Patient Stories Archives - Eggert Family Dentistry Blog

Rebuilding My Smile from the Ground Up – Lynn’s Story

By: Dr. Elizabeth Eggert

How did this start?

Lynn started as a patient of the practice with Dr. Jensen in 2000 and transitioned her dental care to Dr. Elizabeth in 2005, when she took over his practice. During this time, she had five teeth restored with porcelain crowns and continued to require additional restorations over the following years. In 2018, due to the ongoing restorative needs and the complexity of her case, Dr. Elizabeth recommended that Lynn undergo the “Records Process” to allow for a comprehensive evaluation and to develop a detailed treatment plan for her care. Lynn also was having many changes and challenges with her medical history, including serious balance, movement, and mobility movement changes.

Dr. Elizabeth guided Lynn through the Records Process to evaluate how her bite was currently functioning. This process included diagnostic models, clinical photographs, and radiographs of Lynn’s teeth, along with a comprehensive muscle and joint evaluation. These records allowed Dr. Elizabeth to assess and present the current condition of Lynn’s teeth, gums, jaw joints, and the function of her jaw muscles.

Based on the findings, it was recommended that Lynn begin splint therapy using an anterior deprogrammer. This step was necessary to help relax the jaw muscles and determine a stable, repeatable bite position. Part of the reason Lynn kept cracking and chipping her teeth was because she didn’t have a stable bite position. Restoring Lynn’s teeth without first establishing a consistent bite could have compromised the longevity of any work to be done. Once a stable bite position was identified through the deprogramming process, adjustments to her bite were planned with restorations to achieve the best long-term stability.

What was recommended?

As mentioned, Lynn started her splint therapy with an anterior deprogrammer, which should have helped her muscles relax into a more repeatable bite. However, one of the most important things to understand about splint therapy is that it does NOT always improve the condition (at least right away), but no matter if the condition stays the same, gets better, or gets worse, we learn something from this diagnostic process.

Lynn had a fairly difficult time adjusting to the anterior deprogrammer and found that her sleep was affected. She also had many other red flags for poor sleep quality, including the medical changes she was experiencing. Lynn elected to have a formal sleep test done and she was diagnosed with moderate sleep apnea, as well as having many arousal events each night. Lynn and Dr. Elizabeth changed Lynn’s splint therapy to the sleep-based Seattle Protocol and they learned that Lynn’s sleep, pain, and bite improved when her lower jaw was in a forward position. This helped Lynn and Dr. Elizabeth learn that Lynn’s teeth and tongue craved more room to function better. Lynn elected to undergo Invisalign treatment with Dr. Elizabeth. The goals for her treatment were to expand the room in her oral cavity and then restore her teeth to match this improved location for her bite.

Invisalign is a clear aligner orthodontic system and is used to gradually move teeth into their ideal positions. Invisalign uses a series of custom-made, removable aligners that apply gentle, controlled forces to shift the teeth over time. In Lynn’s case, Invisalign was used to properly align her teeth and create the correct spacing and positioning needed before completing her final restorative work. Establishing proper tooth alignment helped ensure a more stable bite and allowed for more predictable, long-lasting restorative results.

What did she want?

Lynn wanted her teeth to look better, but she also wanted things to feel better. She wanted improved sleep, she wanted her teeth to last. She didn’t want to have to always be thinking about them – whether they would break or crack on her. Lynn expressed that she did not want “glowing white” teeth, but she did want her smile to appear noticeably whiter and more natural. Her goal was to achieve teeth that looked healthy, felt both functional, and beautiful. She wanted her new teeth done as quickly as possible, but she understood the benefits of the orthodontic treatment, which did take more time to undergo.

What was involved?

In just over a year, Lynn completed her Invisalign treatment. She was even able to continue her care during her winters in sunny Florida! Invisalign was very successful in expanding for more room for Lynn, but we knew that without restorations throughout her mouth, it would still be difficult to manage her bite long-term. Invisalign helped with improving her muscle stability, but her bite still was not always able to find a repeatable position due to the shapes of her original teeth.

A laboratory wax-up was done to create a blueprint of Lynn’s future restorations. Then, over the course of two days, nearly all her teeth were carefully prepared in preparation for the placement of porcelain crowns and veneers. These restorations would improve Lynn’s bite, function, and overall smile.

What does Lynn think?

Lynn told us that before undergoing this process with Dr. Elizabeth she was unsure what she even wanted or could ask for. “It was all unknowns.” Lynn was excited to have everything done though, especially because of the prospect of how it could improve her breathing and her health and because her husband had undergone some cosmetic tooth work himself.

After all that was involved, Lynn told us that she is very pleased with everything, even though she ran into medical complications and COVID along the way, in the end she notes, “It was effortless. It was surprisingly easy.”

She told us that if she was talking to someone thinking about undergoing a full mouth dental reconstruction, she would tell them “It’s worth it! It’s a long process, but it’s worth it and you’ll feel so much better in the end!”

Congratulations, Lynn! Thank you for putting your trust in us. At Eggert Family Dentistry, we truly believe in helping our patients achieve a lifetime of smiles and yours is a shining example. We were delighted to guide you through this journey and look forward to caring for you and your family for many years to come.

My Healthy Smile with Myobrace – Nathaniel’s Story

By: Dr. Elizabeth Eggert

How did this start?

February is National Children’s Dental Health Month! This month, we’re proud to highlight our Patient of the Month – Nathaniel! Nathaniel is now 8 years old and has been part of our dental family for several years. During his initial visit, at age 5, mom wanted to know if anything could be done about the crowding Nathaniel had with his lower permanent teeth, which were starting to erupt. Dr. Jeff Eggert thought it would be a good idea to see what Nathaniel looked like at his next 6-month check-up appointment to see how he would grow. Unfortunately, Nathaniel had minimal growth in this period and there would be no room for his next set of permanent lower teeth to come in. Early detection and intervention is key to working with patients like Nathaniel so Dr. Jeff sent Nathaniel to Dr. Brian DeVoe of DeVoe Orthodontics for an evaluation.

What was recommended?

Dr. DeVoe wasn’t sure that he could successfully do anything orthodontically for Nathaniel yet since his permanent molars weren’t erupted. He talked with the family about the option to extract some primary (baby) teeth so the permanent teeth would have space to erupt.

Nathaniel’s mom is very progressive and she wondered if that was the only option. She really wanted to help with Nathaniel’s growth and development. Dr. Jeff then asked Dr. Elizabeth Eggert for help as she has had success bringing children like Nathaniel through Myobrace Therapy.

At Eggert Family Dentistry, we pride ourselves on bringing “Dentistry for a Lifetime of Smiles” to all our patients. This means that we spend extra time with our smallest patients looking for any clues that growth and development is not occurring ideally at every one of their visits.

For Nathaniel, he had some indications of an underdeveloped airway, which will often lead to a small oral space (small mouth) and crowding. Nathaniel specifically was showing under developed upper and lower jaws, tilted head and shoulders, long/thick eyelashes, a deep bite, excessive gingival display, mouth breathing, a tongue tie, straining with swallowing, snoring, tossing and turning during sleep, sweating at night, waking up a funny position, chronic allergies, chronic runny nose, and the tendency to interrupt. There are so many “red-flags” for interruptions to growth and so many of them aren’t familiar to the general population. We work hard to educate all of the parents in our practice so they can help make the best decisions for their kids.

What was involved?

Myobrace Therapy is great for early intervention and for some people, it can even help decrease time in orthodontics or eliminate the need for orthodontics all together! Myobrace is built on the idea that muscle function is critical in jaw development. It is designed to support proper jaw development, encourage healthy oral habits, create space for developing teeth, and promote better airway support and function. There are many appliances available to train the muscles and therefore develop the oral cavity. The treatment requires commitment at home, follow-up visits with Dr. Elizabeth Eggert, and takes time during growth.

For Nathaniel, his jaw was so small that we started with the “Infant Trainer” appliance. The appliances are prefabricated, soft, flexible, and with special design features for training the tongue and lip for ideal positioning. Myobrace can also be used to help children correct habits like mouth breathing, thumb sucking, and tongue thrusting. Myobrace works the patient through a series of similar, yet more rigid appliances that encourage growth and development.

Nathiel wore his Myobrace every night and a few hours each day. He worked on tongue, cheek, and lip muscle exercises each night with his father. He came to visit with Dr. Elizabeth about every 3-4 months and through the course of 12 months, changing to the next appliance when appropriate, we saw significant growth in Nathaniel’s mouth – he even had enough room for his teeth to grow in – without extractions!

What does he think?

Nathaniel found it very easy to wear the appliances and he was very committed and compliant. This makes for the most successful Myobrace outcome!

What does his mom think?

Nathaniel’s mother admitted to us that she was a little skeptical before starting Myobrace Therapy and she wasn’t sure it would work. “I didn’t have much knowledge about the theory behind it, so there was definitely some uncertainty.” She wanted Nathaniel to avoid extractions at his young age and she wanted to keep his visits to the dentist easy and successful so that motivated her to commit to the treatment.

After completing the process, she says she would absolutely recommend it. “The whole experience was a learning process for us – understanding what was going on and how it works. I now realize that my uncertainty was just a lack of knowledge. I understand that it works with the muscles, and we had to do our part with the exercises.”

When we asked what she would say to friends or family with similar conditions she said, “I would say try it and do your best to follow the instructions. It works with natural growth, which is a big plus. It’s especially good for young children.”

Interceptive treatment like Myobrace Therapy can make a tremendous difference in a child’s life. Nathaniel did an outstanding job and had an amazing outcome! Thank you for putting your trust in us. We look forward to working with Nathaniel and his family for many years to come!

At Eggert Family Dentistry, we’re passionate about helping our patients achieve healthy, confident smiles. We would love the opportunity to answer your questions and discuss whether Myobrace Therapy is right for anyone in your life.

Finding the Right Fit – Eugene’s Story

By: Dr. Elizabeth Eggert

How did this start?

Family is at the heart of everything we do at Eggert Family Dentistry. When Eugene came to us for his comprehensive treatment, he joined his daughter and granddaughter, who have trusted our practice for more than a decade. Caring for three generations in one family is a true honor and we are amazed at how often this happens for us.

Eugene wanted his teeth to fit together and to fix or change his overbite. He also was concerned because he noticed that his lower teeth were chipping and fracturing and when his last dentist attempted to repair the teeth, they fractured again right away. Eugene met with Dr. Elizabeth for a comprehensive exam and she noticed how his bite put a lot of stress on his teeth. She also was concerned about the bridge on Eugene’s upper front teeth. The bridge was replacing two teeth, but unfortunately was getting a lot of decay and Dr. Elizabeth wasn’t sure if there would be enough tooth structure to attempt another bridge.

To further complicate the treatment and Eugene’s options, his daughter told us that Eugene sometimes has a difficult time remembering discussions so she wanted to be present as much as possible. This situation is common and something we are dealing with more and more as many patients are getting into their 80’s and 90’s, but it definitely can slow progress.

What did Eugene want?

Initially, Eugene really wanted to attempt to save as many of his teeth as possible. He was very concerned about a tooth on his lower left that had fractured many times and he was happy to now be going to the same office as his daughter. Eugene also wasn’t sure that he would be able to tolerate any type of denture option since he was used to having his teeth all solid in his mouth. He also was concerned about the possibility of not having front teeth for awhile since his upper tooth bridge could fracture from the decay so he was motivated to do something!

Eugene wanted to make independent decisions since he believed he was still the best one to make decisions about him. Eugene is in his 80’s and while he wanted what was best for him, there were questions from the family about how much dentistry “would be really worth it?”

What was recommended?

Eugene needed to start with better gum tissue health since he was starting to get early periodontal disease. After his initial cleanings and better work on his part at home, his gum tissue started looking much more healthy.

Because Eugene’s bite was the main reason for his many fracturing teeth, Dr. Elizabeth told him that she needed more information to help generate treatment options. In a case where there is the potential for multiple teeth to be lost, Dr. Elizabeth recommends her patients undergo The Records Process. This helps her see things from all angles and to really get a sense of how we can stabilize the bite while undergoing treatment. If the bite isn’t stable, the muscles, joints, and teeth often continue in a pattern of destruction.

Eugene’s first step was to obtain stability. Stability in his bite would help him eliminate muscle spasms and pain and it would help us determine a good position of where to rebuild teeth. To help obtain stability for his muscles, splint therapy with an Anterior Deprogrammer was recommended. The Anterior Deprogrammer works to keep the back teeth apart so the muscles and joints can relax and become better coordinated.

As Eugene underwent this treatment, we also spent time determining the extent of the decay with his upper bridge and unfortunately, it was determined that 2 teeth would need to be extracted as they were no longer healthy enough to withstand treatment. Eugene had a temporary bridge made for awhile, but then agreed to have the teeth extracted and try a temporary partial denture “just to see how that is.” Dr. Elizabeth thought this would be a good option so he could try out removeable options. Not all people can tolerate dentures of any sort and this would help us know about Eugene.

Eugene also had treatment options like implants or a new bridge to replace his upper front teeth, but Dr. Elizabeth wasn’t sure that Eugene’s bite could be made stable enough for these options without jaw surgery. Eugene didn’t want to think about jaw surgery, but he really wanted an option that would stay in his mouth. In the end, he agreed to the temporary partial denture and Dr. Elizabeth was happy he was willing to try something new. It also helped Eugene to undergo the splint therapy with the Anterior Deprogrammer because then he had practice with something that went in and out of his mouth. Dr. Elizabeth really worked to help both Eugene and his daughter understand all his options and showed them many videos of different treatment options. In the end, they decided to try the denture options.

What was involved?

Some trial and error was needed for Eugene and we addressed his upper arch first before his lower arch. A temporary partial denture was fabricated for his upper teeth and was ready to go into his mouth on the day of his extraction appointment. After that, Dr. Elizabeth tried working through a partial denture for Eugene’s lower arch that would help improve his overbite. Unfortunately, when it came down to it, Eugene was just not able to tolerate that new position.

Therefore, another temporary partial denture was fabricated for his lower arch. Since we were unable to change Eugene’s original bite positions, there was no room to fix his lower front teeth. He had those teeth extracted as well and the temporary partial denture was ready to insert right away. Eugene did fairly well with his partial dentures, but needed quite a few adjustment appointments as he (and his tissues) got used to wearing the new devices.

Eugene’s temporary partial denture for his upper arch has been holding up well. Unfortunately, Eugene’s bony anatomy and his ability to generate forces caused his lower tooth temporary partial denture to break. Dr. Elizabeth had mentioned from the start that Eugene might have to invest in the strongest denture material so he wasn’t surprised. Luckily, he was able to make the decision to move to the strongest partial denture option – a cast metal partial denture – after trusting that a partial denture would work for him.

What does Eugene think?

“Before the procedure, I knew something had to be done because my teeth were breaking, but until I saw Dr. Elizabeth’s presentation, I didn’t realize how bad things really were. At first, the process was confusing because there were so many options and I didn’t fully understand what was happening, but she worked hard to help us understand and as time went on, I began to appreciate both the process and Dr. Elizabeth so much! I am glad I put my trust in her.”

Eugene also told us that he believes he truly believes the partial dentures were the right option for him. “They look nice and I’m so happy to be able to smile again.” It took awhile for Eugene to understand the benefits, but the investment was significantly less than other options like implants or bridges so he was happy to save some money.

Eugene told us that if he were talking to someone considering working with Dr. Elizabeth to complete a lot of dental work, he’d say, “You probably won’t like it at first, but as time goes on, you’ll really understand because of the process Dr. Elizabeth uses – and you’ll really appreciate her too in the end!”

Thanks for your honest feedback Eugene – it’s been a pleasure restoring you back to a healthier smile! We look forward to working with you and your family for many more years to come!

All I Want for Christmas Is My Two Front Teeth! – Alisha’s Story

By: Dr. Elizabeth Eggert

How did this start?

It is the time of year when we gather for the holidays, take pictures with our families, and send Christmas cards to everyone! Having a beautiful smile certainly reminds us of the song from our childhood and resonates now as much as it did when we were the 6-year-olds with missing front teeth.

Meet Alisha, one of Dr. Elizabeth Eggert’s long-time patients. In fact, Alisha was only a teenager when she and Dr. Elizabeth met. Alisha came into the practice with a history of trauma to her two front teeth. She was lucky in that she still had her teeth present, but the trauma caused the need for root canal treatments and overtime, the teeth darkened, cracked, and chipped. When Alisha was old enough and with a steady job, she wanted to invest in herself and change the appearance of her two front teeth.

What was recommended?

Alisha expressed an interest in Invisalign because she thought it might help her tooth esthetics. However, Alisha originally had a complicated bite and it was recommended that she undergo orthodontics with Dr. DeVoe, an orthodontic specialist. There was more to improving Alisha’s smile than esthetics alone. Improving her tooth bite was an important aspect for long-term stability. Dr. Elizabeth explained to Alisha about how orthodontics could enhance both tooth function and esthetics, but also help her change her mouth breathing habit. Dr. Elizabeth also explained to Alisha that completing restorations for her two front teeth after orthodontics would be enough to change the color and protect her teeth from more cracking and chipping. With this information, Alisha decided to move forward.

What did she want?

As a young professional, Alisha wanted to look better, but was also concerned about keeping the treatment affordable for her. Seeing as the treatment would involve her two front teeth, she was also nervous about the outcome. It took more than a couple years for her to feel confident about moving forward, but once she did, the progress moved along quickly. Dr. Elizabeth worked closely with Dr. DeVoe so the final tooth movements would set Alisha up for an amazing outcome.

What was involved?

To help Alisha’s case move more quickly, Dr. DeVoe recommended traditional brackets and wires for her orthodontic treatment. Because of this, he was able to correct her more complicated “cross-bite” and create symmetry in her gum-tissue levels. This symmetry is especially important when gum tissues show during smiling like it does for Alisha. After the orthodontics was complete, Alisha worked with Dr. Elizabeth to prepare her two front teeth for all porcelain crowns, complete one filling on a discolored tooth with decay, and cement the crowns into place. Alisha chose to keep the color of her teeth more natural as she wasn’t interested in the potential maintenance involved with bleaching procedures.

What does she think?

Alisha was very open about the fact that she was nervous about the outcome for her treatment since it would impact her smile so much. But, having been with Dr. Elizabeth for many years she knew it would go well. “I am very pleased with how it all came out. It didn’t take as long or hurt like I thought it would.” Many patients are just like Alisha, very nervous to start the process that can so vastly impact their lives. Not only does dentistry like this enhance esthetics, it does a lot to improve confidence. When we asked Alisha what she would tell someone considering treatment she said, “If you can afford it, do it! My teeth and my smile are going to last a long time. It’s not just esthetic – it’s practical, it’s tooth security!”

Dr. Elizabeth and Dr. Jeff work very hard to keep their promise of “Dentistry for a Lifetime of Smiles” for their patients and Alisha is another great example of that! We truly hope that Alisha and all of our patients are enjoying the holiday season. If you are looking for a way to make changes and create your new beautiful smile, call Eggert Family Dentistry in North Oaks, Minnesota today, 651-482-8412.

New Crowns and Veneers – Not Scary at All! – Joy’s Story

By: Dr. Elizabeth Eggert

How did this start?

Eggert Family Dentistry is celebrating 20 years this October! Joy has been there with Dr. Elizabeth the whole time! In 1993, Joy fell and experienced trauma to her front teeth. She had root canals and crowns done at that time, but was starting to notice a crack in the porcelain of one of the crowns and she didn’t like the staining that showed. She also wondered about better color matching for all her front teeth since at that time, only 2 teeth had crowns. For a few years, she asked Dr. Elizabeth what could be done, but was always nervous to move forward with treatment because she couldn’t decide if she was willing to accept her currently darker coloring or if she wanted something brighter and younger looking for her smile. She also now has Parkinson’s disease and notices that caring for her teeth is getting more difficult, as well as sitting through dental treatment, so she didn’t want to keep putting off the decision.

What was recommended?

Dr. Elizabeth verified the recommended treatment using photographs and 3D models of Joy’s teeth. Joy wanted to improve the color of her teeth, making everything brighter. Therefore, it was recommended to do porcelain restorations for all 4 of her upper front teeth. That way, the old crowns could be replaced and the other front teeth could also be better protected where wear and cracking was starting. Since Joy also wanted brighter teeth throughout her mouth, it was recommended that she start with bleaching so the rest of the teeth could be brighter too!

What was involved?

Joy wondered about her lower teeth and if anything could be done for the crowding, but she didn’t want to undergo Invisalign so she decided to just move ahead with the bleaching and upper restorations. Dr. Elizabeth worked up Joy’s case by mocking up a proposal on Joy’s models, looking at how the crowding in the lower teeth contributed to the slight length discrepancy of her front teeth.

Dr. Elizabeth suggested making the front teeth the same length which would also require adjusting on Joy’s lower teeth. Joy thought this was a better idea for her than Invisalign, so they moved ahead with the plan.

Joy started with Zoom whitening, which really helped her teeth brighten up multiple shades and allowed Joy to have all her teeth brightened, while minimizing the number of restorations.

Joy underwent the preparation appointment. Dr. Elizabeth noticed that Joy’s previously traumatized teeth were especially dark from the trauma. She worked to mask the color difference as much as possible, but informed Joy that perfect color matching might not be possible. Joy accepted that since she really wanted to keep her teeth, rather than extract them and replace with implants. So, after a couple of weeks, Dr. Elizabeth inserted Joy’s porcelain restorations – 2 veneers and 2 crowns.

What does Joy think?

After the procedures were completed we met with Joy to reevaluate her restorations and see how she was feeling about the treatment. She reported that everything was been feeling great and that her bite felt good. We asked Joy what she thought about getting the procedures done. She noted, “It was kind of scary. I knew a lot would be involved so I was scared.” In the end, Joy said the process was better than she thought it would be – actually, not scary at all! Joy told us, “I am so happy with it. I was looking a little dull so this brightens my smile, but it’s not over the top – it’s just enough! It’s better!” When we asked her what she would tell a friend or relative who was considering the same treatment, she said “It’s worth the investment!”

You look fabulous Joy and we appreciate your trust in us for over 20 years! We look forward to continuing to bring you “Dentistry for a Lifetime of Smiles!”

Two Brothers, Both Missing Teeth – the Stories of Anders and Lars

By: Dr. Elizabeth Eggert

How did this start?

Family is very important to us here at Eggert Family Dentistry and serving entire families is one of our biggest joys. We love following trends in families because we can often help stop dental disease in its tracks, especially for children of parents that have been patients for years. We truly appreciate the trust so many families put in the care of our doctors – Dr. Elizabeth Eggert and Dr. Jeff Eggert, as well as our dedicated team. A positive dentist-patient relationship is the cornerstone of good oral health for your whole family. Now, meet Anders and Lars, two brothers who came to us as new patients, joining their father who had been seeing Dr. Elizabeth for over a decade.

Lars and Anders both had congenitally missing teeth, meaning they weren’t born with certain teeth. Missing teeth, also known as hypodontia, is a hereditary condition and often runs in families. A congenitally missing tooth is one of the most common dental developmental anomalies. In fact, roughly 20% of adults have at least one tooth that never developed.

What did Lars and Anders want?

Lars and Anders both started orthodontics before they were patients at Eggert Family Dentistry. With their parents and their orthodontist, Lars and Anders chose to close the space where they were missing a lateral incisor (tooth #10). The hope was that when they were old enough, the canine tooth could be “converted” to look like a lateral incisor. This is not the easiest restorative conversion and it can lead to long-term bite issues, but Dr. Jeff and Dr. Elizabeth were ready to take on the challenge and help Lars and Anders address their esthetic concerns, meanwhile, hoping to help them stabilize their bites for long-term success.

What was involved?

In addition to the missing lateral incisors, both Lars and Anders had spacing and tooth size discrepancies for their other incisors. It was recommended to buildup their anterior teeth with composite resin, doing composite veneers, to address these spacing and tooth shape issues. Because Lars and Anders are still young adults, composite resin was chosen as the material of choice because it is a very conservative option and will allow for easy conversion to porcelain materials down the line for ultimate esthetics as these two move along into adulthood.

After preplanning appointments to gather impressions for models to use for a wax-up and an appointment to mock-up the teeth and view the proposal, both Lars and Anders had their tooth changes done in only one appointment!

What do they think?

Both brothers are typical, busy, college students, but we were able to flag them down regarding their treatment. They report that things have settled in nicely and they are getting used to the changes. Lars told us, “I feel good about the treatment. It’s different, but as I look at them every day, I really like it.” He told us he was a little nervous before the treatment because we were changing the look of his teeth, but he was confident in the doctors at Eggert Family Dentistry and knew the process would be worth it. He would tell someone else considering this procedure to “Trust the process. The doctors at Eggert Family Dentistry know what they are doing. It can be scary, but really there isn’t anything to worry about.”

We are so pleased to be able to give these brothers a new matching set to smile with. Thank you for the trust you place in our team at Eggert Family Dentistry. We look forward to many years caring for you and your family!

Deep Cavities and Conservative Treatment – John’s Story!

By: Dr. Elizabeth Eggert

How did this start?

We met John back in 2013 when he was only 3 years old and needed some fillings on his primary (baby) teeth. After completing this treatment, unfortunately, his family moved out of state and we lost touch with him. Fast forward to this summer when his dad reached out for a second opinion because John was having a severe toothache. They sought out a dentist in Texas, where they live, but the recommendations were extreme, especially for a 15-year-old young man.

Here are the x-rays taken in Texas and sent to Dr. Elizabeth Eggert for a second opinion. It is easy to see the extreme decay in these images on multiple teeth. While Dr. Elizabeth was very concerned that the decay was so deep, it might be infecting the nerves of these teeth, she was also discouraged to hear that the other dental professionals had recommended extraction, or root canals and crowns for someone so young, without truly exploring what was happening in these teeth.

Luckily the family was headed to Minnesota for the summer and after a limited exam with Dr. Elizabeth, along with additional x-rays, it was determined that it was at least worth seeing how deep the decay was in these teeth to see if the teeth were working to protect their nerves by laying down protective layers of tooth structure.

Dr. Elizabeth had a serious conversation with John and his family about why John got infected with these cavities. To only attempt a repair without determining how to prevent serious issues like this in the future, would not help break the cycle. Tooth decay in teenagers is primarily caused by a combination of poor oral hygiene, frequent consumption of sugary foods and drinks, and the presence of bacteria in the mouth that produce acids that erode tooth enamel. In John’s case, the most likely culprit was the sugary candy he often consumed (and hid from his parents) as well as inconsistent dental care over the years.

What did he want?

John and his parents were hoping to avoid the extreme options presented by the dentists in Texas. Not only are the treatments recommended irreversible, but they would have been a huge investment and financial strain for the family. Therefore, they liked Dr. Elizabeth’s conservative option of decay excavation, which is almost like an exploratory surgery. If the decay hadn’t yet reached the nerve, or even if it still was just over the nerve canal system, with John’s young age, there would be a chance that his teeth could heal and protect the nerve if the decay is removed.

In Dr. Elizabeth’s mind, it is very important to attempt to preserve the natural tooth and root for as long as possible. Dr. Elizabeth recommended that they start with decay excavation on the three teeth with the deepest decay, do indirect pulp caps if needed, and finish the treatment with a composite buildup, which will help build back the tooth until the nerve has some time to heal and before a crown is done. This option gives John time to heal and see how well his teeth respond to the treatment.

What was involved?

Dr. Elizabeth saw John for multiple appointments to address as much decay as possible when he was in town. She started on John’s lower right side, where John had the most discomfort. The most interesting thing about John’s case was how deep the decay got internally without giving many outward signs until his toothaches started. These photos show the three teeth with the deepest decay. While there is evidence of “holes” or cavities forming, they do not appear to be as extreme as what the x-rays were showing. This likely kept John’s family from realizing the severity of John’s situation and why regular dental care is so important because it is likely that these areas of decay would have been caught much earlier.

Dr. Elizabeth removed the decay, but had to leave a small amount in order to avoid the nerve. This is called an indirect pulp cap and can help the tooth promote healing. A protective layer is placed over the decay with the hopes that the natural tooth structure will continue to lay down more natural protection. The amount of tooth lost to decay was extreme, but with ideal bonding ability, Dr. Elizabeth replaced the missing tooth structure with resin (composite) filling material for a buildup, knowing that if John is able to keep the infection away and keep his teeth, crowns will be in order in the future.

What does he think?

John and his family were so appreciative for the alternative and conservative treatment option. This definitely is a favorable result, although not necessarily conventional. Unfortunately, since John’s treatment was a unique approach, John’s family is still fighting for insurance coverage and they may never see the benefits they deserve. We are finding that more and more insurance policies place strict limits on what they will and will not cover. Still, John’s family believes this treatment was the right choice for them.

John and his family have gone back to Texas so we won’t be able to follow his treatment long-term. We hope he is able to keep his teeth for many more years to come and that his teeth cooperate and heal fully. John’s story is an important example of why it is very important to implement dental recare appointments at a very young age. These appointments are crucial for maintaining optimal oral health by catching problems early to help prevent serious long-term problems. We’re happy to have your trust John and we wish you the best!

“My Teeth are Chipping, What Can We Do?” – Tim’s Story

By: Dr. Elizabeth Eggert

How did this start?

Tim has been a patient with Eggert Family Dentistry since the early 2000’s. Up until recently he had only been in for his recare appointments and a few restorations, but then he started noticing that his front teeth were chipping. He wanted to know what he could do to address it. As we age, our teeth naturally undergo changes that can affect our appearance and health. These changes include enamel thinning, increased risk of cavities and gum disease, tooth discoloration, and of course chipping. Proactive oral hygiene and regular dental visits can help mitigate these effects and maintain a healthy smile throughout life, but sometimes intervention is needed.

Tim discussed the issue with Dr. Elizabeth Eggert of Eggert Family Dentistry in North Oaks, MN and she invited Tim to undergo the Records Process. She noticed things about Tim’s smile and jaw that would be contributing to his chipping. His current tooth positions and a history of acid erosion on his teeth were especially to blame. She let him know that over time he would continue to have wear and chipping on his front teeth and as they got smaller, he would in turn have excessive forces on his back teeth. Tim wanted to learn more so he took her advice and started the Records Process.

What did he want?

Tim had not really given much thought to his teeth beyond the functionality of them such as eating and speaking, but it was important to him to keep his teeth long term. He only became aware of the chipping a few years ago, even though the process started long ago. Through the Records Process, Dr. Elizabeth helped him better understand what is happening with his muscles, jaws, and teeth and how they all relate to each other. He wanted to understand why the chipping was occurring and he wanted to be able to keep his teeth healthy for the long-haul.

What was involved?

The Records Process helped us gather information about how Tim uses his teeth and we found that the narrowness of his upper and lower jaws put his teeth in a position that put the edges at risk for chipping. Many times, people with a narrow arch produce more acid, which also thins the enamel, making it more prone to wear, tear, and chipping.

Tim’s teeth needed to change position before the chipping could adequately be addressed. Invisalign was recommended as a conservative and convenient way to move his teeth. After completing splint therapy with an anterior deprogrammer to verify his muscle and joint positions, Tim started Invisalign. It took 14 months for Tim’s teeth to move into positions where the edges wouldn’t chip.

Getting the teeth in a better position to stop the chipping meant that more spaces would open up between Tim’s teeth. This was an anticipated side effect and was discussed with Tim during the Records Process. Tim agreed that porcelain veneers should be used to both close down his spacing and protect his enamel. 12 veneers were needed – 6 for Tim’s upper front teeth and 6 for his lower front teeth.

Dr. Elizabeth used emax veneers for Tim’s restorations. Emax is a type of dental porcelain made from lithium disilicate, a glass ceramic, and is known for strength, durability, and a natural appearance. Veneers made from emax are thin, translucent, and closely mimic the look of natural tooth enamel, which makes them a popular choice for cosmetic dental work, or in Tim’s case to also help with improved function and durability!

What does he think?

Tim mentioned that he was concerned with how long the process would take, but he felt informed along the way. He spends a majority of his time in Florida during the winter to get away from the Minnesota cold, but even having to work around that didn’t slow things down. He was able to take his Invisalign aligners with him to Florida and he updated Dr. Elizabeth with photos of his progress. Even through it did take awhile from start to finish, he is very happy with the results and likes that he can eat and speak like normal. When asked what he would say to anyone about his treatment, he said he would recommend it and tell them what the whole process was like for him. Congratulations on your commitment and great result Tim! We love working with you and we thank you for putting your trust in us! Call Eggert Family Dentistry today at 651-482-8412 to talk about your dental issues and to find out if veneers are the right way to improve your smile!

My Spring (Tooth) Break! Fixing a Fractured Front Tooth – Caleb’s Story!

By: Dr. Elizabeth Eggert

How did this start?

Caleb was on spring break in Florida, vacationing with his family at the beach and playing in the sand with his sister. He accidently fell on a metal shovel on the beach and chipped his front tooth. His mom called from Florida to let Eggert Family Dentistry know what had occurred and asked how she should proceed. It was recommended that she send a picture of the tooth and keep the fragment in water so that we would have a better idea of the extent of the fracture. Caleb was still out of town for a few days, but was seen at the office when he returned. Unfortunately, Caleb was ill with a severe cough right after coming home, so it was over 2 weeks before he was able to see Dr. Jeff Eggert to attempt to reattach the fragment.

What was recommended?

Tooth trauma, also known as dental trauma, refers to injuries to the teeth, gums, and surrounding soft tissues of the mouth. These injuries can range from minor chips or cracks to more severe issues like tooth displacement or jaw fractures. Common causes include accidents, sports injuries, falls, and even biting down on hard objects. Symptoms can include pain, bleeding, swelling, and a change in how teeth fit together. Treatment depends on the type and severity of the injury, and may involve repositioning the tooth, root canal treatment, or other procedures.

Upon examination, Dr. Jeff reviewed some signs and symptoms with Caleb and his parents and did some tests to verify the status of the tooth’s nerve. Luckily, the tooth was still responding as vital, which means that the nerve was trying to heal after the injury. Teeth undergoing trauma like Caleb’s are at high risk for nerve necrosis (dying) and abscess (infection). It was decided to repair the tooth with composite filling material to build back what had broken since Caleb’s tooth fragment had now been out of his mouth a few weeks and the fragment available couldn’t replace all of what was missing.

Caleb was only 11 years old at the time of the trauma to his front tooth. When considering repairing a fractured front tooth, the appropriate treatment options and considerations can vary depending on a person’s age. Preserving the natural tooth structure, including the tooth’s pulp for as long as possible is very important for the longevity of the tooth and surrounding tissues. Even though Caleb’s tooth nerve was testing vital, things can change overtime.

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, then months, then years to make sure that complications aren’t developing.

What else was involved?

Caleb’s tooth did very well for about 10 months and then his parents called reporting that he was having intense pain, sensitivity and swelling with the tooth. We saw him for another exam and unfortunately, the tooth was showing signs of a tooth abscess. Caleb saw the root canal specialist for a root canal as they were able to get him in for an appointment faster for that procedure, in fact, they were able to see him the very same day!

Caleb’s tooth has been stable and he now is in braces to help correct his bite. This will help keep his tooth better protected from forces for the long-haul.

What does he think?

It has been over 2 years since Caleb’s accident and his tooth is still doing well. The bonded composite filling has stayed in place and looks very natural. Because of how large the fracture was it is likely that the tooth will eventually benefit from a crown, but while the repair is holding up, Caleb will keep the filling.

Caleb and his parents were very appreciative of how quickly he was taken care of and monitored throughout the process. Caleb said “I thought it was kind of cool, how they just fill my mouth with filler stuff and then make it tooth sized.” He says he feels the same as before his tooth fractured and thinks “you can’t even notice it!” We look forward to seeing Caleb’s magnificent smile and his family as well for many years to come!

At Eggert Family Dentistry we have had many patients over the years that we have been able to help with dental trauma. Here are some additional examples of what trauma can look like:

“Can I Get a New Night Guard?” – Sleep Questions Addressed with the Seattle Protocol and a New Splint – Ann’s Story

By: Dr. Elizabeth Eggert

How did this start?

Ann returned to Eggert Family Dentistry a few years ago after concerns arose at her previous dental office, where she often felt she was being “up-sold” on dental recommendations. In addition, her husband and mom have been patients at Eggert Family Dentistry for years and have been very happy with their experiences. Ann made it very clear from the start that her main concern is overall tooth health, and while she wants a beautiful smile, she is happy with her smile, so she didn’t feel the need to discuss cosmetic options. Ann mentioned at her new patient appointment that she had undergone a sleep study and she was told she didn’t have sleep apnea, but she has been told she snores so she wonders if she is as rested as she could be. She was also told by her previous dentist that she had “TMJ” or Temporal Mandibular Joint Disorder (TMD) and wanted Dr. Elizabeth’s opinion on that. Ann really didn’t have many symptoms of TMD and she wanted to better understand what the previous dentist was seeing.

What was revealed during the records process?

Dr. Elizabeth invited Ann to come back for The Records Process in order to help Ann understand her current dental conditions, including the status of her potential TMD. In the Records Process, we used models, photos, and x-rays, as well as results from an extensive analysis of how Ann’s teeth function. The details of The Records Process revealed that Ann had some evidence of an unstable bite and while it wasn’t causing Ann day-to-day problems, it has the potential to cause faster breakdown of her jaw joints, muscles, and teeth. In addition, with her snoring, Ann had the option of working through the Seattle Protocol, an innovative approach to treating sleep disordered breathing with dental resources, like dental splints. Even though Ann did have evidence of TMD (without current symptoms), she wasn’t interested in pursuing treatment for that, which may have included orthodontics, but she was interested in helping her snoring, so she elected to undergo the Seattle Protocol.

What was involved?

The Seattle Protocol helps us determine the jaw position that best alleviates the patient’s likely airway compromise. The protocol moves the patient through a series of diagnostic steps and treatments using various trial splints (using the myTap system) to find the most effective solution specific to each individual patient. The goal is to move through incremental vertical and horizontal increases to the jaw position. Each step builds upon the last, but patients don’t necessarily need to complete the entire process as the purpose of the protocol is to determine the phase that provides the best relief of the patient’s symptoms.

Seattle Protocol Six Steps

1. Nasal breathing therapy

2. Lower jaw orthotic trial splint

3. Lower jaw anterior repositioning trial splint

4. Dual arch trial splint

5. Dual arch repositioning trial splint

6. Dual arch repositioning trial splint in more forward position.

For Ann, like all patients starting with the Seattle Protocol, we started with Nose Clearing and Mouth Taping, with the goal of rerouting Ann’s breathing through her nose. Ann ended up moving through the first 4 stages and found relief from her snoring and reported sleeping better with stage 3.

What does Ann think?

We asked Ann what she thought about the process of undergoing the Seattle Protocol. She told us she found it very easy and the time went pretty quickly. “Both Dr. Eggert and Tracy helped me move fast through the treatment and my appointments always went smoothly and started on time.” She also found it to be really helpful and that the mouth taping was very beneficial, she even recommended it to some of her friends that she felt it would help.

Ann liked the different options of oral appliances and finding the right one for her after going through all the Seattle Protocol. We asked Ann what she would tell a friend or family member if they were having similar symptoms or issues and she said that she would highly recommend the treatment and working with Eggert Family Dentistry. “You really have to sleep on it! Literally, you have to sleep with the different splints as it is not possible to know how they will benefit you until you try them out. If one version does not work for you, you will know it.”

Congratulations Ann! Thank you for letting us be part of your journey. We’re happy to have found a conservative treatment option that addresses your goals and current conditions. We look forward to working with you and your family for many more years to come!