Fixed and Functional

Bridges and implants are excellent options for replacing missing teeth.

Terry Bracy is a familiar face on Capitol Hill in Washington, DC. From 1966 to 1976, he was an aide to former Congressman Morris K. Udall of Arizona. He later served as chair of the board of the Udall Foundation and founded a public relations and lobbying firm in Washington for which he still works on a part-time basis.

Dr. Stephen Lester of Park Avenue Dentistry in Edgewater created fixed bridges and restored an ailing implant for Terry Bracy.

Terry needs a big, bright smile as a lobbyist on Capitol Hill.

“I was born and raised in St. Louis, then took a graduate fellowship at the University of Arizona in Tucson,” relates Terry. “That’s where I met Congressman Udall, who brought me to Washington to work for him. I’ve lived there all my adult life, but now my wife and I come down to Florida for three months in the winter – January, February and March.”

At 74, Terry began to have issues with his teeth, most of which he blamed on his age. He also had dental work done years ago that was failing and needed to be repaired or replaced.

“I developed, as most people do as they get into their seventies, some chronic dental problems. I had a dental implant that didn’t work very well and needed to be fixed or replaced. I had a few broken teeth and a few that had to be extracted. My two front teeth were knocked out playing football when I was young, and the caps that were there had eroded and needed to be replaced or fixed.

“I was having trouble chewing with several of my teeth. I wasn’t in pain, but I had some unpleasant episodes with my teeth. When I was getting caps on a couple of them, the dentist had to do root canals first.”

Terry had been receiving dental services in Washington, but was unsatisfied with the care he was receiving. This year, he decided to use his time in Florida to try a new dentist to see if he could get improved results. Stephen P. Lester, DDS, of Park Avenue Dentistry in Edgewater came highly recommended.

“Dr. Lester had done a wonderful job for my mother-in-law, who is one hundred years old and still going strong,” states Terry. “She recommended him very highly. I was impressed when I met with Dr. Lester because he wanted to create a strategic plan for my entire dental situation.

“For me, getting my teeth fixed was more of a health matter than a cosmetic matter. My teeth were dying. When Dr. Lester looked at them, he decided the better part of wisdom was to pull a couple and replace them with bridges. He brought out pictures of various types of bridges, which gave me a good sense of what they would look like. I really appreciated that because no other dentist has ever done anything like that for me.”

Bridging Gaps

“When Terry first came to us, he had a front tooth that was broken and not savable,” describes Dr. Lester. “He also had a back tooth, a molar, that had broken and was not fixable. His implant was ailing.”Dr. Stephen Lester of Park Avenue Dentistry in Edgewater placed dental implants for Marian Ford and created a single-visit crown using the E4D® CAD/CAM system for Nancy Davis.

Two options for replacing missing teeth are bridges and dental implants. A bridge is an appliance that spans the gap where a tooth or teeth are missing. It attaches to natural teeth with replacement teeth in between. Dental implants are screw-like posts placed into the jawbone that serve as the roots of teeth. Replacement teeth are securely fastened to them.

“Bridges and implants are both excellent treatments,” grants Dr. Lester. “The dentist takes many factors into consideration, including the patient’s general health and personal health habits, to determine which option is more appropriate. The dentist will then use his or her expertise to help the patient make an informed decision about which option to choose.”

For Terry, the decision was made to create fixed bridges to replace two teeth Dr. Lester extracted, one in the front and one in the back. At Park Avenue Dentistry, getting a bridge is a smooth process, and Dr. Lester makes sure his patients never have to leave the office without teeth in their mouths.

“I removed Terry’s broken front tooth and made him a fixed bridge to replace it,” confirms Dr. Lester. “I did the same for the back tooth. I removed it and made a fixed bridge there as well.

“Typically, I take out the teeth and create a bridge in one appointment. Creating the finished product is a laboratory procedure, but I make temporary devices for the patients to wear while they’re healing and the final bridges are being made. We don’t ever let our patients go toothless.”

Dr. Lester made a removable partial for Terry. For most of his patients, he makes molds and then temporary bridges that include the missing teeth. That way, patients still look good until they come back to Park Avenue Dentistry for their permanent bridges.

Restoring Implants

Dental implants are placed into the patient’s jawbone, where they fuse with the bone to create a solid foundation for the replacement teeth. They should be brushed and flossed daily, the same as natural teeth, but people with implants do need to see their dentists regularly to make sure the implants remain healthy and secure.

In most cases, dental implants last for many years with no complications or problems. Sometimes, however, an implant can loosen or even fail if the health of the jaw changes.

“With Terry’s ailing implant, the bone holding it in place was disappearing from the top down,” explains Dr. Lester. “It’s not a common occurrence, but it’s a real problem that does happen.

“I’m glad I took the time, made the investment and went to the right person: Dr. Lester.” – Terry

“In cases like Terry’s, the bone around the implant starts to disappear from the gum side of the implant and continues downward. This creates a saucer-shaped, crater-like defect that grows over time. Eventually, if it’s not treated, bone loss continues and inflammation and infection occur until the implant is lost.”

In addition, the threads on the screw-like implants become bogged down with bacteria and infected soft tissue. New bone cannot grow back on the implant because these substances are in the way.

“Fortunately, we have an advanced method of treating ailing implants,” assures Dr. Lester. “It’s a surgical procedure using a laser. During the procedure, I open up the patient’s gums in order to access the implant, and then remove the infected or irritated soft tissue growing around the implant.

“I also treat the surrounding bone in the crater-like defect with the laser. Typically, after completing those steps, I perform a bone graft to insert bone to fill in that area.”

It takes at least six months before Dr. Lester can really judge if this procedure has been successful in growing new bone around the implant. The new bone growth can be visualized on x-ray.

“We’ve just done this on Terry, so it hasn’t been long enough yet to see any results, but we’re optimistic it will be successful,” offers Dr. Lester.

“Patients with implants need to have regular visits with their dentists,” he stresses. “When they can observe the implants, dentists can detect if one is losing bone. If so, the problem can be treated early. Once a lot of bone is lost, it’s very difficult to get it back.”

First-Rate Team

Terry does a lot of smiling doing public relations and lobbying in Washington, but he became distressed at the way his teeth deteriorated as he aged. After Dr. Lester completed his strategic dental plan for him, Terry is happy with his teeth once again.

Dr. Stephen Lester of Park Avenue Dentistry in Edgewater created fixed bridges and restored an ailing implant for Terry Bracy.

Dr. Lester (left) created a strategic plan to include all of Terry’s dental needs.

“The results are a big improvement,” he comments. “My smile is great. My chewing ability is just perfect. I eat everything – fish, meat, poultry, everything. The implant seems better, but the surgery was just a week ago.

“It was time to do something about my teeth, and I’m glad I did. I’m glad I took the time, made the investment and went to the right person: Dr. Lester. He did a heck of a job. I’m really pleased.”

It took Terry several visits to Park Avenue Dentistry to have all his dental work completed. He didn’t mind, however. The staff impressed him and made his experience comfortable and positive.

“Dr. Lester has done himself a favor by hiring a terrific staff,” says Terry. “When you walk into Park Avenue Dentistry, you feel you’re in a really professional organization, and you are. Dr. Lester and his staff are among the most professional individuals I’ve run into in a very long time.

“I certainly recommend Dr. Lester and his team; they’re first-rate!”

FHCN article by Patti DiPanfilo. Photos by Nerissa Johnson. Dr. Lester photo courtesy of Park Avenue Dentistry.

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