Smile make-over: USC dentistry helps man start new, healthy life
Ostrow helps a patient put years of drug abuse — and the accompanying dental decay — behind him with a full-mouth rehabilitation.
BY BREANNE GRADY MCM ’10
“Crystal,” “glass” and “ice” are all street names for methamphetamine, slang that makes the recreational stimulant sound smooth, nearly flawless.
Beneath this false veneer, though, methamphetamine addiction destroys millions of lives. For Scotty Sanders*, the drug stole his once beautiful smile and lured him into a life of bad choices.
“I didn’t realize anything about methamphetamine affecting my teeth until I was probably 33 years old,” he reflects. “Within the past 8 years, the enamel wore completely off my teeth and that has inhibited my ability to smile or to feel good about myself.” To see Sanders’ before pictures, scan page 19 with the Layar app.
According to the American Dental Association, the oral effects of methamphetamine abuse are often devastating. Typically, long-term users develop a distinct and severe pattern of decay referred to as “meth mouth” that is evident on the smooth surfaces of the teeth, particularly in between the front teeth.
“Meth mouth” is hypothesized to occur for several reasons, one being the drug’s effect on saliva production. Methamphetamine causes a reduction in saliva, which increases the likelihood of dental caries, enamel erosion and periodontal disease. Other possible factors include teeth grinding, poor dental hygiene and increased intake of sugary foods and beverages (users often report strong sugar cravings).
Sanders has been sober for almost 9 years but spent nearly 20 years battling drug addiction, starting with using crack cocaine at 18 years old. He has served time in 12 out of 33 state prisons in California for a total of 12 years.
After going back to the same prison three times, his cellmate, who is serving a life sentence, gave Sanders some life-altering advice. “He was very clear that if I didn’t make changes in my life then I was going to be spending the rest of my life with him in prison,” Sanders says.
When Sanders got out of prison, he went to the Tarzana Treatment Center in Tarzana, Calif., a transitional housing program with a sober-living environment.
“I came in kicking and screaming,” Sanders admits. “I didn’t want to be clean and sober. Slowly but surely, though, I decided that I wanted to give this 100 percent and that has been successful for me; I haven’t relapsed — it’s been an awesome experience.” He has been sober since Dec. 3, 2007.
Repairing the Damage
Sanders, who has been HIV-positive since 1994, first came in for an assessment at the Dr. Roseann Mulligan Special Patients Clinic.
In addition to patients with HIV/AIDS, the Special Patients Clinic provides dental care to the frail elderly and individuals with intellectual and developmental disabilities as well as neuromuscular disease.
Sanders’ greatest fear was that all of his teeth would need to be removed and that, at just 45 years old, he would have to wear dentures for the rest of his life.
During the assessment, associate professor of clinical dentistry Piedad Suarez OFPOM ’06, MS ’18 grew concerned and wanted to explore alternatives to extraction. Because it was a complex case, she called advanced operative resident Clarisa Amarillas MS ’16, who, along with associate professor Sillas Duarte, came to evaluate Sanders’ teeth.
“Clarisa and Dr. Duarte came downstairs and looked at my mouth,” Sanders says. “Dr. Duarte said, ‘Yeah, we’ll do it.’ I burst into tears at that moment because it felt like he was giving me another chance just to smile again.”
Amarillas, who completed her residency this past spring, describes the approach taken with Sanders as a “full-mouth adhesive rehabilitation.”
“He had severe erosion, so the teeth were worn down to where there was dentin exposed,” Amarillas explains.
Sanders received treatment in the clinics of Ostrow’s new advanced specialty, the advanced operative and adhesive dentistry program, which is the West Coast’s only such program. The program teaches students to provide dental care using the latest technology in adhesion to preserve teeth and enhance dental esthetics.
The advanced operative and adhesive dentistry team — comprised of Duarte, Amarillas, Hamad Alqadhi PERIO ’16 and assistant director of the advanced operative and adhesive dentistry program Neimar Sartori — took great care in determining the best solution for Sanders.
The team opted to do minimally invasive CAD/CAM bonded, all-ceramic crowns to allow for maximum dental tissue preservation. “I think we did a good job trying to maintain as much tooth structure as we could,” Amarillas says.
The entire process was laborsome for both patient and provider, requiring two eight-hour days a week for six months. The periodontal part of the process occurred in late 2015, followed by a preparation phase, provisional restorations, CAD-CAM restoration digital design and then final restorations.
Building a Better Life
“You have these moments where you go through really long days, even with amazing patients like Scotty,” Amarillas explains. “We had some long days, and the way he says thank you at the end of the day, you think, ‘This is why I do it.’ It’s fulfilling to be able to change someone’s life.”
Since his sobriety date, Sanders’ life has taken on new form in many positive ways, including his starting a new career as director of operations at a sober-living facility.
He’s also found the ability to trust.
“These doctors here have done tremendous work and have taken so much time with me,” he says. “It’s given me the idea that I matter. It’s also given me the ability to realize there are people who care.”
And, he adds, now that he once again has a healthy set of teeth, you’ll find him smiling in every picture he takes, thanks to Ostrow’s advanced operative and adhesive dentistry team.
*This story shared with permission from Scott Sanders.
Posted 01.04.2017 from the Fall 2016 TroDent