Implantologist Reveals GERD Teeth Damage

Relocated patient misses ‘family’ implantologist who saved her oral health.

“Dr. Leong is an exceptional dentist. He is very methodical, very patient and very honest.” – Anne

Family is everything to Anne Kimmitt. So, when her daughter, son-in-law and two grandchildren relocated from Florida to Texas late last year, Anne moved with them.

“My grandchildren were just five minutes away from me when we all lived in Melbourne, and that was very convenient; I really liked that,” Anne states. “We’re about 10 minutes away from each other here in Austin, so they’re still nearby, which I like.”

Accompanying Anne to Texas were a Labrador retriever, a golden retriever and a pug, three furry family members that fill her with almost as much joy as her grandchildren.

Alas, there was one member of Anne’s “family” that did not go west. That is Richard Leong Jr., DDS, PA. He’s not part of Anne’s immediate family, but after years as one of his patients, Anne considers him “family” nonetheless.

“I first met him seven years ago when I was having a problem with a dental bridge,” Anne offers. “He was one of the options offered through my insurance, so I picked him more or less at random.”

That proved to be a good choice for Anne, whose path to Dr. Leong began nearly 20 years earlier when she lost seven upper teeth, a couple of lower teeth and a portion of her upper jawbone in an automobile accident.

“It was all on me,” Anne says of the crash. “I was reaching for something in my purse, which was not a smart thing to do, and I ran into the back of a truck. Since then, I’ve had a lot of dental work done.”

That included the development and placement of a seven-tooth bridge that ran from the first molar on the upper right side to the cuspid, or eyetooth, on the upper left. The bridge was strong, Dr. Leong soon learned, but the teeth supporting it were not.

“I found cavities in one of the two teeth holding the bridge in place on the right side, cavities in two of the three teeth holding the bridge in place on the left side and an abscess under the third tooth holding the bridge in place on the left side,” Dr. Leong reports.

But Wait, There’s More

Upon further examination, Dr. Leong also found cavities in six of Anne’s bottom teeth, an abscess beneath one of her front lower teeth and extensive gum disease throughout. He also found that a root canal on a lower molar was failing.

Puzzled by the degree of decay and disease, Dr. Leong recommended that Anne visit her primary care physician to see if there was an underlying cause for those problems. Anne followed that recommendation and soon learned the cause was acid reflux disease.

Acid reflux disease, or gastroesophageal reflux disease (GERD), occurs when stomach acid repeatedly flows back into the esophagus and mouth. The acid, in addition to causing heartburn, can wear away tooth enamel and gum tissue.

“I was pretty sure that was the problem because she was very fastidious about how she took care of her teeth,” Dr. Leong states. “She flossed and brushed properly and followed a good diet, but the cavities and disease told me acid was destroying her teeth.

“It was also destroying her gums, so we treated her gums, got that all cleaned up, and then started working on her teeth. I started that process by removing the lower molar where the root canal had failed and replacing it with a dental implant.”

Dental implants are root-shaped, screw-like bodies that are surgically seated in the jawbone. Once the implant is placed, new bone naturally grows around it to form the foundation for an abutment and replacement teeth.

The replacement teeth can be a crown that is cemented to or screwed onto the abutment, a partial bridge that can be affixed to one or more implants, or a full denture that can be fastened to a series of implants.

Anne Kimmitt

Prior to placing an implant, some patients require a bone graft that is designed to enhance the volume of the jawbone so it can properly support the implant. The amount of time needed for the bone development is about three months.

Bone grafts are not always necessary, but with patients who have been missing teeth for many years, a graft is sometimes required because bone mass deteriorates when there is no pressure from chewing to stimulate natural bone regeneration.

After completing the bone graft, Dr. Leong treated all the cavities he found in Anne’s remaining teeth. He then performed a root canal on the abscessed tooth on the upper left arch. Finally, he turned his attention to constructing a new bridge.

“Anne originally asked me to produce an implant-supported bridge for her upper arch, and that would have been my first suggestion as well,” Dr. Leong notes. “The problem was that she didn’t have enough bone for implants. So, we had to recreate her old bridge.”

That proved quite challenging because in addition to replacing missing teeth and providing proper function, the original bridge was designed to fill out Anne’s face by compensating for all the jawbone that was lost during the car accident.

That was done through the addition of what Dr. Leong referred to as a “very well-constructed bar assembly” that ran along the top of the bridge. Dr. Leong’s challenge was to reconstruct the bridge with a bar that provided the same lift as the old one.

“It’s kind of hard to improve on perfection, but that’s what I had to do because I had to make sure she had the same facial structure and the same bite,” Dr. Leong notes. “It was challenging, but we did it with the help of our lab.”

Dr. Leong’s treatment did not end with the fabrication of a new bridge. Since completing that task three years ago, he has had to address problems caused by Anne’s ongoing bout with acid reflux disease.

That problem is likely to cause more issues for Anne going forward, but Dr. Leong has found a dentist in Austin who will take on those challenges so that Anne doesn’t have to travel back to Florida for her dental work.

Anne can only hope her new dentist is as skilled as Dr. Leong.

“Dr. Leong is an exceptional dentist. He is very methodical, very patient and very honest,” Anne praises. “He tells you exactly what needs to be done to fix whatever problem he finds, and he always does a great job. I’m going to miss him, and I gladly recommend him to anyone.”

FHCN article by Roy Cummings. Photos courtesy of Anne Kimmitt. mkb
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    • Richard Leong, Jr., DDS

      Richard Leong, Jr., DDS, is a general and implant dentist practicing comprehensive dentistry. He is one of the few dentists in the area who place special emphasis on treatment of dental implants and temporomandibular joint dysfunctions, la... Read More

    • Richard Leong, Jr., DDS

      Richard Leong Jr., DDS, is a general and implant dentist practicing comprehensive dentistry. He is one of the few dentists in the area who place special emphasis on treatment of dental implants and temporomandibular joint dysfunction using l... Read More