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Educating Patients on their Oral Health Options

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Dentist Sandy Springs: Gum disease linked to infertility in women

According to research presented at the American Academy of Periodontology conference in 2004,

gum disease is linked to women who

use infertility treatments.[1] The study said women undergoing infertility treatment for more than three menstrual cycles experience increased inflammation and bleeding of the gums. These women also have increased levels of gingival crevicular fluid, which contains tissue breakdown products that may be markers for the progression of gum disease.[2]

The lead author Dr. Cenk M. Haytac, from Cukurova University in Adana, Turkey, postulates that these effects occur because these agents increase body levels of estrogen and the gums apparently are a target for estrogen since they contain estrogen receptors.  Though not definitive, several studies have shown  evidence that gum infections are associated with unsuccessful embryo development or the failure of in-vitro fertilization. Poor oral health is as bad for
fertility as obesity – delaying conception by about two months says latest research.[3]

Experts at the annual meeting of the European Society of Human Reproduction and Embryology in Sweden were presented with evidence how women with gum disease took over seven months to conceive, compared to the usual five months. The researchers believe the underlying cause is inflammation. Unchecked, this can set off a chain of reactions capable of damaging the body’s normal workings.

Periodontal disease has already been linked with heart disease, type 2 diabetes and miscarriage, plus poor sperm quality in men.  An Australian study involving over 3,700 women indicated that those with gum disease had raised blood levels of markers for inflammation.[4]   Although speculative, as a precaution researchers suggest that the treatment of gum disorders might influence the outcome of infertility treatment.  According to Dr. Michael P. Rethman, president of the AAP, “[i]t is reasonable to assume that if low levels of plaque are established and maintained during the infertility treatment, gingival inflammation would not affect the success of infertility treatment,”  “[which] would require meticulous oral hygiene and routine professional cleanings, perhaps at the beginning of each menstrual cycle to ensure the presence of healthy gums.”

Professor Roger Hart advises women trying to get pregnant to get a check-up by their dentist along with other measures like stopping smoking and drinking, maintaining a healthy weight and taking folic acid supplements.  UK fertility expert Dr. Allan Pacey said, “It’s common sense advice really to make sure you are in a healthy condition [including good oral health] if you want to try for a baby.” Around 10% of the population is believed to have severe periodontal disease.[5]

So if you are trying to get pregnant and are unsure of your oral health please see your dentist.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328


[1] Journal of Periodontology, June 2004


[3] Ananya Mandal, MD. Gum Disease Linked to Infertility. (2011)

[4] Professor Roger Hart, of the University of Western Australia.

[5] Gum disease linked to infertility Screen clipping taken: 8/30/2011 5:09 PM  Posted in: Women’s Health News


Dentist Dunwoody: Women and Your Oral Health

As a woman, you know that your health needs are unique and this includes your oral health needs. And because your needs are unique, you need to take extra care of yourself.  While women tend to take better care of their oral health than men do, women’s oral health is not significantly better than men’s.  This is because hormonal fluctuations throughout a woman’s life can affect many tissues, including gum tissue.  These fluctuations occur when you mature and change, as you do during puberty or menopause, or other times when you have special health needs, such as menstruation and particularly during pregnancy.

According to the Journal of Periodontology[1] at least 23 percent of women between the ages 30 to 54 have periodontitis.[2]  And, 44 percent of women ages 55 to 90  who still have their teeth have periodontitis.  Yet many women do not realize they have it until it reaches an advanced state, which is why regular hygiene check-ups are so important.

Stages of your life – steps to protect your oral health.

Puberty – an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum’s sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. Signs to look for in your teenage daughter are swollen, red and/or tender gums.[3]

It is particularly important during this time in your daughter’s life to make sure she follows a good at-home oral hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.[4]

Menstruation – can result in menstruation gingivitis.  Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman’s period and clears up once her period has started.  Sometimes it occurs concurrent with stressful situations and menstruation.

Pregnancy – increase gingivitis or pregnancy gingivitis beginning in the second or third month of pregnancy that increases in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue.[5] As a result of varying hormone levels, between 50%-70% of women will develop gingivitis sometime during their pregnancy – a condition called pregnancy gingivitis.[6] In some cases, gums swollen by pregnancy gingivitis can react strongly to irritants and form large lumps. These growths, called pregnancy tumors, are not cancerous and generally painless.

Studies have shown a possible relationship between periodontal disease and pre-term, low-birth-weight babies. Any infection, including periodontal infection, is cause for concern during pregnancy. In fact, pregnant women who have periodontal disease may be more likely to have a baby that is born too early and too small!

To prevent pregnancy gingivitis it’s especially important to practice good oral hygiene habits, which include brushing at least twice a day, flossing once a day, and using an antimicrobial mouth rinse. If you are due for a professional cleaning, don’t skip it simply because you are pregnant.  Now more than ever, professional dental cleanings are particularly important.

Oral contraceptives – while women are taking drugs to help treat periodontal disease, such as antibiotics, may lessen the effect of an oral contraceptive.  So be sure and consult your dentist about all the medications you are taking.

Menopause and Post-Menopause – not surprising given all the changes happening within your body, but you may experience changes in your mouth as well.  You may notice discomfort such as dry mouth, pain and burning sensations in the gum tissue and altered taste, particularly to salt and pepper.

In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny or bleed easily and range from abnormally pale to deep red may indicate this condition. Most women find that estrogen supplements help to relieve these symptoms.[7]

Bone loss is potentially associated with both periodontal disease and osteoporosis. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth  and your jawbone as well as other parts of the body.

What Should You Do?

See a dental professional for cleaning at least twice a year – you need to monitor your oral health.

If referred, see a periodontist in your area. Problems may include: Bleeding gums during brushing, red, swollen or tender gums.   Other issues such as persistent bad breath or pus between the teeth and gums.  If you’re a denture wearer a change in the fit of your dentures may occur.

Keep your dentist informed about any medications you are taking and any changes in your health history.

Brush and floss properly every day.  Review your techniques with a dental professional.

If there any questions that you might have, please call us to discuss them.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328


January 1999 issue of the Journal of Periodontology

Periodontitis is an advanced state of periodontal disease in which there is
active destruction of the periodontal supporting tissues.



[6] WebMd.
Pregnancy Gingivitis and Pregnancy Turmors.

Women and Gums: American Academy of Periodontology Journal.


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Dentist Dunwoody: How much do dental fillings cost? and Why?

The cost of a filling can vary greatly, depending on who you go to, the type of filling and degree of restoration required.   An amalgam (“silver/mercury filling”) is cheaper than a composite (white/resin filling), but will last significantly longer if you are unconcerned about aesthetics and the back and forth debate over whether or not amalgams may be linked to other health issues.  The US Food and Drug Administration (FDA) and the American Dental Association (ADA) found there is no danger from an amalgam filling, but some specialists and consumers remain unconvinced by the findings.

One of the ways to find out the actual range of cost is to just call a local dentist from the internet and ask them.  You are going to find some hesitancy to quote
over the phone because each person presents a different set of restorative circumstances, but you should be able to get a range of costs or a free consultation.

While costs vary from one area to the next and from one office to the next, the cost of typical amalgam filling ranges from approximately $75 to $175 per filling, whereas a composite resin filling ranges from $125 to $300 for a single surface restoration.  You should expect about 3 to five years (possibly 7 years) of use from the composite and as many as 20 years or longer from an amalgam restoration.  Actually a well-cared-for amalgam filling can last a lifetime, so the expensiveness of the filling really becomes a minor consideration.

Restorative circumstances are going to vary from tooth to tooth and decay may be found in one small spot or throughout a tooth. The restorative fees are based on the number of surfaces needing filling in a single tooth.  A silver amalgam filling on one or two surfaces averages $75 to $175, while for three or more surfaces it could go as high as $120 to $300 or more.  The same type of logic follows with respect to composite restorations.  Since composite resin
fillings are more time consuming and require greater skills to completion they are more expensive than amalgam fillings and weigh in on the more expensive
side of caries restorations.

Typically dental insurance covers most or all of the costs of a silver amalgam filling, but only 50 to 80 percent of the cost of a composite filling because the higher charge for the tooth-colored material is considered a cosmetic option. One exception is when an old amalgam filling is cracked or broken and is replaced with a composite filling.

Your dentist should be advising you of the type of filling based on the size of the cavity and the location of the tooth in your mouth.
Amalgams are more likely to be placed in the back of your mouth while composites are more likely to be used on more-visible front teeth. gives an overview of typical filling procedures and lists pros and cons of different types of fillings.

Amalgam Advantages

  • Amalgam fillings are strong and can withstand the forces of chewing.
  • They are relatively inexpensive and last a long time, compared with alternatives.
  • An amalgam filling is completed in one dental visit.

Amalgam Disadvantages

  • Amalgam doesn’t match the color of your teeth.
  • Healthy parts of your tooth often must be removed to make a space large enough to hold an amalgam filling.
  • Amalgam fillings can corrode or tarnish over time, causing discoloration where the filling meets the tooth.
  • A traditional amalgam filling does not bond (stick) to your tooth, so the cavity preparation developed by your dentist requires undercuts or ledges to
    provide retention of the filling.  Your dentist may have to remove additional tooth structure to establish good retention for the filling.
  • Some people may be allergic to mercury or be concerned about its effects, although research shows the amount of mercury exposure from fillings is
    similar to what people get from other sources in the environment.

Composite Advantages

  • Your fillings will match the color of your teeth and therefore undetectable.
  • A filling should be completed in one dental visit.
  • Composite fillings can bond directly to the tooth, making the tooth stronger than it would be with an amalgam filling.
  • Less drilling is involved than with amalgam fillings because your dentist does not have to shape the space as much to hold the filling securely.  The bonding process holds the composite resin in the tooth.
  • Indirect composite fillings are heat and light cured increasing their strength.
  • Composite resin can be used in combination with other materials, such as glass ionomer, to provide the benefits of both materials.

Composite Disadvantages

  • Although composite resins have become stronger and more resistant to wear, they generally don’t last as long as amalgam fillings under the pressure of chewing.
  • The composite may shrink when placed; this can lead to more cavities in the future in areas where the filling is not making good contact with your
  • This restoration takes more time and skill to place because they are usually placed in layers. The increased time and labor involved also contribute to
    the higher cost (compared with amalgam fillings).
  • Indirect fillings and inlays take at least two visits to complete. Your dentist takes impressions at the first visit and places the filling or inlay at
    the second visit.
  • In large restorations, composites may not last as long as amalgam fillings.

The trick is to find a qualified, well trained dentist, and that requires you to educate yourself about the dentist you choose and a basic knowledge about dentistry.  If we can be of service or answer any questions or concerns please feel free to contact us.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328


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Over 360 unedited reviews of Dr. Novy Scheinfeld and her practice at
Dr. Scheinfeld is an Emory University trained prosthodontist treating 4 generations of patients from Vinings, Marietta, East Cobb, Smyrna, Roswell, Alpharetta, Johns Creek, Dunwoody, Sandy Springs, Norcross, Buckhead and Midtown. Her associate, Dr. Sidney Tourial, the current President-Elect of the Georgia Dental Association has been in the practice for almost 19 years.
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Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200A
Atlanta (Sandy Springs), GA 30328

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Dentist Dunwoody: How much do dental implants cost?

If you are trying to figure out the ins and outs of  implants verses the older more conventional methods of tooth replacement,  cost of dental implants at first blush may appear high, and therefore, unaffordable to most people.  But appearances can be deceiving if you examine the beneficial differences and the time involved by your specialist.  While I have written on those issues before, let’s explore other aspects of price and how different dental implants may differ very significantly depending on different factors.

The real concern for the patient is ‘where and how’ to find a low cost quality dental implant, and is most likely the driven adjective ‘low cost’ a result of the perception by the patient that teeth are utilitarian to their daily life.  That’s really not the case, but to put the cost into perspective, all the while considering that your teeth aren’t really as appreciated as much as they should be, let’s examine what goes into the cost of a dental implant.

4 Factors that Drive the Cost of Dental Implants:

The Material:

The traditional materials – prices of cobalt-chromium alloy and titanium are not the same.  Implants from cobalt-chromium (CC) alloy rods are cheaper than comparable titanium implants, but when it comes to zirconium dioxide, then cost of a dental implant may appear to be cost prohibitive to the patient.  But, depending on where the implant is being placed, you may end up with a less than satisfactory result with the less expensive CC implant.

The Size:

This case is a significant factor.  The bigger the implant, the more material, the more it costs, but also the more it may do.  Also, special coatings applied to the surface of the implant, contribute to better osseo-integration with the bone, will affect the cost of the dental implant.

The Manufacturer:

Different manufacturers put different prices on similar rods made from the same material. Some manufacturers include some kind of an extra charge in the dental implant’s price for their brand name. This is a lot more esoteric and therefore harder to explain.   It’s like trying to explain the difference between Polo and Hanes T-shirts.

Finally, it may depend on where your dentist gets his implants from.  And this factor may be a function of how motivated your provider is in providing you with the best implant material for the least amount of cost to you.  Some of that may just end up being economies of scale by your provider.  Does your provider have contacts directly with manufactures in China or Israel, where the dental implant cost can be significantly reduced, while the indirect purchase of dental implants from U.S dental suppliers may ratchet up the price?

If the price is too good to be true?

The cost of an dental implant starts from around $1,500 up to $5,000.00 .  Anything less may be an indicator that you’re getting an inferior product or one not designed for a particular location in your mouth.  (Mini-plants, which I have discussed before, are the exception to the rule.)  Short term the implant device may appear to be fully functional.  But if we look at the cost and the cost of other materials for dental implants compared to their operational life, the
difference may be likened to the difference between Toyo’s and Michelin tires.  Here again you may get what you pay for and the initial cost may appear affordable, but in the  long term you are going to get a better result with respect to how it functions and how long it lasts if your provider installs Michelins.

A lot of your choice and cost may depend on the choice of your provider.   It’s not to say the more you spend the better you will be.  Rather, a reputable practitioner, who is truly trained in the placement and restoration (and this may be two providers), may be a significant factor in what you end up with and what it  costs.  Trust and reputation are the more difficult factors to define for the patient.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328


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Dentist Sandy Springs: Georgia’s free dental clinics?

The need for free and charitable dental clinics is not going to disappear as a result of Obama health care reform.   Mostly because Obamacare will likely fail.  But that’s an opinion and one better argued in
another discussion.  If you accept the premise, then there is some information that you or someone you know may find valuable information I would like to pass along.

According to the Georgia Free Clinic Network located in Atlanta (678-553-4939) there are 104 free/charity clinics serving Georgia patients.  The network offers health care to the uninsured at no costs to the taxpayers of this State.  GFCN provides a safety net that fills the gaps in our taxpayer-funded system of health care, including oral health care.  One of the local Atlanta clinics, and I have
no idea whether or not it is associated with GFCN, is the Ben Massell Dental Clinic which has local dentists from around metro Atlanta staff and treat indigent patients.

The GFCN is a statewide association of free and charitable medical and dental clinics which vary in size and scope of services are each uniquely dedicated to serving many of Georgia’s more than 1.7 million uninsured population.   Like the Massell Clinic, these facilities are staffed in part by volunteers, operated by non-profit organizations that reach out to their communities with an unwavering commitment to our local population’s underserved needs.

The GFCN’s focus is fourfold:  1) Unifying clinics serving Georgia’s uninsured through advocacy, technical assistance and collective purchasing; 2) Development, implementation and replication of data gathering resources regarding the uninsured; 3) Strengthening the infrastructure to serve GFCN membership; and 4) Assisting in the development of services in areas of highest unmet need.[i] In 2009, GFCN clinics served 200,000 patients,  pproximately 11% of Georgia’s uninsured. According to the Georgia  State Auditor, these clinics provide $200 to $400 million of care. To their, credit, for every $1 invested in a free clinic, $9 worth of services can be provided.  Less I digress for a moment, show me a government program that provides that kind of bang for the buck.  As a phenomenal result of so many volunteers, the uninsured in 90 of Georgia’s 159 counties have access to a charity/free clinic.  Fifty-seven percent of the patients seen in Georgia clinics are female.  Most patients are employed, sometimes holding more than one job. And at an average clinic, the percentage of patients who are: White-40%; African-American-41%; Latino-16%.[ii]

At the public sector level, there is the Georgia Department of Community Health (Atlanta, 404-657-6639), of which its Oral Health Unit was created to prevent oral disease among Georgia’s children through education, prevention and early treatment. According to the Oral Health Unit they play a vital role in improving the quality of life for all the children of Georgia, and in eliminating health disparities. Oral Health Unit programs focus on preventing, controlling and reducing oral diseases and conditions in all of Georgia’s underserved populations.

So there really is no reason why you shouldn’t see a dentist if you are uninsured, under insured or unemployed.   Please take the time to lead someone in need in the right direction.  And as always if we can be of help please feel free to contact our office for oral health needs. Dr. Scheinfeld’s Center is dedicated to exceptional dentistry that’s right for you.

Serving Sandy Springs, Roswell, Buckhead, East Cobb, Dunwoody, Alpharetta, Johns Creek.


Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328


[i] Georgia Free Clinic Network

[ii] Georgia Free Clinic Network


Dentist Sandy Springs: Mouthwash and Oral Cancer

Michael Douglas '63, Oscar-winning actor, play...

Image via Wikipedia

There appears to be controversy with respect to whether or not mouthwash containing alcohol may be related to oral cancer.  This controversy arises out the studies that show a link between oral cancer and those that drink alcohol.  Michael Douglas is the most recent case in point.  He has been reported to be a
heavy smoker and imbibe alcohol on what is rumored to be on frequent occasions.  The obvious link in theory is that most mouthwash formulas contain alcohol, so the conclusion is that a link to mouthwash must exist here also.  The problem is there are no conclusive studies and at this time there appears to be insufficient evidence to alter the ADA’s approval of mouthwash containing  alcohol as an effective method for the prevention and reduction of gingivitis
and plaque above the gumline when used as directed.  The ADA Council on Scientific Affairs awarded  the ADA Seal of Acceptance to these products after a thorough review of data on  their safety and effectiveness.

Of all the studies published on this topic, beginning in 1979,  four studies reported some positive results while five found no association. (citations omitted)  What we know is that  none of the criteria for causality have been fulfilled by the studies that have  been published so far.  The International Agency for Research on Cancer, an extension of the World Health Organization, now identifies the consumption of ethanol in alcoholic beverages as a carcinogenic risk.[1]  Alcohol abuse is associated with cancers of the mouth, pharynx, larynx and  esophagus. Ibid.  However, the reason for this association is  not fully understood – it may be due to a direct effect of alcohol on these  tissue.[2]  Because of the conflicting studies and  endorsements I could advise you  to keep using alcohol formulated mouth rinses.  But if you are concerned and wish to stay on the safe side of the  debate, there are non-alcohol based mouth rinses available that appear to be  effective in the prevention of gingivitis and plaque.

Our job is to try and educate you on the contemporary issues we face in addressing your oral  health and if there are any questions you would like to pose, please feel free to contact us for a free consultation.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328



[1] International
Agency for Research on Cancer. IARC monographs on the evaluation of
carcinogenic risks to humans. Volume 96. Alcoholic beverage consumption and
ethyl carbamate (urethane). Lyon, France: 6-13 February 2007.

[2] Lachenmeier
DW. Safety evaluation of topical applications of ethanol on the skin and inside
the oral cavity. J Occup Med Toxicol 2008;3:26.