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Don’t Smoke? Living Or Working With A Smoker Creates Higher Risks Than Once Thought.


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

I doubt there is anyone in the U.S. who smokes tobacco who is unaware of the fact that it’s an unhealthy habit. Although the heart and lungs are more widely associated with the health risks of smoking, many people miss the fact that it is also damaging to the tissues in the mouth.

Consider the devastating statistics of COVID-19 related deaths in the U.S., nearing the 600,000 mark. Yet, when it comes to your oral health, cigarette smoking is responsible for more than 480,000 deaths per year in the United States. For people who don’t smoke but live or work with a smoker, secondhand smoke exposure accounts for over 41,000 of these.

For nonsmokers who are victims of secondhand smoke, that’s a tough statistic to accept.

Just how harmful is secondhand smoke? British researchers recently released some interesting findings along these lines. Their studies included several major countries and tracked nearly 7,000 adults, with nearly half being exposed to secondhand smoke. The findings showed that breathing in the smoke of another person’s cigarette can increase the risk of oral cancer by more than 50 percent. These cancers include lip, mouth and throat cancers.

On average, smokers die 10 years earlier than nonsmokers. For every person who dies because of smoking, at least 30 people live with a serious illness related to smoking. Smoking leads to disease and disability and harms nearly every organ of the body.

When considering the mouth, smoking can create costly problems in addition to a higher risk of tooth loss.

Twenty years of research shows that cigarette smoking is a risk factor for periodontitis. A smoker is 2 – 3 times as likely to develop periodontitis, which is an advanced stage of gum disease. In addition to increased prevalence, smokers also experience greater severity of gum disease.

Nicotine (in any form) has been shown to reduce blood flow in the gum tissues in the mouth. Pipe smoking can be worse than cigarettes due to the higher temperatures generated in the upper jaw. When it comes to dental implants, smoking is a risk factor for failure. It is also detrimental for conventional bridgework.

Cigarette smoking has long been associated with serious oral conditions, including periodontal (gum) disease, bone loss, tissue loss, and tooth loss. For smokers who opt for dental implants to replace missing teeth, they have a higher risk of peri-implantitis, which is inflammation of the soft and hard gum tissues surrounding a dental implant. To no surprise, smokers have a higher incidence of dental implant failure.

In an article published by the Journal of International’s Society of Preventive & Community Dentistry as far back as 2012, it warned that smoking can impact the rate of dental implant success, accounting for up to 20 percent of failures.

“Clinical trials of endosseous implants consistently rate smoking as a primary patient-centered risk factor for implant loss.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894084/

It is common knowledge that the nicotine in cigarettes, e-cigs and ‘chew’ is an addictive drug. Some concerning quotes shared by the Oral Cancer Foundation are:

“Scientists have found that nicotine is as addictive as heroin, cocaine or amphetamines, and for most people, more addictive than alcohol,” states the article “Nicotine, Harder to Kick than Heroin,” published in the New York Times Magazine.

“Nicotine is similar in all critical measures to prototypic drugs of abuse such as cocaine, morphine and heroin.”

“Nicotine is a poison used as an insecticide.”

https://oralcancerfoundation.org/understanding/tobacco/tobacco-and-addiction/

Now, knowing the effects of secondhand smoke are likened to the non-smoking “victim” as inhaling half as many cigarettes as the user they live or work with, smokers should consider their habit in a different light.

While our Asheville periodontal dental office does not lecture or “guilt” our patients in any way, we feel they deserve to know the hazards of any risk factor related to the well being of their oral health. Without a doubt, smoking (whether cigarettes or vaping) is harmful to oral tissues and the potential to keep natural teeth.

In a report shared by Delta Dental, smokers are about twice as likely to lose their teeth than non-smokers, according to two 30-year studies at Tufts University in Boston. Their findings showed that men who smoke lose about 3 teeth for every 10 years of smoking, with women losing an average of 1.5 teeth per decade.

https://www.deltadentalins.com/oral_health/teethinpack.html

Every year, about half of smokers make some attempt at kicking the habit. Yet, only 6 or so percent are fully successful. All the while, the tobacco industry spends BILLIONS of dollars each year on cigarette and smokeless tobacco advertising and promotions.

According to the Centers for Disease Control & Prevention (CDC), in 2018 “$9.06 billion was spent on advertising and promotion of cigarettes and smokeless tobacco combined—about $25 million every day.” That’s more than $1 million dollars spent every hour of every day.

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm

While nicotine addiction means big money to the tobacco industry, it is enormously costly to our population. Now, knowing that secondhand smoke is so harmful to others, I hope our smoker patients will welcome our respectful support in their efforts to quit as we help them to maintain good oral health and keep their teeth (or dental implants) healthy for a lifetime of confident smiles.

If you’ve considered dental implants to replace missing teeth and smoke, please consult with us to discuss ways we can help you minimize the potential for dental implant failure. We want you to reap the benefits of a smile you’ll want to share proudly.

Call 828-274-9440 to schedule.

 

Your Tongue Is A Multi-Tasker!


Posted on May 05, 2021 by William J. Claiborne, DDS MS

With the tongue occupying such a large area inside the mouth (or ‘oral cavity’), you’d think its anatomy would be common knowledge. Because this muscle functions continually without tiring, it tends to be taken for granted. It’s importance to your overall health, however, is unbounded.

To correct a common misconception about the tongue, it is not the strongest muscle in the body. Although it ranks in the top 5 or so, the muscles surrounding the eyes actually have that supremacy. The heart, deemed the hardest working muscle in the body, and the masseter (jaw muscle) are also among those that are the body’s stand-outs.

The tongue does many things. It provides our sense of taste, is vital in pronunciation, moves food around as we chew, and aids in swallowing while helping to prevent certain things from being swallowed.

Not one muscle but a combination of 8, the tongue is coated with papillae. These are the tiny, bumpy protrusions on its surface. They help in various ways but are mostly credited for our sense of taste.

Different areas of the tongue are more sensitive to certain tastes. For example, the tip of the tongue detects sweet to the greatest extent while the sides detect sour.

Papillae also sense touch so that we can feel the form and texture of food.

Saliva helps to keep the tongue moist so it can move around the oral cavity freely. Saliva is also helpful to the tongue by moving bacteria from its surface. However, saliva cannot keep the tongue bacteria-free.

Saliva and food residue can get stuck in the grooves between the papillae, especially on the last third of the tongue. This can create areas for bacterial growth. These bacteria thrive on remains of protein-rich food like fish, cheese or milk.

Here is where, as an Asheville periodontist, I have a particular interest in the tongue. As bacteria accumulate, a whitish film covers the tongue, which also causes bad breath. Keeping bacteria in the mouth to manageable levels is greatly supported by saliva flow.

The tongue’s underside covers two salivary glands of the lower jaw (submandibular glands). These ducts are located where the tongue meets the floor of the mouth.

If you’ve read some of my previous articles, you’ll recall that I’m constantly reminding readers of the hazards of having a dry mouth. Smoking, consumption of alcohol and caffeine, and many medications are all obstacles to the salivary glands being able to function efficiently.

A dry mouth provides a breeding ground for bacteria reproduction. When you consider the amount of bacteria embedded in the tongue’s surface, oral bacteria levels in the mouth can run rampant.

Because the tongue’s surface color can indicate too much oral bacteria, it should be looked at during at-home oral hygiene regimens. It is advised that, after brushing teeth, using the toothbrush to brush the tongue. This can dislodge an enormous amount of bacteria.

Although brushing the tongue tends to be done on the front area, it’s helpful to brush towards the back of the tongue where most bacteria exist (hence, the whiter color and smoother surface). Gagging will stop you from going too far so use that as a guide.

Some toothbrushes have a tongue scraper surface on the back side of the bristles. There are also tongue scrapers available for purchase. These are flexible strips that should be used to scrape from back to front 3 or more times after brushing. Rinsing the scraper is advised after each pass.

To provide even more support in helping the oral cavity control bacteria, an oral rinse can be very helpful. After brushing (for a minimum of 2 minutes) and flossing, swish for 30 or more seconds with an alcohol-free mouthwash. While the intensity of the mouthwash may be greater with initial use, most people notice its easier to swish around the mouth within a week or so.

Low bacteria levels in the mouth make for fresh breath and reduced risk of developing cavities and gum disease. Periodontal disease begins with gingivitis, which causes gum tissues to be tender and bleed when brushing.

Periodontitis, an advanced stage of gum disease, causes red, sore, spongy gums. Other symptoms are persistent bad breath, bleeding easily, gums that loosen from the base of teeth, and teeth that loosen.

Periodontitis can also cause health risks far beyond the mouth. Because these infectious bacteria can enter the bloodstream through tears in the gum tissues, it has been shown to trigger or worsen the development of serious health problems. Some of these are stroke, heart disease, arthritis, Alzheimer’s disease, some cancers, and diabetes.

When it comes to the tongue, remember its important role to your oral and overall health. Keep the mouth moist and its surface clean and your reward will be sweet (without the calories!).

If you are experiencing any signs of gum disease, call 828-274-9440 for an appointment. Gum disease does not go away on its own and will progressive worsen without treatment. Remember – it is the number one cause of adult tooth loss in the U.S.

 

Advanced Skills & Technology Enhance Comfort, Speed Healing


Posted on Apr 27, 2021 by William J. Claiborne, DDS MS

If you’ve ever watched a cabinet maker, his skill and attention to detail is impressive. He knows the various wood types, understands the details of joints and angles, and respects the individual components as interacting pieces that will work harmoniously as a whole.

Because he has the tools and skills specific to his craft, the coming-together of this typically provides a ‘forever’ result.

In the periodontal specialty, our specific skills create a number of advantages for patients who have different needs. Some of these skills are not always obvious, yet they allow for a higher level of success, greater comfort, and less time required for healing.

A periodontist, as defined by the American Academy of Periodontology (perio.org), is:

“A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”

As an Asheville periodontal specialist for over 25 years, I’ve utilized my advanced skills to help patients with a variety of needs that involve the gum tissues. These include:

– Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)

– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)

– Diagnosis and placement of dental implants

– Treatment of lesions or cysts in oral tissues

Although there are other treatments offered, our main goal is to provide the patient with a comfortable and positive experience within our specialized skills. We believe that patients will come to appreciate the advantages of having a healthy smile and understand how our involvement can create a healthier, more confident individual.

Here, our Western North Carolina periodontal dental office features some of the most advanced technology in dentistry. Many of these are not available in other dental offices elsewhere. Some of these features include:

LANAP With PerioLase MVP 7 – Laser-Assisted New Attachment Procedure is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical 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.

3-D Cone Beam Imaging
 – Ideal for diagnoses and treatment planning, these images provide a clear view of the upper and lower jaw, used for: intricate review of endodontics; periodontics; orthodontics; implantology: TMJ; and prosthodontics, as well as dental and maxillofacial surgery. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The process is quick, painless and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging
 – This enhanced tomography works with 3D imaging for exceptional detail and range.

CS 3600 Intraoral Scanner
 – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily for creating precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments). The scanner can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Computerized Dental Implant Placement
 – This advanced system for pre-surgical positioning of dental implants uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases.

In addition, we offer a unique environment for comfort. We understand how dental fear or anxiety can cause people to delay or avoid having dental treatment, sometimes for decades. Too, when regular dental cleanings and check-ups are not maintained, the results often culminate into more complex problems (and necessary repairs) in the future.

We help patients understand that these fears and concerns are not unusual. Our doctors and staff respect each patient and provide gentle, compassionate care – at every appointment.

For those who have high fear levels, we offer several sedation options, including oral and IV sedation. 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 (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our Asheville office, anesthesia is overseen by a Medical Doctor (MD) who is a board certified Anesthesiologist.

With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

How I would describe the difference between a periodontist and other dental specialists is in how gentle and respectful we are to the tissues in the mouth. These are tender layers that significantly affect the appearance of a smile and the health of teeth. By understanding the techniques to minimize incisions while effectively treating each area in the mouth, a periodontist is your expert.

We feel you’ll find no better periodontal dental environment. Call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.

 

How Straight Teeth Support Oral Health & Dental Implant Success


Posted on Apr 19, 2021 by William J. Claiborne, DDS MS

As a Periodontist, I often work in conjunction with other dental specialists to provide an optimal outcome at the direction of the patient’s general dentist. By combining our specific skills, we are able to create a complete-care integration of services tailored to attend to unique or complex needs.

For example, as a specialist in the treatment of gum disease and placement of dental implants, my skills are beneficial for ideal outcomes as well as in long-term success. This is especially true when I note signs of bite misalignment in a dental implant patient.

The ‘bite’ refers to how the top row of teeth fit to the bottom row. These upper and lower teeth should “rest” together harmoniously. This fit has a great deal to do with a balanced alignment that is far reaching.

For instance, when teeth are not in proper alignment, there is an interference in the

Teeth worn down from grinding, or “bruxing”

interaction of biting, chewing and even speaking.  This misalignment can strain the jaw joints as well as the muscles of the face, extending out to neck and shoulder muscles.

Bite misalignment is a common cause of temporomandibular joint (or TMJ) disorder. The TMJ are located on each side of the head and hinge the lower jaw to the skull. Continual stress on these joints can lead to an inflammation that triggers a series of problems.

In most cases, bite misalignment is what triggers night-time clenching and grinding. Known as bruxing, this action can result in chipped, broken and fractured teeth.  Other symptoms associated with a misaligned bite – and thus, TMJ problems – include frequent headaches and migraines, ear ringing, dizziness and difficulty opening the mouth fully.

As an Asheville periodontist, I also see how bite misalignment can cause the gums to recede. This occurs as misaligned teeth tilt or turn, which causes an unnatural pulling on the gum tissues surrounding the tooth at its base. As more vulnerable sections of the tooth are exposed, the risks for developing cavities and gum disease increases.

When it comes to dental implants, success rates can be greatly compromised with the presence of clenching and grinding. Here’s why…

A dental implant is placed in the jaw bone, serving as a replacement tooth root. During the first 3 – 6 months, the bone grows around it, securing it firmly into the bone surrounding it. This process is known as osseo-integration.

It is during this time that an implant is most vulnerable to the forces that clenching and grinding exert. When you consider that implants require up to 6 months to become fully integrated into the bone structure, the stress from grinding or clenching can disrupt this process.

According to an analysis published in Dental Implants (Oct. 2015), and using data from ten publications, bruxers experienced a 6.45 failure rate (as compared to 3.65 in non-bruxers.(https://journals.lww.com/implantdent/fulltext/2015/10000/bruxism_and_dental_implants__a_meta_analysis.5.aspx)

My involvement helps to detect what is not always apparent, yet could have a tremendous impact for a successful outcome. Working to help dental implant patients avoid problems in the future is my goal and helps to protect the patient’s investment.

Certainly, misaligned teeth that are crowded or crooked tend to bunch up together. These teeth often form tight angles, creating hard-to-reach areas that make thorough toothbrushing more difficult. As oral bacteria remain, these areas become breeding grounds for an overload of bacteria that run rampant. This can lead to the formation of cavities and the development of gum disease.

The problem of misalignment can result in a vicious cycle: (1) greater risk for gum disease; (2) higher potential for TMJ disorder; (3) increased risk for tooth loss; (4) more likelihood for dental implant failure.

Consider that periodontal (gum) disease is the nation’s leading cause of adult tooth loss. Thus, a condition such as bruxing, which can lead to gum disease, can increase the potential for tooth loss. And, in replacing teeth, bruxing can continue to compromise tooth replacement success (with dental implants or other means, such as crown-&-bridge).

If you’re considering dental implants but suspect you clench or grind your teeth, we’ll discuss ways you can achieve your smile goals and protect your investment.

Call our Asheville periodontal dental office at 828-274-9440 to schedule a consultation.