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Gum Contouring
Six Reasons To Have Your Dental Implants Placed By A Periodontist
Posted on Jul 12, 2023 by William J. Claiborne, DDS MS
A periodontist is a dental specialist who is often in the background of various dental procedures. Yet, we are in the forefront when it comes to specialized skills that support specific treatment needs.
Most patients are referred to our Asheville periodontal dental office by general dentists and dental specialists to provide certain aspects of dental treatment, which may involve our skills in cosmetic dentistry, dental implants, and treating all stages of gum disease.
A periodontist has advanced training to properly diagnose and treat all stages of periodontal (gum) disease (including gingivitis and periodontitis) as well as placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures to repair gum-related disparities such as a “gummy smile” or varying gum arches that “jumble” a smile line.
A periodontist receives an additional 3 years of training after 4 years of undergraduate school and 4 years of dental school. This long, rigorous pursuit of the periodontal specialty requires the individual to be highly committed to the advanced care he or she will provide. It is our goal to help people achieve good oral health, a confident smile they love to share, and prevent tooth loss that can result from diseases of the gums.
Dental implants are now seen as the preferred option for tooth replacement. They come in over 40 different types designed to accommodate various challenges and preferences. But, why should you have your dental implants chosen and placed by a periodontist? After all, some dentists perform this in addition to their general dentistry services.
Below are 6 reasons our dental implant patients have particular advantages…
(1). With specialized skills, a periodontist is especially respectful to oral tissues as sensitive layers that have an important role in the appearance of a smile and the health of teeth. Utilizing these skills, a periodontist can help to minimize incisions while effectively treating each area in the mouth.
(2). Rather than be limited to just one or two dental implant systems that were taught in a “crash course” by the implant manufacturers, our speciality understands the complete spectrum of implant systems. Some may be ideal for your needs while others may not. Some provide you with a non-removable (“fixed”) option while others may involve removable teeth. Our specialized skills give you the best choices you should have.
(3). Additionally, the proper selection of your dental implants may greatly save you in treatment fees. For example, the All-On-4 dental implant system needs only 4 implants per arch, and can be placed in shallow bone. The treatment fees are less since the number of implants is low and the need for bone regeneration for severe bone loss may not be required. For these reasons, a periodontist may be able to help you achieve your tooth replacement goals within a budget you can manage.
(4). In our Western NC periodontal dental office, our advanced technology includes 3-D Cone Beam Imaging. This is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes. The imaging process is quick, painless and at minimal radiation levels.
(5). Another feature is our Computerized Dental Implant Placement system. This advanced technology is designed for pre-surgical positioning of dental implants that uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases. This minimizes disruption of gum tissues and targets implant placement at ideal depths and angles. Thus, treatment success rates are higher with faster (and more comfortable) healing time.
(6). Optimal comfort for our patients has always been a priority. For many, a desired level of comfort and relaxation includes sedation options. Here, 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. IV sedation (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. It is administered 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.
If you are considering dental implants, you may wish to begin with a consultation appointment. During this time, we can explain the vast difference in comfort, treatment time, and success available through our specialized skills and extensive technology.
Call 828-274-9440 to schedule. New patients are always welcome and a referral is not always required.
3 At-Home Tips To Lower Risk of Tooth Loss, Gum Disease
Posted on Jun 02, 2023 by William J. Claiborne, DDS MS
Gum disease is the nation’s leading cause of adult tooth loss and one of the most prominent diseases in the U.S., with over 47% of adults having some level.
Yet, this disease is far more devastating than many realize. When oral bacteria build to a point beyond the ability of the immune system to manage, inflammation sets in. This inflammation continues to build as the oral bacteria become infectious.
Oral bacteria is the cause of cavities, gum disease, and a long list of health problems as many years of research has shown. Oral bacteria can become bloodborne through tears in diseased gum tissues, allowing it to travel throughout the body. This can trigger inflammatory reactions that have serious consequences far beyond the mouth.
Because the initial symptoms of periodontal (gum) disease are silent, the early stages of the disease can be perplexing since patients don’t feel anything is wrong. However, like most diseases that form in our bodies, we don’t feel or see anything when they first begin. This allows the disease to progress without our knowledge.
Unfortunately, people tend to delay treatment until the symptoms of periodontal disease are obvious and uncomfortable. These include tender and swollen gums that bleed easily when brushing, consistent bad breath, and gums that are red in color rather than a healthy pink. As gum disease progresses, pus pockets form around teeth as bacterial accumulate. Eventually, teeth will loosen and need to be removed.
Although gum disease can begin without any obvious symptoms, once it exists, progression occurs in three stages (without treatment).
• Gingivitis – As the initial stage of gum disease, inflammation is triggered by plaque buildup at the gum line. When daily brushing and flossing fail to thoroughly remove plaque, toxins form that cause irritation to the gum tissues. Once signs emerge, they may include seeing blood in the sink when brushing or having sore, swollen gums. At this stage, however, damage may be reversed with prompt response.
• Periodontitis (gum disease) – As the disease progresses, the bone structures and fibers that support teeth are damaged by the destruction of infectious oral bacteria. At this stage, inflamed gums form pockets below the gum line, filling with bacteria-laden plaque.
• Advanced Periodontitis – In the advanced stage of gum disease, fibers and bone supporting natural teeth are destroyed. This can cause teeth to shift or loosen, requiring aggressive treatment to prevent tooth loss. Eventually, some teeth may require removal.
As devastating as tooth loss can be to one’s overall health, the bacteria of gum disease can enter the bloodstream. Research has shown this infectious bacteria can trigger inflammatory reactions elsewhere in the body, correlating to heart disease, stroke, high blood pressure, some cancers, diabetes, arthritis, impotency, preterm babies and more.
Obviously, it is important that people are diligent in the care of their oral health. Yet, statistics in America along these lines are not impressive. The Center for Disease Control’s Division of Oral Health cites that 1 out of every 2 American adults 30 and over has periodontal disease. They also shared that periodontal disease is higher in men than women (56.4% vs. 38.4%) with high prevalence rates among smokers (64.2%) and adults 65+ (70.1%).
As a proponent of dental implants to replace lost teeth, I must acknowledge that there is no perfect replacement for natural teeth. Natural teeth provide a stable, dependable means to chew and enjoy food while their tooth roots keep the jaw bones that support them nurtured and stimulated.
In addition to restoring chewing strength and stability, the dental field is a proponent of dental implants largely because of their ability to halt bone loss. Referred to as ‘resorption,’ this is the shrinking of bone mass, which occurs when tooth roots are no longer present in the jaw bone.
Once resorption begins, it continues at an ever-increasing rate with each year. For those who wear a denture or partial, the pressure an appliance places on the bone ridge accelerates it further. Sleeping in an appliance puts pressure on the ridge 24/7, speeding up the rate of bone loss even more.
Resorption can even be seen; it ages one’s appearance far beyond their actual years. As the jaw bone thins, deep wrinkles form around the mouth. Over time, the mouth appears to have sunk into the face. Jowls form and the chin becomes more pointed (creating a ‘granny look’).
Throughout all this, a denture or partial easily slips, requiring more frequent applications of adhesives or pastes. Relines may help for a time, but each reline will only help for a temporary time as the bone continues to decline in height.
Because dental implants are positioned in the jaw bone, they recreate stimulation, which helps them maintain healthy bone mass. They provide dependable, comfortable chewing and speaking ability. And, best of all, they’re designed to last a lifetime.
However, the goal is to avoid the devastation of gum disease. And, this begins at home. While your involvement with your general dentist is very important (with check-ups and cleanings every six months), daily care is a necessary part of having a healthy mouth, lowering disease risks, and keeping your natural teeth (or halting the pace of further tooth loss).
How can you improve your at-home care? There are several ways you can up your game with a few simple add-on’s…
Findings of an 11 year study published in the Journal of Clinical Periodontology tracked the oral health of over 2800 adults. Their use of ELECTRIC TOOTHBRUSHES was monitored to watch for periodontal disease, cavities, and the number of natural teeth.
Participants were examined in 2002 – 2006, with 18% being electric toothbrush users. Follow ups were conducted after 6 and 11 years. At the time of their 11 year follow up, 37 had converted to using electric toothbrushes.
The study showed electric brushing promoted better gum health and slower progression of gum disease. Electric tooth brushing also related to a reduction in tooth loss by 20% (compared to those who brush with manual toothbrushes).
Although manual tooth brushing can be just as effective, it must be done in a proper manner. For manual brushers, some manual brushes can actually be destructive used incorrectly.
For instance, a hard bristle tooth brush can wear down tooth enamel and gum tissues. Too, some people feel the need to press down firmly when brushing and tend to use a scrubbing, ‘back & forth’ motion. This action can wear down the protective shell of tooth enamel, leaving teeth more vulnerable to decay.
To avoid damaging tender gum tissues, choose a soft bristle toothbrush. As you apply gentle pressure on the brush, use a swirling motion. By using a circular pattern over both sides of each tooth and along the tops, teeth are cleansed without wearing away gum tissues. Hint: If the bristles on your toothbrush are fanned out after a couple of months, it’s because you are applying too much pressure when brushing.
Whether using a manual or electric tooth brush, it is necessary to brush twice a day for effective results. In order to thoroughly remove the sticky film of plaque from teeth, you should also brush at least two minutes each time.
Another way to improve gum health, lower cavity risk, and prevent tooth loss is through FLOSSING. It is estimated that only 31% of American adults floss on a daily basis. Because brushing cannot dislodge all food particles caught between teeth, daily flossing should be a part of oral hygiene routines.
Proper flossing is easy for those who are in the habit of it and takes less than a minute. However, the key word here is “proper.” Flossing is best done with about 18 inches of floss. We recommend unwaxed but people with tight teeth find waxed helps them avoid having to ‘pop’ in-between teeth, which can cut into tender gum tissues. Wrap both ends of the floss around the forefingers. Use the thumbs and middle fingers to help maneuver the floss.
Go slowly as you move the floss back and forth to get in-between and scrape down each tooth’s side several times. Move the floss just slightly below the line where teeth meet gum tissues to dislodge bacteria at the base of teeth. Adjust the floss so you have a clean section after flossing every 3-4 teeth. Be sure to scrape the backs of molars (or the farthest back teeth) on top and bottom.
For those who have problems with manual dexterity or find the maneuver awkward, WATER FLOSSERS are effective alternatives (shown to be just as effective as manual flossing) and easy to use. A water flosser pulsates a stream of water between teeth that is forceful enough to dislodge trapped food bits but without harming teeth or gums. They are affordable, available online or in many stores, and easy to use.
Finally, I’ll add the need to keep the mouth moist. A frequent state of ORAL DRYNESS can cause bad breath and lead to higher risks of cavities and gum disease. Saliva, the mouth’s natural rinsing agent, helps to cleanse oral bacteria from the mouth. This keeps bacteria to a minimum and their ability to cause problems at lower risk.
When saliva flow is insufficient, however, bacteria are able to accumulate and multiply rapidly. Contributors to having a dry mouth can occur from consuming alcoholic beverages, caffeine, many medications (both OTC and Rx) and is a normal part of the aging process. Some medical conditions, including acid reflux, sinus infections, diabetes and bronchitis can also cause dry mouth. A bad cold, snoring or just being in the habit of breathing through the mouth are drying as well. Smoking is a major cause of dry mouth.
To overcome the risks imposed by a dry mouth, drink lots of water throughout the day (sports drinks and colas don’t count). Use an ORAL RINSE that is formulated to replenish moisture in the mouth. There are several available over-the-counter (look for ones that DO NOT contain alcohol, which is very drying to oral tissues).
As an Asheville periodontist, I specialize in the treatment of all stages of gum disease, the re-contouring of gum tissues, and the diagnosis and placement of dental implants. Our periodontal dental office optimizes patient outcomes and comfort through our vast array of advanced technology and a commitment to exceptional care. Call (828) 274-9440 to schedule an examination or ask to begin with a consultation.
If dental fear has prevented you from achieving the healthy, confident smile you desire, ask about Oral and I.V. sedation (“twilight sleep”). These are safely administered and recovery is generally quick.
Older Adults (80’s, 90’s, 100’s) Benefit By Dental Implants
Posted on Apr 25, 2023 by William J. Claiborne, DDS MS
Someone once told me, “Old age is always ten years older than the age you are at the time.” I get it. While a teenager may think of anyone over the age of 55 as “old,” aging in the U.S. today has taken a positive position within America’s population.
Proof of this is in how more and more people are living to be 100. Many of them are still sharp and spry. Although reaching the 100 age pinnacle was once a rare feat, it’s a growing trend. Today, there are nearly twice as many 100+ year olds in the U.S. than there were 20 years ago (nearly 90,000 now).
Reaching these elevated ages, of course, depends on factors like location, gender, lifestyle and genetics. Living a long life has evolved from lifestyle changes rather different than what was taken for granted in the 1950’s, for example.
Between 1900 and 2020, life expectancy in the U.S. rose by more than 30 years. Much of this can be credited to life choices, such as things like not smoking. Smoking, a leading contributor to heart disease, can decrease life expectancy by 10 years.
In 1965, 45% of Americans smoked. Now, knowing the health hazards to smoking, the number has declined to only 12.5% as of 2020.
Of course, Americans can also credit medical advances for the centenarian growth in population. The survivability of things like heart attacks and cancer has greatly increased, giving adults a longer lifespan.
As Americans realize their lifespan may well reach age 90, 100 or beyond, the resistance to having dental implants due to “old age” is becoming less of a factor.
Dental implants are the ideal tooth replacement system. Unlike dentures or ‘partials,’ dental implants are supported by the jaw bone, just as natural teeth. While dentures sit on top of the gums, dental implants restore biting strength and stability, giving back the look, feel and function of the teeth you once had.
Two decades ago, some “older” adults would deny themselves the benefits of dental implants, saying things like, “I’m too old to spend that amount of money on myself.” Yet, for my dental implant patients in their 80’s and 90’s, I never had one who didn’t feel it was one of the wisest investments they’d ever made.
Here’s why…
– Dental implants are designed to last your lifetime. They do not decay, need root canals or compromise neighboring teeth or bone structure.
– Because dental implants are positioned in the jaw, they recreate stimulation to the bone. This helps to preserve the bone’s mass, halting the pace of jaw bone shrinkage (known as resorption).
– Resorption is what causes changes in one’s facial appearance, aging one’s appearance far older than their actual age.
– Dental implants do not move or slip when eating, speaking or laughing. A denture is designed to fit the contours of one’s gum ridge; contours that exist at the time the denture is made. However, as resorption reduces bone height, the ridge that holds the denture flattens out over time. This is why a denture becomes ‘wobbly’ or ‘slippery.’
– Dental implant treatment is largely determined by the number of implants placed. In most cases, one implant can support more than one tooth. A full arch (all upper or lower) of teeth are typically supported by several strategically-placed implants.
– Unlike a crown-&-bridge, dental implants so not need the support of adjacent teeth. Therefore, it is not necessary to have teeth shaved down for crowning simply to serve as supports for a bridge.
When it comes to dental implants, there are many decisions and choices that can become confusing without the guidance of a dental specialist. For example, there are over 40 different implant systems.
Dental Implants are designed in a variety of shapes and sizes to accommodate various needs. For those who are missing all upper or lower teeth, for instance, some implant types can support a full arch of removable teeth while others support non-removable (or ‘fixed’) teeth.
As a periodontist for over 3 decades, our patients receive advanced skills in dental implant diagnosis and placement. Additionally, our Asheville periodontal dental office features some of the most advanced technology in the industry today. This includes computerized imaging that can lessen treatment needs, optimize comfort and speed healing.
If you feel you are too old to make this wise investment, check out some of the health benefits that dental implants provide:
• As the ‘arch’ (or ridge) flattens, the appliance is more apt to move while chewing. As the denture rubs against tender gum tissues when eating, sore spots form, which are difficult and slow to heal. And, when small seeds or nut particles become trapped between the appliance and gums, it can cause a piercing, painful sensation.
This discomfort and concern often prompts people to adjust their diets. The chewy, crunchy foods they once enjoyed tend to be bypassed for those that dissolve quickly with minimal chewing required. Unfortunately, these foods are typically lacking in the fiber, vitamins and protein necessary for a healthy diet.
• The gum-colored base of dentures or partials that hold the replacement teeth is made of a porous material. This means there are tiny holes in the base. In the mouth, a denture sits in a warm, dark, moist environment – perfect for bacterial growth. These holes become living spaces to oral bacteria, which thrive and breed at a rapid rate. Bad breath and increased risk of pneumonia are actually some of the lesser problems that can occur.
Additionally, oral bacteria can create havoc throughout the body. It is a known contributor to a long list of serious health diseases and conditions. These include some cancers, stroke, heart disease, diabetes, arthritis, Alzheimer’s disease, pre-term babies and many more.
• The insecurity of a denture that may move when eating causes some people to avoid social gatherings. The fear of embarrassment can be a deterrent to involvement with friends and family. This places the individual at a disadvantage, as research shows that socially active seniors age more slowly than those who avoid social interactions.
If dental fear has prevented you from looking further into dental implants, please know that we have a reputation for respect, a gentle touch, and compassionate care. Additionally, we offer Oral sedation as well as I.V. sedation (also known as ‘twilight sleep’). These are administered safely by a doctor of anesthesia who monitors patients with advanced safety equipment.
Also, financing can be easy through monthly payment plans. Most are interest-free with no down payment required.
To schedule a consultation appointment, call 828-274-9440. Also, get to know more about dental implants at: DrClaiborneDentalImplants
Sources:
https://www.sciencedaily.com/releases/2014/10/141007144514.htm
https://greatergood.berkeley.edu/article/item/how_social_connections_keep_seniors_healthy
Nothing To Fear To Accomplish Healthy Smile Here
Posted on Apr 16, 2023 by William J. Claiborne, DDS MS
As a dental specialist, I find that many people are unfamiliar with exactly what a periodontist does. Yet, when they are recommended to see me (typically by their general dentist), it is because they need specialized care that falls under our unique set of skills.
A periodontist has advanced skills to help patients with a variety of needs that involve the gum tissues. These include:
– Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)
– Diagnosis and placement of dental implants
– Treatment of lesions or cysts in oral tissues
Let’s begin with gum disease.
Because the majority of care I provide has to do with the treatment of all stages of periodontal disease, it may be helpful to understand how this develops. Although many people delay or avoid regular dental care (mistakenly thinking “if nothing hurts, then nothing must be wrong”), I have a close-up view of its destructive nature. Its formation creates cavities, periodontal (gum) disease, and leads to eventual tooth loss.
Even people who are committed to a regimen of thorough at-home oral hygiene (twice-daily brushing, daily flossing), can be doing an insufficient job of removing the daily buildup of plaque. Plaque is a sticky film of bacteria that accumulates in the mouth. When not thoroughly removed, it can harden into a mass that attaches to the base of, or in-between, teeth.
In the form of tartar, this cement-hard mass of bacteria cannot be brushed or flossed away. Once tartar forms, it can only be removed by a dentist or hygienist using special tools. Without removal, it will continue to amass and attack gum tissues, working its way beneath the gum line.
Below the gums lie the support system for natural teeth, consisting of tissues, ligaments and bone. When the bacteria reach an uncontrollable level, they become infectious. As these infectious bacteria accumulate further, symptoms of gum disease become more apparent, such as tender or swollen gums or seeing blood in the sink when brushing teeth. Breath odor may be bad on a regular basis.
As symptoms worsen, the gums become red with infectious and loosen their grip around the base of teeth. The gums may become spongy and pus pockets may form. Breath odor at this point is persistently putrid. Eventually, the structures that support teeth are compromised and teeth may loosen. Gum disease is the leading cause of adult tooth loss in the U.S.
Research has found that certain strains of oral bacteria from gum disease create reactions in the body that can trigger systemic inflammation. Thus far, research findings have shown a correlation between periodontal disease bacteria and some cancers (including pancreatic and lung), Alzheimer’s disease, pre-term babies, heart disease, stroke, diabetes, arthritis and erectile dysfunction (ED).
As if all that weren’t bad enough, one study suggests that gum disease relates to a reduction in one’s quality of life: “Periodontal disease has been linked to lower quality of life.” “Quality of life encompasses several domains, including psychological functioning and social relationships among others. Oral health-related quality of life has been shown to be reduced in patients with periodontal disease.” (https://www.hindawi.com/journals/prm/2017/5491923/)
While estimates show about 75 percent of American adults have some degree of dental fear or anxiety, over 47 percent have some level of periodontal disease. As a periodontist, both are alarming numbers. Nearly half our nation is walking around with a potentially life-threatening disease in their mouths.
Treating this may sound like it would be pretty intimidating. However, Although there are many treatments offered and at various levels, our main goal is to provide patients with comfortable and positive experiences at every visit. One way we accomplish this is through the advanced technology featured here in our Western North Carolina periodontal dental office. We feature some of the most advanced in dentistry, much of which is not available in dental offices elsewhere. Some of these features include:
LANAP With PerioLase MVP 7: Laser-Assisted New Attachment Procedure is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease. LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.
3D Cone Beam Imaging: Ideal for diagnoses and treatment planning, these images provide a clear view of the upper and lower jaw, used for: intricate review of endodontics; periodontics; orthodontics; implantology: TMJ; and prosthodontics, as well as dental and maxillofacial surgery. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The process is quick, painless and at minimal levels of radiation.
CareStream Cone Beam Computer Tomography Imaging: This enhanced tomography works with 3D imaging for exceptional detail and range.
CS 3600 Intraoral Scanner: Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily for creating precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments). The scanner can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.
Computerized Dental Implant Placement: This advanced system for pre-surgical positioning of dental implants uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases.
In addition, we offer a unique environment for comfort. We understand how dental fear or anxiety can cause people to delay or avoid having dental treatment, sometimes for decades. We believe that every patient deserves respect, a gentle touch and knowing they are in a “lecture free” zone. For those who have high fear levels, 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. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our Asheville office, 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.
I hope I’ve given you a helpful and positive picture of what a periodontist does and how he/she can help you with some challenging needs; all the while keeping you comfortable, minimizing treatment time, and shortening treatment time.
Although most of our patients are referred to us by other dentists and dental specialists, a referral is not required for accepting a new patient. Call 828-274-9440 if you feel we can make recommendations for your specific needs or provide helpful information.
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