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Protect Your Heart. Start With Your Smile!


Posted on Jul 17, 2019 by William J. Claiborne, DDS MS

According to a report on the health of Americans (published by the Centers for Disease Control & Prevention, or ‘CDC’), it is estimated that over 47 percent have some form of gum disease. Although we all aspire to have a smile that is appealing, it is what lies beneath the teeth and gums that can reek havoc on one’s overall health.

Signs of gum disease

Over time, inadequate daily oral hygiene enables an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even more susceptible to this bacterial buildup.

This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to ‘wash away’ bacteria at sufficient levels, the accumulation runs rampant.

Oral bacteria are living, eating, and reproducing organisms. They thrive on rotting food particles caught between teeth. They attack gum tissues and tooth enamel. Eventually, they can work their way down tooth roots and attack the bones and tendons that support teeth.

What’s even scarier is the fact that these infectious critters can enter the bloodstream. This potent bacteria are now associated with a number of serious health conditions due to their ability to trigger systemic inflammation.

When the gum tissues can no longer combat the onslaught of bacteria, there can be very few signs of periodontal (gum) disease initially. Signs that emerge are typically frequent bad breath along with swollen, tender and beefy red gums that bleed when you brush. As they grow in number, the gum tissues become weaker and they can penetrate the bloodstream.

According to the American Academy of Periodontology (www.perio.org),
“Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.
“Scientists believe that inflammation caused by periodontal disease may be responsible for the association.
“Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.”

For this reason, cardiologists are more often advising their patients to be evaluated by a periodontist prior to heart surgery. As mentioned above, gums that bleed are a sign of gum disease. These oral bacteria, given an opportunity to enter the bloodstream, are able to travel anywhere, including the heart. They can reach the heart muscle and cause a severe infection.

For decades, researchers have probed the link between gum disease and cardiovascular health. People with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke or other serious cardiovascular event.

Acting as a contributing factor to heart disease is highly serious. Yet, the risks associated with gum disease don’t stop there. Research has shown this potent oral bacteria can set a path of destruction into motion. It has been linked to some cancers, stroke, diabetes, arthritis, preterm babies, impotency, and even Alzheimer’s.

Twice-daily brushing and daily flossing takes mere minutes and is inexpensive to do. Seeing a dentist every 6 months for oral exams and cleanings saves an individual far more by preventing problems than they cost. Yet, too many adults fail to devote the investment to this necessary part of a healthy lifestyle.

An estimated 65 percent of adults ages 18 – 64 see a dentist only once a year. Approximately 55 percent of adults brush their teeth twice a day, which is too little. (https://www.reference.com/health/many-times-day-people-brush-teeth-34d1104798029b7a) I believe it would be jolting to most adults to view dental floss under a microscope after their teeth have been flossed.

As an Asheville periodontal specialist, I have an up-close view of the damaging affects of insufficient oral hygiene. It often results in tooth loss, which is not a natural part of the aging process, as some people believe. Having your natural teeth for a lifetime is more than achievable and has even been shown to add to one’s lifespan (by up to ten years).

If you’ve failed to be fully committed to your oral health, there is no better time to begin than the present. Start with a thorough periodontal examination. Call 828-274-9440.

If dental fears have prevented you from having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. This will be a friendly, informative conversation and you will not be asked to sit in a treatment chair during this visit.

Let’s protect you, top to bottom, beginning with your smile!

Dental Implants – Many Types Available For Different Needs & Preferences


Posted on Jul 10, 2019 by William J. Claiborne, DDS MS

As a periodontist, an area of my dental specialty includes advanced training in the diagnosis and placement of dental implants. This specialized expertise provides implant patients with a high level of success in treatment outcome. It also offers patients a wider variety of choices when it comes to implant systems.

When dental offices offer dental implants, some general dentists refer the placement portion to a periodontal specialist. For their patient, this can mean a higher level of success, especially for complex needs.

For example, a patient who is missing a lot of bone mass (often due to missing natural teeth for many years) benefits from the specialized skills of our Asheville periodontal office. Another example is a patient who has lost teeth due to periodontal (gum) disease. Because a periodontist combines advanced skills in treating gum disease as well as in dental implants, these patients are given a ‘leg up’ when it comes to treatment success.

Dental implant diagnosis and placement skills can vary greatly when offered by general dentists. While some have taken extensive courses in implant dentistry, others may have taken a weekend course here and there. These are typically ‘hosted’ by a particular manufacturer who provides ‘training’ in a limited selection of implant types. In turn, this can limit the patient’s choices when relying on appropriate recommendations for his or her unique needs.

Now seen as the preferred option for tooth replacement, dental implants are available to accommodate various challenges and preferences. There are numerous choices available. Some of the more common include:

Traditional Dental Implants: In this process, dental implants includes a couple of stages. Implant placement is performed first. This involves small incisions in pre-selected placement points. These points are determined through computerized imaging, taking the guesswork out of the depth and angle of each implant placed. Once the implant is in proper position, the gum tissue is closed over the implant sites.
For a ‘healing period’ of 3-6 months, the bone grows around the implants to secure each in place. This process is referred to as ‘osseo-integration,’ which describes the bone growing around the implanted portion. The process is similar to a rope tied around the branch of a tree. Over time, the branch grows around the rope. Osseo-integration is similar to this but occurs at a much more rapid pace.
After several months, the implant sites are uncovered and a post is positioned inside each implant. Onto the posts, the replacement teeth are secured. Rest assured, during the healing phase, patients are able to wear their denture or partial comfortably. Once the final teeth are attached, patients can enjoy their ‘new’ smile along with the biting and chewing comfort like that of natural teeth.

Non-Removable Teeth Attached To Implants: In the past, the more affordable ‘full arch’ systems were typically those designed to support removable teeth. (An ‘arch’ replaces all upper or all lower teeth.) However, some people feel removable teeth are too similar to the denture they have (and detest). Although firmly secured, the chore of having to remove their new teeth to clean is undesirable to many people.
A number of implant systems are available, designed to provide non-removable options that are more affordable. For example, the All On 4 dental implant system is made to support non-removable teeth, often on just 4 implants. With the implanted portions placed at unique angles, these longer implants can fully distribute biting and chewing forces.
 Another advantage of All On Four is their ability to be placed in minimal bone. This is good news for people who are long-time denture wearers and were told they have too little bone to support implants. Or, they may have been advised to have bone grafts to rebuild the bone to an adequate height. This adds time and expense to implant treatment. Often, the All On 4 design is able to overcome this obstacle.

‘Same-Day’ Dental Implants: With advanced implant systems and technology, implant placement and teeth attachment can be accomplished in a single day. Advanced implant designs can position implants in the jaw bone that are ready to support replacement teeth. With the replacement teeth created prior, the teeth may be attached without delay.
 In some cases, a previously-made denture or partial can be reconfigured to attach to newly placed implants. “Implants in a day” isn’t wise for all situations, however. This option should be diagnosed and performed by a skilled, experienced professional who understands both the requirements and limitations involved. Putting your care in the hands of an experienced, skilled and highly-trained dental specialist is the best way to achieve a successful outcome. Just a note – while these quick-&-easy procedures can sound appealing, be cautious of ‘clinic’ settings who promote same-day implants. For an optimal outcome, choose care where your individual needs are a priority, rather than corporate profit goals.

Modern implant dentistry is successful, safe, dependable and can provide nearly immediate benefits. As a dental specialist who has stayed on the cutting edge of implant dentistry’s techniques, technology and materials, I am pleased to witness the transformations our patients undergo after treatment.

Dental implants are designed to last a lifetime and the closest thing to the natural teeth you once had. Too, the restored ability to bite, chew, speak and laugh confidently and even sneeze without worry can provide a tremendous boost to one’s self-esteem, self-confidence.

The type of dental implant best suited for you can be determined after an examination and review of x-rays (we use Cone-Beam digital imaging). Call 828-274-9440 to begin with a private, no obligation consultation to discuss your best options.

A Spot In The Mouth May Resolve On Its Own, Or Not. Know When To React.


Posted on Jul 01, 2019 by William J. Claiborne, DDS MS

Having a sore spot in the mouth occurs from time to time. Biting the inside of the cheek, foods that are highly acidic, or stress can all lead to sores.

Some viruses and other conditions can contribute to worse problems, however. It is important to know what to look for when it comes to an unusual spot in the mouth. Knowing when to watch and when to see a dentist could be a literal lifesaver.

Fortunately, most sores in the mouth resolve on their own. These include…

Canker Sores
Small ulcers with a white or gray base and a red border. Unlike cold sores, canker sores appear inside the mouth. They are not contagious but their exact cause is uncertain. Some experts believe that immune system problems, bacteria or viruses may be involved. Fatigue, stress or allergies can increase the likelihood of a canker sore. A cut caused by biting the cheek or tongue, or reactions from hot foods or beverages may contribute to canker sore development. Intestinal problems, such as ulcerative colitis and Crohn’s disease, also seem to make some people more susceptible. Canker sores usually heal on their own after a week or so. Over-the-counter topical anesthetics, steroid preparations,  and antimicrobial mouth rinses can provide temporary relief.

Cold Sores
Also called fever blisters or Herpes simplex, these are groups of fluid-filled blisters that often erupt around the lips, under the nose, or around the chin. Cold sores caused by herpes virus type 1 are very contagious. Herpes lesions look like multiple tiny fluid-filled blisters that are most common around the edge of the lips. An outbreak may follow a fever, sunburn, skin abrasions or emotional upset. Cold sore blisters usually heal in a week by themselves. Over-the-counter topical anesthetics can provide some relief. Prescription antiviral drugs may reduce the duration of these kinds of viral infections.

Leukoplakia
Leukoplakia cause one or more white patches or spots (lesions) to form inside the mouth. Most who have the condition are males between the age 50 – 70. Although leukoplakia can be caused by a rough tooth or an irregular surface on a denture or a filling, it is often associated with heavy smoking or other tobacco and heavy alcohol. In some cases, however, the cause cannot be determined. Leukoplakia is especially concerning because it can eventually develop into oral cancer.

What will NOT resolve on its own and requires prompt evaluation are changes to oral tissue that do not heal within 14 days. DO NOT DELAY! This is a symptom of Oral Cancer. Nearly 40,000 Americans are diagnosed with oral or oropharyngeal (throat) cancer each year. These cancers kill about 1 person every hour, every day.

Symptoms of Oral Cancer that are most common include:

• white or red patch of tissue
• lesion in the mouth
• difficulty or discomfort when swallowing
• persistent sore throat
• a lump or mass inside the mouth or neck
• wart-like mass
• numbness in the oral/facial region

The survival rate is one of the worst of all cancers, with only 57 percent estimated to be living 5 years from diagnosis. The death rate is higher than cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, thyroid cancer, or skin cancer (malignant melanoma).

Although the death rate has seen a slight decrease since 1980, some symptoms do not emerge until the cancer has reached advanced stages. This is because lesions or discolorations that are early warning signs are not always visible, particularly in the back portion of the mouth (the oropharynx, the tonsils, and base of tongue), which can be an obstacle to early diagnosis and treatment.

This is yet another reason that keeping your regular oral hygiene exam and cleanings is so important. During these times, your dentist and hygienist look for unusual changes in the mouth that can indicate a problem. Please remember – NEVER wait until your scheduled appointment to have anything unusual examined.

Although a stubborn canker or cold sore may not be welcome, they tend to go away in a week or ten days. Again, if an unusual spot or sore is still present after two weeks, call our Asheville periodontal office at 828-274-9440 immediately for an appointment.

A Dry Mouth Can Have Many Causes And Lead To A Number Of Oral Health Problems


Posted on Jun 21, 2019 by William J. Claiborne, DDS MS

Our lips and teeth – our smile – is a stage curtain to what is actually going on inside the mouth. As an Asheville periodontist, I have a daily view of  the hazards that exist beyond the veil.

Oral bacteria is the root source of most problems that occur in the mouth. Their presence is normal, of course. The mouth (or “oral cavity”) is designed to be able to manage a certain level of oral bacteria. It is the over-accumulation of this bacteria that is the origination source of many problems.

Although certain foods, such as a garlicky shrimp or onion-laden hot dogs, can create “stand-offish” bad breath, this breath odor is temporary. The bad breath that is truly offensive and occurs on a more consistent basis comes from an overload of oral bacteria.

The reason we’re advised to brush at least twice a day and floss our teeth daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, the bacteria form a sticky film that coats the teeth and gums. This film is known as plaque.

Keep in mind that bacteria are living, eating, and reproducing organisms. Because they eat, they also create waste – in our mouths! Although that in itself should be reason enough to be committed to brushing and flossing, without pain, people assume that all is well.

Yet, an over-accumulation of oral bacteria can lead to far worse than bad breath. Because oral bacteria critters eat, they look to the gum tissues. As they amass, they can create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth.

Periodontal disease is the leading cause of adult tooth loss. The advanced stage of gum disease, known as periodontitis, creates a bacteria so potent that it has been linked to a wide array of conditions and diseases elsewhere in the body.

The oral bacteria of advanced-stage gum disease has been associated with some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency. As research continues, more and more health problems are being correlated to this bacteria.

The saliva in the mouth is designed to move bacteria out. Twice daily brushing and flossing help. However, certain contributing factors complicate the ability to keep oral bacteria levels to manageable levels. These include:

• Colas/Sodas: Not only is the acidity level in these drinks harmful to tooth enamel, it can make oral tissue to dry out. Downing these beverages because you feel you are replenishing moisture is the last thing they do; refreshing they are not. Drink plain, filtered water instead. It’s much better for your mouth and hydrating to the entire body.

• Coffee/Tea: Like colas, these drinks contain acid added to caffeine. Even green tea often contains caffeine. Caffeine has a drying effect on oral tissues and therefore depletes the helpful rinsing benefits or saliva.

• Alcohol (including beer and wine): Mixed drinks, “shots,” wine and even beer are all drying to oral tissues. Add the acidity and sugar levels that exist in wine or mixers and these drinks pack a double-whammy to oral tissues. If you imbibe, alter your drink with a glass of water in-between to neutralize acids and wash sugars from the mouth.

• Smoking (cigarettes, cigars, vaping, cannabis): People who have smoked for years often have dry skin that has an aged appearance far beyond their actual years. The same is occurring inside the mouth. The smoke of cigarettes and cigars is laden with toxic chemicals; true for e-cigs as well. Vaping doesn’t keep your mouth much safer than cigarettes. Even marijuana has been found to have a negative impact on oral tissues.

• Aging: Through aging, our skin, cartilage, and tissues are less supple. Our bodies simply dry out more and more with each decade. Although there’s nothing we can do to halt the aging process, we can take measures to minimize the damage to our oral health. We recommend drinking plenty of water throughout the day, using an oral rinse designed to replenish moisture in the mouth, and limit sugar and caffeine.

As a periodontist, I also urge people to be familiar with the signs and symptoms of periodontal disease, which begins with gingivitis. In this early-stage of gum disease, the gums may feel tender and swollen in one area. You may notice some bleeding when brushing your teeth. Your breath may feel less-than-fresh more often. However, some people experience no symptoms at all at this early stage.

If not treated, gingivitis can progress to periodontal disease, where symptoms are more obvious. The gum tissues are sore and bleed easily when brushing. Your breath will be bad more frequently. The gum tissues may swell in some areas and turn red.

As gum disease advances, the gums can begin to pull away from their tight grip around the base of some teeth, exposing darker, more sensitive areas of the tooth’s root. The gums will ache often and pus pockets may form at the base of some teeth. The breath is foul, even after brushing. And, tooth brushing is very uncomfortable with blood in the sink each time.

Eventually, the disease will have penetrated the supportive bone and ligaments that support teeth. In advanced cases, the teeth will begin to move and some may require removal.

All of this devastation to the mouth can be avoided, however. When people respond to early signs of gum disease by seeing a periodontal specialist, they can avoid the time and expense required. In addition to preventing the loss of natural teeth,

Enjoy beautiful, relaxing views from our surgical suite.

research now shows that serious health problems far beyond the body can be avoided as well.

If you have delayed or avoided dental care, begin with a consultation to learn about your options to have a healthy smile that is worry-free. Regardless of your love of coffee, your smoking habit, or your age, we can develop a program that allows you to have good oral health.

Begin by calling 828-274-9440 to request a consultation, or begin with a thorough examination in our Asheville periodontal office. We offer the latest techniques, technology, and skills while always putting patient comfort at the top of the list!