Don’t Let Misaligned Teeth Lead To Tooth Loss.
Posted on Feb 25, 2019 by William J. Claiborne, DDS MS
As a periodontist, I have specialized skills in treating all stages of gum disease (known as periodontal disease, or simply “perio” by some). I also have advanced training in the diagnosis and placement of dental implants.
Although my specialty does not cover the advanced training an orthodontist has in bite alignment, my dental education absolutely covered the benefits of having proper “occlusion.” It also covered the repercussions of NOT having a bite that is properly balanced.
Just as an orthodontist can spot telltale signs of gum inflammation, I (along with general dentists and most dental specialists) can see indications of teeth that are not working in unison — even at times when these teeth appear to be “straight.”
While the nation’s number one cause of adult tooth loss is gum disease, having a misaligned bite function (or “malocclusion”) can lead to tooth loss in ways you may not have realized.
For example, during chewing, the upper teeth and lower teeth are designed to work harmoniously together to grind food down for swallowing and digesting. When an upper tooth does not interact smoothly with one below it (or vice versa), a tooth can become chipped, broken or fractured.
When damage to a tooth occurs, it must be quickly repaired before oral bacteria can penetrate tooth structures. Without the protection of enamel, oral bacteria can cause tooth decay and gum disease.
A fracture in a tooth can expand over time, leading to a crack that loosens an entire segment of a tooth. These areas must also be repaired before the tooth is subjected to oral bacteria. This typically requires a crown (or “cap”) that is placed over the top portion of the tooth.
However, a crack in a tooth that extends into the gum tissues typically means the tooth must be removed. If a portion of the tooth breaks “just below” the gum tissue, the tooth can sometimes be saved by a procedure we do called a “crown lengthening.” This is often known as a gingivectomy and is performed to remove excess gum tissues.
A gingivectomy procedure exposes more of the natural tooth so a crown can be placed over the tooth to preserve its remaining structure. (For people who have a “gummy smile,” this is performed, also, to reduce the amount of gum tissue that arches over teeth most visible in a smile.)
Another hazard of bite misalignment relates to dental implants. The overall success rate of dental implants is very high, nearly 98 percent by some estimates (when properly selected, placed and maintained). However, when a newly-placed implant is subjected to the grinding forces of TMJ disorders, its risks for success are much lower.
People are often surprised to learn that they clench and/or grind their teeth at night – primarily due to bite misalignment. When a bite is “off,” the jaw joints can become strained and inflamed. During sleep, the upper and lower jaws go on a subconscious quest of sorts, searching to find a comfortable position that eliminates the strain.
The forces behind some clenching are enough to crack open a walnut. Imagine a newly placed implant that is dependent upon the jaw bones to “heal” it into this firm foundation. When the area of bone around an implant is subjected to night after night of disruption, the implant is against the odds of becoming fully embedded in supporting bone.
Here’s an example: Let’s say you use a screwdriver to firmly anchor a screw into a solid block of wood. However, every day, you use a pair of pliers to grasp the screw head and wriggle it back and forth. Obviously, it wouldn’t take long for the wood surrounding the length of the screw to wear down from the friction of the screw’s motion, even slight as it may seem. Eventually, the screw could be easily moved back and forth and would no longer serve as a dependable base of support.
It’s not unusual for more than one dental specialist to work with another to provide a patient with the combined skills needed in particular cases. I frequently work with other dental specialists and general dentists in a “team treatment” capacity in order to give patients optimal outcomes.
When we place an implant, our goal is for each patient to enjoy its benefits for the remainder of their life. Bite misalignment can jeopardize this. And, if you have all your natural teeth now, be sure to protect them by keeping your gums healthy and ensuring your bite is as well.
After all, every dental professional is on your team when it comes to enjoying confident smiles for a lifetime!
If you’ve noticed indications of gum disease (tender gums that bleed when brushing, for example) or have experienced tooth loss (or fear you are facing it), take charge of your smile now. Call 828-274-9440 to schedule a thorough examination.
Reshaping Gums Can Protect & Beautify Your Smile.
Posted on Jan 08, 2019 by William J. Claiborne, DDS MS
As a periodontal specialist, I spend a great deal of my time treating patients who have periodontal (gum) disease and placing dental implants. My specialty has given me advanced training in both areas; both being important for the preservation of your smile and protection of your health.
Receded gum tissue
One aspect of the periodontal specialty that is not always familiar to the general public, however, is our ability to recontour gum tissues. While this can be done to enhance the appearance of a smile, reshaping the gum tissues is also performed to protect and even save natural teeth. I’ll explain.
For several reasons, gum tissues can pull away from the base of teeth. This can occur from gum tissues becoming drier with age or over-zealous tooth brushing. Gums can also loosen their grip around teeth when teeth tilt out of their proper positions.
When the tight seal around the base of teeth is compromised, the tooth becomes more vulnerable to oral bacteria. Darker, sensitive tooth root segments can be exposed. This not only causes discomfort, these areas are more susceptible to bacteria. And, because of allowing an entry point for oral bacteria, the tooth roots and bones that support teeth are more vulnerable to damage as well.
In cases when a tooth breaks near the gum line, gum re-contouring may be able to expose enough of the tooth structure so a crown can be placed. This means the natural tooth can be saved rather than require removal. Once a natural tooth is removed, it brings with it a long list of decisions and associated costs.
Although protecting and saving teeth is the priority, gum contouring can also be performed to enhance the appearance of a smile. For example, for people who have a “gummy smile,” too much gum tissue is visible above upper teeth in a full smile. A periodontist can use his or her specialized skills to reshape the tissues to provide a more balanced smile line.
This procedure is known as a Gingivectomy. This repositions or removes excess gum tissues so the smile line is more balanced to teeth. The procedure is performed while the patient is fully comfortable and the healing time is greatly reduced with our advanced technology.
Another procedure that greatly enhances the look of a smile is crown lengthening. This is recommended when the gum tissues that arch one or several teeth is at a different level than surrounding teeth. With this uneven alignment of gum tissue, it can create a jumbled look in spite of having attractive, healthy teeth.
A crown lengthening procedure typically combines the repositioning of gum tissues along with placement of a crown. This recreates a smile that has proper balance amongst teeth and gum tissues.
It’s not uncommon for new patients to arrive with misconceptions about the procedures. With advanced technology and techniques, along with specialized skills, our patients enjoy optimal comfort, minimal treatment time, and exceptional outcomes for every periodontal need.
Too, many patients feel these procedures are out of reach financially. For many treatments, we offer payment options that are manageable to most budgets. This way, you can make payments while enjoying the benefits of a healthy, beautiful smile.
Now that you know how a periodontist can enhance the health and appearance of your smile, consider scheduling a consultation and exam. Call 828-274-9440 or tap here to begin.
Gum Disease, Dental Implants – A Periodontist Can Make A BIG Difference.
Posted on Aug 06, 2018 by William J. Claiborne, DDS MS
When it comes to our health, most of us have an internist, or a ‘primary care’ physician. This doctor oversees our general health. However, should a strange rash appear, our internist will likely refer us to a dermatologist. The same is true if we experience persistent back pain; the internist is likely to refer us to an orthopedist.
When it comes to the best way to pinpoint and tackle specific issues with our health, it makes sense to see a doctor who has received specialized training in that area. This helps to take the guesswork out of diagnosis and enhances the potential for a successful outcome in an efficient process.
As a periodontal specialist, I work with a large number of general dentists in Western North Carolina as well as other dental specialists and physicians. In many cases, we work together in “team treatment” so the patient receives specialized dental care that blends comfortably with the positive relationship each has with his or her regular dentist.
Dr. William Claiborne,
What is a periodontist?
A periodontist is a dentist who has continued in education to specialize in the diagnosis and treatment of all areas of the tissues in the mouth. In addition to treating all phases of periodontal (gum) disease, we are uniquely qualified to reshape gum tissues.
For gum disease, we are able to help patients overcome the problems caused by the infectious bacteria in the mouth. Through decades of research, this bacteria has been associated with many health problems elsewhere in the body. It has been found to trigger systemic inflammation and has been linked to a number of health problems, including heart disease, stroke, diabetes and arthritis.
We begin by accurately diagnosing the stage of gum disease present. From there, we develop a customized treatment plan based upon factors such as the patient’s current overall health, their diet, medications, whether they smoke or drink alcohol, and age.
Treatment recommendations are made based on what will effectively resolve the problem without over-treating or under-treating. By restoring the patient to good oral health, we are able to help them avoid tooth loss and rid their mouths (and thus, their bodies) from an overload of oral bacteria.
Gum tissues also play an important role in protecting teeth. When they recede, or pull away from the base of teeth, tooth roots may be exposed. These darker, sensitive areas can be re-covered through procedures that restore the protective seal around teeth as well as the level of the gum line, which plays an important role in a smile’s appearance.
A periodontist specializes in gum contouring to enhance the look of your smile. For example, when the gum tissues that arch over each tooth are a different levels, it can distract from a smile’s appearance. Through reshaping procedures (often referred to as a gingivectomy), we can correct this for a more balanced “smile line.”
The same is true for an individual who is born with a “gummy smile.” This occurs when too much gum tissue shows above top teeth in a full smile. Often, with minor reshaping or “crown lengthening” procedures, we can adjust the gums to a more esthetically-pleasing level.
Periodontists also specialize in the diagnosis and placement of dental implants. They are trained to understand all the intricate concepts involved in selecting the proper type of implant. Then, they are skilled at placing implants at proper depths and angles. As they oversee your “healing” time, periodontists are also able to optimize your comfort and outcome.
A periodontist receives 4 years of “undergraduate” training at a college or university and then goes on to earn a dental doctorate. After 4 years of dental school, they further their education for another 3-4 years before completing stringent requirements for a specialty certification in periodontics.
This 11 years of higher education is a commitment I made with enthusiasm, and I have relished staying on the cutting edge of new developments in the field throughout my career. On an ongoing basis, periodontal findings have revealed the integral connection between our oral health and our overall health.
As research continues, the understanding of good oral health as it benefits our overall health will hopefully become common knowledge to every individual. Sadly, our nation now has an adult population of nearly half that have some level of gum disease.
If you would benefits from the advanced skills of a periodontal specialist, please know that we are fully trained to attend to your specific periodontal needs in a comfortable, effective manner. Our entire team is committed to compassionate, respectful care that is appropriate for each need and our office is equipped to handle your care efficiently, effectively, and gently.
Call 828-274-9440 to learn more or to schedule a consultation.
Your Gums – An Important Part Of Your Smile’s Appearance
Posted on Jun 20, 2018 by William J. Claiborne, DDS MS
The word “smile” actually sums up the combination of several components. What creates a smile is the lips, teeth, and gum tissues. Certainly, the teeth are an important part of what “makes or breaks” a flattering smile. However, as a Periodontist, I know how significantly the shape of the gums can as well.
A periodontal specialist is uniquely trained in the diagnosis and treatment of all phases of periodontal disease and other problems associated with gum tissues. He or she also has advanced skills in the diagnosis and placement of dental implants. To the general public, however, an often unknown skill of the Periodontist is in the “esthetic” contouring of gum tissues.
To understand the intricate involvement a periodontal specialist has in smile enhancement, just look in the mirror and get a close-up view of your smile.
You’ll notice that each tooth is arched by gum tissue. You’ll also see a slight dip of this tissue that seems to separate each individual tooth. What you may not have noticed before is how the gum tissues that border each tooth are in a fairly even line. This is your “smile line.”
In seeing photos of people who have what is deemed as beautiful smiles, the teeth are nicely shaped and the gums are evenly contoured over each. In a smile that has an uneven smile line, it tends to create a jumbled look, even though the teeth may be properly shaped and aligned.
In some situations, people have experienced gum recession. This is when the gums pull away from the base of teeth, which exposes darker, tooth root portions. This not only detracts from a smile’s appearance, it leave the tooth vulnerable to decay. It also causes sensitivity, especially to hot or cold foods and beverages.
In this instance, we often perform a gum graft. This uses a small portion of the patient’s own gum tissue to cover the area of recession. This restores appearance and helps to protect the health of the tooth.
For other people, too much gum tissue may arch the teeth most visible in a smile. This is known as a “gummy smile.” Katie Couric, when she smiles fully, is an example of this. Essentially, a gummy smile is a genetic trait and does not pose a risk to one’s oral health. However, for some people, it causes them to feel self-conscious about their smile’s appearance.
Katie Couric – a famous ‘gummy smile.’
It takes a precision hand and special skills to be able to reshape the gum tissues in order to preserve a natural contour. For example, that “dip” in-between each tooth is an important part of the smile line, as small as it is. This dip is known as a pointed papilla.
One of the reasons we urge people to have an implant placed at the time of tooth removal is to protect the natural contour of the gums, including this slight dip. It takes only days for this small point to begin to flatten. For teeth that are visible in a smile, the lack of this point can detract from the natural appearance in a smile.
In periodontology, we reshape gums through a procedure known as a gingivectomy (gin-geh-vect-om-ee). In this, excess gum tissue is removed. For mild cases, we may be able to reshape the gums without the need for crowning the tooth. In many cases, however, a crown is placed in addition to gum re-contouring. This is known as crown lengthening.
The crown not only enhances the appearance of the tooth involved in treatment, it helps to protect it’s root. If too much gum tissue is removed, sensitive root portions of the tooth can be exposed. This can allow entry of oral bacteria, compromising the health of the tooth and surrounding gum tissues (which can lead to gum disease).
In our office, crown lengthening or gingivectomies are performed with a high level of comfort. Although gum tissues are laden with nerves, we take special measures to minimize anything that would add to one’s discomfort or the amount of time needed for healing. As a specialist in this area, I am trained to help each patient achieve optimal results with treatment that they remember as “no big deal!”
Healthy gums are an important part of your overall health and the foundation for your teeth. The appearance of your gums, however, are an important part of your smile, too. The self-confidence in knowing a smile looks attractive tends to cause people to smile more often. That’s a good reason to ensure your teeth AND gums are in good shape!
If you’ve noticed your smile is less-than-its-best because of uneven or excess gum tissue, call us at 828-274-9440. We will be happy to schedule a consultation appointment. During this time, we’ll make recommendations and I’ll explain the procedure. From there, you can make the decision that is best for your needs and goals.