Giving smile back included 23 appointments over two years

Giving Paula Lee her smile wasn’t a simple process.

First, she had to complete an application for the Give Back a Smile program, a national domestic violence program of the American Academy of Cosmetic Dentistry, or AACD, and the AACD Charitable Foundation.

After her application was approved, she was asked if she would be willing to travel to Anchorage for the work. Her heart sank; she didn’t want to do the commute, but she knew she “wanted my teeth done.”

Fortuitously, her Haven House advocate, Dan Lush, met Dr. David Nelson of NDI in Homer, who is a member of the AACD, and his wife, Luanne.

The Nelsons agreed to interview Lee. After the interview, Dr. Nelson volunteered to do the work, which involved 23 appointments over almost two years.

“It was like a higher power thing for me,” said Lee. “I just live 20 minutes away, so it was perfect.” 

Getting Lee her smile required:

•Six dental implants and subsequent restorations;

•Some bone grafting;

•28 crowns and/or veneers;

•18 composites;

•Vertical dimension correction and adjustments; and

•Tissue laser surgeries.

“This was a total reconstructive case,” said Nelson. “The patient presented with worn, missing (and) extremely compromised teeth, along with significant neuromuscular difficulties,” which meant her entire mouth had to be vertically realigned.

Because Lee had a small mouth, it made the work more difficult.

Still, considering all that needed to be done, it went smoothly and quickly, said Nelson.

Nelson donated his time, skills, laboratory materials, all surgeries, including the placement of six dental implants, impression materials and temporary crowns and veneers. A dental lab donated permanent crowns and veneers. An implant company donated three of the dental implant parts and necessary hardware.

The final cost, including post-op visits and ongoing radiographs, was nearly $70,000.

“It changed her life tremendously,” said Lush. “The Nelsons deserve a tremendous amount of credit for being willing do that much pro bono work. They’re very big hearted.”

For their part, the Nelsons agreed to become involved not only because of the thorough vetting the Give Back a Smile program gives applicants, but also because of something they saw in Lee.

“These are people who have made a commitment to getting better,” said Dr. Nelson of applicants approved for the program. “And Paula’s a giver. She was not going to return her abuser. She was going to have a better life.”

After every appointment, Lee always had one question: “When should I show up next?” said Luanne Nelson. “There was never any doubt of her commitment not just to have her teeth fixed, but to embrace life.” The Nelsons and Lee have developed a friendship as a result of the Give Back A Smile program.

“Luanne is like a case manager. She’s a loving mother hen. Dave’s got a dad’s hand. They’re just wonderful. I feel like I’ve been totally cradled here,” said Lee.

The babying she received helped her through appointments that sometimes lasted four to five hours.

“I hated dentists. I used to be so terrified, because I hate shots and I hate that grinding noise. I was scared to start this whole process, but my mouth was so ugly that it was time to do something.”

The big, warm blanket that she was covered with at each visit lessened her anxiety, as did Dr. Nelson’s step-by-step explanations.

“I didn’t feel like another number. For a person, who cannot afford dentists, that’s always a big, huge weight, too,” said Lee. “I got none of that here. … I’m so grateful.”

The Nelsons, in turn, have been charmed by what they describe as Lee’s twinkle and spirit.

“She’s been an angel to us,” said Luanne Nelson. “She’ll walk in and just spread joy.” Often that includes sharing what she has — a bucket of blueberries or fresh fish.

Like Lee, the Nelsons want others in domestic abuse situations to know there’s hope: “There is hope for reconstruction and rehabilitation and there’s joy in the privilege of giving someone back their smile and their twinkle. … What happened here is so much more than just putting teeth back.” 

Before opening his Homer practice in 2007, Dr. Nelson was a clinical adjunct professor for 27 years at Marquette University School of Dentistry and also was in private practice.

Lori Evans can be reached at