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Aging Adults Need Extra Measures To Prevent Gum Disease, Tooth Loss


Posted on Feb 17, 2020 by William J. Claiborne, DDS MS

Whether visiting a primary care physician, ophthalmologist (eye doctor), dermatologist, or orthopedist, adults in the over-50 category often hear the same comment from their doctor.

“You’re getting older so…”

As we age, the body begins to succumb to wear and tear. The skin sags, bones weaken, joints ache, hearing dulls, and eyesight wanes. More precautions and measures are advised to keep the body operating comfortably and efficiently as we age.

The same is true for your teeth and gums.

Although people tend to react to an odd spot on the skin or blurry vision, things like having a frequent ‘dry mouth’ or gum recession are often brushed off as temporary or just a normal part of growing older.

Yet, the hazards of ignoring the signs and symptoms associated with gum disease and tooth loss should never be taken lightly. Research shows that your OVERALL health is dependent upon a healthy mouth and proper function in biting and chewing.

Here are some typical oral challenges experienced by seniors:

• Having a dry mouth: The tissues inside the mouth need to be kept moist. Saliva flow is designed to do this. However, with age, the flow of saliva is less plentiful. Just as the skin and hair get drier with age, the mouth endures this same consequence. When saliva flow is less efficient at rinsing bacteria from the oral cavity (inside of the mouth), bacteria grow at a more rapid rate. This means bacteria accumulation occurs more frequently than twice-a-day brushing can control.
We advise drinking plenty of filtered water throughout the day, minimizing caffeinated drinks that are drying to oral tissues (coffee, tea, colas), and using an oral rinse twice a day that is formulated to replenish oral moisture. Alcohol and smoking are especially drying to oral tissues. Be especially committed to maintaining adequate oral moisture if you smoke or drink.

• Less efficiency with at-home oral hygiene: Aging causes the fingers to be less nimble and stiffens joints. This is a particular challenge when it comes to brushing and flossing. Angling a toothbrush to reach all areas in the mouth and proper flossing maneuvers require manual dexterity that becomes less capable when the rigors of aging are involved.
We advise using an electric toothbrush 2-3 times a day. Flossing can be done using an electric water flosser. However, we still recommend manual (string) flossing where you can reach. Keep in mind that crowding of natural teeth (which tends to worsen with age) creates particular challenges for reaching nooks where bacteria hide and breed. Use extra time to ensure you are reaching those areas when you brush and floss.

• Medications that interfere with oral health: The average adult in the 65-79 age group has over 27 prescriptions filled each year. (https://www.statista.com/statistics/315476/prescriptions-in-us-per-capita-by-age-group/). Although your health may dictate taking these drugs, it is wise to be aware that some can be detrimental to your oral health.
For example, Coumadin, a commonly prescribed blood thinner, can cause more bleeding during certain procedures. Too, many meds have the side effect of oral dryness. Some prescribed for osteoporosis, bisphosphonates (known by Fosamax, etc.) have been linked with jaw osteonecrosis. The risk for jaw necrosis, or death of the jaw bone, is highest with procedures that directly expose the jaw bone, such as tooth extractions and dental implant placement.
Some herbal supplements can also cause side effects for some dental patients. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting. Be sure to provide a complete list of ALL medications you take (including vitamins and herbal supplements) at each appointment. This enables us to tailor your treatment to your specific needs.

• Hormonal changes: Post menopausal females are at higher risk for gum disease and subsequent tooth loss due to declining estrogen levels. Thus, these women have greater risk for bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is bone loss of the jaw, it can result in tooth loss. Receding gums are a sign of this bone loss since more of the tooth surface is exposed to the causes of tooth decay.

Why are your teeth and gums so important as you age?

As a periodontist in Asheville for over 30 years, I’m still surprised by the number of people who assume that losing natural teeth is to be expected with age. Yet, I see many patients who have kept the majority of their natural teeth well into their 80’s and 90’s.

Although dental implants are excellent replacements for missing teeth, there is nothing as good as the teeth God gave you. They’re referred to as “permanent” teeth for a reason; they were intended to be just that. Regardless of the replacement method, the ability of natural teeth to support neighboring teeth and provide stimulation to the jaw bone is unsurpassed.

Having the ability to comfortably and efficiently bite and chew is vital to having a healthy body. When dentures or partials compromise the ability to eat a diet of healthy foods – and chew food properly – gastrointestinal problems are common.

Too, bacteria overgrowth in the mouth is the cause of gum disease. Periodontal disease is the nation’s leading cause of adult tooth loss. Its bacteria can also enter the bloodstream, causing inflammatory reactions far beyond the mouth.

Advanced gum disease bacteria has been linked to a number of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.

Obviously, maintaining healthy gums and keeping your natural teeth is important. If you’ve experienced tooth loss, we can replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing.

If your gum health needs improvement or there are signs of gum disease, we can structure a program that restores healthy gums and helps you maintain your oral health between visits.

Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

When these indications exist, it is important to seek periodontal treatment as soon as possible. Gum disease only worsens without treatment, requiring more time and expense to rid this serious, even deadly, inflammatory disease.

With proper measures, you can enjoy healthy gums and natural teeth throughout your lifetime. Call 828-274-9440 to schedule a periodontal examination or ask for a consultation to get to know us. New smiles are always welcome!

Are Dentures Or Partials Causing Your Face To ‘Melt’?


Posted on Feb 12, 2020 by William J. Claiborne, DDS MS

Occasionally, I’ll unexpectedly walk by a mirror and notice an old man looking at me, only to realize “that’s ME!”

As we age, hopefully most people don’t “feel” their actual age, although the person in the mirror isn’t quite the image we want to have. Most of us “see” ourselves as looking ten or so years younger (and probably 10 or so pounds lighter!).

Aging gracefully is a positive part of our lives. At any age, as long as we look and feel like we’ve taken pretty good care of ourselves, each birthday should cause more smiles than not. However, for people who are long-time denture or partial wearers, the signs and challenges of aging are more obvious.

Wearing a full denture or a partial denture appears, visually, to replace missing teeth. While the gum based that supports these replacement teeth “plumps up” the face when they are in place, this fullness can be deceiving.

What is really taking place – that you can’t see – is the loss of bone mass, or resorption.

Resorption describes a melting away of bone. For the upper or lower jaw, the areas where natural tooth roots no longer exist experience this almost immediately after they are removed.

Resorption occurs when tooth roots are no longer providing stimulation and nourishment to the bones that support them. This causes the bone “ridge” that holds the denture or partial to flatten out.

Bone loss begins almost immediately after teeth are removed. The pressure on the ridge while wearing dentures or partials actually accelerates the rate of bone loss. For people who sleep in their dentures, this increases the process even more.

In addition to appearance changes, bone loss is the reason that dentures slip or rub. This is because the denture was conformed to the ridge when it was first made. As the ridge flattens, the denture no longer ‘hugs’ the surface it was designed for.

As resorption continues, changes in facial appearance are occurring as wel. The best way to detect bone loss is to remove your ‘appliance’ and look in the mirror. However, even with the denture in place, certain facial changes may be obvious.

Jowls form on the sides of face as facial muscles detach from the declining bone mass. Deep wrinkles form around the lips and the corners of the mouth turn down, even in a smile.

As resorption worsens, the mouth seems to collapse into the face. The chin becomes more pointed and the nose and chin move closer together. This appearance is referred to as a “granny look,” aging one’s appearance far beyond their actual years.

How do you avoid a ‘melting face’?

One of the many advantages of dental implants is their ability to halt bone loss. The implanted portion restores stimulation to the jaw bone and provides a natural biting and chewing stability.

As a periodontist, an area of this advanced dental specialty is the diagnosis and placement of dental implants. Because there are many different types of implant systems, having a specialist select and place the one best for you will enhance your overall outcome.

In our Asheville periodontal office, we also offer oral and IV sedation (twilight sleep). These are administered by a board certified Anesthesiologist. This is a medical doctor (MD) who ensures safety and comfort are priorities throughout your procedure.

With dental implants, you can improve your appearance and health. Learn more about the lifelong benefits of dental implants by visiting our web site or calling 828-274-9440.

 

Tissue Regeneration In Dentistry Is Here & Now!


Posted on Jan 31, 2020 by William J. Claiborne, DDS MS

It may sound far-fetched to think of repairing the urethra by regenerating tissues from the mouth. Yet, it’s being done – with the help of advanced technology.

Stricture of the urethra (the duct that carries urine out of the bladder) affects about 1 percent of the male population. For the one percent who suffer with it, urethral stricture contributes to a severely diminished quality of life.

The condition causes patients to be chronically ill, have low urine flow, pain, urinary infections, urinary stones and can lead to failure of the urinary system. Untreated, life-threatening urinary retention can occur.

Recently, a breakthrough in the surgical treatment of male urethral stricture was reported when over 81 percent of patients with urethral strictures were successfully treated with MukoCell.

MukoCell is a method for tissue-engineered oral mucosa transplantation. It takes a small area of oral mucosa (the secreting tissues in the mouth) that is easily accessible in any patient. (https://www.healtheuropa.eu/treatment-of-mens-disease-with-regenerative-medicine/96925/)

In the past, the most successful treatment for urethral reconstruction was through an oral mucosa graft. However this process requires harvesting a large area of oral tissues. The repercussions can leave patients with persistent pain, bleeding, swelling, sensory loss and oral numbness.

Removing large segments of tissues in the mouth can also cause impaired ability to drink, eat and speak. It can lead to periodontal (gum) disease,tooth loss and dental implant failure along with an increased risk of oral cancer.

MukoCell is a method for a tissue-engineered oral mucosa transplant with even better success rates that the standard grafting procedure. Like our LANAP technology, MukoCell can regenerate tissues, although MukoCell regeneration is through a tissue factory that uses a small piece of the patient’s oral mucosa.

In our Asheville Periodontal dental office, tissue regeneration can be successfully performed in the patient’s mouth. Through our LANAP technology (Laser-Assisted New Attachment Procedure) this highly-advanced method efficiently and effectively treats periodontitis (advanced gum disease).

When it comes to oral structure loss, our LANAP technology is able to stimulate bone regrowth in damaged areas. It can regrow periodontal ligament, alveolar bone (the bony ridge that supports the upper teeth), and regrow the bony film that adheres teeth to the jaw.

LANAP includes a minimally invasive (essentially ‘non-surgical’) PerioLase laser that treats patients with moderate to severe periodontal disease – in as little as one session. It is safe for people with conditions such as diabetes, heart disease, and hemophilia.

LANAP’s laser also eliminates the need for cutting into gum tissues with a scalpel. There are no stitches and patients have minimal discomfort following the procedure.

The advanced technology of LANAP offers a simple yet successful way to rid the infectious bacteria of advanced gum disease. By combating this inflammatory disease, the body is at less risk for systemic inflammation that has been shown to contribute to serious and even deadly health problems.

Overcoming gum disease can help patients to save natural teeth. This means the trauma of tooth loss and decisions for replacement can be avoided.

While we applaud astounding developments in tissue regeneration, MukoCell’s progress reinforces the importance of having a healthy ‘oral cavity’. This is why we committed to include the LANAP protocol into our periodontal dental office, making this cutting edge technology accessible to people all across Western North Carolina.

Although people often think of their smile as ‘teeth,’ the tissues in the mouth are a vital part of your smile, your oral health, and your overall health. They are your blanket of protection that shields vulnerable structures beneath from bacterial destruction. When this covering of gum tissues becomes damaged, LANAP offers an efficient and effective method to restore the healthy state of what was lost.

If you suffer with symptoms of gum disease (tender gums that bleed when brushing, persistent bad breath, or gums that have turned red in color), call our office promptly at 828-274-9440. The condition will only worsen without treatment and could result in tooth loss as well as the release of potent bacteria into the bloodstream.

Osteoporosis Meds May Cause Permanent Damage To Jaw Bone


Posted on Jan 18, 2020 by William J. Claiborne, DDS MS

Many physicians who prescribe bisphosphonates for osteoporosis have relied on the drug makers’ stance of low risk for side effects. This has often left patients unfamiliar with the risks when they are scheduled for dental procedures.

Bisphosphonates include Fosamax, Actonel, Boniva, Reclast, Binosto, Prolia, Zometa and Xgeva. The most prescribed is Fosomax and ranks as one of the top 25 most prescribed drugs on the market.

The complication with bisphosphonates is a risk for jaw osteonecrosis. In simple terms, this is death of the jaw bone.

Jaw osteonecrosis occurs when the bone fails to heal after a surgery, even a minor procedure such as a tooth extraction. It results from obstruction of blood supply, which is caused by the drug’s potential interference with the bone’s ability to repair itself.

Common symptoms of jaw osteonecrosis are pain, swelling or infection of the gums and jaw, gums that don’t heal, and loose teeth. However, its onset can also occur without obvious symptoms.

In addition to treating osteoporosis, bisphosphonates are used to treat cancer that has spread to the bone. In these cases, bisphosphonates are given intravenously and in higher doses. This creates an even greater risk of osteonecrosis of the jaw than for individuals on oral doses.

Jaw osteonecrosis risk seems to increase with the amount of time biphosphonates are taken. However, researchers have determined that bisphosphonates can create a risk for necrosis with even short-term use of the oral medications for osteoporosis.

The most commonly prescribed bisphosphonate, Fosamax, was approved by the FDA in 1995. By 2003, reports began surfacing that linked bisphosphonates with jaw osteonecrosis.

In a study of over 200 participants who took Fosamax for varying durations, 4 percent acquired osteonecrosis. This finding was in contrast to the drug makers’ claims that bisphosphonate use only posed a noticeable risk for those who took the medication intravenously, such as cancer patients.

Not only did the study show that short-term usage can place the patient at risk, the drug can maintain a 10-year half-life in bone tissue. The risk for jaw necrosis is highest with procedures that directly expose the jaw bone, such as tooth extractions and dental implant placement.

Many people are often surprised by the wide range of medications that affect their oral health. For example, Coumadin, a commonly prescribed blood thinner, can cause more bleeding during certain procedures.

Antidepressants and high blood pressure medications can cause elevated levels of plaque and signs of gingivitis. Too, gingival enlargement, a condition that causes the gums to swell and grow over teeth, can lead to severe periodontal infection. Calcium channel blockers used to control high blood pressure can also contribute to this gum tissue overgrowth.

Many cough drops, medications in syrup form and antacids contain sugars that often leave a sticky residue on teeth, making them more susceptible to decay. Certain antibiotics and ibuprofen can cause lesions or ulcers in the mouth.

Oral contraceptives and blood pressure medications have been linked to mouth sores and inflammation. Tetracycline, typically used for treating acne, can discolor teeth as well as supporting bone.

While you may assume that herbal supplements don’t apply, they can actually have serious side effects for some dental patients. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting. For patients undergoing surgical procedures, this can be a serious problem.

Taking high dosages of vitamins before undergoing anesthesia can also put you at risk. For instance, high doses of Vitamin C can weaken the efficiency of anesthesia. On the flip side, supplements such as Kava Kava or St. John’s Wort can accentuate anesthesia’s effectiveness.

This is why it is important to make us aware of all the drugs you take, including over-the-counter supplements. The goal is to provide a successful outcome for each periodontal procedure or dental implant placement. Being familiar with your overall health enhances the potential for positive oral health.

If you have questions regarding the medications you are taking in regard to oral risks, call our Asheville periodontal office at 828-274-9440 prior to your appointment. And, at each visit, keep us updated on your medications.