Personalized Dentistry: Dr. Leong’s Approach to Tailored Smile Restorations

Jordan Pysz / iFoundMyDoctor.com
Norma shows off her new smile while wrapping up the crust for another family-favorite pie.

The highlight of family gatherings that Norma Stillman hosts at her Palm Bay home is always the assortment of pies she makes from scratch using a recipe that’s been in the family for decades. “The secret is in the crust,” Norma says in a whisper. “I usually make the dough for that well ahead of time and freeze it. I have six in the freezer right now, so I’m all set for the holidays. That is, unless I pull them out and make a pie for myself. I do that on occasion.” Norma’s hobby is baking pies. Her cherry and pumpkin pies are her family’s favorites, but she can turn out an apple or pecan pie just as easily. Norma, 83, also likes to cook and sew, although she admits she doesn’t do much of the latter these days. “I used to sew a lot, but I just don’t do much of it anymore,” says Norma, who has devoted much of her time in recent years to correcting the many oral health issues that ravaged her smile. “It all started with a tooth that cracked and was chipping off,” Norma relates. “This was many years ago, and I told my husband at the time that I needed to get something done, so I made an appointment with the dentist that my daughter-in law was seeing.” That dentist is Richard Leong Jr., DDS, P.A. In 2006, during his initial examination of Norma, he discovered several issues that needed to be addressed in addition to the broken tooth.

Much to Do

“When I first saw Norma, she only had seven teeth in her upper arch and one of them, a right lateral incisor, had a hole in it,” Dr. Leong reports. “So, I suggested that we repair and crown that tooth as well as her other three front teeth, all of which had cavities in them. “I also recommended an upper partial denture to replace the missing teeth in the back of the upper arch. Finally, I suggested that we fit her with a new lower denture because she had no teeth on the bottom and was having problems with the denture she had. “That denture was made 20 years earlier, and it was worn down and wasn’t fitting right because she lost bone in her jaw over the years, which happens naturally. The bone shrinks, but the denture keeps the same shape. “So, I put all that together in a treatment plan, and we started working on those issues right away. In the first month, we finished the crowns for the front four teeth.” The second phase of Norma’s treatment plan called for two partial dentures to serve as replacements for the missing teeth in the back of her upper arch. But Norma had those prosthetics and a new lower denture made at a local denture clinic, following the advice of Dr. Leong, who cited the clinic’s “lesser fees.” The clinic’s work was deemed only satisfactory, at best, by Norma. “I talked to Norma about those prosthetics after the work was done and she didn’t seem to like them very much, but it was something, and they were working all right for her until the lower denture broke,” Dr. Leong reports. “That was in 2020, and that’s when she came back to me again.” Norma did not abandon Dr. Leong in the years prior to her return. She visited him regularly for cleanings, but when the lower denture broke, she knew there was only one place to go to get a new one that would fit her just right. “When Norma came back, I simply activated the original treatment plan that we put together for her lower denture,” Dr. Leong explains. “That called for her to be fit with four dental implants, although in this case, because of the lack of bone in her jaw, I actually used mini-implants.” Dental implants are root-shaped, screw-like bodies that are surgically placed into the jawbone. Once the implant is in the jawbone, new bone naturally grows around it to form the foundation for an abutment and replacement teeth. The replacement teeth can be a single crown that is 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 placing an implant, some patients require a grafting procedure to enhance the volume of the jawbone so that it can properly support the implant. This is often the case with patients who have been missing teeth for an extended period. “When someone has been missing teeth for a period of time, there is no pressure from chewing to stimulate new bone growth in the jawbone,” Dr. Leong explains. “That’s why the bone deteriorates, and that is why bone grafting is sometimes necessary with those patients.” That was the case with Norma, but Dr. Leong was able to avoid the grafting procedure by fitting her with the mini-implants, which are small-diameter implants designed to fit into areas where there is less bone to anchor them. “In treating Norma, I fit her with four mini-implants in the front area of the lower arch,” Dr. Leong explains. “I then took one of her old lower dentures, one she never wore because it didn’t fit right, and relined it and filled in the areas where her jawbone had shrunk.”

Leap of Faith

Dr. Leong also adjusted the bite on the old lower denture to make sure it lines up with the existing upper partials, which Norma is still wearing. Norma says she may get those partials changed out as well, but she’s happy with the results of Dr Leong’s other work. “The crowns that Dr. Leong fit me with are just beautiful, and they look and feel just like the teeth I had when I was much younger,” Norma enthuses. “And the denture fits great. I’m very pleased with the work Dr. Leong has done for me. “I think Dr. Leong is the best dentist around. I really like him. I put all my faith in him, and he’s done an excellent job. “I also like the way he explains everything. You’re never going into anything blind with him, so I definitely recommend him.”