Reconstructing Smiles

Decades of grinding and clenching resulted in extreme damage to Timothy Brown’s oral health.

Photo by Nerissa Johnson.

Timothy holds an owl at Treasure Coast Wildlife Center in Palm City.

“I grinded my teeth for so many years that I wore most of them down to nubs,” Timothy shares. “I also neglected my teeth overall because of bad experiences. I would have an abscessed tooth and get an antibiotic to heal the infection, but that didn’t solve the underlying issue. I was a mess.”
Timothy developed sensitivity to hot and cold and could barely eat most foods because his teeth were in such poor condition.
“I had grinded the majority of many of my teeth away to the point where the gum was more visible than the tooth. If I smiled, you mostly saw my gums.”
Timothy’s situation was beyond the scope of what his primary care dentist could fix. He was referred to Stuart Periodontics, where he met with Nicholas DeTure, DMD.

Above the Gumline

After a thorough examination and consultation, Dr. DeTure recommended functional lengthening to begin Timothy’s long-term oral reconstructive plan.
“Tooth lengthening is done by removing some gum tissue to expose more of the natural tooth,” educates Dr. DeTure. “The procedure is typically performed when not enough of the tooth sticks out above the gum to successfully repair the tooth with just a root canal or crown.
“In Timothy’s case, it was more of an aesthetic situation because the teeth were worn down so low,” he continues. “This was obviously a direct result of Timothy’s extreme grinding. Crown lengthening not only improved the appearance of the teeth, but also the function.”
Dr. DeTure confirms that the lengthening process saved the majority of Timothy’s teeth, but several teeth still needed to be extracted where implants would later be placed.
“I had to extract several decayed teeth and then prepare those areas for implants, which were later topped off with crowns by Tim’s restorative dentist,” Dr. DeTure explains. “The best part about Timothy’s case, for me, is being able to save many of his teeth, regardless of how bad his situation was when he first came to the office. In many cases, I have patients come in who have been told by other dentists that all of their teeth need to be removed and dentures are necessary. I try all I can to avoid that being the case for my patients. This is a great example of that success.”
Timothy’s ultimate goal was to have individual teeth, not connected bridges.
“He really wanted individual teeth, so I placed enough implants in order to achieve that goal,” Dr. DeTure relays.
To be sure the implants are placed properly, Dr. DeTure uses a surgical guide to help direct the process. He also uses 3-D imaging to map the bone for exact placement.
“We utilize as much leading-edge technology as possible,” Dr. DeTure stresses. “Our office also provides LANAP® [laser assisted new attachment procedure] to treat gum disease and pinhole rejuvenation to repair gum recession.”

Look Better, Chew Easier

Timothy is still waiting for his gums to heal completely since having the implants placed, so the crown work has not yet been completed.
“I have temporary crowns right now,” he adds. “Even with those, I look like a completely transformed person.”
He can now chew food with ease and plans to wear a night guard for added protection.
“I am so happy I don’t have to limit what I eat anymore. I can bite into an apple or a rib and not worry about chipping any teeth,” Timothy states. “I’m grateful to have been referred to Dr. DeTure.
“It’s amazing to look in the mirror. I hardly recognize the person looking back at me!”

Photo by Nerissa Johnson.

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