Heather's Smile Makeover Story

Our latest makeover contest winner results

Heather Manning has been reborn. Once a self-described recluse who hid her badly decayed teeth from the world, Heather now embraces every day with enthusiasm.

“My self-confidence is through the roof!” Dear Doctor's latest Ultimate Smile Makeover contest winner proclaimed joyfully in a recent interview. “There's no amount of words to describe how grateful I am to everybody.”

By “everybody,” Heather means Dear Doctor magazine, Florida dentists Dr. Eric Burgess and Dr. Robert Karol, their staffs, and Dear Doctor's makeover sponsors who generously donated time, skill, and materials to rebuild her smile and restore her dental health over a two-year period. In so doing, Heather said, they changed every facet of her life. “It's gone literally from a living hell to unbelievable,” she remarked.

Before she began getting the care she so desperately needed, Heather could not face the outside world. “I really had no life,” she said. “I was a major recluse.”

Heather's dental problems began as a child who was never taken to the dentist for routine professional teeth cleanings. “It was really a lack of dental care,” Heather said. “We were not very well off.”

Rampant tooth decay — an infectious disease caused by bacteria — took hold, and Heather began losing her permanent teeth. “I was spitting out pieces of my teeth,” she recalled. By the time she reached age 35, she had just 16 teeth — not all of them whole. “It hurt to smile, it hurt to talk,” she said.

The longer she went without dental care, the more serious things got — and the more prohibitive the price tag to get the situation under control. At the same time, her appearance made it impossible to find work. “All I got was looks of disgust,” she said. “I lost my car, my house, I had to go back to living with family. I lost everything.”

Though her despair made it difficult for her to take action, Heather decided that somehow she needed to rebuild her life — starting with her smile. After doing some online research, she found Dear Doctor's Ultimate Smile Makeover contest, which provides free dental treatment to a lucky winner.

“I entered every day without fail for six months,” Heather said. At last, she received a phone call that was a dream come true: Dr. Mario Vilardi, Dear Doctor's president and publisher, informed her that she had won. “I fell to the floor,” Heather recalled. “I was crying; I just kept thinking to myself, thank God my nightmare is over. I just couldn't believe it.”

It was time to get to work. Heather was sent to cosmetic dentist Dr. Eric Burgess, who gave her a comprehensive oral exam with radiographs (x-ray pictures). He found 16 badly decayed teeth, only 10 of which could be saved.

“When I first examined Heather, I knew that she would be a complicated case,” said Dr. Burgess. “My intention from the beginning was to design a permanent solution to her problems. Since she is still very young, removable dentures were a poor solution that would end up causing greater problems in the future.”

Dr. Burgess knew that Heather's rehabilitation would require input from a periodontist — a dentist who specializes in the gums, bone and connective tissue attachments that support the teeth. So he referred her to Dr. Robert Karol, who also gave her a thorough examination. The two dentists conferred, and came up with a treatment plan for Heather. There would be many steps involved. Ultimately, her smile would be restored with a combination of dental implants, bridgework and ceramic crowns.

Heather's first phase of treatment started at Dr. Karol's office, where she received non-surgical periodontal therapy — scaling and deep cleaning to improve the health of her gums. Dr. Karol also prescribed a fluoride-containing toothpaste for her to use twice each day to help make her teeth more decay-resistant.

“Having received little dental care in the past, her gum-tissue response to periodontal therapy was dramatic,” Dr. Karol said. “All of her periodontal disease was eliminated and a major transformation of her gum tissue was obtained, especially when she mastered her plaque control by complying with our oral hygiene instructions.”

Dr. Karol removed Heather's six unsalvageable teeth and placed bone-grafting material in the tooth sockets to preserve her bone. The grafting material is used by the body as a scaffold to rebuild bone. This bone-preservation technique is now a routine part of tooth-extractions, preventing the bone loss that often results from extraction to help ensure the success of future tooth replacement.

“They kept me nicely numb and made me feel very comfortable,” Heather said.

Another periodontal procedure Heather needed on seven upper teeth was crown lengthening surgery. This was done to aid in restoring her teeth, not because of gum disease. It involves uncovering tooth structure that may be hidden beneath gum tissue and bone. Sometimes it is also done to make the teeth appear longer. But in Heather's case it was necessary because she did not have enough healthy tooth structure above her gum line on which to attach the new crowns. Removing some gum tissue and bone to expose more of the teeth would allow the crowns to be cemented more securely. This made crowning the remaining teeth possible and gave Dr. Burgess a good, solid foundation of support to build upon.

As Heather completed her periodontal therapy, she also received orthodontic clear aligners from ClearCorrect, who graciously donated these appliances for her treatment. The teeth she had left were moved into correct position in order to make it easier to complete the restorations.

Once her orthodontic treatment was completed, Dr. Burgess performed five root canal procedures. Root canal treatment becomes necessary when infection from decay spreads into the living pulp tissue deep inside the tooth. Two other teeth needed more extensive root canal treatment, which was performed by an endodontist (root canal specialist), Dr. Joseph Mavec.

By this time, Heather had been in treatment for almost 6 months and had seen her makeover dentists more than 10 times. “Everybody was really patient with me, really understanding, very caring, and made me feel really comfortable,” Heather said. “That helped a lot.”

With a healthier mouth and all remaining teeth in the right position, it was time to start replacing missing teeth. It would still be some time before Heather would have new, permanent teeth, but fortunately she wouldn't have to wait much longer to see her beautiful new smile.

Dr. Burgess sent models of Heather's mouth to a dental lab, LK Dental Studio, where skilled technicians created a wax model of what Heather's mouth could look like with new, appropriately sized teeth. Once approved by Dr. Burgess and Heather, this model served as a guide in making a set of temporary teeth for Heather as the work proceeded on her new replacement teeth.

The restorative work was divided between Dr. Burgess and Dr. Karol, who placed three dental implants from BioHorizons in Heather's lower jaw, to replace missing teeth. These implants, which are actually small titanium posts that serve as replacement tooth roots, would later be topped by beautiful porcelain dental crowns to form lifelong replacement teeth. Dr. Burgess prepared Heather's upper teeth to receive crowns and bridgework. In this type of tooth-replacement system, missing teeth are replaced with dental crowns that are splinted — attached to each other, and to several natural teeth on either end.

After the teeth are prepared for crowns, it can take a few weeks for the dental lab to make them and then send them back to the dentist. Natural-looking dental crowns take time and artistry to fabricate. But in the meantime, Dr. Burgess gave Heather a set of temporary crowns to wear home that day. When she looked in the mirror, she cried tears of joy.

“It was the first time she had visible maxillary [upper] teeth in years and could smile without her lips closed,” Dr. Burgess explained. “She was amazed that this much change could happen at this appointment.”

“I was really excited just to get my temporaries — I was ecstatic!” Heather exclaimed. “I never had teeth that pretty — ever.”

Temporary teeth serve as trial teeth — mockups upon which the final crowns and bridgework are modeled; if any changes need to be made, they are made to the temporary crowns first. Heather wore her temporary teeth for one day to get used to the look and feel of them and then returned to Dr. Burgess' office to make minor corrections to their size and shape so that they would look and feel as comfortable as possible.

Once she and Dr. Burgess were completely satisfied, photos and impressions of the temporary teeth were sent to LK Dental Studio and ceramist Rocksand Grogan so that these changes would be incorporated into the final ceramic (porcelain) crowns and ceramic/zirconia bridges. These materials were selected because they are strong and would also give Heather the best possible cosmetic result.

With normal-looking teeth, Heather's life took an immediate turn for the better.

“A week after the temporaries were put in, I got a job,” Heather said proudly. “I hadn't worked for seven or eight years.” Heather began working as a cashier at Winn Dixie, and has been working steadily ever since.

After three weeks of wearing her temporary teeth, Heather returned to Dr. Burgess, who removed the temporaries and cemented her final crowns on her natural teeth. He also had a lower partial denture made for her so that she could have functional bottom teeth while her implants continued the healing process. Over the course of months, the implants would gradually fuse to her jawbone in a process called osseo-integration (“osseo” – bone; “integration” – to fuse to). This would create the ideal foundation for more beautiful dental crowns. In the meantime, the lower partial denture completed her smile and kept her new front teeth from receiving too much stress while chewing food.

In another six months, Dr. Karol informed Heather that the three implants were ready for their final crowns; when Dr Burgess cemented those new teeth in place, the transformation was complete.

“It changed my whole life,” Heather said through happy tears. “The person I was inside all along can now come out. I'm more outgoing, more outspoken — more everything.”

With her newfound self-confidence, Heather has been able to make a number of positive changes. She has gotten her driver's license and moved on to a new job with a landscaping business. “I've been able to buy a car, I've been able to get my own apartment, I've been able to be an independent person,” she said.

Dr. Karol said that without the dental and periodontal treatment she received, Heather would surely have lost all her teeth and perhaps the ability to have dental implants placed successfully in the future.

“They didn't have to do for me what they did, but they did,” Heather said. “They're the most wonderful people I've ever met — the dentists and everyone who works for them.”

“Without this treatment, she would have needed upper and lower dentures in a few years,” he said. “But now she doesn't need anything removable in and out of her mouth… She has her own teeth again.”

Meanwhile, Heather is making sure to protect her new smile from the dental disease that caused her so much suffering in the past. She is meticulous about keeping up an effective oral hygiene routine at home so that she never again experiences the ravages of severe tooth decay.

“I do everything that they taught me,” she said. Every day, Heather brushes, flosses, uses mouthwash and a water irrigation device. She also cleans her gums with a rubber-tipped implement. “It's like a whole 30-minute routine,” she said. She also wears a custom-made nightguard to protect her new teeth from unconscious teeth grinding and clenching habits. These are all health-promoting measures Heather is happy to take in order to safeguard the gift she has been given.

“They didn't have to do for me what they did, but they did,” Heather said. “They're the most wonderful people I've ever met — the dentists and everyone who works for them.”

Heather said that with the dignity and self-respect that have come from her smile makeover, she is better able to handle life's many challenges.

“I see so much more now for me that's opening up for the future, with better self-esteem and a more positive attitude,” she said. “Now I have the motivation to improve and reach for my goals and achieve. Without Dr. Burgess and Dr. Karol, none of that would have been possible.”

Heather's Smile Makeover Team

Dr. Eric Burgess – Cosmetic Dentist
Dr. Eric Burgess has been practicing dentistry since 1996 and has received advanced training in cosmetic dentistry and TMJ treatment. He's a founding member of the Florida Academy of Cosmetic Dentistry, achieved fellowships in both the Academy of General Dentistry (AGD) and the International Congress of Oral Implantologists (ICOI), and is an alumnus of the Misch Implant Institute and the Dawson Center for Advanced Dental Study. Dr. Burgess is also a sustaining member of the American Academy of Cosmetic Dentistry (AACD), having passed the rigorous examination and educational requirements. His other memberships include: the American Dental Association (ADA), the Academy of Laser Dentistry (ALD), the Dental Organization for Conscious Sedation (DOCS) and the Academy of Computerized Dentistry (ACD).

Dr. Robert Karol – Periodontist
Dr. Robert Karol is a specialist in the field of periodontics and is dedicated to providing the finest treatment in periodontology and implantology available today. He is a graduate of the University of Medicine and Dentistry of New Jersey and received his specialty training at Columbia University School of Dental and Oral Surgery, one of the nation's most prestigious periodontal programs. Dr. Karol has practiced periodontics and implantology for over 20 years and is a past president of the Jacksonville Dental Society. He is also a member of several dental organizations including the American Academy of Periodontology. As a true expert in his field, Dr. Karol and his highly trained team merge the sciences of periodontology and implantology through the use of advanced dental techniques and proven state-of-the-art technology that is representative of professional dentistry in the 21st century.

Learn More or Enter Today!

Learn more or enter our latest Ultimate Smile Makeover by visiting www.DearDoctor.com/makeover.