Illustration, Brodie WIlliamson, 7th Grade
As we covered in the last blog, treatment plans for patients are approached with set priorities: health, function, and esthetics. Approaching cases in this order helps us find long-term success for our patients. Dentistry is not focused on good looks, but good looks and an appealing smile can be the product of good dentistry – so, in the name of good dentistry, we began with Debbie’s health by helping her get out of pain and get rid of her infection. She had a couple of infected teeth and gum disease. The most painful
tooth was #23 in the lower front. Both #24 and #26 had cavities with one that was down to the nerve. These teeth were crowded as we can see in the picture below. She also was really concerned by the crowding and look of this area. We had determined together that the best solution is to extract #23, 24, 25 and 26. We used the study models we had to make her a temporary bridge. This is the start to straight looking teeth while she heals.
Debbie was nervous about getting teeth pulled but very happy to move towards being pain free. She was excited to be rid of the crooked teeth she hated for so many years. We started by getting her very numb across the whole bottom arch. We then prepared the two teeth we were keeping (#22 and #27) to be the end anchors for the temporary bridge with #22 having some decay we had to repair first. After #22 and 27 were prepped, #23-26 were removed. We had her bite on gauze to clot the sockets and began to make her temporary fixed bridge (#22-27).
Our team did an excellent job creating straight looking teeth where there were none just moments before. The bridge was set at the new height and placement we wanted to establish. It was cemented in place with temporary cement. We will have the gums heal 6-8 weeks before finalizing the bridge. Some composite filling was added on top of the right side back teeth to also temporarily support the new bite we were establishing.
Debbie was pretty sore after this treatment, but she steadily improved each day. She also had some swelling and a little chin bruising which is typical after the removal of teeth. During her next visit we will treat for gum disease.