Posted on Apr 14, 2020 by William J. Claiborne, DDS MS
As a periodontist, I treat all stages of periodontal (gum) disease. Over the years, I’ve helped patients save natural teeth and restoring their ability to enjoy healthy, confident smiles.
When people come close to losing their teeth or find themselves in need of replacing them with something more dependable than dentures or partials, I hear nearly every one express the same regrets: “I wish I’d taken better care of my teeth when I could.”
Signs of gum disease
Hindsight may be 20-20, but it’s never too late. I know patients can go from having gum disease and losing teeth because of it to having excellent oral health – and end up having a renewed commitment to their smiles.
In my dental specialty, I know it begins by helping patients to understand how the problem starts in the first place. When people know the HOW, they can implement measures to bypass the repercussions of gum disease.
I’ve found that most people actually have very little awareness of how the inside of their mouth looks. We smile with lips and front teeth that show very little (if any gums). So, it stands to reason that, if a smile looks good, it’s probably healthy.
Until dental offices began using intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for a condition that didn’t hurt. There were not obvious signs initially, so nothing is wrong – right?
Intra-oral cameras are able to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual has this firsthand view of spongy, receded gums, the decision to treat often go from IF to WHEN.
Although it helps to be able to show patients the signs of gum disease, these emerged signs are indications of long-standing periodontal disease. By the time these signs appear, the early stage of gum disease, gingivitis, is past. This is unfortunate, since early-stage gum disease can be halted with prompt measures.
Gingivitis causes the gums to become tender and swollen in some areas. You may see blood in the sink when brushing. These signs indicate that oral bacteria has accumulated in the mouth beyond the means of your immune system’s ability to manage it.
Twice daily brushing and flossing are important steps in keeping bacteria levels in the mouth under control. Brushing sweeps away built up bacteria on the surface of teeth, which is a sticky film known as plaque. Plaque, just over the course of a couple of days, can harden on teeth where build up is allowed to remain. This cement hard mass of bacteria is tartar, or also known as calculus.
The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.
Yet, try as we might, there are simply angles in the mouth that are difficult to reach with a toothbrush, manual or electric. Say you have an area of jumbled or crooked teeth. Even as you adjust the angle of the toothbrush differently to maneuver the bristles into these areas, it is often difficult to continually keep these areas clean.
This is where flossing comes in, and important step in daily, oral hygiene.
Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.
If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a jolting view of exactly what you do NOT want crawling around and breeding in your mouth. These living and breeding organisms can be highly destructive as they amass.
As research has shown for many years, your overall health is intricately linked to your oral health. The bacteria of gum disease has been linked to a long list of serious health problems, including heart disease, stroke, arthritis, some cancers, diabetes, and preterm babies. Studies are underway to track gum disease bacteria to the path of Alzheimer’s disease.
Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.
Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits): “Only four of 10 Americans floss at least once a day, and 20 percent never floss.”
Perhaps this is one reason why over 47 percent of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.
Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued.
It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.
Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. For our patients, we help them develop an at-home care regimen to maintain a healthy mouth and fresh breath between regular dental check-ups.
Be aware of the signs and symptoms of periodontal disease. Knowing them will allow you to react quickly to minimize the extent of damage and treatment needed to rid it. They include:
- Tender or swollen gums
- Gum tissues that turn red
- Gums that are tender to the touch
- Gums that bleed easily
- Spitting out blood when brushing or flossing your teeth
- Frequent bad breath
- Pus pockets that form between teeth and gums
- Teeth that loosens or shift
- Painful chewing
- Gums that pull away from your teeth (recede), making your teeth look longer than normal
These are all warning signs that bacteria overload is occurring in your mouth. It is a disease, and will only worsen without treatment.
If you suspect you have any stage of gum disease, call 828-274-9440 to schedule a thorough periodontal examination.
Be In-The-Know To Avoid Cavities, Gum Disease
Posted on Apr 02, 2020 by William J. Claiborne, DDS MS
During this highly unusual time, people are relying on the internet for communication (work and social), information, and entertainment. Computers, tablets and smart phones are keeping us connected as we ‘shelter in place’ until this global pandemic is under control.
A lot of Americans are using their “stuck inside” time to expand their minds. Whether it’s to enjoy an audio book, watch PBS specials, or learn how to do something on YouTube, using the time positively is helping people avoid getting mired down in worry and anxiety.
As a periodontal specialist in Asheville, NC, I hope adults will use some of their time to become more aware of the hazards of gum disease. The damage that periodontal disease (‘perio’) can have far reaching consequences, affecting the health inside and mouth and overall health, as I’ll explain.
People are often surprised to hear that they have developed gum disease since it is often without obvious symptoms in early stages. Once it’s fully underway, however, many people ignore the warning signs or assume they’ll “go away”.
In my dental specialty, I believe that by keeping Americans informed of how the progression of gum disease occurs could help to greatly reduce the extent of this disease, which plaques over 47 percent of adults.
Let’s begin by looking at the process of gum disease:
• Oral Bacteria: The mouth is a warm, dark and moist environment — perfect for harboring bacteria. The mouth is the first point of contact for a large extent of the bacteria that enters the body. Bacteria is on food, utensils, lip gloss and even your tooth brush. All mouths have bacteria, some of it are beneficial. Although bacteria in the mouth are perfectly ‘normal’, the problem begins when too much bacteria accumulate.
• Plaque: Without proper brushing, flossing, saliva flow and diet, oral bacteria can reproduce rapidly. For an example of just how quickly these bacteria accumulate, run your tongue over your teeth after brushing in the morning. They should feel slick and clean. Then, before brushing at bedtime, run your tongue over your teeth again. The accumulation of oral bacteria over the mere course of a day has likely formed a sticky film on teeth. This is known as plaque. This film is actually a coating of bacteria.
• Tartar (or Calculus): In just 48 hours, unremoved plaque can harden into tartar. These ‘chunks’ are colonies of oral bacteria and typically attach to the base of teeth near the gum line. These cement-hard masses can no longer be brushed or flossed away. They must be removed by a dentist or hygienist with special tools. If allowed to remain, like plaque, tartar will continue to multiply as these bacterial colonies feed on tooth enamel and tender gum tissues.
• Gingivitis: This is the first stage of gum disease. At this level, gum tissues are under attack and become sore. They may bleed easily when brushing and you may experience an aching sensation in some areas. Breath odor is stronger, even soon after brushing. At this point, with proper measures, you can restore your gums to a healthy state. However, the window of opportunity to combat gingivitis is brief.
• Periodontal (Gum) Disease: At this stage, the gums are inflamed and tender. They begin to darken in color and the seal of gum tissues surrounding teeth begins to loosen. The breath is persistently bad. As this stage of gum disease worsens, it can lead to severe health risks elsewhere in the body.
• Periodontitis: This is the advanced stage of gum disease. The gums are so tender that eating becomes difficult. Breath odor is putrid, as it reflects the rotting state in your mouth. The gum tissues are highly inflamed. Pus pockets may form on the gums near the base of teeth. Eventually, teeth will loosen as the gum tissues and bone structures that support them are destroyed. Tooth removal at this stage is not uncommon.
To no surprise, gum disease is the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.
An even more concerning aspect of gum disease is its ability to enter the bloodstream. Once bloodborne, these infectious bacteria can trigger inflammatory reactions elsewhere in the body. Gum disease bacteria has been linked to heart disease, diabetes, arthritis, stoke, memory loss, preterm babies, impotency, some cancers and even Alzheimer’s disease.
This is why we want you to be aware of the importance of having a healthy mouth. We realize there are financial obstacles for some people. However, most dental and specialty offices offer payment plans, many are interest free with no down payment required.
Some people avoid dental visits because they have anxiety or fears. Dental fear is fairly common, even in America where dental care is so advanced (in most practices). If deep fear or anxiety has prevented you from regular dental visits or having much-need treatment, finding a dentist who is experienced in caring for fearful patients is easier today.
Using advanced technology, such as laser dentistry, cone beam imaging, and other features, we are able to diagnose problems more precisely, which helps to minimize treatment. Many options enhance patient comfort and speed healing time.
For many fearful patients, we also offer oral or IV sedation (“twilight sleep”). We are fully equipped for the safety and comfort of administering sedatives for our patients for treatment in our office. Here, patients know us for our gentle touch and respectful, attentive care for each individual.
Occasionally, I hear a patient relay their impression of tooth loss being “just part of growing older.” That is far from the truth. The human body does ‘break down’ here and there but keeping your teeth for a lifetime is a reasonable expectation with proper measures.
Having healthy gums that support teeth can be achieved with an involved relationship with a dentist and a committed oral hygiene routine at home. With proper care, you can easily enjoy a smile of natural teeth all your life.
Twice daily brushing (at least two minutes per time), daily flossing, drinking ample water and limiting sweets and caffeine are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. And, those 6-month check-ups are important. At this time, any tartar that has accumulated can be removed and signs of early gum disease can be noted.
Losing teeth due to gum disease leads to expensive and lifelong upkeep with crown-&-bridge, partials, full denture or dental implants. These tooth replacement needs can be avoided.
If you are experiencing symptoms of gum disease, call 828-274-9440. If fear is an obstacle to having a healthy, confident smile, begin with a consultation to discuss your needs.
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.
A Periodontal Specialist Explained
Posted on Dec 13, 2019 by William J. Claiborne, DDS MS
Occasionally, I meet someone new who is unfamiliar with my specialty. Although a periodontist may seems to be a “behind the scenes” specialist, our focus actually has an upfront role in your oral health, and beyond.
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.
In addition to having advanced training in the latest techniques for diagnosing and treating periodontal disease, a periodontal specialist is also trained in performing cosmetic procedures that involve gum tissues, such as correcting a “gummy smile”.
Periodontists often treat more problematic periodontal cases, such as people with severe gum disease or have a complex medical history. A periodontist offers a wide range of treatments, such as scaling and root planing (cleaning the infected surface of the root) or root surface debridement (removing damaged gum tissue).
Periodontal specialists can also treat patients with severe gum problems using a range of surgical procedures.
In addition, periodontists are specially trained in the placement, maintenance, and repair of dental implants.
During the initial appointment in our Asheville periodontal office, we typically begin with a review of the patient’s medical and dental histories. This information is important so we are aware of medications being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.
During the examination, we check the patient’s gums to look for gum line recession. We will also assess how the teeth fit together when biting, and check for any loose teeth. An important part of this exam is in the measuring of spaces between gum tissues at the base of teeth.
Using an instrument called a probe that is gently positioned between specific points surrounding each tooth, we determine the depth of periodontal “pockets”. These measurements help us assess the health of your gums. Images (x-rays) may also be taken to revealsthe health of the bone below the gum line.
Periodontal disease, also referred to as “gum disease,” often exists without an individual being aware of its presence. In its early stage, gingivitis, some people even assume that symptoms, such as seeing blood in the sink when brushing, are normal.
Obvious symptoms, such as pain, may not appear until the disease has reached an advanced stage. This is why it is important to be familiar with the signs and symptoms, which include:
• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding (pulling away from the teeth) or make the appear teeth longer than normal
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures
If you notice any of these symptoms, be sure to contact your dentist or periodontist without delay. Gum disease will only worsen without treatment.
Who Should See a Periodontist?
Some patients’ periodontal needs can be managed by their general dentist. However, patients who are experiencing signs and symptoms of moderate or severe levels of gum disease or have more complex cases receive the most efficient and effective care through team treatment between a general dentist and periodontist.
Restoring your gums to a healthy state is important! As research continually shows, gum health is intricately connected to overall health. Oral bacteria of periodontal disease has been linked as a trigger for more and more chronic diseases, including heart disease, some cancers, stroke, memory loss, diabetes, and arthritis. Having prompt periodontal treatment by a trained periodontal specialist may lower the risk for more serious, and even deadly, diseases and health conditions.
If you are experiencing any of the symptoms associated with periodontal disease, a referral is not required. Call 828-274-9440 and we will be happy to assist you.
If you do not have a general dentist, we can also refer some who are near to you and we know to provide gentle, thorough and appropriate care for their patients’ needs.