Dr. Tanner Townsend and Dr. Josh Muir discuss Jan's dental reconstruction journey, highlighting her emotional and physical struggles with her smile. Jan avoided social situations due to her teeth's poor condition and hid her smile. They chose a fixed, screwed-in option for her top teeth, utilizing existing implants to achieve a natural look. Pre-surgical planning involved facial scans and bite adjustments. Jan's surgery was successful, and she felt minimal pain. Post-surgery, she received temporary teeth, which significantly improved her confidence and functionality. The doctors emphasize the emotional and functional benefits of dental reconstruction, encouraging those with similar issues to seek consultations.

Dr. Tanner Townsend 0:05 So what is life really like when you need a dental reconstruction or when you need a smile makeover? Join us as we explore how dental reconstructions have given patients new lease on life. You won’t want to miss this inspiring story about Jan. So let’s talk a little bit about a case that we both worked on together, and it’s Jan’s case, and so we’ve both had the opportunity to work with her and been able to help her through this journey of getting a new smile and having a reconstructed smile. But what were some of the initial issues and concerns that you felt like Jan came with?

Dr. Josh Muir 0:39 So like a lot of patients, Jan came to us with some emotional concerns because of how she viewed herself, but also with some teeth that were falling apart. And you know, she had put up with this for a long time. So in the back, she had some implants, and they were in great shape, so we could use those, but everything that’s visible when she smiled was just falling apart. And so emotionally, she tried to hide her smile. She covered her mouth a lot when she spoke, and she didn’t smile. And so she found herself avoiding happiness, and situations that she should be happy in, because she didn’t want to accidentally smile, even when it was natural to smile, when she was saying that, you know, imagining that all of the happy things that we go to to feel happy and to support people, those are the things that she was avoiding on purpose. You guys met with her for the console. How did that go?

Dr. Tanner Townsend 1:48 Very similar to some of the things you just said, you could just tell she was ready to be done with some of those teeth, and she wanted a nice smile. She she had been putting up with that for years, and she was just so ready to to come up with a solution that worked for her, that could give her her smile back. And so a lot of the consult really focused around what could we do to hopefully utilize the implants that were placed previously, but also make her smile new? And so that was kind of the focus of the consult. So we went through a number of different options. And ultimately, we thought that the screwed and fixed option was going to be the best option for her, especially for the top teeth, change your smile,

Dr. Josh Muir 2:29 And so that would be similar, All-on-4, All-on -X. Those are similar names.

Dr. Tanner Townsend 2:34 Correct.

Dr. Josh Muir 2:34 That can be used, okay, cool. And she wanted something that was the most natural.

Dr. Tanner Townsend 2:40 Yeah. She wanted something that was more natural. And then she felt like her like teeth were kind of collapsed. She when we looked at her bite, she was actually closing on her pallet, the roof of her mouth.

Dr. Josh Muir 2:50 Right. Those lower front teeth were not touching her upper front teeth, they were touching the roof of the mouth.

Dr. Tanner Townsend 2:57 And so it kind of makes someone’s face look real squatty, like they’re like, they’re too close. It’s like someone that doesn’t have any teeth that you kind of seen, and they’re like, hmm, they it makes you just look extra scrunch and it makes you look older.

Dr. Josh Muir 3:09 Well, and then there’s the chewing part with it too.

Dr. Tanner Townsend 3:11 Yeah.

Dr. Josh Muir 3:11 I mean, to chew all the way down, you know, that’s and what are you biting against the roof of your mouth? You know. So it requires, you know, putting her jaw all the way forward, so she’d be on her front teeth, but you can’t chew like that. You can bite something, but then, yeah, her front teeth on the bottom would disappear when she closed down. So interesting. What? What fears did she have? And I know she’s someone that chose to be asleep or be sedated for this procedure. And so what were her fears?

Dr. Tanner Townsend 3:47 She wanted to make sure that she was comfortable during the procedure. She didn’t want to really hurt, which a lot of patients are very similar in that fact that they want to make sure that they’re comfortable and they’re not scared during that procedure. She was really she was like, I want to be not nervous during the procedure, so I just want to be put to sleep, which makes our job really kind of simple in that aspect, too, because we’re not having to worry about that so much,

Dr. Josh Muir 4:11 Right.

Dr. Tanner Townsend 4:12 Of managing patient expectation

Dr. Josh Muir 4:13 When sedation is used, oftentimes patients don’t even remember,

Dr. Tanner Townsend 4:18 Yeah

Dr. Josh Muir 4:19 The surgery, even though it lasted multiple hours. So

Dr. Tanner Townsend 4:22 Yeah, such a blessing that we have sedation.

Dr. Josh Muir 4:25 So tell us, as you guys were talking about, whether to go with the fixed All-on-4 type option versus other options, what were the reasons for that?

Dr. Tanner Townsend 4:36 The fixed versus like a snap-on-denture or a conventional denture wasn’t really something in the cards, because we wanted to use her implants that she already had, and so we felt like they were serviceable. So it was either the snap-on-denture or the scrutiny kind and she was like, Well, I really want to make sure that I have a natural look like you had mentioned previously with some of her issues and concerns. And so we really focused on that, and we knew and kind of explained to her that the screwed in fixed All-on-4 option, or All-on-X option, was going to give her the best look that she was hoping for. And I think that was a wise choice that we went that route.

Dr. Josh Muir 5:16 Yeah, agreed, agreed.

Dr. Tanner Townsend 5:19 So I saw her for the next appointment as well. We did some pre-surgical planning. After that, we had her back in for some records. After we initially had that initial consultation, my biggest concern was opening her bite up so she wasn’t gonna bite on the roof of her mouth. So we did some facial scans. We took some impressions, did some scanning in her mouth of just her teeth that she had there already, and we were able to kind of get her in a position that we felt like was the right spot. Now I made a mistake on this one, where I accidentally opened her a little bit too much with our putty bite to try to figure out where she was supposed to be. And luckily, our designer was able to say, hey, when I put this in the software, it looks like she’s way too far open. So we were able to close it down to make it more manageable, which was perfect for surgery day.

Dr. Josh Muir 6:07 So when I hear you say that, anytime someone says I made a mistake,

Dr. Tanner Townsend 6:11 Yeah

Dr. Josh Muir 6:11 I immediately think, oh, man, you made a mistake,

Dr. Tanner Townsend 6:15 Yeah

Dr. Josh Muir 6:15 But really, what it is is we make educated guesses on what will be best for any given situation, and then we have checks and balances in place. Hey, for our designer, Jay, as you’re doing this, here’s my concern. I’m trying to help her so she’s not biting the roof of her mouth. You notice anything? Then get back to us. And so it’s really that feedback that he gave on our checks and balances.

Dr. Tanner Townsend 6:45 Correct.

Dr. Josh Muir 6:46 And then even on the surgical day, we went through that same thing again to double check again. So okay,

Dr. Tanner Townsend 6:53 I love, I love the way you said that. I think that

Dr. Josh Muir 6:55 not, not necessarily, yeah, not necessarily a mistake. It’s just a step in the process where we know step one, let’s get that one out of the way, and then, okay, is that where we want it, or do we need to go this way or this way? Step two, and really, at every step of the way, we’re constantly evaluating, are we still on track, or do we need to adjust one way or the other? So

Dr. Tanner Townsend 7:20 Yeah, I love that. So tell us as that that was kind of the the pre-surgery day in the planning, as she came back for surgery, how did that go? And walk us through that process.

Dr. Josh Muir 7:30 There are situations that make that make the surgical portion more difficult or less difficult. And there were a few things in this one that made it more difficult. One was as her teeth had moved over the years, they moved into places that weren’t ideal for placing implants. And so one issue we run into is when we take a tooth out, there’s a hole there, there’s not there’s no longer bone there. And so we have to plan around all of those. If the teeth, if the teeth are right where they’re supposed to be, in an ideal situation, oftentimes we can put the implants right in that same spot when they’re not. Well, what if we’re What if the tooth has moved half a tooth, well, now we’re right in between where it should go. And so we ran into that a little bit. She had been through a lot. She had been dealing with some dental issues for for some time. And you know, all of those things led her to get her treatment done at this time. But ultimately, again, she had these previous implants, two in the back left, two in the back right, and she had taken good care of those, and so we were able to use those. And, you know, I think that just shows that, really, any time we can help a patient save some money, save on additional procedures. You know, she didn’t need as many implants because she already had some. I mean, what a blessing now we could have just taken those out and started over, but what a blessing that we could use those for her. You know? The other thing is, the best amount of treatment to get is the least amount that you can get while accomplishing the result that you’re looking for. And so yeah, we could have placed more implants, but we chose to keep the ones that she already had, and I think that was a really good move for her. So throughout that process, she was asleep. She was so relaxed with all of this, and it was so neat, because when she woke up, she was feeling great. She didn’t even know that all of this had happened. She was, she was a good wake her upper, yeah, meaning she was happy. And so that was really good to see. It’s, it’s always refreshing when that’s the case. Yes, and then she came back the next day. We put her new teeth in. And the reason we waited for the next day is we wanted to give her a chance to wake up fully, and by doing that, we could evaluate and assess her bite more fully and make sure that was in the right spot. And really, I think it was excellent. So, and we’ll go over some of those pictures and videos as well.

Dr. Tanner Townsend 10:30 Well as you guys went to that next day delivery, how, how did she feel about herself as she got her teeth?

Dr. Josh Muir 10:41 Yeah, she she brought up again, how there are times when she would just avoid smiling, avoid participating in certain situations that would lead to smiling. You know, she doesn’t want people to tell her jokes and so on, because it might lead to a smile. To be honest, she absolutely looked like an entirely different person. Her whole smile had changed, but not just her smile, really the light, the light that emanated from her, was totally different. She went from being someone that, while she had a beautiful heart, you could tell that that she was everything was in she didn’t want to share anything about herself, and once she had her new smile. I mean, we’re talking the day after surgery, you know, she just opened up, and she was another person. She shared a part of herself that she probably hadn’t shared for a while.

Dr. Tanner Townsend 11:43 Well, how did she had she feel like physically, you feel, that that second day after as well?

Dr. Josh Muir 11:48 You know what we tell patients is, most people, when they go through this, this process, they actually have very little to almost no pain. And when patients hear that, everybody’s a little bit skeptical. Way to say, Hold on, you’re taking out my teeth, you’re putting implants, and you’re doing bone grafting, you’re changing all of this. What do you mean? I’m not going to have any pain. But she felt excellent, and she was, of course, surprised, and her daughter was with her, and they just couldn’t get over how good she felt. And that’s one neat thing about doing it. Then, you know, putting the teeth in the next day is we can have that discussion. So I was, I was grateful for that.

Dr. Tanner Townsend 12:33 That’s awesome. Well, so the next step in her journey is we gotta have her back to have a three week check where we just check and make sure tissue is healing appropriately. But after that, we kind of move on to letting her heal for three to four months, or if not longer, and then kind of moving towards a more updated final teeth walk us through that process.

Dr. Josh Muir 12:57 Yeah, so the way I typically like to do it, and I think it’s the most fair for patients is rather than say, hey, we put the implants in. Here’s your final teeth. We’ll see you “never”.

Dr. Tanner Townsend 13:11 Yeah,

Dr. Josh Muir 13:12 You know, I like starting out with this temporary set of teeth, because initially, when we’re going from teeth that someone totally hated. I mean, almost anything is going to be a big improvement, and so most of the time, patients just can’t get over how nice it is. But that doesn’t mean it’s personalized to make it theirs, and so going through this process of having these temporary teeth during the healing just allows them to make little tweaks, little changes. Hey, I remember I saw these pictures and my teeth were a little narrower, or they were a little longer. You know what? I wish they were darker. I really loved how bright they were at first, but it’s a little too bright or the opposite. Hey, I know I said I wanted them the same color they were before, but I’m smiling so much. I really want these bright I want people to know that I’m coming. And so we see all of those things. And I even tell patients and their families, anytime someone mentions something, write it down. And so I say in the notes section of your phone, just open up a page and write teeth, and then you’re going to say, this is what I like about them. This is what I don’t like about them. This is what my daughter said, This is what my granddaughter said. And all of those things will come into play. And as the healing process goes on, what typically happens is people will cross out some of those. They’ll add some more, and it’s just a great process of fine-tuning and customizing and making it truly belong to that patient. And so as far as the next step goes, we let her heal. Yeah, during. That healing if, if we need to make some tweaks during that time and get her a new temporary we will, typically what happens is the guess that we make on how it should look is really, really close to how it stays. And so we’ll go through a process of getting some new scans and records, and we’ll have the next guess to what the final one should look like, and we put that in as a temporary first, and in nearly every case, that’s how we keep it. And then it’s just a matter of going from the temporary material to the final polished ceramic material. She does not have to get numb a single additional time. Her only numbing was during her sedation appointment.

Dr. Tanner Townsend 15:46 When she was asleep.

Dr. Josh Muir 15:47 She was asleep. Yeah, so pretty amazing, no numbing and the rest of her appointments are all pretty short. So

Dr. Tanner Townsend 15:56 It’s amazing how fast you can go from having teeth that you may not be comfortable with smiling, and then to teeth that you’re so proud of.

Dr. Josh Muir 16:04 Yeah.

Dr. Tanner Townsend 16:04 So fast.

Dr. Josh Muir 16:05 Yep, she’s proud of them. And we’re only in the temporaries. She’s only seen the temporary teeth, which is crazy, which is amazing, and it changed her life so much, even in these temporaries. So that’s what I just love to see and hear,

Dr. Tanner Townsend 16:18 Yeah. And it was so cool to see her. The next day, after she got the seat, she looked like a totally different person.

Dr. Josh Muir 16:22 Yeah, yep,

Dr. Tanner Townsend 16:24 Totally different person.

Dr. Josh Muir 16:25 You know, we’ve talked a lot about the emotional side of getting these new teeth for Jan, but there’s also the functional side, yeah? I mean, you can imagine, if teeth are spaced out a lot, someone’s going to to slur their S’s a little bit more, it’ll be a little bit harder to speak, and of course, it’ll be harder to eat. And so by getting these new teeth, by getting the new smile, she also gets everything that goes with that. And so she can eat better. She can chew better. I know that goes hand in hand, but she can cut her food better, and all of the benefits of her whole health system, no lessens inflammation because she can chew better. She can break up her food into smaller pieces. She can eat different types of food, and all of those just lead to that better quality of life we focus on, what does this do for her, emotionally? But then there’s all of these other things that trickle down. So

Dr. Tanner Townsend 17:30 It really is pretty incredible how that functional component that we don’t often think of as often because we’re more like, wow, that looks amazing, but the functional component is huge, especially for someone that probably was having a harder time eating like you had mentioned being able to eat foods that you’ve never eaten before. I can’t tell you how many times I’ve had patients say, Man, I can’t wait to bite into an apple.

Dr. Josh Muir 17:52 Yeah.

Dr. Tanner Townsend 17:52 And

Dr. Josh Muir 17:53 Or eat a salad.

Dr. Tanner Townsend 17:54 Eat a salad.

Dr. Josh Muir 17:55 And when you’re missing teeth, it’s it’s hard to chew a salad, the lettuce doesn’t break apart, yep, and let alone if you had a carrot or something like that, that’s just gonna get smashed between your teeth.

Dr. Tanner Townsend 18:08 So just kind of to wrap up Jan’s case here, she’s not even done yet, and she’s had a wonderful, transformative smell, even just in her temporary teeth, like we’ve discussed. It also affects her emotionally, affects her, the way she feels about herself and the way she functions and is able to chew so anything that you feel like you kind of took away from this case in addition to that?

Dr. Josh Muir 18:30 Well, there’s also the side of how her family views her.

Dr. Tanner Townsend 18:33 Yes.

Dr. Josh Muir 18:34 I mean, that’s what was amazing. Her family was such a big supporter of, Hey, Mom, it’s time to do this. You’ve waited. Come on, let’s get this done for you seeing her response to how excited they were. I mean, it just adds a whole nother level of excitement. Some people listening or watching may have questions about themselves or their own family member or friend. So what do you have to say to people who may be in the situation where they might benefit from this, or maybe they just have questions about it? Where do they go? Where do they start their journey?

Dr. Tanner Townsend 19:10 Great question. So I think the first place to start would be visiting our website at montanaimplants.com, and scheduling a free consult. You can click on the free consult button, and that will send you a message to help you schedule a free consult and really just come in for that free console and then let’s talk options. Let’s find out what your goals are, and that way, we can incorporate your goals into your new teeth.

Dr. Josh Muir 19:37 Now, what if someone’s embarrassed about their teeth, you’d think that going to the dental office, you shouldn’t be embarrassed to have a dentist see that. Yeah, your teeth have some problems, but a lot of patients are should they be embarrassed? Should they be ashamed?

Dr. Tanner Townsend 19:54 Not at all

Dr. Josh Muir 19:55 Is it a safe space?

Dr. Tanner Townsend 19:57 It is a it is totally a safe space, and and it’s confidential, and so we want to help you achieve your goals. And if you want to look totally different and change your life and change your smile, let us work with you. And we’re like you had mentioned, we’re going to have it be a safe space where we can just talk openly and freely about what your goals and desires are.

Dr. Josh Muir 20:21 Yeah, you know. And we would also invite anyone to like and share our page. You know, after you have a positive experience with us, leave us a review. But let’s, let’s start this journey together. Let’s keep this journey going. And then, you know, our biggest compliment is when you refer someone else to us, and that’s our goal, is to provide that treatment for you that is so incredible that you refer everyone you know that needs it to have the same thing done

Dr. Tanner Townsend 20:50 That was wonderful, kind of going through Jan’s case. Today, next week, we’ll have an opportunity to talk about Insta smiles and how social media can sometimes influence us negatively for on how we view our teeth.

Dr. Josh Muir 21:01 Yeah, that’s that’s going to be an interesting one,

Dr. Tanner Townsend 21:04 And that is it for today’s episode of the Smile Reconstruction Podcast.

Dr. Josh Muir 21:07 Thanks guys.