A One-Stop Dental Shop

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The wife of the pastor is often as involved in the church as her husband. Such is the case with 74-year-old Dianne Breznen, who professes to work “part time” but devotes more than 40 hours a week serving the Lutheran Church of the Holy Cross in West Palm Beach.

“I’m the administrative assistant there,” Dianne says. “I am also a deacon, which means I sometimes conduct the services, distribute Communion, and pray and visit with people.

“When you’re a pastor’s wife, your jobs within the church can cover everything from A to Z and all other duties that are assigned. I am also the worship leader at a Messianic congregation.”

A mother of three and grandmother of nine, Dianne moved into her busy role with the church in 1981 after her family moved to Florida from Michigan. She brought with her a devotion to dental care that is rooted in an oral health issue she dealt with as a child.

“As a youngster, I always had troubled teeth,” Dianne discloses. “That’s largely because I was on antibiotics for a good portion of my time as a young girl. The antibiotics rotted my teeth and forced me to get a lot of caps and fillings.

“Over the years, little by little, all those fillings and things have been replaced, but a bigger problem developed a few years ago when one day, while distributing Communion, a little piece of one of my teeth fell out.”

The damage to Dianne’s tooth sparked a trip to Naved Fatmi, DMD, the founder of Health and Wellness Dentistry, which has locations in Boca Raton (Regency Court Dentistry), Lake Worth (Lake Worth Dentistry) and Boynton Beach (Town Square Dentistry).

A comprehensive dental care practice, Health and Wellness Dentistry has an experienced team of dental professionals and specialists as well as the advanced technology necessary to address the needs of any patient, young or old, no matter the dental issue.

“With our team of specialists, patients don’t need to go anywhere else for care, no matter the dental issue they present with,” Dr. Fatmi asserts. “We have gum specialists, implant specialists and bone specialists so we can handle all patient needs.

“Because of those specialists, we provide a wide array of services, and one of the most important is general maintenance — things like regular cleanings and checkups — because a lot of people think that it’s natural to lose teeth as you get older, but that’s not true at all.

“We don’t naturally lose a limb or a finger as we get older, and it’s the same with our teeth. If we take care of them properly, we can keep all of our teeth, and by keeping our teeth healthy, we can help keep the rest our body healthy as well.”

Health and Wellness Dentistry’s services include oral health examinations, oral hygiene treatments, emergency dental care, cosmetic enhancements such as BOTOX®, JUVEDERM® and Restylane®, teeth whitening, dental aligners and dental implants.

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Dianne underwent procedures to treat periodontal disease. Her teeth and gums are healthy again, and she plans to keep them that way after learning improved oral hygiene practices.

Devoted Patient

Dianne has been a Health and Wellness Dentistry patient for more than a decade, and after losing that piece of a tooth, she learned that the entire tooth was failing.

“I had a massive infection in that tooth,” Dianne reports. “The odd thing about it was that I wasn’t in any pain at all. But the infection was so bad that they had to pull the tooth and fit me with a dental implant.”

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

The replacement can be a crown that is cemented or screwed onto a single abutment, a partial bridge that is affixed to one or more implants, or a full denture that is fastened to a series of implants.

Some patients require a bone graft to enhance the volume of the jawbone so it can properly support the implant. This is often the case with patients who have been missing teeth for an extended period.

“The reason is because bone mass deteriorates when there is no pressure from chewing to stimulate natural bone regeneration,” Dr. Fatmi educates.

Dianne did not require grafting before she was fit with the implant, which resolved the problem with that tooth. But last fall, another problem sprang up that required Dr. Fatmi to call on the services of practice associate and periodontist Jordan Hekmati, DDS.

A periodontist specializes in the prevention, diagnosis and treatment of periodontal, or gum disease, an infection that is the leading cause of tooth loss in people older than 50, according to Dr. Hekmati.

“Periodontal disease is even more harmful than cavities because it’s caused by bacteria that become more and more harmful over time,” Dr. Hekmati educates. “It’s especially harmful when it gets deep into the pockets between the gums and molars, where it’s hard to clean.
-Dr. Hekmati, DDS

“That’s why most people with periodontal disease have issues with their back teeth. What happens is, the bacteria destroy the bone that supports the teeth. That makes the teeth mobile or loose. Eventually, if left untreated, those teeth will fall out.”

During an early phase of periodontal disease known as gingivitis, the gums become red and swollen, and bleed due to a buildup of plaque and bacteria. In advanced stages, the gums can ooze pus and detach from the teeth, which allows the teeth to become loose or mobile.

Digging Deep

Mobility of teeth damaged by periodontal disease is rated on a scale of one to three, with three being unsalvageable. During his examination of Dianne, Dr. Hekmati found six teeth, all molars, with mobility ratings between one and two as well as 50 to 60 percent bone loss.

“In her case, it was the upper molars on each side,” Dr. Hekmati reports. “She was fortunate that her case was localized to those areas, to the maxillary (upper) teeth, and that the mobility was such that we could likely save her teeth.”

To do that, Dr. Hekmati started by performing a deep cleaning (scaling and root planing) to clear out the bacteria causing the damage. This procedure helps improve the health of the gums and allows them to reattach to the teeth.

Dr. Hekmati then performed osseous surgery, a procedure in which he reshaped the bone around the teeth. Using an ultrasonic device, he cleaned deep into the roots through an incision in the gums, which was later closed with stitches.”

Dr. Hekmati also performed guided tissue regeneration, a grafting procedure in which cadaver bone is placed into the areas where bone has been lost to further promote new bone growth.

Because he was only treating six teeth, Dr. Hekmati completed those procedures in about an hour. He then sent Dianne home with a rinse to prevent plaque from building in the treated areas and asked her to return two weeks later to have the stitches removed.

Dianne followed all of Dr. Hekmati’s instructions, and Dr. Hekmati is pleased to report that because of his efforts and Dianne’s improved oral hygiene practices, her teeth and gums are healthy again.

“And I’m happy to say that none of what Dr. Hekmati did was painful in any way,” Dianne adds. “Even after the anesthetic wore off, I was not in any kind of pain whatsoever, so I am very happy with how everything worked out.

“I’m now getting my teeth cleaned every three months to stay ahead of any problems that might come up, and I’m glad to do it because I’m very happy with the dentists and everyone on the staff. They are genuinely concerned about their patients’ health.”

Root of the Problem

Like Dianne, Brittany Secrest recently found herself in need of a specialist at Health and Wellness Dentistry after a piece of her upper right canine, or eyetooth, broke off.

“It was my husband who suggested I go there,” Brittany says. “After the tooth broke, he started looking at reviews of dentists online, and the reviews at Lake Worth Dentistry were all really good, so he said I should check it out.”

When she first visited the practice this year, Brittany was not experiencing a lot of pain from the broken tooth, but it was sensitive to hot and cold. A thorough examination revealed that an infected nerve was the reason.

At that point, Brittany was placed in the care of endodontist Obianuju Mbamalu, DMD. An endodontist specializes in treating the pulp, which is the soft tissue inside the tooth beneath the enamel and dentin. This tissue contains nerves and blood vessels and is located within the pulp chamber and root canals.

Dr. Mbamalu, who refers to herself as “Dr. Uju,” determined that Brittany’s broken tooth was likely the result of a cavity that ate away at the tooth until it became so soft that it could no longer hold up under the pressure of normal function.

“In layman’s terms, the tooth became gunky,” Dr. Uju says. “That’s how I often describe it to my patients, and once that happens, the nerve that’s in there typically goes from being inflamed to being infected. That’s what happened with Brittany.

“The difference between having an infection in a tooth and an infection anywhere else in the body is that with a tooth you can’t just take antibiotics to cure it. You have to pull the tooth or perform a root canal, which is what I recommended for Brittany.”

A root canal is a procedure performed primarily by endodontists that is designed to save a severely damaged tooth by removing the inflamed or infected pulp; disinfecting, reshaping, and refilling the root canal; and sealing the space.

The procedure requires special skills because it calls for the careful removal of the harmful bacteria causing the infection.

The bacteria must be removed completely and cannot be swallowed by the patient. To achieve that goal, the endodontist places what is known as a rubber dam around the tooth being treated. The dam isolates the tooth from the rest of the mouth and collects all the removed bacteria.

After the pulp and bacteria have been removed, the endodontist cleans and disinfects the pulp chamber and root canals. The empty pulp chamber and root canals are then filled with a flexible material before they are resealed with a standard dental filling.

The final step in a root canal is placement of a temporary crown over the tooth. This is later replaced by a permanent crown, typically by a general dentist.

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Painless Procedure

“Most people cringe at the thought of getting a root canal because they think it hurts, but we now have ways to numb our patients so they don’t feel a thing,” Dr. Uju says. “And when done right, a root canal should allow you to take your tooth to the grave.”

Brittany is among those who “didn’t feel a thing” during her root canal. And she’s confident that the work will indeed allow her to keep the tooth for as long as she lives.

“The root canal procedure was completely painless,” Brittany confirms. “And I’ve had no issues with that tooth since the root canal was done. I recently went back for a checkup, and they said everything looks great, so I am very pleased with the outcome.
-Brittany

“And I’m very pleased with Dr. Uju. She’s very nice and reassuring. All through the procedure, she kept telling me that I was doing great and that she would soon be done. It went really, really well.”

Brittany recently learned that she has two other teeth that may require root canals. She says that based on her positive experience with Dr. Uju, she will return to Lake Worth Dentistry to have them performed.

“I really like her,” Brittany says. “She did a great job. It didn’t even hurt when she gave me the shot to numb me up, so I would absolutely recommend her and Lake Worth Dentistry to others.”