Keep The Mouth Moist To Minimize Bacterial Growth
Posted on Jul 22, 2021 by William J. Claiborne, DDS MS
When you think of an environment of a warm, dark, moist space, it would seem to be a perfect breeding ground for bacteria growth. For homeowners, the worry over this is often how easily mold forms in such places.
According to FEMA (Federal Emergency Management Agency), molds are microscopic organisms that thrive anywhere there is a moist environment. Growth can start on a damp surface within 24 to 48 hours.
Molds digest organic material, eventually destroying the material they grow on, and then spread to destroy adjacent organic material. (https://www.fema.gov/pdf/rebuild/recover/fema_mold_brochure_english.pdf)
As an Asheville periodontist, I can’t help but think of the similarities to the mouth. Bacteria in the mouth, when not removed, can multiply and form the sticky film that coats teeth and gums. This is known as plaque.
Like molds, plaque must to be removed to prevent its spread and destructive nature. This is what your twice-daily brushing and flossing regimen is intended to do. When plaque remains in the mouth for roughly 48 hours, it hardens onto teeth. This is tartar and typically forms between teeth or in chunks at the base of teeth.
Essentially, tartar is a hardened mass of bacteria. Like mold, tartar continues to grow if not removed. And, like mold, tartar can cause damage to what it is growing on and spread to surrounding structures.
In addition to a brushing and flossing routine, the mouth has a particular advantage in its ability to control bacteria growth. Saliva is a continual rinsing agent that moves bacteria out of the mouth before the reproductive ability begins or accumulation runs rampant.
However, a dry mouth, which can be the result of a number of factors, means saliva is operating at quite a disadvantage to oral health.
Oral dryness is a natural part of the aging process. It affects about one in five older adults. A dry mouth can also occur from:
• As a side effect of many medications (including prescription and OTC)
• Radiation therapy, especially for head and neck cancer
• Mouth-breathing, which may be due to nasal congestion or snoring
• Medical conditions, such as diabetes, Alzheimer’s disease, stroke and Sjogren’s syndrome
Mold has an odor. So does oral dryness, which reveals itself through bad breath.
Just as mold can destroy things like drywall, carpets and insulation, an overload of bacteria in the mouth can be destructive to teeth and gums. These living and breeding organisms thrive on gum tissues.
Although saliva is an aid in bacteria control, there is a limit to what the flow is able to manage. When oral bacteria reach a certain level, they cause inflammation in oral tissues. The early stage of this, known as gingivitis, causes the gum to become tender and swollen. When brushing, blood may be present in the sink when rinsing.
Gingivitis, at this stage, can be contained and resolved if quickly addressed. If not, the bacteria will continue to multiply. This creates inflammation in the gums. This means the inflammation has progressed to periodontal disease, which requires treatment since it is now below the gum line.
Beneath the gum line, the bacteria continue their attack on the structures that support natural teeth. This includes the bone structures surrounding tooth roots. At this point, the gums bleed easily and breath odor is persistently bad. The gums become red and swollen and may pull away from the base of some teeth (gum recession).
Resolving gum disease at this point requires a procedure known as scaling & root planing. This allows the dental professional to reach below the gum’s surface to remove the bacteria. More extensive than a dental cleaning, the gum tissues are numbed and the process may require more than one visit to complete.
If the disease is not treated, it will reach the stage of periodontitis. This is an advanced stage of gum disease that is highly infectious and destructive. Because it leaves the gum tissues in such a weakened state, the infection can easily penetrate beyond the gums and enter the bloodstream.
Symptoms of periodontitis are very uncomfortable. Gums turn spongy and breath odor is putrid. Pus pockets appear on the gums and it may become painful to eat. Some teeth may loosen and eventually need removal.
This is where the damage of periodontal disease bacteria becomes even more destructive. As bad as tooth loss is, hold onto your hat…
Because these bacteria can trigger inflammatory reactions elsewhere in the body, researchers have linked them to a wide range of serious health problems.
The bacteria of gum disease have been correlated to heart disease, stroke, some cancers, diabetes, arthritis, and preterm babies. This is rather telling as to the potency of this harmful bacteria and the destructive nature.
When mold in a house that began in one spot is ignored, the destruction spreads. That’s a pretty good reason to tend to the problem before it gets out of hand, right? Proper care for oral health is worth the minor investment of time and money to avoid the destruction that can occur, including keeping the mouth moist to support sufficient saliva flow.
Here are a few pointers to help you maintain oral moisture:
• Keep the mouth moist by drinking plenty of water throughout the day. Watch your limit of caffeine, including coffee, tea and colas.
• If you take medications that have a side effect of oral dryness, ask your doctor about options that may be less drying to the mouth. Or, increase your water intake and use a daily rinse to replenish oral moisture.
• If you snore or breath through your mouth during sleep, talk to your doctor about ways to resolve these problems. It may be as easy as adjusting your sleeping position or adding a side pillow. Or, an oral appliance may be advised.
• When medical conditions (acid reflux, sinus infections, diabetes, bronchitis) contribute to a dry mouth, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.
• Know that alcohol (including beer and wine) are drying to oral tissues. Try to swish with water between drinks or have a glass of water nearby to periodically dilute the drying impact.
• Smoking (cigarettes, cigars, vaping) delivers toxic chemicals into the mouth, with the gums taking the first brunt. Be aware of this added risk to the drying effects and take added measures to keep your mouth clean and moist.
I hope you never need the specialty care of a periodontist. However, should you find yourself in need of our care, we place a priority on comfort and ensure a respectful, compassionate approach to each individual.
In our Asheville periodontal office, we provide sedation (“twilight sleep”) for patients during many procedures, if desired. Our office also features some of the most advanced technology available in dentistry, including cone beam imaging, laser dentistry, and computerized guidance for dental implants and other procedures.
Begin with a consultation appointment by calling (828) 274-9440. New patients are always welcome and a referral is not always needed.
Why Seek A Periodontist For Dental Implants
Posted on Jul 13, 2021 by William J. Claiborne, DDS MS
Like many people, I value my relationship with my Internist. Through his care, I am confident that he understands my specific needs to oversee all aspects of my health.
Some of this care occasionally involves being referred to a specialist. For example, my Internist may advise me to see a dermatologist for a particular skin condition. Together, my internist and the dermatologist are able to work in unison so I’m receiving the proper treatment plan according to my particular needs.
I am also a specialist in the dental field. I am a periodontist, which is a specialist who receives most patients through referrals by a general dentist or another dental specialist. This is because a periodontist offers a unique set of skills as well as an advanced level of understanding when it comes to oral tissues and dental implants.
The American Academy of Periodontology defines a Periodontist as: “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.”
To reach this specialty requires an individual to be highly committed. A periodontist begins education by completing 4 years of college (undergraduate training) and then continues another 4 years in dental school to earn a doctorate. To specialize in Periodontics, he or she must further their education for another 3-4 years before completing the stringent requirements for a specialty certification in periodontics.
In addition to treating all phases of periodontal (gum) disease, a periodontal specialist is uniquely qualified to reshape gum tissues. This may be performed to correct a “gummy smile” or even out a smile line through crown lengthening. Periodontists also specialize in the diagnosis and placement of dental implants.
The advantages of a periodontist in dental implant treatment are multi-faceted. This specialist is trained to understand the intricate concepts involved in selecting the proper type of implant and skilled at placing implants at proper depths and angles. A periodontist is also able to optimize patient comfort during treatment and throughout the healing phase.
Using his or her advanced training in the diagnosis and placement of dental implants, a periodontist can help you enjoy a higher potential for dental implant treatment that lasts a lifetime. There are a number of reasons you should strongly consider having a periodontal specialist involved in dental implant treatment, including:
SELECTION OF IMPLANTS – Dental implants come in a wide array of shapes and sizes. Each system is designed to accommodate certain needs and preferences. For example, some implants are designed to support a full arch of teeth while others can be placed in areas where a great deal of bone loss has occurred. The selection of the implant type that is appropriate for your needs and goals requires a unique understanding of all implant types. That is, a periodontist can select the type that will work best for you rather than go with the one or two in which they have received training.
PLACEMENT OF IMPLANTS – In addition to selecting the best type for your needs, proper placement of implants has a great deal to do with having a successful outcome. When an implant that is too long, for instance, is placed in bone that is too shallow, it can have future repercussions that may require its removal. This could occur when a lower implant is placed too close to a nerve that runs horizontal through the jaw bone (mandible). Or, when an upper implant is placed in shallow bone, it can work its way into the sinus cavity. A periodontal specialist considers intricate factors that can effect your potential for success.
STRUCTURAL ISSUES – In addition to the factors involved with bone loss, other issues can ‘make or break’ having a successful treatment outcome with dental implants. For example, for people who have bite misalignment or TMJ disorders, they may be grinding or clenching their teeth during sleep – often unknowingly. Telltale signs of ‘bruxing’ including remaining, natural teeth that are chipped or worn. These forces are enough to crack a walnut. When dental implants endure these forces, especially during their ‘healing’ phase, there is greater risk for implant failure. A periodontist considers these issues prior to your treatment, helping you to bypass problems that can result in eventual removal.
INDIVIDUALIZED TREATMENT CONSIDERATIONS – Our goal is to help you get the most from your dental implants. When there are individual habits or preferences that can complicate success, we work with each patient to help them enjoy their dental implants for a lifetime. For smokers, we advise ways to support saliva flow and minimize oral bacteria levels. For people who take certain medications that can interfere with oral moisture, we recommend methods to keep the mouth properly hydrated. And so on. We want to make sure your care is individualized so your potential for implant success is high!
OPTIMAL COMFORT – For added comfort and relaxation, we offer Oral sedation or I.V. sedation (twilight sleep) for most procedures for those who want or need these options. Both sedations are administered to the highest standards of safety possible. Our sedated patients are closely monitored throughout treatment with advanced safety equipment and trained professionals. 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, also erasing memory of the procedure. At our Asheville office, Biltmore Periodontics administers sedation with the involvement of a highly-trained doctor of anesthesiology for optimal comfort and safety.
For individuals who wish to replace one or more missing teeth, it makes sense that dental implants have become the leading preference. Dental implants restore the look, feel, and function like that of natural teeth. They also help to prevent bone shrinkage that occurs when tooth roots are no longer present in the jaw bone. This process is known as resorption.
Resorption is what contributes to changes in facial appearance when the bone structures that give the face its shape start to shrink. When tooth roots no longer exist in the jaw bone, the stimulation once provided to the bone no longer exists. This causes the bone to shrink, or ‘resorb.’
As the bone mass declines in height and thins out, changes in facial appearance slowly evolve. For example, as the jaw bone thins, deep wrinkles form around the mouth. Eventually, the corners of the mouth will turn down even in a smile. Jowls form on each side of the face as facial muscles detach from the shrinking bone structure.
As the jaw bone continues to shrink, the chin becomes more pointed and the nose seems to get closer to it. This leads to a collapsed mouth that is known as a ‘granny look.’ This look ages the appearance of an individual far beyond their actual years.
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, bone rebuilding procedures can be performed to restore a healthy, more youthful face shape.
In addition to all the advantages of care through a periodontist, our Asheville periodontal office features some of the most advanced technology available. This includes laser dentistry and cone beam imaging as well as highly-advanced computerized options.
If you’ve considered dental implants to replace missing teeth, we invite you to consult with us during a private consultation appointment. A referral is not necessary. During this time, we will discuss your needs and goals as well as any concerns regarding comfort or costs.
To schedule, call (828) 274-9440.
Arthritis? Recommit Yourself To Having Good Oral Health.
Posted on Jun 20, 2021 by William J. Claiborne, DDS MS
According to the Centers For Disease Control & Prevention (CDC), over 47 percent of American adults are living with some level of gum disease. For those age 65 and older, this figure jumps to 70 percent.
These concerning statistics are nothing to ignore. Although gum disease is so common, it increases risks that go far beyond the mouth. Over the years, research has tracked many diseases and conditions that correlate with gum disease bacteria. The inflammatory reactions triggered by these infectious bacteria have been linked to heart disease, stroke, some cancers, diabetes, preterm babies, and impotency.
Research has also shown a notably close relationship between gum disease and rheumatoid arthritis (RA). These studies have been ongoing for many years, and the findings should be concerning to all adults.
RA is a debilitating, painful disease that destroys joints. RA often emerges gradually, initially causing morning stiffness and weak, sore muscles. As inflammation from RA worsens, joints become swollen. Joints become achy and stiff most often in the fingers, wrists, elbows, hips, knees, ankles, toes and neck. Unfortunately, there is no cure for RA.
On a positive note, studies have shown that treating RA patients who have periodontal disease helps to improve RA symptoms. It is felt that this occurs because of a lighter burden of oral inflammation to the body’s immune system.
Below are some of the findings you may want to review. First, however, it’s important to understand how gum disease begins and some signs and symptoms.
In the initial stage of periodontal (gum) disease, known as gingivitis, the gums may bleed when brushing. Bad breath is more frequent and the gums may be tender or swollen. As the disease progresses, the gums turn red and may pull away from the base of some teeth.
Bad breath becomes persistent and pus pockets may form at the base of some teeth. As the infectious bacteria attack the bone structures that support tooth roots, teeth will begin to loosen and may need removal. Gum disease is the leading cause of adult tooth loss in the U.S.
In addition to the devastating damage in the mouth, the infectious bacteria of gum disease can enter the bloodstream through diseased gum tissues, causing the inflammatory triggers that activate serious health problems, such as RA.
Years ago, researchers noticed an RA-perio trait among people with rheumatoid arthritis. While RA sufferers had gum disease more often, they observed that people with gum disease tended to have RA more often.
As researchers delved deeper into the connection, it appeared that the association is much more complicated than previously thought. Findings now suggest that oral bacteria could actually be a cause of rheumatoid arthritis.
In the past, doctors felt that periodontal disease was a result of RA itself since stiff, painful hands make it challenging to maintain good oral hygiene. They also suspected that medications prescribed to treat RA could be a factor since the drugs, which suppress the immune system, inhibited the body’s ability to fight harmful oral bacteria.
Both conditions cause chronic inflammation in tissues that connect to bone with both diseases having a similar inflammatory trigger. Even more similar is the particular species of bacteria found in periodontally-diseased tissues when compared with tissues around arthritic joints. In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis.
In 2017, study findings were released by Johns Hopkins University Division of Rheumatology, which noted evidence that the tissues in the mouth of a periodontally-compromised individual and the tissues of the joint in RA have a number of likenesses. Research has also shown a genetic link between the two.
Above all, these findings reinforce how oral health correlates closely to our overall health. When you consider how the presence of gum disease can significantly increase your risk for serious health conditions, having good oral health should be a priority for every American.
What can you do to lower your risks for tooth loss and contributing to (or worsening) serious health problems? Recommit yourself to thorough oral hygiene at home and having twice-a-year exams and cleanings.
If you have signs of gum disease, have treatment at your earliest convenience. Gum disease will only worsen and requires more treatment time and expense as it progresses.
Call 828-274-9440 to schedule an examination, or begin with a consultation to discuss your needs.
‘Perio’ Dental Terms
Posted on Jun 14, 2021 by William J. Claiborne, DDS MS
Occasionally, I like to remind readers of the benefits of thorough communication in dental offices, and especially in dental specialists‘ offices. When unfamiliar terms are used by the doctor or staff, it can easily leave patients in a confused state.
When patients feel less involved in their dental situation, they struggle to make decisions that are in their best interests, including decisions that can greatly affect long-term dental health.
In our Asheville periodontal dental office, we pride ourselves on providing a comfortable, respectful environment to our patients. We find that even patients who are anxious or “jittery” about dental procedures relax when they feel fully versed as to their needs, how they may have occurred, and their options in resolving the problem(s).
However, some dentists, hygienists, and dental assistants can become “immune” to the foreign nature of some terms. They tend to throw them out without realizing the terms are going askew rather than being absorbed by the patients to whom they’re communicating.
Ideally, any term or explanation that isn’t clear will prompt the patient to ask for clarity.
Below are some fairly common terms you may hear used by your dental caregivers. Hopefully, these will help you better grasp the unique situation you have that brought you to the dental chair in the first place.
PERIODONTAL (or PERIO): Defined, this means relating to or affecting the structures surrounding and supporting the teeth. Generally, however, this refers to the gum tissues in the mouth.
GINGIVITIS: This initial stage of periodontal disease causes inflammation of the gums, typically because a film of plaque (consisting of oral bacteria), has accumulated on teeth. Gingivitis is a non-destructive type of gum disease but, untreated, can progress to more serious levels that are highly destructive.
PERIODONTITIS: This inflammatory reaction is triggered by a buildup of bacteria in dental plaque. This stage of gum disease leads to a loss of tooth-supporting bone, formation of deep “pockets”, and eventually tooth loss.
PROPHY: Also known as a dental cleaning, a prophy is a treatment that involves the cleaning and polishing of tooth surfaces to control bacteria on the teeth and just below the gum line. A prophy is recommended every six months to maintain healthy gums and teeth.
BUCCAL: This is the cheek-side of teeth. For front teeth, it may also be referred to as the facial surface.
LINGUAL: The opposite of buccal, this refers to the surface of teeth that face the tongue.
MESIAL: This is the surface of a tooth that is closest to the midline of the face.
OCCLUSAL: This is the chewing surface of back teeth.
POCKETS: This is a small opening in gum tissues between the gums and the teeth where the gum should normally fit snugly against the tooth. A pocket holds bacteria, which can allow infection to penetrate below the gum line.
DEBRIDEMENT: When a buildup of plaque and calculus becomes imbedded around the gums and between teeth, a dentist or dental specialist often must remove it in order to perform a thorough oral exam.
ROOT PLANING: This is a non-surgical procedure for the removal of plaque, hardened tartar ( calculus), and/or stains from a patient’s teeth and tooth roots. This is typically performed to reach oral bacteria that has moved below the gum line.
MAXILLA: This is your upper jaw, which holds upper tooth roots. This bone is part of the skull structure and does not move.
MANDIBLE: This is the lower jaw bone, where lower teeth are held. This bone is hinged to the skull and moves up and down and slightly sideways, made possible by the temporomandibular joints (TMJ).
ARCH or RIDGE: In dentistry, this refers to the raised, gum covered “u” that supports the upper or lower teeth. For example, a “full arch of teeth” indicates a complete row of all upper or lower teeth.
Our goal is to create informed patients who are active in their care and decision-making process for having excellent dental health.
Research has shown that a healthy mouth supports a healthy body. It has proven that oral health is intricately connected to our whole health. By minimizing the level of bacteria in the mouth, you can avoid many problems associated with the teeth and gums AND give your overall health added support.
Bacteria accumulation can sneak up on you. Gum disease symptoms begin with tender gums that may bleed when brushing. The gums may become red (versus a healthy pink color) and pull away from the base of teeth. Bad breath becomes more frequent and some swelling may occur.
As it progresses, periodontal disease can cause deep, pus filled pockets to form on the gums. The gums may loosen from their grip around teeth and bad breath is persistent. Bleeding gums may occur easily; even eating may prompt bleeding.
Eventually, the bone and tissue structures that support teeth are so damaged that the foundation for teeth gives way and teeth may need to be extracted. Gum disease is the nation’s leading cause for adult tooth loss.
If gum disease exists, it will only worsen without treatment. Please contact our Western NC periodontal office to arrange a consultation or a complete examination. A periodontist specializes in the treatment of oral tissues and is your best choice for restoring a healthy mouth.
Call 828-274-9440. Let’s get you smiling confidently, and often!