your smile and it’s worth it.” Justin’s journey is a wonderful example of how a team approach, careful planning, and patience can help young patients navigate complicated dental situations while keeping their LIFELONG smile in mind. There’s something special about starting a new school year feeling good about your smile. Everyone wants to feel confident, especially teenagers! Justin is heading back to school this year with a different “tooth” than the one he’s had for much of his life – and he couldn’t be happier about it! We’re proud to have been part of Justin’s journey and excited to see him start this school year with a confident new smile. Here’s to a great school year, Justin! Keep smiling! We truly hope that Justin and all of our young patients enjoy the 2026 back-to-school season!



















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Dental veneers