Your Smile’s Desire

From single implants to full smile makeovers, this Port Charlotte dentist does it all.

Debra Scott never thought she would live long enough to make over her smile.

A stroke nearly 17 years ago at age 38 left her with a long list of health issues. Not quite a year ago, Debra had a fainting spell at home and landed face down on the bedroom floor. The fall knocked out several of her teeth and left her with a broken nose and black and blue marks.

Debra Scott had a smile makeover at Port Charlotte Dental Care; Shirley Eisenhauer had a dental implant placed by Dr. Farag using the X-Guide™ at Port Charlotte Dental Care.

Shirley is confident her crown will last a lifetime.

“My blood pressure often fluctuates since I had the stroke,” says Debra, now 55. “I felt my blood pressure drop, and I was trying to get to the bed. I knew I was going to fall; I just didn’t know it would happen that quickly.”

Ever since that fall, Debra says she hated smiling in front of others.

“I would automatically put my hand up near my mouth to block people from seeing my teeth,” Debra says. “I was embarrassed because of my teeth. It was a natural habit. I got so used to doing that. I know it was from something that was out of my control, but it bothered me nonetheless. I hated having my picture taken. I would try to smile without showing my teeth.”

In addition to her smile looking less than ideal, Debra’s mouth caused her a great deal of pain most of the time. She was unable to eat without pain.

“I could not even bite into a sandwich,” she recalls. “I had to cut it up into tiny, little pieces. I couldn’t eat ribs or any meat off of a bone. I ate soft foods – lots of pasta, rice, cooked vegetables, things like that. It was really hard. My mouth was in so much pain.”

Debra’s husband, Mark, was a patient of Joseph H. Farag, DMD, at Port Charlotte Dental Care.

“Mark is a patient of Dr. Farag’s and just absolutely loves him and his staff,” Debra shares. “I have so many other health issues, I had not gone to see him myself up to that point. But, once I had the fall, I had to see someone who could help. My mouth hurt all the time. Mark knew Dr. Farag could work his magic.”

Longer-Lasting Smile

“When Debra came to me, she had only a few teeth on the top to work with,” recalls Dr. Farag. “I really wanted her jaw pain to go away first. I remember her not wanting me to touch her mouth at all in the beginning because of the pain she was in. We stabilized her with a therapeutic splint to help reduce her bite and jaw pain.Debra Scott had a smile makeover at Port Charlotte Dental Care; Shirley Eisenhauer had a dental implant placed by Dr. Farag using the X-Guide™ at Port Charlotte Dental Care.

“Once the pain was reduced, we discussed her treatment plan and reconstruction. Together, we decided that it would be best for her to move forward with a dental prosthesis that’s permanent, cemented in, doesn’t come out and looks beautiful that she can chew with reliably. So, she had an upper and lower bridge done.”

The advances in the dental materials used today allow dentists, like Dr. Farag, the ability to create smiles that will last a lifetime.

  “Today, we use a newer, longer-lasting material called zirconia to make bridges,” Dr. Farag educates. “Years ago, dentists used porcelain-fused-to-metal material. If one of the teeth chipped, it was harder to fix. Also, over time, people would get black lines across the gumline.

“With today’s zirconia material, we no longer have to worry about those black lines at the gumline, and the bridges are much more durable. Every year, we get a new generation of zirconia, and it’s tougher and stronger and more natural looking than the one before. You could take the bridge out of her mouth, put it on a wood table, hit it with a hammer, and it would stick into the table and not break. That’s the strength of today’s material. That provides both the dental professional and the patient with confidence in the product.”Debra Scott had a smile makeover at Port Charlotte Dental Care; Shirley Eisenhauer had a dental implant placed by Dr. Farag using the X-Guide™ at Port Charlotte Dental Care.

Put Your Hand Down

Now that Debra’s reconstruction is complete and she has both a top and bottom permanent prosthesis, old habits continue to be hard to break.

“Even after, when we finished her case and she had a perfect set of teeth with a beautiful smile, she was still covering her face,” Dr. Farag says. “I told her, Debra, you don’t need to do that anymore.”

Dr. Farag feels his job is most rewarding when he sees a patient transform, like Debra has.

“Being able to see where she started and where she finished is definitely rewarding,” he says. “When I finish a case like this and you see someone transform their personality because of their teeth, it’s a great feeling.”

Debra says she is absolutely amazed at how far she has come since she first walked into Dr. Farag’s office.

“I was a complete mess when I first went in to see him,” Debra describes. “I never dreamed I would be able to afford to fix my teeth. My teeth look great now, and I owe it all to Dr. Farag. I recommend him to everyone. He is competent, skilled and has a great personality. And his staff is great, too. They are all very calming and welcoming. They make you feel at home.

“I don’t put my hand over my mouth anymore, and I can’t stop smiling!”

Seasonal Solution

A snowbird from North Carolina, Shirley Eisenhauer spends her winters in balmy Port Charlotte.

“My dad and my brother live down here, so spending the winters here, away from the snow, is a blessing. We have a farm in the mountains of North Carolina, and it’s just too cold in the winter with the snow. We love the Florida sunshine.”

Being a seasonal resident, Shirley never really thought about seeking a dentist in the area until a dental issue caught her off guard.

“I had a crown on a bottom tooth that became loose when we were in North Carolina,” Shirley shares. “It wasn’t causing me any pain; it just wasn’t secured. I think when you have a crown, especially an older one on a tooth for twenty years or more, those things are bound to happen.

“I ended up having the tooth pulled by my dentist in North Carolina,” she continues. “I knew I wanted an implant because I heard a lot about them, but at that time, I was told I needed to wait several months for the bone to regrow before an implant could be placed there. By that time, we were in Florida for the winter months.”

Being from out-of-state, Shirley hadn’t found a dentist here locally and wasn’t sure where to go to have an implant and crown placed.Debra Scott had a smile makeover at Port Charlotte Dental Care; Shirley Eisenhauer had a dental implant placed by Dr. Farag using the X-Guide™ at Port Charlotte Dental Care.

“There are so many dentists in town that without a good recommendation, it’s difficult to know who is reputable and who is not,” Shirley says. “My brother happened to read an article about Port Charlotte Dental Care in Florida Health Care News. He gave it to me to read, and I was impressed with what others had to say about the practice, so I made an appointment.”

“When I first saw Shirley, the area where she had the tooth removed was in decent shape and was ready for an implant,” describes Dr. Farag. “I suggested to Shirley that she would be the perfect candidate to utilize the X-Guide™ Dynamic 3D Navigation system to place the implant.

X-Guides the Spot

“The X-Guide system is minimally invasive, and it only requires a hole punch,” he continues. “What that means is typically in an area where you have sufficient bone for the implant, you need to be precise about where you place it to maximize its stability. The X-Guide gives us that ability.”

Dr. Farag says the X-Guide Dynamic 3D Navigation system is the newest instrument in implant-placement technology available today.

Developed in close collaboration with leading oral and maxillofacial surgeons, the X-Guide system is the latest in digital dentistry. It allows dentists to use 3-D information at their fingertips in real time. In collaboration with the X-Guide system, surgeons also use the cone beam 3-D image scan to plan and place implants with detailed accuracy.Debra Scott had a smile makeover at Port Charlotte Dental Care; Shirley Eisenhauer had a dental implant placed by Dr. Farag using the X-Guide™ at Port Charlotte Dental Care.

The X-Guide system is designed to make it easy to be exact by combining the latest software plus new, patent-pending X-Point™ navigation technology, which reportedly is the first single-view guidance of implant position, angle and depth. The technology allows oral surgeons to place implants in remarkable detail.

“With the X-Guide, visualizing the placement of the implant is done in real time on a computer screen,” Dr. Farag describes. “With this technology, implants are placed with ten times more accuracy than if placed freehand. The precision is within about a half degree, whereas unguided, you could have up to a five-degree deviation.

“The technological process begins even before we place the implant,” Dr. Farag continues. “When the patient first comes in, we take a 3-D x-ray so that we can properly evaluate the bone and tissue in three dimensions and plan for placement based on the measurements we take off of that 3-D image. It is done with amazing accuracy and in real time. This is a remarkable advancement for patients and surgeons alike. I am pleased to be able to offer this to my patients.”

Dr. Farag emphasizes that the X-Guide is not used only for single implants. In fact, he says, it is preferred when placing bridges as well.

“If I’m placing multiple implants, like a bridge for example, with the guided system, I know where the teeth are going to go, so I can place the implants where I want them, and I can confirm that accuracy in real time as I’m putting them in. It’s amazing technology.”

Once her implant was complete, the next step for Shirley was creating and placing a crown.

Crowns in an Hour

Another example of the advanced equipment used at Port Charlotte Dental Care is the CEREC® Omnicam, which expedites the process of creating an implant-supported crown in the office.Debra Scott had a smile makeover at Port Charlotte Dental Care; Shirley Eisenhauer had a dental implant placed by Dr. Farag using the X-Guide™ at Port Charlotte Dental Care.

The entire process takes approximately one and a half hours.

First, a special scanning cap is placed on the implant. “Using a special camera, I make an image of the scanning cap. This optical impression is then used to design the necessary crown.”

Once Dr. Farag has designed the crown, it is milled from a block of porcelain and then finished, stained and glazed, and screwed onto the implant.

Dr. Farag points out that the material used to create CEREC crowns is the closest thing in dentistry to human enamel. The natural-looking, time-tested material is anti-abrasive and plaque resistant, making the crowns reliable and long-lasting.

Traditionally, those in need of a crown could expect to visit the dentist twice: once to have impressions made and a temporary crown created, and again to have the newly fabricated, permanent crown placed. But now, Dr. Farag’s patients can have a crown or even a bridge done the same day, thanks to advanced technology.

“After my mouth healed from the implant, I went in and he did the crown in just a few hours,” enthuses Shirley. “It was unbelievable.”

“CEREC Omnicam brings a number of advancements to the table, specifically with the image capture,” Dr. Farag advises. “It’s now in full color, so that 3-D model that I work with on the computer is actually in tissue color and tooth color, which gives a lot more definition for my design. The image capture process is now a lot easier and can capture a full arch very quickly and in a higher resolution.”

With the CEREC Omnicam, Dr. Farag can see every integral part of the tooth in three dimensions and in full color. “The CEREC computer gives a good representation of the tooth based on several factors: the shape of the other teeth, the size of the jaw, the angulation of the other teeth in the mouth and the anatomy of the teeth. The opposing teeth are also taken into consideration. Consequently, the bite is incredibly accurate.”

In addition to fashioning full-porcelain crowns, CEREC Omnicam has the ability to design and contour all types of porcelain restorations, including onlays, inlays and veneers. An onlay replaces part of a tooth, including one or more points, or cusps, of the tooth. An inlay is a custom-made filling, and a veneer is a thin layer of porcelain that fits over the front of the tooth.

“The CEREC is excellent for inlays and onlays because the material that is used is typically stronger and more wear resistant than that used for a traditional filling,” observes Dr. Farag, “so for large fillings, the porcelain is a better choice.”

Shirley says she is happy with the results and has no worries that the crown will last her a lifetime.

“I know it won’t come loose, like the first one did, because of the advanced materials and technology he used,” Shirley says. “That is the one thing I appreciate about Dr. Farag. He is smart, and he knows exactly what he is doing, and he cares about doing it right. I highly recommend him to anyone for any dental needs they may have.”

FHCN article by Judy Wade. Photos by Jordan Pysz & Fred Bellet. X-Guide photo and before and after images courtesy of Port Charlotte Dental Care. Graphic from
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    • Port Charlotte Dental Care

      Dr. Farag provides a full range of quality, caring dental services to the Port Charlotte community. He looks forward to hearing from the viewers of the Florida Health Care News website. For more information or to schedule an appointment, pl... Read More

    • Joseph H. Farag, DMD

      Joseph H. Farag, DMD, earned his Doctor of Dental Medicine degree from the University of Florida College of Dentistry, Gainesville, FL after completing his undergraduate degree at Florida Atlantic University, Boca Raton, FL. Dr. Farag served an... Read More