Case Study
Cost-Conscious
Complex Care
Effective solutions achieved on a limited budget through phased, minimally invasive treatment
Patient presentation
The patient had not seen a dentist in over a decade and was seeking options to avoid full dentures. Two other clinics had advised her to remove all her remaining teeth for All-on-X implants or full dentures—plans she found both unaffordable and unappealing.
At her initial appointment, she appeared visibly anxious and distressed, even shaking in the waiting room. She reported significant social isolation, noting that her daughter and grandson were the only people she interacted with without wearing a mask. Clinically, her oral health was severely compromised, with advanced periodontal disease, multiple teeth with poor prognosis, and a history of heavy smoking, approximately 15 cigarettes per day.
Clinical challenges
Financial constraints: The patient had a very limited budget, requiring a cost-conscious, phased approach to a complex dental case.
Advanced periodontal disease: Severe gum issues increased the risk of further tooth loss and made restorative planning more challenging.
Behavioral factors: Heavy smoking posed a higher risk for healing complications and could affect the long-term success of restorative treatments.
Emotional and psychological barriers: High levels of anxiety and stress required careful communication and a patient-centred approach throughout care.
Treatment plan
The treatment focused on restoring oral function and aesthetics while stabilising periodontal health, all within the patient’s limited budget. Key interventions included:
Comprehensive scaling and root planing were performed to reduce infection risk, improve gum health, and create a stable foundation for restorative treatments.
Teeth with poor prognosis were removed to protect the remaining dentition and support future prosthetic planning.
Functional teeth were restored using minimally invasive, cost-effective 3D-printed crowns, providing immediate improvement without extensive procedures.
These temporary dentures offered instant functional and aesthetic restoration after extractions, allowing the patient to eat, speak, and smile comfortably while the mouth healed before definitive dentures were fabricated.
Special considerations
Dr Scott provided a large portion of this treatment pro bono, with the understanding that the patient would follow hygiene instructions closely and make significant reductions in smoking. This collaborative approach aimed to support the patient’s journey toward better oral health while minimising further risks, allowing her to take meaningful steps toward restoring function and comfort.
- The patient adhered closely to hygiene instructions and successfully reduced her smoking from 15 to 2–3 cigarettes per day.
- She now attends appointments with greater ease, engaging comfortably with clinic staff.
- Functional and aesthetic improvements were achieved within her limited budget, showing that even complex cases can be managed effectively with thoughtful planning and a phased approach.
- Definitive dentures may be required in the future, depending on the progression of the patient’s periodontal health.
- Ongoing follow-ups and strict adherence to oral hygiene protocols will help preserve the current restorations and protect the remaining natural teeth, supporting long-term oral health.
Turning challenges into smiles
This case demonstrates how thoughtful, patient-focused care can transform even the most complex dental situations on a limited budget. Through careful planning, strict adherence to hygiene instructions, and phased treatment, meaningful improvements in oral function and appearance are achievable while keeping future options open for ongoing care.