Archives for August 2017

I’ve been turned down for dental implants. Does this make sense?

Posted on August 29, 2017 by AllSmiles.

I lost two of my lower molars to a very bad infection when I was younger. The dentist I had at that time made a bridge for me, and for years, that worked fine. I’m 55 now, and I decided I’d like to get implants instead because my friend got one and he loves it. But when I went to my current dentist, she said I’m not a candidate for dental implants. How can that be? When I asked her why, she said my health is not good enough. But I’m in good health. Do you think I should ask a different dentist?

Carl B.
Macon, Georgia

Hello Carl,

It’s hard to nail this down without more specific information about what your dentist meant when she said your health isn’t good enough, but let’s explore the types of health conditions that could be a barrier to successful dental implant treatment. Then we’ll take a look at low bone density and the reason some dentists don’t feel comfortable providing the treatment.

If your health really is the problem here, it will most likely fall into one or more of the following categories. Diseases of a chronic nature, like diabetes, immune-deficiency disorders, and hemophilia would make getting implants a high-risk proposition for you, mainly because there would be a higher probability of developing an infection around the tooth root form that is implanted into your jaw. Smoking also makes implant failure more likely. In fact the evidence shows that smokers experience dental implant failure at more than double the rate of non-smokers. Alcohol and other substance abuse also increase risk because associated health problems can jeopardize treatment and make it less likely that the follow-up care instructions can be followed. And it is not a good idea to get dental implants during pregnancy.

We’ll rule this last one out unless you forgot to add a final “a” to your name, Carl. If any of these conditions are present, you may well have your answer. However there are also two other areas we’ll explore, just to be thorough.

The jawbone under the two teeth you lost when you were younger is bound to be thinner because our body absorbs bone-building minerals from the jaw in the location of lost teeth. It is possible that your dentist felt that your bone density was too low, but we have to assume she would have said so if that were the case. And bone grafting is a standard treatment when the bone has thinned.

All that being said, it’s possible that your dentist doesn’t have the skill set required to provide dental implant treatment. Until recently, these skills and techniques were not taught in dental schools, and it takes years of postdoctoral training and experience to reliably provide dental implants.

You might talk to you current dentist to clarify her reasoning, and if she isn’t able to provide an answer that helps you understand, it would probably be a good idea to seek a second opinion. Perhaps you could seek out someone who specializes in dental implants.

In the mean time, there’s some great information beyond what we were able to explore in this post at Pumphrey Periodontics’ page entitled Am I a Candidate for Dental Implants?

This Blog is brought to you by Dr. David Pumphrey of Pumphrey Periodontics in Atlanta.

Dental implants seem too good to be true. What’s the catch?

Posted on August 16, 2017 by AllSmiles.

Hi there, I was playing softball with my team last night, and one of my teeth got knocked out. I heard you were supposed to look for it and take it to the dentist right away, but we couldn’t find it. We even went back this morning and looked when it was light out, but no tooth. I was wondering does that mean I have to wear a fake tooth for the rest of my life? Someone said I could get a dental implant and that it would be just like getting my old tooth back, but is that really true? I really thought the only way to not have to hassle about it was if I found my old tooth.

Thanks for your time here.
Jean K.
Atlanta

Hi Jean,

Sorry to hear that you lost your tooth, but that doesn’t mean you’ll be “hassling” with a fake tooth for life! Dental implants are, in fact, very like having a natural tooth. And an implant is not your only option. So let’s take a look at the pros and cons of dental implants and bridges.

Dental implants are titanium or ceramic root forms that are surgically placed into your jawbone. As they heal, the body deposits more bone-building minerals around the forms, actually making them a part of the jawbone. Once this process is complete, a lifelike crown will be attached to the root form. You can see the parts of a dental implant in the diagram to the left.

Dental Implants

In a couple of important ways, an implant mimics a natural tooth. First, the dental implant will look, feel, and function just like your other teeth. And second, because it replaces more than just the crown, a dental implant prevents the bone loss that always accompanies the loss of a tooth.

This bone loss happens because the body senses that the tooth is no longer there, and it begins to absorb the bone-building minerals that supported that tooth for use elsewhere in the body. That is why dental implants are becoming a standard treatment for lost teeth. However, dental implants involve more cost and healing time than dental bridges. Click here to read Pumphrey Periodontics’ page on the Benefits of Dental Implants.

In addition, dental implantology is not something most dentists studied in dental school, so it is very important to seek out a dentist or periodontist who has the requisite training and experience to place an implant for you. This is not the type of treatment you want to cut corners on, and the consequences seeking out cheap implants can be severe.

If you choose to have a dental bridge, the two teeth on either side of the gap will be prepared to receive crowns. This involves removing some of the surface of the tooth while leaving a solid structure to support the crown. Then a set of three crowns will be prepared, and the two outer ones will be fused to the one replacing the lost tooth. The drawing to the left illustrates what the bridge looks like and how the two outer teeth are prepared.

As you can see, the downside of choosing a bridge is that it requires the two nearest teeth to be altered in order to support the middle one, and if those two teeth are healthy, you may not want to do that. But a bridge will usually cost less than a dental implant. In addition, the skills for this type of treatment are taught as part of the curriculum in dental schools, so just about any dentist should be able to provide the service.

And finally, both treatments will provide a long-lasting, lifelike solution that nobody will be able to detect. Your dentist can help you decide which treatment option is best in your particular situation. But either way, you won’t be in for life-long hassles.

Here’s to a solution that will really work for you.

This blog is brought to you by Dr. David Pumphrey of Pumphrey Periodontics in Atlanta.

Putting my teeth back in with crazy glue

Posted on August 5, 2017 by iowasmiles.

“Bout 3 months ago my teeth just starting falling out root and all the whole tooth. I been using crazy glue but it is starting to mess up the inside of my mouth and it hurts all the time the crazy glue is killing me cause when I’m inhaling it but I have to leave the house and I want let people see me with out teeth but I only go out when I have to I have no life I stay home out the times I don’t date I want go out with friends please help me.”
– (we’re not posting a name with this question)

Unfortunately, we don’t think we have a good answer for this poor woman. There is an answer, but we don’t think she’s going to like it. We’re writing this blog post because we think it’s interesting what she has tried to do.

First we want to comment on the severity of her gum disease and the hopelessness of trying to get these teeth to stay in, even with crazy glue or superglue. We have seen gum disease so bad that the teeth fall out spontaneously, and to be that bad the teeth already have to be dangling somewhat from the root. Here is a photograph of the teeth of a patient with advanced periodontal disease. As bad as this is, it’s not nearly the stage of periodontitis that this woman is experiencing.

This patient’s lower four incisors are getting close to being loose enough to fall out, but they’re not that bad yet. Imagine a little more of the root showing–this is what this woman had.

Putting them back in with crazy glue or superglue? These glues have cyanoacryate, which is is an excellent soft tissue adhesive, but it would only hold for a day or two, maximum, we’re imagining from our experience with it. And the teeth would still flop around.

Our guess is that it’s been a number of years since this woman visited a dentist.

She needs a dentist badly now, and our guess is that none of the teeth are saveable at this point. She needs removable dentures or dental implants.

I’m facing gum surgery, and I’m terrified.

Posted on August 4, 2017 by AllSmiles.

My parents both had gum disease, so I know what it looks like. I’ve been afraid to go to the dentist for many years, but I know if I do, they’re going to operate because I have the family problem. My mom had gum surgery when I was young, and I remember how painful it was. She was in pain for days. Now I’m facing the same thing. Aren’t there better painkillers now?

Theresa V.
Atlanta

Hi Theresa,
It sounds like your mom had a very bad experience with both gum disease and gum surgery, and that may have contributed to your being afraid and avoiding the dentist. That’s unfortunate, but there’s a very bright side here. Your fear may have kept you away, but during your absence, there have been a lot of advances in the way gum disease is diagnosed and treated. None of them include the kind of pain your mom experienced.

It can be hard to overcome long-lasting fear, but you may be pleasantly surprised. Instead of assuming you need gum surgery, if you allow a qualified periodontist to examine your teeth, you may find out that your dental condition is easily treatable without surgery.

Healthy Gums vs. Periodontal Disease

Let’s break things down a little here. Sometimes straightforward information can be the best prescription for fear and avoidance. To begin with, periodontal disease is caused by plaque and tartar that attach to the tooth root below the gumline where brushing and flossing can’t reach. These pockets of plaque and tartar cause inflammation, which damages the bone structure that keeps our teeth stable. The drawing above shows this process.

Even diagnosing the extent of the inflammation and damage used to be fairly difficult. But a new, high-tech camera, called a perioscope, now allows the periodontist to see how far the damage extends. In addition, the laser technology that uses both heat and water to eliminate pain now enables non-surgical gum treatment to smooth the tooth root and remove bacterial toxins. This procedure is called scaling and root planing, and it does not require incisions, sutures, or a long healing process. In essence, it is a deep cleaning that can be accomplished in one or more appointments, leaving healthy tissue intact.

Here’s hoping you find a solution to your fear and your dental condition soon!

This Blog is brought to you by Dr. David Pumphrey of Pumphrey Periodontics in Atlanta.