Some Surprising Repercussions of Dental Fear

Posted on Mar 24, 2022 by William J. Claiborne, DDS MS

Dental fear has been ranked fifth among the most common of all fears, affecting nearly 50 million people in the U.S. Although a traumatic dental experience during childhood is often assumed to be the leading cause of dental fear, some findings show this is the case for about half of these adults.

For decades, dental fear has been to blame for many adults failing to have adequate oral health. Although cost, access, and awareness of need can be factors, nearly half of American adults avoid dentistry due to having some level of associated fear.

There are a number of false perceptions that don’t help lower this statistic. For example, a parent who tells a child “It won’t hurt much” before a dental visit simply sets the anticipation of pain into place. Hearing things like “That’ll be worse than a root canal,” and “nothing is wrong because nothing hurts,” add to the misconceptions when it comes to the reasons for avoiding regular, preventive dental care.

By some estimates, an adult with dental fear will endure pain for over two weeks to avoid seeing a dentist. They will self-medicate, use ice packs or try ‘home remedies’ found online, all to no avail. Some people end up in an emergency room because they could not force themselves to see a dentist.

Another factor may have to do with genetic makeup. In research conducted at the National Institute of Dental & Craniofacial Oral Health Research Center in Appalachia, “a gene variant was found that may contribute to heightened pain sensitivity and thus dental anxiety.”

If you’ve ever heard the term, “you don’t know what you don’t know,” this is especially true for oral health. Although people are generally aware that insufficient oral hygiene can lead to bad breath and cavities, too many are unaware of some far worse consequences. Poor oral hygiene at home and lack of regular dental check-ups and cleanings form a straight line to developing periodontal (gum) disease.

While gum disease is the nation’s leading cause of adult tooth loss, it can also contribute to devastating health problems far beyond the mouth. The bacteria of gum disease are inflammatory. These infectious bacteria can enter the bloodstream through tears in weakened gum tissues, triggering a number of serious reactions.

To name a few, gum disease bacteria has been associated with the development or worsening of:
• Heart disease
• Stroke
• Alzheimer’s disease
• Pre-term babies
• Arthritis
• Diabetes
• High blood pressure
• Some cancers

Obviously, these bacteria are highly potent. Although being committed to a thorough, twice daily oral hygiene regimen at home is an important part of having good oral health, regular dental care is also necessary. These visits help to catch early signs of gum disease (which can begin without obvious symptoms). Early treatment can help to reduce treatment costs and time. And, the care can be essentially ‘painless’ when administered by the advanced skills of a periodontal specialist.

As a periodontist in Asheville NC, I want to be encouraging to adults about the risks associated with lack of dental care. I can cite the hazards of non-compliance of regular check-ups over and over. But, for people who have deep-seated fears when it comes to dental visits, far more support is needed to help an individual go from being fearful to relaxed.

A periodontal specialist has advanced training and skills in the diagnosis and placement of all types of dental implants. In our beautiful Asheville periodontal dental office, patient comfort is a priority at every visit. Our office is designed to pamper patients from the moment they enter. For certain procedures or patients who prefer the addition of sedatives, we offer oral sedation as well as I.V. sedation (twilight sleep).

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 sleep state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our office, this is overseen by a board certified Anesthesiologist.

With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

When patients realize our goal is to provide exceptional care in comfort, they relax. Over time, many patients feel they no longer need a sedative and are able to have regular dental care without worry.

Another way we enhance comfort for our patients is through our immense array of dental technology. In many cases, this advanced technology shortens both treatment time and speeds healing. For example, our LANAP (Laser-Assisted New Attachment Procedure) provides an advanced protocol to efficiently and effectively treat periodontitis (advanced gum disease).

Essentially non-surgical, LANAP treatment provides an alternative for patients with moderate to severe periodontal disease with a quick recovery time.

Regardless of numerous features to optimize patient comfort, it’s still difficult for many to feel ‘ready’ for dental care. We can reassure people on the phone, yet, some simply cannot make an appointment and actually arrive. This is why we often begin with a consultation in our comfortable, private consultation room. This room is removed from the clinical side of the office.

To learn more, call 828-274-9440 to begin with a consultation appointment. New patients are always welcome and a referral is not required.

ED Risks Higher With Presence of Gum Disease

Posted on Feb 25, 2022 by William J. Claiborne, DDS MS

For over two decades, medical researchers have closely focused on inflammation in the body and its power to activate health problems, heart and cardiovascular diseases in particular.

It has been determined that inflammation anywhere in the body can set off a series of biochemical changes in the bloodstream; those that are designed to help the body repair inflamed tissues. However, when inflammation becomes chronic, blood chemistry never returns to normal, and trouble ensues. Researchers have noted this significantly in its increased risk of heart attack and stroke.

Think of chronic inflammation as a pan of water that is boiling on the stove. When the body is in proper control, the boiling process ceases when the stove is turned to “off.” In chronic inflammation, however, the water continues to boil even after the pan is removed from the stove top.

Chronic inflammation can exist in the mouth, set at a constant “boiling point” due to advanced gum disease (known as periodontitis). Common symptoms are puffy gums that turn red in color; inflamed, swollen, or bleeding gums; gums that loosen from the base of teeth; persistent bad breath; gums that become spongy and bleed easily; and, pus pockets that form on the gums at the base of teeth.

In addition to creating higher risks of heart disease and stroke, advanced gum disease has been shown to increase the risks for diabetes, arthritis, preterm babies, some cancers, Alzheimer’s disease, high blood pressure and erectile dysfunction (ED). Yes, even ED.

Below are findings of several recent studies showing that periodontitis to be a significant risk factor for erectile dysfunction. Rather telling is as gum disease worsens, so does erection impairment.

• Turkish investigators studied 162 men, age 30 to 40. Eighty-two of the participants had normal erection function and 80 who complained of ED. Some men in both groups had chronic periodontitis, but the condition was more than twice as prevalent in the ED group. Men with periodontitis who also presented with decayed or missing teeth showed the greatest level of ED.

• Chinese scientists examined data of several studies involving a total of 213,076 men. Compared with those who had good erection function, those with ED had three times the risk of periodontal disease.

• The University of Granada School of Dentistry found that men with severe gum disease are more than twice as likely to suffer from erectile dysfunction. This was true even after careful adjustments were made for other health issues that could distort the findings, including socioeconomic data. In the study, 80 men with clear indications of erectile dysfunction were given a periodontal examination. According to the researchers, 74 percent of the participants with ED also presented with chronic periodontitis. The researchers concluded that patients with chronic periodontitis were more likely to have erectile dysfunction independent of other confounders.

• Israeli researchers surveyed the erection function of 305 men, average age 40, and then examined their gums. Those with chronic periodontitis had the greatest risk of ED.

The connection is actually logical. Periodontal disease has emerged as an independent risk factor for cardiovascular disease, and cardiovascular disease raises risk for ED. These studies show that everything that raises the risk for cardiovascular disease (such as smoking, obesity, chronic stress, high cholesterol, high blood pressure, and chronic sleep apnea) also raises the risk of ED.

This finding also makes biochemical sense. During sexual arousal, the body releases nitric oxide, which plays a key role in enabling erection. Chronic inflammations, including periodontal disease, impairs release of nitric oxide and contributes to ED.

Health risks such as our propensity for cancer or a decline in eyesight can occur regardless of lifestyle choices. However, it makes perfect sense to eliminate or greatly minimize risk factors, including periodontal disease. Research findings on ED’s association with infectious oral bacteria of gum disease will hopefully spurn more men to devote a higher level of commitment to care for their gums.

It takes mere minutes a day to maintain a healthy mouth and reduce the risks for developing gum disease.

These include brushing teeth for at least two minutes twice a day. Daily flossing will remove bacteria in the gums that may elude brushing. And, keeping the mouth moist will support saliva flow, the mouth’s natural rinsing agent.

If you feel your erections are worth the effort, then these measures will become higher priorities in your daily hygiene upkeep. It is also important to see a dentist regularly. If you don’t feel anything is wrong because “nothing hurts,” you are only cheating yourself.

Gum disease can exist without obvious symptoms. Catching it early and before it begins to “boil” will help you avoid costly and time-consuming treatment later. And, these steps may keep your sex life active.

If you are experiencing any of the signs of gum disease (as mentioned prior), please know that gum disease will only worsen without treatment. It is also the leading cause of adult tooth loss.

A periodontist is a dental specialist who treats all stages of gum disease. If it is found to exist, this periodontal specialist can help to resolve the problem and restore your smile to a healthy state in the most conservative way possible. He or she can then help you maintain good oral health, which will support your overall health.

For an examination, or to begin with a consultation, call 828-274-9440.

Dental Fear Can Lead To Gum Disease, Tooth Loss

Posted on Nov 23, 2021 by William J. Claiborne, DDS MS

Fear is a natural reaction to things that may harm us; it’s a safety mechanism activated by the brain. Take snakes, for instance. Even harmless snakes tend to provoke an initial reaction that warns of impending danger.

Some fears are learned, however. Some people are afraid of dogs, usually stemming from a frightful encounter as children. The incident triggers something in the brain that reminds the individual, even into adulthood, that dogs are to be feared.

When it comes to the fear of dentistry, it often exists because of a traumatic incident in the patient’s past. Or, in some cases, it exists for unknown reasons. Too, certain smells, sounds or sights can trigger the “panicky” reaction some people have to dental visits.

As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss.

Typically, adults who avoid dental visits feel they are doing an adequate job maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass recommended 6-month dental check-ups and cleanings.

Yet, even the best of at-home dental hygiene can be insufficient to the buildup of tartar.

Tartar is the hardened form of plaque, which is a sticky film of bacteria that accumulates in the mouth. In the form of tartar, this cement-hard mass of bacteria cannot be brushed or flossed away. It can only be removed by a dentist or hygienist using special tools.

While plaque can cause bad breath and a “furry” feeling mouth, tartar eats away at tender gum tissues and bores into tooth enamel. As it grows, it works its way below the gum line, creating inflammation in the gum tissues.

Early symptoms of gum disease, known as gingivitis, are tender or swollen gums. You may see blood in the sink when brushing teeth. Breath odor may be bad on a regular basis.

At this point, proper measures may be able to reverse the progression of these rapidly-reproducing bacteria. This requires thorough brushing (twice a day, at the very least), daily flossing, drinking lots of plain water, and using an oral rinse to control bacteria levels.

However, if tartar exists, it’s not going to go away. It will continue to amass and attack the gums and work its way into the tissues below. When the bacteria reach an uncontrollable level, they become infectious.

Think of gum disease bacteria as you would water in a pan on the stove. The heat will eventually cause bubbles to form on the bottom of the pan. This can be likened to gingivitis.

However, as the water heats more, bubbles start to move to the surface. This can symbolize the development of gum disease. The symptoms of gum disease include gums that turn red and bleed easily and persistent bad breath.

When advanced stage periodontal disease develops (periodontitis), imagine the water at full boil. Unfortunately, once aboil, the roil continues even after you remove the pan from the heat. This is known as systemic inflammation.

Gum disease is the nation’s leading cause of adult tooth loss. Yet, the bacteria that destroy gums and the structures that support natural teeth don’t remain confined to the mouth. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.

Research has correlated oral bacteria to a long list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. These include heart disease, stroke, Alzheimer’s disease, arthritis, diabetes, preterm babies, erectile dysfunction (ED), some cancers (including pancreatic), and more.

Obviously, these bacteria are potent and a threat to overall health. For those who avoid dental care due to anxiety or fear, knowing all this is not necessarily going to change their resistance. We understand that it’s still difficult to overcome the challenges even knowing there are risks.

There are options, however, for even high fear dental patients.

In our office, we offer I.V. sedation (“twilight sleep”) as well as oral sedation. Oral sedation is in pill form and creates a totally relaxed feeling. It enables patients to recover quickly and offers an amnesiac effect.

I.V. sedation is a deeper level of sedative. This places patients in a sleep state and erases most or all memory of the procedure after. With both sedations, however, we apply numbing medications to the area being treated to create optimal comfort for patients. We want patients to be in total comfort throughout their treatment, regardless of the addition of sedation.

We also have a reputation for treating our patients with respect and a gentle touch. We are just as committed to comfort for patients who do not want to be sedated as we are for those who are. Our goal is to help each person achieve a healthy, confident smile.

One of the most satisfying parts of my specialty is helping a once-fearful patient achieve a healthy, confident smile and see dental care as a welcomed part of their health care commitment.

If you are ready to get past your dental fears so you can have the smile you desire, begin by calling our Asheville periodontal office at: 828-274-9440 and speaking with our friendly staff. You can begin with a consultation, if desired.


Serious Disease Connections To Oral Health

Posted on Oct 12, 2021 by William J. Claiborne, DDS MS

As an Asheville periodontist, I have advanced skills in the diagnosis and treatment of all stages of periodontal (gum) disease. Over the years, I have closely followed the extensive amount of research that associates the health of the mouth with overall health. There are amazing connections between the bacteria of gum disease to severe (and even deadly) health problems far beyond the mouth.

Periodontal disease is an infection that destroys gum tissues and the structures that support teeth. As gum tissues are attacked and weakened, the bacteria of gum disease can enter the bloodstream through tears in diseased tissues.

This infectious bacteria is capable of causing inflammatory reactions elsewhere in the body. Systemic inflammation is the now-known epicenter of a number of major health problems, including heart disease, stroke, high blood pressure, diabetes, arthritis, impotency and more.

You may be interested to read about just some of the correlations between oral bacteria of gum disease and…

Dementia & Alzheimer’s disease: Gum disease occurs when infection of the oral tissues develops. It causes bleeding gums, putrid breath odor, loose teeth, and even tooth loss. Oral bacteria and the inflammatory molecules that develop can enter the bloodstream, making their way to the brain. Previous lab studies have suggested that this is a potential risk factor in the sequence of events that lead to dementia.

In data from the National Health and Nutrition Examination Survey (NHANES), different age groups at baseline, with up to 26 years of follow-up, analyzed over 6,000 study participants. The researchers examined whether gum disease and infectious oral bacteria were linked to dementia and deaths.

Participants had received a dental exam for signs of gum disease as well as blood tests for antibodies against causative bacteria. The team analyzed antibodies against 19 oral bacteria for an association with the diagnosis of Alzheimer’s, diagnosis of any kind of dementia, and death from Alzheimer’s. Of these 19, Porphyromonas gingivalis is the most common culprit of gum disease. In fact, a recent study suggests that plaques of beta-amyloid protein, a major hallmark of Alzheimer’s disease, may be produced as a response to this infection.

Erectile Dysfunction: In the U.S., an estimated 18 percent of males have erectile dysfunction. Men over the age of 70 are more likely to have ED compared to 5 percent between ages 20 – 40.

Studies have shown an association between gum disease and pancreatic cancer. From analyzed data of five studies between 2009 – 2014, the studies covered 213,000 participants aged 20 to 80.

Each study found erectile dysfunction (ED) was more common among men being treated for chronic periodontitis, particularly for those younger than 40 and older than 59. After accounting for other health factors, erectile dysfunction was found to be 2.28 times more common for men who had advanced gum disease than for men without it.

Stroke: In one study of 265 stroke patients, researchers found that patients with gum disease had twice as many strokes due to thickening and hardening of brain arteries as patients without. Additionally, patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.

In a separate study of over 1,100 patients who had not experienced a stroke, researchers noted that 10 percent had severely blocked brain arteries. They also found that patients with gum inflammation were twice as likely to have moderately severe narrowing of brain arteries.

Pre-Term Babies: The elevated hormone levels during pregnancy create a higher vulnerability to gum disease; the reason about half of pregnant females experience swollen, red and tender gums that bleed while brushing. Known as Pregnancy Gingivitis, the gums are more susceptible to inflammation, thus more sensitive to the bacteria of gum disease.

Studies have shown that gum disease increases the risk for preterm delivery (before 37 weeks) and low birth weight babies. Gum disease also increases the risk for poor obstetrical outcomes, late miscarriage and pre-eclampsia. For example, the preterm birth rate for women without periodontal disease is approximately 11 percent compared to nearly 29 percent for females with moderate to severe gum disease.

Through tears in gum tissues, oral bacteria can enter the bloodstream. Once this bacteria reaches placental membranes, it can trigger inflammation that can cause preeclampsia or labor.

Arthritis: For decades, it was perceived that RA (rheumatoid arthritis) patients had such a high risk of gum disease due to poor oral hygiene because of dexterity problems with using a toothbrush. However, more recent studies now show that gum disease is actually a risk factor for arthritis.

While genetic factors certainly contribute to greater RA susceptibility, the true source has been determined to be inflammatory reactions. This inflammation is triggered primarily by bacterial infections, with oral bacteria being a significant contributor to inflammatory arthritis.

They found that people with severe periodontal disease also had severe rheumatoid arthritis. Patients with the most plaque, bleeding and gum tissue breakdown had worse RA by all measures, including disease activity and inflammatory markers. Other studies have found that even with treatment, RA patients with periodontitis continue to have worse arthritis symptoms and are 50% less likely to be in remission.

The relationship between gum disease and arthritis isn’t seen only in adults. Kids with juvenile idiopathic arthritis (JIA) have inflammatory mouth bacteria not found in their healthy peers.  Different types of bacteria seem to correspond to specific aspects of JIA. Some are associated with higher disease activity and others with a greater number of affected joints.

Pancreatic Cancer: Research reveals that the bacteria of gum disease may contribute to a higher risk of pancreatic cancer. Through a cancer prevention and screening study, the National Cancer Institute and American Cancer Society studied oral samples. Their findings showed notably higher levels of two types of oral bacteria in study participants with pancreatic cancer. One bacteria was found to create a 50 percent increased risk for pancreatic cancer and a second bacteria led to a 59 percent greater likelihood.

The results indicated a significantly positive association between periodontal disease and the risk of pancreatic cancer.

Although I could go on and on citing studies and research findings, I think you get the picture. The need for good oral health is indisputable.

Signs and symptoms of gum disease are gums that bleed when brushing, frequent bad breath, tender gums that turn red in color, swollen gums, receded and sensitive gums. If you have any of these, please know that gum disease will only worsen without treatment. It is also the leading cause of adult tooth loss.

For an examination, or to begin with a consultation, call 828-274-9440.




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