Patient Stories Archives - Page 2 of 6 - Eggert Family Dentistry Blog

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.

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.

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!

My Journey to a New Smile – Roxanne’s Story

By: Dr. Elizabeth Eggert

How did this start?

Roxanne has been a long time, loyal patient with us since even before Dr. Elizabeth Eggert started in 2005. In 2013 she went through the Records Process because she wanted to address jaw pain that had been getting worse since a car accident in 1981. She also was unhappy with her tooth wear. Dr. Elizabeth used models, photos, and x-rays of Roxanne’s teeth along with our thorough muscle and joint evaluation to present Roxanne with the current health of her teeth, gums and the function of her jaw and muscles. The details of the initial records process revealed that Roxanne would benefit from splint therapy in order to help her jaw and tooth pain. Because of the tooth wear on her front teeth, Roxanne was hitting her back teeth very hard, especially when chewing, causing her muscles and joint to become overworked. An anterior deprogrammer was recommended for her splint therapy, then veneers were recommended to change the length of her front teeth in order to eliminate the interferences of her back teeth.

What did Roxanne want?

Roxanne’s main objective was to be pain free and have a fuller, brighter smile. Roxanne underwent splint therapy with an anterior deprogrammer, but it wasn’t quite enough to get her completely pain free. She was “pain better,” but not “pain free.” The stress in Roxanne’s life compounded her pain and it took many years, including work with an orthodontist, a neurologist, an acupuncture specialist, as well as decreased stress in her life to get her to a stable enough position to address her cosmetic concerns.

Roxanne wondered if bleaching alone would give enough improvement to her smile so she started with Zoom whitening. Unfortunately, although Zoom helped whiten her smile, it wasn’t to the extent she was looking for. Plus, whitening alone couldn’t lengthen her front teeth in order to eliminate the interferences in her bite and keep her pain stable.

Therefore, Roxanne was ready to talk about a more comprehensive treatment option for her teeth. Dr. Elizabeth recommended that Roxanne start with Invisalign in order to improve her crowding and gum tissue levels as well as give her tongue and airway more space. Invisalign would be able to broaden her smile so she wouldn’t have to do a full mouth of veneers or crowns to get the look she was hoping for.

What was involved?

Roxanne underwent Invisalign treatment with the goals of improving her crowding, expanding her arch, creating space for porcelain veneers (which would introduce spacing between her teeth), leveling gingival tissue, and providing support for her joints and muscles.

After only 7 months of Invisalign, Roxanne was then ready to plan for her restorations. Before starting the final planning stage, Dr. Elizabeth performed equilibration to refine and finalize even contacts with her bite to keep her potential for future pain symptoms under control. Roxanne wanted her teeth even and white and elected to restore 8 teeth on her upper arch and 6 teeth on her lower arch. Roxanne did a lot of research before doing her veneers and wanted a “Hollywood Style” look. The teeth were prepared for the restorations and in less than 3 weeks, Roxanne had her final results.

What does Roxanne think of her results?

Before the procedures Roxanne was nervous about the time it took and the “permanency of it all,” yet she was very confident in Dr. Elizabeth. In her final interview, Roxanne said “Dr. Elizabeth told me exactly what would happen, what I should expect, and there were no surprises. The timeline was just as discussed.” She also said, “My jaw feels great and my new smile is good. It’s what I was expecting.” She would definitely recommend the treatment to others and says that it is a team effort and you have to do everything that is expected of you for the best results. Roxanne knows that having a better smile is fantastic. “My smile is pretty important. If you look better, you feel better!”

Roxanne was also so kind to write a 5-Star Google Review of our practice and noted “Dr. Elizabeth and I completed a 9 month process of realigning my bite and correcting my dysfunctional jaw. Along with a complete restoration of my upper and lower teeth. The results were everything I had hoped for. I appreciate her knowledge and dedication everyday when I look at my new smile!” Thank you Roxanne! You truly are a treasure for us! We look forward to reading other 5-Star Google Reviews from our patients. Submit yours today!

What to do When You Have Missing Teeth? – Jasmine’s Story

By: Dr. Elizabeth Eggert

How did this start?

Jasmine came to us in the summer of 2020 with several concerns that included advanced periodontal disease, several missing teeth, and current tooth and gum infections. She was having a lot of pain. Unfortunately, her situation was compounded due to complications from trauma that had occurred from an accident thirty years prior.

What did she want?

After several years of treatment for periodontal disease with a periodontist to try to save her natural teeth, Jasmine wondered if it was time for complete dentures. She had a friend in China with complete dentures that she liked very much. Dr. Jeff Eggert talked with Jasmine about all tooth replacement options including implant supported options as well as full traditional dentures. Jasmine noted it was important to her that she get out of pain, but she wanted her tooth replacements to be very stable and allow her to chew naturally as she was only using her front teeth now. She was very concerned about the costs involved with implant supported dentures and didn’t like the idea of full dentures slipping all over her mouth. After many discussions of the pros and cons to all treatment options, Jasmine decided that she wanted to do removable partial dentures. She felt this would be the best option for her because it would be less expensive overall and she would still have some anchorage from her remaining natural teeth. Even though Jasmine has suffered from periodontal disease, she still had a number of natural teeth to work with that could help support a partial denture.

What was involved?

Jasmine and Dr. Jeff discussed several options and decided to do both upper and lower partial dentures. Jasmine had two remaining upper teeth that were severely infected from periodontal disease. These teeth had to be removed, otherwise the new partial denture would increase the infection. The planning for Jasmine’s partial dentures was done before these teeth were extracted and on the day Jasmine underwent the final fitting for her new partial dentures, Dr. Jeff Eggert removed the two teeth. Jasmine was excited to have her new partials. She was given care instructions and guidance for inserting and removing the partial dentures on her own.

What does she think?

Jasmine was a little nervous before the procedure because she had had some poor experiences with a temporary partial denture made by one of her past dentists, but she had lost a lot of teeth and her chewing was really affected. She says that everything now is much better especially now that she can use her lower left side for chewing hard foods. She notes, “They fit in my mouth very well and feel comfortable.” She was pleased with the cost and how well the new partials look and feel. Of Dr. Jeff’s work, she notes “This clinic can do partials very well and is affordable!” Congratulations on your new partial dentures Jasmine! Thanks for putting your trust in us at Eggert Family Dentistry!

The Power of a Great Bite – Steve’s Story

By: Dr. Elizabeth Eggert

How did this start?

Steve came to us in 2020 and talked to us about how his bite never felt right after a new crown had been done at another dental office. Steve said that he even had undergone two rounds of Invisalign trying to make his bite feel normal again. He told us he chose our office because he researched and found that Dr. Elizabeth Eggert had the experience he was looking for in regard to helping people feel better about their bites. He told us, “I am not happy with my bite and I really just want my jaw to feel better.” He was not concerned cosmetically about his teeth, but wanted to be comfortable with his bite and to be able to eat again without feeling like he would break his teeth.

What was involved?

Steve underwent the Records Process and some interesting things were noted from the analysis. Dr. Elizabeth was able to obtain Steve’s pre-Invisalign records and noticed that he started with spaces between many of his front teeth.

Pre-Initial Invisalign

The analysis helped her find that Steve had a strained muscle and jaw position and therefore, it made sense for Steve to start his treatment with splint therapy to help find a consistent bite position for jaw and muscle comfort. The best appliance for Steve was an Anterior Deprogrammer to help his muscles release and decrease pressure and stress on his functional system. After splint therapy, it was clear that Steve’s bite had unevenly high points and his body seemed to crave more space in his mouth because his lower jaw wanted to be forward from where it was. It was almost like he was “locked” into an uncomfortable position. Dr. Elizabeth suspected that because Steve’s first Invisalign treatments closed the spaces between his teeth, that a cascade of muscle imbalances followed for him.

She recommended that Steve undergo Invisalign AGAIN in order to open the spaces back up and then restore his teeth to fill in the gaps.

Invisalign helped gain space back and Steve’s muscles were finally able to relax again, however his teeth still hit somewhat unevenly in the back. Therefore, equilibration was also completed for Steve to even out the bite forces on his teeth now that his muscles were in a calm position. After the 3^rd round of Invisalign and the equilibration, Steve told us “My muscles feel REALLY GOOD!”

Before restoring his anterior teeth with porcelain veneers to fill in the gaps, Steve also wanted the rest of his teeth whiter. Steve completed the Zoom bleaching procedure and brightened up at least 5 shades!

What does Steve think?

Steve is very happy with the final results and said that during the procedure he did not have any worries.

“I think it was a good process and I didn’t have any sensitivity with my teeth.” He told us his muscles and bite feel much more stable and he no longer gets the feeling that he is going to break his teeth. He said “The timeline was good and it went by fast.” His family also likes the results, but Steve says “It really wasn’t about the cosmetic aspect for me, but it was worth it to have the stability in my bite!”

Congratulations Steve – your results are amazing! We are so happy we were able to get your bite back for you. This case was a fun puzzler for Dr. Elizabeth because she was able to figure out how important your “pre-condition” was to a future successful outcome! We appreciate you putting your trust in us!

What Can Composites Do for You? – Liv’s and Gretchen’s Stories

By: Dr. Elizabeth Eggert

How did this start? Liv’s Story

Liv came to us for an evaluation with Dr. Elizabeth Eggert prior to beginning Invisalign treatment. Liv was about to start Invisalign with Dr. Wang, but she and her parents wanted to discuss her options for addressing the spacing she had between some teeth.

Liv was born with undersized lateral incisors, sometimes called “peg laterals.” With this condition, there often are spacing issues because the tooth size doesn’t match the arch size. In Liv’s case, this left a space between her two front teeth that she wasn’t fond of. It even kept her from smiling in public!

Pre-planning was done so that after Invisalign treatment, Liv would be left with even spacing, an expanded arch, and a broader smile. Then, Dr. Elizabeth would be able to change the size of her teeth with composite and finish building Liv a beautiful smile.

What was involved?

When Liv completed her Invisalign, she noted she wanted whiter teeth too, so before we completed her restorations, Liv underwent the Zoom Whitening procedure. Her teeth brightened up very nicely.

Dr. Elizabeth then discussed pros and cons with Liv and her parents regarding restoration options. There are two materials available for veneers – composite resin (plastic) or porcelain. Both are conservative options, both will give a nice color match, and both hold up well. Composite can stain over time, but initially isn’t as much of an investment. Because Liv is still young and her body will continue to evolve, it was decided to do two composite veneers now and in a few years’ time, reevaluate the need for porcelain, possibly extending to more teeth in the future. Dr. Elizabeth did a mock-up of the possible restorations and after seeing this mock-up, Liv was really excited and ready to proceed!

What does she think?

Liv is very happy with how everything turned out. She said she was excited to use composite, which will leave things more flexible for her future. She thought it seemed like the best option for her age. She said “It is easy to maintain and it feels very natural and normal. I smile more now and I actually show my teeth. I didn’t used to do that.” This is what now makes her parents very happy!

When asked what she would say to someone considering getting this done, she said that is quick and not a long procedure: “It was very easy for me!”

We are so happy that we could work with Liv and collaborate with her team of doctors to help give her a smile she can be proud of!

How did this start? Gretchen’s Story

Gretchen came to us as a new patient and Dr. Elizabeth noticed she had decay around an existing composite veneer on her right-side lateral incisor as well as decay on her right-side central incisor. While Gretchen certainly would benefit from a more comprehensive treatment plan to address her bite and wear pattern, Gretchen was nervous about replacing her existing composite veneer and was concerned about costs. Therefore, after some encouragement to at least address the decay, Gretchen agreed to move forward with a new composite veneer and filling.

What was involved?

Since Gretchen wanted a more limited approach, no pre-planning was completed and all the treatment was done free-hand by Dr. Elizabeth in one appointment. Gretchen wanted a better color match (her original veneer was much brighter than the current shade of her natural teeth), she didn’t want to feel the gap with her tongue on the back of her current veneer (due to the decay), and she wanted the shape and contour to remain similar to her original veneer.

What does she think?

Gretchen is happy with her results and she said “It doesn’t feel like there is a gap in the back anymore.” She is also happy she can still use her original retainer. This was a concern for her as well. Even in a more limited approach, composite can give beautiful results!

Sometimes the Results are Worth the Wait – M’s Story

By: Dr. Elizabeth Eggert

How did this start?

M (name omitted by request) has been a loyal patient of Eggert Family Dentistry for nearly 20 years, since even before Dr. Elizabeth’s time. In 2013, M underwent jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, which corrects irregularities of the jaw bones and realigns the jaws and teeth to improve the way they work.

In December 2015, during a recare visit, he mentioned that he had to force his muscles to bite correctly and wondered if that was normal after jaw surgery. He also noted that his teeth were jagged and did not have a clean line. He didn’t want to think about them all the time, like when eating or when looking at himself in photos.

At that time, M decided to undergo our records process to determine how lengthening his front teeth would help improve his bite. While M’s bite was improved after his orthodontics and jaw surgery, there had been enough prior damage to the teeth and the joints that M still had some bite imbalances after he healed from his surgery.

After working up M’s case, Dr. Elizabeth determined that with six upper veneers to lengthen his front teeth and some minor equilibration to even out high spots in his bite, M should feel better about both how his teeth fit together and with how they look.

What did M want?

M wanted to get rid of the gap he saw between his lateral and canine incisors and he wanted no chips on the front teeth. He wanted a whiter and brighter smile as well without all the white lines on his natural teeth.

What was involved?

Dr. Elizabeth started the case by mocking up the new shape of the teeth on dental models. M really liked the result. We started the treatment by evening out M’s bite with equilibration. Then, impressions of his new bite were taken and sent to the dental lab so a lab wax-up could be completed. This gave us the actual blue print for his new teeth. In the interim, M underwent the Zoom In-Office Whitening procedure to brighten his teeth to the desired color for his new veneers. Soon after the whitening procedure, M came for his preparation appointment and then 2 weeks later, his veneers were carefully inserted.

What does M think?

In his final interview, M was asked how he felt about his course of treatment and his decision to complete the veneers. He said, “I was concerned about it being painful or that there were going to be a lot of appointments to complete the treatment. While there were a lot of appointments, the time went quickly and it was painless.” He is very happy with the outcome and would recommend that anyone thinking of getting veneers to just get them done! He said it was easy to have an open dialogue with Dr. Elizabeth and it was great to have a solid plan along the way.

M did say that he hasn’t had many comments on his veneers, but he’s glad about that because he wanted everything to look very natural.

M’s story is just one of many others who have experienced magnificent results with Dr. Elizabeth Eggert. Veneers 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 M for trusting us to help you continue to smile big and now more confidently!

CEREC and The Primescan Up Close – Ann’s Story

By: Dr. Elizabeth Eggert

It is always ideal when your dental exam reveals no problems, but sometimes issues do arise. If your tooth has a large cavity, cracks, or is broken, Dr. Elizabeth or Dr. Jeff will likely recommend a crown to help restore the integrity of your tooth. A crown will reinforce the tooth and help keep it functioning for eating, smiling, and speaking.

Crowns have been around for decades and fortunately the materials and process for making crowns has continued to evolve and improve. Traditionally, getting a crown on your tooth involved two appointments. Currently, technology exists that allows us to make crowns in our dental office in one appointment. This offers a number of advantages, probably the biggest of which is convenience in coming to the office for only one appointment instead of two. Another advantage is the ability to take a digital impression with an intraoral scanner. This eliminates the need to take a traditional impression with putty material that sets up in your mouth. A crown in one day also means there is no need for a temporary crown. Temporaries are durable but do occasionally break or come loose, necessitating a visit to have a new temporary made or recemented. An additional remarkable feature of the “same-day crown” is the ability to replicate the shape and anatomy of an existing tooth or crown, which makes it easy for your new crown to fit well into your bite.

We have been using this technology with the CEREC system for many years and we recently upgraded our intraoral scanner to the Sirona Primescan, which makes taking digital impressions even faster and easier. Not every case can be completed in one visit, but many can, which most people find preferable. A recent patient, Ann, commented, “It is very convenient to get the crown fitted and designed in one visit versus having to come back!”

We want to share some photos with you of Ann’s case so you can see this technology in action. If one of your teeth ends up needing a crown, you can trust that our great team at Eggert Family Dentistry will take wonderful care of you too!

Call us today at 651-482-8412 to inquire about getting your next crown in one day!

Restoring Teeth with Implants: When Infections Cause the Need for Creativity. Judy’s Story.

By: Dr. Elizabeth Eggert

How did this start?

Judy came to her regular 6-month recare appointment and mentioned that she thought one of her front teeth was turning darker. Joanna, our hygienist, noticed an issue right away as it looked as if Judy may be developing an infection near that upper front tooth. Joanna took an x-ray and Dr. Elizabeth did some tests and it was evident that Judy had lost a lot of bone near the roots of some upper front teeth. For an unknown reason (likely a trauma that occurred long ago), Judy’s teeth had started dying, creating an infection and bone loss. Dr. Elizabeth referred Judy to the root canal specialist and Dr. Aguirre confirmed the extent of the damage with a 3-D x-ray. Dr. Aguirre agreed that the lesion was excessively large. He was not confident that root canals alone could clear the infection so recommended that Judy work with an oral surgeon to remove the teeth, the infection, place a bone graft, and hopefully implant(s).

Because Judy didn’t remember any past trauma to her teeth and because of the extent of the bone loss could render all traditional treatment options unpredictable, Dr. Elizabeth recommended Judy undergo the records process to determine all her options going forward.

What did Judy want?

Judy wanted to be able to have front teeth and she wanted to be able to predictably clear her infection. She agreed to go through the records process to learn about her options and hopefully determine if her current bite could be part of the reason for the trauma that caused her infection. It was also important to Judy to be able to eat and speak normally after her teeth were restored. She met with Dr. Wade, an oral surgeon, who agreed that two teeth should come out. He was fairly confident that the infection was confined to only two teeth. He noted a large bone graft would be needed for Judy and implants would not be able to be placed until the graft was fully integrated. He recommended Judy have a temporary denture made to replace her teeth for awhile.

What was involved?

At the records appointment, Dr. Elizabeth took photos and x-rays of Judy’s teeth and did a thorough muscle and joint evaluation. She used the information gathered at that appointment to develop possible treatment options for Judy. It was evident after the bite analysis of the records process that Judy has an anterior open bite, which means that her upper and lower front teeth don’t meet up with each other. This concerned Dr. Elizabeth the most because it meant that Judy’s bite may not adjust well to change, but we knew Judy would undergo a change because of the infection. There was also a risk that her other two front teeth (or possibly more) could eventually become infected so any plan for Judy had to allow for flexibility in the future. Dr. Elizabeth presented Judy with multiple options, including implant-based options, a tooth-based bridge option, or a long-term removable partial denture. In the end, Judy’s treatment choice could have been limited by what would be discovered during surgery, but Judy wanted to restore the missing teeth with one implant that would hold two teeth (better for gum esthetics) and she wanted to repair her bite to make her upper and lower front teeth touch. This would help with long-term functionality and predictability.

Judy had 2 teeth extracted, the infection removed, and a large bone graft placed by Dr. Wade. Dr. Elizabeth had a temporary partial denture ready to insert after surgery. In addition, Dr. Elizabeth built up the edges of Judy’s other front teeth to mimic what her final restorations would look like.

Once the bone graft was integrated, Dr. Wade went back for another surgery to place an implant for Judy. One implant was placed that would eventually hold and replace two teeth. After three additional months of healing, Dr. Wade placed a customized healing abutment to help shape the tissue for the eventual tooth restorations. Judy continued to wear her temporary partial denture during this time. Dr. Elizabeth also wanted to influence the tissue at the site for her “other tooth” so she built up Judy’s temporary partial denture to put pressure on the tissue and shape it so it would eventually look like a tooth is emerging from the tissue.

During the healing time, Judy also decided she wanted to lighten the color of her teeth so she underwent the Zoom bleaching procedure and improved her shade to 5 times brighter! Finally, Judy did the final planning with Dr. Elizabeth, completing a lab wax-up, like a blue print, for her future restorations. When the surgeon gave the “all-clear,” Dr. Elizabeth prepared Judy’s remaining upper front teeth and got impressions of the implant site so 5 restorations could be fabricated for her 6 front teeth.

What does Judy think?

Judy had a long treatment process. She notes she learned a lot as a lot went into the decision making. Judy notes “I didn’t have a choice, it was something that had to be done. It was interesting to learn more about my bite and what it would mean to have longer teeth in the end.”

Judy notes she thinks her teeth look “very nice” and is happy to be done with everything. “It was a bigger procedure than I expected, but it turned out nice in the end!”

We’re so grateful to have you as a patient, Judy – thank you for putting your trust in us! It was a pleasure to be able to use our creative thinking skills to help you through this interesting case.

Fixing a Fractured Front Tooth – Tim’s story

By: Dr. Elizabeth Eggert

How did this start?

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

What was involved?

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

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

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

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

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

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

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

Identical Twin Expansion: Zack and Ryan’s Story

By: Dr. Elizabeth Eggert

When Did this Start?

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

What Was Involved?

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

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

What Do Zack and Ryan Think?

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