Your Tongue Is A Multi-Tasker!


Posted on May 05, 2021 by William J. Claiborne, DDS MS

With the tongue occupying such a large area inside the mouth (or ‘oral cavity’), you’d think its anatomy would be common knowledge. Because this muscle functions continually without tiring, it tends to be taken for granted. It’s importance to your overall health, however, is unbounded.

To correct a common misconception about the tongue, it is not the strongest muscle in the body. Although it ranks in the top 5 or so, the muscles surrounding the eyes actually have that supremacy. The heart, deemed the hardest working muscle in the body, and the masseter (jaw muscle) are also among those that are the body’s stand-outs.

The tongue does many things. It provides our sense of taste, is vital in pronunciation, moves food around as we chew, and aids in swallowing while helping to prevent certain things from being swallowed.

Not one muscle but a combination of 8, the tongue is coated with papillae. These are the tiny, bumpy protrusions on its surface. They help in various ways but are mostly credited for our sense of taste.

Different areas of the tongue are more sensitive to certain tastes. For example, the tip of the tongue detects sweet to the greatest extent while the sides detect sour.

Papillae also sense touch so that we can feel the form and texture of food.

Saliva helps to keep the tongue moist so it can move around the oral cavity freely. Saliva is also helpful to the tongue by moving bacteria from its surface. However, saliva cannot keep the tongue bacteria-free.

Saliva and food residue can get stuck in the grooves between the papillae, especially on the last third of the tongue. This can create areas for bacterial growth. These bacteria thrive on remains of protein-rich food like fish, cheese or milk.

Here is where, as an Asheville periodontist, I have a particular interest in the tongue. As bacteria accumulate, a whitish film covers the tongue, which also causes bad breath. Keeping bacteria in the mouth to manageable levels is greatly supported by saliva flow.

The tongue’s underside covers two salivary glands of the lower jaw (submandibular glands). These ducts are located where the tongue meets the floor of the mouth.

If you’ve read some of my previous articles, you’ll recall that I’m constantly reminding readers of the hazards of having a dry mouth. Smoking, consumption of alcohol and caffeine, and many medications are all obstacles to the salivary glands being able to function efficiently.

A dry mouth provides a breeding ground for bacteria reproduction. When you consider the amount of bacteria embedded in the tongue’s surface, oral bacteria levels in the mouth can run rampant.

Because the tongue’s surface color can indicate too much oral bacteria, it should be looked at during at-home oral hygiene regimens. It is advised that, after brushing teeth, using the toothbrush to brush the tongue. This can dislodge an enormous amount of bacteria.

Although brushing the tongue tends to be done on the front area, it’s helpful to brush towards the back of the tongue where most bacteria exist (hence, the whiter color and smoother surface). Gagging will stop you from going too far so use that as a guide.

Some toothbrushes have a tongue scraper surface on the back side of the bristles. There are also tongue scrapers available for purchase. These are flexible strips that should be used to scrape from back to front 3 or more times after brushing. Rinsing the scraper is advised after each pass.

To provide even more support in helping the oral cavity control bacteria, an oral rinse can be very helpful. After brushing (for a minimum of 2 minutes) and flossing, swish for 30 or more seconds with an alcohol-free mouthwash. While the intensity of the mouthwash may be greater with initial use, most people notice its easier to swish around the mouth within a week or so.

Low bacteria levels in the mouth make for fresh breath and reduced risk of developing cavities and gum disease. Periodontal disease begins with gingivitis, which causes gum tissues to be tender and bleed when brushing.

Periodontitis, an advanced stage of gum disease, causes red, sore, spongy gums. Other symptoms are persistent bad breath, bleeding easily, gums that loosen from the base of teeth, and teeth that loosen.

Periodontitis can also cause health risks far beyond the mouth. Because these infectious bacteria can enter the bloodstream through tears in the gum tissues, it has been shown to trigger or worsen the development of serious health problems. Some of these are stroke, heart disease, arthritis, Alzheimer’s disease, some cancers, and diabetes.

When it comes to the tongue, remember its important role to your oral and overall health. Keep the mouth moist and its surface clean and your reward will be sweet (without the calories!).

If you are experiencing any signs of gum disease, call 828-274-9440 for an appointment. Gum disease does not go away on its own and will progressive worsen without treatment. Remember – it is the number one cause of adult tooth loss in the U.S.

 

Flossing – A Valuable Step In Avoiding Gum Disease & Tooth Loss


Posted on Mar 17, 2021 by William J. Claiborne, DDS MS

Adults who wish to stay healthy and active as they age often workout daily, walk at least 30 minutes per day, try to get 7 – 8 hours of sleep each night, and brush their teeth twice a day.

Tooth brushing helps to keep oral bacteria levels in the mouth to manageable levels. With the help of saliva, which is a rinsing agent for the mouth, these bacteria are generally kept under control. By preventing rampant growth, the ‘oral cavity’ (interior of the mouth) is able to avoid a destructive onslaught caused by these icky organisms.

A study shared by Dental Dental showed that about 70 percent of American adults brush their teeth twice a day. Unfortunately, this leaves more than a fourth of adults who do not.

Daily flossing is also recommended by the American Dental Association (ADA) as a preventative way to keep cavities and gum disease at bay. Still, an estimated 30 percent are committed to daily flossing – less than a third.

This means that a whopping 70 percent do not include flossing in their daily oral hygiene regimens. Too, about a third of Americans admit to never flossing, with 39 percent of men and 27 percent of women who do not.

Yet, the devotion of twice daily brushing and daily flossing requires only about 5 minutes of time – total. It is recommended to spend two minutes brushing teeth in the morning and before bed. A practiced flosser requires about a minute to floss. (Consider that five minutes is about the amount of time for a commercial break between TV programs.)

Yet, if you could see what I see…

As a periodontist, my specialty includes advanced training in the treatment of gum disease. I know the destructive nature of infectious oral bacteria. I have a bird’s eye view of what can occur without a committed oral hygiene routine at home. When an overload of bacteria accumulate in the mouth, cavities are able to form and gum tissues become food for living and breeding bacteria.

While brushing twice a day is important, the bristles of a toothbrush are typically unable to dislodge food particles caught between teeth. Left behind, these particles begin to rot rather quickly, leaving even more sustenance for bacterial growth and reproduction.

To see just how much your toothbrush misses, brush your teeth thoroughly for the recommended two minutes at the end of the day. Rinse and spit a couple of times. Then, using a strand of floss, move gently between teeth, easing up and down to reach the sides of all teeth. Move the floss just slightly beneath the gums at the base of each tooth. After all teeth are flossed, rinse and spit again. Most people are shocked at just how much their toothbrush failed to remove.

When oral bacteria amass past the point that is manageable by the immune system, these bacteria become infectious. This causes inflammation in the gum tissues, which can lead to the formation of periodontal (gum) disease. This begins with gingivitis, which has mild symptoms. Untreated, it worsens to periodontal disease and the advanced level of periodontitis.

It begins when oral bacteria accumulation creates a sticky film in the mouth known as plaque. When not removed thoroughly and frequently, plaque can form cement-hard bacteria colonies that attach to teeth. This hardened form of bacteria is known as tartar and, once formed, can no longer be brushed or flossed away.

As a Periodontist, I often see people who have developed periodontal disease who come (or have been referred) because they have obvious symptoms, such as red, swollen gums. However, I also see patients who are surprised to learn they have developed the disease. Yet, even without obvious symptoms, gum disease may exist and be fully underway.

Nearly half of American adults have some level of gum disease (over 47 percent in recent estimates). Periodontal (gum) disease is the nation’s leading cause of adult tooth loss even though it’s one of the most preventable of all diseases with simple measures.

Losing natural teeth leaves an individual with having to make decisions for replacement – crown-&-bridge combination, partial denture, full denture or Dental Implant. These time-consuming procedures and expenses can be avoided. And, contrary to what many believe, losing teeth is not a natural part of the aging process. With proper care, you can easily enjoy a smile of natural teeth all your life.

It is often surprising to people to learn that oral health is an integral part of overall health. Inflammation in the mouth doesn’t simply remain in the mouth. Through tears in diseased gum tissues, the oral bacteria of gum disease are able to enter the bloodstream. As the bacteria travel throughout the body, their toxic nature can activate inflammatory effects elsewhere.

Infectious gum disease bacteria have been the focus of a numerous amount of research over the years. Studies have found that the bacteria of gum disease can trigger or worsen heart disease, stroke, preterm babies, arthritis, diabetes, some cancers, Alzheimer’s disease, erectile dysfunction (ED) and impotency. As research continues, even more serious (and deadly) connections are being made.

They key is to keep oral bacteria levels to a minimum, which is why brushing and flossing are an important part of your daily care routine. Neither step should be taken for granted. Yet, as a periodontal specialist, I understand how it can be difficult to get into the habit of daily flossing.

For some, the tight floss around fingers is uncomfortable. For others who have large fingers or problems with manual dexterity, the act of flossing is awkward or challenging. However, for those who floss on a daily basis, it becomes a maneuver that is as simple as brushing teeth.

For individuals who are challenged by manual flossing, there are some excellent water flossers on the market. These are affordable and can be just as effective as ‘string’ flossing when used properly – and daily.

Twice daily brushing (at least two minutes per time), daily flossing, drinking ample water and limiting sweets and caffeine are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. And, those 6-month check-ups are important. During these visits, tartar that may have formed can be removed and signs of early gum disease can be addressed.

If you are experiencing symptoms of gum disease, call 828-274-9440. In our state-of-the-art Asheville periodontal dental office, our patients are treated with respect, compassion and a gentle touch. Here, you’ll never be lectured. Our goal is to restore your smile to a healthy state and develop a program to help you keep it at its best.

New patients are always welcome. A referral is not needed to become a patient.

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.

 

 

 

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