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Bad Breath? That May Be The Least Of Your Problems!


Posted on May 23, 2019 by William J. Claiborne, DDS MS

We’ve all run into people who have bad breath. Although a tuna salad lunch or onion-laden hot dog can cause folks to pull back from close-up conversations, these forms of bad breath are temporary.

The smelly breath odor that is more concerning is that which comes from the sticky film of bacteria that coats the mouth and emits sulfuric odors (likened to rotten eggs). This film, known as plaque, coats the teeth and gums when allowed to build up.

For example, the reason you wake up with not-so-fresh breath in the morning is the result of the mouth being closed all night while bacteria reproduces and accumulates. Without brushing and due to declined saliva flow (your mouth’s natural rinsing agent) during sleep, oral bacteria amass. Thus, you wake up with the sticky film and the breath that goes with it.

For those who are mouth-breathers during sleep or who snore, dry oral tissues allow for even more bacterial growth.

Once you brush and rinse thoroughly, however, you can expect your breath to become more pleasant. Persistent bad breath, however, may be the a side effect of medication, an illness, or periodontal (gum) disease.

As a periodontal specialist, I’m very much aware of the distinct odor produced by gum disease. Although it varies slightly from person to person, it has an offensive scent than that of typical bad breath.

The best way to determine gum disease as the true source is through a periodontal exam. In addition to persistent bad breath, periodontal disease symptoms include gum tenderness, gums that bleed when brushing, and gums that are red in color rather than a healthy pink. Early stage gum disease (gingivitis) may not cause any obvious symptoms, however.

Regardless of the source of unpleasant breath odor, it is imperative to have and maintain good oral health – for reasons that can impact your overall health. Through decades of research and studies, the bacteria of gum disease has been linked to serious health problems, including heart disease, stroke, arthritis, diabetes, impotency and some cancers.

For example, rheumatoid arthritis (RA) and pneumonia are just two diseases that have a connection to gum disease. Researchers have found that RA sufferers have a higher incidence of periodontal (gum) disease compared to individuals with a healthy oral condition.

Studies have also shown that RA patients are nearly 8 times more likely to have gum disease. Although insufficient oral hygiene can certainly be a determining factor in acquiring gum disease, other parameters point to a deeper association between RA and gum disease.

Because both RA and gum disease both cause internal inflammation, a connection between the two are most prevalent when examining the joints and oral tissues. Oral tissues with the presence of periodontitis compared to tissues of RA-affected joints show a number of similarities. Research has also discovered a genetic link between the two.

And the health threats go further. One study published by Science Daily found that the bacteria present in the mouth can release toxins that can make their way into the brain. (https://www.sciencedaily.com/releases/2019/01/190123165002.htm)

Once there, they may contribute to Alzheimer’s disease. While studies on this connection continue, other studies have found a clear path of triggers traced to the inflammatory reactions caused by the bacteria of gum disease.

Once periodontal disease is established in the mouth, its pathological byproducts can enter the bloodstream, lymph fluid, and bone structures. This can lead to the spread of infection and inflammation to all areas of the body. In this way, periodontal disease has been shown to be a cause of systemic disease.

While fresh breath and a gleaming smile are important, it’s clear that oral wellness plays a leading role in helping you avoid serious, and even deadly, health conditions.

If you’re experiencing any of the symptoms of gum disease mentioned above or are past due for a dental exam, call our Asheville periodontal office at 828-274-7440. If desired, you can begin with a private consultation, where we will discuss your symptoms and health history. During this time, I’ll answer your questions, explain treatment options and discuss comfort methods.

Asheville Periodontic Specialty Office Offers Latest To Enhance Treatment Outcomes, Comfort.


Posted on May 13, 2019 by William J. Claiborne, DDS MS

As an Asheville NC periodontist, I know it is more than my specialized skills that keep us busy. Many dentists and other dental specialists refer patients to our office because they know each patient receives optimal care with a gentle, respectful touch.

Another thing we are known for is the state-of-the-art technology we use to save patients time while they achieve the very best results in minimal treatment time. Some of our advanced features available include:

LANAP Protocol Using PerioLase MVP-7 – An acronym for Laser-Assisted New Attachment Procedure, LANAP provides an advanced protocol to more efficiently and effectively treat periodontitis (advanced gum disease) with the PerioLase® MVP-7™ laser. This offers a minimally invasive (non-surgical) treatment alternative for patients with moderate to severe periodontal disease.LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

Dental Radiology With 3-D Cone Beam Technology
 – We rely on 3D imaging in diagnostic and treatment planning. This latest level of 3D imaging covers the whole dentition area, giving a clear view of the mandible and maxilla (upper and lower jaw) for intricate review for the diagnostic requirements of endodontics, periodontics, orthodontics, implantology, TMJ and prosthodontics as well as dental and maxillofacial surgery.

In addition to imaging, cone beam radiographs provide images in sagittal, axial, and coronal planes. This makes it possible to locate and trace the mandibular nerve canal for pre-surgical planning for an ideal implant position.

We also like that our patients are exposed to only minute levels of radiation through a process that is fast and comfortable.

CareStream Cone Beam Computer Tomography Imaging
 – Our office features the Carestream 9300. This Cone Beam Computer Tomography provides dual modality panoramic and 3D imaging with exceptional detail and range. The CS 9300 can deliver 3D imaging at a significantly lower dose than 2D panoramic imaging. In fact, in a recent study, the CS 9300 and CS 9300 had up to an 85% lower radiation dose than traditional panoramic imaging.

Carestream 3600

CS 3600 intraoral scanner
 – No longer do our patients have impressions made with bulky, goopy trays held in their mouths!

The CS 3600 Scanner is designed to quickly and comfortably scan areas inside our patient’s mouth. It acquires digital impressions accurately and easily, scanning a full or dual arch for the fabrication of digital models or appliances.

The CS 3600 provides a highly accurate digital impression using a small, handheld scanner. It can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Just some of the superior features of the CS 3600 Scanner include:

• Acquires digital impressions to design crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments and RPD;
• Has an Intelligent Matching System that prevents missing data in any area. Plus, it even sends a warning to indicate areas of the scan that lack detail;
• Has adaptive hole filling that automatically identifies holes and selects the appropriate anatomical color for optimal aesthetic outcomes;
• Enhances outcomes for restorations, orthodontics and implants; and,
• Displays precise, accurate HD 3D color images with vivid color and details for improved case review, analysis and communication between doctors, referrals and labs.

Simplant Dental Software for Computerized Dental Implant Placement
 – This advanced software system allows for pre-surgical positioning of dental implants on the computer using a 3D model of the patient’s jaw. Once the implant type is selected, a surgical template is developed that ensures a precision fit. Simplant creates optimal implant treatment success, even for complex cases. It also simplifies the team treatment process so intricate aspects of the surgical process can be discussed prior to placement.

Intraoral Camera Technology – 
This self-contained intraoral camera features full motion video with outstanding image quality from an internal camera that captures ideal angles and images with the click of a button. The images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment issues.

Computer Imaging In Treatment Suites
 – Treatment suites are equipped with computers for convenient image sharing with patients. This allows patients to have a more complete understanding of their individual needs through images that can be pulled up by our dental team, with the ability to enlarge certain areas to show specific details. Through this, patients have greater involvement in treatment decisions.

Advanced Sterilization – Our custom sterilization unit is designed to adhere to or exceed established Centers For Disease Control & Prevention (CDC) guidelines for instrument processing protocols. Intuitive colored lighting identifies the receiving and cleaning of instruments.

Fully-Equipped Surgical Suites – Relax during treatment (under sedation, if desired) while you are surrounded with the serene views surrounding our Asheville periodontal office.

So you see, we are committed to providing each patient with advanced skills, experience, comfort, and technology that provides the very best in periodontal and dental implant treatment available.

If you have experienced periodontal (gum) disease or are considering gum recontouring or tooth replacement with dental implants, being referred is not always needed. Call our friendly staff to discuss your needs: 828-274-9440.

Scared? Afraid? Simple Steps To Get Past Dental Fears.


Posted on Apr 30, 2019 by William J. Claiborne, DDS MS

If you’re one of those people who have no dread of going to see a dentist, be glad. For the large percentage of adults who do experience anxiety or fear associated with dental visits,  they are actually in the majority.

In the U.S., an estimated 70 percent of adults have some level of dental fear, unfortunately. About 5-10 percent of them can be categorized as “dental phobics.” These individuals have such an intense fear of dental visits that the mere thoughts of walking into an office causes reactions such as sweating or more rapid breathing.

As a periodontist, I’m a frequent witness to just how severe dental fears can be. Some people cry, some keep a white-knuckled grip on the arms of a dental chair (once they finally talk themselves into one), and some ask to be put to sleep for things as minor as dental cleanings.

The periodontal specialty provides patients with a dental professional who has advanced training in the diagnosis and treatment of gum disease. It also covers the diagnosis and placement of dental implants, which are the “ideal” tooth replacement. In this field, I’ve seen the repercussions of both due to dental fear.

By not receiving regular dental cleanings and exams, the risks for developing gum disease rise significantly. And, since gum disease is the leading cause of adult tooth loss, it plays a key role in one’s potential to lose natural teeth.

Dental fear leads to a vicious cycle of poor oral health and tooth loss. When people are too afraid to see a dentist for regular care and fail to have small problems repaired while treatment needs (and costs) are still minimal, the process is ongoing. As gum health declines, the risks for tooth loss increases.

No one wants to end up in dentures. While TV commercials for denture adhesives or same-day denture clinics try to come across as upbeat, life wearing a denture is anything but. Long-time denture wearers struggle to bite, chew, and even speak without worrisome, uncomfortable slips or rubbing against tender gum tissues.

Too, the uncertainty of a denture can make some people uneasy when dining out or in other social settings. It’s not unusual for denture wearers to decline invitations when food is a key centerpiece of the gathering. This is sad. It is also detrimental to one’s health. Social involvement is an important part of our overall well-being.

If you are among those who avoid dental care because of uncontrollable jitters or downright “scared” feelings, below are several steps you may wish to consider to help you move past them:

• Begin by writing down what you believe caused your fears in the first place. Was it a painful procedure? Was it a rough dentist who ignored your obvious discomfort? If you know what sparked your fear in the first place and can look-it-in-the-eye in actual words, you can begin to deal with them. This may help you bring them out of the shadows and into the light where you can begin to conquer them.

• Close your eyes and imagine your life with a healthy smile — one that makes you feel good about being close to others. Imagine conversations having fresh breath and smiling with confidence. Imagine getting compliments on your smile! Think about how you may interact more confidently with others with a smile you’re proud to share.

• If you haven’t seen a dentist on a regular basis, you may need to begin with a periodontal examination. You can do an internet search (Periodontist) in your area and get to know them through their web sites. Read the doctor’s bio and become familiar with what he or she offers in terms of technology and comfort options. When a periodontist keeps current on the techniques and technology surrounding this specialty, patient comfort is typically a leading factor among these features.

• Visit the periodontist’s office after hours. Yes, go there when they are closed so you’ll feel less intimated. Sit in the parking lot and imagine where you’d park for your visit, once scheduled. Walk up to the entrance and become familiar with the look of the entryway. This way, when your appointment is made, you’ll feel more comfortable making your way in the door.

• Call the office and be comfortable sharing your concerns. Don’t feel shy about saying, “I have a lot of dental fear and would like to begin by meeting the doctor.” Most offices have these conversations with new callers more often than you realize. As mentioned prior, dental fear and anxiety are fairly common. Most offices offer an initial consultation so you can get to know the doctor before scheduling an exam. Ask about where this consult will be held. The periodontist should have a private room available for this, where it is not part of the clinical side of the practice.

• The day of your appointment, call the office and ask about anticipated waiting time for your appointment. Most offices run on-time and your wait should be less than 15 minutes. However, unforeseen emergencies do arise that may disrupt an on-time schedule. If delayed, consider rescheduling. Having a lengthy wait time may add to your anxiety and it may be best to arrange another visit.

• When you go, take a book, newspaper, or favorite magazine for your wait time. Don’t assume that the periodontist has a selection you’ll be interested in. Some people like to work a crossword or ‘Jumble’ during their brief wait here.

• When meeting the doctor or staff, know that it is important to be straight-forward about your fear level. Don’t gloss over it. Being upfront will help the doctor tailor your care to address your fears or concerns at an appropriate level.

• Ask the doctor about comfort options, including sedation. Both oral and IV sedation (twilight sleep) should be available. Feel free to ask questions about how they are administered, recovery time, and safety monitoring measures. Your safety is as important as your comfort.

• Finally, listen to your gut. Did you feel the doctor truly ‘heard’ your concerns? Did you feel the staff was attentive? Did you feel confident in the appearance of the practice? Sometimes, the most important measure of comfort is what that “little voice” inside is telling us. If you don’t feel good about moving forward, consider a consult at another periodontal office. You should leave your consult feeling positive about moving forward.

One of the most satisfying parts of my specialty is watching a once-fearful patient transform into one with a healthy, confident smile! And, the foundation of that is a relationship of trust between the doctor and the patient.

If you are ready to get past your dental fears so you can have the smile you desire, begin by calling our Asheville periodontal office and speaking with our friendly staff at: 828-274-9440. Or, start with the steps listed above and move at a pace that feels best for you.

Pregnant? Make Oral Health A Particular Priority!


Posted on Apr 23, 2019 by William J. Claiborne, DDS MS

With pregnancy, there seems to be a long list of do’s and don’ts for the mom-to-be. For instance, pregnant women are advised to avoid most drugs, alcohol, certain foods, and all smoking! Proper exercise, a balanced diet, and plenty of sleep help to keep both mother and baby healthy when it comes time for delivery.

Now, obstetricians are urging their pregnant patients (or those trying to become pregnant) to add a very important item to this list. They are advising particular devotion to achieving and maintaining good oral health.

The reason to keep a healthy mouth is based on decades of research and findings related to how infectious bacteria of periodontal (gum) disease can penetrate the bloodstream. Once bloodborne, the bacteria are able to activate inflammatory triggers elsewhere in the body.

A mother-to-be is especially vulnerable to gum disease due to hormonal changes during her pregnancy. Almost 50 percent develop pregnancy gingivitis, a mild form of gum disease that causes gums to become swollen, tender and bleed easily when brushing.

However, because of their susceptibility, the risk for full-blown gum disease is higher for pregnant females with nearly a third developing gum disease.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and babies of low birth weight (less than 5.5 lbs.). One study showed the preterm birth rate for females without gum disease to be approximately 11 percent compared to nearly 29 percent for pregnant women with moderate to severe periodontal disease.

It has also been shown that gum disease increases the likelihood for late-term miscarriage and pre-eclampsia. When oral bacteria reach placental membranes via the bloodstream, inflammatory reactions were found to trigger pre-eclampsia or early labor.

One study showed that pregnant women with higher blood levels of antibodies to oral bacteria also had higher incidences of preterm birth and babies of low birth weight. These elevated antibodies have been found in amniotic fluid and fetal cord blood samples of infants who were preterm or of low birth weight at birth.

When periodontal disease is present, however, successful treatment has shown to lower the risk of preterm births.

For all individuals, however, the bacteria of gum disease is coming to light as a major contributor to a number of serious health problems. It is the nation’s’ leading cause of adult tooth loss and has been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

Once the infectious bacteria of gum disease enter the bloodstream (typically through tears in weakened gum tissues), it can trigger inflammatory reactions, many serious and some that can have deadly consequences.

It is important to know the signs and symptoms of gum disease. These include gums that bleed when brushing, frequent bad breath, swollen or tender gums, gums that pull away from the base of teeth, or gums that darken in color.

While any of these should prompt an individual to seek out periodontal treatment, pregnant women have a particular need to seek care. A periodontist has specialized training in the diagnosis and treatment of all levels of gum disease – in a way that is safe for pregnant women (as well as all patients).

If you have any of the symptoms mentioned above (whether pregnant or not), you are urged to schedule an appointment at your earliest convenience. Call 828-274-9440 to arrange an examination to begin.