“Invisalign Has Been Really Nice!” – Ashley’s Story

By: Dr. Elizabeth Eggert

Where did Ashley start?

Ashley came to Eggert Family Dentistry as a new patient in the fall of 2016 with pain in the areas of her wisdom teeth, also known as 3rd molars.  The panoramic image shown below shows the need to have her wisdom teeth extracted due to the impacted angle and their inability to erupt on their own.  They were also putting a lot of pressure on her erupted second molars. With the impaction, Ashley’s teeth were also becoming more crowded, which she didn’t like.  Dr. Jeff referred Ashley to an oral surgeon to have her wisdom teeth extracted and that took care of one problem.

Ashley was also experiencing tissue recession, mostly due to the crowding and current position of her teeth.  One option Dr. Jeff discussed with Ashley was the possibility for gingival grafting (gum-tissue grafting).  In a grafting procedure, tissue is added to the root surface to cover the root back up again and increase gingival height and thickness.  For Ashley, this may have worked, however, due to her crowding, the ability for the graft to last a lifetime was very unlikely.  Therefore, Dr. Jeff suggested Ashley consider orthodontically moving her teeth.  Ashely was most interested in Invisalign and had read about it from our blogs, learning that we do that procedure here at Eggert Family Dentistry in North Oaks, MN with Dr. Elizabeth Eggert.  Dr. Elizabeth met with Ashley and determined she would be a great candidate for Invisalign!

What was involved?

Ashley went through the “Invisalign Records Process.”  At that time, we took impressions and photos of her teeth and sent them to Invisalign so they could create a 3D simulation of how her teeth could move with Invisalign treatment.  Ashley was very happy with the simulation, which showed a significant improvement to her crowding.

During the Invisalign Records Process, Dr. Elizabeth also noted with Ashely a fair amount of muscle tension and while Ashley didn’t initially report having frequent headaches, throughout treatment, she noticed a difference in her tension and that she no longer was having headaches.  It is amazing how people learn to live with what ails them, but how much better they can feel working their way to healthy!

Ashley’s case was expected to consist of 28 aligners that she would wear 22 hours a day.  Ashley’s case called for a few “buttons,” which are attachments on the teeth.  Basically, these small buttons allow the Invisalign aligners to grip onto your teeth more effectively (similar to a traditional orthodontic metal bracket).  These attachments help move the teeth more effectively.  Ashley was very compliant and consistent in wearing her aligners as instructed and was able to complete her case after the expected 28 aligners, needing no refinements!

What does Ashley think?

When we asked Ashley what she thought about the Invisalign process, she said her only thought is that it was more appealing than getting traditional braces.  “It’s been really nice!  It has reduced my headaches and that was the biggest thing, and it has reduced the crowding too.”  She says that if she were discussing Invisalign with someone considering the treatment she would tell them, “It’s definitely worth it.  Don’t get discouraged the first few weeks; it gets better.  It may be uncomfortable at first, but it gets much better.”

We are so happy that we could help Ashley on her journey and fulfill our motto of providing “Dentistry for a Lifetime of Smiles!”  Congratulations, Ashley on your wonderful results!

My Journey with Adult Orthodontics and Porcelain Veneers – Cathy’s Story

By: Dr. Elizabeth Eggert

How did this start?

For over 20 years Cathy has been a loyal patient with Eggert Family Dentistry and Dr. Elizabeth Eggert.  Back in 2020 Cathy was having pain and she believed it to be due to her bony ridges growing on her lower right under her tongue.  These bony growths are known as tori.  Cathy noticed she had more pain in the evening and thought it was getting worse.  Typically, tori aren’t dangerous, but they can be uncomfortable and inconvenient.  They can also be linked to heavy forces being applied in your mouth.  Dr. Elizabeth explained to Cathy that her bone was likely continuing to grow due to the heavy forces her muscles were placing on her teeth and bones.  It was at that time that Cathy got serious about considering adult orthodontics because Dr. Elizabeth had mentioned the benefits of correcting her bite in the past and Cathy didn’t want to keep letting her muscles win!

What did Cathy want?

Cathy was not interested in removing the tori but was interested in Invisalign as an option for adult orthodontics.  It was determined after a consultation with Dr. DeVoe that conventional braces were a better option for Cathy and so she agreed to follow his professional advice.

What was involved?

During orthodontic treatment, the wear pattern on Cathy’s teeth became more apparent because Dr. DeVoe had to choose whether to align her front teeth at her gum line or at the biting surface.  Since Cathy shows a fair amount of gum tissue when she smiles, it was recommended to align the teeth at her gum level and change the tooth shapes with porcelain veneer restorations.  Dr. Elizabeth talked with Cathy about how she could elect to only restore her front teeth and about the advantages, including color matching and tooth proportions, of restoring her six anterior teeth.

Cathy decided she wanted to change her tooth color and shape for all six of her front teeth and so Dr. DeVoe and Dr. Elizabeth coordinated her final orthodontic movements to set her up for porcelain veneers.

Cathy at the end of her orthodontic treatment

Cathy wanted whiter teeth so Dr. Elizabeth recommended that Cathy undergo Zoom in-office whitening to brighten all her teeth so the porcelain veneers could be made to the same brighter color.  Cathy’s teeth responded well to the Zoom procedure.

Before and After Zoom Whitening

Once the whitening was completed, Dr. Elizabeth did a wax-up for Cathy to see what her teeth would look like once the restorations were completed.  A wax-up helps you be able to visualize the final outcome.  Dr. Elizabeth was also able to do a mock-up of the wax-up in Cathy’s actual mouth, using a plastic material.  This really helped Cahty see how the veneers would look before changing her teeth.  After only seeing the wax-up, Cathy thought it looked nice, but said “It is hard to know without seeing it in my mouth.”  Luckily, doing the mock-up worked and Cathy’s reaction was “Oh wow!”  She was very pleased and was ready to move forward with the preparation for the veneers.

Cathy’s Mock-up

What does Cathy think?

When asked what Cathy thought about her restorations before actually proceeding she said, “I was nervous about the prep and what that would be like.  I didn’t know how much tooth structure would be there, but I was also excited about correcting the teeth that were uneven.”  After all the treatment was completed, she said she is very pleased with her results.  When asked what she would say to a friend that has similar issues or is considering getting this type of treatment done she said, “I would say positive things about the outcome!  I would let them know about the time frame and the prep appointments.  It’s a commitment, but well worth it!”

Thank you Cathy for putting your trust in us!  We love your results and look forward to serving you for many years to come!

Cathy After

Replacing My Old “Cap” – Marcia’s Story

By: Dr. Elizabeth Eggert

How did this start?       

Marcia is a loyal long-time patient of Dr. Elizabeth Eggert’s since she started Eggert Family Dentistry in 2005.  Marcia has had multiple crowns placed by Dr. Elizabeth over the years.  For many years, Marcia talked with Dr. Elizabeth about the discoloration she noticed on her front tooth.  Marcia had a history of a root canal and porcelain-fused-to-metal (PFM) crown on her upper left front tooth and the metal caused a discoloration at her gumline after it had been in place a few years.

For many years, PFM crowns were commonly used in dentistry for the repair of damaged teeth.  PFM crowns have good mechanical properties, are strong and stand up well to oral forces, they look decent, and the gingival tissues tolerate them fairly well.  However, Marcia’s front crown looked dark to her from the metal substructure of the crown and it bothered her for many years.  She told us “I have a nice smile, but that cap is always what I see first.”

What did Marcia want?

Marcia wanted her smile to be more consistent.  She didn’t want her front tooth to stick out.  She noticed the discoloration and also felt anxious because she felt that her mouth was small and she had trouble when it came to having dental treatment done.  She was very concerned that any changes she might make would not look as good as what she currently had in her mouth.

What was involved?

Dr. Elizabeth used photos and x-rays of Marcia’s teeth along with the results of a thorough muscle and joint evaluation to develop Marcia’s plan.  The details of the records process revealed that Marcia would benefit from Invisalign before any changes to her front tooth because of the crowding of her surrounding front teeth that contributed to the shadowing and discoloration.  Part of the reason that Marcia noticed the front crowned tooth first is that the tooth was in a prominent position.  Invisalign would eliminate the crowding, improve the tooth display in her smile and provide a smooth surface for the upper teeth to bite and chew by eliminating the crowding of the lower teeth.  Dr. Elizabeth suspected that Marcia’s bite was currently putting her teeth at higher risk and was probably at least part of the reason Marcia had needed a number of crowns and root canals over the years.

Dr. Elizabeth and Marcia decided that Invisalign would be first in order to improve her crowding and her bite and then would be best to then replace the crown on her upper front left tooth as well as veneer 4 other front teeth that also had anterior wear and chipping.  Marcia also underwent the Zoom bleaching procedure to help brighten her teeth that were not getting new restorations.

What does Marcia think?

Marcia said that she was nervous when it came to the restorations and was afraid what would be revealed under the existing PFM crown on her upper left front tooth, but it had to be done if she wanted to change her smile.  “Even though it took a fair amount of time, you guys were awesome!  I would do it again because I like the result.”  She was very happy that she did it and wished she would have done it 20 years ago!  Marcia would tell someone that was considering getting this done that it is really worth it.  “Don’t wait, just do it.”

Congratulations on your amazing results Marcia and thank you for putting your trust in us!  We were delighted to help you through this journey and look forward to working with you and your family for many years to come!

A New Year’s Smile with Invisalign and Bonding – Ted’s Story

By: Dr. Elizabeth Eggert

Where did this start?

Ted has been a loyal patient of Eggert Family Dentistry and Dr. Elizabeth Eggert for over 13 years.  Ted was having an issue with chipping of his front teeth.  Over the years the enamel of his front teeth started to get thinner.  This was mostly because of the tooth positions of his lower front teeth.  Dr. Elizabeth talked with Ted about orthodontic movements to help increase the longevity of any future restorations, but Ted wasn’t ready to do anything until he additionally bumped his front tooth and because of the weak enamel, a significant chip occurred.  Ted still wasn’t ready for orthodontics and asked Dr. Elizabeth to start by simply fixing the tooth with composite.

Fast forward nearly 2 years and Ted started to notice the enamel thinning again with his front teeth.  He understood that the lower front tooth positions put more strain on his edges and he was ready to talk about Invisalign options for orthodontic tooth movement.

What was involved?

Dr. Elizabeth gathered the records needed for Invisalign orthodontic treatment.  She sent impressions, photos, and x-rays of Ted’s teeth to Invisalign where they created a 3D simulation, called a clincheck, to show how his teeth could move with Invisalign treatment.  Ted was very happy with the simulation, which showed a significant improvement to his crowding, especially on the lower front teeth and he decided to move forward with Invisalign.

Ted’s case was expected to consist of 19 aligners that he would wear for one to two weeks at a time for 9-12 months.  As part of Ted’s Invisalign treatment, Dr. Elizabeth included “bite ramps” on his aligners because he clenches heavily on his teeth.  Bite ramps prevent patients from being able to bite down completely and clench.  They help give the muscles a “stop” point and remind the muscles to stay in a more relaxed position.  Ted was consistent in wearing his aligners as instructed.

After his Invisalign treatment was complete, Dr. Elizabeth made minor alterations to the biting surface of some of Ted’s teeth to remove interferences and even out his bite.  This process is called equilibration and will help prevent further wear on Ted’s new smile.  Once the equilibration was complete and Ted completed some whitening with Opalescence whitening solution at home, Ted was ready to strengthen his front teeth with composite bonding.  Dr. Elizabeth added resin plastic filling material to his central incisors.  Because his teeth are now in a better position, it was even possible to add a little length to Ted’s teeth, giving him a more youthful smile.

What does Ted think?

Ted said “I wanted my teeth fixed!  I was more curious than anything as I read about orthodontic options online.  I am happy I chose to do Invisalign with Dr. Elizabeth, but I wasn’t sure how long it would take.”  Ted was really happy with the results and said that it was not nearly as bad as he had initially anticipated.  He was concerned about not being able to eat and drink with the aligners in, but after living with them awhile, he realized it wasn’t as bad over the course of the year as he thought it would be.  “They still are a bit inconvenient” but “well worth it.”  When asked what he would say if he were talking to someone considering getting this type of treatment done, Ted noted he would tell them it’s “Absolutely worth it!”  Ted, thank you for putting your trust in us to complete your care!  We love your new bright smile and are happy that with the tooth movements, the results will be much more stable over the long-haul!  Congratulations!

 

A Quick New Smile for a Lifetime! – Jim’s Story

By: Dr. Elizabeth Eggert

How did this start and what did Jim want?

Jim has been a loyal patient of Dr. Elizabeth Eggert for over 15 years.  She has placed multiple posterior crowns for Jim over the years, but there came a time when Jim’s front teeth, which had previously been treated with PFM (porcelain fused to metal) crowns, were decaying and needed to be replaced.  Jim was interested in getting his crowns all done in one day and he wanted them to look natural.  We were able to address his front four teeth in one 3-hour appointment and his two upper canine (eye-teeth) at a subsequent 2-hour appointment.

What was involved?

We were able to complete CEREC crowns for Jim’s front teeth.  This means we were able to make the crowns right in our office!

How CEREC Works

CEREC (Chairside Economical Restoration of Esthetic Ceramic) is a method of creating dental restorations right at Eggert Family Dentistry in one appointment!  These restorations are typically used to repair damaged teeth due to decay or injury.

Specifically, restorations are designed and created using CAD/CAM (computer-aided design and computer-aided manufacturing).  This process means designs are made after scanning with a highly advanced scanning unit and then computer software helps Dr. Jeff and Dr. Elizabeth design your crown!  The design is sent to the milling unit and your crown is ready in minutes.

C – Chair-Side:  The CAD/CAM technology is in the office and can be used while you are the dental chair.
E – Economical:  The procedure allows our office to keep our costs as low as possible for patients.
R –Restorations:  The CEREC procedure restores your tooth to its natural beauty, function, and strength.
E – Esthetic:  CEREC restorations are metal-free and tooth-colored.
C – Ceramic:  The ceramics we are able to use in-office are similar in strength to enamel, your natural tooth structure.   

What does Jim think?

Jim loves his new smile and was so happy to be able to get all his crowns done without multiple visits and without the risks that comes with wearing temporary crowns (like them accidentally coming loose).  Jim’s story is just one of many others who have 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 Jim for trusting us to help you continue to smile big and confidently!

Jim After

Jim After

 

From Crowded to Confident – Matthew’s Story

By: Dr. Elizabeth Eggert

How did this start?

Matthew has been a patient of the practice for nearly 20 years, starting with Dr. Furey and then transitioning to Dr. Jeff.  As a teenager he underwent traditional orthodontics and felt that his teeth were straight.  Unfortunately, like so many, Matthew had periods of not wearing his retainers and his teeth moved over time, especially his lower front teeth.  As Matthew entered his 30’s it was starting to bother him more and he asked Dr. Jeff if Invisalign would be right for him.  Dr. Elizabeth met with Matthew and together, they determined that Invisalign would be able to help bring his smile back to where he was as a teenager.

What was involved?

Dr. Elizabeth sent impressions, photos, and x-rays of Matthew’s teeth to Invisalign where they created a 3D simulation of how his teeth could move with Invisalign treatment.  Matthew was very happy with the simulation, which showed a significant improvement to his crowding.  He decided to move forward with Invisalign.

As part of Matthew’s Invisalign treatment, Dr. Elizabeth included “Bite Ramps” on his aligners because he clenches his teeth very heavily.  Bite ramps prevent patients from being able to bite down completely and clench.  It helps give the muscles a “stop” point and reminds the muscles to stay in a more relaxed position.  Matthew liked his bite ramps as his muscles felt very good while wearing the aligners.

Matthew’s case was expected to consist of 20 aligners that he would wear for 10-14 days at a time.  Matthew was very compliant and consistent in wearing his aligners as instructed and was able to complete his case after the 20 aligners as expected.

What does Matthew think?

Matthew thought it was something he wanted to do because he wanted to straighten his teeth and after looking into Invisalign he decided it was the best option for him.  What he liked most about the process was that it did not take as much time and it wasn’t painful at all!  When asked what he would tell a friend that was considering Invisalign treatment he said he would highly recommend it.  It is definitely an investment in your time and money, but it is worth it!

Matthew’s case was expected to consist of 20 aligners that he would wear for 10-14 days at a time.  Matthew was very compliant and consistent in wearing his aligners as instructed and was able to complete his case after the 20 aligners as expected.

 

From Chipped to Confident – Christine’s Story

By: Dr. Elizabeth Eggert

How did this start?

Christine has been a long-time patient of Dr. Elizabeth Eggert, for nearly 15 years.  She was bothered by chipping on her front teeth and had noticed it getting worse over the last few years.  She wondered what could be done.  She was hoping the teeth could be smoothed, but that would have made her front teeth look too short.  She wondered if Dr. Elizabeth could add filling material to the chipped area, but unfortunately, Christine’s tooth positions caused her to bite too heavily on the front teeth and that kept them at risk of chipping, even with a repair.

What was recommended?

Dr. Elizabeth explained that until the teeth were in better positions, the chipping would continue.  She recommended Christine consider Invisalign to move her teeth, which would then keep them from chipping.  Christine underwent the Invisalign Records Process.  Through this process, we realized that Chrisine would develop spacing between her teeth as her teeth were moved into a position where they wouldn’t hit too hard against each other.  Therefore, Dr. Elizabeth recommended 4 upper anterior veneers to help change the tooth shapes and sizes and also repair the chipping.  These restorations would be completed after the teeth were moved with Invisalign.  Christine also mentioned that she was unhappy with the color of her lower teeth and wanted to whiten so Dr. Elizabeth talked to her about all of her bleaching options.

What did Christine want?

Christine’s main objective was to fix the anterior front teeth that were chipped and straighten her lower front teeth as well.  She understood how her current bite was causing the chipping and understood the need for tooth movement.  She liked the idea of Invisalign since having metal in her mouth didn’t appeal to her.  As for bleaching, Christine elected to try Crest over-the-counter white strips and those worked well for her, although they caused slight tooth sensitivity.  Christine wasn’t too sure she wanted to commit to 4 upper anterior veneers, but understood that there were limitations to what Invisalign could do alone because she was able to view the ClinCheck simulation of her tooth movements.  She was ready to talk about a more comprehensive treatment approach and agreed to treatment.

What was involved?

Dr. Elizabeth recommended that Christine start with Invisalign in order to improve her crowding as well as give her tongue and airway more space.  Invisalign would be able to broaden and widen her smile so she wouldn’t have to do a full mouth of veneers or crowns to get the look she was hoping for.  Christine’s tooth movements also evened out spacing for her eventual porcelain veneers.

Examples of Invisalign Aligners

After only 11 months of Invisalign, Christine was ready to plan for her restorations.  Before starting the final planning stage, Dr. Elizabeth performed an equilibration for Christine to even out her biting contacts.  In the end, Christine agreed that by doing 4 veneers, the spacing could be more evenly distributed, giving her the look she wanted.  

 

What does Christine think?

Before the procedures Christine thought that Invisalign would be an easy alternative to metal braces.  Christine wanted to preserve what her teeth looked like before and was unsure if this procedure would allow for that.  She reports “I am very happy with how the veneers look!” and she notes she likes how natural her smile is.

 

All I Really Want Is My New Front Teeth- PC’s Story

By: Dr. Elizabeth Eggert

How did this start?

PC (name withheld by patient request) has been a long-time patient of Eggert Family Dentistry and was having issues with headaches and some trouble sleeping.  She was interested in fixing her “two front teeth.”  “My two front teeth are too big!  One is longer than the other, the color bothers me and one front tooth is father forward.  I had bonding done years ago and it doesn’t look good anymore.”

After many years, PC decided to undergo the records process with Dr. Elizabeth’s encouragement.  During the records process, Dr. Elizabeth used models, x-rays, and photos of PC’s teeth, gums, and bite to better understand the options and to help PC understand any risks that may occur with treatment due to underlying functional issues.    

What was recommended?

Through the records process and with information from Dr. Elizabeth, it was determined that the position of PC’s front teeth and the existing wear (flattened edges of her front teeth) likely are at least partially due to airway compromises, both at night and during the day.  Before restoring her teeth, it was recommended that PC undergo the Seattle Protocol to help determine if we could decrease the damage being done to her teeth and help protect her new restorations for the long-haul.  However, it was difficult for PC to coordinate this as she travels out of the country to help her family multiple times each year.  She and Dr. Elizabeth also discussed the option of talking with an ENT to improve nasal breathing, but PC declined this as well.

Therefore, PC elected to move forward with tooth restorations to address her esthetic concerns.  Yet, PC’s tooth positions due to crowding caused some esthetic hurdles.  Dr. Elizabeth talked with PC and recommended orthodontics to improve tooth spacing and gingival levels.  PC also declined this so Dr. Elizabeth had to think outside the box, encouraging PC to minimally seek treatment with a periodontist (gum and tissue specialist) to level out her gingival architecture.

What did she want?

PC was the most concerned about her front teeth.  She understood that by declining treatment to address her airway and tooth positions, we would be somewhat limited in our options and this was a risk she was willing to take.  She really wanted her front teeth to be the same color and same shape.  She wanted to minimize the number of restorations, but didn’t want to have to rely on bleaching to maintain the color of the upper front teeth.

What was involved?

After deciding that she would do bleaching to improve the color for her bottom front teeth and that she would do 6 upper front tooth restorations to give the best symmetry and color options, while still limiting the number of restorations, PC started by consulting with the periodontist so she could level her gingival architecture.  PC had this minor surgery completed and after 6 weeks of healing, we were ready to plan for her restorations.

At the time that impressions were taken to develop a wax-up or “blue print” for her restorations, PC underwent the in-office Zoom Whitening procedure to brighten her natural teeth.  PC was happy with the color and happy with the wax-up and so her teeth were prepared and the restorations were fabricated.

What does she think?

Once the restorations and bleaching were all completed, we asked PC what she thought about the process.  She noted there were a lot of things she hadn’t thought about.  She hadn’t realized how interconnected all the pieces were.  “I thought it would be so simple, just put a little cover over my teeth.”  She said she was amazed at how complex it really was and she was really impressed with Dr. Elizabeth’s knowledge, skills, and attention to detail.  She is really pleased with how everything turned out.  Thanks, PC,  for putting your trust in us!  We love serving you as our patient.

Replacing Maryland Bridges – Kate’s Story

By Dr. Elizabeth Eggert

How did this start?

Kate works in the medical field and came to us as a new patient in 2019.  At her new patient exam, Dr. Elizabeth noted that Kate was congenitally missing her upper lateral incisors.  The lateral incisor is the small tooth next to the central, front tooth. Missing lateral incisors are most commonly caused by a condition called hypodontia, in which someone is born with missing teeth.  This situation is more common than you realize.  Kate had her lateral incisors replaced by “Maryland” bridges over 30 years ago and she had some issues with them staying bonded in the past.  Maryland bridges aren’t used much anymore, but can be a decent way to replace teeth (temporarily) for patients that are young because over time tooth and gum changes are expected.

Kate had a bridge on her lower right side as well that came out due to the fracture of one of the abutment (anchor) teeth.  After this occurred, Kate decided it was time to work on her bite since she wanted implants to replace her lower teeth and once implants are placed, it is more difficult to idealize a bite since the implants can’t be moved with orthodontics like teeth can.

Patient Story - Kate

What did Kate want?

Kate wanted to complete her treatment as soon as possible, but she understood that changing her bite would include orthodontic treatment.  Kate worked with Dr. Brian DeVoe and had traditional brackets and wires placed.  Luckily, Dr. Elizabeth was able to section Kate’s original Maryland bridges so the teeth could still be moved, but Kate would not have to go without teeth in the front during her orthodontic treatment.  Kate was hoping to replace her missing teeth with implants so she would not have to use her adjacent teeth as anchors, however, due to the fact that Kate had been missing her lateral incisors her whole life, there wasn’t enough bone for implants without serious bone grafting interventions.  Even with surgical interventions, Kate still only would have had a guarded prognosis for implants.  Therefore, Kate decided to complete her case with conventional bridges.

Patient Story - Kate

What was involved?

Kate spent approximately 18 months in braces.  After she completed orthodontics, Kate came to our office for the pre-planning phase for her new conventional bridges.  We took impressions for a wax-up so Kate could preview her new restorations.  With the wax-up, we were able to complete a mock-up in Kate’s face so she could really see how the new bridges would look.  Kate also spent some time bleaching of her natural teeth so she could use a white porcelain for her new bridges.  This helped to brighten her smile.  One interesting thing occurred while Kate was bleaching.  She had purchased bleach online from the Amazon store, but ended up with a severe ulceration of her tissues from that bleach.  After reviewing techniques for healing, her tissue did heal and we were able to continue on with her treatment plan.

After Kate approved the mock-up and her gingival tissue healed, she returned to our office for the preparation of her teeth for conventional bridges.  We placed temporary bridges for a couple of weeks and then the final bridges were cemented.  She finished her treatment by having new orthodontic retainers fabricated.

Patient Story - Kate

What does Kate think?

When we asked Kate what she thought about the treatment once completed, she said that she didn’t understand everything that would go into correcting her bite and planning for new restorations.  She initially thought it would be a shorter process.  She was surprised at all the detail that went into the planning and the treatment.  “I am just amazed at the precision and every single thing that was considered.  Dr. Elizabeth Eggert’s skill and ability to do what she does truly amazes me.”  When asked what she would tell someone thinking of getting this done, she said, “I would tell them to trust the process and to trust Dr. Elizabeth.  It may not be the easiest to live through or it may seem long and tedious, but the end results are so worth it!”  Thank you for putting your trust in us to complete your care, Kate!  We love your new bright smile!

Patient Story - Kate

My New Smile – “It was Necessary:” ML’s Story

By: Dr. Elizabeth Eggert

How did this start?

ML (name withheld by request of patient) has been a patient of Dr. Elizabeth Eggert for over 10 years.  When ML first came as a patient, Dr. Elizabeth had been working to do a complete oral reconstruction for his mother.  His mom urged him to seek Dr. Elizabeth’s council as she was concerned for the long-term health of his teeth.  When ML came to us, he mentioned that he knew he had a lot of tooth wear.  In interviewing ML, he noted he had difficulty sleeping and said it would take up to 45 minutes for him to fall asleep.  He also didn’t think he had a stable bite, despite being in orthodontics on and off for 14 years of his childhood and teenage years.  He did have 4 teeth extracted for his first orthodontic treatment (2 upper bicuspids and 2 lower bicuspids).  You can note from the BEFORE photos that ML had tooth wear and his upper teeth were stuck inside his lower teeth – this is a condition called “crossbite.”

What was recommended?

ML went through the Records Process and it was determined that the wear on his teeth was increasing at an accelerated rate and the current position of his teeth would put them at high risk for continued wear, chipping, cracking, breaking, and potentially even tooth loss.  The recommendations were to get ML’s teeth into a more idealized position, keep bone support for the teeth, and restore the teeth where they have worn in order to build back to normal tooth proportions.

Years ago when ML underwent orthodontics for the first time, we didn’t know as much as dental professionals about airway and jaw constriction.  It was fairly common for patients like ML to undergo extractions in order to “gain space” and “alleviate crowding.”  We know more now as a profession about how this affects sleep, breathing, and tooth wear over time.  Instead of extractions to “gain space” it is much more common now to encourage the bones to grow into positions that can support all the teeth.  We are much more likely to recommend expansion or expanders.  This solution works very well in growing children.  As an adult, this was still possible for ML, but would require jaw surgery to make the corrections.  Therefore, orthodontics, jaw surgery, and restorations were recommended for ML.  Dr. Elizabeth also talked to ML about the alternative treatment of restoring all of his teeth and rebuilding to a different bite, but ML wanted to limit the number of restorations and Dr. Elizabeth told ML that she preferred to see a wider arch for his teeth anyway.

What did ML want?

“My lifetime goal for my teeth is to keep them.”  He reported he has never been happy with the appearance of his teeth.  He didn’t want “nuclear” white teeth, but he said if he was going to improve his bite, he wanted his teeth to look nicer too.  ML started the process with Dr. DeVoe (orthodontist) to change his bite without any surgical correction.  Dr. DeVoe did a nice job improving ML’s crossbite and moving the teeth into a position where restorations could be done to rebuild tooth proportions.

Second Round

However, even after this second round of orthodontics (ML’s first round as an adult), it was still difficult to even out his bite forces without doing a large number of restorations.  Also, there was an “elephant in the room:”  ML’s tongue.  Dr. Elizabeth couldn’t help but notice how much space ML’s tongue wanted.  As you can see in the photo above, ML’s tongue wanted lots of room and would spill over his teeth with his teeth apart.  It was also always very visible in photos and very active when working on ML.

While doing the consultation after this second round of orthodontics, ML said “Well, there is always still the option of jaw surgery.”  While ML had not been set up orthodontically for jaw surgery, Dr. Elizabeth told ML that he was correct, there still was that option, if he was willing to undergo more orthodontics.  She also shared with him the story of her mom’s journey with jaw surgery and orthodontics.

What was involved?

ML went back into orthodontics.  He had 2 different surgeries with Dr. Andreasen of Momenta Oral Surgery.  One to open his upper arch and expand that space and another to move his upper and lower jaw bones forward.  This extended his treatment time frame, but after this third round of orthodontics, he was ready for restorations.  ML felt his teeth were disappearing, it was time to rebuild them back to visible proportions.

Third Round

It is easy to see how ML’s oral space improved after his jaw surgeries.  His tongue is happy to have so much more room!  For color and tooth proportion corrections, Dr. Elizabeth recommended a minimum of 14 restorations (8 upper teeth and 6 lower teeth) along with equilibration to finalize the bite.  ML wanted whiter teeth, but it was decided that since he was doing 14 restorations, his back teeth wouldn’t show in his smile so bleaching was not needed before the restorations were done.  Therefore, we did a wax-up so ML could see what the final restorations would look like and after he approved the wax-up, we prepared the teeth for restorations and a few weeks later seated his restorations.                  

What does he think?

When we asked ML what he thought about doing the procedure before we started he stated, “This was necessary; I never saw this as elective, but I wasn’t really looking forward to it.  The thought of something happening to my teeth was a little uncomfortable.  I don’t think anybody likes doing something to their body that is irreversible.”

However, ML is very happy he completed the procedures and ended up doing the jaw surgeries after all.  He is surprised at how much bigger his airway is and that he no longer makes sounds at night when sleeping.  He always believed he could not breathe through his nose because of allergies, but that does not seem to be the case after this treatment, it appears that he needed expansion of his oral spaces.  (Note there is NO tongue visible in ML’s AFTER photo.)  ML says it was a long road and he learned a lot along the way, but it was necessary!

Congratulations on your amazing results ML and thank you for putting your trust in us!  We were delighted to help you through this journey!

After