If Your Mouth Is Frequently Dry, You Have Higher Risk For Gum Disease
Posted on Dec 02, 2020 by William J. Claiborne, DDS MS
Our bodies are home to trillions of micro-organisms. This includes micro ‘ponds’ of viruses, fungi, and bacteria. As we’ve learned over the years, some of this bacteria is highly beneficial to how our systems operate.
Although the thoughts of bacteria often conjure up images of infectious organisms, the mouth is home to some very “good” bacteria. For bacteria that are present under normal circumstances, they do not cause disease and actually have a purpose. It’s the “bad” bacteria I want to focus on for now.
Oral bacteria is the source of nearly every problem that develops in the mouth. The oral cavity (mouth) is structured to manage a certain level of bacteria. As the entry point of most of the bacteria we add to our bodies, it can process a “normal” amount on a day-to-day basis. It is the overload of bacteria that becomes the origination source of problems.
The reason people are advised to brush at least twice a day and floss daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, a sticky film of bacteria form that coats the teeth and gums. This film is known as plaque. Without sufficient and frequent removal of plaque, it begins to harden at the base of teeth.
This is tartar (or calculus), which is actually a cement-hard mass of oral bacteria. Tartar cannot be brushed or flossed away; it requires removal by a dental professional. During your dental cleanings, you probably notice when your hygienist is scraping away at teeth. It is tartar that she is trying to remove.
Your periodic dental cleanings are important. If tartar is allowed to further amass, the bacteria can become inflamed, attacking gum tissues. As bacteria continue to reproduce, they create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth, including tooth roots, tissues, ligaments and bone.
Periodontal disease is the leading cause of adult tooth loss. The advanced stage of gum disease, known as periodontitis, creates a bacteria so potent that research has linked it to serious diseases elsewhere in the body. These include some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency.
Saliva is the mouth’s natural rinse that helps cleanse oral bacteria from the mouth. This keeps bacteria levels to a minimum and lowers their ability to cause problems. When saliva flow is depleted, however, bacteria remain in the mouth longer – and multiply rapidly.
Saliva helps to continually cleanse your mouth, removing particles that can rot and cause bad odors. A condition called “dry mouth” (known as Xerostomia) is when production of saliva is decreased.
When the “dry mouth” condition is continual, the problem may be due to low salivary gland production or some diseases. Dry mouth naturally occurs during sleep and in people who breathe through their mouth. However, as a periodontal specialist, I find that most cases are due to factors that can be easily controlled with simple changes.
To support saliva flow and reduce “bad” bacteria in the mouth, twice daily brushing and flossing help. However, knowing contributors to a dry mouth can help you better manage or control oral bacteria levels. These include:
The aging process – Aging causes the skin, cartilage, and tissues to become less supple, drier. We can’t stop the aging process but can help protect our oral health by drinking plenty of water throughout the day. Coffee, tea and colas don’t count. Also, consider using an oral rinse designed to replenish moisture in the mouth.
Medications – Many over-the-counter and prescribed medications today have a side effect of oral dryness. Some of the worst culprits are antihistamines, depression and incontinence medications, and some that control blood pressure. If you take one of these, ask your doctor about options that may be less drying to the mouth. Or, increase your water intake and use a daily rinse to replenish oral moisture.
Sleep habits – To dry something out, a flow of air is just the thing. This also applies to the mouth. Snoring or breathing through the mouth during sleep create added dryness to oral tissues. Talk to your doctor about ways to resolve these problems. It may be as easy as adjusting your sleeping position or adding a side pillow.
Medical conditions – Having acid reflux, sinus infections, diabetes and bronchitis can cause dry mouth. A bad cold can also force people to breathe more through their mouth. For these conditions, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.
Caffeinated beverages – Caffeine has a drying effect on oral tissues and therefore depletes the helpful rinsing benefits of saliva. Most colas contain caffeine, which is drying to oral tissues. Add to that the high acidity level in colas (also harmful to tooth enamel). Also drying are coffee and tea. Like colas, these drinks contain acid added to caffeine. If you drink these beverages, be sure to rinse your mouth after or alternate with gulps of water.
Alcohol (including beer and wine) – Mixed drinks, wine and beer are all drying to oral tissues. Add the acidity and sugar levels that exist in wine or mixers and these drinks pack a double-whammy to oral tissues. Again, swish with water between drinks or have a glass of water nearby to dilute the impact of these.
Smoking (cigarettes, cigars, vaping) – People who have smoked for years often have dry skin that ages their appearance far beyond their actual years. The same is occurring inside the mouth. Cigarette and cigar smoke is laden with toxic chemicals, which is true for e-cigs as well. Just be aware at your added risk and the drying effects and take added measures to keep your mouth clean and moist.
If you have delayed or avoided dental care, call 828-274-9440 to request a consultation, or begin with a thorough examination in our Asheville periodontal office. We offer the latest techniques, technology, and skills while always making patient comfort a top priority.
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.