Part With Your Partial Forever

Implant-secured bridge provides improved function.

He never followed the band for weeks on end, attending show after show the way the originators did. In fact, Jim Burton attended only one Grateful Dead concert. Nevertheless, he considers himself a “Deadhead.” And why not?

He is, after all, a fan whose passion for the Dead is so great that he’s included the title of one of the band’s best-known songs, Wharf Rat, in his email address. He even used that title as the name for his 20-foot Shamrock fishing boat.

“It just seemed to fit,” Jim explains. “The band’s music is something I grew up listening to, and I’ve followed their career ever since. So, yes, I’m a Deadhead. I enjoy listening to just about everything they did.”

A retired engineer who splits his time between Port Charlotte and a summer home on 22 acres of mountain land in North Carolina, Jim often listens to the Dead while tending to his vast vegetable garden.

“I grow beans, melons, potatoes, onions, among other fruits and vegetables,” Jim says. “And I like to eat everything I grow, so most of that ends up being part of my dinner at some point. My garden is probably my biggest hobby.”

Jim Burton

For years, whether it came from his garden or not, there were certain fruits and vegetables Jim simply couldn’t eat. Apples, corn on the cob, even bananas fell into that category. A dysfunctional partial denture was the reason.

“I’ve had problems with my teeth all my life. Five or six years ago, I had to have my front teeth extracted because of gum problems,” Jim reveals. “After that, I was fit with a partial by a dentist in North Carolina, but the partial didn’t work very well. I guess it was more for looks than anything because I couldn’t bite into anything. Not even a sandwich or a hot dog or a hamburger. I couldn’t eat those foods because the partial wasn’t strong enough.

“I don’t know why, but I put up with it for about four years. Then one day while we were down in Port Charlotte, I mentioned that I was thinking about finding a dentist there. My brother-in-law suggested that I go see Dr. Farag at Port Charlotte Dental Care.”

Missing Molars

Joseph H. Farag, DMD, of Port Charlotte Dental Care, first saw Jim about a year ago and learned immediately that Jim’s dental issues spread beyond the flawed partial.

“He was over the whole removable prosthetic thing and wanted something more permanent for his upper-front teeth,” Dr. Farag confirms. “But he also had some periodontal disease, and because of that he had lost some other teeth as well.”

In addition to the two incisors, Jim had also lost two teeth directly to their left and a molar on each side of his upper arch. To correct those problems, Dr. Farag put together an extensive treatment plan that Jim agreed to.

The plan called for Dr. Farag to first arrest Jim’s gum disease. That would allow for the creation of a healthy periodontal foundation for Jim’s replacement teeth. In laying that new foundation, Dr. Farag performed a laser-assisted new attachment procedure, or LANAP.

“My whole mouth, the gums and everything, are healthy now.” – Jim

In addition to healing gum tissue, LANAP can improve the quality and density of the jawbone. In some cases, it can even spark the regeneration of new bone.

“Using the LANAP procedure, we can treat a patient’s entire mouth in about two hours,” Dr. Farag explains. “During that time, we make three passes with the laser in which we clean, disinfect and sanitize the gums without cutting anything open.”

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

During the second pass, 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 bacteria. The diseased lining of the tissue is removed, and the bone surrounding the teeth is debrided of infected tissue.

During the final pass, 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 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, the patient is asked to briefly stay on a soft-food diet to prevent any tearing of the new tissue, the doctor explains.

Not long after the treatment, Jim returned to Dr. Farag to begin the procedure for replacing missing teeth. That called for the insertion of four dental implants, including two that would secure an upper frontal bridge.

By precisely matching the color of his replacement teeth with that of his existing teeth, Jon was given a new smile he can be proud of.

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

The replacement 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 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.

A Healthy Bite

Jim required grafts prior to the placement of his implants. The procedure is short, but it takes about four months for bone to grow strong enough to support an implant, so the implantation is typically delayed a few months.

When the time came to place the implants, Dr. Farag made sure he would provide Jim with the proper function he needed by using a digital scanner to determine the precise placement and specific size of the implants.

“I was pretty impressed with all the equipment Dr. Farag has in his office,” Jim states. “As an engineer, it was fascinating to see how it all worked. He also has a lot of capable people working with him as well.

“As far as Dr. Farag goes, he’s exceptional. The work he did is great. My whole mouth, the gums and everything are healthy now, and I can eat anything I want, even an apple. I’m not a big fan of apples, but I can bite into one now if I want to.

“The whole process took a while, but I’m really glad I did it. And I’m really glad my brother-in-law recommended Dr. Farag. He’s a great dentist, and just as my brother-in-law did with me, I’d highly recommend him to anyone.”

Crowning Achievement

By early October each year, a mix of falling temperatures, bright sunny days and the occasional rain shower has turned the leaves across the Great Smoky Mountains into a collage of colors that makes them look like a bowl of Skittles.

Linda Wille

That’s when Linda Wille, 62, and her husband make their annual trek to the mountain range. It’s a chance to get a real feel for fall, but Linda would also like to take a trip to the Smokies in late January or early February.

“I grew up in Rochester, New York, and the only thing I really miss about it is the fall and playing around in the snow in the winter,” she says. “I’ve been telling my husband that we need to make another trip to the Smokies in the winter to enjoy the snow a bit.

“The Smokies are absolutely beautiful in the fall with all the colors and everything. I’m sure it’s just as beautiful, but in another way, in the winter with snow on the mountaintops. I’d love to experience that. I think it would be a lot of fun.”

The thoughts of frolicking in the snow are among the fond memories Linda has of her childhood. Unfortunately, she also has some not-so-fond memories of that time relating to dental struggles.

“When I was little, I had a mouth full of teeth. I also had buck teeth,” Linda reveals. “It was like my two front teeth stuck out of my head, so my parents eventually took me to the dentist to get braces.

Before Linda could get braces, however, the dentist had to eventually pull 14 teeth.

“He said I had too many teeth and that my teeth would need room to shift after I got the braces,” she recalls. “After they finally put the braces on, I wore them for two or three years. What happened, though, is the teeth on the sides of my top two front teeth started to separate, and I wound up with these big spaces between them.

“When I got a little older, my sister went to work for a dentist and she told me one day that the dentist could fix that. So, I went to see him, and he ended up making me a bridge that ran from one eyetooth to the other eyetooth.”

“I’m thrilled with the work Dr. Farag did. I’m back to getting compliments when I smile.” – Linda

Linda, who was in her early 20s, says the bridge was “beautiful.” She regularly received compliments on her smile, but as time passed, the beauty of that bridge faded.

“This was like 30 or 35 years later, and with gum recession and all that, you could see the metal underneath the bridge,” Linda explains. “It looked terrible. I said, I’ve got to find a fix for this somewhere.

Living in West Palm Beach at the time, Linda found that fix through a dentist who spent more than a year replacing the old bridge. The new bridge never looked as good as the old one initially did, though.

“It looked like plastic in my mouth,” Linda laments. “It didn’t even go up to my gum line. I was never happy with it because the teeth didn’t look natural. They were too big. I didn’t smile a lot. I tried to get the dentist to fix it, but she said that was the best she could do.

A short time later, Linda and her husband moved to Punta Gorda.

“I started looking for a dentist, and a co-worker suggested I go see Dr. Farag, so I did,” Linda states. “I remember during my first appointment, he asked if I was happy with my teeth because he could see I had this bridge. I said, Honestly? No. I’m not. He said, Well, I can fix that if you’d like. I said, OK, let’s do it.

Digital Dentistry

Dr. Farag’s question regarding Linda’s smile was prompted by several problems he detected with her bridge, including the color, which did not match her other teeth, and the fit, which negatively affected her bite.

To correct those issues and give Linda a smile she could be proud of, Dr. Farag recommended replacing the bridge with crowns for each of the teeth in her smile line, six teeth in all from the canines on the left to the canines on the right.

“We start that process by doing a diagnostic wax-up, which is basically a mock-up with the lab technician,” Dr. Farag educates. “This is all done digitally, and we go through a couple of iterations of it on the computer to see what we like best.

“Once we’re happy with the color, size and shape, we give the lab the final go-ahead to prepare temporary teeth. We then remove the old bridge or crowns and place temporary crowns that match our design.

The temporaries are worn for a couple of weeks in case any changes need to be made.

“For example, if we want to round off or square off the teeth or change anything, we note those changes, finalize everything and make the final restorations,” Dr. Farag says.

A variety of materials, including lithium disilicate and zirconia, can be used to create a crown, depending on which tooth is being crowned and the color desired. In all cases,
crowns made of such materials are monolithic. That creates several natural advantages over older crowns made of porcelain fused to metal. For starters, monolithic crowns are stronger. They are also more aesthetically pleasing, in part because there is no metal collar at the top.

“These new materials also mimic the enamel translucency of natural teeth because they allow light to transfer in and out of the tooth,” Dr. Farag notes. “And people like that because it looks more like a real tooth, even close up.

“With the old porcelain fused to metal crowns, your teeth might look good from far away. But if you get up close you can start to notice that there’s something different about them, and they don’t look as real or as good.”

Smiling Wide Again

Linda can attest to that. After years of hiding her teeth, the new crowns have allowed her to smile wide and with pride again. And it’s all due to the work Dr. Farag did renovating her outdated bridge.

“I’m thrilled with the work Dr. Farag did. I’m back to getting compliments when I smile,” Linda raves.

“He even did a root canal on one of my teeth, and I will tell you that it was no big deal at all. I never had a root canal done before and, of course, I’d only heard bad things about them, like it’s the worst thing you can ever have done. I was expecting the worst, but I never felt a thing other than a little bit of pressure.

Linda now makes an appointment with Dr. Farag once every three months for cleanings.

“I want to take good care of my teeth, she explains. “I can even floss between my new teeth because they’re all individual crowns. I couldn’t do that before.

“I’m really thankful my friend recommended Dr. Farag. He’s awesome, and I absolutely recommend him — in a heartbeat. My husband sees Dr. Farag as well, and we both like and appreciate everybody in the office. The whole staff is great.”

© FHCN article by Roy Cummings. Jim’s photo courtesy of Jim Burton. Linda’s photo by Jordan Pysz. Before and after images courtesy of Port Charlotte Dental Care. mkb
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    • Port Charlotte Dental Care

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

    • Joseph H. Farag, DMD

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