sedation dentistry Archives - Atlanta Dental Implants

I Have a Bump Behind my Tooth

Posted on August 21, 2020 by writeradmin.

I periodically get a bump behind my front tooth. Usually, they go away, but this one has been here for over a two days. Is this nothing to worry about or should I get it seen? My dentist didn’t mention anything last visit, but I’ve never had a bump stay this long before.

Dalton

Dalton,

If I were your dentist, the first thing I’d be looking for is gum disease. What you’ve described sounds like a pimple on your gums which can be an abscess. This is an infection. It can be an infection on your gums from gum disease or one spilling out from an infected tooth.

Sadly, some dentists, more than I care to admit, don’t screen for gum disease. That is the first thing I’d check. If it turns out you are showing signs, I would request a referral to a periodontist. These are gum disease specialists. Often this can sneak up on patients because the signs are invisible at first. If it is allowed to progress too far, it can advance enough that your adult teeth start to come loose. A periodontist can get your gums healthy much faster than a traditional dentist.

If it is a tooth infection, which means decay reached the pulp of your teeth, then the appropriate treatment is to have a root canal done. This cleans all the infected pulp out of the tooth. Often it requires a dental crown as well because the tooth becomes brittle.

Some patients are intimidated by having their gums worked on. This is especially true during gum disease because their gums are tender. If you have any concern or anxiety about this, you can always visit a periodontist who offers dental sedation options. This won’t knock you out, but does completely relax you and you will have a pain-free appointment.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Is It Better to Get Screw-Retained Implant Crowns?

Posted on March 26, 2019 by writeradmin.

I’ve had a consultation with a few dentists for dental implants. One them explained that he only placed screw-retained crowns with his dental implants and that is why he has a higher rate than his colleagues in successful dental implant cases. I haven’t found a way to verify that, so could you help me understand the differences in the types of implant crowns and whether they make a difference?

Casey

Dear Casey,

Dental implant illustration with three phases

Generally, there are two ways of bonding on a dental crown to dental implants. The first bonds it on with cement. The second is the screw-retained crowns one of your potential dentists mentioned.

Cemented Crowns to Dental Implants

As its name implies, this type of crown uses cement to bond it on. The biggest problem with this type of crown is the potential for infection. No matter how careful a dentist is, some of the cement will seep out. They then use handtools to remove the remainder of cement.

However, if any gets left, at best it will irritate your gums and trap bacteria. At worst, it will flare up an infection leading to dental implant failure.

Screw-Retained Crowns for Dental Implants

There are two big advantages to using a screw-retained crown for your dental implants. The biggest is it avoids the cement, which as you’ve learned can cause some complications.

The second advantage is if the crown ever needs to be replaced. It is much easier to unscrew a porcelain crown and place a new one than it is to replace a crown which has been cemented in.

You should be aware there are times a screw-retained crown isn’t possible. It takes longer to place these and some patients just aren’t able to keep their mouths open that long. However, using dental sedation can eliminate this problem, allowing the patient to sleep through the procedure.

Another reason is if the placement of the dental implant won’t allow for it due to aesthetic reasons.

The key to a successful dental implant procedure is the training and experience of the dentist. Focus on that rather than the type of crown. For instance, look at Dr. Pumphrey’s dental implant training to get an idea of what type of dentist you’re looking for.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Can a Twenty Something Get All-on-4 Dental Implants?

Posted on January 21, 2019 by writeradmin.

I’m 24 and have a horrible time with my teeth. I was never taken to the dentist as a child. Now my mouth is a mess and I need a ton of work. I’m always in pain. I’m considering just getting rid of the teeth and doing this procedure I just read about called all-on-4 dental implants. Is this something which will work for someone my age? It sounds better than dentures.

Banner

Dear Banner,

I’m very sorry you are in so much pain. I have loved ones who live with chronic pain for other conditions, so I know how distracting and discouraging that feels. All-on-four dental implants are better than dentures, of course, but won’t be the best solution for someone at your age.

If you need a lot of dental work, you may also have some gum disease present. If that’s the case, you wouldn’t be a candidate for this procedure anyway. As gum disease progresses, it will cause you to lose teeth. If your body can’t sustain your teeth, it can’t sustain your implants either.

In that situation, what do you do? Ideally, you’ll want to save as many teeth as possible. You’d start by getting your gum disease treated. That will likely take care of a lot of the problems on its own.

When You Need a Lot of Work and Dread the Dentist

You are in a position not of your own making. One thing which helps when you need so much work is to try sedation dentistry. You just take a simple pill and you are completely relaxed. Most patients are so relaxed they sleep through the entire procedure.

The additional benefit is your dentist will be able to get a LOT more work done in one sitting. This means you could be back to a completely healthy mouth in less time than you’d expect.

This blog is brought to you by Atlanta Periodontist Dr. David PUmphrey.

The Three Levels of Sedation Dentistry

Posted on January 28, 2018 by AllSmiles.

My mother is in her late 60s and is very fearful of the dentist, but she has some work she absolutely needs to have done soon. Her dentist told her that provides three levels of sedation dentistry and that she doesn’t need to fear or worry. I’m trying to help her understand exactly what she can expect, but I don’t know enough to really give a clear explanation. Can you explain what those three levels entail and what she can expect?

Craig, Atlanta

Hi Craig,

Sedation dentistry is a great way to help people overcome their anxiety, so they can receive the dental care they need. If your mother has ever had a traumatic experience at the dentist, or if she is one of the people who have a hard time getting numb with novocaine, sedation can probably help. Let’s take a look at the three levels of sedation your dentist talked about.

Sedation Level I: Nitrous Oxide

You have probably heard of the phrase “laughing gas,” but you may not know that it refers to nitrous oxide. This is a sedative gas that is breathed in through your nose while the dentist is working on your teeth. You can see an example of this nose mask in the image above: it covers just the nose, leaving the mouth free for the procedure. The gas produces a mildly euphoric state that can help you relax completely while remaining awake and aware. And for many patients who have a harder time getting completely numb, it can increase the effectiveness of novocaine, making dental care a much less frightening experience. And once the procedure is done and the nitrous oxide stops flowing, your mom will be ready to go about her daily life activities, including driving, because there are no after-effects of the gas.

Sedation Level II: Oral Sedation

There are people for whom nitrous doesn’t work, so the second level of sedation is offered. This is called oral sedation. If your mom is really scared, her dentist can give her a pill to take about a half hour before her appointment. This will require that she has someone to drive her to and from her office visit because she will be in too relaxed a state to drive. This pill will help reduce anxiety and produce a deeper feeling of relaxation. Again, even though the patient will feel very calm, she will be completely awake and aware of what is going on, but may not remember the procedure afterward.

Sedation Level III: IV Sedation

Finally, for people who experience a sense of extreme anxiety or fear, intravenous or IV sedation is available. This kind of sedative will place the patient in a very dreamy state, in which she won’t really care about what is taking place around her. While she will be awake enough to respond to requests from the dentist, she will likely not remember the procedure at all afterward. And this level will again require that someone drive her to and from her appointment because the effects can last for a while.

Whatever level of sedation your mom eventually chooses, you can help her understand that she is not likely to have another traumatic experience. Perhaps she can look forward to a lifetime of great dental care from here on.

Good luck to you and your mom in finding the dental health to improve your life.

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

Can sedation dentistry help me with my dental fear?

Posted on November 14, 2017 by AllSmiles.

I am afraid to go to the dentist, and I’m wondering if sedation dentistry might help me. When I was about ten years old, I had to have oral surgery. It was a pretty traumatic experience because the dentist started operating before I was numb, and when I reacted to the pain, he just said, “What’s wrong?” When I told him he was hurting me, he basically told me I was imagining things. Ever since then, I have been really afraid. Even thinking about it makes me queasy. But I’ve made a resolution that this year I will find a way to get my dental health back. I’ve heard that sedation can really help people like me. Do you think it would be enough?

Jennifer, Florida

Hi Jennifer,

Good for you for reaching out. It takes a lot of courage, as you said, to overcome dental fear enough to even ask about sedation dentistry. But your resolution is going to go a long way to helping you overcome your fear. Once you’ve decided that you no longer have to live with the consequences of someone else’s mistake and are willing to reach out for help, you’re more than half way there.

Overview of Sedation Dentistry

To answer your question in a word, yes. Sedation dentistry and a calm, gentle, and understanding dentist can help, and both are probably equally important. Some people, and you sound like you may be one of them, simply don’t get completely numb with novocaine alone. And the important thing to understand about that is that sometimes sedation can change that. Many patients who don’t get numb with novocaine alone have no trouble if they have nitrous oxide or oral sedation, and for patients whose fear is extreme, IV sedation can remove all anxiety along with any memory of the procedure. So let’s take a look at these three types of sedation.

Nitrous Oxide

Nitrous oxide is a sedative that is breathed in along with oxygen through your nose. It’s often been called “laughing gas” because it produces a very nice relaxed state that can ease any anxiety and help novocaine work more effectively. The great thing about novocaine is that once you stop breathing it, the effects are gone immediately, so you can drive and return to work or other activities quickly.

Oral Sedation

If nitrous oxide doesn’t work well enough for you, oral sedation might. Oral sedation is a pill that you will take about a half hour before your procedure. This is usually a common medication that will give you a deeper sense of relaxation and ease. Many people experience it as a feeling of not caring about anything, and with this type of sedation, you may or may not even remember your time in the dentist’s chair. You will, however, need someone to drive you home afterwards, because you will be too relaxed drive safely.

IV Sedation

IV sedation causes a more profoundly relaxed state, almost like sleep. You will be awake and aware enough to respond to requests to open your mouth, etc., but you will likely not remember anything about the procedure. Again, with this type of sedation, you will need someone to drive you home after your appointment.

Many dentists offer a complimentary consultation for patients who are fearful or who are looking for more extensive work. It’s a great idea to take advantage of this opportunity to speak with a dentist before you decide to have a complete exam. If the dentist is a sedation dentist, it is much more likely that he or she will understand what you need to overcome your fear and begin to enjoy the benefits of regular dental care.

Best of luck to you in finding the right dentist to help you.

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

Is bone grafting dangerous? It sounds terrible!

Posted on October 5, 2017 by AllSmiles.

I’m facing bone grafting, and I think it sounds like a terrible ordeal to go through. I have three missing teeth on the lower left side of my mouth, and my dentist wants to to do a bone graft before he places dental implants. I had a bridge there for a lot of years, but it finally broke, and after what I learned about implants, I decided to go that way.

My dentist said I lost bone from my jaw while I had the bridge there and that bone grafting will make that part of my jawbone strong enough to support the implants. But bone grafting just seems like it would be too much for me. My wife laughs at me because I’m so afraid, and I think I could handle the implant surgery, just not the bone grafting part.

John in Georgia

Hello John,

It can be scary to approach a procedure when it sounds strange and unfamiliar. Once you understand more about bone grafting, you’ll probably feel as comfortable with the procedure as you seem to feel with the surgery to place the dental implants.

Let’s start by talking about what a bone graft is, and then we can explore some facts that could make it even easier for you to face. It’s true that we lose bone density when we lose a tooth. Without the tooth root there to signal the body that the the jawbone is needed to support that particular tooth, the body absorbs, or resorbs, as the process is called, the minerals for use elsewhere in the body. So it’s no surprise that you have had some bone loss if you’ve been without those three teeth for many years. The good news it that with bone grafting and dental implants, your bone loss will not grow worse over the years.

The bone used in the grafting procedure can sometimes be taken from your own jaw, and it can also be obtained from a tissue bank, but the most important point to remember is that the grafting materials that are used these days a safe and effective.

The procedure, as rough as it may sound, is minimally invasive. That’s because advanced technology enables something called guided tissue regeneration. This happens because your body recognizes the grafting material as natural bone, and during the healing process, it will bring more bone-building minerals to the site and actually replace the graft with your own bone materials.

And finally, you may not have heard about sedation dentistry. Something as simple as nitrous oxide works to help many patients relax and experience less stress, but if you are really fearful, a good sedation dentist can make sure that you don’t remember your procedure. With the right kind of sedation, you can be aware enough to respond to requests during treatment, but the whole process can be forgotten.

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