Dentaltown October 2017 - 32

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case study

Composite
Case

Rebuilding a bulimic patient's devastated
dentition using direct composite

This 33-year-old patient's bulimia had devastated her dentition; her upper posterior teeth
were missing a ton of tooth structure. She had
seen several dentists in her home state of Florida
but the treatment plans ran up to $80,000, which
she couldn't afford. (Who could?!) Many of the
treatment plans included root canal treatments
(RCTs) on most of her upper teeth, and crowns
on all her teeth.
The patient had already undergone typical
rehab treatment (RCTs and crowns) on her four
front teeth, and because she could not afford
more of this conventional treatment, she used
the internet to research dentists who use direct
composite to restore badly wrecked dentitions.
One was in Italy, another in Poland; because
I was (relatively) nearby in Canada, she called
and we talked about her teeth. She sent photos
and X-rays, and after multiple discussions,
I decided that I could restore her teeth with
direct composite. She flew up to Perth-Andover,
New Brunswick, and stayed for four days while
I worked on her teeth. The procedure took
two days and about 15 hours. She requested
no anesthetic, so I didn't use any. Tough lady!

Fig. 1: Her upper teeth were badly eroded; she told me she had been bulimic for
more than 12 to 15 years; she's 5 foot 4 and less than 100 pounds. Not sure she is
cured now, but she eats only organic food and is somewhat of a vegan.

by Dr. Terry Shaw
Dr. Terry Shaw practices in Perth-Andover,
New Brunswick. He graduated from
Dalhousie Dental School in 1976 and has a
chronic affection for composite dentistry.
He is the continuing education chairperson
for the Atlantic Canada Academy of General
Dentistry.

32

OCTOBER 2017 // dentaltown.com

Fig. 2: I sandblasted
her dentin surfaces to
remove stains and any
crud. No way I would put
a bur to the dentin!

Fig. 3: You can see
the outline of where
the pulps were, but
secondary dentin has
formed and pulps have
shrunk a ton.

Fig. 4: Palatal gingiva
was higher than the
remaining tooth
structure.



http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown October 2017

Dentaltown October 2017 - Intro
Dentaltown October 2017 - Cover1
Dentaltown October 2017 - Cover2
Dentaltown October 2017 - 1
Dentaltown October 2017 - 2
Dentaltown October 2017 - 3
Dentaltown October 2017 - 4
Dentaltown October 2017 - 5
Dentaltown October 2017 - 6
Dentaltown October 2017 - 7
Dentaltown October 2017 - 8
Dentaltown October 2017 - 9
Dentaltown October 2017 - 10
Dentaltown October 2017 - 11
Dentaltown October 2017 - 12
Dentaltown October 2017 - 13
Dentaltown October 2017 - 14
Dentaltown October 2017 - 15
Dentaltown October 2017 - 16
Dentaltown October 2017 - 17
Dentaltown October 2017 - 18
Dentaltown October 2017 - 19
Dentaltown October 2017 - 20
Dentaltown October 2017 - 21
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Dentaltown October 2017 - 23
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Dentaltown October 2017 - 30
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Dentaltown October 2017 - 32
Dentaltown October 2017 - 33
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Dentaltown October 2017 - 36
Dentaltown October 2017 - 37
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Dentaltown October 2017 - 39
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Dentaltown October 2017 - Cover3
Dentaltown October 2017 - Cover4
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