Before she knew it, Cindy Wildes was on the brink of
losing all of her teeth.
“It was about ten years ago,” remembers the 63-year-old.
“It came on ever so fast. I developed indigestion, which was later diagnosed as
acid reflux, but I didn’t really pay much attention to it. Then, in an
incredibly short period of time, it had eroded all the enamel from my teeth.”
She confides that she is forever thankful that her dentist
is Stephen G. Blank, DDS, who practices cosmetic and functional dentistry in
Port St. Lucie.
“It was actually his hygienist who first recognized my
condition,” reveals Cindy. “I had no idea there was even a problem.”
Dr. Blank recalls Cindy’s 2001 examination: “When we
checked her teeth, all her enamel on the tongue side was almost gone. Instead
of a white layer, we were only seeing a white halo at the edges. Other than
that, we were looking at the dentin.”
Dentin is the creamy, yellow-brown substance that lies
under the enamel and protects the innermost part of the tooth. “Once the dentin
is exposed, the wear continues faster and faster. Dentin wears down between five
and eight times more rapidly than enamel. This meant that Cindy’s teeth were
destined to wear down to an even greater extent.”
Cindy says that when her hygienist saw the damage, she
immediately brought it to Dr. Blank’s attention.
“Even the biting surfaces of Cindy’s back teeth had worn
off,” observes Dr. Blank. “The cuspid tips were worn down, and her bite had
changed. Her bite was what patients often refer to as
slippery
, she was able to chew sideways or
more like a cow
! Rather than her cuspids guiding Cindy’s jaw into
place and guaranteeing a proper fit, her jaw was sliding in big circles, mowing
everything flat. That causes more and more wear of the same pattern.”
Dr. Blank’s diagnosis was that Cindy needed all of her
teeth rebuilt.
“Without dental insurance, it seemed overwhelming,” she
admits, “but Dr. Blank worked with me. He was able to repair my teeth in phases
so that I was able to accomplish my goal in a reasonable amount of time.”
Treatment plan
Dr. Blank laid out his treatment plan for Cindy: “We used
bonded tooth-colored composite resin on Cindy’s teeth as an interim measure
while we rebuilt her teeth in phases with permanent materials. For instance,
when we did the first corner of her back teeth with crowns, which made those
teeth higher, durable, and strong again, we coated the other sections with
resin, shaping them like teeth and polishing them. Had we not built up those
other areas with the composite, only the crowned teeth would have touched when
she closed her mouth.”
Dr. Blank explains that when he uses resin to fill a
cavity in the groove of a tooth, there is a strong tooth surrounding it, so it
can be considered a permanent treatment. However, when he coats the entire
tooth with the resin, it is taking the entire load of pressure when the patient
bites down. “While the composite resin was perfect to use as a durable,
protective material for a long-term interim period to take her from where she
was to where she was going, it does not have the strength of a porcelain
crown.”
Dr. Blank also coated the back of Cindy’s front teeth with
resin to protect them until Cindy was ready for new crowns on the front teeth.
New Crowns
Dr. Blank designs the size, shape, color and position of
the tooth restorations. Study models and photographs of his patient’s mouth are
taken and sent to the laboratory for a wax-up.
A wax-up, or a wax model of how the enhanced or repaired
teeth will look, is completed by the laboratory, following Dr. Blank’s
prescription. It simulates the new teeth and is used to make any necessary
changes before the lab proceeds to make the patient’s new porcelain crowns.
“During the next step, the teeth are prepared for the new
restorations, and any old, obstructing dentistry is removed,” says Dr. Blank.
“Impressions are made for the laboratory, and temporaries that match the wax-up
are created.”
Copies of the temporaries are sent to the laboratory
technician for better results.
Following this visit, patients leave Dr. Blank’s office
with resin temporaries.
“The temporaries look just like the new teeth are going to
look,” adds Dr. Blank.
The final step is to bond the porcelain crowns to his
patient’s teeth.
Success
To resolve her acid reflux, Cindy says she went to a
gastrologist, began taking over-the-counter antacids, and changed her diet, all
of which control her condition.
“I did have naturally beautiful teeth,” reflects Cindy,
“and I have to admit that I didn’t recognize there was any problem.”
“Without a closer examination, most people would have had
no idea about Cindy’s dental problem,” supports Dr. Blank. “Most patients don’t
realize the extent of the damage their teeth may be suffering. It is just very
difficult to examine one’s own teeth carefully.”
Cindy acknowledges that before she first went to Dr.
Blank, she had been afraid of going to the dentist. However, despite her
earlier apprehension about dental care, she says that after working with him,
she’s not scared anymore: “I would let him do practically anything to my
mouth,” she says with a laugh. “I couldn’t be happier with my new smile.
“In fact, he and his staff are so easy to work with that I
talked my husband, Mac, into going to see him about his TMJ.”