Creative Solutions

Innovative approaches solve challenging dental problems.

Robin Black’s 15 minutes of fame came when she was offered a staff position on then-Sen. John F. Kennedy’s team as he began his run for president.

Robin Black on her patio holding a blue birdhouse and smiling.

Robin is “delighted” with the implant-supported hybrid prosthesis created for her upper arch.

“My uncle was a Capitol Hill photographer, and I often went with him to big dinners and luncheons to write down the order of the politicians and celebrities in the photos and to gather any other information he needed,” Robin recounts. “It was my uncle who found out that JFK was looking for a secretary, and he told me about it.

“I went to the Senate office building and was interviewed on four occasions. They wanted me to be his private secretary. He was getting ready to run for president, and his current secretary couldn’t handle all that went with that. They wanted me to work with her and ultimately replace her, but the job demanded my entire life so I turned them down.

“Almost being JFK’s secretary is my claim to fame.”

Robin, 87, is a North Carolina native who resided in the Washington, DC, area for most of her adult life. Her family owned a business in Florida, so she regularly visited the Sunshine State. In 2001, she made Florida her permanent home. After relocating, she transitioned most of her health care to Florida providers. The exception was her dental care.

“As a youngster and into my 30s, I had horrible dental experiences, so I was traumatized when it came to going to the dentist,” Robin shares. “But in Silver Springs, Maryland, I finally found a wonderful dentist who took away all my fears and apprehensions.

“Even after moving to Florida, I continued to go up to Maryland a couple times a year to see that dentist. Then a few years ago, going there became more difficult due to scheduling conflicts and getting older. I knew I needed to find a local dentist.”

Robin thought finding a local dentist as good as the one she had in Maryland would be an impossible task. Then a friend had what he described as an “outstanding experience” with a teeth-whitening service offered by Stephen P. Lester, DDS, at Park Avenue Dentistry in Edgewater. Based on her friend’s review, Robin decided to give Dr. Lester a try.

“Right away, I was impressed,” Robin recalls. “After two appointments, I realized that the impossible had become possible.

Dr. Lester was wonderful. He allayed all the apprehensions I had and made me feel very comfortable. His manner and expertise were top of the line and state of the art. He’s exceptional, and I knew I could trust him.”

Hybrid Prosthesis

Dr. Lester began his care of Robin by replacing a failing lower bridge with a porcelain bridge that runs along the front of her lower arch. He then addressed her upper arch, where Robin’s bridgework was failing because of decay on the teeth supporting that bridge.

“That upper bridge was falling apart piece by piece,” Dr. Lester explains. “My recommendation to Robin, and she committed to it, was to replace that bridge with a single piece, a full upper arch of teeth resting on and retained by a half-dozen dental implants.”

The process of replacing Robin’s failing upper bridge and teeth began with Dr. Lester examining Robin’s jawbone three-dimensionally with a CT scan to ensure there was enough bone mass to secure the implants.

“People have no idea I don’t have my own teeth.” – Robin

“The CT images are also used to determine where to place the dental implants,” explains Dr. Lester, who also took impressions of Robin’s teeth to make molds to follow when creating replacement teeth.

During the next phase, Dr. Lester pulled the remaining 14 failing teeth in Robin’s upper jaw. Initially, Robin wore a transitional denture so that at no time was she without teeth.

“There are many dentists who advertise under various trademarked and brand names what are essentially teeth-in-a-day services,” Dr. Lester points out. “We offer a similar service at Park Avenue Dentistry.

“As part of our service, we first fabricate a denture. When the denture is ready to be placed in the patient’s mouth, we extract the teeth and put in the denture. Shortly after, it could be the same day, we place the implants. If the implants are nice and sturdy, we screw the denture onto the implants, fixing it into place.

Complete bottom teeth that secure to multiple implants

Full Lower Arch of Teeth

“I do not market this service as teeth in a day because there are several preparatory appointments. Those appointments are necessary for designing and creating the dentures prior to the day of tooth extraction and implant placement.”

Once patients receive the fixed dentures, they wear them about three months. During that time, the jawbone grows around and fuses with the implants to become a strong, solid unit.

“At the end of the three months, we throw away the transitional denture and create a really nice, strong and aesthetically pleasing permanent denture that goes the distance,” Dr. Lester says. “The technical term for this is an implant-supported hybrid prosthesis. It is called a ‘hybrid’ because it is not a denture alone; there are implants involved.”

Robin states: “My final prosthesis, which is porcelain, literally screws onto the implants, which no one can see unless they’re a dentist. Even I can’t see or feel them.”

Confounding Conundrum

It has been said that physicians make terrible patients. Yet, Randall Whitney, MD, was a willing and cooperative patient when he needed the services of a fellow provider. His years as a doctor taught him to recognize when a problem was beyond his medical facility.

Dr. Whitney at home standing in front of his fireplace with an aqua dinner jacket on.

Dr. Whitney can flash his bright, new smile with confidence.

“I went into practice on July 1, 1965, a month before President Lyndon Johnson signed Medicare into law,” he notes. “I was board-certified in family practice but also did obstetrics for a while. I operated a freestanding birth center in Daytona Beach in the late ’70s, early ’80s. That was the last time I did obstetrics. Since then, I do mostly family practice and gynecology, all here in Central Florida.”

When he developed an abscess, or infection, in his gums, Dr. Whitney took the old saying, “physician, heal thyself,” to heart. Because he knew which antibiotic to use, he successfully treated the infection himself. Of course, he also knew that to stave off another infection, the underlying problem needed to be addressed by a qualified dentist. He found just such a dentist while visiting another doctor for another issue.

“Earlier this year, I was at my cardiologist’s office in Port Orange, and I picked up a newspaper, which was Volusia Health Care News,” Dr. Whitney relates. “In it was a very good article about Dr. Lester, who is a master dentist in the Academy of General Dentistry. I was quite intrigued because there are not many master dentists in the country.

“I was considering getting a second opinion regarding what to do about this 2-year-old abscess. Food was getting trapped in the gap between two adjacent crowns, and that gap was difficult to access and clean.”

Inspired Solution

The first dentist suggested replacing the failing crowns, but Dr. Whitney knew that would not address cause of the problem because the gap would still be there. Dr. Lester presented a different plan, which Dr. Whitney knew would resolve the problem. The approach called for an endodontist to perform root canals on the teeth with the failing crowns.

Dr. Lester would then put his creativity to work to complete the process of ridding Dr. Whitney of the unusual dental issue.

“Dr. Lester would follow up the root canals by preparing a single crown that would fit around two teeth,” Dr. Whitney shares. “It was quite unique. He bridged the new crown so that it was one unit, and it fit me perfectly. I was just delighted. I couldn’t believe how nice it felt, how perfect it was.

Prior to beginning that work, Dr. Lester ordered a comprehensive three-dimensional scan of Dr. Whitney’s left maxillary sinus and jaw area.

“When I read the report, I realized how bad that abscess had been,” Dr. Whitney explains. “It was very close to the maxillary sinus, but I don’t think it penetrated the sinus because I have no sinus trouble.”

Dr. Whitney was astounded that Dr. Lester went so far as to examine the possible effects of the infection on other facial structures. In fact, many qualities about Dr. Lester were remarkable.

“I understand he also flies a helicopter,” Dr. Whitney comments. “That’s amazing to me. His wife also works in the office. She has her own business.”

The entire staff at Park Avenue Dentistry is outstanding, Dr. Whitney says.

“Dr. Lester is a brilliant, kind and quiet-spoken gentleman who is very attentive and bright,” he observes.

Individual Ideas

At Park Avenue Dentistry, unusual dental problems are a common occurrence. But Dr. Lester has an exceptional talent for finding nonconventional paths for overcoming these obstacles. Dr. Whitney’s case is one example.

“In his case, we were able to find a creative solution to the problem, and it worked for him,” Dr. Lester observes. “However, it’s not the answer for everybody in a similar situation.”

Dr. Lester describes how any solution begins with a thorough understanding of the patient’s problem, as well as lifestyle and hygiene habits. He considers all information before presenting treatment options.

“We treat everybody as an individual,” Dr. Lester offers. “Everybody is different in some way, whether it’s physically, dentally, psychologically or regarding the health issues they have. We are very exhaustive in our workup. We give each patient a thorough exam and ask many questions to really get to know them before we ever lay hands on them or even start making plans about the kind of treatment we think they need.”

“I think Dr. Lester is an exceptional person and dentist.” – Dr. Randall Whitney

The dentist notes how a detailed exam can reveal areas of weakness or damage that need to be addressed before a procedure can be performed, or areas to be avoided during a procedure. This can save the patient from unnecessary complications and pain.

“When we took Dr. Whitney’s full-mouth x-rays, part of our comprehensive workup on new patients, we found something that looked amiss in his left sinus,” Dr. Lester notes. “To pursue that, we performed a three-dimensional CT scan on him, and we sent the scan to an oral and maxillofacial radiologist, who is a specialist for reading dental scans. The good news is that everything came back OK.”

Having access to high-quality CT images enables Dr. Lester to discover conditions very early in the process, when they can be addressed before other dental work is started.

Multidimensional Care

Dr. Lester’s modern approach to dentistry is a byproduct of his commitment to continuing education and advanced training. He performs most required dental procedures so patients don’t need to travel to other providers.

“There are times, if it is in the patient’s best interest, when I do refer patients to qualified specialists for specific procedures and therapies,” Dr. Lester notes. “There is a group of specialists in the community I work with that I have vetted and know provide the highest quality patient care and treatment.”

Dr. Lester’s ultimate goal is to improve his patients’ overall dental health, no matter their dental situation or age.

“Robin may be 87, but patients are never too old to achieve good dental health,” he comments. “Good dental health contributes to good general health and helps people look good. And looking good makes them feel good, which makes them want to go on living and being active and healthy.”

Exceptional Choice

The road to superior results is one Dr. Whitney will gladly travel again. He is impressed with Dr. Lester and his creativity in finding a solution to his unusual problem. He is also thrilled with the finished product.

“It’s just like they’re my original teeth,” Dr. Whitney describes. “You can’t tell the difference. It looks fine and feels wonderful, so I’m very pleased with the results. I have no discomfort whatsoever.”

He likes the atmosphere and he feels that it makes his time there more pleasant.

“It’s a beautiful office,” he relates. “Everything about it is very well done. He even has a little room for patients to sit and compose themselves or just relax. I think he’s put it all together. “When you’re sitting in the dental chair, looking out the window while he’s working on you, you’re treated to a very picturesque view with waterfall buckets in cascading fashion, and a very attractive display. It’s very relaxing.”

As a new patient of Dr. Lester and Park Avenue Dentistry, Dr. Whitney has just begun to witness the creative thinking that sets the practice apart. What he does know is that he’s happy to be there and happy with everyone who is a part of it.

“I had a cleaning after all this crown work was done, and Dr. Lester’s dental hygienist gave me the best cleaning I’ve ever had, says Dr. Whitney. “I’m very delighted with the work, and I think Dr. Lester is an exceptional person and dentist. I’m very happy with my new dentist.”

High Praise

Robin was impressed by the care taken to ensure her bite was correct, and the prostheses looked natural and were in the proper positions. Dr. Lester’s efforts, she insists, made a visible difference in the quality of the finished product.

“Sometimes, artificial teeth are set back too far and there’s no natural protrusion and meeting with the lips,” Robin observes. “But mine aren’t like that. They look wonderful. I’m delighted with them. People have no idea I don’t have my own teeth.”

Robin offers high praise for the skilled dentist and his staff.

“Dr. Lester and his staff are the best,” she says. “They are professional, congenial and easy to work with. I recommend Dr. Lester to anyone who needs a dentist. You can’t do any better!”

© FHCN article by Patti DiPanfilo. Robin Black’s photo by Jordan Pysz. Dr. Randall Whitney FHCN file photo. mkb
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