Two Routes to Restoration

Different roads lead to the same destination.

Before she retired, Connie Miller worked as an administrative assistant for a downtown architectural firm. In her role, she was a visible face of the company she represented. She always cared for her appearance to look her best at her job, as well as in her social life.Dr. Stephen Lester of Park Avenue Dentistry in Edgewater restored the teeth of Nicole Otto using implants and Connie Miller using crowns and partial dentures.

A year ago, Connie suffered an incident that affected her face and smile. A fairly new resident of the New Smyrna area, Connie needed to find help close to home.

“Both my husband and I are from the same small town in Southern Indiana,” she notes. “I lived and worked there until my early forties, then I moved to Orlando in 1991. My husband and I got married four years ago and moved to New Smyrna Beach.”

In making the transition from Orlando to New Smyrna, Connie had yet to find a local dentist. She wasn’t too concerned at first, but then the unspeakable happened.

“I wasn’t really having any major dental issues. I’d had a root canal and a couple of crowns,” she explains. “I also had two back teeth that were missing and had partial dentures that were not fitting properly. I knew I needed to go to the dentist, but I just kept putting it off.

“Then last year, my husband and I were visiting family in Destin, and a crown broke off a front tooth at the gumline. Now, I had a front tooth missing, and it was very traumatic. I didn’t have a dentist in New Smyrna. Most of my doctors were still in Orlando. I immediately called a friend of mine who lives here and asked about her dentist. She was a patient of Dr. Lester.”

Connie was able to get an appointment with Stephen P. Lester, DDS, of Park Avenue Dentistry in Edgewater. She liked Dr. Lester immediately and felt completely confident in his ability to restore her smile.

“When I first met Dr. Lester, I could tell he was the type of person I could totally trust,” she comments. “He took a look in my mouth, took some x-rays and then did another scan. After looking at all that, he told me he was pretty sure he would have to do a root canal, and he was afraid some of my other teeth were in danger.

“He talked to me briefly about possibly doing some implants, then said, I’ll know more after I get a closer look at the x-rays and see what’s really going on in there.Dr. Stephen Lester of Park Avenue Dentistry in Edgewater restored the teeth of Nicole Otto using implants and Connie Miller using crowns and partial dentures.

Unfortunately, Connie was not a good candidate for dental implants, but Dr. Lester was not deterred. He developed a treatment plan for Connie that included adjusting her bite and restoring some failing teeth, as well as replacing several missing teeth, including her broken front tooth.

“Dr. Lester had it all laid out, what he wanted to do,” confirms Connie. “He wanted to replace all my existing crowns and also put crowns on my bottom front teeth. He needed to build those teeth up so I’d have a better bite. That was really a problem because my teeth were breaking down.”

Easing Anxiety

Dr. Lester remembers Connie as very conscious of her health and appearance. However, she was having trouble with a number of her teeth. Not only was her front tooth cracked, she was also missing most of her molars, upper and lower, on both sides of her mouth.

“To restore Connie’s mouth, I crowned her teeth,” Dr. Lester reports. “I used zirconia crowns. Zirconia is a very strong and durable material. It is also very natural-
looking and cosmetically appealing.

“I also made removable partials for her missing back teeth that are more cosmetic than the partials she had before. The new ones are not held in place with ugly, metal clasps, those silver hooks that go around the adjacent teeth to secure them. Instead, I used a gum-colored, flexible polymer material so the partials aren’t visible. All you see are the teeth.”

The dentist explains that it can be a very long appointment when patients get multiple crowns or procedures in one day. Sometimes, they get anxious sitting in the dental chair for a long time, or they can be anxious about the work itself. For these patients, Park Avenue Dentistry offers several types of sedation to make their experience easier.

“Connie is one of those patients,” acknowledges Dr. Lester. “She was anxious about going to the dentist and having so much dental work done. I suggested intravenous conscious sedation to make her more comfortable.”

“I was always afraid of dentists,” says Connie. “I had some bad experiences early in my life, so I had a fear of going to the dentist and having pain. But I felt totally at ease going to Dr. Lester.”

“The IV sedation, which I used on Connie, is my favorite type of sedation because I get moment-to-moment control,” informs Dr. Lester. “If patients get a little light and become too aware of what’s going on, I can put a little more medication in the IV line. A few seconds later, they’re fully sedated again.”

Dr. Stephen Lester of Park Avenue Dentistry in Edgewater restored the teeth of Nicole Otto using implants and Connie Miller using crowns and partial dentures.

Connie and her husband, Charles, are all smiles as they prepare dinner.

With this type of sedation, most people have no memory of the dental appointment. It also creates a “time warp.” When patients come out of the sedation, they don’t realize they’ve been sitting in a dental chair for hours.

“I also offer oral sedation, which is medication in pill form,” continues the dentist. “I don’t like this as much as conscious sedation because I don’t get that moment-to-moment control. It is a good option for someone who doesn’t like needles. It also lasts a long time, so it’s a good choice for extra-long appointments.”

A third type of sedation is nitrous oxide, which is the gentlest of the three types. A benefit of nitrous oxide is that it is a very pleasant experience for the patient. It’s effective for anxiety control, and patients can drive themselves home after their appointments. Also, after taking nitrous oxide, a patient can go about the rest of the day normally without any lingering effects.

Total Trust

With a long history of dental problems, Nicole Otto had been to many dentists over the years. She did not suffer the same anxieties as Connie and did not use sedation during her appointments. The route to restoring her teeth was straightforward, with little discomfort.

Nicole has cared for the health of others as a registered nurse in home care for more than 26 years. The Edgewater/New Smyrna native has also battled with her own health concerns, primarily her dental health. With genetically poor dentition, Nicole has struggled to keep her natural teeth healthy, but eventually, her family history caught up with her.

Dr. Stephen Lester of Park Avenue Dentistry in Edgewater restored the teeth of Nicole Otto using implants and Connie Miller using crowns and partial dentures.

Nicole opted for dental implants to restore her smile.

“I’ve had a lot of dental issues going way back,” she relates. “My father had real soft teeth and had a full set of dentures in his early twenties. I’ve fought tooth and nail to save my teeth. I’ve had just about all of them root-canaled, built up, crowned and re-crowned, but over time, several of my teeth just deteriorated.

“One of my back teeth that had a root canal and had been repaired broke off underneath the crown, and it created an abscess. Because my teeth were soft, my dentist couldn’t do any more repair work on the tooth. It had to be removed.”

At the same time, Nicole had other teeth that had failed. She ended up with four missing molars, two in the upper jaw and two in the lower, all on the left side. Nothing hurt, but with an entire side of her mouth out of commission, Nicole had to make some adjustments to function. Her chewing and eating were affected.

“I had no pain to speak of, but my jaw was swollen from the abscess,” she describes. “I knew something was going on, but by the time I got to my dentist, it was too late to save the teeth.

“I couldn’t use my back teeth to chew, so I started using my front teeth. Now, they will need some work down the road because they got a little chipped up from using them for chewing.”

Nicole’s family dentist recommended she get her missing teeth replaced. He told her she could go with dentures or dental implants.

“I’m only forty-nine years old; I didn’t want dentures,” states Nicole. “I didn’t want to see my teeth in a jar.”

However, Nicole was curious about the dental implant option, so she made an appointment with Dr. Lester.

When they met, Dr. Lester made a good impression on Nicole, and she immediately felt comfortable in his skilled hands.

“Dr. Lester was very knowledgeable and concerned,” she says. “He was eager to educate me about different procedures and what my options were. At that point, I was looking at a denture, a partial plate or implants.”

“Nicole came in with a bad tooth, which I removed,” remembers Dr. Lester. “That created an open space in her upper jaw. She already had quite a large space in her lower jaw from losing teeth previously, so she had two spaces to fill.

“Rather than dentures or a partial, Nicole decided to go with dental implants. I placed four implants, two on the top and two on the bottom, and then put crowns on them. Now, she has a full set of teeth again.”

“He told me what he thought was the best route for me, but it was ultimately my decision which way to go. Dr. Lester recommended the implant route, and that’s the route I chose to take.”

Impressive Process

The process of getting dental implants is completed over several months. Unlike Nicole, some patients do get anxious during the process because placing implants is a surgical procedure and involves drilling. These patients can benefit from the same sedation choices as Connie did. Nicole was fully aware during all the implant procedures, and Dr. Lester’s process impressed her.Dr. Stephen Lester of Park Avenue Dentistry in Edgewater restored the teeth of Nicole Otto using implants and Connie Miller using crowns and partial dentures.

“First, they completed a CT scan of my head. That helps Dr. Lester safely and accurately place the implants,” she describes. “They have a mobile CT unit right there at the office. It was really nice to have the procedure done there. It was one-stop shopping. I didn’t have to go to a hospital to have it done.

“Dr. Lester did some bone grafting, and let that heal for a few months. I went back, and he put the screws in and let that heal. Then, I got the crowns put on. The only time it was at all uncomfortable was when he put the screws in my jaw, but a shot of Novocain® was enough to take care of that.”

Million-Dollar Smiles

Nicole and Connie took different routes to reach their restoration goals. Both women are pleased with the final results. Nicole is especially glad to be back to full function. She’s also happy with the way the implants look and feel.

“Now, I can chew with no problem,” she offers. “I had steak for supper last night, and I can snack on pistachio nuts, which are my favorite, go-to snack. I eat them in the car, between patients. I can now chew them with no trouble.

Dr. Stephen Lester of Park Avenue Dentistry in Edgewater restored the teeth of Nicole Otto using implants and Connie Miller using crowns and partial dentures.

With soft teeth, Nicole had a long history of dental issues.

“The implants feel natural, like I was born with them. They’re in the back of my mouth, so I can’t see them, but I showed them to a woman at work. She said they look like real teeth. She couldn’t tell which were my natural teeth and which were the implants.”

Dr. Lester’s exceptional care and concern stood out to Connie. Like Nicole, Connie is happy with the improved function of her teeth after the work was done. She is also thankful for the dentist’s gentle approach to her treatment.

“The work started in June and was finished at the end of October, but there were no surprises,” she states. “Dr. Lester was there every step of the way, and he told me exactly what was going on and what to expect. I trusted him completely.”

“Dr. Lester and his staff at Park Avenue Dentistry are very knowledgeable, kind and compassionate,” adds Nicole. “I like being instructed about what’s going on, what they’re looking for and any problems that may occur. I like the education they provide.

“Even the receptionists are kind and sweet. They follow up with you after every appointment.”

Nicole and Connie are thrilled with their experiences at Park Avenue Dentistry, as well as their outcomes.

“For someone my age, I definitely recommend dental implants over dentures, and I also recommend Dr. Lester,” relates Nicole. “In fact, my daughter and husband are going to him now.”

“My results are phenomenal,” says Connie. “I couldn’t be happier with the outcome. I’ve always been a positive, happy person who is always smiling. When the crown broke off my front tooth, it was very devastating. Now, I have a million-dollar smile.

“I’m so pleased and happy I found Dr. Lester and Park Avenue Dentistry.”

FHCN staff article. Photos by Jordan Pysz. Graphics from nj
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