This blog is a live interactive page for our patients and visitors interested in keeping abreast with the latest advancements in technology in Dentistry.  We thought we would start off by featuring Dagmar, a delightful German lady who just recently completed her dental implant treatment with us.

Case Study

Clinical team

Prosthodontist: Dr Dennis Leong
Oral Maxillofacial Surgeon:Dr Juliet Tay
Endodontist: Dr Leroy McCully
General Dentist: Dr Brendan Gin

Brief Summary

At almost 50 yrs of age, Dagmar Eschenfelder, a German national, had already worn dentures for thirty years from the time when she lost her first adult tooth at the age of 18.  With each additional loss,  new dentures were made but they never felt comfortable nor looked good. By the time she came to us in March 2008, she had lost 18 teeth with only 4 upper and 6 lower natural teeth remaining.  Of these, two had root fractures and were the next to be removed.  Her latest upper and lower dentures were only one year old but caused her tremendous discomfort as they rocked in the mouth whenever she ate. She could never enjoy simple things like biting into an apple.   She decided it was time she did something once and for all.

Living in Germany most of her life, Dagmar had previously sought help there but dentists in her town of 20,000 were unable to do much.  The costs of treatment by specialists in bigger towns were simply prohibitive.  Nevertheless, she was hopeful. Her request to us was simple.  She wanted us to help her bite apples again. 

Treatment

Dagmar underwent a thorough clinical examination with radiographs including CT scans to determine the exact topography of her bone structure. To get her off dentures, dental implants were the only solution as we needed them to support new artificial teeth that would be immovable and absolutely firm when eating and speaking. 

A comprehensive treatment plan was then developed by the clinical team.  Our examination showed that she had lost so much bone in the thirty years that in order for us to place implants we had to reinforce it by grafting new bone. In her case, the amount required was much more than usual and the only way was to get the bone from her hip. Dagmar readily agreed because she had previously undergone the hip procedure when she fractured an arm.  She knew it would not be a problem doing it again.

Under general anesthesia in May 2008, Dr Juliet Tay removed part of Dagmar’s hip and transferred the bone to the mouth to reinforce the bony structure that would support the implants. The two broken roots were removed.  A total of 15 implants were subsequently inserted over the next few months.  Root canal treatment was carried out by Dr Leroy McCully to save the remaining teeth.  In the meantime, Dr Dennis Leong made her a new temporary upper denture for social reasons.   Time was allowed for complete healing before Dr Leong finally began the final phase of constructing the new teeth in March 2009.  In April 2009, 13 months after we started, 25 new crowns were installed and permanently fixed onto her implants and remaining natural teeth.  Dagmar couldn’t believe how differently she felt.  She was elated and constantly smiling.  The next day she went off on a diving trip.

After thirty years, Dagmar could finally bite her apples again. 
 

Q.  Dagmar, it has been some time now since you had your new teeth.  How do you feel so far?

A. good.

Q.  What problems did you have, if any, adapting to the new teeth considering it is such a drastic change from your dentures? 

A. I have still a slight strange feeling in the lower front area but this improves from week to week. And I am playing around with the tongue because the free upper gum is great feeling! No plastic or metal disturbing.

Q. Can you tell us more about how differently it feels when you eat nowadays? 

A. The taste is much more intensive, I feel the temperatures earlier, I do not need to think about any balancing the food in the mouth to avoid moving of the denture, no more fear to loose the denture falling into a soup (which happened to my mother once!)

Q.  What about your appearance? How have your new teeth changed it?

A. The greatest change came from the bone graft- the cheeks are fuller, the face is a little rounded which looks younger. The teeth itself give a healthy and positive charisma.

Q.  In what way has your speech been affected, if at all?

A.  The speech changed, yes and I am still mumbling a little bit- especially in my mother tongue, it is less obvious in English. So I am singing now, reading loud and doing some exercises to improve this. In the moment I have to speak concentrated. But I think this will also improve soon. It is just a few weeks ago!

Q. Did your family and friends notice the new you?

A. of course! My husband said not much, to be honest-he said nothing, but he looked at me and smiled. My sons both said that it looks good. The small one mentioned that there is no plastic seen when laughing! One colleague who did not know about my new teeth asked me if I had holiday because I look so recharged and younger……so the change was there but not too obvious, the appearance is absolutely natural.

Q. Besides apples, what can you eat now that you had difficulty eating before?

A. Since a long time I did not eat chewing gum, raw carrots or salad- even sticky rice was a small problem because it slacked the denture.

Q. What other things can you do now that you couldn’t when you were wearing dentures?

A. gaping without covering the mouth……..there are a few little things, laughing loud and showing the teeth, kissing?

Q.  You underwent extensive treatment for a year.  Can you tell us about your experience? What was it like during that period? Was there much anxiety, fear, pain, discomfort? 

A. To be honest, there were 2 or 3 days I wanted to stop this and go back to original situation. The hip graft was no problem but even with anesthesia I had days were I was really afflicted by doubts to do the right thing. There was never fear or anxiety but pain and discomfort. The pain few days after a treatment and the discomfort took a little longer. My personal mechanism to overcome discomfort or pain is sleeping- and I remember I slept some days 15-20 hours and when waked up it was nearly ok.  

Q.  What made you finally decide to have the treatment here in Singapore?

A. Two important factors, first I had a very good feeling about the competency of the doctors. They were positive from the first second on, I had the feeling they have fun and enjoy the project. They never doubt that they will bring me to my apple bite. The second important factor was money; the costs are much but still about 30% cheaper than in Germany and here everything is close together. The closest dental clinic from my place is 120km away so beside the treatment cost you have to organize the trips.

Q. Is there anything you wish to tell others that will be useful to them?

A. Maybe they should think about it in advance and then trust their gut feeling. If the attitude is positive it is always the right decision. Even with a little pain and discomfort. I think decisions like this can not be made just by ratio.

Q.  Do you have any regrets?

A. none