Feb. 23--One by one, the dentist took pliers to the woman's top teeth, gently working them out of their sockets and dropping them on a paper-covered tray. In 10 minutes, the tray was littered with teeth and specks of blood, and the woman's gums were empty.
On that day in May, Lori Maxfield had both her fears and her dreams realized.
By February, the Twin Falls woman would have a smile like a movie star, and the hereditary periodontal disease that had haunted her for her entire life would be gone. Unlike her mother, she wouldn't have to resort to removing a denture each night, leaving a caved-in, toothless mouth.
"I remember as a kid I'd look at her and say, 'I never want to do that,'" Maxfield said the morning of the procedure that removed all her upper teeth. "I'm glad to get rid of these ugly things, I'll tell you."
Maxfield, 47, won The Worst Bite Contest held last spring by Twin Falls cosmetic dentist Bret Davis. A friend signed up Maxfield for the competition, and she was stunned when she learned she'd receive a free total mouth reconstruction from Davis.
"I've been waiting to do a smile makeover thing for years," the dentist said in April at one of Maxfield's first appointments, where he compared mock-ups of what her new smile would look like and her "before" pictures.
"It's like a dream, and I don't want to wake up," Maxfield said. "I used to watch your commercials and say, 'I wish that would happen to me.'"
Maxfield, who is self-employed, hasn't had dental insurance for about 15 years, so despite her care with flossing and brushing, her genetic makeup meant she was just a few years from permanently losing her teeth to disease. Her enamel would chip, her fillings would fall out, and new cavities constantly appeared.
"What I saw in you was this collapsed bite, these missing teeth, and I thought, 'I'm going to have to bring my A game,'" Davis said.
Rather than fit Maxfield with a removable denture, which wouldn't retard the bone loss in her jaw, Davis turned to a new technique called "all on four" that attaches a permanent denture to four titanium posts implanted in the bone. He said Maxfield is the first patient to have this procedure done in Magic Valley. Maxfield will soon get veneers on her bottom teeth to complete her mouth makeover.
The implants and permanent denture were constructed by Precision Dental Arts, a Twin Falls-based firm that has created prosthetics for television makeover shows and has been published in international journals. It uses computer-assisted design and manufacturing to build the tiny screws and perfectly shaped artificial teeth that make up implant dentures.
The company also created a plastic device shaped like a retainer, with four precisely placed holes. Davis used the device as a guide, drilling with a graduated bit that let him make holes in the bones of Maxfield's jaw without cutting into and retracting her gum tissue. Although pain during the procedures wasn't a concern because of local anesthetic and a Demerol drip, less impact on the gum tissue meant a shorter recovery and less pain for Maxfield after the implants' installation.
All these devices were created based on high-resolution images of Maxfield's jawbones, which showed the technicians and dentist the ideal spots to place the implants.
As he operated the high-speed drill in January, Davis noted the difference in having the guide made compared with a more traditional implant procedure.
"Look at that, no blood," he said. "That's cool. No stitches, no flaps."
For several months after her teeth were pulled, Maxfield lived with a removable denture, waiting for her bone and gums to heal. On the morning of Inauguration Day, she returned to Davis' office, fidgeting on a sofa as she contemplated the national history being played out on the waiting room television and the personal history that was about to be made.
"I'm nervous but happy," she said. She smiled widely, and, unlike the previous April, did so without raising her hand to cover her mouth.
"The denture to me is very pretty," she said, comparing her temporary denture to the permanent one that waited in a foam-filled box on the counter. "Dr. Davis reassures me they're going to look better."
In the box were small, sealed vials containing the titanium implants, and the white, straight teeth that, in just a few hours, would greet Maxfield in the mirror.
Then it was time for the Demerol drip again, and another iteration of the now-familiar joke that she would wake up with a permanent-marker moustache. Holes were drilled, implants inserted, and then Maxfield's new teeth were locked into place.
Though she had warned Davis in April that she would probably cry when she saw her new smile, instead Maxfield could barely take her eyes off the hand mirror a dental assistant handed her.
"Oh, land ... Thank you so much."
Ariel Hansen may be reached at 208-788-3475 or ahansen@magicvalley.com.
The smile makers
Dr. Bret Davis specializes in cosmetic dentistry: 788 Eastland Drive, Suite A, Twin Falls; 733-2621 or idahosmilemaker.com.
Lori Maxfield's implants and dentures were created by Precision Dental Arts: 834 Falls Ave., Suite 2060, Twin Falls; 733-0383 or precision-dental-arts.com.
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