Reshaping Gum Tissues To Protect Oral Health & Enhance Smiling Appearance

Posted on Mar 21, 2024 by William J. Claiborne, DDS MS

When people think about the appearance of their smiles, it’s typically the teeth that are the focus. Everyone wants a smile that enhances appearance, instills self-confidence and gets compliments. Yet, the appearance of a smile involves more than just teeth. The “frame” of gum tissues that arch the teeth most visible in a smile have a lot to do with how a smile looks.

As a periodontal specialist in Asheville, NC, part of my specialty involves the treatment of all stages of periodontal (gum) disease, the placement of dental implants, and the contouring of gum tissues. Gum contouring is generally done for esthetic reasons but may also be advised for oral wellness.

Gums most often pull away from the base of teeth (or “recede”), exposing darker areas of the tooth. This darker area is part of the tooth’s root and highly vulnerable to damage. Recession also causes teeth to look longer and expose darker tooth root areas of the tooth. Being sensitive to hot or cold – causing a sudden jolt of pain – is often the final warning sign that the gums are not protecting tender root segments of the tooth.

Gum recession is commonly due to:

• Gum disease, which destroys gums tissues, causing them to loosen their firm grip around the base of teeth. This enables oral bacteria to penetrate beneath the gum line, reaching vulnerable bone and tissues.

• Over-vigorous toothbrushing can wear away precious gum tissues that surround the base of teeth. When using a back-&-forth scrubbing motion, or a hard toothbrush, gum tissues can be scrubbed off. Too, using abrasive substances to brush (such as baking soda) not only wear down gum tissues, they wear away tooth enamel.

• The aging process lessens hydration in the body. Because the gum tissues are moist layers that require continual hydration (supported by saliva), oral dryness can cause the gums to draw up as they become drier. Unfortunately, this creates more challenges in maintaining healthy teeth.

While gum recession is an oral health concern, it is a cosmetic issue as well. For an attractive smile, teeth should be arched by a balanced level and shape of gum tissues. When there is too much gum tissue showing above teeth or varying heights of gums arching teeth, the height and symmetry of gum tissues can be corrected by a periodontist.

For example, in a gummy smile, too much of the gum line is visible. This makes teeth look short and draws the eye to the gums rather than the teeth. Gum tissues should complement teeth with a balanced line of gum tissues. While a gummy smile is not generally problematic for one’s oral health, many people find it makes them “hold back” on smiling fully.

The procedure to correct a gummy smile is a gingival lift, also known as a gum lift or gum contouring. This in-office procedure is performed to reduce and reshape highly visible gums.

In our Western NC periodontal dental office, we use a dental laser to perform a gingival lift. Our dental laser gives a precision line while only removing specific areas of the gums, leaving all surrounding tissue unharmed. This allows us to reshape the gums to create better balance in the smile.

A laser gingival lift also offers patients a more comfortable experience since it causes very little pain and therefore requires only topical anesthesia. In addition, laser treatments result in almost no bleeding and tissues tend to heal more quickly than after traditional surgery.

We also perform gum grafting that recovers areas where gum recession has occurred. This helps to protect the tooth roots and improves the appearance of the smile.

In gum grafting, we normally take a small area of tissue from the roof of the mouth and place it in the area of recession. When there is not sufficient tissue available, a graft may be from a donor source. The graft is attached to the natural gum tissue and gently sutured into the position where it corrects a smile’s appearance and reduces further recession and the potential for gum disease.

Several teeth may be involved in gum grafting when used to even out the gum line or reduce the risk of gum and bone collapse after a tooth has been lost. In these cases, cosmetic gum surgery is beneficial in reshaping excess gum and bone tissue. It also reduces sensitivity from exposed roots to hot or cold foods.

As a periodontist, I most commonly see gums that cover too much of the teeth as being due to genetics. When gums fail to cover sufficiently over the base of teeth, it’s typically the cause of recession, which can occur from several reasons (as listed prior). Regardless of why it has occurred, our goal is to provide the patient with the most healthy and esthetic outcome in a procedure that is comfortable, successful, and requires minimal healing time.

In our Asheville periodontal dental office, we offer some of the most advanced dental technology available. In addition to amazing imaging, such as Cone Beam 3D imaging, we provide Laser-Assisted New Attachment Procedure (or LANAP). This is a cutting-edge protocol to more efficiently and effectively treat periodontitis (advanced gum disease) with the PerioLase® MVP-7™ laser. Treatment is minimally invasive and helps to minimize both discomfort and recovery time. It has also been found to stimulate bone regrowth in damaged areas.

Additionally, our office offers both oral and I.V. sedation (“twilight sleep”) for complete relaxation during treatment. Sedation is administered safely by a doctor of anesthesia to provide optimal safety and comfort.

If finances have kept you from seeking out the care you need or the beautiful smile you desire, feel free to contact our friendly staff and arrange a consultation appointment. During this time, we can discuss the best options for you, cost estimates, and predicted treatment time.

We can also review several payment plans that make treatment affordable through extended, interest-free payment periods with no down payment required. These often help our patients enjoy their confident, new smiles while making easy monthly payments that are budget friendly.

Call 828-274-9440 to schedule.

Achieve Smile Goals With A Periodontist

Posted on Dec 11, 2023 by William J. Claiborne, DDS MS

If you’re like me, I’m usually looking at the end of each year feeling like there are several things I wanted to accomplish for the year, but kept putting them off until I ran out of time.

For some people, their oral health and appearance goals are on this list, with some who keep moving the goals to the next year and the next. These goals may include:

• Improving the appearance of a smile

• Having a “cleaner” mouth with fresh breath, etc.

• Replacing missing teeth

• Getting past fear or anxiety of dental visits

If you have one of these on your list, you may be surprised that a periodontal specialist can play a major role in helping you achieve your goals. And, because of the advanced skill level of a periodontist, your comfort, time in treatment and overall results can make the process easier for you.

Many general dentists and other dental specialists refer their patients to a for their specific skills. A periodontist is a dental specialist who is the expert in caring for the gum tissues in your mouth and in the placement of dental implants.

The majority of patients arrive because of periodontal (gum) disease. Common symptoms are red, swollen and tender gums. It often causes gum that bleed easily (often noticed when brushing teeth) and persistent bad breath.

Gum disease (sometimes referred to as ‘perio’ disease) only worsens without treatment. It is the leading cause of adult tooth loss. Additionally, it has been linked to the development or worsening of a long list of serious health problems elsewhere in the body.

Because the inflammatory bacteria disease can enter the bloodstream through diseased gums, their presence can activate conditions that are seemingly unrelated to oral health. Yet, the connection is severe. These health problems include stroke, heart attack, Alzheimer’s disease, dementia, preterm babies, some cancers, arthritis, diabetes, and erectile dysfunction (ED).

In our Asheville periodontal dental office, we are able to treat all stages of gum disease to restore your oral health and minimize the risk of tooth loss. For those who have developed gum disease because they’ve been afraid of dental visits, we offer oral and IV sedation (“twilight sleep”).

Sedation is administered safely by a doctor in anesthesia who uses advanced safety equipment. Our priority is always patient comfort with their safety equally so.

Too, our advanced technology is able to minimize treatment time with amazing results. For example, LANAP (Laser-Assisted New Attachment Procedure) combined with PERIOLASE MVP-7 is designed to efficiently and effectively treat periodontitis (advanced gum disease) with the advantages of a dental laser. This offers non-surgical treatment for patients with moderate to severe periodontal disease. LANAP treatment minimizes discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

When tooth loss has occurred (whether from gum disease, an accident, or due to genetics), our NW NC dental specialty office also works with a number of dentists in the diagnosis and placement of dental implants.

With over 40 different implant systems, the one suited best for you depends on factors that an experienced dentist must take into consideration. For example, the number of implants you need and how much jaw bone mass exists.

For individuals who have lost a great deal of bone, specific implant types may be recommended. Some, like the “All On 4” implant system, uses specially designed implants which are placed at specific angles.

Bone loss can also be overcome by incorporating a bone rebuilding process into treatment. This is done prior to implant placement and does not require a bone graft. In many cases, we can apply a bone rebuilding material that restores ample bone mass.

The same is true when the sinus cavity will be too close to the proximity. This can be remedied through a “sinus lift.” We provide complete services of these procedures as well as dental implant placement – all performed with advanced skills and technology, such as our Cone Beam 3D imaging.

These images are ideal in diagnosis and treatment planning by giving a clear view of the mandible and maxilla (upper and lower jaw). Cone beam radiographs provide images in sagittal, axial, and coronal planes. This makes it possible to locate and trace the mandibular nerve canal for pre-surgical planning for an ideal implant position. Patients are exposed to only minute levels of radiation through a process that is fast and comfortable.

When the enhanced appearance of a smile is being sought, a periodontist also plays a part in helping to create a balanced smile line. In the procedure known as “crown lengthening,” the arch of gum tissues over teeth visible in a smile can be repositioned. This is done in a procedure known as a gingivectomy.

A gingivectomy is also performed to repair a “gummy smile.” This is when too much gum tissue shows above the teeth most visible in a smile. While the condition is not detrimental to oral health, some individuals seek to have it corrected by a periodontist.

Get the coming year started with your smile goals achieved! Call our Asheville periodontal dental office to schedule a consultation. Our friendly staff can help you arrange this private time together by calling 828-274-9440.

 

A Periodontist Can Contour Gum Tissues For A More Beautiful Smile

Posted on Nov 23, 2023 by William J. Claiborne, DDS MS

During the holidays, my wife and I attend gatherings where we occasionally meet new people. A common question, as applies to most of us, is “What do you do?” When I reply that I’m a periodontist, it is often met with a look of not knowing what a periodontist is but not wanting to appear as if that’s the case.

I’d like to explain what “we” are and, from a smile enhancement basis, what we can provide. I typically find that when I say “periodontal plastic surgery” it comes across as far more familiar than “performing gingivectomies.”

A periodontist is a dental specialist who has an advanced level of understanding when it comes to diseases of the oral tissues, reshaping of gum tissues and in the selection and placement of dental implants.

The American Academy of Periodontology defines a Periodontist as:

“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. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”

https://www.perio.org/consumer/what-is-a-periodontist

To reach this specialty begins with educational requirements that are extensive. First, there is completion of 4 years of college (for an undergraduate degree) followed by another 4 years in dental school (for a doctorate). To specialize in Periodontics, he or she must further their education for another 3-4 years before completing the stringent requirements for specialty certification in periodontics.

The gums are rather under-rated when it comes to the tremendous role they play in both oral health and even your overall health.

Think of the gum tissues as a protective blanket in the mouth. The gums cover over the structures that support teeth and house the tissues and bone that are vital to our health. For instance, look at the base of each tooth. You’ll see that gum tissues snugly wrap around the base of each tooth. This protective seal is what prevents bacterial penetration beneath the gum line.

When oral bacteria amass to an extent that cannot be controlled by oral hygiene measures at home, they cause inflammation in the gums. In turn, the gums loosen their tight grip around teeth, which allows entry of the now-potent bacteria. These infectious bacteria have been linked to a number of problems related to a long list of serious health problems.

Oral bacteria has been found to trigger or worsen systemic conditions, including atherosclerotic vascular (heart) disease, pulmonary (respiratory) disease, diabetes, pregnancy-related complications (including preterm births), osteoporosis (bone loss), and kidney disease. A shared trait between gum disease and these medical conditions is that they are chronic conditions that take a long time to develop.

https://www.agd.org/docs/default-source/self-instruction-(gendent)/gendent_nd17_aafp_kane.pdf

It is important to be familiar with the signs and symptoms of periodontal (gum) disease, which include:

• Red, swollen or tender gums
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that pull away from the teeth (recede) or make the teeth appear longer than normal
• Loose or separating teeth
• Pus pockets that form between gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way teeth fit together when biting
• A change in the fit of partial dentures

If you have any of these, you are urged to seek a thorough periodontal evaluation as soon as possible. This disease will only worsen without treatment. Gum disease is the nation’s leading cause of adult tooth loss.

Healthy gum tissues do more than serve in a protective role. The appearance of a smile can be greatly affected by the shape and amount of gum tissues exposed when smiling.

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 flow at a similar height. These gum arches are in a complimentary line to teeth, rather than at varying levels over teeth. When the gum lime is not evenly balanced, it causes a smile to have a jumbled look.

Crown lengthening is performed to reposition the gum tissues to enhance the appearance of a smile. In addition to creating a more appealing look, crown lengthening is also performed to restore the tight seal of protection around teeth. While you enjoy the beauty of your new smile, crown lengthening gives your oral health a boost at the same time.

When the height of gum tissues that show above all teeth in a smile is too high, it is referred to as a “gummy smile.” A gummy smile is not detrimental to your oral health. However, having one does affect the appearance of a smile based on balance. For some people, it makes them “hold back” on a full smile.

This can be corrected with a gingivectomy. To begin, we numb the gum tissues and carefully trim the excess. As a Periodontist, I take specific measures to ensure a natural looking arch remains over the teeth while preserving the natural points that ‘dip’ between each tooth.

A gingivectomy is performed in our Asheville periodontal office with a dental laser. This provides patients with a number of advantages: (1) enhanced comfort; (2) precision lines; (3) minimal or no bleeding; and, (4) faster healing time.

In our Asheville NC periodontal office, we use the highly-advanced LANAP with PerioLase MVP 7 Laser-Assisted Attachment Procedure. This is an advanced protocol that efficiently and effectively treats advanced gum disease (periodontitis) with the added advantages of a dental laser. It is a non-surgical alternative for patients with moderate to severe periodontal disease, causes very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

In some cases, the crown lengthening procedure can save a tooth from removal. Typically, when a tooth fractures or breaks at the gum line, it must be removed since there is not enough tooth structure to support a crown. However, a crown lengthening procedure may be able to expose more of the tooth’s structure, essentially saving the natural tooth.

For those who have avoided gum treatment due to dental fear, we offer several sedation options, including oral and IV 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 (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. Here, anesthesia is overseen by a medical doctor (MD) who is a board certified Anesthesiologist. With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

We help patients understand that their fears and concerns are not unusual. The doctors and staff of our Asheville periodontal dental office respect each patient and provide gentle, compassionate care – at every appointment.

We believe you’ll find no better periodontal dental environment in western NC. Whatever your need for the treatment of gum disease, recontouring of gum tissues, or in the placement of dental implants, call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.

Laser Dentistry, Cone Beam Imaging Among Our Advanced Features!

Posted on Nov 15, 2023 by William J. Claiborne, DDS MS

Like your “adult” teeth, your gum tissues are irreplaceable. Without question, they deserve the care and attention that come with keeping them healthy and doing their job.

Gum tissues are designed to protect the structures underneath. These include bones, tooth roots, tendons, and muscles to prevent entry of harmful bacteria. Gums are designed to snugly wrap the base of each tooth to keep bacteria from penetrating sensitive root segments of teeth.

Without this protective seal around teeth, the potential for periodontal (gum) disease greatly increases. And gum disease is at concerningly high levels in the U.S. with an estimated 47% of adults having some level of gum disease.

I believe that this high level of gum disease is largely in part due to Americans not being fully familiar with the symptoms. Some are easily ignored or “brushed off” as normal. 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 pulling away from the base of teeth, making them appear teeth longer
• 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 biting
• A change in the fit of partial dentures

If you are experiencing any of these symptoms, you are urged to seek care with a periodontal specialist as soon as possible. This disease will only worsen without treatment.

Why should you be concerned about periodontal disease?

Gum disease is the nation’s leading cause of adult tooth loss. Additionally, research has linked the bacteria of periodontitis with serious health problems. These include heart disease, stroke, arthritis, diabetes, some cancers, preterm babies, erectile dysfunction (ED) and high blood pressure. Studies on links to Alzheimer’s disease are showing concerning correlations.

A periodontist is an expert in the treatment of all stages of gum disease, including gingivitis, periodontal disease, and the advanced form of periodontitis.

In addition to having these specific skills, I’d like to share the benefits of some of our amazing technology we make available to our Western NC patients. One with a wide range of benefits to patient care is our Dental Laser.

Nd: YAG Dental Laser: This is a small, hand-held device that eliminates or greatly minimizes bleeding during procedures. It also reduces numbing requirements, removes bacteria and easily uncovers gum tissue where dental implants have been placed.

Additionally, laser dentistry can quickly repair oral ulcers and beautifully re-contours or repairs gum tissue with a precision line. Some specific treatments that are ideal for a dental laser include:

Canker & Cold Sores: The laser is also ideal for rapid healing of canker and cold sores. Laser therapy can halt the progression of canker sores, reducing the pain in a day or so. Otherwise, they can last up to 2 weeks. When it comes to cold sores, they are best treated with our laser when the very first symptom arises. Tingling or burning sensation is the first sign that a cold sore is about to erupt. Although lasers can still treat these lesions in later stages, the treatment is most effective in initial stages. Most patients notice significant improvement in comfort after laser treatment with a much shorter duration.

Gum Disease Treatment: In our office, we also use a dental laser to destroy the bacteria of gum disease. This technology also speeds the process and heightens your comfort, saving you treatment time with faster healing.

Correcting a “Gummy Smile”: This is when a smile shows too much gum tissue above upper teeth when smiling fully. We correct this in a procedure known as crown lengthening. In this, a gingivectomy adjusts the height of gum tissues so the smile has a more even smile line. This may involve the use of a dental laser, which provides a precision line and speeds healing.

Balancing a smile line: A gingivectomy is also advised to rebalance the frame of gum tissues that arch the teeth visible in a smile. When one or two teeth have different heights of gum tissue, the smile has a jumbled look. A dental laser can even out the smile line and enhance the beauty of a smile.

Saving a tooth broken near the gum line: When a tooth breaks at or near the gum line, it often requires removal. In some cases, however, we can save the tooth by exposing enough of the structure to receive a crown. This helps the patient to avoid removal and thereby preserves the supporting jaw bone.

In our Asheville NC periodontal dental office, we feature additional technologies, some of the most advanced in the industry. These include:

LANAP Protocol Using PerioLase MVP-7: This process is designed to efficiently and effectively treat periodontitis (advanced gum disease) through laser technology. Treatment is administered with minimal (or no) discomfort and recovery time is minimal. Amazingly, this technology has also been able to stimulate bone regrowth in damaged areas.

Cone Beam 3D Imaging: These views allow us to see your jaw in 3D dimensions and to be able to view it at varying angles. This enables us to see what used to be hidden from view.

Cone Beam images are often used to assess:
• Dental Implant Positions
• Temporomandibular Joints (TMJ)
• Airway Passages
• Bone Structure Damage or Bone Loss
• Teeth, Tooth Roots and Facial Structures
• Signs Of Infections, Cysts, Or Tumors

CS 3600 Intraoral Scanner: Through this process, our patient no longer have impressions made with bulky, goopy trays held in their mouths. This technology quickly and comfortably scans the mouth’s interior for digital impressions using a small, handheld scanner. It can also reach difficult–to–access areas in the patient’s mouth with improved patient comfort.

Simplant Dental Software for Computerized Dental Implant Placement: This system helps in pre-surgical positioning of dental implants on the computer, using a 3D model of the patient’s jaw. This aids in the selection of the implant type to ensure a precision fit.

Intraoral Camera Technology: This provides outstanding quality of images within the mouth. These images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment needs.

Computer Imaging In Treatment Suites: Treatment suites are equipped with computers for convenient image sharing with patients.

Oral & IV Sedation: We take patient comfort very seriously in our Asheville periodontal dental office. That’s a commitment we make to every patient at every appointment. Here, patient comfort is supported by our sedation options. These include oral and I.V. sedation. Also referred to as “twilight sleep” or “sleep dentistry,” these sedatives are administered by a highly-skilled anesthesiologist who uses advanced safety monitoring equipment throughout the patient’s procedure.

My staff and I also take great pride in providing patients with an environment of respect. Some adults come to us embarrassed by the condition of their oral health or missing teeth. Here, we strive to make patients feel they are in the right hands in the right place.

If tooth loss has occurred, a periodontist also specializes in the selection and placement of all types of dental implants. Dental implants, for many reasons, are the preferred option for tooth replacement.

Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office. New patients are always welcome and a referral is not always necessary.