Recent Posts



Missing Tooth Roots At The ‘Root’ Of Your Problem

Posted on Mar 28, 2016 by William J. Claiborne, DDS MS

When natural tooth roots are missing, the upper or lower jaw bone that once held them goes through a change. It’s a process known as ‘resorption,’ which describes the shrinking or declining mass of the bone.

Resorption occurs because the bone no longer has the stimulating presence of the tooth root. As the bone declines in height and width, neighboring teeth feel the effects of this bone loss. Adjacent tooth roots become bordered by an insufficient bone structure, causing these areas to become susceptible to a higher risk of cavities, gum disease, and tooth breaks or fractures.

While a crown-&-bridge combination can replace missing teeth, a bridge does not restore stimulation to the jaw bone. Eventually, the decline in bone mass reveals itself when a gap becomes visible between the bridge and the gums.

For those who wear a denture or partial denture to replace missing teeth, the pressure on the gums from these appliances actually accelerates the rate of bone loss. And, for those who sleep in these appliances, the 24/7 rate of pressure speeds up bone loss even more.

Profiles of healthy jaw bone and resorbed bone.

Profiles of healthy jaw bone and resorbed bone.

Bone loss through resorption is also the cause of facial changes, most of which are aging to one’s appearance. These include deep wrinkles that form around the mouth, the corners of the mouth turning downward even in a smile, a pointed chin, jowls that form from the detachment of facial muscles and a mouth that looks collapsed into the face (known as a ‘granny look’).

Halting bone loss can be done through the placement of Dental Implants. Since they are positioned in the jaw bone, they recreate the stimulation of tooth roots. Additionally, Dental Implants restore biting strength and stability without the fear of embarrassing slips.

Dental Implants are also self-supporting. This means that crowning neighboring teeth to support a bridge or partial is not necessary. With the jaw bone as their foundation, Dental Implants stand strong on their own.

Another bonus of Dental Implants? With proper selection, placement and care, Dental Implants are designed to last a lifetime. This is why it is important to have your implants placed by a skilled, experienced doctor. As a Periodontist, my specialty includes this advanced skill in both diagnosis and treatment.

Whenever possible, save your natural teeth to keep those tooth roots where they belong! However, losing a natural tooth doesn’t mean you need to suffer the long-term repercussions of bone loss.

Ask about Dental Implants to restore a natural look and feel while you protect surrounding teeth and bone structure. Call 828-274-9440. Begin with a consultation, if you prefer.

Reasons For Crown Lengthening Procedures

Posted on Mar 21, 2016 by William J. Claiborne, DDS MS

As a Periodontist, my specialty surrounds the treatment of all stages of gum disease and the placement of Dental Implants, for the most part. However, another focus of the periodontal specialty is in the recontouring of gum tissues.

In some cases, this is done to provide cosmetic enhancement to the appearance of a smile. For example, crown lengthening is often performed to correct an uneven smile line. This occurs when there are varying levels of gum tissue arching each tooth. This uneven line of gum tissue leaves an up-&-down frame for teeth most visible in a smile. Even straight teeth look less attractive with uneven gum arches. By contouring the gums to provide a unified border over teeth, crown lengthening provides a more appealing smile overall.

Another esthetic reason for crown lengthening is to repair a ‘gummy smile.’ A gummy smile is one that shows too much gum tissue above the teeth. While this is a genetic trait and is not related to an oral health issue, some people with a gummy smile feel self-conscious when smiling a full smile and tend to ‘hold back.’ In some cases, excess gum tissue can be corrected by careful removal while others may require crowning involved teeth. Crowns ensure the gums can be contoured to a more natural level without compromising the future health of teeth.

Katie Couric - a famous 'gummy smile.'

Katie Couric – a famous ‘gummy smile.’

There are other reasons for crown lengthening, such as helping to save a tooth from removal. For example, when a tooth has broken close to the gum line, crown lengthening procedures can remove gum tissue to expose more of the tooth. Because a tooth that breaks at the gum line must be removed, this procedure can make sufficient tooth structure available to support a crown. Saving a tooth can keep the patient from having to deal with the decisions of tooth replacement and associated costs.

Crown lengthening is also beneficial in sealing gum tissues surrounding a tooth at its base. This is important after a new crown is placed as it prevents bacteria from penetrating the gums during the vulnerable stage of attaching. By securing the gum tissue around the crown, bacterial entry is avoided and the risk for periodontal (gum) disease decreased.

The crown lengthening procedure is clinically referred to as a Gingivectomy. It is performed with the patient sedated and comfortable. Some swelling and gum tenderness may follow, although most patients only require over-the-counter medications. If you smoke, you can expect the healing period to take longer since the chemicals in tobacco have drying effects on gum tissues. However, most patients are back to normal within several weeks with the beautiful look that crown lengthening provides.

If gum recontouring could provide a more appealing smile, the results of crown lengthening, in many cases, are significant. However, when crown lengthening can save a tooth or help to prevent gum disease, from a Periodontists’ point of view, the advantages are priceless!

Begin with a consultation to discuss creating the smile you desire. Call 828-274-9440 to schedule.


Rocky Dentures? Why Relines Are Of Little Help.

Posted on Mar 16, 2016 by William J. Claiborne, DDS MS

As a dental specialist, I am referred most of our patients by other dentists. Being a Periodontist, my advanced training and skills are ideal for people who have any level of periodontal disease as well as those who want or need dental implants.

When it comes to dental implant patients, what I see most often are those who have worn dentures for a number of years who are exhausted with the uncomfortable rubbing and the inability to eat the foods they once enjoyed.

These patients typically tell me that their denture fit snugly when it was first made. Over time, however, they started noticing that the denture would cause sore spots on their gums. It would move when they chewed certain foods, even when they used denture adhesives or pastes.

Healthy Jaw Bone Vs Bone Loss From Wearing Dentures

Healthy Jaw Bone Vs Bone Loss From Wearing Dentures

I’ve heard patients describe how painful it is to have something as small as a strawberry seed or nut particle become trapped under the denture, piercing into their tender gum tissue. Some have shared how they had to eventually switch to a diet of soft foods that dissolved easily so they wouldn’t have to chew. And, many admit that they started declining invitations that included a meal.

What many people don’t realize when they first opt for a denture is what occurs underneath the gum tissue. This is where the problem lies. It’s not that the denture is shrinking or changing shape. It’s your jaw bone. And the pressure placed on the bone from wearing dentures is only making matters worse.

When natural tooth roots are removed, the jaw bone that once held them is no longer fed the stimulants that kept it healthy. After a few years, it will shrink in height. This decline in mass is what causes changes in facial appearance, such as deep wrinkling around the mouth and the formation of jowls. And, it’s what causes the denture to move.

As time goes on, so does the process of bone loss. This means that the ‘ridge’ your denture was designed for flattens. A reline can rebuild the denture to accommodate some of the change. However, as the bone continues to decline, the denture continues to be ill-fitting.

While the pressure of wearing a denture certainly accelerates the rate of bone loss, a number of denture wearers also sleep in their denture. This round-the-clock pressure speeds up the rate of bone loss even more.

Not being able to eat and fear of embarrassment are common complaints of denture wearers. The solution is dental implants. Not only do implants restore the ability to bite and chew comfortably, they halt the bone loss associated with dentures. This is because they recreate the presence of tooth roots in the jaw bone.

When it comes to your smile, words like rocky, wobbly and slippery should never be a part of the description. When people opt for dental implants to replace an unstable denture, they smile, laugh, eat and even sneeze with confidence.

Eating a healthy diet, socializing with friends and family, and feeling confident are not luxuries. They are essential to a healthy, happy life. Call 828-274-9440 to schedule a consultation. During this, I’ll explain the type of implants that may be best for your needs and goals. We can also discuss estimated costs and payment options.


Important To Keep Your Dentist Updated On Your Medications

Posted on Mar 09, 2016 by William J. Claiborne, DDS MS

So what does the prescription you take for high blood pressure have to do with your dental care? And, why should you bother to tell us if you’re taking a supplement for anxiety?

Many medications don’t interact well with other medications, and even some supplements. It is important that your dentist and dental specialist have an up-to-date list of ALL medications you take. Here is why:

Medications such as Heparin or Warfarin help to reduce blood clotting, which lowers your risk for stroke and heart disease. That’s good. However, it is important that your dentist know about these since they can cause bleeding problems during oral surgery or periodontal treatment.

For those who take medications that help to strengthen bones, these have been associated with a rare but serious condition called osteo-necrosis of the jaw. Simply put, it refers to death of the bone. These prescriptions include Fosamax, Actonel, Atelvia, Didronel and Boniva and are taken to help prevent or treat osteoporosis. There are also versions administered by injection, including Boniva IV, Reclast and Prolia.

Osteo-necrosis of the jaw commonly occurs after dental procedures (tooth extraction, implant placement). Over 90 percent of those who have experienced osteo-necrosis are those who have taken the medication in repeated high doses due to cancer or other diseases. However, 10 percent who experienced osteo-necrosis were taking much lower doses, mostly intended to treat osteoporosis. Those who are taking these medications or have taken them within the past year should reveal this to their dentist.

Certain medications also affect the ability to taste, including cardiovascular agents, central nervous system stimulants, non-steroidal anti-inflammatory drugs, respiratory inhalants and nicotine skin patches.

Some medications can cause the development of oral sores, inflammation or discoloration of gum tissues in the mouth. These oral sores or discolorations may arise from taking medications for blood pressure, oral contraceptives and chemotherapy agents. Keeping your dentist aware that you are taking these drugs helps he or she monitor these areas closely and appropriately. Some spots and discolorations in the mouth can actually be symptoms of oral cancer. When your dentist is aware of the side effects of the medications you take, you can be adequately monitored without being treated for pseudo illnesses.

Dry mouth is a common side effect of a wide variety of medications, including those prescribed and over-the-counter. These include antihistamines, decongestants, painkillers, high blood pressure medications, muscle relaxants, drugs for urinary incontinence,
anti-depressants and many others. Drying causes the soft tissues in the mouth to become inflamed and makes you more susceptible to infection. When saliva flow is depleted, your risk for tooth decay and gum disease increases.

Supplements that may seem unconnected to your oral health can actually effect your care more than you realize. It is important for your dentist to know if you take…
 • Ginkgo biloba or evening primrose – These herbs can reduce your blood’s ability to clot, possibly leading to excessive bleeding during and/or after a dental procedure.
 • St. John’s Wort – This herb, which is often taken to reduce anxiety, can interfere with the metabolism of other medications, including sedatives, antibiotics and anti-inflammatory drugs such as prednisone and Decadron. When combined with St. John’s Wort, these drugs can be less effective. On the other hand, narcotics such as codeine, Vicodin and oxycodone can become more potent when taken with St. John’s Wort. This can lead to sleepiness, lethargy and dizziness.
• Valerian – This herb has mild sedative effects. If your dentist prescribes drugs for anxiety or painkillers containing codeine, the effects of both together are greatly accentuated. This can lead to severe sleepiness, lethargy and dizziness that can last into the next day.
• Calcium and magnesium – When these supplements are combined with certain antibiotics, they can decrease the antibiotics being properly absorbed. This can compromise your ability to fight off infection.

Your oral health is an important part of your overall health. Always keep your dental care givers updated on your health status and the medications (and supplements) you take.