Rheumatoid Arthritis (RA) Linked To Periodontal Disease


Posted on Oct 02, 2019 by William J. Claiborne, DDS MS

As a periodontist, I specialize in the treatment of all stages of periodontal (gum) disease. Although this particular dental specialty is not as visible as a general dentist, we are very-involved members of the medical and dental community. According to the Centers for Disease Control & Prevention (CDC), over 47 percent of American adults have some level of gum disease.

Like the formation of cancer, many individuals are unaware when periodontal disease becomes active. When early symptoms appear (such as bleeding gums when brushing, bad breath and gum tenderness), many people shrug them off as temporary.

However, gum disease only progresses once underway. Eventually, gums become red in color and pus pockets form at the base of teeth. In advanced stages, teeth loosen and may require removal. Gum disease, to no surprise, is the nation’s leading cause of adult tooth loss.

The potent bacteria of periodontal disease can enter the bloodstream through tears in weakened gum tissues. This allows it to travel throughout the body. Research has shown it is able to trigger a number of serious health problems, including heart disease, stroke, diabetes, memory loss, and impotency.

Rheumatoid arthritis (RA), a condition seemingly unrelated to gum disease, is a debilitating disease that destroys joints. It is disabling and painful. In most cases, RA emerges gradually, often beginning with morning stiffness along with weak and aching muscles. Joint pain follows, with joints feeling sore and stiff. RA is typically found in the fingers, wrists, elbows, hips, knees, ankles, toes, shoulder and neck.

As inflammation from RA increases, joints become swollen with symptoms including fever, disfiguring of hands and feet, numbness and tingling. There is no cure for RA and lifelong treatment is required. Treatment may consist of medications, physical therapy, or even surgery.

Yet, like RA, gum disease causes pain, swelling, and tenderness. As it worsens, the associated inflammation can lead to destruction of the bone that supports teeth along with surrounding tissues. And, the similarities go much deeper.

Both gum disease and RA share a genetic likeness in clinical makeup and structures. This has been particularly apparent in pathogens, which are agents in the body that lead to disease or illness. The pathological processes that occurs in both gum disease and RA are almost identical.

Too, the particular species of bacteria found in gum-diseased oral tissues and tissues that surround joints in those who suffer with RA. Equally concerning is, while both conditions clearly cause chronic inflammation in tissues connected to bone, researchers have found the two diseases share a similar inflammatory trigger.

In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis. It has also been shown that, by treating periodontal disease in RA patients, RA symptoms often improve ( likely due to the system’s reduced burden of oral inflammation).

These findings reveal just how closely our oral health correlates

A relaxing and comfy environment.

to our overall health. This information should send up alarms that the presence of gum disease can greatly increase your risk for serious health conditions. Clearly, people who have RA should be particularly diligent when it comes to their oral health.

If you are experiencing symptoms of gum disease (as mentioned above), seek treatment at your earliest convenience. You can begin with a consultation appointment in our  comfortable Asheville periodontal office. A referral is not needed.

Call 828-274-9440 to learn more.

Using A Manual Or Electric Toothbrush Could Make A BIG Difference.


Posted on Sep 11, 2019 by William J. Claiborne, DDS MS

If you use an electric toothbrush, that can help in the prevention of tooth loss. However, it’s but one part of the steps needed for thorough oral hygiene at home.

Findings of an 11 year study published in the Journal of Clinical Periodontology tracked the oral health of over 2800 adults. Their use of electric toothbrushes was monitored to watch for periodontal disease, cavities, and the number of natural teeth.

Participants were examined in 2002 – 2006, with 18 percent being electric tooth brush users. Follow ups were conducted after six and 11 years. At the time of their 11 year follow up, 37 had converted to using electric toothbrushes.

The study showed electric brushing promoted better gum health and slower progression of gum disease. Electric tooth brushing also related to a reduction in tooth loss by 20 percent (compared to those who brush with manual toothbrushes). The study did not reveal measurable reduction in cavities, however.

Although more adults are using them, their long-term effectiveness has not been proven to be significant. It is suspected that this is due to technique more than the brushing tool itself. For manual brushers, a major hazard with manual brushes is one’s choice of bristles. Stiffer bristles can be very damaging.

If you use a hard bristle tooth brush, you may be damaging tooth enamel and gum tissues. People often feel they need to press down firmly as they brush and use a scrubbing, ‘back & forth’ motion. This action can wear down the protective shell of tooth enamel, leaving teeth more vulnerable to decay.

Another problem with using a hard bristle tooth brush is its ability to damage tender gum tissues. If the bristles on your toothbrush are fanned out after a couple of months, it’s because you are applying too much pressure when brushing.

The ideal technique for brushing teeth is applying gentle pressure on the brush in a swirling motion. By using a circular pattern over both sides of each tooth and along the tops, teeth are cleansed without wearing away gum tissues.

This is where electric toothbrushes can help greatly. Many of the newer models include timers to indicate the time needed for each quadrant of your mouth. This is your teeth divided into 4 sections. They also warn you when you are using too much pressure.

While tooth enamel is important, equally so are the health of your gum tissues. The gums provide a seal around the base of each tooth. This seal helps to prevent the entry of bacteria that can lead to periodontal (gum) disease, which the nation’s leading cause of adult tooth loss.

As devastating as tooth loss can be to one’s overall health, as we now know that the bacteria of gum disease can enter the bloodstream. Research has shown this infectious bacteria can trigger inflammatory reactions elsewhere in the body, correlating to heart disease, stroke, high blood pressure, some cancers, diabetes, arthritis, impotency, preterm babies and more.

Whether using a manual or electric tooth brush, it is necessary to brush twice a day for effective results. In order to thoroughly remove the sticky film of plaque from teeth, you should also brush at least two minutes each time.

Plaque is a buildup of oral bacteria that coats teeth and gums. If not removed daily, it forms a hardened mass of calculus (or tartar) that attaches to teeth. This is what you may feel your hygienist scraping off teeth during cleanings since it cannot be brushed or flossed away.

Another place for oral bacteria to thrive are the grooves in the tongue. These offer a dark, warm and moist environment for bacterial reproduction. To uproot these organisms (that reproduce rapidly), use your toothbrush to brush your tongue after brushing teeth. Be sure to reach the back of the tongue where the majority of oral bacteria are embedded. Swish with water several times after.

Another way to improve gum health, lower cavity risk, and prevent tooth loss is through flossing. It is estimated that only 31 percent of American adults floss on a daily basis. Because brushing cannot dislodge all food particles caught between teeth, daily flossing should be a part of oral hygiene routines.

Flossing removes trapped bits of food remain in the mouth, which feeds oral bacteria and helps them to quickly multiply. Proper flossing is easy for those who are in the habit of it and takes under a minute each day. For those who have problems with manual dexterity or find the maneuver awkward, water flossers are effective alternatives and easy to use.

Practice the recommended techniques mentioned above and you’ll not only do a better job at having a clean mouth, you’ll find your time at the sink requires less effort. If you feel you may be experiencing symptoms of periodontal disease, however, don’t delay. You should be seen at your earliest convenience for treatment since this disease will only worsen over time.

Signs of gum disease include tender gums that bleed easily when brushing, gums that darken in color to red (versus a healthy pink), frequent bad breath, and gums that pull away from teeth (receded gums) and expose darker root areas of the tooth.

If you’ve noticed any of these, please know that the condition will only worsen without treatment. As a periodontist, I specialize in gum tissues (as well as dental implants). Our environment optimizes patient outcomes and comfort throughout treatment.

Call 828-274-9440 to learn more.

Men Have Greater Risks For Dental Problems.


Posted on Aug 20, 2019 by William J. Claiborne, DDS MS

Research has found that periodontal disease is higher in men (56.4 percent) than in women (38.4 percent). https://www.perio.org/consumer/gum-disease-and-men

The reason for this significantly higher number may be due to some findings revealed through some unsettling findings. According to a survey by the Centers For Disease Control & Prevention (CDC), only 66 percent of males brush their teeth twice or more a day compared with 86 percent of females who do so.

This was revealed through a study of over 800 participants. Evaluation included a written questionnaire on dental knowledge and oral health habits. It also included an oral exam of each participant to detect signs of periodontal disease. (https://www.perio.org/consumer/gender-differences)

Flossing had even worse numbers, but that pertains to both sexes. Only 49 percent in the survey stated they floss on a daily basis. Only 1 out of 3 assumed that seeing blood in the sink when brushing is normal and were unaware it is a sign of periodontal (gum) disease.

While women were as twice as likely to see their dentist for regular dental check-ups, they were also more likely to follow through with recommended dental treatment than men. As a result, the study revealed women had better levels of gum health with less dental plaque, calculus, and bleeding.

The Journal of Periodontology shared nine risk factors for tooth loss due to periodontal (gum) disease, including …

• Being over age 35
• Being male
• Not having professional dental care
• Not brushing teeth
• Smoking
• Being diabetic
• Having high blood pressure
• Having RA (rheumatoid arthritis)

Although age and gender are unchangeable, decisions to not brush your teeth or to smoke, for example, are something you can control. As of 2017, 18.6 percent of American men smoke, compared with 14.3 percent of women. (https://www.edrugstore.com/blog/current-health-news/men-smoke-more/) Because more males smoke cigarettes (or use tobacco in other forms), they are more likely to develop gum disease.

Why should you worry about gum disease? In addition to causing tooth loss, oral bacteria can enter then bloodstream through tears in diseased tissues in the mouth. Once in the bloodstream, this bacteria can trigger inflammatory reactions elsewhere in the body.

The bacteria of gum disease has been linked to heart disease, stroke, memory loss, preterm babies, arthritis, diabetes, and even impotency. According to the American Academy of Periodontology (perio.org), men who fail to maintain good oral health are also at higher risk for:

PROSTATE PROBLEMS – Prostate-specific antigen (PSA) is an enzyme created in the prostate that is normally secreted in very small amounts. However, when the prostate becomes inflamed, infected, or affected by cancer, PSA levels rise. Research has shown that men with indicators of periodontal disease such as red, swollen or tender gums  as well as prostatitis (inflammation of the prostate) have higher levels of PSA than men with only one of the conditions. This means that prostate health may be associated with periodontal health, and vice versa.

HEART DISEASE – Research indicates that periodontal disease and cardiovascular disease are associated; having periodontal disease may actually increase your risk of cardiovascular disease. Both diseases are chronic inflammatory conditions, and researchers believe that inflammation is the connection between gum disease and heart disease. Since men are already more likely to develop heart disease than women, maintaining periodontal health is another way to reduce this risk.

IMPOTENCE – Men with periodontal disease, especially those younger than 30 or older than 70, are at increased risk of developing impotence, according to research. Researchers believe that inflammation may be the link between the two conditions; prolonged chronic inflammation (the same type of inflammation that is associated with periodontal disease) can damage blood vessels leading to impotence.

CANCER – Research has found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. Specifically, men with periodontal disease may be 49 percent more likely than women to develop kidney cancer, 54 percent more likely to develop pancreatic cancer, and 30 percent more likely to develop blood cancers.

If you aren’t concerned about losing teeth, these overall health risks should get your attention. Treating gum disease before it becomes severe can be done comfortably and affordably. In our Asheville periodontal dental office, we use the latest technology and offer I.V. sedation for those who desire a “twilight sleep” state during treatment.

Gum disease will only worsen without treatment. Call (828) 274-9440 if you have tender, sore gums or see blood in the sink when brushing. You need to be seen promptly.

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!

 

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