Could Poor Gum Health Increase Stroke Risk?
Posted on Mar 12, 2020 by William J. Claiborne, DDS MS
The human body is a complex structure on the inside and out. Each body is built for movement and action, its parts governed by a central control system – the brain.
Like any complex machine with its many intricate parts, there is a delicate balance. Working together, the body stays interconnected and functioning properly.
When any part malfunctions, the problem seldom stays within its own realm. Other areas are typically affected, which is what research is finding when it comes to the health inside your mouth, or your oral health.
For decades, it has been shown that the bacteria of periodontal (gum) disease can enter the bloodstream through tears in weakened gum tissues. Research has found that this bacteria can trigger harmful reactions.
For example, the bacteria can trigger inflammation that sets into motion risks factors connected to arthritis and diabetes. Some cancers have also been correlated to this bacteria. Heart disease and high blood pressure been as well.
Stroke, too, is among the long list of serious health problems associated with the potent bacteria of gum disease. 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).
Say the word “stroke” and people immediately think of a deadly or debilitating, disfiguring episode that may never be recoverable. Strokes are the third leading cause of death in the United States.
There are several types of strokes. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. These cause death in about 50 percent of cases.
However, most strokes are Ischemic strokes, caused by an abrupt blockage of arteries leading to the brain. These occur when the brain’s blood vessels become narrowed or blocked, severely reducing blood flow.
Blocked or narrowed blood vessels are caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through your bloodstream and lodge in the blood vessels in your brain.
In one study, 265 patients who experienced a stroke between 2015 and 2017 were followed. Researchers noted that large artery strokes – those located inside the brain – were twice as common in patients with gum disease as in those without gum disease.
What connection could gum disease bacteria have with arteries in the brain?
Let’s step back and look at the makeup of bacteria found within gum disease.
It all begins when plaque, the sticky film that builds up around teeth, is allowed to remain and multiply. In the meantime, the plaque found in blood can accumulate inside arteries. Known as atherosclerosis, this fatty plaque is the hallmark of coronary artery disease.
People with gum disease have 2 – 3 times the risk of having a heart attack, stroke, or other cardiovascular event. Still, finding a direct connection has yet to be determined. Although researchers have taken into consideration factors like smoking or a poor diet, there is an emerging concern that gum disease may be a factor – on its own – when it comes to heart disease.
Gum disease is an inflammatory disease that starts as gingivitis, the initial stage of periodontal disease. This causes gum tissues to turn red, swell and bleed sometimes when brushing. Untreated, gingivitis will progress to periodontitis, advanced gum disease.
The inflammation of periodontitis can destroy tissue and bone in the mouth, causing gums to separate from the teeth. This separation allows bacteria to infect the gums, and, over time, can lead to tooth loss.
Although we recommend that people react promptly to signs of gum disease, we also felt it beneficial to provide the signs and symptoms of stroke (for you or someone else). These include:
• Trouble speaking and understanding what others are saying. This may include confusion, slurring or having difficulty understanding speech.
• Paralysis or numbness of the face, arm or leg, typically on one side of the body.
• Vision problems in one or both eyes. This may cause blurred or blackened vision in one or both eyes, or seeing double.
• Headache, which may be sudden and severe. This may cause vomiting and/or dizziness.
• Trouble walking, sudden dizziness or loss of coordination.
Some studies indicate that treating gum disease (with other stroke risk factors) could reduce your risk for stroke.
While the direct path of gum disease to stroke may not be known at this time, research has clearly shown that the bacteria of periodontitis is harmful far beyond the mouth.
If you would like a periodontal evaluation, call our Asheville periodontal dental office at 828-274-9440. As a periodontist, my specialty is the treatment of all stages of gum disease. Through our advanced skills and technology, we can restore your smile to a healthy state and give your overall health a leg up!
What You Eat & Drink May Be Compromising Your Oral Health
Posted on Mar 05, 2020 by William J. Claiborne, DDS MS
Everyone would like to have healthy bodies and brains. We all know that the best way to enjoy a full, active life is to eat a nutritionally balanced diet, get regular exercise, have periodic screenings and checkups, and stay socially involved.
Yet, in our attempts to live as we should, things like improper movements while exercising or an overloaded social calendar can actually backfire on us, having negative results. Sometimes, it’s what we don’t know in our quest for bettering our lives that can lead to damaging consequences.
Take, for example, your diet. Do you squeeze lemon in your water? Do you relax with a glass of wine each evening? Are you a chocolate lover who has switched to dark as a healthier choice?
Although these are all good for you in some ways, when it comes to your teeth and gums, they can cause problems over time. Knowing what can occur may save you much in costly dental treatment in the future.
There are a number of foods and beverages that contribute to periodontal (gum) disease, cavities, and tooth loss. Some may even surprise you, which include:
Caffeine: Caffeinated beverages such as coffee, tea, colas, and many energy drinks can have a drying effect on oral tissues. Having “dry mouth” means there is insufficient saliva flow. This leaves the mouth without its natural ‘rinsing’ agent, which is what helps to flush out bacteria to maintain manageable levels. Without this, oral bacteria have an environment where they can rapidly breed and thrive. Since bacteria accumulation is the origin of most oral problems, this heightens the risks for your oral health.
Wine: Although wine (especially red) is believed to be a healthy drink, it is the way it is consumed that makes it a particular problem for teeth and gums. Whenever you eat or drink something, an acid attack begins in the mouth. While this is an initial part of digestion, this acid is highly potent; so much that it can soften tooth enamel for up to 30 minutes after. This makes teeth more prone to decay. Because most people drink wine in sips over time, this merely extends the acid surge period. When wine’s acidity combines with digestive acids in the mouth, you place teeth at a doubly higher risk for decay. (This also applies to any alcoholic beverage, especially drinks with sweetened mixers.)
Citrus & Acidic Foods & Beverages: The acidity in citrus (such as oranges, lemons, and grapefruit) can be tough on tooth enamel and tender gum tissues. This also includes tomatoes and tomato-based foods such as spaghetti sauce, catsup, salsa, etc. that can have a highly acidic effect.
Sugar & Carbohydrates: Globally, Americans are the leading nation for sugar consumption. We also love our carbs, which essentially break down as sugar in the mouth. Oral bacteria love these foods, too, because they supercharge their ability to reproduce. Because many sweet and carb-laden foods stick to teeth longer, their ability to cause damage is even greater.
Snacking: As mentioned earlier, eating or drinking triggers an acid attack in the mouth. This means for every sip of cola or granola bar bite, an acidic bombardment occurs in the mouth for approximately 30 minutes. When the mouth endures these frequent acid attacks, the damage to precious tooth enamel will catch up to you in the form of cavities.
Research has shown that the health of teeth and gum tissues is intricately connected to your overall health. Serious diseases have been linked to the bacteria of gum disease. These include heart disease, stroke, diabetes, arthritis, some cancers, preterm babies, impotency, and Alzheimer’s disease. These bacteria, once in the bloodstream, trigger serious reactions that are obviously harmful far beyond the mouth.
Start by reading these tips on maintaining a healthy mouth…
• When snacking, eat what you wish in a brief amount of time rather than pace eating over an extended time.
• Be conscious of what alcohol you drink. Try to limit your drinks to 1 or 2 a day and omit sweet mixers. Between each drink, take gulps of plain water and let it linger in the mouth for a few seconds before swallowing. Or, swish in the bathroom between each drink. This helps dilute oral acids and rinse them from the mouth before they can damage tooth enamel.
• Brush at least twice a day and floss daily. By removing bacteria that has accumulated in the mouth, you’ll help to decrease the risk for gum disease and cavities. Although many people feel wine is a healthy drink, remember – it is highly acidic. When this acidity mixes with oral acids, your mouth is bombarded with a potent assault strong enough to soften tooth enamel.
• Limit sugar and snacking. If you like a sweet treat during the day, choose an apple or wait until a meal and have the treat while an acid attack is already underway. This will help you avoid triggering a new one.
Having a healthy mouth will help you to smile more confidently and give your overall health a leg up by minimizing bacteria that originate in the mouth.
If you have signs of gum disease (tender, bleeding gums and frequent bad breath), you should see a periodontal specialist as soon as possible. Gum disease does not improve without treatment and is the nation’s leading cause of adult tooth loss.
Call 828-274-9440 to schedule an appointment.
Aging Adults Need Extra Measures To Prevent Gum Disease, Tooth Loss
Posted on Feb 17, 2020 by William J. Claiborne, DDS MS
Whether visiting a primary care physician, ophthalmologist (eye doctor), dermatologist, or orthopedist, adults in the over-50 category often hear the same comment from their doctor.
“You’re getting older so…”
As we age, the body begins to succumb to wear and tear. The skin sags, bones weaken, joints ache, hearing dulls, and eyesight wanes. More precautions and measures are advised to keep the body operating comfortably and efficiently as we age.
The same is true for your teeth and gums.
Although people tend to react to an odd spot on the skin or blurry vision, things like having a frequent ‘dry mouth’ or gum recession are often brushed off as temporary or just a normal part of growing older.
Yet, the hazards of ignoring the signs and symptoms associated with gum disease and tooth loss should never be taken lightly. Research shows that your OVERALL health is dependent upon a healthy mouth and proper function in biting and chewing.
Here are some typical oral challenges experienced by seniors:
• Having a dry mouth: The tissues inside the mouth need to be kept moist. Saliva flow is designed to do this. However, with age, the flow of saliva is less plentiful. Just as the skin and hair get drier with age, the mouth endures this same consequence. When saliva flow is less efficient at rinsing bacteria from the oral cavity (inside of the mouth), bacteria grow at a more rapid rate. This means bacteria accumulation occurs more frequently than twice-a-day brushing can control.
We advise drinking plenty of filtered water throughout the day, minimizing caffeinated drinks that are drying to oral tissues (coffee, tea, colas), and using an oral rinse twice a day that is formulated to replenish oral moisture. Alcohol and smoking are especially drying to oral tissues. Be especially committed to maintaining adequate oral moisture if you smoke or drink.
• Less efficiency with at-home oral hygiene: Aging causes the fingers to be less nimble and stiffens joints. This is a particular challenge when it comes to brushing and flossing. Angling a toothbrush to reach all areas in the mouth and proper flossing maneuvers require manual dexterity that becomes less capable when the rigors of aging are involved.
We advise using an electric toothbrush 2-3 times a day. Flossing can be done using an electric water flosser. However, we still recommend manual (string) flossing where you can reach. Keep in mind that crowding of natural teeth (which tends to worsen with age) creates particular challenges for reaching nooks where bacteria hide and breed. Use extra time to ensure you are reaching those areas when you brush and floss.
• Medications that interfere with oral health: The average adult in the 65-79 age group has over 27 prescriptions filled each year. (https://www.statista.com/statistics/315476/prescriptions-in-us-per-capita-by-age-group/). Although your health may dictate taking these drugs, it is wise to be aware that some can be detrimental to your oral health.
For example, Coumadin, a commonly prescribed blood thinner, can cause more bleeding during certain procedures. Too, many meds have the side effect of oral dryness. Some prescribed for osteoporosis, bisphosphonates (known by Fosamax, etc.) have been linked with jaw osteonecrosis. The risk for jaw necrosis, or death of the jaw bone, is highest with procedures that directly expose the jaw bone, such as tooth extractions and dental implant placement.
Some herbal supplements can also cause side effects for some dental patients. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting. Be sure to provide a complete list of ALL medications you take (including vitamins and herbal supplements) at each appointment. This enables us to tailor your treatment to your specific needs.
• Hormonal changes: Post menopausal females are at higher risk for gum disease and subsequent tooth loss due to declining estrogen levels. Thus, these women have greater risk for bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is bone loss of the jaw, it can result in tooth loss. Receding gums are a sign of this bone loss since more of the tooth surface is exposed to the causes of tooth decay.
Why are your teeth and gums so important as you age?
As a periodontist in Asheville for over 30 years, I’m still surprised by the number of people who assume that losing natural teeth is to be expected with age. Yet, I see many patients who have kept the majority of their natural teeth well into their 80’s and 90’s.
Although dental implants are excellent replacements for missing teeth, there is nothing as good as the teeth God gave you. They’re referred to as “permanent” teeth for a reason; they were intended to be just that. Regardless of the replacement method, the ability of natural teeth to support neighboring teeth and provide stimulation to the jaw bone is unsurpassed.
Having the ability to comfortably and efficiently bite and chew is vital to having a healthy body. When dentures or partials compromise the ability to eat a diet of healthy foods – and chew food properly – gastrointestinal problems are common.
Too, bacteria overgrowth in the mouth is the cause of gum disease. Periodontal disease is the nation’s leading cause of adult tooth loss. Its bacteria can also enter the bloodstream, causing inflammatory reactions far beyond the mouth.
Advanced gum disease bacteria has been linked to a number of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.
Obviously, maintaining healthy gums and keeping your natural teeth is important. If you’ve experienced tooth loss, we can replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing.
If your gum health needs improvement or there are signs of gum disease, we can structure a program that restores healthy gums and helps you maintain your oral health between visits.
Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:
• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath
When these indications exist, it is important to seek periodontal treatment as soon as possible. Gum disease only worsens without treatment, requiring more time and expense to rid this serious, even deadly, inflammatory disease.
With proper measures, you can enjoy healthy gums and natural teeth throughout your lifetime. Call 828-274-9440 to schedule a periodontal examination or ask for a consultation to get to know us. New smiles are always welcome!
A Periodontal Specialist Explained
Posted on Dec 13, 2019 by William J. Claiborne, DDS MS
Occasionally, I meet someone new who is unfamiliar with my specialty. Although a periodontist may seems to be a “behind the scenes” specialist, our focus actually has an upfront role in your oral health, and beyond.
A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school.
In addition to having advanced training in the latest techniques for diagnosing and treating periodontal disease, a periodontal specialist is also trained in performing cosmetic procedures that involve gum tissues, such as correcting a “gummy smile”.
Periodontists often treat more problematic periodontal cases, such as people with severe gum disease or have a complex medical history. A periodontist offers a wide range of treatments, such as scaling and root planing (cleaning the infected surface of the root) or root surface debridement (removing damaged gum tissue).
Periodontal specialists can also treat patients with severe gum problems using a range of surgical procedures.
In addition, periodontists are specially trained in the placement, maintenance, and repair of dental implants.
During the initial appointment in our Asheville periodontal office, we typically begin with a review of the patient’s medical and dental histories. This information is important so we are aware of medications being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.
During the examination, we check the patient’s gums to look for gum line recession. We will also assess how the teeth fit together when biting, and check for any loose teeth. An important part of this exam is in the measuring of spaces between gum tissues at the base of teeth.
Using an instrument called a probe that is gently positioned between specific points surrounding each tooth, we determine the depth of periodontal “pockets”. These measurements help us assess the health of your gums. Images (x-rays) may also be taken to revealsthe health of the bone below the gum line.
Periodontal disease, also referred to as “gum disease,” often exists without an individual being aware of its presence. In its early stage, gingivitis, some people even assume that symptoms, such as seeing blood in the sink when brushing, are normal.
Obvious symptoms, such as pain, may not appear until the disease has reached an advanced stage. 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 are receding (pulling away from the teeth) or make the appear teeth longer than normal
• 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 you bite
• A change in the fit of partial dentures
If you notice any of these symptoms, be sure to contact your dentist or periodontist without delay. Gum disease will only worsen without treatment.
Who Should See a Periodontist?
Some patients’ periodontal needs can be managed by their general dentist. However, patients who are experiencing signs and symptoms of moderate or severe levels of gum disease or have more complex cases receive the most efficient and effective care through team treatment between a general dentist and periodontist.
Restoring your gums to a healthy state is important! As research continually shows, gum health is intricately connected to overall health. Oral bacteria of periodontal disease has been linked as a trigger for more and more chronic diseases, including heart disease, some cancers, stroke, memory loss, diabetes, and arthritis. Having prompt periodontal treatment by a trained periodontal specialist may lower the risk for more serious, and even deadly, diseases and health conditions.
If you are experiencing any of the symptoms associated with periodontal disease, a referral is not required. Call 828-274-9440 and we will be happy to assist you.
If you do not have a general dentist, we can also refer some who are near to you and we know to provide gentle, thorough and appropriate care for their patients’ needs.