Author Archive

Enrichment Through Memory Care

Knowing mom is happy and safe gives family peace of mind.

Laura McLaren first saw Grace Manor Port Orange when she visited the assisted living and memory care community as a volunteer with her church group.

Laura McLaren tells how her mother, Annie, thrives at Grace Manor Port Orange, an assisted living and memory care community.

Laura visits her mother, Annie, at Grace Manor.

“It was Christmas time and our church group was caroling at different places and we went to Grace Manor. All the residents there seemed so happy and I thought to myself, If and when my mom needs assisted living, this would be such a nice place for her.

At the time, Laura and her four

siblings were concerned about their mother, Annie, who had lived in the same house for more than 40 years. One of Annie’s granddaughters lived with her, but Annie’s dementia was progressing. Her overall health seemed to be declining, too. Annie wasn’t interested in eating properly and had lost a good deal of weight.

Only a month after Laura’s visit to Grace Manor, the family realized Annie needed more care than they could provide by themselves.

“She was doing things like going out the door of her house and saying, I want to get a cab and go home,” recalls Laura. “That was when we knew, It’s time.

Laura remembered what she had seen at Grace Manor. She believed the community’s smaller size and caring atmosphere would be a good fit for her mother. Grace Manor’s cleanliness, professional staff and high level of security gives the family peace of mind.

“I like the fact that Grace Manor is an assisted living and memory care community,” notes Laura. “We knew our mother needed that kind of environment. The fact that it’s smaller was right for her, especially since she was coming from her own house. She would have been lost in a big facility.”

Participation and Joy

Grace Manor is a community of 54 private suites where the emphasis is on care. Seniors enjoy apartment-style suites with assistance for activities of daily living like bathing, dressing, grooming and hygiene.

The design of the building and grounds is purposely serene through selection of soft colors and simple flooring patterns. Suites are equipped with motion alarms and a call-bell system that is linked to a staff pager system to ensure safety.

The community is kept secure through controlled access. Residents can safely enjoy the courtyard walking path and other engaging activities. Meals are prepared under the guidance of a dietitian and dining is in place to support a feeling of normalcy.

A roster of activities that encourages participation and joy are abundant at Grace Manor. They include outings for lunch and community events. Other ongoing activities include exercise classes and reminiscence therapy.

“We do things like music therapy where we bring in entertainers. The residents participate and they sing along and use instruments like drums and tambourines,” notes Caryn Lauver, Grace Manor’s risk manager and director of health and wellness.

A personal touch is that residents have shadow boxes displayed outside their suites. The memory boxes are filled with photos and mementos that have personal significance. For people with memory impairments, it helps in locating their suite.

“We ask the family to post or provide pictures of the residents and their family members. We have a lot of people with wedding photos and pictures of their kids,” says Caryn. “It’s a memory box, so people include the things that mean something to them. One man has a medal from the Army in his.”

The memory boxes not only help the residents, but also give the staff a wider perspective about the people they are caring for.

“The memory boxes let the staff know that at one time the resident was a doctor, a lawyer, a police officer, a very important mother to young children,” notes Caryn. “We want to remember to see them as more than just our residents. The staff gets a little bit of insight about who they once were.”

Resident assistants who work with patients with Alzheimer’s disease or other forms of dementia undergo special training. They use methods to align themselves with whatever the resident is experiencing in the moment. The goal is to help the person struggling with the effects of dementia to feel reassured, calm and not so alone.

“We have a life enrichment program for our memory care residents that offers specific activities that cater to those with cognitive impairments like Alzheimer’s and dementia,” adds Caryn. “We do lots of sensory activities. For instance, we can listen to recordings and videos of laughing babies that make the residents laugh. The system is really unique.”

Up and Dancing

Annie, who is 93, has thrived since moving to Grace Manor two years ago, says her daughter.

“She has gained ten to fifteen pounds just from being around other people and interacting with them,” adds Laura. “The nice thing is that the staff doesn’t just leave the residents in their rooms. They encourage them to come out and be with the other residents.

“If you ask anybody there what Annie is like, they will tell you she loves to dance. They bring in plenty of different musicians and she just absolutely loves it. She’ll get up in her walker and lead the conga line,” Laura continues.

“You put some music on and her foot starts tapping and she wants to get up and dance. She really likes it, too, when the musician comes in who brings drums and tambourines. She just loves that. And they have different volunteers who come in and help with crafts, along with other activities.”

Laura visits Annie often, so she knows the staff and residents.

“I can pop in and visit, so I’m there just about every day. I know all the residents there – it’s just a wonderful group. My mom absolutely loves Carol, the activities director. You only need to say Carol’s name and Mom lights up,” reports Laura.

“The staff is excellent. They’re always looking out for my mom, so I can always call them and ask how she is doing if I can’t get over there that day.”

The family’s decision that Annie couldn’t live at home any longer wasn’t an easy one. But seeing how the care she receives at Grace Manor has helped their mother assures them it was the right choice, says Laura.

“Everyone in our family thinks it is a great place,” she adds. “We are all very happy with Grace Manor.”

FHCN article by Susan Hemmingway. Photo by Jordan Pysz. Graphic courtesy of VectorVaco.

Back to Natural

“Perfect teeth” replace gold caps

As a 19-year-old, Richard* admired the gold teeth of rap star Lil Wayne, whom he once met up close in Daytona. A mouthful of gold was a signature fashion adornment among hip-hop artists: upper and lower front teeth, all encased in gold caps.Richard* has rap-star-inspired gold crowns on front teeth removed & replaced by porcelain crowns by Nicholas G. Rendon, DDS.

“A couple of my friends and I were trying to start a record label, and at that time, I was a rapper,” shares Richard. “Gold teeth were more of a performer/rapper look.”

Richard wanted gold caps of his own, but was turned down on his initial try.

“The first dentist I went to said he wouldn’t do it because my teeth were almost perfect,” recalls Richard.

His mother urged him not to pursue it, but Richard found another dentist who was willing to give him a mouth of gold. Twelve of Richard’s front teeth, six on the top and six on the bottom, were crowned in gold. From then on, whenever he spoke or smiled, two rows of golden teeth were front and center.

As often happens, growing older changed Richard’s perspective. By the time Richard was in his early 30s, gold teeth weren’t looking so good to him.

“You know, you get a little older and you grow out of things. Now, I wish I hadn’t done it,” he confides.

He found that having the gold caps removed and replaced by natural-looking crowns might not be simple.

“I had been struggling to get them off for about a year and a half. I talked to four or five different dentists,” explains Richard.

He didn’t feel comfortable with any of them. The dentist or their staff gave him worst-case scenarios and cautioned that unforeseeable possibilities could dramatically affect the final cost. At one office, the estimate’s range equaled the price of a new car.

Then, Richard’s wife talked to her dentist, Nicholas G. Rendon, DDS, about Richard’s situation.

“We scheduled an appointment for me to see Dr. Rendon,” continues Richard.

Artistic Touch

In Richard’s first visit, Dr. Rendon provided a complete dental examination, including x-rays. He evaluated Richard’s bite – how his upper and lower teeth fit together – and recorded the depth of Richard’s gums around each tooth to check for any signs of periodontal disease.

“We talked to Richard about what he was looking for and what we thought we could provide for him,” notes Dr. Rendon.

Richard liked Dr. Rendon’s straightforward and friendly manner. It made him feel comfortable.

“Dr. Rendon walked me through the process and said that hopefully the person who put on my gold crowns did a good job,” explains Richard. “He didn’t talk about what could go wrong. He knew exactly what to do. I felt like I could trust him.”

When Richard first got the gold caps, his teeth had been filed down, a standard procedure in preparing teeth for crowns. It meant that the gold caps couldn’t simply be removed. His teeth would need to be covered with new crowns.

Richard chose to have the work on his upper and lower front teeth done separately. Dr. Rendon focused first on removing all of the upper gold caps. Richard admits that he was a little concerned about how painful the procedure might be; the caps had to be cut off and any remaining cement ground down. He needn’t have worried.

“Actually, it was painless,” he describes. “In about two and a half to three hours, I had my new temporary crowns to replace the gold ones.”

Working on the entire row of upper front teeth at the same time was an advantage.

“We have several different types of crowns that we can create and many different shades of material we’re able to use,” explains Dr. Rendon. “In Richard’s case, we weren’t locked into trying to pick a particular type of material that would match one or two teeth or give us the best look in one particular spot. We were able to pick a porcelain crown that we knew would be consistently attractive across his front teeth for a nice cosmetic, overall result.”

Dr. Rendon’s artistic touch in creating the new crowns was critical. Richard’s gold caps were bulky. The new crowns would be designed for a better, more aesthetic match.

“For his new crowns, we chose an aesthetic look for the crown ratios, proportions and angulation,” notes the skilled dentist. “We wanted the shape of the crown to fit in with the overall appearance of his face, such as the shape of his face and his lip line. We take a lot of those small factors into consideration.”

Dr. Rendon also kept in close communication with the dental lab that fabricated Richard’s porcelain crowns.

“You don’t want to just take an impression and hand it off to the lab and say, Good luck, let’s see what you give us,” he observes. “You want to convey to the technician what you’re looking for and what you want done. You want to use a good, reputable lab that is used to doing aesthetic cases.

“We wanted Richard’s crowns to look like teeth that had grown in together, like natural teeth would have done. When you have a lab technician who can take over and use the same batch of porcelain to construct all of the crowns, the outcome is going to be a lot better. It’s going to be a lot more aesthetic and more uniform. The result is more natural-looking teeth.”Richard* has rap-star-inspired gold crowns on front teeth removed & replaced by porcelain crowns by Nicholas G. Rendon, DDS.

What a Difference

Once Richard’s teeth were liberated from the gold caps and encased in porcelain crowns, the results were significant.

“It was a pretty striking change for him,” says Dr. Rendon. “He was pretty astounded and surprised.”

Richard describes his new look as amazing.

He has noticed that having a non-gold smile seems to be advantageous in his work life. As a salesman for a soft drink company, Richard creates displays and keeps soda shelves stocked in supermarkets and convenience stores.

“I’m not saying that’s why I wanted the gold teeth out, but afterward, I noticed a change in how people react to me,” he describes. “Sometimes, I go into a store to get an extra account and with gold teeth, the manager might think, Well, I don’t really want to deal with this guy. How I do my job is the same no matter how I look, but the gold teeth create negative stereotypes.”

He plans to have Dr. Rendon remove the gold caps on his lower front teeth and replace them with porcelain crowns as well.

In the meantime, Richard had to take a little ribbing from his mother about his new look.

“She said, I told you before you were thirty-five that you would want the gold teeth out. You kind of hate to have to end up telling your parents they were right,” he jokes.

Among his friends who also opted for gold caps when younger, the look of Richard’s new porcelain crowns has been impressive. Already, several have seen Dr. Rendon for their own gold-to-natural transformations.

“I recommend Dr. Rendon to anybody,” enthuses Richard. “Everywhere I go, people are saying, You’ve got perfect teeth!

FHCN article by Susan Hemmingway. Stock photo from Before and after images courtesy of Nicholas G. Rendon, DDS.
*Patient’s name withheld per his request.

New Technology for Better Vision

Gloria Von Stein was having trouble driving after dark. Glare from the headlights of oncoming cars made it more difficult to see.Gloria Von Stein treated for cataracts with new Symfony® IOL by William J. Mallon, MD, at Center for Advanced Eye Care

She was experiencing other vision changes, too. Gloria had worn glasses for reading since her 40s, but by her mid 70s, she needed new prescriptions for multiple distances.

Not accustomed to wearing glasses all the time, she frequently forgot them. At the grocery store, she often resorted to squinting when attempting to read a food label.

“My glasses never seemed to be where I was,” she explains.

Gloria’s symptoms were from cataracts, a common condition that clouds the eye’s natural lens. William J. Mallon, MD, at the Center for Advanced Eye Care alerted her of the cataracts when they started to form.

Cataracts alter vision from slightly to significantly, but patients usually notice as they progress. Dr. Mallon advises scheduling cataract surgery when they interfere with daily life.

Based on how cataracts were affecting her everyday life, from needing glasses all the time to the difficulty she had driving at night, Gloria decided she was ready to take the next step.

“We had been following the progression of Gloria’s cataracts for some time,” he notes. “My philosophy has always been for patients to tell me when they are ready for surgery. I say to them, I don’t have to tell you when you’re ready. You’re going to be telling me.”

Pick Your Lens

At the Center for Advanced Eye Care, cataract surgery is an outpatient procedure that is quick and painless. The patient’s cloudy lens is removed and replaced with a new intraocular lens (IOL). One eye is done at a time, usually a few weeks apart.

The surgery is performed with eye drop anesthesia. Patients therefore don’t have to undergo sedation or preoperative testing. They can return to normal activities the day of surgery.

Dr. Mallon believes that an in-depth assessment and pre-surgery evaluation are critical.

“Ninety-five percent of a successful cataract surgery outcome is determined in the pre-operative planning and measurement,” he explains. “The actual surgery needs to be performed, but the planning and pre-operative work is really the most important part.”

Another key to success is helping patients understand the many options for lens implants. They range from standard monofocal lenses that correct sight at a single distance to advanced multifocal lenses.

The advanced lenses make it possible to reduce or eliminate dependence on glasses, but they aren’t for everyone.

“We spend a lot of time talking to patients about their goals, wants and options. Everyone is different, so that’s crucial,” notes Dr. Mallon.

New Class of Intraocular Lens

Gloria was a candidate for a new technology IOL called Symfony®. The US Food and Drug Administration approved the Symfony lens in July 2016.

“The Symfony lens has been used in Europe for several years and in Canada with very good results,” notes Dr. Mallon. “It helps vision at multiple distances, but it’s very different from a multifocal IOL.”

The Symfony lens utilizes a new technology called extended depth of focus. An advantage is how it helps intermediate vision for tasks such as reading a grocery shelf label or working at a computer.

“The ideal patient is someone who golfs and wants to be able to see the scorecard and also the ball on the fairway. Or they like to read on an iPad® or computer, which are mid-range vision activities,” observes Dr. Mallon.

“This lens is very good in providing distance vision and also providing mid-range vision without some of the visual side effects we see with true multifocal lenses.”

The Symfony lens is also available in a Toric version that corrects astigmatism. Gloria had astigmatism and cataracts and benefitted from the Symfony Toric lens. Astigmatism affects the shape of the cornea and causes blurry vision; it is a common reason for glasses.

The benefit of astigmatism correction boosted the probability that Gloria wouldn’t need glasses very often, if at all, after her surgery.

Gloria Von Stein treated for cataracts with new Symfony® IOL by William J. Mallon, MD, at Center for Advanced Eye Care

Gloria can easily read food labels
without glasses.

Everything Is Brighter

Gloria became a patient of Dr. Mallon after witnessing how the skilled ophthalmologist successfully treated the impaired vision of someone she knew.

“That’s all it took for me to make an appointment with him. I knew he was an excellent doctor,” she reports.

Gloria’s experience confirmed she made the right choice.

“They have a video program for patients to watch about cataract surgery, but Dr. Mallon also took the time to go through it all with me,” she reports. “The surgery on my first eye was painless, and it was the same with my second eye. It was all just like clockwork.”

Gloria was surprised – and appreciative – when Dr. Mallon personally called her at home the night of her surgery.

“I got a call from him at nine-thirty that night. He calls every patient himself to make sure they are okay and not experiencing any side effects,” she notes.

The results from cataract surgery and Symfony IOLs were transformative.

“It was just like night and day,” says Gloria. “Colors were brighter and deeper. Everything just popped out at me.”

The location of her glasses is no longer a worry. Her distance vision is 20/20, and she can read small print without glasses, too.

“I read my Kindle without glasses. I play bridge and Mahjong without glasses. I’m able to read the food label on a can. It’s really remarkable,” comments Gloria.

“Dr. Mallon and his staff and the professionalism of their office are wonderful. You’re in good hands.”

FHCN article by Susan Hemmingway. Photos by Nerissa Johnson. Stock photos from Building photo courtesy of Center for Advanced Eye Care.

Going the Distance for Best Dental Care

Sometimes, good experiences at a dentist’s office outweigh the distance it takes to get there. That’s the case for retired educator and Florida snowbird Michael Washousky. His permanent residence is in New York; his dentist is Merrill A. Grant, DMD, in Satellite Beach.

Michael Washousky has missing teeth replaced by Merrill A. Grant, DMD, in Satellite Beach.

Michael is happy he found Dr. Grant.

Michael, who is 69 and spends part of the year in Satellite Beach, made his first appointment with Dr. Grant after noticing the office on Jackson Avenue. He had a toothache that needed attention and also wanted to explore options for improving his oral health and smile.

“Over the past five to six years, I’ve had extensive dental work done in New York,” shares Michael. “I had a partial that I was wearing for a while, but that didn’t work very well. I was having trouble chewing.”

From his first consultation, Michael was impressed by Dr. Grant’s professionalism and manner. He learned why many of Dr. Grant’s patients have relied on the skilled dentist for years.

Along with general and preventive dentistry, Dr. Grant’s wide range of skills includes cosmetic and restorative dentistry. His practice has been in Satellite Beach for more than three decades.

“I was very impressed with how thorough Dr. Grant is,” recalls Michael. “I found that he has a very effective use of technology whereby a lot of x-rays were taken, and I was able to look at them. He took a great deal of time going over the information with me and pointing out where the problems were.”

Michael appreciates a principle of Dr. Grant’s practice: He educates people about choices when they need dental work and encourages them to make their own decision about which course of treatment to pursue.

“Dr. Grant gave me two or three different options to think about before he started any work,” notes Michael. “He talked about the possibility of implants and the possibility of a denture and left it up to me to make the decision. I felt I was very well informed about what my options were and how things would go based on what I picked.”

Above and Beyond

Michael decided a denture would be his best choice for replacing his upper teeth, along with a partial denture for missing lower teeth and crowns to restore other teeth in need of repair.

“I started treatment in March and then went back to New York, but I came down to Florida during the course of the summer to visit my son, who lives in the area. It took about eight to ten visits to complete the work,” says Michael.

Scheduling dental visits long-distance isn’t an obstacle.

“The scheduling process is very favorable for me. Whenever I fly down, Dr. Grant is always able to make the time to see me. I am always completely informed about what is going on and what to expect.”

He also knew he could call Dr. Grant anytime, whether from New York or in Florida: “He is always able to take calls,” explains Michael. “The other thing that I’ve been impressed by is that Dr. Grant calls you in the evening after the work is done, no matter the extensiveness of it, just to find out how you’re doing.”

Michael likes the atmosphere of Dr. Grant’s office and the friendly professionalism of his staff. Dr. Grant creates a “high-trust, low-fear” relationship with patients. He understands that most people would rather avoid the dentist’s office, and he goes above and beyond to create a comfortable environment for everyone.

“I’m impressed with the whole operation,” explains Michael. “The staff are totally competent and very friendly. If you have any questions about the financial or the business aspect of anything, they go out of their way to accommodate your request.”

The Personal Touch

“For every patient, we create a treatment plan based on the individual’s needs and wants,” notes Dr. Grant. “We take photographs and make videos of the patient’s smile and then discuss what they want changed, what they don’t want to change, what they like and what they don’t like about their smile.”

Michael noticed that while Dr. Grant utilizes top technology, he also incorporates a personal touch in working with patients and making them feel comfortable.

“Dr. Grant doesn’t rely on technology to do all of the explaining. He has a personality and sense of patient care that just comes through in his conversation during consultations and procedures,” explains Michael. “He tells you exactly what he’s doing and what to expect next. He’s a very caring and informative dentist.”

Excellence in dentistry is a combination of technical and artistic skills, and Dr. Grant earns high marks in both arenas from Michael.

“You can sense that he takes pride in his work. I immediately felt a lot of confidence about what he’s able to do. You can tell that he pursues professional development education all the time and keeps building his skill base,” says Michael.

“Dr. Grant took the time to make sure my denture fit right, and I think that requires artistry. He is very thorough in making sure everything fits perfectly and that you’re satisfied with the way it looks.

“I don’t know if everybody takes that amount of time, with that much pride, in their work,” continues Michael. “So I do see him as an artist and a craftsman, in addition to being a dentist with a high level of technical skills.”

For now, Michael is keeping a permanent residence in New York but is thinking about relocating to Satellite Beach year-round. When in Florida, he enjoys the ocean, riding his bicycle and spending lots of time at the gym.

And he does it all with a new smile, thanks to Dr. Grant.

According to Michael, there isn’t a question about who will be his dentist, no matter where his primary home is located.

“I’m very satisfied with the results of Dr. Grant’s work. My teeth look great,” he enthuses. “I definitely plan to use him as my dentist.”

FHCN article by Susan Hemmingway. Photo by Nerissa Johnson.

Dental Implants Restore Quality of Life

When Robert Barnes, 75, grew bored with retirement, he helped found The Children’s Hunger Project. The project became a labor of love for the retired broadcaster and marketing specialist. It provides food packages for Brevard County school children who otherwise would go hungry.

Robert Barnes treated with dental implants to replace missing molars and William Reichley treated with subperiosteal dental implant for slipping denture by Clark F. Brown, Jr., DDS, at Implant Dentistry of Florida.

Robert is no longer limited in what he can eat.

“We provide packages of food for over sixteen hundred kids every weekend at over three dozen elementary schools,” notes Robert. “It’s for children teachers know would be coming to school hungry on Monday morning.”

In between working many hours at the charity, Robert had to take care of another issue. His teeth had given him trouble since his youth, and some were missing or loose.

“I’ve had gum problems since I was very young and lost a good number of my teeth. It was time to do some fix-up, so to speak,” he explains. “I wanted to make sure that I had a decent look and the ability to chew properly.”

His immediate concerns were two damaged molars on the left side of his mouth.

“They didn’t necessarily limit me from eating certain foods, but if I was chewing something that was difficult, like a steak, I would make sure I was chewing on the right side,” explains Robert. “The right side was more stable, and that was just something that I had to be conscious about when eating.”

In characteristic fashion, Robert delved into finding the best dentist who could help. He asked for recommendations from friends and acquaintances, and their feedback led him to Clark F. Brown, Jr., DDS, at Implant Dentistry of Florida in Melbourne.

“I started asking around, talking to different people in the community, and Dr. Brown’s name popped up,” recalls Robert. “I went and interviewed him and was very comfortable speaking with Dr. Brown and his staff. I said to myself, Boy, this is good!

Dr. Brown is a comprehensively trained and experienced dentist who has practiced cosmetic, general and implant dentistry for more than 30 years. His credentials and the personal warmth of his office convinced Robert that Dr. Brown was the dentist he was seeking.

Protecting Front Teeth

“When Robert first came to my office, he had just lost the molar on his left side about five months earlier,” notes Dr. Brown. “He found that it was more difficult to chew, and he knew he was just chewing more with his front teeth, and that wasn’t efficient.

Robert Barnes treated with dental implants to replace missing molars and William Reichley treated with subperiosteal dental implant for slipping denture by Clark F. Brown, Jr., DDS, at Implant Dentistry of Florida.

Subperiosteal implant

“Robert didn’t have a partial denture, and he didn’t want one. He was looking to replace his missing teeth with implants.”

Many people don’t realize that replacing missing back teeth is important for good oral health, explains Dr. Brown. An adverse effect is how missing back teeth can affect the front teeth.

“Often, patients are just interested in replacing missing front teeth because they want to be able to smile,” comments Dr. Brown. “Of course, smiling is important, but the back teeth should not be ignored. The teeth in the front weren’t meant to chew. They’re meant to bite into food and move it to the back, where there are larger teeth designed to chew food.

“When patients are missing teeth in the back, not only are they not chewing properly, they’re also putting more force on the teeth in the front, which can accelerate tooth loss in the front. So, having teeth in the back is important, and implants are the best way to get those teeth back.”

People who have a partial denture for missing molars also may believe they can chew without inserting their denture.

“A partial is something that comes in and out and is clustered around remaining, natural teeth. It can feel foreign in your mouth and if you’re not used to it, a lot of times, you’re not going to want to wear it,” explains Dr. Brown.

“Sometimes when people have enough back teeth that they can still chew, they don’t wear their partial,” he continues. “But it becomes just a matter of time before they don’t have their front teeth because of the additional stress placed on them, and now they’re in dentures.”

Implants are recognized as the gold standard for replacing missing teeth. They are surgically placed in the jawbone, where their function becomes similar to the roots of natural teeth. The implants fuse to the bone. They are then able to firmly support an attached crown for a single tooth or a denture that replaces multiple teeth. The restorations remain permanently in place and are cared for by brushing, flossing and routine professional cleaning, just like natural teeth.

Dr. Brown has been placing and restoring dental implants since 1982. He is board certified by the American Board of Oral Implantology, is a Diplomate of the International Congress of Oral Implantologists and a Fellow of the American Academy of Implant Dentistry.

Through advanced technology at Implant Dentistry of Florida, Dr. Brown is able to complete all aspects of the implant procedure under one roof. It includes 3-D imaging that guides exact placement of the implant, as well as making the attached crowns.

He knows the importance of creating a detailed plan to guide him in the process of restoring an individual’s lost teeth.

“I begin by asking what the patient wants as an end result and what are their goals and desires,” explains Dr. Brown. “Then, it is a matter of planning how we can accomplish those goals and give them what they would really like. And with the technology we have and the experience I have, it enables me to do that.”

“Dr. Brown is very meticulous and very knowledgeable,” emphasizes Robert, who also appreciated the skilled dentist’s ability to help him feel calm.

“You have to understand, and I can’t emphasize this enough – I’m a very fearful patient. I’m a nervous wreck when I go in to get my teeth cleaned,” Robert admits.

Dr. Brown’s gentle and reassuring manner helped allay Robert’s anxiety. He made sure Robert was always comfortable and that he didn’t experience any pain.

Robert Barnes treated with dental implants to replace missing molars and William Reichley treated with subperiosteal dental implant for slipping denture by Clark F. Brown, Jr., DDS, at Implant Dentistry of Florida.

Dr. Brown explains to Robert how replacing missing molars with
implants protects
overall oral health.

“There were no problems at all,” reports Robert. “As a matter of fact, the experience of having this done, quite frankly, was easier than getting a tooth filled. It was the best dental experience I’ve had in my life.”

Recently, Robert needed implants to replace loose molars on the other side of his mouth. He didn’t hesitate to return to Dr. Brown for the procedure nor did he feel the anxiety he once did about seeing a dentist.

“I had very little fear when I came back to have the right side done,” he says.

He faced an additional hurdle, however, for his second procedure. The bone mass in his upper jaw wasn’t thick enough to hold the implants in place. He needed a sinus graft to augment bone density.

“For Robert, it all went pretty easily,” assures Dr. Brown. “We placed the implant and at the same time did what is called a sinus augmentation to add grafting material in the sinus that helps support the implant. It worked out well for him.

“Now, he can use those back teeth to chew again. He will also be preserving his front teeth from the accelerated wear they would have otherwise had.”

New, Secure Smile

Like Robert, William Reichley struggled with dental challenges since early adulthood.

As a young man, William lost all of his teeth and needed dentures ever since. At 72, the retired orchid nursery owner was enjoying retirement. What he wasn’t enjoying was how his lower denture was affecting his quality of life.

The denture frequently slipped out of place, which was a problem at restaurants. William enjoys dining out with friends, but in the middle of meals, he often had to excuse himself from the table to reapply denture adhesive.

“As I was eating, the adhesive would disappear. My denture would actually come up off my jawbone and float,” he shares.

The ill-fitting denture affected his ability to chew. “One of my favorite foods is steak. To eat it, I had to cut the meat into very small pieces. I just had no chewing power left in my bottom jaw,” he continues.

“There were times when I wanted a salad but wouldn’t order one because I knew I wouldn’t be able to eat it. I would order the soup instead. I steered away from anything that required a lot of chewing.”

Reapplying denture adhesive was part of William’s routine outside of restaurants, too. Not only was the process inconvenient and messy, but it also worried him.

“I had to apply adhesive to my lower plate several times a day, and I knew that this couldn’t go on. I was concerned about what all that adhesive might be doing to my body,” relates William. “I was miserable because I couldn’t keep my dentures where they belonged.”

William began to consider traditional dental implants. His search for a dentist he could trust led him to Dr. Brown.

Robert Barnes treated with dental implants to replace missing molars and William Reichley treated with subperiosteal dental implant for slipping denture by Clark F. Brown, Jr., DDS, at Implant Dentistry of Florida.

Progressive bone loss
caused by tooth loss
still allows placement of the subperiosteal implant.

“I was quite impressed by Dr. Brown’s many successes,” notes William. “And I liked that not only does he perform dental implant procedures, he also teaches the procedures. I figured anyone who teaches other dentists must be really good.”

Overcoming Bone Loss

During William’s initial visit, a complete evaluation by Dr. Brown revealed why William’s denture frequently slipped out of place. The bone structure of his jaw had atrophied from his long use of dentures, which isn’t unusual. The body naturally reabsorbs bone that surrounds teeth roots when teeth are missing, and over time, this will affect how dentures fit.

“Very often, people who have worn dentures for a long time don’t have enough bone to hold a denture in place,” notes Dr. Brown.

Lack of bone density presented another challenge. William didn’t have enough bone for placement of traditional dental implants. In fact, the bone loss was so extensive that bone grafts weren’t going to be a practical solution.

“William would have needed an extensive amount of grafting for traditional implants. During the process, he would also have had to go on using his loose, uncomfortable denture for another six to seven months,” notes Dr. Brown.

However, William wasn’t out of luck, or doomed to an ill-fitting denture.

Dr. Brown recommended an alternative: a type of implant that doesn’t require bone grafts, called a subperiosteal implant. A subperiosteal implant differs from traditional implants in shape and placement, and bypasses the challenge of a thinned jawbone.

A subperiosteal implant is a custom-made metal framework placed on top of the jawbone, underneath the gum.

“During the healing process, a fibrous membrane on the jawbone’s outer surface, the periosteum, firmly attaches to the implant’s framework,” educates Dr. Brown.

“That is what keeps the implant solidly in place and prevents it from moving,” he continues. “All that is seen are metal posts that protrude from the gum tissue. The denture just snaps into place.”

Subperiosteal implants are a time-tested technology. They first started being used as a solution for securing loose dentures in 1948.

“I’ve been placing implants for nearly thirty-five years, and the first two I did were subperiosteal implants,” notes Dr. Brown. “More than three decades later, those two patients are still doing well with them.”

Advancements in technology have made the procedure for subperiosteal implants less invasive.

Previously, the gum had to be surgically opened twice for a subperiosteal implant. The gum was first opened to make an impression of the jawbone that was used to manufacture the implant. After the implant was finished and ready for insertion, the gum was opened a second time to place the device.

“We have a cone beam CT scanner that creates a high-definition, three-dimensional image of the jawbone. This digital image eliminates the need to open the gum to take an impression,” explains Dr. Brown.

“The CT scan is sent to a company that then makes an exact replica of the patient’s jaw,” he says. “From there, the replica is sent to a lab to create the implant that will precisely match the individual’s jaw. The only surgery needed is to place the implant.”

William had the in-office procedure with moderate IV conscious sedation. He only needed an over-the-counter pain reliever the next day.

Dr. Brown’s expertise, along with the warm and friendly atmosphere of his office, gave William confidence about having the procedure. He knew that he was in good hands.

“I never had a moment of anxiety about what was going to happen,” he notes. “Everything was explained to me so well that I went in with no fears, no doubts and no questions whatsoever.”

Phenomenal Results

Both Robert and William are pleased with the results of their dental implants. Having implants allows them to chew normally and adds to their quality of life, they report.

Robert Barnes treated with dental implants to replace missing molars and William Reichley treated with subperiosteal dental implant for slipping denture by Clark F. Brown, Jr., DDS, at Implant Dentistry of Florida.

William is thrilled with how a new dental implant has improved his quality of life.

“I don’t have to think about how I’m chewing when I’m eating,” notes Robert about how he no longer has to favor one side of his mouth. “I can just chew normally, like most people are able to do.”

William describes his new implant as “absolutely wonderful.” For the first time in decades, William can get through his day without worrying about being embarrassed by a dislodged denture.

The implant doesn’t move at all, even when he’s eating. Plus, not a single drop of dental adhesive is required.

“Having a dental implant has been phenomenal. It’s a great, great result and I’m very happy,” enthuses William. “I eat anything I want. In fact, I recently went out and had a steak dinner – with a salad. I am still enjoying going out with friends and being able to say, Guess what. I’m chewing and I don’t have to leave and put denture adhesive in my mouth.

“I recommend Dr. Brown to people all the time. His clinic is wonderful and so is his staff,” he continues. “I can only say good things about Dr. Brown and what he has done for my life.”

FHCN article by Susan Hemmingway. Photos by Nerissa Johnson & Jordan Pysz. Graphics courtesy of Implant Dentistry of Florida.

Power of PRP

Body’s platelets ease arthritis pain and promote hair growth.

Louis Politano’s throbbing right knee was getting worse.

Louis Politano treated for chronic knee pain with PRP therapy, Judy* (alias) treated with PRP therapy for hair loss at Physical Medicine Center.

Lou is happy that he avoided knee surgery through PRP therapy.

“I’m a security manager, and I’m my feet constantly. My knee was destroying me. It constantly ached, and I couldn’t take enough Advil®,” he relates.

“The Advil helped me sleep at night, but when I got up, the pain I felt in my knee when walking was really unbearable,” continues Louis.

His knee never bothered him before, but at 68, Louis had spent plenty of time over the years in physically demanding activities and jobs.

“I was very active in sports when I was younger, and I was a bartender for a lot of years, so I was standing all the time,” he notes.

On a scale of one to ten, his knee pain was nearly always a constant nine.

He knew toughing out intense pain wasn’t a long-term solution. Plus, he was planning a vacation in Europe. It would require a lot of walking, and the knee wasn’t functioning.

He was at the point where knee replacement surgery might be the next step. But Louis was determined to avoid surgery at all costs.

He witnessed how knee surgery affected family members. The surgery is invasive and the recovery period can be painful. And like any major operation, it carries the risk of complications.

“My brothers had knee replacement surgeries, and they suffered,” he explains. “The recovery is forever.”

In his research for an alternative, he read about platelet-rich plasma therapy, known as PRP, to relieve injured joints, tendons, ligaments and muscles. He decided to try it and made an appointment with Robert C. Lupo, DC, at Physical Medicine Center.

Utilizing Plasma Cells

Physical Medicine Center is a multidisciplinary care center in Tampa offering chiropractic care, physical and massage therapy, medical care, anti-aging treatments and low-level laser therapy.Louis Politano treated for chronic knee pain with PRP therapy, Judy* (alias) treated with PRP therapy for hair loss at Physical Medicine Center.

The center offers PRP for relief from musculoskeletal conditions and has a program to relieve pain from osteoarthritis in the joints of knees, shoulders, hips and spine through the utilization of PRP therapy.

“Louis tried some other ways to find relief from knee pain before he came to us, such as corticosteroid injections, some physical therapy, ice, rest and braces,” says Dr. Lupo. “But his knee was just getting worse.”

During Louis’ office visit, Dr. Lupo examined x-rays of Louis’ knee and took a detailed medical history. He noted Louis was experiencing classic symptoms of degenerative joint changes from osteoarthritis. The knee was stiff and achy, and it was difficult for him to rise from a sitting to standing position. He had trouble climbing stairs or standing for long periods of time.

“All kinds of normal activities had become difficult for him because of his knee,” observes Dr. Lupo.

He agreed with Louis that knee surgery should be a last resort and recommended PRP therapy.

“People should avoid knee surgery whenever possible because of issues like scarring and problems that can come afterward, such as infection,” cautions Dr. Lupo. “We hear of people all the time dying of blood clots and things secondary to some simple, elective surgery that could have been prevented altogether. PRP may be a way for many patients to avoid surgery and still relieve the pain.”

PRP is autologous, meaning the patient’s own cells are used. The therapy utilizes the body’s platelets, the blood cells that promote clotting, to repair wounds and accelerate healing.

The first step is to draw blood from the patient, similar to how blood is drawn for routine blood work. While the patient waits, the blood is spun in a centrifuge to create a concentration of platelet-rich plasma.

Once the platelet solution is ready, it is injected into the area of the body being treated. The key to PRP treatment is that when platelets are activated in the body, they release healing proteins called growth factors.

“PRP treatment has the ability to utilize growth factors to promote the healing process and rejuvenation of damaged tissue. It also has a very good anti-inflammatory action,” explains Dr. Lupo.

Louis Politano treated for chronic knee pain with PRP therapy, Judy* (alias) treated with PRP therapy for hair loss at Physical Medicine Center.

Closeup portrait of beautiful senior husband and wife.

To help relieve joint pain, people typically are treated with a series of three to four injections about a month apart.

“Typically, within the first couple of weeks after their first treatment, people will notice decreasing pain with better function and movement,” notes Dr. Lupo.

“The first month is when the most changes are reported by the patient. The second month is when a deeper healing process is taking place, and the procedure is showing the good things it can do. By the third month, we’re typically just assisting in some further repair.”

Dramatic Results

In treating Louis, the physicians at Physical Medicine Center injected PRP into both sides of his arthritic knee. He had three treatments, a month apart.

“The procedure was painless,” reports Louis. “I started feeling better after the first set of injections.”

The overall results were dramatic: Louis could barely walk before the therapy because it hurt to put any weight on his right leg. After PRP, the knee pain he had been suffering with for months was gone.

“My knee is perfect now. I have no pain at all,” says Louis. “It’s like I have a new leg. I went to Europe and walked about fifty miles during my vacation. I didn’t have one issue with my knee.

“Now, it’s time to get back to the gym again. I like to go to the gym and ride my bike and was doing that a couple of times a week, but I had to stop because of my knee.”

Louis is happy that he discovered PRP and sought treatment from Dr. Lupo at Physical Medicine Center.

“Dr. Lupo is very knowledgeable and knows what he’s doing. He and his office staff are very professional. And they treat you like a human being because they all know who you are. You couldn’t ask for anything more,” he comments.

“I hadn’t heard of PRP before, but when you’re in a lot of pain, you want to try something else. And it worked!”

PRP for Hair

Judy’s* hair loss started on one side of her forehead and expanded to other areas of her scalp.

Louis Politano treated for chronic knee pain with PRP therapy, Judy* (alias) treated with PRP therapy for hair loss at Physical Medicine Center.

Composition of Blood

“I had hair loss on one side for a long time, but on the other side, my hair was always long enough to comb over it. Then, the hair on the other side started getting shorter because it was breaking off,” shares Judy, who is 81.

Eventually, her hair loss receded from ear to ear across her forehead. It made her self-conscious. Judy managed to hide her hair loss by wearing a wig.

“I wouldn’t stop going out. I can’t be idle,” she says. “But a wig is not good in Florida. It’s too hot. I’d wear the wig when I went out and take it off as soon as I got back in my house. Sometimes, I’d take it off while still in my car on the way home,” she describes.

“I tried a lot of things to make my hair grow back. Hot oil treatments and different products people were telling me about. You name it, I’ve tried it. Nothing worked.”

Then, she read an article about PRP for hair loss in Tampa Health Care News. The article explained how the therapy is being used at Physical Medicine Center to promote hair growth.

“I read where it worked for other people and thought to myself, Let me try it. I’ve already tried everything else.”

Stimulating Hair Follicles

“When Judy came to see me, we just sat down and talked about what was bothering her,” says Dr. Lupo at Physical Medicine Center. “For women, hair loss is a very sensitive issue.”Louis Politano treated for chronic knee pain with PRP therapy, Judy* (alias) treated with PRP therapy for hair loss at Physical Medicine Center.

The many reasons for hair loss include medication, stress, hormone changes and thyroid changes, he explains. Typical hair loss patterns for men are at the front of the scalp and crown, but tend to vary in women.

“Sometimes in women we see hair loss occurring only in the crown or receding from the front, but sometimes it can be hair loss in multiple areas around the scalp. Everyone’s a little bit different,” adds Dr. Lupo.

At Physical Medicine Center, PRP therapy has been used for hair loss in both men and women for more than two years.

Just like PRP for joint pain, PRP for hair loss utilizes the patient’s own blood cells. Blood is drawn from the patient and spun in a centrifuge. The concentrated platelet-rich plasma solution is then injected into tiny pockets in the scalp to stimulate hair follicles.

In treatment sessions, scalp preparation is utilized to jumpstart the process.

“To promote hair growth, we use a special micro-needling stimulator to stimulate the dermis, or skin, of the scalp,” says Dr. Lupo. “This micro-needling stimulation opens micro channels to the dermis that induce other healing and growth repair cells into action. Highly concentrated platelet-rich plasma is then used on the scalp.”

The primary purpose of using PRP in hair restoration is to stimulate inactive hair follicles into an active growth phase.

“PRP contains many growth factors that rejuvenate and stimulate hair follicles,” educates Dr. Lupo. “PRP will actually help finer hairs grow a little thicker and stronger and certainly grow more prolifically.”

Hair follicles are where individual strands of hair originate. Each strand follows a growth cycle from active to dormant. Eventually, old strands fall out, which is normal. Ideally, new growth replaces lost hair as the follicle moves into the active phase.

“At Physical Medicine Center, we usually perform a round of about five treatments, a month apart, mainly because hair strands aren’t all growing in the same stage at any one time. Some of the hair will be in the growth phase, some will be in a resting phase and some will be in the falling-out stage,” explains Dr. Lupo.

Other modalities are added as needed.

“For men and women, we have a topical treatment called 82M. It is a customized compound formula containing pharmaceutical-grade minoxidil,” says Dr. Lupo. “Each patient will have different needs, and that is what we look for and address.”

Fresh, New Growth

Judy began to see results after her second PRP treatment. To her delight, she could see fresh growth where her hair had receded.

“I could see a little fuzz and said, Oh my goodness, it’s working!” she remembers. “It’s only been a couple of months. It’s still fuzzy, but it’s growing.”

As an addition to her PRP treatment, Judy was also prescribed an oral vitamin formula.

The retired teacher’s aide likes to work out every day with aerobics classes, both in and out of the water, and is a mother and grandmother. She plans to reveal her new hair to family and friends when more hair growth comes in.

“I’m still wearing my wig, and I haven’t shown anybody the new hair growth for now. I want to surprise everybody!” says Judy. “I am very happy!”

FHCN article by Susan Hemmingway. Photos by Jordan Pysz. Stock photos from
*Patient’s name changed

All She Wanted Was One Front Tooth

Bonnie Kaye and her husband, Dan, were spending the Christmas holidays at their home in The Villages when her dental disaster occurred.

Bonnie Kaye’s positive experiences at Village Dental, where her dentist is Richard P. Hall II, DMD, have made her a loyal patient.

Bonnie is investing in future good health by taking care of her teeth and gums at Village Dental.

Their permanent home was still in Illinois, where Bonnie was in the process of getting dental implants to replace her two front teeth. She was at the stage where the implants were surgically placed and temporary crowns were positioned on the implants.

On Dec. 23, the abutment on one of her implants broke. It was the connector that held the temporary crown and she was left with a toothless gap.

“When I smiled there was definitely a hole and I was panicked,” shares Bonnie. “I didn’t have a dentist in Florida yet.”

She picked up a phonebook and started dialing, hoping to find an open dental office.

“I started crying because there was no answer, no answer, no answer,” she laments. “Then I dialed the number for Village Dental and a girl answered. She said, We’re closed and I’m here doing bookwork. But tell me what the issue is.

“After I told her, she said, Dr. Hall would never let you go through the Christmas holidays with a missing tooth! Let me call him.

The office assistant was referring to Richard P. Hall II, DMD, one of Village Dental’s four dentists. After being informed about Bonnie’s predicament, Dr. Hall made a special trip to meet her at Village Dental that afternoon.

He reattached her crown with a temporary adhesive and informed Bonnie he wanted to talk to her dentist in Illinois before proceeding further. The next day, Christmas Eve, he secured the crown so it wouldn’t fall off.

Impressed and grateful, Bonnie told him, “You’re my dentist from now on!”

Healthy Retirement

Bonnie, 62, is a retired teacher who now lives in The Villages year-round. She enjoys all The Villages has to offer from golfing and bowling to dancing and crafts.

The emergency that first led her to Village Dental seven years ago had a silver lining. She found a dental practice where excellence and devotion to patients is a top priority.

Staying healthy is part of her plan and that includes taking good care of her teeth.

“I’m always smiling and I want my teeth to look as nice and white and clean as they can be,” she notes. “There are also health issues with your teeth that can affect your heart and lungs.”

As Bonnie notes, people can face dental challenges in retirement years that influence overall health. For instance, studies have shown that inflammation caused by periodontal disease can contribute to heart disease.

Seniors also are susceptible to cavities when medication causes dry mouth or gums have receded.

Bonnie gets four preventive cleanings at Village Dental annually; her bottom teeth are slightly crooked, where plaque builds up faster. Preventive visits include fluoride treatments. The municipal water is not fluoridated.

“We want to help our patients take the best care of their teeth possible,” notes Beth Hards, a dental hygienist at Village Dental. “Fluoride helps preserve crowns and other restorations. Many people also have gum recessions and fluoride protects the exposed root surface.”

Like all Village Dental patients, Bonnie received a comprehensive care plan. It is based on a complete evaluation of her teeth and gums by Dr. Hall, and designed to stop potential issues before they occur.

The combination of highly skilled dental professionals and state-of-the-art equipment at Village Dental makes it possible for most dental services to be completed on site. These include periodontal work, implants, diagnostic imaging, creating dental crowns and more, so there is no need to see specialist after specialist in multiple locations.

“One thing I really like is that all the dentists at Village Dental are masters,” says Bonnie, referring to their mastership status from the Academy of General Dentistry.

With four master dentists, the practice is in a rare league. This elite distinction requires hundreds of hours of continued training. Only one percent of dentists who belong to the Academy of General Dentistry are masters.

Five Star Service

Just as importantly, the entire staff at Village Dental strives to help patients feel comfortable so their dental visits are enjoyable. It’s all part of Village Dental’s signature Five Star Service.

“The whole office is just very friendly. Whenever I’m there, they know who I am. It’s like family,” notes Bonnie.

Five Star Service starts at the front desk, where the staff takes care of insurance paperwork. Patients are assigned to the same hygienist from visit to visit, and treated to luxuries like blankets and warm towels. As a thank-you from the staff, patients go home with a long-stemmed rose.

“I absolutely love the place,” enthuses Bonnie. “Not many people say that about a dental office, but I do love Village Dental. I was lucky to find them!”

FHCN article by Susan Hemmingway. Photo by Jordan Pysz. Graphic from

New Smile in Just a Day

Stabilize dentures with implants.

Sam Pitak struggled with the challenges of missing teeth for years.

Sam Pitak and Sandy Larson have an implant procedure where they receive a secured denture on the same day. David L. Walker, DMD, and Eric C. Raynal, DMD, at Walker and Raynal, DMD in Brandon created the restorations.

Sam enjoys being able to care for his implant-supported denture like natural teeth.

“My gums had receded so badly that I was losing my teeth one at a time,” he explains. “It got to where I only had four lower teeth left.”

He tried to cope with a partial denture, but it was difficult and painful for him when eating.

“I used adhesive to help keep the partial denture in place while I ate. That helped a little, but the denture still moved around. Food particles would get underneath it and cause a lot of pain,” he laments.

“Last year, I broke my partial three times, once by dropping it, when it broke in half. Each time, the process for fixing it was like getting a new one fitted all over again,” adds Sam.

Sam, who works in parts inventory control, longed to get rid of the partial denture altogether. He researched the possibility of dental implants, but was advised he wasn’t a good candidate.

“I always wanted to have some type of implant. But I had been told several times by specialists that I didn’t have enough bone in my jaw,” he shares.

Good News

As a patient of Walker and Raynal, DMD in Brandon, Sam avoided getting a full removable denture as long as possible. He started seeing Dr. Raynal seven years ago, after being referred by a co-worker.

“Sam was missing multiple lower teeth due to past periodontal issues,” notes Dr. Raynal. “We tried to keep his natural teeth as long as we could. But as Sam’s four remaining teeth got looser and looser, we were unable to use a partial denture any longer.”

In hopes that new technology might make Sam a candidate for implants after all, he was referred to an oral surgeon for another evaluation.Sam Pitak and Sandy Larson have an implant procedure where they receive a secured denture on the same day. David L. Walker, DMD, and Eric C. Raynal, DMD, at Walker and Raynal, DMD in Brandon created the restorations.

Imaging tests revealed Sam had enough bone in the front of his mouth for an innovative implant procedure. It secures a denture with only four implants that are placed in the front of the upper or lower arch.

The procedure would give him functional and attractive teeth immediately. On the day of his implant surgery, he would go home with a firm and solid set of new teeth that remain attached to the implants.

More Good News

Like Sam, Sandy Larson was also dealing with bone loss in her jaw. She had unstable teeth in her upper arch and knew it was a matter of time before she would lose them.

When her former dentist moved, she was referred to Walker and Raynal, DMD from an oral surgeon and became a patient of David L. Walker, DMD. She talked to Dr. Walker about options for replacing her upper teeth.

“Sandy knew the problems with her teeth needed to be resolved,” says Dr. Walker. “We determined that her upper teeth couldn’t be saved and talked to her about dentures.

“We always give our patients options and talk to them about full dentures, implants and the procedure that gives them teeth in one day.”

Sandy, a retired dental assistant, knew what she didn’t want: a traditional removable denture. She worried it would trigger her strong gag reflex. She also didn’t like that she would need to remove it at night.

“I could never go without teeth,” she explains.

When she learned about the implant procedure that could give her secure teeth in one day, she knew it was for her.

“I worked as a dental assistant for twenty-five years, but I got out of dentistry long before this procedure was available. It’s really an amazing thing,” raves Sandy.

Another plus is that her implant-supported upper denture would feel more natural compared to a conventional upper denture.

Sam Pitak and Sandy Larson have an implant procedure where they receive a secured denture on the same day. David L. Walker, DMD, and Eric C. Raynal, DMD, at Walker and Raynal, DMD in Brandon created the restorations.

Sandra loves the look and comfort on her implant-supported upper denture.

A traditional upper denture features an acrylic plate that covers the roof of the mouth, which can affect the sense of taste. Supported by implants, Sandy’s new upper denture would be made of very strong and smooth Zirconia porcelain. Furthermore, the roof of her mouth would remain uncovered, resulting in a more natural and functional appliance.

New Teeth, Same Day

Dr. Walker and Dr. Raynal are masters in restorative dentistry, which includes replacing missing teeth with dentures, bridges and crowns.

“For our teeth-in-a-single-day
procedure, patients come to our office, where we go through all the steps we would normally take to create a full denture,” advises Dr. Walker.

“We make their impressions, ensure their bite is right and everything is in good shape throughout the process,” he continues. “The day of their implant surgery, their denture is already completed.”

Sam, who recently underwent implant surgery, is in the stage where the implants are integrating into his jawbone.

“Right after my surgery, I was able to eat soft foods,” relates Sam. “Having a stable, fixed denture is much better than the partial denture I had before. I don’t have any discomfort like I had when eating with my partial denture, or the inconvenience.”

After four to six months, when the implants are fully integrated, Sam will get a final denture made of hard and very durable zirconia-based porcelain. He will be able to care for it by brushing and flossing, like natural teeth.

Sam has nothing but praise for the care he received from Dr. Raynal.

“Dr. Raynal took the time to make sure all the impressions for making the denture were perfect. He worked with the lab to make sure the lab technicians knew everything they had to do and that communication was perfect,” explains Sam.

Sandy is also thrilled by the procedure that gave her a secured denture right away.

“From the beginning, you don’t have to deal with a denture that is removable. It’s not something that’s going to come out because it’s literally screwed onto the implants,” she notes.

“Once your mouth heals after the surgery, there are no restrictions on what you can eat and what you can’t eat.”

As a former dental assistant, Sandy is particular about the dental office she chooses and is glad she picked Dr. Walker.

“There are certain things that I look for in a dental office,” she explains. “I want to make sure everything is done right and that the dentist has good credentials.

“I was very comfortable with Dr. Walker and very impressed with his practice. I think his practice and his work are really great.”

Sandy is happy with the appearance of her teeth, too.

“They look great,” she observes. “No one would ever really know they aren’t my real teeth. In fact, they look better than my old teeth.”

FHCN article by Susan Hemmingway. Photos by Jordan Pysz. Before and after images courtesy of Walker and Raynal.

BOTOX® Therapy for Chronic Migraines

Last January, Alison* feared she was having a stroke, even though she was only 40.Alison (alias for patient’s name) treated for chronic migraines with BOTOX® therapy.

“It was scary. I started having numbness in my fingertips. Then, the numbness
went into my face and lips, eye, tongue, ears and leg,” she recounts. “I went to the hospital. Although my blood pressure was fine, they were concerned about what it was. They kept me overnight for observation and wanted me to see a neurologist.”

At the hospital, Alison met with Rabih Kashouty, MD, a board-certified neurologist. Dr. Kashouty and his partner, Noor Yono, MD, at the Premier Neurology & Wellness Center would unravel the mystery of Alison’s illness.

The symptoms that made her seek emergency care were from migraines. Alison had experienced the intense headaches for years without knowing what they were. They occurred with regularity and could make it impossible for her to get out of bed.

“I would just take a lot of MOTRIN®, not really knowing what was going on,” she shares. “I’d gone to a doctor who told me they were cluster headaches and recommended over-the-counter painkillers.”

Alison was happy to learn from Dr. Kashouty and Dr. Yono that chronic migraines can be controlled through preventive therapy.

The Right Treatment

Alison works as a financial educator for a bank and has three children. Most of the time, she juggled home and work while under the grip of a headache. Her migraines were chronic; they occurred so frequently that she was in pain for at least half of every month.

Migraines can cause an intense, pulsing pain along with symptoms like nausea and sensitivity to light. Some people experience a migraine aura before the actual attack; they may see flickering lights or feel pins and needles or numbness in parts of the body.

To confirm their diagnosis of Alison, Dr. Kashouty and Dr. Yono ordered a CT scan and MRI to rule out other medical conditions that can cause headaches.

“Any person who has headaches where the characteristics are unclear or the headache is changing should see a neurologist,” advises Dr. Yono. “A neurologist will look at diagnostic imaging for other causes that we don’t want to miss, like a slowly growing tumor or bleeding vessel in the brain.”

The treatment goal for Alison was to prevent her migraines from occurring. After a number of preventive medications failed to produce satisfactory results,
Dr. Yono prescribed BOTOX injections.

BOTOX is a popular cosmetic treatment for fine lines and wrinkles, but is also used medically. The FDA approved it as a preventive for chronic migraines in 2010. There is a specific protocol: Injections are delivered in areas of the head, behind the ears, and in the shoulders, and repeated every 12 weeks.

It was a treatment that finally worked for Alison. In the three months after her first BOTOX injections, she experienced only a single headache and it was mild.

“I was shocked,” says Alison about the results. “I’m headache free now. It’s been life-changing.

“I can praise Dr. Kashouty and Dr. Yono all day long,” she enthuses. “They are very thorough. They listen and they care. For me to be headache free lets me live life again.”

FHCN article by Susan Hemmingway. Stock photo from *Patient’s name withheld at her request.

The Right Care for Better Hearing

Tom Walsh struggled with his hearing for years, despite wearing hearing aids. It wasn’t until he became a patient of Jay H. Underwood, MA, at First Coast Hearing Clinic that he discovered why the devices weren’t helping like they should.

Tom Walsh and Rich Nowell fitted with hearing aids by Jay Underwood, MA, at First Coast Hearing Clinic.

Tom can turn down the
volume of his TV and still hear perfectly.

Tom, 68, is a retired civil engineer who worked for the Commonwealth of Massachusetts building highways and bridges. He and his wife relocated to Florida three years ago after one too many frigid winters.

The way he discovered his hearing loss is a common story: His wife noticed that his hearing was getting worse. “My wife was instrumental in getting my hearing checked. I kept turning up the television, and she kept turning it down,” he shares.

He was fitted with his first pair of hearing aids nearly ten years ago, but hearing was still a challenge, especially in difficult listening environments.

“I had trouble hearing if I was listening to a speaker in church and when I’d be in a restaurant because of background noise,” he describes. “I missed a lot of key words.”

He learned about First Coast Hearing Clinic from a friend at church and made an appointment with Mr. Underwood.

Programming Is Key

Tom was ready for new hearing aids after a thorough evaluation of his hearing by Mr. Underwood and undergoing First Coast Hearing Clinic’s process that assesses lifestyle and goals.

“I decided I wanted the more powerful over-the-ear hearing aids,” relates Tom. “If I’m in an important meeting or if I’m listening to a sermon, I don’t want to miss any words. It’s really important that I hear everything.”

He still wanted to use his old hearing aids when working in his yard to protect his new set from any accidental damage.Tom Walsh and Rich Nowell fitted with hearing aids by Jay Underwood, MA, at First Coast Hearing Clinic.

In checking Tom’s old devices, Mr. Underwood discovered they had been improperly programmed, and that was why they weren’t working very well.

Today’s hearing aids are digital instruments and must be precisely programmed according to the user’s hearing loss for the best results. Mr. Underwood and his team of audiologists have advanced academic degrees in the science of hearing and are highly skilled in the digital programming of hearing aids.

“Jay used his computer and adjusted my old hearing aids,” relates Tom. “After that, I was hearing fifty percent better when wearing them than I had in years. I thought that I was just getting deafer, but the hearing aids hadn’t been set right” by his previous provider.

When first wearing the reprogrammed devices, he recalls that he heard sounds that he hadn’t been aware of previously: “I remember when I came home and asked my wife, What is that noise? She said, It’s the refrigerator. It always does that.

His new set of hearing aids improved his hearing even more. Equipped with advanced technology, they have made a remarkable difference in Tom’s ability to hear and understand speech.

Previously, he had dropped out of a Bible study group simply because of trouble hearing. The acoustics of the group’s meeting place were challenging for Tom, and some members spoke with voices too soft for him to hear and understand.

“I just couldn’t hear the people in the room. It was frustrating,” he recalls. “When I got my new hearing aids, I decided to go back and try the group again. We’ve stayed because I don’t have any trouble hearing anyone talking now.”

His new, advanced hearing aids have given him confidence about his hearing ability. For the first time in years, he can go to church and attend meetings and hear and understand what is being said.

Always Stay Connected

Rich Nowell is a retired professor of deaf education who discovered he had a hearing loss in graduate school.

Tom Walsh and Rich Nowell fitted with hearing aids by Jay Underwood, MA, at First Coast Hearing Clinic.

Rich controls features of his hearing aids through his iPhone.

“I was preparing to go into my field working with the deaf and hard of hearing and took an audiology course,” recalls Rich. “We tested each other in class, and for the first time, I found out I had a hearing loss.”

That was nearly 50 years ago, when he was in his early 20s.

“Back then, they didn’t have any hearing aids that could help people who had a real high-frequency hearing loss like mine was, so I didn’t start using hearing aids until much later, when the technology improved,” notes Rich.

After retiring in Pennsylvania and moving to Florida four years ago, Rich needed to find a new audiologist.

“I asked around for recommendations, and First Coast Hearing Clinic and Jay Underwood came highly recommended,” he says. “I have always sought out independent audiologists and clinics with good follow-up programs. My background is within the same field [as audiology], and I have some good reasons for choosing independent audiologists. One is that I think they are more inclined to provide personal service and be more patient-centered than those working for large companies.”

Rich recently was fitted with advanced hearing aids at First Coast Hearing Clinic that can be controlled through his iPhone®. Like all of Mr. Underwood’s patients, he can rely on high-quality follow-up care.

“The quality of service at First Coast Hearing Clinic has been excellent,” he describes. “Jay makes sure that I’m in there for follow-ups and checks out everything to make sure it’s working just perfectly.”

Rich is very active in retirement, and the ability to hear and communicate is vital to his quality of life. He serves as the president of the board for the St. John’s Ecumenical Ministries Food Pantry, participates in community service projects with his church and enjoys acting in community theater.

“I would be frustrated without hearing aids,” he reveals. “I didn’t lose my hearing from aging, but my type of hearing loss is similar to what many older people experience. It’s not like you can’t hear anything; it’s just really hard to comprehend speech, and you miss a lot.

“The importance of hearing aids, especially for people who are older, is that it keeps you from losing touch with the world around you.”

While hearing aids helped when Rich started wearing them 30 years ago, he is impressed by how much better the technology is today.

“What hearing aids do now in terms of sound quality and clarity of speech is amazing,” he adds. “The product I have now is so sophisticated. For example, I was in a group situation recently, and I went into an app in my iPhone that controls my hearing aids. I pressed a button to suppress background noise. It was much easier for me to understand what people were saying around me.”

During one of Rich’s visits, Mr. Underwood installed a new music-listening program in Rich’s hearing aids. A recent advancement in hearing aid technology is programming that has improved the way hearing aid users experience listening to music.

“It just so happened that I was performing in a musical at the time,” recalls Rich. “So every time I went to the theater, I set my hearing aids for the music program, and it helped a lot.”

Importance of Audiologists

As both Tom’s and Rich’s experiences show, success with hearing aids depends on many factors. One of the most important is choice of provider.

“When I lived in Massachusetts and was going to the place where I got my first hearing aids, I complained for years about the difficulty I was having and not being able to understand people,” shares Tom.

“All I got from them was, That’s the best we can do with your hearing. As it turns out, it wasn’t the best that could be done. It was the best they were capable of.”

To ensure top results, only certified audiologists see patients at First Coast Hearing Clinic, which has offices in St. Augustine and Palm Coast.

Unlike some other practices, First Coast Hearing Clinic doesn’t employ hearing instrument specialists to see patients. Hearing instrument specialists are licensed to dispense hearing aids but have far less academic and professional training than audiologists.

The requirements in Florida to obtain a hearing instrument specialist’s license are a high school diploma, completion of a distance learning course and six months of training under a sponsor who dispenses hearing aids. Prospective specialists must also pass a state board exam.

In comparison, audiologists need to graduate from two-year Master’s programs or four-year doctoral programs with comprehensive training in the diagnosis and treatment of hearing loss.

The philosophy for patient care at First Coast Hearing Clinic also contributes to high-level outcomes.

“We try to help people based on their hearing lifestyle, their hearing loss and their budget,” explains Mr. Underwood. “We look at the person as a whole individual, and not just as a pair of ears.”

A founding partner of Audigy Group, LLC, the largest member-owned organization in the hearing care industry, First Coast Hearing Clinic provides care consistent with the group’s core values.

One of the unique aspects of Audigy’s service is ePatient, the digital version of its Patient for Life program. New hearing aid patients can feel overwhelmed by the bewildering array of choices available, and ePatient is able to explain their particular hearing loss and demonstrate the best options for their budget and lifestyle.

An essential component is listening to the patient. Audiologists at First Coast Hearing Clinic seek to learn how loss of hearing has affected the patient’s quality of life and where the patient most desires improvement.

The goal is to drill down and find out what patients are hearing, what they aren’t hearing and what they most want to hear. For instance, are they in frequent background noise and have a very active lifestyle, or do they have a more casual to quiet lifestyle in an environment that is only occasionally noisy?Tom Walsh and Rich Nowell fitted with hearing aids by Jay Underwood, MA, at First Coast Hearing Clinic.

Consistent Follow-Up

“What’s also important is consistent follow-up care,” notes Mr. Underwood. “Providers really have to do more than conduct a hearing test, fit the hearing aids and send the patient out the door.

“That’s one reason why we offer a seventy-five day trial period as opposed to a thirty-day trial period,” he continues. “Our patients have seventy-five days to get comfortable with the technology because the brain has to acclimate over a period of time to hearing again.”

During a two-and-a-half month rehabilitative process, patients are scheduled for follow-up visits to ensure high-level performance of their new hearing aids. They are encouraged to share how well they are hearing in varied listening environments. The devices’ digital programming is then adjusted and fine-tuned by the audiologist as needed.

Patients also depend on First Coast Hearing Clinic for long-term service anytime they have questions or need help with their hearing aids.

“As an Audigy-certified practice, we are in the top two to three percent of providers in the country in terms of the level of care we provide the patient,” assures Mr. Underwood.

He recommends being a smart consumer when considering hearing aids and hearing aid providers.

“We’re finding that a lot of our patients have called other practices and were told they would see an audiologist. But when they got there, they were seeing a hearing aid specialist or a hearing aid specialist in training.

“People need to be sure they are really getting the hearing aid they were told they were getting. They need to know that it is the proper technologic level and not just what the provider had in stock that they needed to sell,” warns Mr. Underwood.

Also, be wary of bait-and-switch advertisements, he adds. Too often, patients learn that the low-cost hearing device being advertised isn’t available for their type of hearing loss and are told they will need a more costly model.

Professionalism and Skill

Rich notes that the staff at First Coast Hearing Clinic is skilled when working with patients.

“Everyone there is very patient-centered. They’re very professional in what they do and at the same time they’re not intimidating. They explain everything carefully,” reflects Rich.

Tom also appreciates the friendly and caring atmosphere that Mr. Underwood and his team have created.

“The people at First Coast Hearing Clinic are very warm. They make you feel like you’re going in to visit a friend,” explains Tom. “They’re always glad to see you and want you to come in. I can’t say enough good things about them. They’ve really helped me a lot.

“To me, the most important thing is their competence. They’re extremely competent,” stresses Tom. “The technology in hearing aids nowadays is amazing, but I think more importantly, they have to be adjusted to fit your particular hearing loss.

“Apparently, that isn’t as easy as most people might think,” he notes, remembering the problems he had with his old devices until they were adjusted by Mr. Underwood. “I can hear really well with my new hearing aids,” states Tom. “I can sit farther back in church without a problem. And as a matter of fact, my wife is asking me now to turn up the volume on the television. That’s a little reversal from when she was always asking me to turn it down.”

FHCN article by Susan Hemmingway. Photos by Jordan Pysz. Graphics from
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