Archives for September 2017

Sinus lift for Dental Implant?

Posted on September 27, 2017 by AllSmiles.

Last year, I was involved in a bicycle accident. Although I was wearing my helmet, I did hit my cheek against a curb, and one of my upper teeth was knocked out. I had other, more serious injuries, so the paramedics didn’t notice that the tooth was gone until it was too late to try to find it.

I’ve fully recovered now, and I feel like I have the energy to get my tooth replaced. I have done a bit of research online, and I have decided that I’d rather get a dental implant than a bridge, because the two teeth on either side of my lost one are in perfect shape. I also looked at who the best dentist might be, and I thought I had chosen a good one.

I went in for my initial exam, and my dentist did a 3D CT scan, and then told me that we’d need to do a sinus lift procedure before we could place the implant. I’m wondering if you can help me figure out what is going on here. I don’t mean to seem impatient, but I feel like this is just another procedure I have to go through, and I’ve never even heard of it before. I’m thinking about just getting a new dentist at this point because I want my life back. Do you think I should just go with a bridge instead?

Jacob in Florida

Hi Jacob,

It’s good that you’re asking about the sinus lift procedure, and it’s completely understandable that you would want to get your life back after what seems like a long healing process. The good news here is that from what you said about your dentist, you are probably in capable hands. Of course it is not possible to know without checking her credentials, but from what you say about her process, it seems you’re on the right track. So you don’t need to worry about starting from scratch or going with a choice you didn’t really want in the first place.

The dental implant procedure is a very precise diagnostic and treatment set. Your dentist needs to know exactly how much bone there is present at the implant site. In addition, there are blood vessels and nerve fibers to avoid. And with an upper implant, because the bone that separates the mouth from the sinus cavity is usually pretty thin, she needs to ensure both that there is enough bone present to securely anchor the implant and that the implant doesn’t impinge on the sinus cavity.

The only way to visualize all these structures is with the use of three-dimensional computer tomography, or the 3D CT scan you mentioned. This technology allows your dentist to see that, as in your case, there may not be enough bone between the teeth and the sinus. If your dentist was trying to rely on a two-dimensional x-ray to complete her digital implant planning, it could be a signal that she is taking shortcuts that can lead to implant failure.

The sinus lift she is recommending doesn’t just lift up the sinus cavity, it includes a bone graft to develop more bone material, so your implant will be fully supported. During a surgical procedure, the sinus membrane will be moved up so a bone graft can be placed on top of your available bone. During the healing process, your body will integrate the new bone material by bring more bone-building minerals to the site, and within a few months, you’ll be ready to receive your dental implant.

Again, it is understandable that you may want a shorter process, but it sounds like you made your choice to go with a dental implant vs. a bridge based on good information. Here’s to a good solution that will help you heal even further.

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

Thrush or oral yeast infection

Posted on September 15, 2017 by AllSmiles.

About a month ago, I had an infection in my gums around two lower front teeth. I went to the dentist, and she told me it wasn’t serious. She examined my teeth and took x-rays, and then she told her hygienist to be extra careful with my cleaning.

For follow-up care, she recommended that I rinse my mouth with hydrogen peroxide twice a day, and let her know if it didn’t clear up. I’ve been following her advice, and the infection has cleared up just fine, but I’ve been in pain for about a week now. My mouth and cheeks and gums feel sore, and there are white patches on my cheeks and tongue.

When I showed my girlfriend last night, she said she thought it was an oral yeast infection and she mentioned something about thrush. I’ve never heard of a yeast infection in your mouth, and I thought a thrush was some kind of bird! Can you help me?

Joshua T., Atlanta

Hi there Joshua,
Absolutely! We can clear things up for you, both literally and figuratively. While a thrush is indeed a kind of song bird, thrush is also the term for an oral yeast infection, often called candidiasis. And as you have noted, it can be quite painful.

Basically, we have a number of species of small organisms living in our mouths all the time. Bacteria are one type, and Candida Albicans, a type of yeast, is another. Normally, the bacteria will keep the yeast in balance, but if something disrupts that balance, an overgrowth of yeast will result.

More than likely, your instructions for using the hydrogen peroxide rinse included a two-week cutoff, and you may have just missed this detail. While the rinse is great for short-term use, killing many strains of bacteria, it is so good at its job that after about two weeks, it will kill off too many bacteria, leaving the yeast to proliferate and cause problems.

You can make sure by scraping away one of those white patches. If you have thrush, you’ll be able to rub it off and the tissue underneath will be red and inflamed. Your dentist will most likely help you resolve your infection with the help of an anti-fungal agent, such as Nystatin. And you don’t have to worry in the meantime, because this type of infection is not contagious.

Thrush, the oral yeast infection

A thrush, the songbird.

The illustrations to the left and the right will enable you to see what an oral yeast infection looks like. More importantly, they will provide a clear distinction between thrush and a thrush and hopefully brighten up your day while you are calling your dentist. The photo on the left shows the characteristic white patches of oral candidiasis, while the one on the right shows the characteristic spotted breast and belly of the songbird.

There are certain populations that are more susceptible to these types of infections. Infants have not yet established the full spectrum of oral bacteria. Undernourished people often lack essential nutrients, leading to thrush. Denture wearers who do not take their dentures out can unintentionally foster yeast growth beneath the dental appliances. And finally, people with compromised immune systems are usually more susceptible.

You can find out more about different types of oral infections on Pumphrey Periodontics’ Gum Disease page.

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

What’s that gritty yellow stuff around my teeth? Dental tartar buildup.

Posted on September 4, 2017 by AllSmiles.

I grew up in a family that, I guess, didn’t really pay too much attention to teeth. I just found out I have to floss and brush my teeth, so I started flossing about a month ago. I have noticed that when I am flossing, sometimes pieces of my teeth seem to crack off. My teeth are nice and white and smooth except nearer the gums, where they’re yellower and not so smooth. It’s these lower parts of the teeth that sometimes crack off when I am flossing. My teeth don’t hurt when this happens, and I don’t have any other pain. Do you think I need to go to the dentist?

Jolene, Atlanta

Hi there Jolene,
Yes. You do need to see a dentist, and it would be a good idea to go as soon as you can. You don’t need an emergency appointment, but I would try to get an appointment as quickly as you can. What you are describing as the lower parts of your teeth is actually dental tartar that has built up.

When we eat, food particles and sugars mix with saliva and create a sticky substance called plaque that clings to our teeth. When we don’t brush and floss regularly, this plaque can harden into tartar, which can only be completely removed by a dental hygienist during a dental cleaning.

Moderate Dental Tartar

Dental Tartar Buildup

These illustrations will help you better understand tartar. On the left is a drawing of a moderate amount of tarter on the teeth. The dental hygienist scrapes this away with special instruments to leave the enamel clean. The photo to the right shows a more severe buildup of tartar. It may look familiar to you.

Even though you don’t have any other type of dental pain, the tartar that has built up on the lower parts of your teeth may have already caused a certain level of gum disease. If it is not removed, it can lead to other, more serious problems. You didn’t say how old you are, but tarter starts to build up when we are in our twenties.

It sounds like you haven’t had much education regarding the care of your teeth, but once your dentist has resolved this issue, you should plan on returning every six months. That way, as problems arise, they will be found quickly and treated early, when treatment is most effective and inexpensive.

Don’t feel bad, though. The good news is that once you have your teeth checked by a dentist and the tartar is removed, you don’t ever have to have yellow tartar in your mouth again. And you may be amazed by how beautiful your smile is when the cleaning reveals your “real” teeth!

Find out more about how lack of dental hygiene contributes to periodontal disease by reading Pumphrey Periodontals’ page entitled Bleeding Gums.

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