Mr H first came to Surbiton Smile Centre in 2006 with a loose bridge. He was a smart-looking gentleman, but seemed shy and avoided smiling. His teeth had been damaged in a rugby game several years previous – his front teeth were shunted forward and he had lost a tooth on the upper right side, which had been replaced by a cantilever bridge supported by his top-right canine.
Unfortunately, the canine was fractured and the entire bridge came out. His upper-left incisor was infected and needed to be extracted, and Mr H also clenched his teeth, which wore down the surfaces of all his teeth. Taking time to talk with Mr H, he revealed that he didn’t like his teeth. He said that he tried to stop himself smiling and made sure to keep his lips closed when he talked. Mr H asked me if there was any way to improve the look of his teeth. He had not smiled for a long time. I assured him that it was possible to restore his teeth and give him, once again, a healthy, natural smile.
Mr H and I worked closely together to devise a cost-effective personal treatment plan that took into consideration his wishes and budget. It was to be a multi-disciplinary procedure, which would require long-term commitment from Mr H, but that would in the end fully reconstruct his mouth. Typically, the first stage of a long procedure is to improve general oral hygiene, starting with our dental hygienist training Mr H in preventative care.
Then, the upper-right canine and upper-left incisor were extracted, and the decayed and damaged teeth restored. The second stage involved orthodontist treatment to straighten the teeth and align them in the upper and lower jaw. Good oral hygiene was maintained during this period by visits to the hygienist every three months. Mr H wanted to keep his healthy teeth intact and only replace the missing teeth. Building another bridge would have required shaping the teeth adjacent to the gap, so according with Mr H’ wishes we positioned implants for his missing teeth.
In the fourth and final stage, three crowns were placed on the implants and the back teeth were reconstructed. Due to his clenching and grinding, and a large filling, they had worn unevenly and given him an unbalanced bite. It was crucial to stabilise Mr H’ bite to reduce the risk of overload on his teeth and new implants. Excessive load can cause implants to fail or teeth to break. We provided Mr H with a personalised mouth guard to wear at night, which would relax his jaw muscles and help him to reduce the grinding and clenching.
All his back teeth were restored with metal-free ceramic crowns. Mr H is an amazingly cooperative patient. His treatment now over, he regularly attends the hygienist four times a year and comes twice year for a routine dental check-up. It is a great feeling for our team at the Surbiton Smile Centre to see this nice man smiling once again with confidence, meeting our eyes and facing the world with pride.