In Joan’s other life, she is an equestrian breeder and highly sought after judge of Arabian horses. She and her husband, Ron, own and manage Vantage Point Farm II, Ltd, an Arabian breeding and show stable located in Cheney, Washington. This year, Joan is honored to have been selected to adjudicate at the US Arabian National Horse Show, in Tulsa Oklahoma, where 2200 Arabian horses will compete in multiple disciplines. She also manages the All Arabian Horse Show, Midsummer Classic, held each June at the Evergreen Equestrian Park in Monroe, Washington.

Joan leads a busy life, commuting between Eastern Washington and Seattle, but her “double life” as a dental hygienist and equestrian has not dampened her enthusiasm. Joan says she would not change a thing, and says she is proud to be a part of the life-changing dental care and esthetics created in the office of Bryant and Junge Prosthodontics.

The criteria included years of experience, amount of continuing education, use of new techniques and technologies, and physical results. Dentists with the highest ratings were selected for the final list.

Dr. Bryant and Dr. Junge are among the few prosthodontists practicing in downtown Seattle to make the list, and the fact that both were ranked among the top in their field is a testament to their commitment to excellence, and the respect of their fellow dentists.

If you’d like to see the full list of Seattle Met magazine’s Top Dentists for 2013, visit www.seattlemet.com/lists/top-dentists-2013.

This is an inherited, genetically linked condition. But, since several genes affect the formation of enamel, amelogenesis imperfecta can have different inheritance patterns depending on which gene is altered.

It is not possible to grow new enamel on teeth afflicted with amelogenesis imperfecta, but patients should receive treatment in order to eliminate their dental sensitivity and to improve their dental health and appearance. Left untreated, these patients would usually lose their teeth as a result of cavities. Crowns can prevent or eliminate the tooth decay associated with this condition, and they are the first line of defense and treatment. However, if decay has already progressed too far, teeth may have to be extracted, necessitating the use of implants or dentures to replace the missing teeth.

Case Presentation

The following case presentation is typical of the complexity of treatment that amelogenesis imperfecta patients may present. This patient is gracious enough to allow us to present her case in the hopes that it will help to create a better understanding of amelogenesis imperfecta and the type of treatment that patients can expect from Drs. Bryant and Junge.

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Our patient first presented for treatment at 14 years of age [see photo #1]. She expressed concern about the appearance and sensitivity of her teeth and her difficulty eating. This was a source of great distress to her and her family, who were already familiar with amelogenesis imperfecta. The patient’s father, aunt and sister were also afflicted with this congenital anomaly.

At this stage, all of her teeth required new crowns, but because of her young age and continuing growth, it was not prudent to place permanent porcelain restorations on all of her teeth [see photo #2]. In addition, she had a malocclusion (“bad bite”) that would require orthodontic treatment and jaw surgery. Furthermore, her gums were overgrowing some of the teeth and would require periodontal surgery in order to expose them. We developed a comprehensive restorative treatment plan and a team of specialists to address her many concerns. In addition to prosthodontic treatment, she would also require an orthodontist, oral surgeon, endodontist and periodontist over several years in order to complete her treatment.

Initial treatment began with removing the stainless steel crowns that were previously placed by her childhood dentist. This was followed by surgical periodontal crown lengthening to fully expose all teeth. Impressions were then made in preparation for the creation and placement of long-term temporary restorations. The acrylic temporary crowns were fabricated and attached to each tooth [see photo #3].

Our patient then proceeded with orthodontic treatment to create an ideal alignment as she continued to grow [see photo #4]. Completion of orthodontic treatment and jaw surgery created ideal positions for her teeth and bite. Finally, the acrylic temporary crowns were removed, and all teeth were prepared for permanent porcelain restorations [see photo #5]. This reconstruction with porcelain restorations created a beautiful smile with a perfect bite and normal function [see photos #6 and #7]. Although this extensive treatment took over eight years to complete, without treatment, all teeth would have been lost as a result of dental cavities.

This case represented the “ultimate restorative challenge,” because there was no frame of reference regarding the correct size, proportion or position of each tooth. Heightened aesthetic and technical skills were essential in designing her smile and creating restorations that look and function like normal, healthy teeth. This transformation not only changed her smile and outward appearance, but it also greatly contributed to her improved physical and emotional well-being.

This patient is typical of the type of service and coordination of treatment that Drs. Bryant and Junge provide. If you know of anyone with amelogenesis imperfecta, or other developmental anomaly of their teeth, we would be honored for your referral and to provide their personalized care.

If you have a congenital tooth abnormality and would like to find out more information about treatment, please call our office for a complimentary consultation.

We would like to thank our patient once again for allowing us to present her case.

“Being part of a team that is so passionate about the work they do and the people they help is, in a few words, beyond wonderful. I got my start in the administrative dental field through medical billing and was referred by an old employer (and patient of Bryant & Junge Prosthodontics). Based on my externship with Casey, the office manager, I immediately felt good about working here and continue to feel lucky that this opportunity found me!”

Though Sarah is a full-time front-office administrator, she knows the importance of balancing work and her personal life. Last year, Sarah had the most exciting year ever. She got married to her long-time boyfriend and best friend, Manny, and gave birth to a sweet, healthy baby, Brooklyn. Being a new mom and wife has brought Sarah more joy than she ever imagined possible. She feels that her world is complete. “I have my little family now, and life couldn’t be better. Between my work and my family, I get the best of both worlds! I am such a lucky girl!”

Carbohydrates are part of a healthy diet, but it’s important that their residue and the dental plaque are removed from the teeth before too much acid is produced. Having pasta or a dessert is not harmful to your teeth if you brush and floss within a reasonable time afterward. But, sipping sweet drinks or sucking on mints all day long is very harmful, because the sugars and acids remain in contact with the teeth for a long time.

We recommend brushing and flossing at least twice a day. Because plaque is sticky, it must be physically rubbed off the teeth and cannot be removed by simply rinsing with mouthwash or squirting with a Waterpik. We can’t stress enough the importance of flossing, as it removes food and bacteria from between teeth, where a toothbrush can’t reach. When our patients complain that they don’t have time to floss their teeth, we jest with a timesaving recommendation: Just floss the teeth you want to keep.

Patients with hard-to-reach areas may also benefit from additional tools or methods to aid in thoroughness. During routine hygiene appointments, we coach our patients and make recommendations for improving their homecare.

The simple truth about cavities? In a nutshell, they’re preventable. Brush and floss at least twice a day and get a professional dental cleaning at least once every six months. This saves your teeth and saves you money.

If you haven’t had a cleaning in a while, we encourage you to call and schedule an appointment today. You’ll be glad you did.

He devoted upwards of 12 hours each day seeing patients, and spent his nights sleeping in a primitive tent. Though the schedule was grueling, he found the work exhilarating. “You’re dedicated to helping people, and everyone around you feeds off the positive energy.” Dr. Junge was inspired by the spiritual nature of Bhutan. “The people seem so happy. They spread happiness. It’s inspiring to see how a life with so little can be lived with so much joy.”

Dr. Junge feels that working with Flying Doctors of America has changed his outlook on life, especially when it relates to living in the United States. “I’m grateful for every little convenience we take for granted, and I recognize how fortunate we are. It’s easy to get stuck in a bubble, but getting out and experiencing the world on this level has helped me realize what is really important.”

He plans on continuing his work with the organization and is looking forward to a trip to Peru in the future. “If you are able, as a medical professional,” he concludes, “you should try to donate your services at least once in your life. The personal reward far exceeds any time or effort spent.”

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But with early detection, the disease can be caught before it spreads. And nothing can detect oral cancer earlier than the VELscope. The device uses a special blue light that illuminates the soft tissue in the mouth and gums. Under this light, any abnormalities will stand out, including those invisible to the naked eye. We take note of these abnormalities, so they can be checked further and treated if necessary.

An annual VELscope screening, which is quick and pain-free, is recommended for all adults. It is included in our yearly exams at no additional cost to our patients. If you haven’t had yours, we invite you to make it a priority and call for your appointment today.