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!
