Although I typically speak on occlusion in cosmetic dentistry in my lectures, I always find time to tell people about our Give Back a Smile (GBAS) program, and in particular the happy/sad story of Michelle, my most successful failure.
Michelle had a hard life. A heavy smoker, she looked at least 15 years older than I was, even though she was really a year younger. The last straw had been when her husband hit her in the mouth with an ashtray knocking out the bridge (FPD) that made up her smile. Still, she persevered, taking her daughter, moving out and sticking her teeth back in with Crazy Glue, ignoring the health of her teeth while struggling to start a new life.
By the time Michelle found out about GBAS and got to me, with multiple layers of Crazy Glue, none of her maxillary teeth were salvageable but with her trademark enthusiasm, she excitedly began treatment for a full denture with the one hope that we could just get a smile in time for her to finally be in the family Christmas pictures. You see, with only her daughter and parents in their small family, pictures to remember the happy times became very important to them. Since she was embarrassed by her smile, and it reminded her of unhappy times,
Michelle was never in any pictures. She was so excited that as a goal, she set up an appointment with a professional photographer for an official family picture she could give her daughter as a present to keep forever. Starting essentially from scratch, after a complete exam, we began by extracting her hopeless root tips, providing a thorough hygiene appointment, and restoring her cavities. Michelle was always on time, happy and grateful. So much that after enjoying several movies in the chair with our video glasses, as a gift in return, she came one day with a huge box filled with all the movies her family had enjoyed but no longer watched.
We soon began impressions, and with the extraordinary help of Kreyer Dental Prosthetics, who donated all their time and expert help, soon after Thanksgiving went to try-in, right on schedule for those pictures! The only problem was a minor one: her anterior teeth were set without coupling, and since they weren't touching, it meant she wouldn't have an anterior guided occlusion, which would have doomed her to all the problems commonly associated with complete dentures for the rest of her life. No problem! I sat in my lab and soon reset her teeth, but in my rush to fulfill Michelle's dream, I forgot to make a plaster index to show the lab where the teeth needed to be. Michelle, for her part, was more excited than ever. Faced with a full smile in the mirror again, she began working on losing weight and even, she proudly announced, had quit smoking! So you can imagine all of our disappointment when her processed denture arrived and, somehow in transit or processing, her canines had shifted not only enough to eliminate canine guidance, but so much so that they looked "fangy." Reluctantly, we agreed to have the teeth reset, but I couldn't destroy her dream. Before sending out her denture, I took the extra step and duplicated it with alginate and acrylic in my pressure cooker, then custom added and sculpted the offending canines in her mouth, allowing her to not only have her portraits taken, but many more happy memories over the holidays, with the hope of even better teeth to come in new year. I still remember looking over her beautiful denture that January 6th morning, wondering where Michelle was, asking my office concierge to call to find out, and the look on her face.
Michelle's mother had picked up the phone, tremendously apologetic for not telling us, but Michelle had passed away. Rather than be completely devastated though, the family was able to take solace in one thing: thanks to those teeth I made her, Michelle was able to get those pictures, the only pictures in years she ended up in, with a big smile. Exactly the gift she'd wanted to leave for her daughter. That, then, is the true meaning of Give Back a Smile, to fulfill that dream, that last wish, to give a victim back some dignity to enjoy the rest of their life, however many days that may be.