Laser Dentistry, Cone Beam Imaging Among Our Advanced Features!

Posted on Nov 15, 2023 by William J. Claiborne, DDS MS

Like your “adult” teeth, your gum tissues are irreplaceable. Without question, they deserve the care and attention that come with keeping them healthy and doing their job.

Gum tissues are designed to protect the structures underneath. These include bones, tooth roots, tendons, and muscles to prevent entry of harmful bacteria. Gums are designed to snugly wrap the base of each tooth to keep bacteria from penetrating sensitive root segments of teeth.

Without this protective seal around teeth, the potential for periodontal (gum) disease greatly increases. And gum disease is at concerningly high levels in the U.S. with an estimated 47% of adults having some level of gum disease.

I believe that this high level of gum disease is largely in part due to Americans not being fully familiar with the symptoms. Some are easily ignored or “brushed off” as normal. This is why it is important to be familiar with the signs and symptoms, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that pulling away from the base of teeth, making them appear teeth longer
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when biting
• A change in the fit of partial dentures

If you are experiencing any of these symptoms, you are urged to seek care with a periodontal specialist as soon as possible. This disease will only worsen without treatment.

Why should you be concerned about periodontal disease?

Gum disease is the nation’s leading cause of adult tooth loss. Additionally, research has linked the bacteria of periodontitis with serious health problems. These include heart disease, stroke, arthritis, diabetes, some cancers, preterm babies, erectile dysfunction (ED) and high blood pressure. Studies on links to Alzheimer’s disease are showing concerning correlations.

A periodontist is an expert in the treatment of all stages of gum disease, including gingivitis, periodontal disease, and the advanced form of periodontitis.

In addition to having these specific skills, I’d like to share the benefits of some of our amazing technology we make available to our Western NC patients. One with a wide range of benefits to patient care is our Dental Laser.

Nd: YAG Dental Laser: This is a small, hand-held device that eliminates or greatly minimizes bleeding during procedures. It also reduces numbing requirements, removes bacteria and easily uncovers gum tissue where dental implants have been placed.

Additionally, laser dentistry can quickly repair oral ulcers and beautifully re-contours or repairs gum tissue with a precision line. Some specific treatments that are ideal for a dental laser include:

Canker & Cold Sores: The laser is also ideal for rapid healing of canker and cold sores. Laser therapy can halt the progression of canker sores, reducing the pain in a day or so. Otherwise, they can last up to 2 weeks. When it comes to cold sores, they are best treated with our laser when the very first symptom arises. Tingling or burning sensation is the first sign that a cold sore is about to erupt. Although lasers can still treat these lesions in later stages, the treatment is most effective in initial stages. Most patients notice significant improvement in comfort after laser treatment with a much shorter duration.

Gum Disease Treatment: In our office, we also use a dental laser to destroy the bacteria of gum disease. This technology also speeds the process and heightens your comfort, saving you treatment time with faster healing.

Correcting a “Gummy Smile”: This is when a smile shows too much gum tissue above upper teeth when smiling fully. We correct this in a procedure known as crown lengthening. In this, a gingivectomy adjusts the height of gum tissues so the smile has a more even smile line. This may involve the use of a dental laser, which provides a precision line and speeds healing.

Balancing a smile line: A gingivectomy is also advised to rebalance the frame of gum tissues that arch the teeth visible in a smile. When one or two teeth have different heights of gum tissue, the smile has a jumbled look. A dental laser can even out the smile line and enhance the beauty of a smile.

Saving a tooth broken near the gum line: When a tooth breaks at or near the gum line, it often requires removal. In some cases, however, we can save the tooth by exposing enough of the structure to receive a crown. This helps the patient to avoid removal and thereby preserves the supporting jaw bone.

In our Asheville NC periodontal dental office, we feature additional technologies, some of the most advanced in the industry. These include:

LANAP Protocol Using PerioLase MVP-7: This process is designed to efficiently and effectively treat periodontitis (advanced gum disease) through laser technology. Treatment is administered with minimal (or no) discomfort and recovery time is minimal. Amazingly, this technology has also been able to stimulate bone regrowth in damaged areas.

Cone Beam 3D Imaging: These views allow us to see your jaw in 3D dimensions and to be able to view it at varying angles. This enables us to see what used to be hidden from view.

Cone Beam images are often used to assess:
• Dental Implant Positions
• Temporomandibular Joints (TMJ)
• Airway Passages
• Bone Structure Damage or Bone Loss
• Teeth, Tooth Roots and Facial Structures
• Signs Of Infections, Cysts, Or Tumors

CS 3600 Intraoral Scanner: Through this process, our patient no longer have impressions made with bulky, goopy trays held in their mouths. This technology quickly and comfortably scans the mouth’s interior for digital impressions using a small, handheld scanner. It can also reach difficult–to–access areas in the patient’s mouth with improved patient comfort.

Simplant Dental Software for Computerized Dental Implant Placement: This system helps in pre-surgical positioning of dental implants on the computer, using a 3D model of the patient’s jaw. This aids in the selection of the implant type to ensure a precision fit.

Intraoral Camera Technology: This provides outstanding quality of images within the mouth. These images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment needs.

Computer Imaging In Treatment Suites: Treatment suites are equipped with computers for convenient image sharing with patients.

Oral & IV Sedation: We take patient comfort very seriously in our Asheville periodontal dental office. That’s a commitment we make to every patient at every appointment. Here, patient comfort is supported by our sedation options. These include oral and I.V. sedation. Also referred to as “twilight sleep” or “sleep dentistry,” these sedatives are administered by a highly-skilled anesthesiologist who uses advanced safety monitoring equipment throughout the patient’s procedure.

My staff and I also take great pride in providing patients with an environment of respect. Some adults come to us embarrassed by the condition of their oral health or missing teeth. Here, we strive to make patients feel they are in the right hands in the right place.

If tooth loss has occurred, a periodontist also specializes in the selection and placement of all types of dental implants. Dental implants, for many reasons, are the preferred option for tooth replacement.

Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office. New patients are always welcome and a referral is not always necessary.

Know How Oral Bacteria Form & Cause Damage

Posted on Nov 07, 2023 by William J. Claiborne, DDS MS

Often, once people understand how something breaks down, they are able to watch for telltale signs or take preventive measures. For example, when the grooves in a vehicle’s tires become more shallow, it’s obvious they need to make arrangements for new tires.

This is true, also, for your oral health. Knowing concerning oral signs and symptoms can help you prevent cavities, periodontal (gum) disease and tooth loss.

Oral bacteria exists in every mouth; some of it is “good” bacteria. The good bacteria are even helpful to the digestive system. However, harmful bacteria can run rampant if not kept under control.

The average mouth houses around 20 billion (that’s billion with a “b”), consisting of about 700 different types. Bacteria breed very quickly. The numbers can grow amazingly fast and their buildup produces a bacterial film that coats the teeth and gums. This is known as plaque.

Plaque is the sticky coating in your mouth, most obvious when you first wake up. When plaque is not removed regularly (through thorough brushing), the bacteria attack tooth enamel. Results include bad breath, yellowed teeth, cavities and tender gums.

Plaque formation actually begins as you chew carbohydrates, which seems to be prevalent in most of the foods we eat in today’s diet. As carbohydrates blend with saliva and existing bacteria in the mouth, an acid is created.

Plaque that is allowed to remain on teeth for about 48 hours hardens. This is known as tartar, which is a mass of bacteria that forms between and at the base of teeth.

Once in this hardened form, removal can only occur with special tools used by your dentist or dental hygienist. This is what your hygienist is scraping off during cleanings. Without tartar being removed, it causes the gums to swell, feel tender and may bleed when brushing. This is typically the initial stage of gum disease, known as gingivitis.

However, for people who brush twice a day and still have tartar formation between dental hygiene appointments, there are factors that may be contributing. Some of these are not common knowledge, which is important to know in your prevention goals. These include:

---

Having “dry mouth”: There are a number of reasons that some people suffer with a drier mouth than others. Unfortunately, those who have insufficient saliva flow (which continually helps to cleanse the mouth) are more susceptible to tooth decay from plaque and tartar.

Saliva protects teeth and gums by helping to manage the growth of harmful bacteria while maintaining a neutral pH in the mouth. This slows microbial growth and keeps bacteria from sticking to teeth.

Other contributors to dry mouth include aging, caffeine (including coffee, tea, sodas, and chocolate), smoking, and a wide range of medications (such as antidepressants, decongestants and diuretics).

---

Poor oral hygiene: Since the pandemic, normal routines have been uprooted for many people as they have adjusted their “ready for the day” tasks to more casual timetables. Unfortunately, this seems to have left the habitual brushing and flossing times to days where oral hygiene has dropped out of the twice-a-day routine.

A March 2023 poll (conducted on behalf of CeraVe) included 2,000 men between the ages of 18 – 42. They found that only 54% brush their teeth daily (with one-third admitting to only once a day when they do brush). To no surprise, a recent report by the Centers for Disease Control & Prevention reveals that nearly 26% of ages 20 – 44 have untreated dental caries.

---

Frequent snacking: Every time you eat or drink, an acid attack begins in the mouth. This acid flows in with saliva to begin the initial stage of digestion. However, this acid is very potent, enough to even soften tooth enamel. So, every time you take a bite of a cookie, acid flows into the mouth and remains there for about 20-30 minutes. When the mouth endures frequent acid attacks from snacking between meals, the damage to precious tooth enamel will catch up to you in the form of cavities.

---

In addition to the harm that oral bacteria can cause teeth, the gum tissues – essentially the protective coating to the vital structures that support teeth – endure the rigors of bacterial overload. Eventually, this catches up to most people in the form of:

• Gingivitis – As the initial stage of gum disease, inflammation is triggered by plaque buildup at the gum line. When daily brushing and flossing fail to thoroughly remove plaque, toxins form that cause irritation to the gum tissues. Once symptoms emerge, they may include seeing blood in the sink when brushing or having sore, swollen gums.

• Periodontitis – As the disease advances, the bone structures and fibers that support teeth are damaged by the destruction of infectious oral bacteria. At this stage, pockets form below the gum line, filling with bacteria-laden plaque.

• Advanced Periodontitis – In the advanced stage of gum disease, fibers and bone supporting natural teeth are destroyed. This can cause teeth to shift or loosen, requiring aggressive treatment to prevent tooth loss. Eventually, some teeth may require removal.

Proactive measures NOW can help you avoid costly repairs to teeth, tooth replacement or the treatment process to rid periodontal disease. Start now with:

  –  Brush twice daily, floss every day and maintain regular dental check-ups. Thorough at-home oral care and regular dental check-ups can help you avoid problems from occurring in the first place.

  –  Delay brushing after eating or drinking. Wait 20-30 minutes to allow the acid attack in your mouth to subside. Remember, this acid can soften tooth enamel. The abrasiveness of a tooth brush or tooth paste can wear away precious tooth enamel.

  –  Swish with water. Enjoy a cup of coffee or glass of wine but try to alter these with a glass of water, allowing it to wash over teeth before swallowing. Or, swish with water.

  –  Eat sweets only with meals. Rather than forgo a sweet indulgence as a snack, enjoy your favorites as dessert following your meal since your mouth is already enduring an acid attack. This merely prolongs an acid attack rather than trigger a new one.

A healthy mouth is important for your overall health, as research has shown. We now know that the inflammatory bacteria of periodontal (gum) disease are able to enter the bloodstream through tears in weakened gum tissues. Numerous studies have found this bacteria can trigger harmful reactions.

For example, the bacteria can cause inflammation that sets into motion risks factors connected to arthritis and diabetes. Some cancers have also been correlated to this bacteria. Heart disease, stroke and high blood pressure have been as well. Alzheimer’s is also being studied along these lines.

While there is no clear pathway to verify gum disease bacteria are the “cause” of these serious conditions, research has continually shown they are linked, which can greatly increase one’s potential for having these problems develop (or worsen).

If you haven’t been fully committed to your oral health, there is no better time to begin than the present. Start with a thorough periodontal examination by calling 828-274-9440.

If dental fears have caused you to delay or avoid regular dental care, consider beginning with a consultation. This occurs in a comfortable, private room that is removed from the clinical side of the office. Too, many treatments can include oral or IV sedation (sleep dentistry, or “twilight sleep”).

And, if budget constraints are an obstacle, we offer several payment plans. Most are interest-free with no down payment required (for qualified individuals). Feel free to ask about these during your consultation.

Sources:

www.todaysrdh.com/

perio.org

It’s Flu Season – Why You Should Keep Your Oral Health In Tip-Top Shape.

Posted on Oct 16, 2023 by William J. Claiborne, DDS MS

It’s cold and flu season. Now having weathered the worst pandemic Americans have ever experienced, a new emphasis has taken hold for the need to have flu vaccines and the latest Covid booster.

Vaccines, of course, do not fully eliminate the potential to acquire these health conditions. While they lower the chances of their development, the immune system still relies on our own actions. This includes taking measures to avoid their development in the first place, such as frequent handwashing, eating a healthy diet, mask-wearing in crowds for vulnerable populations, etc.

We learned much about the immune system during the Covid pandemic. And, the need for keeping oral health in good condition became more clear than ever.

During the worst of the outbreak, a 2020 study found that individuals with gum disease who contracted COVID-19 were 9 times more likely to die. And, the study showed that COVID patients who already had periodontitis (the advanced form of gum disease) were 3 times more likely to end up in intensive care or on a ventilator.

Evidence shows, too, that avoiding dental care may actually increase the potential to contract the virus. And, poor oral health can increase its severity, and even fatality rates.
https://onlinelibrary.wiley.com/doi/10.1111/jcpe.13435

This is not only a concern for U.S. citizens, it’s a worldwide wake-up call. About 50% of the world’s population over the age of 30 suffer from periodontitis. Americans aren’t in much better shape – with over 47% having some form of gum disease.

Because gum disease can begin without obvious symptoms, or be present without having pain, it can be easily ignored. This allows the disease to progress further.

This is why dental care is deemed by Congress as “essential healthcare,” as it supports the need for preventive measures for gum disease and tooth loss. As a periodontist, I believe it is also important that Americans understand the signs and symptoms of gum disease as well as the overall health risks it brings.

Although gum disease can exist without obvious indication (typically in the early stage known as gingivitis), warning signs of gum disease usually begin with swollen and tender gums that bleed easily when brushing teeth.

As it worsens, the healthy pink hue of gums darkens to more of a red or purple color and breath odor is persistently bad. The gums begin to loosen their strong grip around the base of teeth, allowing infectious bacteria to reach bone structures that support tooth roots. In advanced stages, pus pockets form near the base of some teeth and gum tissues become spongy in texture.

The bacteria of periodontal disease don’t just damage oral health. This is where there is so much concern throughout the healthcare fields.

Through weakened oral tissues, the bacteria can enter the bloodstream and trigger inflammatory reactions. These reactions can worsen some serious health conditions and even activate others. Research has found correlations between these bacteria and heart disease, stroke, diabetes, arthritis, some cancers (including pancreatic), preterm babies, erectile dysfunction, and Alzheimer’s disease.

With such serious correlations, it should be common knowledge that oral wellness is a necessary part of maintaining good overall health. However, this isn’t necessarily the case. A report commissioned by Delta Dental Plans Association recently revealed concerning information regarding age groups and perceptions of oral health.

With over 1,000 online participants, 87% listed their priority for maintaining proper oral care was to save money or avoid unexpected expenses. Two-thirds of the group listed their commitment to at-home dental hygiene being to avoid tooth decay and gum disease. Yet, only 79% of adults stated they brushed their teeth twice a day with only 33% claiming to floss daily.

In reviewing age groups, the report found that baby boomers (those born between 1946 – 1964) understand there is a strong link between their oral and overall health but are less aware than other generations about the connection between poor dental health and chronic diseases (such as arthritis and diabetes).

Those listed in the Generation Z group (born between 1997 – 2012) showed less commitment to their oral health as the “boomers,” but were more focused on eco-friendly and nontraditional oral care products. Only 76% of Generation Z agreed that oral health is closely connected to overall health.

https://www.deltadental.com/content/dam/ddpa/us/en/state-of-america%27s-oral-health-and-wellness-report/DDPA_State%20of%20Oral%20Health%20Report_2023-Release_FINAL.pdfse-you

If you wear dentures or partials, keeping them clean is an important measure to take to avoid getting sick. Why?

One study (published in the Journal of The American Dental Association) assessed bacteria levels of the porous material that make up the gum base of dentures and partials. In the mouth, it becomes coated with a sticky bacteria known as biofilm.

One study found that wearing dentures while sleeping doubles the risk of pneumonia in elderly adults. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541085/)

It has also been found that this biofilm can harbor MRSA or bacteria that is resistant to antibiotics. It was also found that the bacteria in the biofilm doesn’t just stay in the mouth. It can be inhaled into the lungs where infections become much more difficult to treat. (https://www.nbcnews.com/healthmain/dirty-dentures-dangerous-mrsa-may-be-lurking-dentists-say-662637)

Regardless of age, Americans must maintain a healthy smile in order to support their immune systems. Research shows that oral bacteria are also connected to gut health, so keeping bacteria levels in the mouth in check can go a long way in healthy benefits far beyond the mouth.

For those who have avoided regular dental care due to dental fear or anxiety, we offer several comfort options, including oral and IV sedation.

Oral sedation is a pill that helps patients relax.  I.V. sedation (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety with patients closely monitored with advanced safety equipment throughout treatment.

Call 828-274-9440 to arrange an examination appointment or to learn more about our Asheville periodontal dental office.

 

Oral Health & Tooth Loss Within America’s Aging Population

Posted on Sep 18, 2023 by William J. Claiborne, DDS MS

There are currently 54.1 million U.S. adults ages 65 and over; a number that is expected to grow to 95 million by 2060.

In 1900, the percentage of American adults over the age of 65 was just 4.1%. Today, that number has grown to nearly 16%. By 2040, the elderly adult population is estimated to be more than double the senior population of the year 2000.

https://www.aplaceformom.com/caregiver-resources/articles/elderly-nursing-home-population

Many baby boomers (Americans born between 1946 – 1964) will keep their teeth longer than any generation before, yet they continue to experience a preventable decline in oral health.

Common risk factors such as smoking, poor diet, a reduced capacity to care for one’s teeth and obtain professional dental care, and biological mechanisms – such as low salivary flow caused by medications – may contribute to tooth decay and tooth loss.

Periodontitis (advanced gum disease) is a prevalent oral disease in older adults. It is typically marked by inflammation of the gums and supporting structures of the teeth, resulting in sore and bleeding gums as well as painful chewing problems. Loss of the supporting structures of the teeth (including supportive bone) results from an imbalance of bacteria that exist in the space between the teeth and the gums. This leads to an inflammatory response that develops into periodontal disease.

As teeth lose support from their diseased foundation, mobility and tooth drifting can occur in addition to abscesses, which can ultimately result in tooth loss. As the disease intensifies, bone loss around affected teeth can advance with a worsening infection that can lead to serious health problems far beyond the mouth.

Periodontal disease is associated with chronic diseases such as cardiovascular disease, diabetes, respiratory disease, and dementia. Along with other challenges to maintaining good health, the prevalence of any periodontitis among older adults is high. Three in five older adults are affected, with prevalence higher in men and persons with low incomes. Four in five older adults who smoke cigarettes have some form of periodontitis.

The loss of all natural teeth, known as edentulism, reduces quality of life because it interferes with the ability to eat, speak, and feel comfortable among other people. Tooth loss also affects a person’s ability to consume nutritious food and can impact social involvement with others while consuming food.

Overall, 17% of adults 65 and older are edentulous. Fortunately, edentulism has declined over the years among older adults aged 65 to 74, from about 50% in the 1960s to 13% today.

https://www.cdc.gov/oralhealth/pdfs_and_other_files/Oral-Health-Surveillance-Report-2019-h.pdf

Prevalence of total tooth loss among adults ages 65 and over is higher in both North and South Carolina than many other states, which is in the 16.6 – 26.3 percentage range. This compares to states like Illinois, Wisconsin and Utah, which are some states in the 6.2 – 11.3 percent range.

https://www.ncbi.nlm.nih.gov/books/NBK578296/figure/ch6.fig6/?report=objectonly

Having fewer than nine teeth is considered severe tooth loss and can cause major difficulties in eating a healthy diet of fresh and nutritious fruits, protein-rich meats and sufficient fiber. Without chewing comfort, strength and stability, food choices can result in either weight loss or obesity. Extensive tooth loss also detracts from physical appearance and impedes speech, another challenge to social contact and job prospects. This can also inhibit intimacy, lower self-esteem, and impact overall quality of life.

https://www.nidcr.nih.gov/sites/default/files/2017-10/hck1ocv.%40www.surgeon.fullrpt.pdf

Another challenge for older adults is orofacial pain. Orofacial pain in older adults can originate inside the mouth from tooth-related or gum infections. It may also originate outside the mouth, such as pain in the jaw joint area, or face and cheeks. Orofacial pain often results from ill-fitting dentures or a microbial infection causing an inflammatory reaction known as denture stomatitis (an oral yeast or fungus condition)

Older adults also struggle with “dry mouth.” Dry mouth is surprisingly common – an estimated 35 million U.S. adults may have this condition, known as xerostomia. Common causes include medications, autoimmune disease, systemic diseases, and as a result of head and neck irradiation.

Drugs are by far the most common risk factors for chronic dry mouth. Nearly 9 in 10 (89%) adults aged 65 and older take prescription medicine. More than half (54%) report taking four or more prescription drugs. The drugs most consistently implicated in “dry mouth” are antidepressants, diuretics, beta blockers, bronchodilators, and antihistamines.

High-risk behaviors are generally less common among older adults than in younger age groups. About 9% of those 65 years and older reported that they were current smokers, and 8% reported excessive alcohol consumption (having five or more drinks in one day at least once in the past year). Cannabis use also is on the rise among seniors although it remains less than 5%.

The problems associated with poor oral health and tooth loss extend greatly to other areas of the body. Oral bacteria and their toxins can spread into the bloodstream through ulcerated or inflamed tissues during chewing, routine oral hygiene, and dental procedures. In weakened gum tissues, even the act of tooth brushing can open up entry points for bacteria plaque and gingival inflammation in the bloodstream.

In addition, the presence of oral bacteria or their toxins may induce inflammatory responses, which can prompt insulin resistance. Oral bacteria can reach tissues in the lung, heart, gut, placenta, joints, and even the brain. They have been associated with infective endocarditis, and chronic inflammation may contribute to systemic conditions such as cardiovascular disease and diabetes.

Obviously, there are many causes for oral health challenges, all having a detrimental effect on quality of life to some extent. We want to help the residents of Western North Carolina enjoy their retirement years with a healthy, confident smile and oral health that supports good overall health.

First, know the signs and symptoms of periodontal (gum) disease, which include:

• Swollen or puffy gums
• Gums that turn red, dark red or dark purple gums
• Gums that are tender or bleed easily
• Seeing blood when brushing or flossing
• Persistent bad breath
• Pus pockets that form between teeth and gums

When periodontal disease exists, it is important to know that this will not go away without treatment. Once this infection is underway, it will only worsen, leading to more painful symptoms and even eventual tooth loss.

If you have signs of gum disease, see a periodontal specialist as soon as possible. In addition to lowering the risk of tooth loss, a periodontist can help you lower the risks of gum disease’s infectious bacteria in the bloodstream, which research has linked to serious (and even deadly) health problems.

Call our Asheville periodontal dental office to schedule a consultation. If fear or anxiety has prevented you from regular dental visits, we can discuss several options (including oral or IV sedation) to provide comfortable, relaxed appointments. Call 828-274-9440.