Diabetics Wise To Give Oral Health Added Attention

Posted on Mar 13, 2017 by William J. Claiborne, DDS MS

Diabetes is a metabolic disease that occurs when the body is unable to properly process carbohydrates, fats and proteins.. It stems from insufficient insulin secretion or being resistant to insulin.

The American Diabetes Association reports these statistics among adults in the U.S. (http://www.diabetes.org/diabetes-basics/statistics/):

Diabetes is a leading cause of death due to the vascular complications it causes. The most common types of diabetes are type 1, which requires insulin control, and Type 2, which is the non-insulin dependent form.

Diabetes is far from being a problem isolated to the United States. The World Health Organization (WHO) declared diabetes to be at a pandemic level with a prevalence that has risen dramatically over recent decades. They estimate that the number of those affected by diabetes will triple over the next decade.

Regardless of the advancements in treating diabetes, the U.S. National Library of Medicine & National Institutes of Health reports that it is “a growing public health concern and a common chronic metabolic disease worldwide.”

Although diabetes affects all age groups, it is most common in adults. According to the American Diabetes Association, the largest segment of those who suffer with diabetics have Type 2 diabetes, which usually begins after age 45. However, over 18,000 youth are diagnosed with diabetes each year.

In a study study published in the journal Diabetes Care, the Centers For Disease Control & Prevention (CDC) noted that the annual medical expenses for youth with diabetes to be over $9,000, compared to less than $1,500 per year for youth without the disease.

Early warning signs of Type 2 diabetes are bad breath and bleeding gums, which are also symptoms of gum disease. Gum disease has been found to be more frequent and severe for patients who have poor control of their diabetes. By properly controlling glucose levels, diabetics can greatly help in the prevention of periodontal (gum) disease, which is the nation’s leading cause of tooth loss. Well-controlled glucose levels also help when it comes to the successful treatment of gum disease.

For many years, the medical and scientific fields studied the connections between inflammatory diseases such as diabetes and periodontal disease. With gum disease being the sixth greatest complication of diabetes, they noted that diabetes would initially reveal symptoms in the form of oral problems. However, continued research has shown that one can even trigger the other.

Periodontal disease is an inflammatory condition that can create inflammatory reactions elsewhere in the body. This is because its bacteria can enter the bloodstream through tears in weakened gum tissues. As it travels throughout the body, it can cause inflammatory triggers elsewhere.

Because of the connections between diabetes and periodontal disease, diabetics are strongly urged to have dental exams every 3-4 months (versus the standard of every 6 months) to avoid the inflammatory reactions of gum disease, and vice versa. Diabetics should also respond to any signs of gum disease promptly, rather than wait for their next visit.

Symptoms of periodontal disease include gum tenderness, bleeding gums when brushing, frequent bad breath, receding gums and gums that darken in color. When these signs are present, seeing a Periodontal specialist is advised so the most appropriate treatment can be discussed.

Because diabetics have a greater vulnerability to inflammatory reactions in the body, the need for prompt treatment warrants immediate response. Call 828-274-9440 to arrange an appointment. And remember, gum disease only worsens without treatment, resulting in greater treatment time and expense with delays.

Meds For Osteoporosis Can Cause Severe Damage To Jaw Bone

Posted on Mar 06, 2017 by William J. Claiborne, DDS MS

It seems every time I turn on the television, I see a commercial touting some new ‘wonder drug.’ Typically, I’m blown away when the list of potential side effects are mentioned. Apparently, many of these drugs solve one problem only to create ten more. This brings to mind a concern for those who are taking drugs for osteoporosis.

As we age, so does the structure of our bones. After the age of 40, adults begin to lose bone as the body’s ability to build up bone tissues decreases. Adults who have the most risk for bone loss include:

• Females
• Being over the age of 65
• Women who are going through menopause or are post-menopausal
• Being small in statue or having low body weight
• Using tobacco and excessive alcohol use
• Having a family history of fractures associated with osteoporosis
• Seventy percent of people with osteoporosis are women. Because men lose calcium at a slower rate than women, their risk is lower. However, older men are also at risk for osteoporosis.
• Osteoporosis is also more common in people who have a small body frame and bone structure. Low body weight also contributes to osteoporosis risk.
• Calcium and vitamin D deficiencies are risk factors for both males and females.

Osteoporosis literally means ‘porous bone’ and occurs when bones become weak and fragile. People who have osteoporosis are at greater risk for fracturing their bones, especially in the hip, vertebrae (spine) and wrist.

For an aging adult, the dreaded risk of breaking a hip is one reason many consider taking osteoporosis medications. Hip fractures often require hospitalization, surgical procedures, and can require lengthy healing periods. Some never fully recover after a hip fracture.

Among the aging, these fractures are a common cause of disability and death, especially in post-menopausal women. Only 40% of hip fracture patients ever regain their independence and nearly 25% die within a year. Vertebral fractures can cause debilitating back pain, and they, too, increase the risk of premature death. (see interesting information at: http://www.health.harvard.edu/diseases-and-conditions/whats_the_story_with_fosamax)

Bisphosphonates have emerged as the leading medication for preventing and treating osteoporosis. Studies show these drugs are effective and safe for up to 5 years. Eventually, however, bone loss continues with bisphosphonates.

So, what does this have to do with your dental health? Keep in mind that the teeth, their roots and the bones that support them are bone. Add to that the fact that many people are often surprised by the wide range of medications that affect their oral health.

Some medications – including prescription, over-the-counter and even herbal supplements – can cause complications during oral surgeries like extractions or dental implant placement. While drugs such as Coumadin, a commonly-prescribed blood thinner, may cause more bleeding during oral procedures, certain drugs create a much greater risk. 

The complication with bisphosphonates, often prescribed to treat osteoporosis, is a risk for jaw osteonecrosis. In simple terms, this is death of the jaw bone. Jaw osteonecrosis occurs when the bone fails to heal after a surgery, even a minor procedure such as a tooth extraction. The risk for jaw necrosis is highest with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery.

Osteonecrosis results from obstruction of blood supply from the drug’s potential interference with the bone’s ability to repair itself. Initially, it causes pain, swelling or infection of the gums and jaw. It also prevents gum tissues from healing and can lead to tooth loss. Its onset, however, can occur without obvious symptoms.

Trade names of the most prescribed bisphosphonates are Fosamax, Actonel, Boniva, Reclast, Binosto, Prolia, Zometa and Xgeva. The most prescribed, Fosamax, is one of the top 25 most prescribed drugs on the drug market today. Approved by the FDA in 1995, reports began surfacing in 2003 that linked Fosamax with jaw osteonecrosis.

Jaw osteonecrosis risk seems to increase with the amount of time the medications are taken. However, researchers have determined that bisphosphonates can create a risk for necrosis with even short-term use.

In a study of 208 participants who took Fosamax for varying durations, 4% developed osteonecrosis. Not only did the study show that short-term usage can place the patient at risk, the drug can maintain a 10-year ‘half-life’ in bone tissue. This finding was in contrast to the drug makers’ claims that bisphosphonate use only posed a noticeable risk for those who took the medication intravenously, such as in treating cancer patients.

Although the drug makers of bisphosphonates claim a low risk to any adverse reactions, prescribing physicians have often failed to warn patients of actual risks when having dental procedures. This is why it is important to make us aware of all the drugs you take, including over-the-counter types.

Our goal is to provide you with a successful outcome for every procedure. If you have questions regarding the medications you are taking in regard to oral risks, call our office at 828-274-9440.

Arthritis Patients Urged To Keep Oral Health In Tip-Top Shape

Posted on Feb 06, 2017 by William J. Claiborne, DDS MS

As a Periodontist, I have spent my career seeing how destructive periodontal (gum) disease can be to the mouth. Imagine an infectious bacteria so potent it destroys gums, eats into tooth enamel, an damages the bone and tissues that support tooth roots.

To no surprise, gum disease is the nation’s leading cause of adult tooth loss. It affects an estimated 47% of American adults yet is often ignored until symptoms become unbearable. Symptoms include gums that bleed easily when brushing, sore and swollen gums, gums that darken in color, gums that recede from teeth, persistent bad breath, pus pockets that form on gums at the base of some teeth and loosening teeth.

Modern research has found a link between the bacteria of gum disease and serious health problems such as heart disease, stroke, memory loss, preterm babies, diabetes and impotency. The connection occurs from inflammation that is triggered when the infectious oral bacteria of gum disease enters the bloodstream through weakened gum tissues.

For people who have rheumatoid arthritis (RA), research is showing a strong connection to periodontal disease through the inflammatory triggers brought on by this potent oral bacteria.

Research has found that gum disease and RA share a genetic likeness. Their clinical makeup shows similar structures, primarily in pathogens, which are agents in the body that cause disease or illness. Studies have shown that the pathological processes that occur in periodontal disease and RA are almost identical.

Both conditions cause chronic inflammation in tissues that connect to bone. Yet, researchers have also noted that both diseases have a similar inflammatory trigger. Also alike is the particular species of bacteria found in periodontally-diseased oral tissues and tissues that surround joints in those who suffer with RA.

In another study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis. It has also been shown that, by treating periodontal disease in RA patients, RA symptoms often improve. This is likely due to the system’s reduced burden of oral inflammation.

RA is a debilitating and painful disease that destroys joints. RA typically emerges on a gradual basis, often beginning with morning stiffness and weak, aching muscles. Joints that are stiff and sore follow, typically affecting the fingers, wrists, elbows, ankles, toes, hips, knees, shoulder and neck.

As inflammation from RA increases, joints swell and are often accompanied by fever, disfiguring of hands and feet, numbness and tingling. There is no cure for RA and lifelong treatment is required, including medications, physical therapy or surgery for certain cases.

These research findings show just how closely our oral health relates to our overall health. Hopefully, as more Americans become aware of how gum disease can increase one’s risk of serious health conditions, its prevalence will decline. With proper oral hygiene measures, including a thorough oral hygiene regimen at home, gum disease rates will drop.

Be committed to your oral well-being just as you are your heart health, prevention of cancers and your vision. If you have signs of gum disease (as mentioned above), call 828-274-9440 to arrange an appointment, and promptly. As a specialist in this field, I can assure you that gum disease will only worsen without treatment.

Individualized Care For Unique Patient Needs

Posted on Jan 25, 2017 by William J. Claiborne, DDS MS

I once heard the term, “not everything fits into a box.” I agree. While this may be related to the phrase, “think outside the box,” it reminds me of how we approach patient care.

As a Periodontist, my specialty includes treating all levels of periodontal (gum) disease, reshaping gum tissues, and the diagnosis and placement of dental implants. Summed up, however, I restore smiles to a healthy, confident state. This is why I love what I do.

In our office, we only exist because of our patients. That’s where our commitment lies and is the foundation for every decision we make. This is also why we look at each patient’s needs individually. No two mouths are alike and no two patients are alike.

As far as gum disease goes, there are various stages that require different approaches in order to effectively treat it. Although some individuals may have similar stages of gum disease as others, certain factors must be considered as the most appropriate treatment is determined.

In addition to their existing level of gum disease, we take into account the patient’s age, medical and dental history, their current medications, and number of remaining teeth. We also consider any anxiety or fears associated with dental procedures.

Fear has been a major deterrent for many to receive regular dental care. This is why adults often end up with gum disease and tooth loss. By the time many arrive at my office, they are at a point where they have no other choice in order to rid their mouths of the infectious bacteria or replace missing teeth from to the destructive nature of gum disease.

To help anxious or fearful patients relax, we make sure we are communicating thoroughly. Our belief is that patients who are fully informed of their needs and the procedures required are more confident in proceeding with treatment. This, in turn, creates a patient who is able to relax and let fears go.

Some patients are unable to relax, however. This is why our office provides Oral or I.V. Sedation. Oral sedation is a pill form of relaxation. Although most patients have little or no memory of the procedure afterwards, this provides deep relaxation with a quick recovery.

I.V. sedation (also referred to a ‘twilight sleep’) is a deeper level of relaxation. This is an in-the-vein medication administered via a drip. Patients doze while their procedures are accomplished and have no memory of their treatment. Recovery time is longer but some patients are fine with that. Most are able to resume normally within 24 hours.

Regardless of the sedation chosen, patients are closely monitored by trained staff and advanced safety equipment. Your safety is as important to us as your comfort, so we ensure all measures are taken to provide both to optimal levels.

Please know that your procedure, comfort option, and individual needs are important to everyone in this office. We promise you’ll be respected, given exceptional care, and never over-treated or under-treated. We are here to help you regain the smile you desire.

Your oral health is a vital component of your overall health. Research has shown that the health of your gums and number of teeth directly correspond to a healthier you. Don’t delay care that you need, even if fear has prevented this in the past.

To begin, call 828-274-9440 and schedule a consultation appointment. During this time, we can discuss the treatments that may work best for your needs. I’ll explain comfort options and have our financial coordinator review payment options with you, if desired.