MY SEARCH FOR A SMILE NEARLY KILLED ME. By David Longstaffe

Lisa Hewer and her horrific experience whilst in the search for a beautiful smile

Her story touches so many hundreds of thousands of people each year, and if procedures and legislation are not changed one day sadly somebody could be permanently injured or be exposed to an ever increasing risk of loss of life from incorrect application of what we all take for granted from dental treatment in this Country.

"At my darkest moment Mark found me with bottles of tablets, I was on the edge and I couldn't go on anymore"

Lisa was fortunate that by chance her guardian angel was watching the television and witnessed her ordeal being discussed on Breakfast television. Some people might not be so lucky in the future.

The events of Lisa's experience are one that should never have happened and involves Travel Companies in the UK offering budget Dentistry packaged up into a Holiday. Well this is one holiday experience that Lisa and her partner wished they had never booked.

There is an ever increasing demand for NHS dentists and it is quite apparent that the NHS insists on fixing the situation with a simple plaster to temporary heal the growing demand. The demand is driven by an ever increasing population and poor oral hygiene, with lack of basic influencing and education of our children and the public.

The NHS "fill it or extract it" syndrome, and when they are all gone plug the hole with dentures or a bridge, is not getting to the core problem which is that as a nation we simply just don't take care of our teeth. Our Dentists are pushed to their limits and the dental reform has only put higher targets onto our already stretched NHS Dental bureaucratic system.

The old fashioned "I want to be seen today if at all possible" has been replaced by "will I get to see my dentist this month". The NHS dentist is driven by targets and protocol of paper work and the Euro political correctness which drives up the stress levels of dentists and their teams in practices across the country.

The cost of all this is that we as a nation are persisting with out of date dental procedures. These may be of a direct cost benefit to the NHS but at a real cost to the patients self esteem, not to mention the time consuming re-visits for badly fitting dentures and bridges.

Can our teeth take the 30 years learning curve while foreign Dental Package holidays are being promoted by the travel industry despite many instances of poor workmanship?

In terms of Manufacturing. Europe and the United States are counting the cost for not recognising many years ago that China was quickly becoming the workshop of the world. With ISO Quality systems to go around the world several times, China has lifted the stakes on the global market in a bid to shake off the "Made in China" image of a product. However, how many times do we read in the press of a huge malfunction of a Company's product that were made in China? This is only the tip of the iceberg and in a global Brand market Companies fight to protect their image and product reliability, so there will be a greater number of unreported incidents concerning quality issues from China. It's taken over thirty years but China are moving in the right direction and sometimes products have been so cheap that if they were faulty, then it was cheaper to sometimes just throw them away rather than correct them.

Well in human costs and especially teeth we can't just throw them away because they don't work correctly or don't meet with the correct performance or aesthetic qualities, because our teeth have nerves the pain levels from poor dental work can sometimes be worse than the initial dental pain that drove you so desperately to the dentist in the first place.

For nearly 20 years Lisa endured a NHS denture unit due to a moped accident which caused her to lose several of her teeth.

Slowly over the years that followed, the sight of her own teeth forced her to hide her mouth when talking or simply walking down the street. Lisa would avoid smiling at all costs and even when she met her new partner Mark it was several months before she acknowledged to him that she wore a denture and she would wait until he went to sleep before she removed it.

Lisa: No confidence with her teeth

In July this year, Lisa read an article in a magazine about going to Hungary for dental treatment at a fraction of the price it would cost in this Country. Lisa and her partner investigated the possibility and were reassured when the Company they were in contact with was featured on a national television programme.

The London based Travel Company were well supported by a web site and offered Hungarian Dental and full concierge travel arrangements with a comprehensive Guarantee.

The Managing Director of the Company personally contacted Lisa and Mark to discuss their requirements, and promote the services that his Company could offer, after liaison with his Hungarian dental colleagues.

Lisa was eventually quoted £3500 to carry out the work required in Hungary, Lisa and Mark were delighted and in marked contrast their enquiries with UK dentists were in excess of £17,000. They decided with the reassurance of the London Travel consultancy that they would proceed and book the course of treatment.

This would include the preparation of the existing teeth that she had left and a full 14 tooth new bridge, tooth whitening to the lower teeth and replacement of 5 black fillings to white fillings.

Excited at the prospect that something could be done to enable her to smile again, her family gave Lisa the money with their blessing and hoped that Lisa's smile could be restored.

On Sunday 12th August, Lisa and Mark flew from Stansted into Graz in Austria where they were met by a representative who drove them to Szombathely in Hungary.

At 9am the following day, the consultation began in a well established clinic 5 minutes from their Hotel.

Initially, they did a full x-ray of her mouth and then through an interpreter informed Lisa of the work that was going to be started that day.

During the following days Lisa was put through extremely intense and very exhausting long hours of dental work, sometimes having up to eight needles at a time to numb the pain.

Finally, when her new bridges were fitted and her existing teeth had been whitened, Lisa couldn't believe that she could smile again. She was re-assured by the Dentist that her acute pain was normal but would slowly disappear over a period of fourteen days.

On Sunday 19th August, Lisa and Mark flew back into Stansted and her whole family were so happy and excited for her.

Before Treatment

Lisa's concerns about the pain were intensifying and after the fourteen days were up Lisa visited her GP, who upon examination prescribed pain killers.

Their call to the Managing Director of the Travel Company informed them to carry on taking the pain killers and reassured Lisa that this was perfectly normal.

Over the course of the following weeks, Lisa and Mark telephoned the travel Company requesting to speak to the Managing Director. Eventually, he did call them back and promised to get her to a dental surgery for an X-RAY, although he did warn Lisa that she would be expected to pay for her own travel to and from Hungary. He also stated that there was a strong possibility that she would have to pay for any corrective work that the dentist in Hungary recommended.

Despite Lisa and Mark attempting to get this resolved through the Travel Company and their Guarantee on the Companies web site, eventually the Travel Company and its Managing Director ignored their telephone calls.

"The pain became too much and it was consuming mine and my families life.

It was unbearable and in my darkest moment I decided that the only way out of this pain was to take my life."

Mark had seen enough and took matters completely into his own hands and took Lisa to the A&E department at their local hospital because there was no out of hour's emergency Dental service available in their area.

The Hospital gave Lisa some more pain killers and advised her to seek the advice of a dentist at 9am the following morning.

Lisa could barely open her eye with the swelling and she looked like she had been subjected to a severe beating. When eventually a Dentist did agree to see her through the emergency programme currently in place by the NHS, they immediately took an X-RAY. This confirmed that the nerve had been killed on Lisa's front upper tooth due to the Hungarian dentist filing it down too much.

The Dentist advised that she had to drill a hole in the back of her gum to drain the puss from her face before septicaemia set in. When the drilling was complete, the dentist was alarmed at how long this had been allowed to carry on and informed Lisa that the Hungarian dentist or their UK representative should have recommended an immediate visit to a dentist for a full examination.

Eventually through many weeks of pain taking her to the brink of doing something very silly to end her life, Lisa had relief from the swelling and pain but this was only the beginning. To try and get the situation corrected, several dentists seemed to agree that the only way forward was for Lisa to have all of her teeth removed and a complete set of dentures fitted. This news sent Lisa into despair and through trying to improve her life; she could now potentially suffer from a greater set back that would affect her for the rest of her life.

In a desperate plight to get their story out to warn others of their nightmare, a national newspaper ran their story on a full page and within days Lisa and Mark were on Breakfast Television.

On 28th September 2007, Lisa and Mark attended Evolution and he gives his evaluation and plan of procedure to correct Lisa's teeth.

"I saw Lisa at our Implant Centre. On clinical assessment it was clear that the new bridge had altered her bite to the point that it was causing severe pain whenever she tried to chew her food. The bridge itself was made as a one piece linking all 14 teeth together. This made cleaning very difficult and was causing repeated gum infections despite cleaning. X rays showed that the facial swelling she had suffered had come from the upper left central incisor which had an acute abscess. The x rays also showed more than adequate bone for the placement of 4 implants; something she was advised was not possible and far less successful than bridgework. I removed the old bridge and placed 4 implants into the gaps and my technicians constructed a provisional bridge (which had a much more comfortable bite!) which we fitted at that visit. Lisa and Mark then drove back to Portsmouth that evening. They phoned the next day to tell us things felt much better.

Review on the 9th October 2007 indicated no problems with implant placement and situation stabilised.

Final fit on 24th October 2007 of a complete new upper smile without experiencing any problem.

Final review on 25th October 2007 minor bite balancing but I am happy to say she has no pain and the smile of her dreams!

General Concerns
After discussion with Lisa and her partner Mark, I expressed my reservations about her initial treatment on the grounds that:

Whilst I am delighted that Lisa is now happy with her smile, as a health professional I am dismayed that greater emphasis is not placed upon the dangers of
having work carried out abroad when all these
procedures are available in the United Kingdom and often at far lower prices than are quoted in the media.

On the 12th of November, Lisa and Mark attended Evolution to allow for the opportunity to have a final consultation with Lisa. I was there to witness and photograph Lisa conducting the acid test, biting into an apple and being able to chew it without any pain or feeling that she is conscious of her teeth. Belief, Beauty, Creation, Perfection is the ethos behind Evolution.

Lisa: Enjoying life and food

The images of how Lisa can confidently smile, enjoy and interact in life again is nothing short of miraculous. However the final words must come from Lisa.

"I was desperate to smile again and at times through my ordeal have experienced depths of my soul and levels of pain that nobody should ever be allowed to visit in our modern world. If Evolution hadn't contacted us and so generously and confidently set out a plan to correct my personal plight, I would have been pushed down the route of dentures and a life of misery. I cannot thank the clinical teams at Evolution enough. My life is as complete as I could wish and Mark and I have made plans to marry in September 2008. I just hope that my story being highlighted stops this situation re-occurring."