A Dry Mouth Can Have Many Causes And Lead To A Number Of Oral Health Problems
Posted on Jun 21, 2019 by William J. Claiborne, DDS MS
Our lips and teeth – our smile – is a stage curtain to what is actually going on inside the mouth. As an Asheville periodontist, I have a daily view of the hazards that exist beyond the veil.
Oral bacteria is the root source of most problems that occur in the mouth. Their presence is normal, of course. The mouth (or “oral cavity”) is designed to be able to manage a certain level of oral bacteria. It is the over-accumulation of this bacteria that is the origination source of many problems.
Although certain foods, such as a garlicky shrimp or onion-laden hot dogs, can create “stand-offish” bad breath, this breath odor is temporary. The bad breath that is truly offensive and occurs on a more consistent basis comes from an overload of oral bacteria.
The reason we’re advised to brush at least twice a day and floss our teeth daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, the bacteria form a sticky film that coats the teeth and gums. This film is known as plaque.
Keep in mind that bacteria are living, eating, and reproducing organisms. Because they eat, they also create waste – in our mouths! Although that in itself should be reason enough to be committed to brushing and flossing, without pain, people assume that all is well.
Yet, an over-accumulation of oral bacteria can lead to far worse than bad breath. Because oral bacteria critters eat, they look to the gum tissues. As they amass, they can create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth.
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 it has been linked to a wide array of conditions and diseases elsewhere in the body.
The oral bacteria of advanced-stage gum disease has been associated with some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency. As research continues, more and more health problems are being correlated to this bacteria.
The saliva in the mouth is designed to move bacteria out. Twice daily brushing and flossing help. However, certain contributing factors complicate the ability to keep oral bacteria levels to manageable levels. These include:
• Colas/Sodas: Not only is the acidity level in these drinks harmful to tooth enamel, it can make oral tissue to dry out. Downing these beverages because you feel you are replenishing moisture is the last thing they do; refreshing they are not. Drink plain, filtered water instead. It’s much better for your mouth and hydrating to the entire body.
• Coffee/Tea: Like colas, these drinks contain acid added to caffeine. Even green tea often contains caffeine. Caffeine has a drying effect on oral tissues and therefore depletes the helpful rinsing benefits or saliva.
• Alcohol (including beer and wine): Mixed drinks, “shots,” wine and even 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. If you imbibe, alter your drink with a glass of water in-between to neutralize acids and wash sugars from the mouth.
• Smoking (cigarettes, cigars, vaping, cannabis): People who have smoked for years often have dry skin that has an aged appearance far beyond their actual years. The same is occurring inside the mouth. The smoke of cigarettes and cigars is laden with toxic chemicals; true for e-cigs as well. Vaping doesn’t keep your mouth much safer than cigarettes. Even marijuana has been found to have a negative impact on oral tissues.
• Aging: Through aging, our skin, cartilage, and tissues are less supple. Our bodies simply dry out more and more with each decade. Although there’s nothing we can do to halt the aging process, we can take measures to minimize the damage to our oral health. We recommend drinking plenty of water throughout the day, using an oral rinse designed to replenish moisture in the mouth, and limit sugar and caffeine.
As a periodontist, I also urge people to be familiar with the signs and symptoms of periodontal disease, which begins with gingivitis. In this early-stage of gum disease, the gums may feel tender and swollen in one area. You may notice some bleeding when brushing your teeth. Your breath may feel less-than-fresh more often. However, some people experience no symptoms at all at this early stage.
If not treated, gingivitis can progress to periodontal disease, where symptoms are more obvious. The gum tissues are sore and bleed easily when brushing. Your breath will be bad more frequently. The gum tissues may swell in some areas and turn red.
As gum disease advances, the gums can begin to pull away from their tight grip around the base of some teeth, exposing darker, more sensitive areas of the tooth’s root. The gums will ache often and pus pockets may form at the base of some teeth. The breath is foul, even after brushing. And, tooth brushing is very uncomfortable with blood in the sink each time.
Eventually, the disease will have penetrated the supportive bone and ligaments that support teeth. In advanced cases, the teeth will begin to move and some may require removal.
All of this devastation to the mouth can be avoided, however. When people respond to early signs of gum disease by seeing a periodontal specialist, they can avoid the time and expense required. In addition to preventing the loss of natural teeth,
Enjoy beautiful, relaxing views from our surgical suite.
research now shows that serious health problems far beyond the body can be avoided as well.
If you have delayed or avoided dental care, begin with a consultation to learn about your options to have a healthy smile that is worry-free. Regardless of your love of coffee, your smoking habit, or your age, we can develop a program that allows you to have good oral health.
Begin by calling 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 putting patient comfort at the top of the list!
Bad Breath? That May Be The Least Of Your Problems!
Posted on May 23, 2019 by William J. Claiborne, DDS MS
We’ve all run into people who have bad breath. Although a tuna salad lunch or onion-laden hot dog can cause folks to pull back from close-up conversations, these forms of bad breath are temporary.
The smelly breath odor that is more concerning is that which comes from the sticky film of bacteria that coats the mouth and emits sulfuric odors (likened to rotten eggs). This film, known as plaque, coats the teeth and gums when allowed to build up.
For example, the reason you wake up with not-so-fresh breath in the morning is the result of the mouth being closed all night while bacteria reproduces and accumulates. Without brushing and due to declined saliva flow (your mouth’s natural rinsing agent) during sleep, oral bacteria amass. Thus, you wake up with the sticky film and the breath that goes with it.
For those who are mouth-breathers during sleep or who snore, dry oral tissues allow for even more bacterial growth.
Once you brush and rinse thoroughly, however, you can expect your breath to become more pleasant. Persistent bad breath, however, may be the a side effect of medication, an illness, or periodontal (gum) disease.
As a periodontal specialist, I’m very much aware of the distinct odor produced by gum disease. Although it varies slightly from person to person, it has an offensive scent than that of typical bad breath.
The best way to determine gum disease as the true source is through a periodontal exam. In addition to persistent bad breath, periodontal disease symptoms include gum tenderness, gums that bleed when brushing, and gums that are red in color rather than a healthy pink. Early stage gum disease (gingivitis) may not cause any obvious symptoms, however.
Regardless of the source of unpleasant breath odor, it is imperative to have and maintain good oral health – for reasons that can impact your overall health. Through decades of research and studies, the bacteria of gum disease has been linked to serious health problems, including heart disease, stroke, arthritis, diabetes, impotency and some cancers.
For example, rheumatoid arthritis (RA) and pneumonia are just two diseases that have a connection to gum disease. Researchers have found that RA sufferers have a higher incidence of periodontal (gum) disease compared to individuals with a healthy oral condition.
Studies have also shown that RA patients are nearly 8 times more likely to have gum disease. Although insufficient oral hygiene can certainly be a determining factor in acquiring gum disease, other parameters point to a deeper association between RA and gum disease.
Because both RA and gum disease both cause internal inflammation, a connection between the two are most prevalent when examining the joints and oral tissues. Oral tissues with the presence of periodontitis compared to tissues of RA-affected joints show a number of similarities. Research has also discovered a genetic link between the two.
And the health threats go further. One study published by Science Daily found that the bacteria present in the mouth can release toxins that can make their way into the brain. (https://www.sciencedaily.com/releases/2019/01/190123165002.htm)
Once there, they may contribute to Alzheimer’s disease. While studies on this connection continue, other studies have found a clear path of triggers traced to the inflammatory reactions caused by the bacteria of gum disease.
Once periodontal disease is established in the mouth, its pathological byproducts can enter the bloodstream, lymph fluid, and bone structures. This can lead to the spread of infection and inflammation to all areas of the body. In this way, periodontal disease has been shown to be a cause of systemic disease.
While fresh breath and a gleaming smile are important, it’s clear that oral wellness plays a leading role in helping you avoid serious, and even deadly, health conditions.
If you’re experiencing any of the symptoms of gum disease mentioned above or are past due for a dental exam, call our Asheville periodontal office at 828-274-7440. If desired, you can begin with a private consultation, where we will discuss your symptoms and health history. During this time, I’ll answer your questions, explain treatment options and discuss comfort methods.
You CAN Avoid Gum Disease – Know How It Forms & Easy Prevention Tips
Posted on Dec 14, 2018 by William J. Claiborne, DDS MS
I know of so many friends and family members who have avoided or minimized serious health problems (and perhaps even death) by taking preventive measures when it comes to their health. Annual screenings (such as mammograms, prostate checks, pap smears, and colonoscopies, to name a few) have enabled countless people to simply treat or avoid serious conditions and get back to their lives and loved ones.
When we “take charge” of our health, we can also avoid the time and expense required for treating problems that could have been prevented in the first place. For example, not smoking helps us avoid the risk of many cancers and respiratory diseases. Eating a healthy diet and regular exercise lowers our risk for heart disease.
I believe that when people know what to do to avoid problems, they can be proactive in their health. This is especially true for periodontal (gum) disease. What I find is that many individuals are simply not familiar with effective prevention measures nor the signs and symptoms of this infectious disease.
People are often surprised to learn that gum disease first begins without obvious symptoms. Even when it’s fully underway, the warning signs are often ignored or deemed “normal.” For instance, seeing blood in the sink when brushing is a sign that the gums are weak and inflamed, even though some people assume this means they’re doing a good job. (BTW, you should NEVER see blood in the sink when brushing!)
The path that leads to gum disease can easily be bypassed, however. The process of how it forms and progresses is:
• Oral Bacteria Overload: Bacteria in our mouths is unavoidable. It is on our food, utensils, the glasses we drink from and the pencil we hold between our teeth. Because the mouth is a warm, dark, and moist environment, it offers an ideal setting for bacterial growth. Although certain bacteria levels are manageable through brushing, flossing, and saliva flow, problems begin when too much bacteria accumulate and remain in the mouth.
• Plaque: Without regular brushing, flossing, sufficient saliva flow, and low-sugar diet, oral bacteria can reproduce rapidly. Their accumulation can quickly form a sticky film that you feel on teeth (a ‘fuzzy’ feeling), known as plaque.
• Tartar (or Calculus): In just 48 hours, plaque can harden on teeth. This is known as tartar (or calculus) and is actually a cement-hard mass of oral bacteria. Like plaque, tartar will continually grow as the bacteria reproduce. Their destruction includes boring into tooth enamel and eating away at gum tissues.
• Gingivitis: This is actually the first phase of gum disease. At this stage, gum tissues are under attack and become sore. It can cause the gums to bleed when brushing and gum tenderness. You may experience an aching sensation in some areas. Your breath will be bad more often. By taking proper measures as soon as you notice these symptoms, the gums can be restored to a healthy state. However, there is a fine line between being able to undo gingivitis and its progression to gum disease.
• Gum Disease: At this level, the gums are inflamed and tender and red rather than a healthy pink color. Your breath will be unpleasant on a consistent basis. The gums may also begin to pull away from the base of some teeth, exposing sensitive tooth root areas. As the inflammation progresses, pus pockets may form at the base of some teeth. Without treatment, teeth will loosen as the bacteria destroy the structures that support tooth roots. Eventually, tooth removal may be required.
Almost half of American adults have some level of periodontal disease, which is also the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.
It has also been found that the bacteria of gum disease can enter the bloodstream, triggering systemic inflammation. Gum disease has been linked to a long list of serious health problems. These include heart disease, some cancers (including prostate, lung, and pancreatic cancers), stroke, preterm babies, arthritis, diabetes, Alzheimer’s disease and erectile dysfunction (ED).
Twice daily brushing (at least two minutes each time), daily flossing, drinking plenty of water, and limiting sweets and caffeine (including colas, tea, and coffee) are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. Remember that your 6-month check-ups are very important. During these visits, any tartar that has accumulated can be removed and signs of early gum disease can be noted – and promptly resolved.
These simple steps can help you avoid the discomfort of gum disease as well as the devastation of losing your teeth and having to decide on replacement. These procedures – and the expense – can be avoided. And, contrary to what some people believe, losing teeth is NOT a natural part of the aging process. With proper care, you can easily enjoy a smile of natural teeth throughout your lifetime.
If you are experiencing symptoms of gingivitis or periodontal disease, call our Asheville periodontal office at 828-274-9440. As a periodontist, I have specialized skills to restore your oral health and customize a program to help you keep it at its best.
Being Overweight Can Make You More Susceptible To Gum Disease.
Posted on Oct 22, 2018 by William J. Claiborne, DDS MS
An alarming percentage of Americans are more than just fat, they are obese. Obesity is when body mass index is 30 or greater. According to the Centers For Disease Control & Prevention (CDC), the prevalence of adults in the U.S. who are categorized as obese was 39.8 percent in 2015~2016. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813989/)
This means that nearly one-third of an obese adult is made up of fat. And, it’s not just our country that suffers from toting an excessive load of weight. In 2014, the World Health Organization (WHO) estimated that approximately 600 million obese adults were obese with numbers expected to rise due to high-calorie diets and sedentary lifestyles.
An oft-unknown side effect of obesity is chronic inflammation, which has been found to exacerbate other inflammatory disorders, including periodontitis (advanced gum disease). The systemic effect of obesity seems to trigger a predisposition to a variety of serious health conditions. In addition to a higher risk for periodontal disease, these include Type 2 Diabetes and cardiovascular disease.
These findings are nothing new, however. Over a decade ago, the Journal of Dental Research reported that “The possible causal relationship between obesity and periodontitis and potential underlying biological mechanisms remain to be established; however, the adipose tissue actively secretes a variety of cytokines and hormones that are involved in inflammatory processes, pointing toward similar pathways involved in the pathophysiology of obesity, periodontitis, and related inflammatory diseases.” (http://journals.sagepub.com/doi/abs/10.1177/154405910708600503?journalCode=jdrb)
As research continues to study the cause-&-effect, Periodontists have learned that obese patients have a 6 times higher potential to develop periodontal (gum) disease. While the role of a periodontal specialist is to tend to the oral well-being of patients regardless of their BMI, addressing this higher risk with obese individuals can be a sensitive issue.
Losing weight is not easy. And, research has even shown that factors such as sleep quality and what we eat (as much as how much we eat) can cause the brain to make the path to shedding pounds even more difficult.
For instance, studies have shown that sugar can be addictive. Sugar consumption even activates the same regions in the brain that react to cocaine. Giving up sugar to the recommended 6 teaspoons per day limit can be rather challenging for those who have a “sweet tooth.” (https://www.brainmdhealth.com/blog/what-do-sugar-and-cocaine-have-in-common/)
Insufficient sleep also complicates the brain’s ability to regulate hunger hormones, known as ghrelin and leptin. Ghrelin stimulates the appetite while leptin sends signals of feeling full. When the body is sleep-deprived, the level of ghrelin rises while leptin levels decrease. This leads to an increase in hunger.
The National Sleep Foundation states that “people who don’t get enough sleep eat twice as much fat and more than 300 extra calories the next day, compared with those who sleep for eight hours.” (https://www.sleepfoundation.org/sleep-topics/the-connection-between-sleep-and-overeating)
As difficult as losing weight can be, it is important to be aware of risk factors that can make you more vulnerable to gum disease, which is the nation’s leading cause of adult tooth loss. Early symptoms include gums that are tender, swollen, and may bleed easily when brushing teeth. This stage is known as gingivitis, which can be reversed with prompt and thorough oral hygiene measures.
As it worsens, however, the inflammation of oral bacteria can lead to persistent bad breath, receded gums that expose sensitive tooth roots, and gums that darken in color. If untreated, pus pockets can form on gums and teeth may loosen, eventually requiring removal.
There is no doubt that an association between obesity and periodontal disease exists. Overweight adults should take special precautions to maintain good oral health, both at home and through regular dental check-ups. This is particularly important since the bacteria of gum disease has been linked to serious health problems because of its ability to trigger inflammatory reactions. These include heart disease, diabetes, arthritis, some cancers, preterm babies, impotency, and Alzheimer’s disease.
If you are experiencing symptoms of gum disease, however, it is paramount that you be seen by a periodontist promptly to halt further progression. A periodontist is a dental specialist who has advanced training in treating all stages of gum disease as well as in the placement of dental implants.
Call 828-274-9440 to schedule an initial examination and consultation.