Reconstructive Dentistry

My Grandfather, my Father and I all suffer from Amelogenesis imperfecta (AI). AI is a disorder of tooth development. This condition causes teeth to be unusually small, discolored, pitted or grooved, and prone to rapid wear and breakage. Other dental abnormalities are also possible. These defects, which vary among affected individuals, can affect both primary (baby) teeth and permanent (adult) teeth.

Unfortunately, the medical description does not begin to explain the pain and discomfort the condition can cause and how difficult it is to live with. The primary problem those like me, with AI, have is that we have little to no enamel on our teeth. Most of you have experienced the pain of a cavity at some time in your life. Well, a cavity is just a small hole in your enamel which exposes the underlying nerves. Imagine having no enamel on any of your teeth and living for years with all of those nerves exposed to the environment! Eating things like ice cream, drinking hot chocolate, trying to chew meat, catching a snow flake on your tongue would all be causes for you to writhe in pain. Even smiling and exposing your teeth to the air could be unbearable, depending on the weather. As you can imagine, this will affect your nutrition, state of mind, confidence, general health and how you could speak. My nickname on the Football Team is “Wobs” because I could only mumble my last name Wallace the first time I had to introduce myself.

The description of the teeth being small and discolored does not begin to describe the appearance my teeth had after 16 years of use. They were worn down to the point of looking like broken pencil points.

They were the size of baby teeth, and were yellow/brown in color. My jaw was not as defined and I felt like my mouth was caving in. Even though I am now 6 feet tall and a 260 pound football player, I have been bullied and picked on because of the appearance of my teeth. Even in elementary school I was accused of being a smoker! zombie! vampire! I was accused of not brushing my teeth, being dirty and contagious. I even had a girl tell me she wanted to throw up when she looked at me. Over the years my parents have taken me to several Dentists. None of them were able to help me, and one of them actually ground one of my teeth down to the point that I almost lost it. Thankfully, during the Fall of my Freshman I bit into a wrap at lunch and lost one of the temporary caps that I did have on a front tooth. This was more than obvious and I rushed home to show my parents and to ask them to get it fixed right away. My Dad at this point was very frustrated with my dental care and started a search for a Dentist that could do cosmetic dentistry and would be willing to help me with my condition. After a brief internet search he kept coming up with recommendations for one man, Dr. Ira Koeppel. Dr. Koeppel agreed to see me that night! He was nice to me and made me feel comfortable right away, and had empathy for everything I had been through.

Dr. Koeppel had my Dad and I come back that weekend. He and his staff took x-rays, pictures, and molds of my teeth. He listened to my life story and how my teeth were affecting every part of my life. He promised right there and then that he was going to help me to overcome this disease and to be able to enjoy all of the things I have been missing. That day started a fight with my Dad’s health insurance company that lasted a year and a half. Dr. Koeppel’s staff; Marie, Ginette, Alex and the rest of the women worked tirelessly to convince them that this birth defect was a health issue that needed to be fixed. Eventually, because of their perseverance the insurance company finally gave in and agreed this past March that work could begin! Dr. Koeppel, with the help of Dr.Alan Berman, my periodontist then started with me from scratch preparing to make me look like a Million Bucks! He promised me that I would look like a Rock Star when he was done and made me feel like I was going to be his only patient until I looked as good as God intended. Marie made a schedule of 9 appointments for me spanning from May until August and Dr. Koeppel got to work.

Tonight is the eve of my last appointment with Dr. Koeppel to finish the restoration process on my teeth. During the last few weeks, I have grown more confident and am smiling more. I feel like my jaw is more defined and that I am making a more positive appearance. I can eat foods that I could never enjoy before like; hard pretzels, steak, ice cream, cold drinks. One of my teammates from the Football Team actually said,”Hey Wobs, show me your Million Dollar Smile!” The nickname has become a term of affection over the past two years, but the request was proof to me that Dr. Koeppel had kept his promise and worked all of his magic to help me get to this great place in my life. James P. Wallace

Others, loose enamel from sucking lemons, or eating a lot of food that contains citric acid. Sour gummy bears or sugar-filled gum can cause teeth to dissolve. Frequently eating candies or mints can also cause acid erosion. Without enamel, teeth are more prone to infection, often this leads to ramped decay.

Some medications can cause xerostomia (dry mouth). Smoking, illness and age can also be contributors to this. When there is no saliva in the mouth, the teeth become a harvesting ground for decay, and the friction caused by dry mouth may cause wear and fractures.

Sometimes this severe decay is caused by previous full mouth dental work gone awry. Leaking fillings invite new decay to breakdown more tooth structure. Crowns that do not fit properly can do the same. Fillings not adjusted properly can trap bacteria in food traps, becoming more difficult to clean.

Soda, in excess, is kryptonite for healthy teeth. Soda is liquid candy packed with sugar. There are about 14 tablespoons of sugar in one serving of soda. One who drinks soda all day is depleting the body of calcium rapidly due to the acidic content in sodas. Most soda drinkers do not brush their teeth right after they have had a glass of soda, so the sugar content stays on the teeth and breaks them down.