Five Years Without Teeth

She had been told no more than once.

Not enough bone. Too frail for the surgery. Unable to sit in a chair long enough for the treatment that was being described to her, because of an accident that had left her back unable to tolerate it. The painkillers she was given afterward had produced a severe dry mouth, and her teeth had dissolved away over the following years.

She had also decided, firmly, that she would not wear dentures under any circumstances.

Which left her with nothing at all, and no route back.

There was bone available in her jaws. Not a great deal, but enough, and in the right places.

The constraint that actually shaped this case was not her anatomy. It was her back. Any plan requiring long procedures, staged surgeries and repeated healing was a plan she could not physically complete, however good it looked on paper.

So the question became what could be achieved without invading the deeper structures, and without asking her to endure what she could not endure.

Four implants per jaw, regular implants of regular size, distributed for support. No zygomatic implants. No pterygoid implants. No sinus lift. No additional surgery of any kind.

The compromise, and it was discussed openly, was ten teeth per jaw rather than a full complement.

That is the shortened dental arch, and it is not a shortcut. The evidence behind it is substantial, including Dr. Reshad's own published work in the California Dental Association literature. Ten teeth per jaw, correctly sized and properly managed, is all most people need to chew and to smile.

What it avoids is the difficult surgery, the longer healing, and the cost that comes with both. For her, that was the entire difference between possible and impossible.

Her treatment was completed in two short procedures.

Experience is what compresses chair time without compromising the work, and here that experience was not a convenience. It was the reason she could be treated at all.

She received her teeth immediately, within a day of the implants being placed.

After five years, she walked out able to chew.

The temporaries did the work temporaries do. Four months of getting used to the function, the form, the phonetics, the shape. Four months of observation, to see how she adapted, whether she liked the aesthetics, and whether she wanted anything changed.

Underneath, the soft tissue matured and the implants integrated into the bone. Osseointegration. She did beautifully throughout.

Once the implants had integrated and every parameter had been tested, the finals were made in zirconium, harder and more beautiful than the provisional material, by one of our master technicians.

That is a promise here rather than a feature. Every technician on the team builds bespoke ceramics for the individual: face shape, face size, the position of the smile, and the patient's own requests for texture, form, color and reflection.

Her whole treatment was finished within six months.

Look at her smile and count. You will not, because it never occurs to you to.

A shortened arch is designed so that the smile shows no more than the teeth it has. Done properly, nobody knows, including the person wearing it.

Treatment was carried out more than ten years ago, and she is still enjoying the same teeth.

The woman who arrived had not eaten properly in five years, had stopped seeing people, and had been told by everyone she asked that there was nothing to be done.

Her sons brought her in. She walked out with a smile, and then she went back to her life.