Richard’s Journey to a Confident Smile with Dental Implants

How Carolinas Center for Oral & Facial Surgery and Envision Dental Implant Center Helped Him Overcome Ectodermal Dysplasia

For Richard, dental challenges were part of life from the very beginning. A rare genetic condition meant missing teeth, long-term dental prosthetics, and years of adapting to limitations most people never have to consider.

Richard lives in York, South Carolina, and was born with ectodermal dysplasia, a genetic condition that affects the development of hair, fingernails, sweat glands, and teeth. In his case, many of his permanent adult teeth never developed, and those that did were misshapen and difficult to maintain.

Growing Up with Missing Teeth

While other children watched their adult teeth come in, Richard’s dental development followed a very different path. By his mid-teens, he had already undergone years of orthodontic treatment and received a permanent bridge across his upper teeth.

That bridge, placed when he was just 16, lasted more than two decades. Over time, it became increasingly difficult to manage. Decay developed around the bridge, his gums receded, and chewing grew more uncomfortable. He found himself relying on one side of his mouth and avoiding certain foods entirely.

The emotional impact was just as significant.

“I didn’t want to smile in pictures,” Richard shares. “If I did, I’d smile without showing my teeth.”

Moments that should have felt natural, such as meeting new people, taking family photos, or attending social gatherings, often carried an added layer of self-consciousness.

Searching for Answers

As the years passed, Richard continued searching for solutions. He partnered with the National Foundation for Ectodermal Dysplasia, consulted with different dental providers, and even traveled out of state for consultations. Each time, the recommendation was familiar: replace the existing bridge with another temporary solution that still fell outside his financial reach.

A turning point came when Richard carefully reviewed his medical insurance policy and discovered that dental treatment related to a genetic condition could be covered under medical insurance. That realization led to a referral and ultimately to Dr. Hunter Dawson at Envision Dental Implant Center in Charlotte.

An Implant Consultation That Changed Everything

From the first visit, the conversation focused on long-term stability rather than another temporary repair.

“The ride home after meeting Dr. Dawson was completely different,” Richard recalls. “It felt like I hit the jackpot.”

Dr. Hunter Dawson, a prosthodontist at Envision Dental Implant Center in Charlotte, NC, immediately recognized the complexity of Richard’s case and the need for comprehensive planning.

“Richard was missing a significant number of adult teeth and had decay around existing restorations,” Dr. Dawson explains. “He didn’t just need replacement teeth. He needed a comprehensive rehabilitation that restored function, esthetics, and long-term stability.”

That reassurance mattered.

Dr. Dawson developed the overall treatment plan and coordinated the next steps. However, before implants could be placed, the underlying bone deficiency needed to be addressed.

Why Envision Was the Right Fit

Envision’s multidisciplinary structure played a critical role in Richard’s care. Prosthodontists, oral and maxillofacial surgeons, and anesthesiology support work together in one location, allowing complex cases to be planned and delivered collaboratively.

“We are a multi-specialty practice,” Dr. Dawson says. “That collaboration allows us to treat complex conditions in a coordinated, thoughtful way.”

Dr. Dawson served as the architect of Richard’s treatment plan, working closely with Dr. Rick Kapitan, oral and maxillofacial surgeon at Carolinas Center for Oral & Facial Surgery in Charlotte, to build a stable foundation for lasting implant-supported restorations.

“Our goals are always the same,” Dr. Dawson explains. “The outcome must be esthetic, functional, and improve quality of life so patients don’t have to think about their teeth every day.”

Dr. Kapitan emphasizes that collaboration is especially important for patients with congenital conditions.

“It can be difficult for patients to fully understand what their total needs even are, much less who to seek the information and ultimate treatment from,” Dr. Kapitan explains. “By seeking care through a multispecialty team, patients receive coordinated expertise tailored to their individual condition.”

He adds, “Richard’s story is proof that the qualifications of a patient’s provider team can determine their treatment outcome.”

Coordinated Oral Surgery Care with Dr. Rick Kapitan

Because ectodermal dysplasia affects jaw development as well as tooth formation, Richard’s treatment required advanced surgical reconstruction before implants could be placed.

Dr. Rick Kapitan, oral and maxillofacial surgeon at Carolinas Center for Oral & Facial Surgery, specializes in complex bone grafting and implant surgery for patients with significant jaw deficiency. In cases like Richard’s, rebuilding the foundation is the first critical step toward long-term stability.

Ectodermal dysplasia often involves more than missing teeth. It can significantly impact jaw development due to the lack of normal tooth stimulation over time.

Dr. Kapitan explains: “Ectodermal Dysplasia is a genetic birth anomaly that affects hair, teeth, fingernails, and sweat gland development. One of the results of this condition is the absence of multiple primary and adult teeth. Since the presence of teeth stimulates bone growth in the jaws, patients with this condition often have only a fraction of the correct number of teeth and severely deficient bone in their jaws.”

In Richard’s case, decades without proper tooth development left him with insufficient bone to support implants without surgical reconstruction.

“The treatment that Richard needed involved staged surgery where we first reconstructed the missing bone in his jaws through various types of bone grafting, followed by the placement of implants where he was missing teeth,” Dr. Kapitan says.

Throughout this process, surgical planning and restorative design were closely coordinated.

“When we plan these cases together from the beginning, the surgical and restorative phases support each other,” Dr. Dawson explains. “That coordination is what allows us to deliver predictable, long-term results.”

Trust Built Over Time

Because Richard had been let down so many times before, trust mattered. From the earliest visits through each phase of treatment, the Envision team consistently followed through, addressing concerns promptly and making Richard feel supported at every step.

Over time, frequent visits turned into familiarity. Richard felt known by the team and confident that his care was a priority, reinforcing the sense that he was truly in the right place.

Dr. Kapitan notes that trust is especially important in staged surgical cases.

“Complex reconstruction requires patience and careful sequencing,” he says. “When patients understand the plan and see each phase building toward a long-term solution, it creates confidence in the process.”

A Life Changed by Confidence with Dental Implants

When treatment was complete, the changes were immediate and meaningful.

“My quality of life has changed drastically,” Richard shares. “I can smile in pictures. I can eat whatever I want. I don’t have that constant worry anymore.”

Foods he once avoided, like steak and ice cream, are now part of everyday life again. Even more impactful was the return of confidence, something his family noticed right away.

“For patients with severe bone deficiency, rebuilding the foundation properly makes all the difference,” Dr. Kapitan says. “When implants are placed in stable, reconstructed bone, we are restoring long-term function and stability.”

Dr. Dawson agrees. “Seeing patients regain comfort and confidence is why we do this,” he says. “It is about giving them back the ability to live without constantly thinking about their teeth.”

Looking Ahead and Giving Back

Ectodermal dysplasia runs in Richard’s family, and his daughter shares the same condition. That reality gave his journey even deeper meaning.

Going through the process himself allowed Richard to create a clearer path forward for his daughter. She has already been evaluated by Dr. Dawson, and Richard feels confident knowing her future care will be guided by a team he trusts.

“Knowing that this type of care can positively impact not just one patient, but an entire family, is incredibly rewarding,” Dr. Dawson says. “That is why we do what we do.”

Dr. Kapitan adds, “When we are able to provide a long-term surgical and restorative solution for someone born with a condition like this, the impact extends beyond the individual patient. It changes the trajectory for the entire family.”