Back in the Groove

A new approach to dental implants.

Ed Jones’ singing career began at a firehouse in Lakeside, Virginia on a cold winter’s night when his parents encouraged the then four-year-old to lead the fire fighters his grandfather captained in Christmas carols.

Photo by Jordan Pysz.

Ed sings with a smile now, thanks to
Dr. Farag and Port Charlotte Dental Care.

Since then, and more as a hobby than a vocation, Ed has regularly moonlighted as a performer, singing everything from country and western songs to rock and roll, and even 80s and 90s hits. It all depends on the audience.
It wasn’t until just recently, though, that Ed, now 63, began singing with a smile.
“I’ve always had problems with my teeth, ever since I was about eleven or twelve years old, so when I’d sing, I’d sing almost with a closed mouth,’’ Ed relates. “It’s something I’ve always been a little self-conscious of.
“Of course, it didn’t help that the first time I ever went to a dentist, I had a bad experience. I remember him saying over and over, Oh, this is not going to hurt at all, and then the next thing I knew, I was in terrible pain.
“After that, I pretty much did everything I could to avoid going to a dentist. I probably went sixteen or seventeen years without going at one stretch. It got to the point where, when I did go, I was only going because my teeth were hurting so bad that I had to go.’’
Most of those visits resulted in teeth being extracted, which only made Ed more hesitant to return for regular treatment. Finally, after the teeth that were holding a bridge began to go bad, Ed had no choice but to seek a permanent solution.
He found it, he explains, after his wife read an article in Florida Health Care News about Port Charlotte Dental Care and the work Joseph H. Farag, DMD, had done for patients who suffered from the effects of bad teeth for years.

Working Backward

“When Ed came to us, he had a lot of failing dentistry, and he had some failing teeth,’’
Dr. Farag reports. “He had decay and periodontal disease all at one time, and it had really taken a toll on his teeth. In dental terms, they were what we call hopeless dentition.

Scan graphics courtesy of Port Charlotte Dental Care

A virtual image is done on the computer in order to confirm correct placement of implants according to desired tooth position.

“So I asked him, What do you want to have as far as a finished outcome? What is your goal? Ed replied, I want to be able to smile. I want to be able to eat. I want to be able to function normally and not have to worry about these things.
Dr. Farag laid out a series of options for Ed that included either dentures or a combination of implants and permeant restorations. However, he explained that in order to meet Ed’s goals the best way to go was with implants and a permeant fixed prosthesis.
“I explained to him that in some areas we are going to need to graft because of infection,’’ Dr. Farag reports. “Ed had lost some bone, and we needed to replace that first. We needed to rebuild the jaw so that we could put the implants in an ideal position.’’
Dr. Farag further explained that recovering from the grafting procedure could take as long as three months but that it was critical to the outcome to wait until the healing process was completed before finalizing the implant procedure.
The dentist ensures that there’s no unappealing outcome later on because he works from the teeth and the finished smile backward. It is a unique approach that begins with his team and lab technician Robert Ohm at All Smiles Dental Lab performing a 3-D scan of the mouth and a virtual mockup of what the completed smile will look like.
“We display the teeth as they’ll look on the patient’s jaw at the end of the procedure in a 3-D simulated environment on the computer,’’ Dr. Farag explains. “We actually put the teeth where we ultimately want them to be before we do anything else.
“From the tooth, we work backward to the implant. Some dentists do it the other way around. They stick the implants wherever they can and then sometimes come back and say, Okay, now let’s place the teeth. But the teeth may not end up in the ideal position that way.

Photo by Jordan Pysz.

Dental implants helped put a smile back on Ed’s face.

“That’s why we do it the other way around,” continues Dr. Farag. “We work backward to put the implants in positions that will facilitate the positions we want for the teeth so that the smile is exactly how we want it.
“That’s huge, because we already know where we’re going to end up. We know we’re going to have a nice smile, a good midline and good aesthetics. We know we’re going to have good speech because everything is already planned from that point backward.’’
In addition to working from the teeth backward and using 3-D imagery and virtual reality in his approach, there is another technological advancement Dr. Farag uses to ensure the final outcome leaves his patients smiling broadly and proud.
At the point in the process where a preliminary set of the final teeth is inserted, Dr. Farag first places a custom-made surgical guide into the mouth. The guide contains sleeves that allow the implants to be guided into the positions dictated by the 3-D image.
“That part of the procedure is a piece of cake,’’ Dr. Farag notes of guiding the implants into position. “It doesn’t take very long, and there’s little to no bleeding whatsoever because there are no sutures. It’s all done through the guide.
“The implants are placed through that guide into the jaw, and they’re already prepped in terms of their location, depth and length – everything, including angulation – because that’s all pre-determined.

Prosthesis and scan graphics courtesy of Port Charlotte Dental Care

Final digital design and laboratory fabrication done by Robert Ohm at All Smiles Dental Lab.

“The patient will leave that day wearing a healing prosthesis that we create based off of the original plan to have the teeth where we want them. If there are any changes that have to be made, that’s the time we make them.
“We can move them up a little bit, down a little bit, change the color, change the size – anything they want us to do. It’s easy at that point because we’ve already planned it. We already know where the teeth need to go and how they need to look.’’
Dr. Farag says most patients wear the healing prosthesis for anywhere from two weeks to a month to ensure everything is just right. Ed, however, returned after only a few days to let him know the fit was just what he wanted.
“That was surprising,’’ Dr. Farag reveals. “The folks in my lab were saying, Shouldn’t he wear it a little longer, just to be sure? But I replied, No, he’s done. He doesn’t want it to be any different than what it is. He’s good to go.’’
Apparently so.
“I’m just overjoyed with the results,’’ Ed reports. “I would absolutely recommend
Dr. Farag because the whole process, from meeting him and going through the options with him and having an opportunity to try things out and fix them if you need to, it was great.
“I’m hoping that now that I actually have some nice teeth and a healthy smile and everything feels right that it’ll be a bit easier for me to sing. I’m also hoping to start doing a little more singing because I really do enjoy it.’’

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    • Port Charlotte Dental Care

      Dr. Farag provides a full range of quality, caring dental services to the Port Charlotte community. He looks forward to hearing from the viewers of the Florida Health Care News website. For more information or to schedule an appointment, pl... Read More

    • Joseph H. Farag, DMD

      Joseph H. Farag, DMD, earned his Doctor of Dental Medicine degree from the University of Florida College of Dentistry, Gainesville, FL after completing his undergraduate degree at Florida Atlantic University, Boca Raton, FL. Dr. Farag served an... Read More