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.

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…

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(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.

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(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.

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(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.

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(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.

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(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.

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(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.

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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.

Choose A Periodontist To Correct A Gummy Smile

Posted on Aug 29, 2022 by William J. Claiborne, DDS MS

About Periodontal Plastic Surgery

When Lauren Hutton, the model well-known for a space between her front teeth, began modeling, she felt she needed to camouflage the gap (or “diastema”). Yet, she soon began to feel it was a unique feature that set her apart from the others. She was right, and now at the age of 77, she’s been on more front covers than nearly any other model.

Each smile is unique. Hopefully, your smile makes you feel good every time you share it. And, the very act of smiling has been shown to release endorphins in the brain. Those are the chemicals that create a bit of a ‘natural high.’ Smiling is obviously an asset to our well-being.

If you have a “gummy” smile, you may be perfectly fine with it. After all, it is not detrimental to oral health if you care for your gums properly (which goes for everyone). And, it can be a positive part of your personality. Katie Couric has a gummy smile and shares hers openly.

However, not everyone with this trait feels comfortable with the look nor the way it makes them feel when smiling. Some people tend to suppress  a full smile. Others often conceal their smile with a hand when smiling fully or laughing. Some people smile with their lips only.

A gummy smile, in the periodontal specialty, is known as EGD, an abbreviation for excessive gingival display or a gingival smile (GS). The trait occurs more often in females than in males. (Gingival is of or relating to the gums.)

Esthetically, a balanced smile typically shows the front top 6 or 8 teeth. Arching each tooth, there is generally minimal gum tissues showing , and sometimes none. Another esthetic complement to a smile is having gum tissues that  show a slight arch over each tooth at a similar line as those that arch adjacent teeth. Gums that are lower over one or two teeth tend to create a jumbled look in a full smile.

When the height of gum tissues distract from the appearance of a smile, a periodontist is your expert. This dental specialist has specialized skills in all aspects of oral tissues. Through their advanced training, they are able to safely and beautifully reshape the tissues that surround teeth.  

For people who wish to have a gummy smile or uneven gum line re-contoured, a periodontist performs a gingivectomy. A gingivectomy is a procedure during which excess gum tissue is remove. During this, the gumline is sculpted to give your smile balance with a more even smile line.

In addition to repairing a gummy smile, a gingivectomy is involved in a procedure known as crown lengthening. Crown lengthening involves removing the excessive gum tissue to expose more of the crown of the tooth, as well as sculpting the gumline to make it higher up. After the gum tissues are shaped, a crown is typically placed to protect the tooth above the gum line and to create a more beautiful smile.

A crown lengthening may also help to save a tooth from removal. When a tooth breaks off near the gum line, a crown lengthening can be performed to expose a sufficient amount of the tooth’s base so it can support a crown.

Another procedure a periodontist  expertly performs is gum grafting. This is often to cover exposed roots, to reduce further gum recession, protect vulnerable tooth roots from decay, and improve your smile. Recession can occur as a result of periodontal disease, which causes tooth roots to become exposed and makes the teeth look long.

Gum tissues are very tender tissues with many nerves. Procedures that involve the gums must be performed with precision to minimize discomfort and speed healing time. A periodontist excels in the skills to create an optimal outcome with the most conservative treatment needed.

Our Asheville periodontal dental office provides some of the most advanced imaging and computerized technology available. This includes cone beam 3D imaging and laser dentistry. Additionally, we provide oral and IV sedation (“twilight sleep”) so patients are able to relax or snooze comfortably while being monitored by specially-trained team members who use advanced safety equipment.

Begin with a consultation with an experienced periodontist, who can answer your questions thoroughly and determine the best treatment option for your individual needs. Call 828-274-9440.

Some sources:

https://www.colgate.com/en-us/oral-health/mouth-and-teeth-anatomy/3-treatment-options-for-a-gummy-smile

https://www.researchgate.net/figure/Female-and-male-percentages-in-the-gummy-smile-sample_tbl1_340258838

Many Reasons To Repair Gum Recession

Posted on May 19, 2022 by William J. Claiborne, DDS MS

If you are occasionally experiencing sensitivity around one or more teeth, especially when eating ice-cream or drinking hot coffee, this is likely due to receded gums.

While using a sensitivity toothpaste can somewhat minimize these sensations (which can become painful jolts), the problem will remain. The source of sensitivity, most often, is because the highly-sensitive tooth’s root area has been exposed by the pulling away of gum tissues.

The gum tissues are designed to provide a tight seal around the base of each tooth, which blocks bacterial entry to the sensitive tooth root area. In addition to sensitivity, recession means oral bacteria can penetrate beneath the gum’s surface. Once beneath the surface, the accumulating presence of this bacteria can lead to inflammation of the gums.

Eventually, the infectious bacteria attack the structures that support natural teeth. This bacteria indicates the presence of periodontal (gum) disease. Signs and symptoms of gum disease in its first stage include:

• Gum tissues that turn red

• Gums that become tender or swollen

• Gums that bleed when brushing

• Persistent bad breath

Obviously, it’s important to ensure the gums are healthy so the grip they have around teeth is snug. It’s also important to be aware of the causes of gum recession. These are:

The aging process – As people age, their gums become drier. This causes them to shrink and be less capable of keeping a secure grip around the base of teeth.

Periodontal (gum) disease – As mentioned above, gum disease destroys oral tissues and the bone that supports natural tooth roots. A sign of periodontal disease is gum recession. Gum disease is also the nation’s leading cause of adult tooth loss.

Poor dental hygiene – When twice-daily brushing, daily flossing, and keeping the mouth moist are insufficient to rid the mouth of bacteria, their accumulation can result in the sticky film you feel on teeth. This is plaque. In just a day or so, plaque can harden on teeth into tartar. This is a cement-hard bacterial colony that cannot be removed by brushing or flossing . It can only be removed during a professional tooth cleaning. If not removed, teeth, gums and the structures below the gum line can be damaged.

Brushing too hard – Brushing teeth rigorously doesn’t mean you are doing a good job. Using a scrubbing, back-&-forth motion can wear away tooth enamel and cause the gums to recede. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.

Hormones – Females experience fluctuations in estrogen levels during puberty, menstrual periods, pregnancy and menopause. During these times, the gums can be more sensitive and vulnerable to gum recession.

Tobacco use – In addition to the many health hazards smokers risk, they are more likely to develop plaque due to the oral drying effects of smoking. This dryness can lead to gum recession (not to mention brown teeth and bad breath).

Bite misalignment – When teeth don’t come together evenly, too much force can be exerted on the gums and surrounding bone, allowing gums to recede. Bite misalignment can also lead to grinding or clenching teeth. These harsh forces on teeth can cause the gums to loosen their grip.

If you have mild sensations of sensitivity, desensitizing toothpastes can help soothe the nerves by forming a protective barrier over teeth while blocking sensitivity signals. Although this type of toothpaste can be helpful, it should be used as a temporary aid.

The goal should be to repair recession and halt the problem from recurring. To do this, we begin by determining why the gum recession is occurring. The next step is to restore the gums to their proper positions.

The corrective procedure most often performed is a “gingivectomy” performed by a periodontal specialist. In addition to treating all stages of gum disease, a periodontist specializes in contouring gum tissues. Using advanced skills, a periodontist is able to create a natural look and restore your oral health.

A gingivectomy can reposition or graft gum tissues over the area of recession to restore a healthy seal and protect the tooth structures below the surface.

Another advantage of a gingivectomy is to help save a natural tooth. When a tooth breaks near the gum line, a “crown lengthening” procedure may be advised. In this, a periodontist may be able to expose enough of the tooth structure for the placement of a crown.

A crown lengthening procedure is an ideal accompaniment to many cosmetic dentistry treatments. When there are different heights of gum tissues framing the teeth most visible in a smile. This tends to create a jumbled looking smile, when when the teeth are straight.

Crown lengthening rebalances the height of gum tissues that arch the teeth to restore a smile that is balanced. From this, the eye is drawn to the smile as a whole rather than one or two teeth with varying heights of gum tissue.

A gingivectomy is also performed for individuals who wish to correct a “gummy smile.” This is when a smile shows too much gum tissue above upper teeth when smiling fully.

Gingivectomies are performed while the patient is comfortably numbed. For some people, sedation may be a preference for enhanced relaxation. Oral sedation is available in pill form, which allows patients to ‘doze’ through procedures. I.V. sedation, also known as “twilight sleep”, is available for patients who prefer a deeper level of sedation.

Both sedations are administered by fully trained team members who use advanced safety monitoring equipment. We believe your safety is as important as your comfort.

In our Asheville periodontal dental office, we also offer a wide array of technology. This often saves the patient time in treatment, enhances comfort, and speeds healing. For example, our dental laser can seal tissues as it contours it. This eliminates or greatly minimizes bleeding.

Pain is how the body indicates that something is wrong. When the gum tissues have receded, they are not going to repair on their own. Let’s discuss your particular needs, whether for improved oral health or to enhance the appearance of your smile (or both) during a consultation appointment.

Call 828-274-9440 to schedule a time.