Throughout my 25 years there are many memorable cases, but there is one that stands out due to a somewhat unusual conclusion.

A patient in his mid 30's had a rare immunity disorder that had led to the early loss of jawbone around his back teeth. The extreme looseness of these teeth made it difficult for him to enjoy such foods as a nice, big, tasty piece of steak - much to his frustration.

We decided to replace all his back teeth with implant supported bridges, which due to his immunity problems was very challenging and difficult to do. The total treatment period was almost a year in which the patient remained very positive and increasingly excited about his 'new teeth'.

On the day we finished, the result was fantastic and he announced that he had organised a special dinner that evening at a local Steak House to celebrate. Both my wife and I were invited. He ordered the biggest steak on the menu and ate it with gusto, much to everyone's delight and my relief.

My patient was an older man who had not visited a dentist for 10 years. He was unhappy with the appearance of his teeth but was so anxious and phobic that he had considered having all his teeth extracted and replaced with implants or dentures while under general anaesthestic in just one visit! After many discussions, together we developed a plan of treatment to address his cosmetic, functional and psychological needs. We managed his anxiety using distraction tactics, sedation and counseling. While we had to remove some of his teeth we were able to restore his smile in a way which achieved a great physical result and even led to a longer term reduction in his anxiety of the dentist.

A very nervous lady attended our practice with a severe toothache. She had walked past our front door over 20 times before having the courage to enter, whereupon she broke down in tears for twenty minutes. A very bad childhood experience had stopped her from seeking regular dental care and accordingly both aesthetically and functionally her teeth had suffered. Although a well groomed and successful businesswoman she would shy away from smiling, laughing or any close person to person conversation. Her overall attitude to dentistry was very negative to the point of neglecting her own home care. After many visits acclimatising her to the dental environment we were able to build her trust and confidence to enable me to resolve her immediate toothache problems and restore function. Even a good preventative care home program was organised.

The change in her attitude to dentistry was astounding - laughing and joking when attending the clinic and she became very motivated with her dental homecare. In her own words, she didn't have the smile to suit her new found attitude and regained confidence. Using the latest porcelain materials we were able to rebuild and restore her smile. A regular six monthly attendee, this formerly very nervous patient is now able to reminisce positively about that life changing first visit.

A 25 year old man - tall, unshaven, vivid tattoos on his arms and shoulders, shaved head — kind of 'rough looking' – appeared at the clinic because his girlfriend had agreed to marry him only if he had his teeth fixed. And because previously he had only ever visited the dentist when he was in pain, his teeth were in a pretty bad way. He had several missing teeth (including the front ones) and most of his remaining teeth were either decayed or broken from years of neglect and fights at the local pub, and heavily stained from smoking. It took a few visits for examination, consultation and discussions before we finalised the treatment plan. This included 8 crowns and 2 sets of bridges as well as 5 teeth requiring root canal treatment, teeth whitening and some minor gum surgery. In other words, a full mouth rehabilitation. Treatment took 2 months, with 1-2 long visits per week. Both the patient and his fiancée were thrilled with the outcome, and both of them became regular dental patients who attend every six months. Due to his dental makeover this young man has more confidence and self esteem. No longer embarrassed about his teeth, he smiles more often and he even gained an office job for a large company after his marriage. The last time we spoke, he was planning to start his own business! To quote: “The first steps into your practice, Doc, were the best thing I ever did (apart from marrying my wife, of course). It changed my life forever, and I can't be happier. Thank you.”

In the past five years I’ve spent a fair bit of time doing dental work as a volunteer in Cambodia, providing treatment to people who otherwise might never have a chance to see a dentist. Most of the treatment involves pain and infection control caused by rampant tooth decay.

One memorable treatment experience occurred when I was volunteering at Angkor Hospital for Children in Siem Reap. Being the only dentist there, I was called into the operating room to open and drain a large facial swelling caused by an abscessed tooth on a 15 year old boy. This case itself was very simple, but the boy was so sick that he had a high fever and was admitted to the hospital. Although I have treated similar infections before it had been years since I had worked in an operating room, and indeed years since I had seen such an advanced infection. In this case everything went well. I made a large incision to drain the abscess, removed the offending tooth and cleaned out the area before stitching it back up. After a course of antibiotics the boy was fit to return to his village. One wonders what would have happened to him were I not in the area.

I had a patient who was so fearful that even touching her lips made her jump! This lady had had a particularly traumatic experience as a child, involving multiple procedures. It was not the treatment itself which traumatised her, but the way her dentist was 'rough' with her. Even an injection can be a traumatic experience if not handled with care, and patients often remember such experiences their whole lives.

After her ordeal, the patient did not visit a dentist again for more than 20 years. Even basic hygiene such as brushing and flossing was neglected on a daily basis, as her experience had made her feel helpless to manage her oral hygiene herself. So much so that when I met her, her oral condition had deteriorated to the point that many teeth in her mouth were broken and rotten, with rampant infection. Sadly, the only reason she came to see me was the pain of infection. This perfectly normal, pretty young woman in her 20s had a mouth where all her teeth were broken and stained; not even her front teeth were spared.

During my initial exam she was scrunched up on the dental chair in a foetal position with her legs up, hugging a pillow for comfort. That first day I literally was only able to examine her front teeth! What followed were many sessions of counselling, educating and very small steps to begin cleaning her teeth. Over many visits she gradually began to trust that her treatment could be pain free and that I had a genuine desire to help her get better. As her condition was progressively treated this young lady gained confidence in both her dentist and in her appearance. She began to smile, laugh and joke with us. She began to pay more attention to herself and wore makeup. The improvement in her oral health encouraged her to take better care of herself too. She even joined a gym. It wonderful to be able to help her not only regain her health and confidence in seeing the dentist, but most importantly, in seeing her regain her self-esteem.

A shy woman in her twenties presented with teeth that had been worn down almost to her gums and were severely discoloured. After a long discussion I discovered that she was bulimic and her stomach acid had eroded the enamel. In addition to which she only ate lemons for two years! Needless to say, her teeth were very sensitive. Fortunately she had counseling and recovered. Because this woman wanted to look normal again, but could not afford complicated treatment, we reconstructed her teeth with resin veneers. In a single visit she had her beautiful smile back.

A couple of years later I could not recognize her - she was a successful model brimming with self confidence. She said that after having her teeth fixed she discovered that huge change can be achieved, and this inspired her to make other changes in her life. It was truly gratifying to have been involved in her amazing transformation.

I was contacted by a young woman who had neglected her teeth due to a 3-year struggle with breast cancer. She needed immediate surgery and was told by the surgeon that all the infection and disease in her mouth needed to be eliminated before he would operate. She had 14 teeth that needed crowns and onlays and was told by another dentist the only way to quickly remove the decay and infection was to extract all the teeth! Since we had Cerec technology in our office we were able to restore all 14 teeth in one day. The young woman was able to have her operation that same week. She still sends me my favorite chocolates every year on my birthday.

Dietary changes are a key challenge in dental health today. Many popular drinks not only contain high levels of sugar, but also contain extremely high levels of acid. A man in his early twenties presented with a complaint of broken, sensitive and yellowing teeth. He had a history of consuming highly acidic drinks throughout the day and while he had no decay, he had all but destroyed all the enamel from the inner surfaces of his front and molar teeth through dietary acid erosion. With education and support we were able to change and modify his dietary habits, and then restore the tooth structure he had lost with a series of tooth coloured resin and porcelain restorations. With this treatment the young man was able to function as he had before, and was also very pleased with the aesthetic improvement. He was amazed at how much destruction had occurred from the acid drink, and grateful that we had stopped any further damage!

I had a patient who was in sales with some success, but she saw me because she had an anterior open bite (the front teeth do not touch when biting). She felt that she was unable to be as successful as she wanted because prospective clients would see that her front teeth could not touch and likened that situation to a predator that could bite and hold its prey. Therefore, the prospective client (the prey) could flee from the predator (my patient) with the end result that her sales were low, despite the fact she knew she was good at her job and had a great product. She felt if that I could correct the open bite, clients would see her teeth touching and would feel they cannot escape and they would buy her paintings. The open bite was corrected and she was happy with the result, though I can't say for sure if her sales improved thereafter.

I recently saw a 10 year old boy who had slipped on wet tiles and broken two of his new upper front teeth. One tooth had the nerve tissue exposed, while the dentine layer was exposed on the other. Fortunately his quick thinking mother had retrieved the larger fragment and kept it moist. X-rays revealed that both these new teeth still had immature roots.

The exposed nerve was protected with a medicament to help the tooth regenerate a barrier to protect the remaining nerve. The saved fragment fitted this tooth like a piece from a jigsaw puzzle and was reattached to the tooth using dental bonding agent. The other tooth was restored with tooth coloured composite resin. The result was that you couldn't tell these teeth were once broken! Both the boy and his mother were very pleased indeed.

Although teeth that have been traumatised are reported to be erratic in their nerve responses, hopefully he will now be able to keep his upper permanent front teeth for a long time.

In addition the child was referred to our Orthodontist for treatment of his occlusion (buck teeth), to reduce the risk of future injury. A sportsguard will certainly be recommended if he plans to keep playing sports!

Funnily enough, they are all interesting, because a typical root canal patient is usually in pain, often tired, hungry and most often of all, unhappy. Add to this cocktail the horror stories about root canal treatment and you end up with a very fearful and reluctant patient. Happily, equipment, materials and techniques have improved tremendously to a level where patients experience little or no discomfort. With the specialized microscope I have I can pinpoint the problem exactly and effect treatment with minimal invasion. In fact, I would say that most of the time my patients are either enjoying movies or comedies on the TV (they might even be laughing, strange as that sounds) or they have fallen asleep.

I had a patient who came to me because he could no longer see his teeth; many were completely covered with tartar. His teeth had been like that for some time, but the worse they got the more embarrassed he was to go to a dental clinic. His girlfriend was a patient of mine, so she was able to reassure him that I wouldn’t lecture him for staying away from a dentist or a dental clinic for so long! First, I congratulated him for coming in. Then I congratulated him again when we uncovered his teeth and they were beautiful, white and cavity free! It took a few cleaning visits to get his mouth into great shape again, but it was wonderful to see him leave the office after our first visit smiling with his head held high. He was so happy to be on the road to better health. (His girlfriend was very pleased too.)