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Younger Age Groups Are Falling Behind On Maintaining A Healthy Smile


Posted on Feb 10, 2021 by William J. Claiborne, DDS MS

A recent survey, commissioned by the American Association of Endodontists, showed that working or studying from home is having a negative impact on the oral health of adults. It findings reveal that more than half of Americans say the pandemic has caused them to delay their regular dental exams and cleanings, which can lead to serious oral health problems.

Being stuck in one’s home has become an adjustment people across the globe have had to make. In spite of having easy access to a toothbrush and toothpaste, this has resulted in factors that are out-doing daily dental hygiene routines. Significant findings include:

31% admit to snacking more on sweets

24% report they are flossing less frequently with another 23% not flossing

1 in 4 said they delay brushing until later in the morning, while 21% aren’t brushing in the morning at all

28% didn’t schedule or forgot to schedule a dental visit

https://www.prnewswire.com/news-releases/survey-reveals-covid-19-is-a-major-factor-in-americans-failing-dental-health-301223396.html

This has become a more prevalent problem for adults in the millennial age group. These adults were born between 1981 – 1996 and are presently between the ages 24 of 39. According to several surveys, millennials are not only doing a poor job at oral hygiene upkeep, the convenience of working from home is working against them as well.

In a 2017 study, 30% of millennials polled admitted to only brushing their teeth once a day, and some millennials have gone over 2 days without a brushing at all. Because this survey was conducted prior to the pandemic constraints, keeping more adults inside 24/7, the figures are likely even worse.

At the time of the survey, 43% stated that working from home or attending virtual classes disrupted their usual oral hygiene regimens during the pandemic lockdown. Couple this with not having a set schedule to follow (thus, no daily brush-&-floss routine). Work-from-home adults (or students) also have 24/7 access to snacking.

All these factors equal future oral health problems for a large percentage of millennials. These include cavities, gum disease, and subsequent tooth loss. Is the nonchalance of oral hygiene because tooth loss is not a true worry, as with baby boomers?

Many baby boomers (now between ages 57-75) grew up with parents or grandparents who kept a glass by the bathroom sink where their dentures would “soak” during the night. This image may have helped to keep the over 55 age group more determined to maintain good oral health and keep their natural teeth.

Regular dental care is important for all ages, but especially for the aging adult. A thorough brushing and flossing routine at home is simply a greater need as older adult experience more challenges when it comes to oral health.

Older adults must deal with oral dryness, which creates an environment for more rapid bacteria growth. The cracks and fractures that natural teeth endured over the years can also give way. This leads to the need for crowns and even dental implants to replace lost teeth.

And, wallets are thinner in retirement. As people retire, there is less insurance coverages for dental expenses in addition to less income. To continue with regular, preventive dental care, an older adult must budget carefully to include these appointments.

Yet, baby boomers are also more determined to hold onto a more youthful sense. Losing natural teeth, to this age group in particular, is associated with an “old age” mindset that has been widely resisted by boomers.

Statistics from 2018  showed that nearly 50,000 more cosmetic procedures were performed on those 55 and older than in the previous year, with noticeable increases in surgical procedures like liposuction, hair transplantation and breast augmentation along with options like Botox and fillers. This age group also accounted for nearly half of all eyelid surgeries and two-thirds of facelifts.

https://www.plasticsurgery.org/news/press-releases/more-baby-boomers-seek-cosmetic-procedures-as-they-re-enter-dating-scene

However, segmenting oral health habits into age groups is not the chief concern among those of us who are dental caregivers. As a periodontal specialist, I see all ages and know every adult should be highly committed to good oral health. Now, more than ever, having a healthy mouth can be a booster to the body’s overall immune system.

Gum disease occurs from an overload of infectious bacteria that the immune system can no longer manage. It extends below the surface and can no longer be brushed or flossed away.

These destructive bacteria can enter the bloodstream through tears in diseased gum tissues. Research has linked this bacteria to serious health conditions including heart disease, stroke, high blood pressure, some cancers, preterm babies, arthritis, diabetes, impotency and even Alzheimer’s disease.

However, twice-daily brushing and daily flossing, on their own, will not shield you from developing gum disease. If you’ve been avoiding regular dental check-ups, the problems in the future can require costly repairs and even tooth replacement – problems that may have  been easily prevented.

If you have delayed dental care or have been less-than-diligent in maintaining good oral health, be aware of the signs of periodontal disease. These include seeing blood in the sink when brushing teeth, sore or swollen gums, gums that darken to a red color, persistent bad breath and sensitivity to hot or cold.

In our Asheville periodontal dental office, patients can begin with a consult in our private consultation room to discuss oral health options. A referral is not required.

Call 828-274-9440 to schedule.

Smokers CAN Lower Oral Health Risks With Proper Measures


Posted on Feb 04, 2021 by William J. Claiborne, DDS MS

If you smoke, you may be tempted to quit as one of your New Year’s resolutions. By now, you may be “over the hump” and feel success in this challenge (and breathing much easier!). Good for you!

However, if you’ve stumbled and faltered (and perhaps even thrown up your hands in defeat), you are not alone. According to the Centers for Disease Control & Prevention (CDC), over 55 percent of smokers in the U.S. had made a quit attempt in 2018, with only 7.5 percent succeeding. (https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html)

Yet, less than 7 percent of adult smokers reported (in 2015) that they had sought counseling or medications in their attempts to quit. Yet, the need for support is clear. For most people who are trying to quit, it is a long, tough journey. The CDC also reports that:

“more people in the United States are addicted to nicotine than to any other drug. Research suggests that nicotine may be as addictive as heroin, cocaine, or alcohol.”

As the need to maintain healthy immune systems has never been more urgent, smokers will hopefully reach out to every source in order to kick the habit, for good. Data assembled by a team at the University of California (San Francisco) found that smoking nearly doubles the rate of COVID progression.

The analysis took into account over 11,500 COVID patients. The findings showed by current and former smokers were twice as likely to have conditions that require hospitalization and higher death rates. (https://www.ucsf.edu/news/2020/05/417411/smoking-nearly-doubles-rate-covid-19-progression)

The authors of the study warned that both cigarettes and e-cigs were involved in this higher risk rate.

Smoking increases mucus production and inflammation, which injures the lungs’ defense system. This is why people who smoke are more likely to have serious respiratory infections and illnesses.

However, my role as an Asheville periodontist is not to lecture our patients. We believe our patients deserve to be informed about the risks to their oral health, in particular, and provide encouragement. Too, we want patients to understand the best ways to avoid developing periodontal (gum) disease and the subsequent repercussions (such as tooth loss) as a result.

So, let’s focus on your periodontal health if you smoke (including cigarette smoking or vaping).

Smokers are often unaware of what occurs in the mouth from smoking. To begin, smokers have a greater risk of periodontal (gum) disease due to its drying effect on the soft tissues in the mouth. When saliva flow is depleted, its ability to rinse away oral bacteria enables the mouth to a bacterial breeding ground.

As oral bacteria reproduce and accumulate in the mouth, gum tissues become inflamed. In the early stages of gum disease, symptoms may include frequent bad breath, tender and swollen gums, and gums that bleed easily when brushing teeth.

As gum disease progresses, the gums change in color from a healthy pink hue to red. The gums loosen their grip around the base of teeth and seem more spongy. Breath odor is consistently bad. Pus pockets may form at the base of some teeth.

Eventually, the bone and the tissue structures that support natural teeth are under attack. The infectious bacteria ramp up their onslaught of attack, tooth roots no longer have the firm support they need. Some teeth begin to loosen and may require removal.

Advanced periodontal disease, known as periodontitis, is a health risk that goes far beyond the mouth. For years, research has shown an intricate connection between the “good” bacteria in the mouth, especially beneficial in gut health. It has also been known that the “bad” and infectious bacteria of advanced gum disease can alter the roles of certain factors in the body that help to prevent the formation of disease.

For example, certain cancers can be activated or progressed through the inflammatory bacteria of gum disease. These bacteria are able to become blood borne and activate “pathogens” that create a domino effect of disease development.

When you factor in the vulnerability to the lungs from inhaling the toxic smoke of cigarettes, you have a perfect storm. Consider that the gum tissues are the first contact with these inhaled chemicals. Because oral tissues are absorbent in nature, they are at the front line of smoking’s effect.

If you do smoke, we want to help you minimize the risks it poses to your oral health. In addition to maintaining regular dental check-ups and cleanings (at least every 6 months), below are some tips for your at-home oral hygiene regimen.

Brush twice a day (at least) for two minutes each time. Use a fluoridated toothpaste and a soft to medium bristle toothbrush.
Floss your teeth every day and floss before your brush. You would be surprised at how many particles can be lodged between teeth that brushing won’t rid. If flossing is an awkward maneuver, try one of the water flossers, which are affordable and as effective as manual flossing.
Brush your tongue after your teeth to unroot embedded bacteria, especially reaching the back area of the tongue (where most bacteria are embedded). This also helps to give you fresh breath.
• Use an oral rinse that replenishes moisture (and is alcohol-free) twice a day (or as directed). These are available OTC at most drug stores.
• Chew sugarless gum, preferably a brand that contains Xylitol. Xylitol looks and tastes like sugar, yet has 40 percent fewer calories.
• Drink plenty of water throughout the day. Be aware that beverages such as most coffee, tea and colas contain caffeine are drying to the mouth. Many medications also have the side effect of oral dryness – another good reason to stay hydrated.
• Limit your intake of sugar and carbohydrates. These are oral bacteria super boosters.

In our Asheville periodontal dental office, please know that we are here for you regardless of your needs or goals. Although we prefer you give up smoking, we want to give you the very best care possible so you can enjoy a healthy mouth and confident smile.

If you haven’t had regular dental exams or have any of the symptoms associated with gum disease (mentioned above), call our dental office to schedule a thorough periodontal exam at 828-274-9440.

 

Missing Teeth? Know The Ends-&-Outs of Dental Implants


Posted on Jan 29, 2021 by William J. Claiborne, DDS MS

If you are one of the millions of adults who are missing one or more natural teeth, you are actually in the majority if you are over the age of 50.

According to the Centers of Disease Control & Prevention (CDC), by the age of 50, Americans have lost an average of 12 teeth. For those between the ages of 50 to 64, over 10 percent have no remaining natural teeth. Twenty-six percent – more than one-fourth – of adults between 65 – 74, have lost ALL of their natural teeth.

Replacing natural teeth may seem simple. Often, people assume that a partial or bridge will solve the problem. Yet, these dental appliances merely worsen an already precarious situation. While these dental prosthetics “mimic” the appearance of teeth, what’s occurring beneath the gum line has a significant impact on what’s to come.

To understand the rocky road in the future, consider the foundation of natural teeth – the jaw bone.

The reason biting and chewing occurs dependably and with stability with natural teeth is because they are secured by the jaw bone. When natural teeth are removed, their roots are no longer present in the jaw bone. The presence of these roots actually provides stimulation to the jaw bone, which helps to preserve the bone’s mass. Without this stimulation, the bone resorbs, a process of which bone mass “melts away”.

Resorption is to blame for dentures or partials that start to move or slip over time, even though the fit was snug when first made. Because resorption reduces bone height, the ridge the denture was contoured to fit begins to flatten. A shrinking ridge leaves the denture with an insufficient base.

The pace of bone loss speeds up a little more each year. The pressure of a denture on the ridge accelerates the rate. For people who sleep in their dentures or partials, the continual pressure ramps up the pace further.

As the ridge flattens, denture adhesives or pastes become of little help while trying to eat. This leads many denture wearers to switch to a diet of soft foods that dissolve easily in the mouth. Often, the pleasure of eating is overshadowed by trying to avoid sore spots on tender gum tissues or embarrassing slips.

Declining bone mass also leads to changes in facial appearance, contributing to an appearance that is far older than one’s actual age. As bone mass declines, jowls form as facial muscles detach from a shrinking bone mass. Deep wrinkles form around the mouth and the corners of the mouth turn downward, even in a smile. As bone loss becomes severe, the chin points and the nose moves closer to the chin, creating a ‘granny look.’

As an Asheville periodontist, my dental specialty includes the diagnosis and placement of dental implants. Dental implants are the closest thing to natural teeth, for many reasons.

Dental implants restore the ability to bite and chew comfortably and without the fear of embarrassment or uncomfortable rubbing. Because implants are placed in the jaw bone, they have the same dependable foundation as that of natural teeth.

Among the many benefits of dental implants, they also provide stimulation to the jaw bone. This helps to halt the process of bone loss. For those who have already lost a great deal of bone loss, bone rebuilding procedures can be performed to restore a healthy, more youthful face shape.

An added advantage of implants is they do not rely on the crowning of otherwise healthy, neighboring teeth for the mere purpose of supporting a bridge. While a traditional crown-&-bridge combination relies on crowned teeth for support, an implant uses the sturdy foundation of your jaw bone.

There are over 40 different types of dental implant systems, each designed to accommodate specific needs and goals. For example, some implants are designed for placement in minimal bone mass. Others can be strategically placed to support a bridge of two or more teeth or support a full arch.

When choosing Dental Implants to replace teeth, you are making a lifelong investment. Since implants are designed to last a lifetime, they provide a ‘one & done’ choice for dependable tooth replacement. There are not many things these days that give you so much value!

If you struggle with dental fear or anxiety, rest assured that patient comfort – at every appointment – is of the highest priority. Our office is structured to attend to the specific needs of each patient, gently and respectfully. Patients begin with a consultation in a comfortable, private setting rather than seated in a treatment chair.

For patients who desire a “sleep” state, we offer oral sedation as well as I.V. sedation (twilight sleep). Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward.

I.V. sedation places the patient in a deeper sedative state (twilight sleep), also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety.

With both, patients are closely monitored with advanced safety equipment throughout treatment. Patients also find our entire staff to be a unified team, each bringing a sincere level of compassion and commitment to excellent care.

Rather than bypass the very best option for replacing lost teeth, consider a consultation to discuss the benefits, anticipated costs, and treatment process. Call 828-274-9440 for an appointment in our Asheville periodontal dental office.

Tooth Loss Cause of Shrinking Face, Sunken-In Mouth


Posted on Jan 14, 2021 by William J. Claiborne, DDS MS

The aging process is not an easy one. Joints begin to creak, muscles are more easily strained, skin dries out, eyesight wanes and hearing declines.

Yet, throughout the aging process, some adults seem to go through it as less of an ordeal than others. Although diseases and certain health conditions can occur regardless of how well some people manage, some people take a number of steps that can have a significant impact on aging well and “getting old.”

The basics of good health include a diet low in sugar, alcohol and unhealthy fats. NOT smoking is a big factor in maintaining a healthy body. Regular exercise, sufficient sleep and regular physicals and dental check-ups are all beneficial.

A factor that plays a bigger role in having good overall health is having natural teeth. Having the ability to comfortably bite and chew food is important to effective digestion, since the digestive process begins in the mouth. When adults struggle to eat with a denture or partial, the efficiency of this initial stage of digestion is compromised.

It’s not unusual for adults who have “rocky” or “slippery” dentures to opt for soft foods that dissolve easily in the mouth. These are often carb heavy and lack the nutritional value of a diet that combines healthy proteins, fruits and vegetables. However, missing teeth or dentures that move when eating can cause other detrimental problems.

When people sense their dentures may cause embarrassment when eating, speaking or laughing with others, social involvement can take a hit. According to a 2012 statement by the World Health Organization:

Oral health is essential to general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psycho-social well-being.

An extensive study on “The Link Between Teeth and Emotions” was published by Clinical Psychology of Oral Health (https://journals.sagepub.com/doi/full/10.1177/2158244017728319) in 2017.

In the study, the concept of quality of life was categorized in five dimensions: physical well-being, material well-being, social well-being, emotional well-being, and development and activity”.

The authors found that oral health is “an integral part of general health and well-being” and examined how oral disorders may impair at least three of the five dimensions: the physical, emotional, and social well-being.

The authors found also an association between oral health and late life depression (LLD) in older adults, who experienced “compromised social function and impaired self-maintenance skills (e.g., bathing, dressing, hygiene).” This depression can cause a loss of pleasure and interest for daily life activities, and even in the interest in personal oral hygiene.

Oral health not only has an impact on the psychological well-being of older adults, the physical changes attributed to tooth loss are of equal concern to many denture wearers.

Let’s look at your oral anatomy for a moment…

Your natural teeth are supported by your upper and lower jaw bone, known respectfully as the Maxilla and Mandible. With these strong, study bones, tooth roots are held securely. Thus, biting and chewing occurs comfortably.

The jaw bones are actually kept healthy by the presence of tooth roots. These roots provide stimulation to the bone as well as nourishment that feeds through the tooth’s interior.

When a tooth is removed, so is the stimulation and nourishment to that area of the jaw bone. Without it, the bone begins to shrink. As it declines in height, the adjacent teeth are more vulnerable to loss. Statistics show that teeth adjacent to areas where natural teeth are missing will be the most likely to be lost next.

This has a domino effect. Partials can replace the presence of teeth above the gum line, but there is nothing to benefit the jaw bones below. Thus, tooth loss continues and can go from a few missing teeth to losing all teeth (being “edentulous”).

According to the Center for Disease Control & Prevention (CDC), 69 percent of adults between the ages of 35 – 44 have lost at least one permanent tooth. By age 50, Americans are missing an average of 12 teeth. For adults between the ages of 65 – 74, 26 percent are missing all of their natural teeth. That’s over one-fourth of the adult population over age 65.

Although dentures and partials mimic the presence of teeth, the jaw bones below are shrinking away, and at a rather rapid pace. The pressure of wearing a denture or partial actually speeds this process up, known as “resorption.”

As these bones decline in mass, deep wrinkles form around the mouth. The corners of the mouth turn downward. The chin takes on a more pointed form and the mouth sinks into the face. The nose seems to get closer to the chin as the jaw bones thin. Jowls form as facial muscles detach from shrinking bone structure.

Dental implants were designed to recreate the presence of natural teeth both above and below the gum line. Because teeth attached to the implants are supported by the jaw bones, the study foundation restores the ability to bite and chew without movement or fear of embarrassing slips.

For patients who are missing a great deal of bone, we offer bone rebuilding that does not require a bone graft. We also perform sinus lifts (when the upper jaw has declined to a significant level) to restore sufficient bone distance between vital structures.

For many of our dental implant patients, their lives become more active with the restored confidence. They become more socially involved, have more self-confidence and higher self-esteem.

Although dentures and partials may seem to be a less-expensive way to replace teeth, the savings is hardly worth the detrimental repercussions associated with them. Too, the upkeep required for dentures over time is actually high, considering replacement, relines and repairs.

As a periodontal specialist serving Western NC, I take great pride in the diagnosis and placement of dental implants. Each is selected based upon the patient’s individual needs and goals. We provide oral or I.V. sedation to ensure a comfortable experience and a friendly, respectful environment.

Begin with a friendly conversation in our private consultation room. In this comfortable setting, we’ll discuss your options and I’ll answer your questions. For many people, they are able to make a decision on how they wish to proceed after this conversation, even if it’s to go forward with dentures. We are supportive of each person’s preferences.

Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office. I think you’ll feel especially confident in learning about our specialized skills and highly-advanced technology, not available in many dental offices in this area.