Need A Deeper Dental Dive?

Jordan Pysz / iFoundMyDoctor.com
“Dr. Leong is always so patient and kind and understanding.
He’s an exceptional dentist.” – Andora Strieter

From anywhere in Florida, it will take you the better part of two days to fly to the western Pacific microstate of Palau. But avid scuba divers such as Andora Strieter will tell you that the payoff is well worth the exhausting investment in travel time.

“Palau is the most beautiful place I’ve ever been to, and I didn’t even see much of the country because I spent most of my time there underwater,” Andora says of the Micronesian getaway. “As hard as it is to get there, I would gladly go back again. It’s fabulous.”

Located between Guam and the Philippines, Palau became the final resting place of more than two dozen ships that were downed there during World War II. In turn, that wreckage has spawned one of the world’s most colorful coral gardens.

“The sea critters you see there are just amazing,” Andora adds. “We saw sea clams so big you could fit inside them. You can also see lionfish, barracuda and sharks. We were right there with a lot of sharks — reef sharks, blacktips and whitetips. It was incredible.”

Along with her husband, Andora has made more than 600 dives, and she’ll soon be making more now that a long-running and agonizing dental issue is behind her. The problem dates back nearly three years.

That’s when Andora began to experience what can best be described as an oldfashioned toothache. Unfortunately for Andora, it took three dentists and six months to discover the cause. During that time, Andora suffered in utter agony.

“It was an awful time,” the 56-year-old confirms. “What I had was nerve pain in that tooth, which was a lower right molar, and that kind of pain just changes you. It affects everything you do and just makes you miserable and cranky, which I was.

“It also changes the way you eat. Because of this nerve pain on the lower right side, I started eating everything over on the left side. That eventually led to a whole different problem, but at the time, that lower right molar was the issue.”

Third Dentist A Charm

Andora first sought help for that issue in November 2021. Though x-rays showed no damage to the molar, Andora’s dentist placed a crown to protect the tooth. Andora’s pain remained, however.

Within two weeks, she was back in the dentist’s chair begging for relief. Now concerned that the pain was the result of an abscess, a pocket of pus caused by an infection, the dentist sent her to an endodontist with instructions to perform a root canal.

That proved to be a bit of an ordeal as well as the endodontist struggled to adequately numb the area around Andora’s aching tooth.

After several injections of oral anesthetic, the endodontist finally achieved that objective and completed the root canal.

As with the crown, though, the root canal did nothing to alleviate Andora’s pain. She remained in anguish, which prompted her to call her mother, whose dentist is Richard Leong Jr., DDS, P.A.

Could Dr. Leong do something, anything to ease her suffering, she wondered?

Despite receiving the distress call on a Saturday, Dr. Leong immediately invited Andora to his practice, where he began his treatment by performing a thorough examination that included x-rays and an oral CT scan.

“I studied that CT scan for several hours, but I could not find anything that would cause the kind of pain she was experiencing,” Dr. Leong reports. “I finally concluded that her pain was likely a result of an abscess that was there even before the crown was placed.

“I say that because the two dentists she saw before me both had difficulty getting her numb, and an abscessed tooth is hard to numb. But the more you try to numb it, the more injections you give it, the more the infection spreads.

“So, the best suggestion I could offer was to take the tooth out, which Andora agreed to. We then had to decide how to replace that tooth, and because her surrounding teeth were very strong, I didn’t want to fit her with a bridge. So, I suggested a dental implant.”

Dental implants are screw-like bodies that are implanted into the jawbone. Once seated, the implant becomes the foundation for replacement teeth, which for Andora was a crown screwed onto an abutment affixed to the implant.

While pulling the tooth, Dr. Leong confirmed his suspicion that Andora’s pain was due to a deep infection. That presented a new problem, however, because implants will fail if they are placed into an infected bed.

To resolve the infection, Dr. Leong used a laser to debride the affected area. He then prepared the site for the implant by treating it with a natural growth product called platelet rich fibrin, which is obtained by drawing blood from the patient’s arm.

The blood is placed in a centrifuge to separate a fibrin clot containing platelets and white blood cells. The fibrin clot, known as platelet rich fibrin, or PRF, is used to accelerate tissue repair. The PRF is then mixed with bone graft material that helps the bone heal faster and regrow stronger.

“The PRF also has antibiotic characteristics to it that helps it clear the infection,” the doctor educates. “I then placed a barrier that holds in the bone graft and PRF mixture and keeps gum tissue, which grows faster than bone, from growing into the implant site.”

Pain-Free at Last

Implants typically need three or more months to heal and become secure enough to support an abutment and crown, so after seating Andora’s implant in late March 2022, Dr. Leong turned his attention to another pressing issue.

“When Andora first came to me, she was also having pain in the back of her upper right arch,” Dr. Leong informs. “In investigating that problem, I found the same issue as with the lower tooth — an abscess right above the one we’d just taken out.”

Dr. Leong also found a massive cavity in that tooth, an upper right molar, numbered by dentists as tooth number 2. Andora wanted to save the tooth, so instead of pulling it, Dr. Leong performed a root canal and placed a crown on top.

“I warned her, though, that this tooth was very weak and that she might continue to have problems with it, which she did,” Dr. Leong adds. “A few months later, she came back and was still having problems with that tooth as well as another one, tooth number 30.”

Dr. Leong found a crack in tooth 30, for which he recommended a root canal. While away on a diving trip, Andora decided against the root canal and opted instead for extraction and the placement of dental implants for numbers 2 and 30, a lower right molar.

“That was in February, and it was the right decision because I’m finally out of pain,” Andora enthuses. “And I can’t tell you what a relief that is. Like I said, I was miserable for several months, but thanks to Dr. Leong, I’m a lot better now.”

Dr. Leong also treated a cavity on a lower left molar, tooth number 18, with a crown. Lastly, he fit Andora with a night guard to help prevent future problems.

“That’s really where all of this started because I’ve grinded my teeth for years,” Andora notes. “I’ve done that since I was in my 20s, and I’ve worn a night guard for all those years, but Dr. Leong has given me a new one that should work better for me.

“My mother has always raved about Dr. Leong, and now I know why. The fact that he saw me for the first time out of nowhere on a Saturday was just amazing to me, but since then he’s done so much for me, I just can’t thank him enough,

“Dr. Leong is always so patient and kind and understanding. He’s an exceptional dentist, and just like my mom did with me when I needed some help, I would absolutely recommend him to others who need a dentist. He’s great.