Reaching New Heights

Dental reconstruction plan improves smile and function.

The 300 block of 9th Avenue in New York City has long been one of the busiest blocks in the United States. For years, it was the site of the New York Station on the Hudson River Railroad Line, the spot from which Abraham Lincoln’s funeral train departed for Springfield, Illinois on April 25, 1861.

Patient photos by Nerissa Johnson.

Jaime Lugo – AFTER

That station is long gone, but in its place stands the Morgan General Mailing Facility, which just happens to be the largest mail sorting facility in the country. For 37 years, Jaime Lugo worked at that facility, the last 23 as a senior manager.

“I was in charge of all the mail processing there from four o’clock in the afternoon until midnight,” Jaime explains. “I had about fourteen hundred employees working under me, and anything that happened between those hours, it was on me to take care of it.”

Jaime’s nearly four-decade-long career with the US Postal Service came to an end in 2005, when he retired and moved to Florida. A little more than a decade later, he decided to get busy correcting a very noticeable dental issue.

“Ever since childhood, I’ve always had small teeth because I’ve always grinded my teeth,’’ Jamie reveals. “Even as an adult I’ve grinded my teeth and for years now, my family and friends have always mentioned it and said I should do something about it.

“It wasn’t anything that really bothered me. It’s not like I was ever embarrassed by it. But I knew it was something I should probably address at some time or another and so I eventually decided, Why not get it fixed?”

Jaime’s decision to repair his teeth came as he was growing frustrated with the dentist he’d been seeing since he first arrived in Florida years earlier. He wasn’t necessarily looking for a new dentist, but he found a new one nonetheless in a rather unique way.

“I like to go bike riding, and one day, I was riding my bike and saw this dental office that I’d been passing for years and suddenly thought, It’s time to try something new,” Jaime recalls. “That’s how Dr. Blank became my dentist.”

Stephen G. Blank, DDS, has practiced dentistry since 1982. He practices cosmetic and functional dentistry and willingly embraces leading-edge technologies as part of his commitment to providing the best care possible for his patients.

Before image courtesy of Dr. Blank.

Jaime Lugo – BEFORE

The Muscles Win

“When I first examined Jaime, I found that all his teeth had been worn short,” Dr. Blank reports. “His lower incisor, for example, measured five millimeters tall, which is about half the size of a typical, healthy lower incisor.

“That was a result of the fact he has very square jaws and very strong muscles. In cases like that, the muscles always win out over the teeth. When patients clench or grind, the muscles are always busy rubbing teeth against one another, and the teeth lose out because they can’t grow back.”

Jaime’s issues were not unique. It’s typical for people with strong, square jaws to grind their teeth. If the problem is detected early, the grinding can be abated by fitting the patient with a bite guard appliance they often wear at night while sleeping to protect the teeth.

Jaime had never been fit with such an appliance. As a result, his teeth had become so worn that he looked as if he didn’t have teeth even when he smiled. That wasn’t the only aesthetic issue caused by his worn-down teeth.

“The only thing that keeps your chin from reaching your nose is the teeth in the middle, so with his teeth being as worn down as they were, his chin was getting closer to his nose all the time,” Dr. Blank describes. “His face was actually collapsing.

“What we needed to do was rebuild his teeth. Our goal was to give Jaime back the missing tooth structure he’d lost in both arches over the years and thereby increase the vertical dimension, or the height from the nose to the chin.”

Jaime agreed with the reconstruction plan, which began in April 2018 with a smile design visit. Dr. Blank measured all of Jaime’s upper and lower teeth, took photos and created impressions to be used in the creation of a wax model of each arch.

“Dr. Blank did a great job. He’s so professional and caring. He told me if I ever had a problem with anything to visit the office and he would follow up. He’s really exceptional, and I highly recommend him.” – Jaime

Using the wax models as a guide, ceramic crowns were made to fit over the existing teeth with the lowers treated first to help accommodate Jaime’s desire to break the treatment in half.

During a second visit, Dr. Blank prepared Jaime’s teeth for the crowns and fit him with temporary crowns. During the third visit, the temporary crowns were removed, and Jaime received his permanent all ceramic crowns.

Never Too Late

About six months later, Jaime’s upper teeth were prepared, and crowns were placed during a second series of appointments. The result is a full, bright, new smile that Dr. Blank might not have been able to produce the way he did had Jaime waited much longer to address the grinding issue.

Patient photos by Nerissa Johnson.

Jaime’s full mouth restoration has given him a bright new smile.

“If the teeth get too short and I prepare them to accept crowns, there may not be enough tooth left to grab the crown,” Dr. Blank explains. “When patients wait too long, the teeth are too short, and crowns may come off. So, you need to have a certain amount of tooth to do this.

“Thankfully, Jaime’s teeth were not too worn down. Had his teeth gotten much shorter, his prognosis would have been worse. So, he’s a good example of why it’s never too late to come in and get a consultation to find out what can be done.

“A lot of people think their teeth are too far gone, and they stop caring for them. But I always tell patients, Keep caring for your teeth just in case we can fix them, because it gives us more to work with and gives the patient the best chance for a good outcome.”

Jaime got what he describes as an excellent outcome. He says the days of him smiling and no one seeing his teeth are over. He now has a “beautiful,” healthy smile that looks natural and that he is proud to show off.

“Dr. Blank did a great job,” Jaime enthuses. “And he wasn’t pushy at all. When we were discussing the options I had and the best way to go about repairing the problem, he gave me the chance to make the decision that I was most comfortable with.

“That was really important to me, because this was an investment. Dr. Blank is just so professional and caring, and he told me if I ever had a problem with anything to visit the office and he would follow up. He’s really exceptional, and I highly recommend him.”

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    • Stephen G. Blank, DDS office

      Stephen G. Blank, DDS, is a 1982 graduate of Northwestern University Dental School in Chicago. He has since completed intensive continuing education studies. Dr. Blank has studied temporomandibular joint (TMJ) disorders under Mark Piper, MD, D... Read More

    • Stephen G. Blank, DDS

      Stephen G. Blank, DDS, is a 1982 graduate of Northwestern University Dental School in Chicago. He has since completed intensive continuing education studies. Dr. Blank has studied TMJ under Mark Piper, MD, DMD, at the Piper Education and Resea... Read More