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Be “Sweet” To Your Smile By Monitoring Sugar Intake

Posted on Aug 31, 2021 by William J. Claiborne, DDS MS

If Americans truly calculated the amount of sugar they’ve consumed at the end of each day, I believe most would be shocked. Even unintentionally, sugar intake can easily reach levels that are far beyond what is assumed.

For example, in a 2015 Washington Post article, it was reported that 25 percent of catsup is sugar. Alarmingly, one tablespoon has four grams of sugar, which is more sugar than a typical chocolate chip cookie.

The World Health Organization (WHO) recommends a maximum of no more than 10 teaspoons of free sugars per day. Regardless of age, the WHO advises keeping daily sugar consumption to less than 10 percent of calories “to reduce the risk of unhealthy weight gain and dental caries.”

However, our goal in limiting sugar is often sabotaged by hidden sugars.

Sugar comes in far more forms than just the white or brown bags of granular “cane sugar” we purchase in the grocery store. If you read the list of ingredients in foods and beverages, you may be surprised at how many forms of sugar are concealed with different names. At this time, there are more than sixty.

Here’s how to catch some of them:

Added sugar may be listed as syrup (examples are corn syrup or rice syrup) or anything with an ingredient that ends in “ose” (such as fructose, sucrose, maltose, dextrose). Other examples of added sugar include fruit nectars, juice concentrates, honey, agave and molasses.

Ideally, the WHO urges an intake of no more than 6 teaspoons (or less than 5 percent) of sugars per day to “provide additional health benefits.” This is an ambitious goal for Americans who have become literally addicted to sugar.

In a study of lab rats who were provided with a diet of food and intermittent supplies of sugar water, the results showed indications of addiction and symptoms of withdrawal.

The study spurned on a succession of additional studies. In one, it was noted that sugar “lights up” the same area of the brain as cocaine.

As a periodontist, I’m especially concerned about sugar intake to the detriment of oral health. Sugar lowers the natural pH levels in saliva and triggers a process that is the beginning of tooth demineralization. Demineralization describes the process where the enamel and tooth structures are dissolved.

Although sugar is not a healthy food choice for any part of the body, it is important to remember that it is the mouth that is the entry point for what we eat or drink. Thus, the destructive nature of sugar begins by causing an imbalance in the mouth through altering the healthy formulation of saliva.

For a minute, think of the foods you consumed yesterday. Coffee with sweetened creamer? Toast with jam? Sweet tea with lunch? A candy bar and cola as a mid-afternoon snack? Catsup over your fries at dinner, followed by a bowl of ice-cream?

When we are conscious of just how much sugar is being consumed over the course of a day, it becomes easier to make better choices. As we taper down little by little, it actually helps us to “wean” off the dependency of sugar so it doesn’t feel like deprivation.

As an Asheville Periodontist, I see patients every day who have periodontal disease, cavities and missing teeth that can be attributed to diet, smoking and insufficient oral hygiene. Many face involved treatment decisions that can be costly and take months to accomplish.


Although we pride ourselves on providing our patients with a comfortab

le experience backed by advanced skills and technology, so much of our treatment can be prevented with easy proactive measures. Eating a healthy diet, keeping the mouth moist, brushing and flossing, and seeing a dentist regularly are all practical ways to keep a healthy, confident smile.

Yet, “we don’t know what we don’t know.” Because our population is largely unaware of the extent of sugars in many foods and beverages, it is easy to consume far more than is realized.

Take charge of your oral health by reading food labels, meal planning that limits sugars, and being highly committed to your oral hygiene routine at home. A few tips for a healthy mouth between dental check-ups are:

Brush twice a day (at least) for two minutes each time. Use a fluoride toothpaste with a soft to medium bristle toothbrush.
Floss your teeth every day before your brush to dislodge food particles caught between teeth. If flossing is difficult for you, try one of the water flossers. These are affordable and as effective as manual flossing.
Brush your tongue after your teeth to unroot embedded bacteria, especially reaching the back area of the tongue (where most bacteria are embedded).
• Use an oral rinse that replenishes moisture twice a day (or as directed). These are available at most drug stores.
• Chew sugarless gum, preferably a brand that contains Xylitol. Xylitol looks and tastes like sugar, yet has 40 percent fewer calories.
• Drink plenty of water throughout the day. Be aware that beverages such as most coffee, tea and colas contain caffeine are drying to the mouth. Many medications also have the side effect of oral dryness – another good reason to stay hydrated.

Also, be aware of the signs and symptoms of gum disease. Sore, tender, bleeding, swollen or red gums are all warning signs. With prompt measures, we can greatly minimize treatment needs to rid your mouth of this dangerous bacteria that has been associated with a number of serious health problems (including stroke and some cancers).

If you haven’t seen your general dentist on a regular basis, call 828-274-9440. Our Asheville periodontal office can help to restore your mouth to a healthy state with the most conservative, yet effective, treatment possible.


Seniors Have Unique Oral Health Challenges

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

A friend once told me, “Someone who is a senior is always ten years older than I am.” I loved that, especially since, like most ‘older’ adults, I don’t feel like I’m in my senior years.

Like many individuals who are my age, I like being in the over-55 age group. There are definite advantages to being ‘older and wiser.’ I feel more confident, most self-assured, and more health conscious than I have ever been.

Yet, I am no stranger to the challenges that come with age. No matter how well we eat or how fit we try to stay, the body gradually succumbs to the natural process of aging. Hair thins, eyesight wanes, hearing declines, and flexibility decreases.

Not quite as obvious to many aging adults are the increasing challenges to oral health.

It seems seniors assume that having more aches and pains in joints is to be expected. And, when it comes to the need to replace or repair natural teeth on an ever-increasing basis, it just seems to come with the territory.

As an Asheville periodontist, I can confirm that dental needs do increase as we age. What I can also assure, however is that certain measures can greatly decrease the risks for oral health problems. Most of these are simple, proactive steps that can turn the tables on the potential for tooth loss and oral diseases.

One of the most common contributors to ‘oral aging’ is oral dryness.

It is a fact that we “dry up” as we age. Hair and skin become drier, the cushioning discs between spinal vertebrae shrink and the lubricating coating surrounding joints thins. So, it makes perfect sense that the moist coverage of gum tissues in the mouth is affected as well.

Because of this, the gum tissues that wrap the base of each tooth thin and pull away. As the gums shrink, more area of the natural tooth is exposed. This can leave vulnerable segments of the tooth’s root exposed. When oral bacteria are able to penetrate into this area, teeth are more susceptible to decay.

Too, oral bacteria below the gum line can become infectious. The inflammatory reaction that results can damage the structures that support natural teeth, including bone. Gum disease is the leading cause of adult tooth loss.

The good news? It is actually easy to avoid the repercussions that can result from oral dryness. It’s rather inexpensive and takes mere minutes a day.

First, drink plenty of water. I’m referring to plain, unflavored, unsweetened water. This can be tap or filtered, room temp or chilled. But, water is your most hydrating substance and there is no substitute for it. Colas, tea, coffee, sports drinks or juices do not count. As a matter of fact, many work against you.

The acid and caffeine in many of these are very drying and harmful to tooth enamel as well as challenging to the make-up of saliva. Too, even natural juices contain a sugar, even if it is ‘natural.’ (And adding a squeeze of lemon to water makes it too acidic.)

Next, assess the day-to-day add-in’s your mouth endures. Wine and alcoholic drinks are drying to oral tissues, contain sugar and are more acidic than many people realize. If you indulge in a cocktail, keep a glass of water nearby and take occasional gulps that linger in the mouth before swallowing. This will help dilute the acids and wash out some of the components that are problematic to oral health.

If you have a sweet tooth, don’t think I’m going to tell you to avoid your Snickers bar or bowl of ice-cream. (I’m in your court!) However, think about indulging in your sweet treat just after a meal as a dessert rather than a snack.

The reason is, every time you eat, an acid flows into the mouth through saliva. This is a normal part of early digestion and helps begin the breakdown of food before swallowing. However, this is a potent acid that can actually soften tooth enamel for 20-30 minutes. Thus, if you add your Rocky Road to the end of your dinner as dessert (rather than have it two hours later), you merely extend the acid’s longevity rather than trigger a new acid flow. As with cocktails, try to drink some water following your sweets or swish a couple of times.

Another challenge to oral health for older adults is that they take more medications. It is estimated that 39 percent of seniors take five or more prescriptions each day. ( Surprisingly, many have a side effect of oral dryness. Those most commonly associated with oral dryness include antidepressants, decongestants, antihistamines, muscle relaxants and those prescribed for blood pressure. However, there is a long list of meds (both prescriptive and OTC) with a drying side effect. If you take meds that seem to be causing you to have a drier mouth, there are several things you can do.

If your doctor has no medication substitute that has less drying side effects, up your daily water intake. Be sure to brush thoroughly at least twice a day and floss daily. Use an oral rinse that is specially formulated for oral dryness at least once a day. Try to limit your caffeine and alcohol intake. And, chew sugarless gum occasionally during the day, which will help to activate saliva flow.

Keep in mind that teeth are not rocks. Although they seem rock hard, years of use can leave teeth with fractures and cracks. Teeth that are over-filled by cavity repair can finally give way and break. Be conscious of things that can add undue pressure on teeth, such as chewing ice. Remember, too, that teeth are not meant to be tools. Biting down on hard things that are not meant to be chewed is a sure way to fracture or break teeth.

For post-menopausal females, changes to hormonal levels add further to the risks for periodontal disease and tooth loss. Thus, older females have a particular need to maintain excellent oral health. This may be a good reason to have dental check-ups and cleanings every 4 months versus every six. Speak to your general dentist about the best dental hygiene schedule and at-home routine for your individual needs.

The good news is that tooth loss doesn’t have to be a ‘symptom’ of aging. With proper measures, the majority of your natural teeth can last for your lifetime. If you are missing one or more, however, the best option for replacement is dental implants. These help to preserve supporting bone structure and do not rely on neighboring teeth for support. Too, dental implants, properly selected, placed and maintained are an investment designed to last your lifetime.

For optimal oral health and replacement of teeth via dental implants, it is advised to see a periodontal specialist. This is an expert in the care of gum health and a specialist with advanced skills in dental implants. Begin with a consultation with a periodontist to learn what may be advisable to keep your smile in great shape as you age.

Keep in mind that research has shown that having good oral health has a direct impact on your ability to have a healthier you. Your oral health is intricately connected to your body’s immune system and digestive ‘checks and balances’, which is an especially important asset during this time of viral vulnerability.

When your mouth is healthy, you’ll smile more (another benefit to overall health!), your breath will be fresher, your body will have a ‘leg up’ in maintaining good, overall health, and the time and costs for repairs and tooth replacement will be minimized.

Begin with a thorough periodontal examination by a Board Certified Periodontal Specialist. In my speciality, we are able to treat all stages of periodontal (gum) disease and are the experts in the selection and placement of all types of dental implants (including the All On 4 implant system).

Call 828-274-9440 to schedule or to request additional information.

How The Contours of Your Gums Can Enhance Smile’s Appearance

Posted on Aug 10, 2021 by William J. Claiborne, DDS MS

I remember the home of a beloved Great Aunt, whom I visited often growing up. One of the things that made her home so “homey” were the displays of bric-a-brac. As a youngster, I didn’t term her arrangements of china tea sets and Hummel figurines as bric-a-brac (they were “knick knacks,” to me). However, I found myself being drawn to her displays on shelves, in curios, and on tables moreso as I grew older.

To me, what was impressive about these groupings was how balanced they were. The china tea pots were centered, surrounded by carefully spaced cups and saucers. Hummel children were in playful arrays to appear as a happenstance assembly of friends.

As a Periodontist, I am now far more appreciative of how my Aunt kept such proper balance to these displays. Everything seemed so coordinated, harmonized.

As a specialist in the treatment of all stages of periodontal (gum) disease and the placement of dental implants, I am also the expert when it comes to the contours of gum tissues surrounding teeth. The gums are important to the health of your teeth as well as the appearance of a smile.

When it comes to protecting teeth, think of the gum tissues as a protective blanket. The gums cover over the under-structures of the mouth’s interior (oral cavity). If you’ll look at the base of each tooth, you’ll see that the gum tissues snugly wrap the base of each tooth. This protective seal is what prevents bacterial penetration below the gum line.

When gum tissues loosen their grip around teeth, the leading cause is gum disease. Gum disease weakens oral tissues and causes them to become inflamed. As the gums loosen, bacteria is able to work their way into the structures that support natural teeth (including bone).

When bacteria reach this level of oral structures, ridding it involves a more involved procedure than what a mere dental cleaning can combat. As it progresses, the gums become spongy and pus pockets form. Teeth loosen and may need removal. Gum disease is the leading cause of adult tooth loss.

Yet, gum tissues not only serve as a protective element of your mouth. The appearance of a smile can be greatly affected by the shape and amount of gum tissues exposed when smiling.

Balance is an element of beauty, according to studies. We are drawn to it. According to Penn State’s “Science in Our World: Certainty and Controversy”,

“Studies show that symmetrical faces are preferred and more attractive to others than people who have asymmetrical faces. Similarly shaped eyes and eyebrows, sides of the nose mouth can all fall into the symmetrical category.”

They shared findings of one study, performed over the course of two decades, that had men and women rank the attractiveness of people in photos. The study revealed:

“Men and women both overwhelmingly chose the most symmetric face. This test was an observational study, so it was only as clear and truthful as the participants of the study were. There wouldn’t really be a way to make this sort of study an experimental test, so as far as attraction goes, studies must rely on the opinions of the participants. However, the majority of the participants chose the most symmetrical faces as the most attractive ones, so it is easily said that it is true, symmetry equals attractiveness.”

Although “beauty is in the eye of the beholder,” symmetry seems to be a component of what humans define as beautiful and what we’re drawn to (although inner beauty is an important factor in what keeps us connected to an individual).

When a smile shows too much or too little gum tissue bordering the tops of teeth, it moves the smile line out of balance. For example, in a “beautiful” smile, the arches of gum tissues visible in a full smile are at a similar level. The amount of gum arches are in a complimentary line to teeth, rather than an amount that draws the eye. Too much gum tissue showing is referred to as a “gummy smile.”

A gummy smile is not an unattractive feature. Having one does, however, alter the appearance of a smile based on balance. For example, a diastema is a wide space between the two front teeth. It is often a hereditary trait. Although it is not unattractive feature, the eye seems drawn to that one spot rather than seeing the smile, as a whole, as a complement to other facial features. The individual may have beautiful lips or eyes, but the gap between the teeth is what is noticed as being “off.”

Quite frankly, some people are perfectly comfortable with having a gummy smile or a diastema. For them, it’s part of their personality or signature look. After all, what would Lauren Hutton, the famous model of the 70’s, have been without her diastema?

For other people, these features cause shyness, insecurity or a feeling of awkwardness. Some people try to smile with lips only. Others try to conceal a full smile with a hand. “Holding back” on a smile is a shame, especially since smiling is a proven asset to our frame of mind.

The act of smiling causes the brain to release chemicals known as endorphins. These trigger somewhat of a natural high, creating a happier mood. This has been shown to be true even when faking a smile.

Additionally, people who smile often are deemed happier, more confident and even younger. In smiling, the facial muscles pull upward and smooth out the skin to give the face a bit of a lift. Free of charge!

Another distortion in a balanced smile can be an uneven line of gum tissues, where there is more gum showing on some teeth than others. This up-and-down line of gum tissues creates a jumbled look. Again, the appeal of balance is disrupted.

In these cases, a crown lengthening procedure is often advised. This is a simple procedure that alters the height of the gum tissues prior to placement of a crown (‘cap’). Not only does this provide a more flattering smile line, it protects the teeth involved while enhancing the tooth’s shape.

Another issue that impacts both appearance and the health of a tooth is gum recession. When the gums recede from the base of teeth, more sensitive and vulnerable areas of the tooth’s root are exposed. Exposure can lead to sensitivity and higher risk for bacterial penetration.

The procedure for most gum recontouring is known as a Gingivectomy. In this, our Asheville Periodontal dental office uses a dental laser. Gingivectomy is the most common procedure performed with a laser, which is used to precisely contour gingiva (gum tissue) for restorative, cosmetic, and periodontal needs.

The laser promotes rapid healing and reduces discomfort post-operatively with periodontal packing or sutures rarely needed. In the hands of a skilled periodontal specialist, laser technology also minimizes penetration depths. For minor procedures, lasers can sometimes require little or no anesthetic.

For more involved gum contouring, our Asheville periodontal office offers both oral and I.V. 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 places the patient in a deeper sleep state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our office, this is overseen by Dr. Brad Stone, a Medical Doctor (MD) who is a board certified Anesthesiologist & Pediatric Anesthesiologist.

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

The health and appearance of your smile are important. It is proven that good oral health is a supportive component to your overall health. It is also shown that the appearance of a smile can add positively to an individual’s perception of “self”.

If you’re interested in improvements in the health and appearance of your smile, let’s discuss the possibilities during a consultation appointment. Call 828-274-9440. A referral is not always needed.