Smoking, Vaping Lead To Gum Disease, Tooth Loss.


Posted on Sep 15, 2020 by William J. Claiborne, DDS MS

With all good intentions, adults occasionally trade one bad habit for another. For instance, a commitment to exercise more often for weight loss can easily backfire when justifying a thick smoothie as a daily reward.

This is what worries me about Vaping. Vaping, the use of e-cigarettes, hit the market around 2007. It is designed to deliver nicotine through a vapor. Although the vapor is generally not labeled as harmful (it’s not “safe”, either), its nicotine is no less harmful to the user as that delivered via cigarette smoke.

Unfortunately, many cigarette users switched to vaping based on the perception that “e-cigs” were a safer alternative. For those who wanted to wean themselves off of cigarettes through this switch, very few achieve that goal as a result.

A 2018 report by the National Academy of Sciences, Engineering, and Medicine concluded there was “evidence that e-cigarette use increases the frequency and intensity of cigarette smoking in the future.”

Teens have been most susceptible to the hazards of vaping. It is the most commonly used tobacco product among U.S. youth. E-cigarette use among middle and high school students increased 900 percent during 2011-2015. According to the Surgeon General, 1 in 5 high school students and 1 in 20 middle school students were using e-cigarettes in 2018.

Unfortunately, nicotine exposure can harm the brain as it develops, until about age 25. During adolescence, nicotine use can affect learning, memory and attention span as well as increase their risk for future drug addictions. (https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf)

As a periodontist in Asheville, NC, my concern when it comes to oral health is what many cigarette smokers and vapers don’t realize when it comes to high risks to their smiles.

In our periodontal dental office, I’ve seen how significantly the habit of cigarette smoking can have on one’s smile. It’s no secret that smoking cigarettes can stain teeth and cause bad breath. However, nicotine in any form is a hazardous force in the mouth.

According to the American Dental Association (ADA), smoking can cause the gums to recede from teeth, exposing vulnerable tooth root sections. This enables easier entry of oral bacteria into the structures that support tooth roots. Smoking can also delay healing following periodontal therapy, extractions or implant placement. The longer it takes oral tissues to heal, the greater the risks for infection to develop.

Additionally, smoking increases the risks of oral cancer, lesions inside the mouth, periodontal (gum) disease, enamel erosion and tooth loss. It greatly reduces saliva flow in the mouth, which is a tremendous aid in removing bacteria and food particles from the mouth, helping to control bacteria levels. The condition of “dry mouth” also causes bad breath.

Because of the vape’s moist presence in the mouth, the assumption with vaping over smoking cigarettes is the “benefit” of oral dryness. However, this is easily dispelled when looking at the true facts.

While there are more than 7,000 chemicals found in the smoke of tobacco products, (including nicotine, tar, carbon monoxide, acetaldehyde and N-nitrosamines),  nicotine is the primary addicting component. A study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, as well as potentially toxic metal particles from the device itself.

The e-liquids delivered by these devices typically contain nicotine, propylene or polyethylene glycol, glycerin, and additives. Sound safe? Not at all.

According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker. (https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)

When a patient is diagnosed with advanced periodontal disease (periodontitis), they must make a commitment of time and expense to rid this inflammatory disease from their mouths. For those who ignore its presence or assume it will get better on its own, the disease will simply progress further.

Gum disease begins with sore gums that may bleed while brushing teeth. Or, it may cause no noticeable symptoms at all in early stages.

As it worsens, gum disease will cause frequent bad breath, tender gums that turn red, gum recession, and gums that bleed easily when brushing. Pus pockets may form on the gums. As it attacks the structures beneath the gum line, teeth may loosen or shift.

As the nation’s leading cause of adult tooth loss, it brings the hard decisions (and expense) for replacement. After all, you need teeth for eating and speaking. Do you go with dental implants? Or, do you take on the challenges that come with dentures and partials? As hard as the decisions of replacing teeth can be, gum disease can bring even more devastation with it.

Research has linked the bacteria of gum disease to serious health problems. These include heart disease, stroke, preterm babies, arthritis, diabetes, impotency, some cancers and even Alzheimer’s disease. These connections occur through the infectious bacteria of gum disease entering the bloodstream through tears in diseased gum tissues.

Once in the bloodstream, the bacteria can travel throughout the body and create inflammatory reactions. This “systemic inflammation” is able to trigger the onset of some diseases and conditions or even further the development of others.

Certainly, we all have the right to determine what is in our best interest as far as our own health goes. However, I believe that many individuals end up in our office with serious gum problems and facing tooth loss because of what they did not know. Having factual information allows us to make wise decisions for our health and well-being.

As a periodontist, I have advanced skills in the treatment of all stages of periodontal (gum) disease. My dental specialty also includes the diagnosis and placement of dental implants. Here, our patients can relax under Oral or IV sedation (“twilight sleep”) while having their smiles restored. We also create a customized care program that allows each person to maintain good oral health once their treatment is complete.

If you smoke or vape, don’t assume “that won’t happen to me.” The reason we wear seat belts in cars is because there are great risks when we do not. The risks for losing your teeth and having potent bacteria running rampant through your system is something you can take easy measures to prevent.

Experiencing symptoms associated with gum disease? We urge you to schedule an examination appointment as soon as possible. Call our beautiful, comfortable Asheville office at 828-274-9440. A referral is not necessary.

 

 

 

Gum Disease Connected To Dementia, Alzheimer’s Disease


Posted on Aug 11, 2020 by William J. Claiborne, DDS MS

The statistics of periodontal (gum) disease are alarming. In the U.S., nearly half of the adult population has some level of gum disease.

There is a misconception among the general population when it comes to the serious nature of gum disease. Too often, people perceive “if it doesn’t hurt, then nothing is wrong” when it comes to their oral health. That’s far from the case. Although symptoms of gum disease may include tender gums that bleed when brushing, gum disease can begin without any obvious signs.

This shouldn’t be surprising. When cancer forms in the body, its initial presence isn’t obvious. The reason for screenings such as mammograms or colonoscopies are to catch mutant formations at their earliest stages.

Early treatment helps to resolve the problem with hopefully positive outcomes. This is why it is so important to have 6-month dental check-ups. These visits allow your dentist to catch gum disease early so treatment needs and expense can be minimal.

While gum disease forms in the mouth, that’s not necessarily where it remains without proper treatment. The bacteria of gum disease can enter the bloodstream. It has been found to trigger serious reactions elsewhere in the body. Some of these lead to the formation of cancer (oral, throat, pancreatic, lung) and some activate conditions such as diabetes and arthritis.

Obviously, the health of your mouth is an important part of supporting a healthy body, especially in disease prevention. To illustrate the extent of gum disease’s damaging impact to health, research is tracking its correlation to dementia and Alzheimer’s disease.

In a recent study that included over 8,200 adults, an increased risk for developing dementia was found in those having severe gum disease and missing teeth. Participants in the study had an average age of 63 at the study’s onset.

In a follow-up after 18 years, those who had severe gingivitis in addition to tooth loss had a 22 percent higher risk for developing Alzheimer’s disease or dementia. Having no natural teeth was associated with a 26 percent increased risk.

Broken down, 14 percent of individuals with healthy gums and all their teeth at the start of the study developed dementia by the end of the study. For those with mild gum disease, 18 percent (623 out of 3,470) developed dementia. Twenty-two percent of participants with severe gum disease developed dementia. For those who had no remaining teeth, 23 percent developed dementia – nearly 17 cases for every 1,000 persons.

They found the bacteria present in periodontal disease can travel through the mucous membranes of the mouth to the brain, potentially causing brain damage.

In the study, participants were carefully assessed based on age, gender, education, cholesterol, high blood pressure, coronary heart disease, smoking and body weight. Psych Central.com (https://psychcentral.com/news/2020/07/30/gum-disease-may-be-linked-to-later-dementia/158497.html?MvBriefArticleId=25473)

Prior studies have led researchers to continue tracking oral tissue related factors that may contribute to dementia and Alzheimer’s disease, which is affecting a growing percentage of American adults (as well as those globally). Currently, 10 percent of adults age 65 and over have Alzheimer’s disease. For people ages 85 and older, this increases to 32 percent.

In the U.S., it is the 6th leading cause of death. (https://www.alzheimers.net/resources/alzheimers-statistics/) By the year 2025, the number of people 65 and older with Alzheimer’s disease is expected to reach 7.1 million people, a 27 percent increase from the 5.6 million age 65 and older in 2019.

Maintaining a healthy smile – good gum health and healthy teeth – is important and achievable for every adult. If you suspect you have gum disease (gums that bleed when brushing, tender or swollen gums, gums that have reddened or receded from teeth), it is important to be seen by a periodontist. This dental specialist can restore your gums to a healthy state.

A periodontist is also a specialist in the diagnosis and placement of all types of dental implants. For adults who are missing natural teeth, dental implants are the closest thing to providing the look, feel and function of ‘real’ teeth. They restore the ability to bite and chew comfortably and dependably. Dental implants are also designed to last a lifetime, making them a wise investment.

Take charge of your health by overseeing your oral health as carefully as you do to other needs. For a consultation to discuss how a periodontist can help you, call 828-274-9440.

If dental fear has kept you from having regular dental care, we will be happy to discuss our many comfort options in our comfortable Asheville office, including Oral and I.V. sedation (“twilight sleep”).

Afraid Of The Dentist? Let’s Help You Get Past That For A Healthy Smile!


Posted on Jul 22, 2020 by William J. Claiborne, DDS MS

By some estimates, having a fear of dental visits affects over 70 percent of American adults. When people are afraid of going to the dentist, many often do not receive the regular care necessary to maintain a healthy smile.

As an Asheville Periodontist, I find that the origin of many who develop periodontal (gum) disease is from fear associated with dental visits. It is not unusual for a fearful dental patient to avoid going to the dentist for years, only ‘giving in’ when something becomes so painful they can no longer delay treatment.

We know that when it comes to dental fear, different people have different levels. Some patients are very relaxed in our office from the moment they walk in and throughout treatment. Others are fine until they are seated in the treatment chair. Still, others are anxious throughout their visit.

A study published by the Dental Research Journal revealed nearly 59 percent of 473 adult participants had dental fears. The study included males and females of varying ages and education levels. Although females presented a higher likelihood for dental fear, there was very little difference elsewhere. What did stand out, however, was how many had experienced traumatic dental episodes.

Unfortunately, a traumatic experience in a dental chair with a too-rough dentist tends to remain in the subconscious forever. Many fears are the result of a frightful experience as a child, feeling helpless and afraid. Such an experience tends to make an indelible mark on the subconscious and resurface whenever a dentist or dental office comes to mind.

If you experience these feelings associated with dental visits, there is nothing ‘wrong’ with you. However, delays in care can allow small problems to become more complex, requiring more involved treatment.

Many high-fear patients only force themselves into a dental chair when they are in such pain that they have no choice. It is far easier for adults to find a way to have regular exams and cleanings to prevent emergency needs. This begins by finding the right dental office.

Until then, regular dental check-ups are something that can’t be duplicated at home. Even a thorough, daily brushing and flossing routine misses bacteria on occasion. Within the course of just 48 hours, oral bacteria can form a cement-hard colony attached to tooth surfaces. This accumulation of bacteria eats away at tooth enamel and gum tissues.

As oral bacteria consume gum tissues, inflammation begins. This is gingivitis, the initial stage of gum disease. In this, the gums are tender and occasionally bleed when brushing. As gingivitis progresses to periodontal disease, symptoms include persistent bad breath and gums that turn red versus a healthy pink color. Gum tissues may begin to recede, exposing sensitive areas of tooth roots.

Eventually, the infectious bacteria will attack further beneath the gum line. This inflammation leads to damage to the bone structures that support tooth roots. Pus pockets may form on gums and teeth may loosen. To no surprise, periodontal disease is the nation’s leading cause of adult tooth loss.

This infectious bacteria doesn’t just remain in the mouth. Through tears in weakened gum tissues, it can enter the bloodstream. It’s presence can trigger inflammatory reactions that have been linked to heart disease, stroke, some cancers, preterm babies, arthritis, diabetes, erectile dysfunction (ED), and impotency. Some studies are showing a correlation to Alzheimer’s disease.

What we often find with high-fear patients is their assumption that good at-home care can take the place of their regular care visits. However, even a diligent home-care routine leaves them susceptible to oral bacteria. A number of factors heighten vulnerability to bacterial accumulation, including dry mouth and diet.

Dry mouth occurs due to a wide range of factors. Some medications have a drying affect on the mouth. Certain foods and beverages contribute to dry mouth, especially those containing caffeine and alcohol. Smoking is very drying to oral tissues. And, the aging process leaves us with drier mouths.

Eating sugary foods and many carbohydrates are just as detrimental to oral health. Many Americans snack during the day, often on chips, crackers and candy bars – which are then washed down with sugary sodas. All this converts into a sugar based super-food in the mouth that provides oral bacteria with sustenance that super charges their reproduction.

How does a fearful adult overcome the problem so they can have the dental care they need?

In our office, patient comfort is a priority at every visit. We have even designed our reception area to pamper you from the moment you enter. Patients in this area can enjoy a selection of gourmet coffees, cable television and WIFI connection. The seating is comfortable and our front office staff are attentive to your needs.

We offer a private consultation room for patients as well. In this room, we can discuss treatment and answer questions in a comfortable setting. This allows patients to become better informed about their treatment needs and options versus communicating while they are seated in a treatment chair.

Our surgical suite offers a rather unique setting for a periodontal office. A large window provides beautiful mountain views, very soothing to our patients. In addition, we offer oral sedation as well as I.V. sedation (twilight sleep) for most procedures, if desired.

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 places the patient in a deeper sedative state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are monitored with advanced safety equipment throughout treatment.

Our patients also find our entire staff is a unified team who reflect sincere compassion and commitment to exceptional, comfortable care. While the doctors involved in your care are all top-notch, I must admit that our staff are the pros at making our patients feel truly pampered.

When patients realize that our goal is to provide exceptional care and comfort, most relax. This creates a sense of trust that causes many to no longer perceive dental care as dreaded, frightening events. Once the obstacle of fear is replaced with feelings of trust, the process to achieve a healthy, confident smile becomes a much easier one.

If you or someone you know has fear that has prevented dental care, the possibility of gum disease is pretty high. We suggest beginning with a consultation appointment, which occurs in our private consultation room. This is removed from the clinical area and provides a relaxed setting where patients can share their unique needs and concerns.

Call 828-274-9440 to schedule or learn more. I’m sure you’ll find our friendly telephone staff is welcoming and reassuring from the very first conversation.

Why Floss?


Posted on Apr 14, 2020 by William J. Claiborne, DDS MS

As a periodontist, I treat all stages of periodontal (gum) disease. Over the years, I’ve helped patients save natural teeth and restoring their ability to enjoy healthy, confident smiles.

When people come close to losing their teeth or find themselves in need of replacing them with something more dependable than dentures or partials, I hear nearly every one express the same regrets: “I wish I’d taken better care of my teeth when I could.”

Signs of gum disease

Hindsight may be 20-20, but it’s never too late. I know patients can go from having gum disease and losing teeth because of it to having excellent oral health – and end up having a renewed commitment to their smiles.

In my dental specialty, I know it begins by helping patients to understand how the problem starts in the first place. When people know the HOW, they can implement measures to bypass the repercussions of gum disease.

I’ve found that most people actually have very little awareness of how the inside of their mouth looks. We smile with lips and front teeth that show very little (if any gums). So, it stands to reason that, if a smile looks good, it’s probably healthy.

Until dental offices began using intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for a condition that didn’t hurt. There were not obvious signs initially, so nothing is wrong – right?

Intra-oral cameras are able to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual has this firsthand view of spongy, receded gums, the decision to treat often go from IF to WHEN.

Although it helps to be able to show patients the signs of gum disease, these emerged signs are indications of long-standing periodontal disease. By the time these signs appear, the early stage of gum disease, gingivitis, is past.  This is unfortunate, since early-stage gum disease can be halted with prompt measures.

Gingivitis causes the gums to become tender and swollen in some areas. You may see blood in the sink when brushing. These signs indicate that oral bacteria has accumulated in the mouth beyond the means of your immune system’s ability to manage it.

Twice daily brushing and flossing are important steps in keeping bacteria levels in the mouth under control. Brushing sweeps away built up bacteria on the surface of teeth, which is a sticky film known as plaque. Plaque, just over the course of a couple of days, can harden on teeth where build up is allowed to remain. This cement hard mass of bacteria is tartar, or also known as calculus.

The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.

Yet, try as we might, there are simply angles in the mouth that are difficult to reach with a toothbrush, manual or electric. Say you have an area of jumbled or crooked teeth. Even as you adjust the angle of the toothbrush differently to maneuver the bristles into these areas, it is often difficult to continually keep these areas clean.

This is where flossing comes in, and important step in daily, oral hygiene.

Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.

If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a jolting view of exactly what you do NOT want crawling around and breeding in your mouth. These living and breeding organisms can be highly destructive as they amass.

As research has shown for many years, your overall health is intricately linked to your oral health. The bacteria of gum disease has been linked to a long list of serious health problems, including heart disease, stroke, arthritis, some cancers, diabetes, and preterm babies. Studies are underway to track gum disease bacteria to the path of Alzheimer’s disease.

Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.

Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits): “Only four of 10 Americans floss at least once a day, and 20 percent never floss.”

Perhaps this is one reason why over 47 percent of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.

Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued.

It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.

Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. For our patients, we help them develop an at-home care regimen to maintain a healthy mouth and fresh breath between regular dental check-ups.

Be aware of the signs and symptoms of periodontal disease. Knowing them will allow you to react quickly to minimize the extent of damage and treatment needed to rid it. They include:

  • Tender or swollen gums
  • Gum tissues that turn red
  • Gums that are tender to the touch
  • Gums that bleed easily
  • Spitting out blood when brushing or flossing your teeth
  • Frequent bad breath
  • Pus pockets that form between teeth and gums
  • Teeth that loosens or shift
  • Painful chewing
  • Gums that pull away from your teeth (recede), making your teeth look longer than normal

These are all warning signs that bacteria overload is occurring in your mouth. It is a disease, and will only worsen without treatment.

If you suspect you have any stage of gum disease, call 828-274-9440 to schedule a thorough periodontal examination.

 

 

Recent Posts

Categories

Archives