Rising To The Occasion

Implantologist specializes in tackling challenging, complex cases

Like her birthday, her wedding anniversary and the dates that each of her children were born, Barbara Keenan can not only recall the last day she shoveled snow, she also has a tendency to celebrate the occasion.

“It was December 10, 2017,” the 82-year-old former Long Island, New York, resident reveals. “I remember it because that was the day I held the open house before I sold my home up there and moved down to Florida.”

Dr. Leong did such a great job. He really knows what he’s doing. – Barbara

“Dr. Leong did such a great job. He really knows what he’s doing.” – Barbara

 

As her willingness to celebrate the occasion suggests, Barbara left Long Island largely to escape the area’s difficult winters. She also left to escape the high tax rates that Long Island residents are required to pay on property and purchases.

“After I retired, I couldn’t afford to live there anymore,” Barbara shares. “So, I moved to Florida and I love it. I love the weather, especially in the winter, because I hated having to go out and shovel snow and scrape snow and ice off the windshield of my car.”

A retired registered nurse, Barbara now spends the majority of her free time sewing and reading true-crime novels. A couple of years ago, she finally decided to devote some of that free time to resolving a longstanding dental issue.

“I didn’t inherit good teeth, and I’ve had some pretty bad dental care in the past as well,” Barbara reports. “As a result, I’ve had a lot of problems with my teeth. After I moved to Florida, I decided it was time to take care of those problems.

“The biggest problem for me was that I was missing several teeth on the lower left side of my jaw and had some others that were not in very good condition. Because of that, I had to be very careful about what I ate because I couldn’t chew properly.

“I had to eat mostly softer foods that didn’t require a lot of chewing, which meant I needed to avoid steak or anything crunchy. If I did try to eat things like that, I had to move the food around in my mouth, so I was chewing with my good teeth.”

Barbara’s poor dental health compromised more than her diet. It also ate away at her confidence and appearance. Because of her missing teeth, she was hesitant to smile widely in front of others out of fear they would see the large gaps where teeth were missing.

“I had to be careful when I was eating and careful when I smiled or laughed, so one of the first things I did when I got to Florida was go online and start researching dentists in my area,” she explains, “and read the Brevard Health Care News.

“Considering the problems I had with dentists in the past, I was pretty picky about selecting a dentist this time. That’s why I chose Dr. Leong, because he’s an implantologist and a teacher. When I saw that, I said, Yep, he’s the one.”

A New Foundation 

Richard Leong Jr., DDS, is a Melbourne-based general and implant dentist who practices comprehensive, full-treatment dentistry, including full mouth reconstructions. Since 1982, Dr. Leong has also taught implantology.

Dr. Leong first saw Barbara in 2019 and, as he does with all his patients, began his care by performing a comprehensive examination that included a visual inspection of her teeth, a full set of dental x-rays, a CT scan and an oral cancer screening.

That exam revealed problems more pressing than those Barbara came for. Dr. Leong discovered an infection that had reached the bone supporting Barbara’s upper right bicuspid.

“I deal with a lot of complicated cases, people who have a number of serious issues,” Dr. Leong offers. “So, I always start out by treating any infections I find first because our primary goal is to get people back in good oral health.

The infection left several cracks in the tooth and rendered it unsalvageable, so Dr. Leong began his restoration work by treating the infection and performing a thorough cleaning of Barbara’s remaining teeth and gums.

 “It’s important to create a healthy foundation for the repairs or changes that we’re going to make,” Dr. Leong explains. 

The infection was so deep that it had also eaten away at some of her jawbone. To correct that problem, Dr. Leong extracted the infected failing tooth and performed two advanced restoration treatments. The first required the use of a special laser to clear out the infection. The second, which was designed to expedite healing and spur new bone growth in the jaw, required the use of a blood derivative called platelet rich fibrin, or PRF.

PRF is obtained by drawing blood from the patient’s arm. The blood is spun in a centrifuge that separates the fibrin clot material, which is high in growth factors, from other parts of the blood. The PRF is then injected into the target area of the patient.

Dr. Leong completed that project by replacing the extracted bicuspid with a bridge connected to two adjoining teeth. He then turned his focus to the replacement of Barbara’s missing teeth and the restoration of a few others that were failing.

In addition to missing four teeth on the lower left side of her jaw, Barbara was also missing two teeth, a second bicuspid and a first molar, on the lower right side. Dr. Leong replaced those teeth by placing dental implants.

Dental implants are screw-like bodies that are surgically seated in the jawbone as replacements for the roots of missing teeth. Once an implant is in place, 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 or screwed onto the abutment, a partial bridge affixed to one or more implants, or a full denture fastened to a series of implants.

All in a Day’s Work 

For Barbara, Dr. Leong seated four implants, two on the lower left and two on the lower right. Those implants became the foundation for two bridges created as replacements for her missing teeth.

“The implants I placed for Barbara are smaller in diameter than normal implants,” Dr. Leong explains. “These implants don’t need as much bone as normal implants, and because we used two of them to secure the bridge, they don’t need to be as strong.

“By using these special implants, I was able to seat the implants and fit her with a temporary bridge on the same day. A few months later, after new bone had formed to secure the implants, she was fit with permanent bridges.”

In addition to seating the implants and fitting the temporary bridges, Dr. Leong restored two crowns, on the lower right first bicuspid and the lower right first molar. He did that on the same day that he seated the implants and fit the bridges.

Since then, Dr. Leong has replaced a few of Barbara’s old fillings and performed a root canal on a tooth where an abscess developed. Barbara’s oral health is now the best it’s been in years.

“I have all my teeth now, and they’re all very strong, so I no longer need to be careful about what I eat,” Barbara reveals. “I can eat anything I want now, including steak, because I can chew anything. And let me tell you, that is such a pleasure.

“I can also smile with confidence again. I’m no longer self-conscious about laughing or anything like that because my teeth look great.”

Barbara says Dr. Leong is the best dentist she has dealt with.

“Dr. Leong did such a tremendous job,” she exclaims. “He really knows what he’s doing. He’s a craftsman. He’s very precise and very careful. He doesn’t just slap things together and say, OK, you’re finished. He makes sure everything fits right, works perfectly and looks great.” 

She also appreciates the lengths Dr. Leong goes to ensure his patients remain safe through the ongoing COVID pandemic. 

“Dr. Leong and everyone on his staff wear full protective gear – booties, hats, facemasks, the whole thing,” she details. “And his offices are so clean. I swear you could do surgery in his facility. He’s really on top of it, and I highly recommend him to anyone.”

© FHCN article by Roy Cummings. Photos by Jordan Pysz. Before and after images courtesy of Richard Leong, Jr., DDS. mkb
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