Periodontal Specialists – Dr. Herbert Veisman

Tooth Replacement with dental implants

Some people lose all their teeth at an early age. In this case, Margaret is a 60 year old female who who lives in Newfoundland, Canada. She lost all of her upper teeth when she was 16 years old. Since then, she has been embarrassed to smile, covered her mouth whenever she did smile, and was limited in what she could eat. Three years ago, her daughter ( a nuclear physics student at the University of Toronto) found Herbert Veisman, BSc, DDS, FRCD on-line along with other specialists and practitioners. Since we were the only office to address her questions on-line and offered to see her for a consultation at her convenience, she decided to take a flight to Toronto and meet with us. No one offers our services within a 1000 km of where she lives.
When she arrived, she was very emotional about the fact that she had a difficult few years (having lost a number of family members). She wanted a new lease on life and she felt that if she could get her smile back, life would be much better. When she initially presented, she was overwhelmed by the amount of work that was needed and the associated costs of treatment. Margaret was told that she would need major bone grafting (due to years of atrophy and bone loss after losing her teeth  almost 45 years prior), would also need 8 dental implants along with a sophisticated dental bridge which these implants would then support. The cost would be around $80,000.
After thinking about her options for a couple of weeks, she returned for a second consultation and decided to proceed with the treatment. She was a little apprehensive but mostly excited to turn her life around. We started with the bone grafting procedures. During the healing and interim period, she sore a full upper denture (same one she had been wearing for several years) so there was little change to her life. After 6 months of bone healing, we proceeded to the 8 dental implants. After another 3 months of healing, work commenced on her final dental bridge which would be supported by the 8 dental implants.
Now, she returns to Toronto every 3 months to ensure that she protects her investment in her new smile. She can talk, smile, eat and kiss with confidence. She is happier then she has ever been. Her story was featured in Elevate Magazine (see www.torontoimplant.com PATIENT section first page) and several people have since come in for the same identical treatment because they were inspired by her. They all had identical experiences and have, in turn, referred many of their friends and family from all over Canada.
We are pleased to illustrated Margaret’s case here with BEFORE and AFTER photos.
Patient: Margaret
Age: 60
Home: Newfoundland, Canada
History: lost all her upper teeth almost 45 years ago
Treatment Goals: Replace all her upper teeth with a FIXED dental bridge on dental implants
Limitations: Patient lost most of her bone that would support dental implants, therefore, requiring BONE GRAFTS first
Innovative Technology Used: Donor Bone block technique; 3D CAT scan imaging; IV sedation anaesthesia
Time of treatment: 9-12 months
Cost: $80,000 (payment plan available)
Prognosis: Excellent (should last for the rest of her life with proper maintenance)

Always consult a specialist for your surgical needs

If you are considering having any kind of surgery, my best advise to you is to ALWAYS CONSULT A SPECIALIST.
Only specialists have the 3-5  years of training above and beyond dental school. Specialists receive intensive specialized training under strict supervision of an accredited university. General dentists and physicians do not have such training and may not be in a comparable position to handle any complications which could arise after surgery. Specialists receive hundreds of hours of clinical training, must read thousands of scientific articles and journals, and take many Board/ Regional/National examinations to ensure quality control and qualify to perform surgery. General physicians and dentists do not go through such rigours and do not have the years of experience dealing with various complications in university-based environments. Anyone can perform a surgery. Few can handle the complications that can arise.
Remember that when you are seeking various medical and dental opinions, you should NEVER allow cost to skew your judgement. Remember the old saying: YOU GET WHAT YOU PAY FOR. There is nothing in this world that you can’t find for lower price or inferior quality. Benjamin Franklin once said that “The bitterness of poor quality remains long after the sweetness of low price is forgotten”.
As well, an old friend of mine used to have a saying: People who pay for quality only cry once! 
My advice to my patients is that if you cannot afford to do your treatment right now with someone who is a specialist, you are better off waiting until you can afford to do it right. Otherwise, you risk not only losing all your money, but you also risk your safety and well-being by having specialized, high-risk services performed by an unqualified or under-qualified operator. Most of the time, complications arising from operator error are not reversible and you could be disabled for life. In some cases, you could even die from such complications.
ALWAYS ASK YOUR PHYSICIAN OR DENTIST IF THEY ARE A SPECIALIST AND ASK TO SEE THEIR SPECIALIZED CERTIFICATE. YOU CAN ALSO CHECK ONLINE  OR SPEAK WITH THE COLLEGE OF PHYSICIANS AND SURGEONS OR COLLEGE OF DENTAL SURGEONS OF ONTARIO TO CHECK AS TO WHETHER OR NOT THE PROFESSIONAL IN QUESTION IS ACTUALLY A SPECIALIST. 
NEVER TRUST ANYONE! ALWAYS VERIFY FIRST!
As in anything else in life, when it comes to shopping around for the best surgeon, the old adage “buyer beware” applies.

Intravenous Sedation and Anesthesia

Our patients appreciate having the option to sleep right through all bone grafting, extractions, dental implants and gum surgical procedures in our office. The advantages of having treatment with anesthesia include:
1. Having more treatment completed in one sitting so you don’t have keep coming back for more and more treatment
2. Able to monitor people who are medically compromised
3. Having a portal IV in the vein for delivery of life saving medications in case of an emergency
4. Delivery of antibiotics directly into your system to drastically reduce chance of post operative infection
5. Delivery of anti-inflammatory medications to reduce chance of any swelling and pain post operatively
6. Can’t hear, feel or see any of the treatment and you awaken happy and refreshed after completion of surgery.
 
Many patients equate having sedation during surgery to “flying FIRST CLASS” on an airline. It’s a great feeling to go for surgery and not feel anything or be nervous throughout the entire treatment.

Bone grafts in periodontics

There are various types of bone grafts that can be performed in the periodontal office.
1. Guided Tissue Regeneration- bone grafting around an already existing tooth which has lost bone due various problematic issues. The bone grafting procedure consists of opening the gum around the tooth, cleaning out the defect, adding bone and a resorbable membrane and closing the gums tightly around the tooth with suture. The bone takes about 6 months to grow back around the tooth. This technique has been around for 30 years and is effective in saving certain teeth.
2. Guided Bone Regeneration- bone grafting of a tooth socket AFTER extraction of the tooth in question. The socket bone is regenerated because an implant may be planned as tooth replacement in the empty tooth site. After FOUR months, the extraction site is x-rayed and assessed for a dental implant and crown placement.
3. Bone Block Graft- when there is enough vertical hight of bone to place a dental implant but not enough HORIZONTAL bone, then a bone block graft is placed on the ridge and stabilized with at least two stainless steel screws. The screws are left in position for four months. Once an x-ray is taken after four months, the site is assessed for a dental implant. Once it is decided to place a dental implant, the gum is opened and the stainless steel screws are removed. Finally, a titanium implant is placed in position. Three months later, a crown can be placed.
4. Sinus Lift Procedure- when someone loses an upper molar, there may be extensive bone loss such that implants may not be possible UNLESS a bone graft is performed. Such a bone graft procedure is called a SINUS ELEVATION (LIFT). The gum is opened, a window is created on the lateral aspect of the upper jawbone and bone grafting material is used to fill the sinus site. If there is at least 3-4 mm of bone, an implant may be stabilized at the same time as the bone grafting procedure. Dental implant crowns may be placed at 4-6 months. Otherwise, if there is less then 3-4 mm of bone, the bone graft is performed and then 6 months later, the implants may be placed. Three months later, the crowns may be placed.

3D CONE BEAM COMPUTED TOMOGRAPHY

I am amazed at the incredible benefits of 3D CAT scan imaging we have been performing in our office for the past 14 months. Computed tomography is a vast improvement over linear tomography and panoramic radiography. It is possible to view all aspects of a specific location of the head and neck, thereby readily identifying any pathology and locating any vital anatomical structures critical to bone grafting and dental implant placement. We are one of only a few dental offices in Ontario with license to use a 3D CAT scan imaging machine. In the past,  patients would have to see a radiologist in a recognized hospital. But today, we take the imagine and are able to play “virtual reality dental implant surgery” right in front of the patient. We can locate and place dental implants right on the 3D image immediately after taking the image and right in front of the patient. Once the image is taken, a patient can make the decision to proceed with treatment. This drastically reduces wait times and anyone can have dental implant and crown and bridge in a quick and expedited fashion allowing a rapid turnaround time and improvement in quality of life

Gummy Smile Correction

Lucie is a beautiful 18 year old young lady who lost the confidence to smile because of her gummy smile. But, thanks to techniques like the gummy smile smile correction (aka Crown Lengthening), within one hour, she had a brand new smile with just the right proportion of tooth and gums.
 

Gummy Smile Correction or Crown Lengthening cosmetic procedure

There is now a solution to the gummy smile. A simple procedure, called a Gum Lift (crown lengthening), can help improve your smile and give you back your confidence, self-esteem, and peace of mind. And the results are INSTANT! Imagine this: you wake up in the morning with a gummy, unsightly smile! You go to sleep that night with a gorgeous NEW smile!
Both of these beautiful ladies were scared to smile in public and always covered up their smile with their hand. They both came in with concern that they could not socialize or enjoy life to the fullest. Now, they both date, laugh, go out with friends, and travel more then ever.  This gum lift procedure changed their lives in under an hour….. FOREVER!
GUMMY
Linda was embarrassed to smile until she had her gum lift procedure
Jean would not go out in public until she found out about the gum lift procedure. Her life has improved 100% since her treatment.