One For All

Family practice takes care of all your dental needs.

As a 7-year-old growing up in one of the hardscrabble neighborhoods of Troy, New York, Chris Williams became familiar with a service regularly provided by police that goes unnoticed far too often.

Chris has “absolute confidence” in Dr. Farag (left).

“I grew up in the projects, in one of the lower-income areas, and I always enjoyed it when members of the city police department or the housing authority peace officers would come through the neighborhood and interact with the kids,” Chris remembers.

“Having that relationship and being a beneficiary of that community outreach effort made a real impression on me. Ever since I was 7 years old, I always wanted to be a public servant, a police officer. So far, things are working out pretty well.”

Now in his 17th year in law enforcement, Chris has exceeded his goals of becoming a sergeant and member of a SWAT team. He has risen to the rank of lieutenant and commander of the Charlotte County Sheriff’s Office SWAT unit.

“I’m also a special operations commander who oversees the marine patrol canine unit, the traffic unit and most of our ancillary units,” says the 47-year-old husband and father of a 15-year-old son. Chris’s son recently achieved a goal all his own.

“My son recently got his first buck,” says Chris, who shares a passion for deer hunting with his son. “He got a five-pointer just a couple weeks after Thanksgiving. It was an awesome memory that we were able to experience together.”

A few years after the birth of their son, Chris and his wife went in search of a dentist who could care for the entire family. They found what they were looking for in Joseph H. Farag, DMD, of Port Charlotte Dental Care.

“The dentist we had when our son was born didn’t offer pediatric care, so a co-worker suggested we visit Dr. Farag,” Chris recalls. “He said that Dr. Farag offers the full component of coverage, so we checked him out and we’re very glad we did.

“From day one, the care our entire family has received from Dr. Farag has been exceptional. It’s all about quality with Dr. Farag and his staff. They really care about their patients. I know because I’ve kept them in business with all the work I’ve had done.”

Restoration Project

Most of that work has been routine. Chris has enjoyed relatively good oral health over the years, but when the crown came off an upper-right second molar a couple of years ago,
Dr. Farag had no choice but to take Chris’ care to another level.

“When Chris lost that crown, he had a lot of tenderness in that tooth and he had some pus coming from it,” Dr. Farag reports. “We discovered that the cause was a recurrent infection in an old root canal.

“The root canal had been done a number of years earlier, before Chris started seeing me, and it simply failed. He ended up with a recurrent abscess, and the tooth was feeling a little squishy — that was Chris’ word for it.”

The failing status of Chris’ tooth left Dr. Farag with no choice but to extract it and treat the infection. The only question was what to do to replace the tooth. Dr. Farag’s recommendation was a dental implant.

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

The replacement teeth can be a crown cemented 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.

Prior to seating an implant, some patients require a bone grafting procedure designed to enhance the volume of the jawbone. By using either autologous bone or synthetic bone substitute, the graft gives the jawbone the strength it needs to support an implant.

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

“It’s all about quality with Dr. Farag and his staff. They really do care about their patients.” – Chris

Chris required a bone graft because the infection caused severe deterioration of the jawbone around it. Grafts can be done when an implant is seated, but it takes between three and six months for new bone to grow to a point where it can support an implant. That’s why Dr. Farag often waits until new bone has developed before seating an implant.

To ensure his bone was strong enough to support the implant, Dr. Farag followed his typical routine and waited three months before seating Chris’ implant.

Dr. Farag used a system called X-Guide®, which uses computer technology and imagery to create a 3D model of the mouth. That model then guides the dentist through the precise placement of the implant.

“The guidance system is a little like the lunar lander,” Dr. Farag explains. “It creates these little circles, and when they line up, you know you’re placing the implant exactly where it needs to be.

“It allows us to seat the implant with tremendous precision and a very small margin for error. That’s important because some patients don’t have room for a large margin of error. So this system is very accurate, and it’s not invasive at all. When using the X-Guide system, the process of seating an implant is usually completed within a half-hour.

“We don’t need to custom design anything for the patient because we just scan the area where the implant is to be placed, and the system guides us through the implant placement virtually. This guarantees a successful outcome.”

Advanced Technology

As he did with the bone graft, Dr. Farag waited a couple of months before placing Chris’ crown because he wanted to be sure the implant was secure. In creating the crown, Dr. Farag used another leading-edge tool, the computer-aided CEREC machine.

Chris Williams

CEREC stands for Chairside Economic Restorations of Esthetic Ceramics. It allows dentists to create crowns in their offices within minutes. That eliminates the need for patients to wait two or three weeks to receive the crown.

“The advantage of having all these tools is that it allows us to do all the work necessary in one place, even in a difficult case like Chris’,” Dr. Farag emphasizes. “That’s very beneficial to the patient because they don’t need to run around to a bunch of dentists to get all this work done.”

Chris says Dr. Farag’s ability to perform any dental procedure in the office is one of the reasons he feels fortunate to have found him. He appreciates the convenience as well as Dr. Farag’s level of expertise.

“I have absolute confidence in Dr. Farag,” Chris exudes. “He’s exceptional. And I can tell you that his work through the entire implant process was flawless and absolutely pain-free. I was completely comfortable, and I wasn’t under any sedation during this process.

“All Dr. Farag did was numb the area he worked on, and I’m reaping the benefits of his work today. It has made my quality of life so much better. Dr. Farag and his staff are tremendous.

“Their customer service is by far the best I’ve ever experienced with a dentist, and I went to a couple of dentists before finding Dr. Farag. Dr. Farag and his staff go above and beyond for their patients.”

The LANAP procedure allowed Pam to save a failing molar.

Periodontal Do-Over

Of all the positions she filled during her long career in the health care industry, the one 69-year-old Pam Bicking found most rewarding was with the nonprofit Healthy Start.

“Healthy Start is a program that helps women with their pregnancies,” Pam explains. “It especially helps women who are on Medicaid, and what we try to do is improve pregnancy outcomes. I was what they call a mom care advisor.

“I loved the job because it made me feel like a mom. A lot of the women I dealt with were younger, had never been through a pregnancy and didn’t know which way was up. I helped them get through it all.”

The mother of two grown children, Pam had to get through a medical issue herself a couple of years ago while visiting a daughter in Atlanta. A toothache prompted a trip to the dentist, but during that exam Pam learned she had another dental issue.

In addition to that bothersome tooth, one the dentist said would likely need to be extracted because it was on the brink of failing, Pam was told her gums were afflicted with a severe case of periodontal disease.

“I wasn’t surprised to hear about the gum disease,” Pam admits. “My mother had problems with her gums and so did my sister. And when I brushed my teeth, my gums would bleed. Not a lot, but enough that I knew there was probably a problem.”

Pam soon learned her gum disease was bad enough to endanger her other teeth. Resolving the problem long-term, the dentist said, would require a procedure called periodontal flap surgery.

Armed with that information, Pam returned to Florida, where she soon visited a dentist who confirmed the diagnosis and agreed that a periodontal flap procedure — in which the gums would be repaired surgically — was her best option.

Despite being a bit apprehensive, Pam agreed to have the surgery. However, she changed her mind a few days before after reading an article in Florida Health Care News about a more modern fix for severe gum disease.

“The dentist in Atlanta had mentioned this procedure, but I thought there was no way it was available in Port Charlotte,” Pam reveals. “Then I read this article about a dentist who did the procedure here, so I went out and called him right away.”

That dentist was Dr. Farag.

Regenerative Procedure

The procedure she read about is called LANAP®, which stands for laser-assisted new attachment procedure.

“Pam first came to me primarily because she wanted to learn about LANAP,” Dr. Farag remembers. “I told her all about it, then I examined her. It was after the examination that I told her I thought LANAP would work very well for her.

“One reason was because she told me the other dentist she had visited wanted to extract the bad tooth. I could see why someone might want to extract that tooth, but I also thought that with LANAP we might be able to save it. It wasn’t a dead tooth. She just had a periodontal infection and not necessarily an abscess. If we do the LANAP, we can wait and see how that tooth looks afterward and decide whether it really needs to come out.”

Encouraged by what she learned of LANAP, which would not only rid her of her periodontal disease but offer her a chance to salvage her failing tooth, Pam agreed to undergo the procedure.

Dr. Farag considered it a wise choice, largely because he strongly believes LANAP provides far better results than the traditional flap procedure, during which a dentist uses a scalpel to remove the diseased tissue.

“With the flap procedure, you cut the gums open and then you scrape the diseased tissue out, clean the roots and scrape the bone,” Dr. Farag explains. “Then, after you’re done with all that, you sew it back together. It works, but the result is usually a very high gum line, a lot of recession, gum loss and sensitive teeth.

LANAP provides better results without the gingival recession because the tissue isn’t cut, Dr. Farag says.

“What we do instead is use the laser to make small troughs that are three hairs thick between the gum and bone,” he details. “We then put our instruments into that gap and debride, disinfect and sanitize all the way to the bone and flush out the bad stuff. The gums stay where they are, so it’s a nice way of getting up in there and cleaning things out, and disinfecting and sanitizing the periodontal pockets without cutting everything open.”

In addition to healing gum tissue, LANAP can also improve bone quality and density. In some cases, it can even spark the regeneration of bone, according to Dr. Farag, who treats a patient’s entire mouth in three phases during a visit that lasts about two hours.

Dr. Farag explains that during the first pass of the laser, the energy from the laser kills any bacteria in the gums, vaporizes the diseased gum tissue and dehydrates the tartar on the teeth, making it brittle and easy to remove.

During the second step, the tartar is removed with a fine-tipped, vibrating, ultrasonic instrument. The teeth are then rinsed with an antimicrobial substance that halts the growth of new bacteria. During this step, the diseased lining of the tissue is removed, and the bone surrounding the teeth is debrided of infected tissue.

Finally, during a third pass of the laser at a different setting than the first, an antimicrobial seal is created that prevents reinfection and releases growth factors from blood cells that help regenerate the attachment between the gums and the teeth.

“The patient doesn’t have any sensation of what we’re doing during the procedure because we use a local dental anesthetic, just as we do if we’re doing a filling,” Dr. Farag says. “That’s how patients stay comfortable during the process.

“And there’s no postop discomfort because we’re not traumatizing anything. The gums are not inflamed, so they’re not painful. Afterward, we simply ask patients to briefly stay on a soft-food diet to prevent any tearing of the new tissue that’s forming.”

More Brushing

Pam says that sticking to a soft-food diet for a few days was a small sacrifice she was more than willing to make to avoid the invasive nature of a periodontal flap procedure.

“What I really liked about LANAP was that it didn’t involve any cutting or stitches and all that recuperative time afterward,” Pam says. “And this procedure takes care of your whole mouth in one visit.

“It wasn’t painful at all, and now, when I brush my teeth, there’s no bleeding. I brush my teeth and floss more than ever now because it doesn’t hurt to brush, and I really want to take care of my teeth.”

“I am ecstatic with the results of the procedure and thrilled with Dr. Farag and his staff.” – Pam

That includes the molar she was in danger of losing. As Dr. Farag suggested, the LANAP allowed her to save that tooth while improving the status of several others.

“That tooth was such a bother because the pockets were so big around it that food would get stuck in it sometimes,” Pam says. “But I haven’t had a problem with that tooth since the LANAP. I am ecstatic with the results and thrilled with Dr. Farag and his staff. I get regular cleanings from them every three months. They take such good care of me.

“I really appreciate everything they’ve done for me. And if it weren’t for Florida Health Care News, I wouldn’t have found them. I don’t know how my teeth and gums would be had I not read that article, but I doubt they’d be as healthy as they are now.”

© FHCN article by Roy Cummings. Photos by Jordan Pysz. mkb
Print This Article
    • 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