Smiles All Around

High-tech practice gives failing bridge, broken tooth careful attention

Jordan pysz/ Florida health care news: John now has an aesthetic, functional smile.

While working his way through college, John Al- den applied for and accept- ed a job with a major air- line. Over the next few years, he literally worked his way from the ground up. “I worked ground jobs for several years but was eventually promoted into the flight program,” the 80-year-old Ohio native remembers. “I went on to log 21,000 flight hours, but back then, pilots had to retire at age 60, so that’s what I did.”

John flew out of several major air- ports. Typically, larger airports can ac- commodate a greater variety of aircraft. The opportunity for career diversity was a big motivator.

“I was based all over the country,” he relates. “At times, I was based in Miami, Chicago, Washington and Cleveland. I moved around to where I could fly the airplanes I wanted to fly.”

Moving around did have drawbacks. For one, it was difficult to find a regular dentist. John considered himself fortu- nate, though, that no serious dental is- sues arose – or so he thought.

“I didn’t think there was much wrong with my teeth, but when I finally de- cided to get a regular dentist, he told me during my first visit that I needed crowns on 15 teeth,” John recalls.

“I forget what it would’ve cost, but it was a huge amount. I thought, This guy must need a new automobile, so I walked out. Pardon the pun, but that experience left a bad taste in my mouth. I stayed away from dentists for a long time after that.

“Then, last year, one of my front teeth broke off, so getting a crown became a necessity,” he says.

In his time of need, John entrust- ed his smile to Stephen P. Lester, DDS, MAGD, PA, of Park Avenue Dentistry in Edgewater.

“I read an article in Volusia Health Care News about Dr. Lester and the computerized equipment he uses to manufacture crowns and how quickly it’s done.,” John explains. “I called and they got me in that same day.”

Upon arrival, John was immediately struck by the environment of Dr. Lester’s office.

“It’s like walking into someone’s living room,” he describes. “First thing, they gave me a tour of the facility. It’s not fancy, but it’s very homey and meticulously cared for. I felt great comfort when I saw everything they have. They even have a library and a large chair to sit in while you’re waiting for your crowns to be made.

“From the dental chair, you look out through two large windows at a beautiful garden with a waterfall, and you can see the squirrels playing outside. Somebody put a lot of thought into setting up the office so that it’s pretty and comfortable. That’s something patients can appreciate and enjoy.”

During John’s appointment, Dr. Lester examined his broken tooth, then asked him to return the next day to receive his crown. Dr. Lester created the crown in his office with the E4D system, which uses computer-aided design and computer-aided manufacturing (CAD/ CAM) to expedite the creation of dental restorations.

Retooled Technology

CAD/CAM technology has been used for years to design and manufacture products such as machine and auto parts. More recently, it was retooled for dentistry to meet a growing need for comfort and convenience. That fueled the development of in-office CAD/ CAM systems such as the E4D.

“The E4D system is a technology that creates porcelain restorations quickly and easily in the dentist’s office, often in one visit,” Dr. Lester acknowledges. “It can make dental crowns, inlays, onlays, veneers, even bridges.”

The E4D consists of three main parts: computer system, software and milling machine. These work in concert to cre- ate the finished restoration, which in John’s case was a crown.

The process began with Dr. Lester using a high-tech laser to scan John’s teeth quickly and accurately into the computer. Dr. Lester then used the software to design the crown.

The computer took Dr. Lester’s design and prepared it for the milling machine, which cuts the restorations out of a block of porcelain. For John, this happened during the same appointment.

“Dr. Lester used a laser device to scan my tooth’s dimensions,” John recalls. “He then ground my tooth down to pre- pare it for the crown, and in just a short time, he used the dimensions he got from the laser scan to make the crown using his computerized machine.

“The crown was made from a material that matched the tone and color of my other teeth. After he polished it, Dr. Lester fit the crown right over my prepared tooth. He told me the process takes two hours, but I don’t believe I was there that long.

“I was amazed that a crown could be made so quickly.”

Using the E4D system has a number of benefits for patients, Dr. Lester reports.

“First of all, we don’t have to put that messy goo in their mouths to make the impressions of their teeth because impressions are created digitally,” he says. “Second, patients don’t have to wear temporary restorations, which tend to fall off at inconvenient times. Finally, our patients seldom if ever must return for a second visit because their restorations can be designed and fabricated in a day.”

During a more recent visit, Dr. Lester found a crack in one of John’s molars. Just as he did with the broken front tooth, Dr. Lester recommended repairing the crack by capping it with a crown made with the E4D system.

“We had to consider cosmetics for John’s front tooth, but the molar in the back is primarily functional,” Dr. Lester notes. “Its job is to grind food, and by using our E4D system, we can create crowns that are strong as well as aesthetically pleasing.”

John is very happy with his crowns, but he’s even more impressed by the efforts of Dr. Lester and the staff at Park Avenue Dentistry.

“I look at Dr. Lester and his staff as first responders, and I’d be surprised if you could get care and service with everything so safety-oriented anywhere else,” John raves. “They’re a great bunch of people at Park Avenue Dentistry, and I’m very comfortable with them. I recommend them to anyone.”

Stabilizing Suggestion

Albert*, 79, was among the last draftees for active duty during the Vietnam War. While in the Army, Albert trained as a medic, specifically to assist surgeons in Mobile Army Surgical Hospitals, or MASH units.

The skills he learned translated into a successful career after the war in

civilian life.
“I worked as a surgical assistant

for 40 years but am now retired,” the Schenectady, New York, native elaborates. “My job encompassed all of surgery, but I did work for an orthopedic surgeon for 13 years. I liked my job. I liked taking care of people.”

Early in his career, Albert traveled across the country offering his services. But in 1988, he met a woman from Wisconsin and settled down in the Badger State, where the couple purchased a small farm.


“It was my hobby farm,” Albert describes. “We kept horses and sheep, and that’s where we raised our two daughters. After 30 years, we sold the farm and moved to a place on a lake. It’s a large property and requires a lot of care, but I enjoy it.”

For a few years in the early ’80s, Albert’s job as a surgical assistant brought him to Florida. He liked the Sunshine State so much that he and his wife eventually became snowbirds.

While visiting Florida a few years ago, Albert required a dentist after a bridge he had for more than 30 years finally faltered.

“That bridge is a result of an incident that happened when I was a teenager,’’ Albert explains. “I got some of my teeth knocked out playing pickup football, and over the years I went through a lot of dental work. I eventually ended up with a bridge on my bottom jaw.

“About the time that prosthetic started to fail, I was visiting a friend who lives next to Dr. Lester’s office. I was at my friend’s and saw Dr. Lester outside, so I approached him and described my dental problem. After talking with him for a few minutes, I decided to give Dr. Lester a try.”

Upon Albert’s arrival at Park Avenue Dentistry, Dr. Lester performed a thorough examination and determined that the Army veteran’s remaining lower teeth were unsalvageable and required extraction. The dentist recommended a full lower denture to replace the extracted teeth.

“I suspected that Albert would not be happy with a traditional lower denture because traditional lower dentures tend to move around, and that can be annoying and uncomfortable,” Dr. Lester offers.

“Most people are unhappy with traditional lower dentures for that reason, and that’s why I suggested we secure Albert’s lower denture using

dental implants. The denture would then snap onto the top of the implants, which lock the denture in place and make it more stable.”

Alternate Approach

Dental implants are small, threaded metal posts that resemble screws. They are surgically implanted into the jawbone to serve as the foundation for replacement teeth, which can be a crown to replace a single tooth, a bridge to replace multiple teeth or a denture to replace an arch of teeth. Dr. Lester recommended a full implant-secured denture for Albert.

“There are many benefits to securing a lower denture with dental implants,” Dr. Lester asserts. “For one thing, food cannot accumulate underneath an implant-secured denture the way it can with traditional dentures.

“The best case scenario with traditional dentures is that people excuse themselves from the table after the meal to go to the restroom and rinse the food from their dentures. Often, however, they do not make it that long. They must get up from the table in the middle of the meal to rinse. That is inconvenient and, for some people, humiliating.

“Another benefit of implant-secured dentures is they improve speech because people can use their stabilized denture teeth to form hard-to-pronounce sounds such as /s/, /f/ and /v/.

“Implant-secured dentures also provide security in social situations. If a person suddenly coughs or sneezes, their denture will not come out of their mouth, which can

be extremely embarrassing.”
In cases such as Albert’s, where the

teeth are missing or have been extracted, Dr. Lester typically secures lower dentures using two to four implants. But in cases where some of the teeth are healthy, lower dentures can be secured using the patient’s tooth roots.

“For patients who have a few good, strategically placed teeth, we can remove the top portion of those teeth and utilize their roots,

which lie under the gums within the bone,” Dr. Lester explains. “We can snap the dentures onto the roots in the same fashion that we snap them onto dental implants.

“The main advantage of this approach is that patients are not required to undergo implant surgery. And some patients are not candidates for implants

because they do not have enough bone or have a health condition that precludes them from getting implants; these patients can still secure their dentures with this method.”

The tooth root approach is also a quicker process. Patients receiving a denture secured by implants typically need to wait three or four months for the implants to integrate with the jawbone before they can be fit with their permanent denture.

“When patients come to me seeking dental implants to secure their dentures, I first look for teeth that I think will last,” Dr. Lester observes. “If I find several good teeth, I suggest that the patients secure their dentures using their tooth roots. It is easier, quicker and just as effective as securing the dentures with implants.”

“Warm and Welcoming”

Albert had no remaining teeth to serve as anchors for his denture, so he was fit with implants that needed a few months to integrate with his jawbone. He now wears a permanent denture that fits securely and provides the function he needs.

“And it looks great,” Albert adds. “The appearance of the denture wasn’t a priority in my view, but it’s beautifully made. If you don’t know that it’s a denture, you can’t tell.”

Like John, Albert has a high opinion of Dr. Lester and his staff.

“Dr. Lester is a very nice gentleman and very knowledgeable,” Albert describes. “His staff is totally accommodating and very communicative. They sent texts to remind me of my visits and always checked on me after an appointment to see if I was doing all right. And they sent a lovely birthday card. The staff is very warm and welcoming. If someone needs dental work, I would tell them that Park Avenue Dentistry is a good place to go.” ■

© FHCN article by Patti DiPanfilo
* Patient’s name was changed at his request.

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