Men: Gums Can Impact Erectile Dysfunction (ED) and Heart Health
Posted on Jan 24, 2023 by William J. Claiborne, DDS MS
It may be an awkward subject, but the issue of erectile dysfunction (ED) seems to appear rather frequently via TV commercials. I see ads for pills and medical clinics rather often. Agreeably, it is a problem estimated to affect a rather large percentage of men. For those ages 40 – 70, it affects over 40%. Nearly 70% of men at age 70 are affected.
In no way am I wanting to dissuade a male from medications or seeking treatment. However, as an Asheville NC periodontal specialist, I want to relay an issue that may be a bigger influence in ED than many are aware.
Below are findings of several studies showing that periodontitis (advanced gum disease) to be a significant risk factor for erectile dysfunction. Rather telling is as gum disease worsens, so does erection impairment.
• In a study of 162 males ages 30 to 40, Turkish researchers found that 82 of the participants had normal erection function while 80 who complained of ED, nearly half. Some men in both groups had chronic periodontitis, but the condition was more than twice as prevalent in the ED group. Men with periodontitis accompanied by decayed or missing teeth had the greatest level of ED.
• In another study conducted at the University of Granada School of Dentistry, 80 male participants who had severe gum disease were more than twice as likely to suffer from erectile dysfunction. This was true even after adjustments were made for other issues that could distort the findings. In the study, 74% of the participants with ED also presented with chronic periodontitis.
• Israeli researchers conducted a survey of the erection function of 305 men with an average age 40. The participants were given a thorough examination of their gums. Those with chronic periodontitis had the greatest risk of ED.
• 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.
Men with gum disease showed a higher risk of developing impotence due to inflammation associated with periodontal disease. This inflammation has been known to damage to blood vessels, which can lead to impotency. Men younger than 30 or older than 70 are especially at risk.
A separate study found that men with a history of gum disease are 14% more likely at risk for cancer than men with healthy gums. Specifically, men with periodontal disease are 49% more likely than women to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.
For over two decades, medical researchers have closely focused on inflammation in the body and its power to activate health problems, heart and cardiovascular diseases in particular. However, men have notably higher risks in some areas in addition to ED, one being the heart.
When it comes to ED and heart disease, the connection to periodontal disease has emerged as an independent risk factor. Cardiovascular disease raises risk for ED. Thus, anything that increases the risk for cardiovascular disease (such as smoking, obesity, chronic stress, high cholesterol, high blood pressure, and chronic sleep apnea) also raises the risk of ED.
Men, especially, need to know that they should be committed to having healthy teeth and gums. Research has found that periodontal disease is higher in men (56.4%) than in women (38.4%) – an 18% difference. https://www.perio.org/consumer/gum-disease-and-men
According to a survey by the Centers For Disease Control & Prevention (CDC), only 66% of males brush their teeth twice or more a day compared with 86% 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% in the survey claim to floss daily. Only 1 out of 3 assumed that seeing blood in the sink when brushing is normal and unaware of it as a sign of periodontal (gum) disease.
Regardless of gender, over time an inadequate daily oral hygiene leads to an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even greater.
This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to rinse away bacteria at sufficient levels, the accumulation runs rampant.
As a Western NC periodontist, I have an up-close view of the damaging affects of insufficient oral hygiene. It often results in tooth loss, which is (contrary to many perceptions) NOT a natural part of the aging process. Having natural teeth for a lifetime is more than achievable and has even been shown to add to one’s lifespan (by up to ten years).
If you haven’t been fully committed to your oral health, there is no better time to begin than the present. Start the year with a thorough periodontal examination. Call 828-274-9440.
If dental fears have caused you to delay or avoid having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. Too, many treatments can include oral or I.V. sedation (sleep dentistry, or “twilight sleep”).
And, if financial constraints are an obstacle in receiving treatment, 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.
Get Dental Fear Out Of The Way and Enjoy A Healthy Confident Smile
Posted on Jan 18, 2023 by William J. Claiborne, DDS MS
It’s a new year. Hopefully, this new beginning has given you renewed determination to conquer challenges that have held you back from living the life you want.
While some people want to lose weight and others wish to learn something new, I tend to see many people at the first of each year who wish to achieve a healthy, confident smile. A large number of these people have been less-than-successful in the past because of having dental fear.
Dental fear and high anxiety associated with dental visits is not uncommon. These fears are often borne from a traumatic incident in the patient’s past. Or, in some cases, it exists for unknown reasons. Too, certain smells, sounds or sights can trigger reactions that evoke fear at even mere thoughts of dental visits.
Oral health is an integral part of your overall health. For decades, studies have proven a direct contact between poor oral health and disease related to other organs. By neglecting dental hygiene, people are at greater risk of developing (or the worsening of) serious diseases and conditions. To avoid these risks, good dental care at home and having regular dental check-ups help empower adults in improving oral health and wellness.
As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Certainly, avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss. However, the repercussions of poor oral health can wreak havoc on one’s overall health.
It’s not uncommon for adults who avoid dental visits to feel they are doing a “good enough job” at maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass regular dental cleanings and exams. Yet, even the best of at-home dental hygiene can be insufficient.
Even people who feel they are dong a good job at the sink can easily miss areas of bacteria accumulation. Grooves in the tops of teeth and the tight nooks formed by crooked teeth become ideal hiding spots for bacteria growth.
Oral bacteria reproduce rapidly and, when at a certain point, can trigger inflammatory reactions. In addition to being the origin of cavities and periodontal (gum) disease, these reactions can extend far beyond the mouth (some of which are listed below).
Gum disease is the nation’s leading cause of adult tooth loss. The same infectious bacteria that destroy gums and structures that support natural teeth aren’t confined to the oral proximity. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.
Research has correlated oral bacteria to an extensive list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. For those who avoid dental care due to anxiety or fear, knowing this is not necessarily going to quell their anxiety. However, allowing dental fear to prevent you from achieving a healthy smile can increase health risks you may not realize.
Just how bad are the risks?
Dementia & Alzheimer’s disease: Gum disease occurs when infection of the oral tissues develops. It causes bleeding gums, putrid breath odor, loose teeth, and tooth loss. Oral bacteria and the inflammatory molecules that develop can enter the bloodstream, making their way to the brain. Previous lab studies have suggested that this is a potential risk factor in the sequence of events that lead to dementia.
Alzheimer’s disease is the most common form of dementia that destroys memory, shrinks the brain, and affects the brain cells to die. It degenerates the functioning of mental health, which leads to memory loss and confusion. During Alzheimer’s, loss of appetite may worsen, eventually giving rise to oral health problems. The bacterium P. gingivalis appears to migrate from the mouth to the brain of some individuals as they age with a significant proportion of subjects developing Alzheimer’s disease.
Cardiovascular disease: A potential association exists between atherosclerosis (i.e. plaque deposition in blood vessels) and periodontal pathogens. There is a broad base of common genetic variants which increase both the risk of cardiovascular disease and the risk of periodontitis.
Endocarditis: Bacteremia (defined as the entry of bacteria into the blood stream) is a precondition for endocarditis. The vast majority of bacteremia do not cause endocarditis, even in patients at high risk. However, in high-risk patients, the more frequently and the more intensely bacteremia occurs, the greater the likelihood of endocarditis. Periodontal therapy has been shown to have a protective effect in people at risk of endocarditis.
Erectile Dysfunction: In the U.S., an estimated 18% of males have erectile dysfunction (ED). Men over the age of 70 are more likely to have ED compared to 5% between ages 20 – 40. Studies have shown an association between gum disease and pancreatic cancer. From analyzed data of five studies between 2009 – 2014, studies followed 213,000 participants aged 20 – 80.
Each study found erectile dysfunction was more common among men with chronic periodontitis, particularly for those younger than 40 and older than 59. After accounting for other health factors, erectile dysfunction was found to be 2.28 times more common for men who had advanced gum disease than for men without it.
Stroke: In one study of 265 stroke patients, researchers found that patients with gum disease had twice as many strokes due to thickening and hardening of brain arteries as patients without. Additionally, patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.
In a separate study of over 1,100 patients who had not experienced a stroke, researchers noted that 10% had severely blocked brain arteries. They also found that patients with gum inflammation were twice as likely to have moderately severe narrowing of brain arteries.
Arthritis: For decades, it was perceived that RA (rheumatoid arthritis) patients had such a high risk of gum disease due to poor oral hygiene because of dexterity problems with using a toothbrush. However, more recent studies now show that gum disease is actually a risk factor for arthritis.
While genetic factors certainly contribute to greater RA susceptibility, the true source has been determined to be inflammatory reactions. This inflammation is triggered primarily by bacterial infections, with oral bacteria being a significant contributor to inflammatory arthritis.
Researchers found that people with severe periodontal disease also had severe rheumatoid arthritis. Patients with the most plaque, bleeding and gum tissue breakdown had worse RA by all measures, including disease activity and inflammatory markers. Other studies have found that even with treatment, RA patients with periodontitis continue to have worse arthritis symptoms and are 50% less likely to be in remission.
The relationship between gum disease and arthritis isn’t just seen in adults. Kids with juvenile idiopathic arthritis (JIA) have inflammatory mouth bacteria not found in their healthy peers. Different types of bacteria seem to correspond to specific aspects of JIA.
Some are associated with higher disease activity and others with a greater number of affected joints.
Diabetes: It has been known that acute inflammation may lead to poor glycemic control. This is due to the fact that infections reduce the uptake of glucose into cells, and endotoxins and inflammatory mediators reduce the efficiency of insulin. Due to these pathways, periodontitis (advanced gum disease) has long been regarded as a risk factor for poor blood glucose control in diabetes patients.
Pre-Term Babies: The elevated hormone levels during pregnancy create a higher vulnerability to gum disease; the reason about half of pregnant females experience swollen, red and tender gums that bleed while brushing. Known as Pregnancy Gingivitis, the gums are more susceptible to inflammation, thus more sensitive to the bacteria of gum disease.
Studies have shown that gum disease increases the risk for preterm delivery (before 37 weeks) and low birth weight babies. Gum disease also increases the risk for poor obstetrical outcomes, late miscarriage and pre-eclampsia. For example, the preterm birth rate for women without periodontal disease is approximately 11% compared to nearly 29% for females with moderate to severe gum disease.
Through tears in gum tissues, oral bacteria can enter the bloodstream. Once this bacteria reaches placental membranes, it can trigger inflammation that can cause preeclampsia or labor.
While these health concerns are all reasons to renew your commitment to achieving and maintaining a healthy smile, the image of having a terrific smile you want to share often is an added perk of having good oral health. As a periodontist, I have advanced skills in the treatment of all stages of gum disease as well as the placement of all types of dental implants.
If dental fear is holding you back, let us help your 2023 be the year you take your smile back! Begin by understanding that having discomfort or pain is NOT a part of today’s dentistry. In our Asheville periodontal dental office, we have advanced skills and technology that enhance comfort and minimize treatment time.
Here, we make patient comfort a priority at every visit. We have even designed our reception area to pamper you from the moment you enter.
We offer a private consultation room for patients as well. In this room, we can discuss your treatment and answer your questions in a comfortable setting. This allows patients to become better informed about their treatment needs and options versus communicating while they are seated in a treatment chair.
Our surgical suite offers a rather unique setting for a periodontal office. A large window provides beautiful mountain views, very soothing to our patients. In addition, we offer oral sedation as well as I.V. sedation (twilight sleep) for most procedures, if desired.
Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation places the patient in a deeper sedative state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are monitored with advanced safety equipment throughout treatment.
Our entire staff provide a unified team, each bringing a sincere level of compassion and commitment to excellent care. While the doctors involved in your care are top-notch, I must admit that our staff are the pros at making our patients feel truly pampered.
When patients realize that our goal is to provide exceptional care in TOTAL comfort, they relax. When they experience this, they relax even more. When they experience this more than once, a sense of trust is born. When patients trust us, they feel they no longer need to avoid dental care. Like everyone, fearful patients desire a healthy, confident smile. Once the obstacle of fear is removed, their ability to achieve that is greatly heightened.
If you or someone you know has fear that has prevented needed or desired dental care, schedule a consultation appointment. This will take place in our private consultation room. Here, we can discuss your needs and concerns and have your questions answered thoroughly. From there, you can determine what pace is best for you.
Call 828-274-9440 to learn more. Our friendly phone staff will make you feel good from the very beginning!
Boost Immune System By Investing In Gum Health
Posted on Nov 17, 2022 by William J. Claiborne, DDS MS
There is no argument that the price of about everything has gone up and up over the past couple of years. The challenges that most individuals face at this time have been significant for some people but felt by about all.
Yet, there are still reasons to “spend less now so we’re not spending more later.” This is true with things such as auto maintenance, home repairs and taking good care of our health. A signifiant part of maintaining good overall health is having good oral health. The key, however, is to make the investment while the costs are still low, and avoid the big expenses later to pay for repairs and more extensive treatment.
I’d like to point out the need to bolster our immunity system, brought front-&-center during the pandemic, is actually supported by your oral health. Although the Covid virus continues to be a threat, the experience has made populations more aware of the benefits of vaccines and healthy habits such as hand-washing. Still, it is in our immune system that makes people more or less vulnerable.
By investing in having healthy gums, the immune system is actually supported more than is largely known. I’ll explain.
The bacteria in the mouth, or “oral cavity,” is intricately connected to your overall health; so much so that “bad” oral bacteria can disrupt the healthy balance in the digestive system. This bacteria comes from oral plaque, which is a cesspool of sorts formed from bacteria accumulation.
As a layer of biofilm, plaque coats teeth and gums. It is the sticky coating you feel in your mouth when you wake up, during which time the bacteria has had an opportunity to amass during sleep. Plaque, mot removed, becomes tartar. This hardened mass of oral bacteria continues to grow, doing damage in the mouth and far beyond.
Researchers have tracked oral bacteria as it enters the bloodstream. This occurs through weakened gum tissues, allowing the bacteria to travel throughout the body. Studies have shown that the bacteria are able to activate or worsen the development of a number of serious health problems.
These include heart disease, stroke, arthritis, diabetes, preterm babies, some cancers, erectile dysfunction and dementia. Research is currently being conducted to further the connections suspected between periodontitis to Alzheimer’s disease.
How does oral bacteria become destructive? Gingivitis is the initial stage of gum disease. Symptoms typically include gums that are tender in spots and some bleeding when you brush. These are warning signs that signal an immediate need for attention.
Periodontal (gum) disease and (often) its subsequent tooth loss are, simply put, products of bacterial overload in the mouth. The mouth is constantly being supplied with sustenance for these organisms. Bacteria are able to thrive through food that enters, especially sugars, and other bacteria-laden items put into the mouth.
The bacteria that cause cavities that feeds on sugar from the foods and drinks you consume. This weakens tooth enamel due as bacteria convert sugar into acids. As bacteria thrive, they are able to reproduce very rapidly.
When bacteria levels become more than the immune system can tackle, infection can set in. Accumulation of bacteria can evolve into gum disease, which is an inflammation that attacks teeth, oral tissues and the bone structures that support tooth roots.
Gum disease symptoms are those more prominent than gingivitis. These include sore gums that bleed when brushing, persistent bad breath, gums that pull away from the base around teeth, gums that darken in color.
As it worsens to the stage known as periodontitis, pus pockets may form on the gums at the base of some teeth. In advanced stages, gum disease causes teeth to loosen and eventually require removal.
The reason that 6-month dental check-ups and dental cleanings is to remove tartar buildup before damage can occur. Your hygienist and dentist can look for signs of gum disease so measures can be taken before the disease explodes into the need for more costly treatment to resolve the problem. Since gum disease is the nation’s leading cause of adult tooth loss, the associated expenses of replacing teeth can also be avoided by maintaining good oral health.
Prevention begins at home: Begin by twice daily brushing with a soft bristle tooth brush and use a fluoridated tooth paste. Brush for at least two minutes each time. Floss daily. Be sure not to pop the floss between teeth to avoid damaging tender gums. Move the floss in a back-&-forth motion between teeth to ease it down so you can scrape the sides of each tooth.
You can remove a tremendous amount of oral bacteria by using a tongue scrapper daily. Or, brush your tongue with your tooth brush at the end of each brushing. This helps to dislodge bacteria that is embedded in the grooves of the tongue.
Drink lots of water during the day. This will help keep saliva flow at ample levels. Saliva is designed to move oral bacteria from the mouth on a consistent basis. Oral dryness is the enemy. Avoid foods and beverages that are drying to oral tissues such as caffeine, alcohol, and spicy foods. Also, try to minimize the amount of sugar and carbohydrates you consume. These foods amplify the reproduction of oral bacteria.
Oral dryness gives bacteria a favorable environment for reproduction. The chemicals in cigarette smoke are very drying to oral tissues. If you smoke, consider using an oral rinse that replenishes moisture in the mouth. Some oral rinses are specifically designed for moisture.
Lowering treatment costs begins with early care: If you have delayed or avoided regular dental care, it is recommended that you begin by having a periodontal examination. A periodontist is a dental specialist who can determine your precise level of gum disease and the most appropriate treatment to restore good oral health. We can detect all stages of gum disease and provide comfortable, thorough treatment to restore your gums to a health state.
If you have lost teeth due to periodontal disease, a periodontist also specializes in the diagnosis and placement of dental implants. This ideal method to replace teeth provides a lifetime solution, making them an excellent investment.
Call 828-274-9440 if you have questions about your gums or if you are experiencing any symptoms associated with gum disease. Also, visit our web site to learn more about our sedation options (including “twilight sleep”) and advanced technology, which often reduces treatment time while enhancing comfort.
Challenges of Aging to Oral Health
Posted on Oct 28, 2022 by William J. Claiborne, DDS MS
Hopefully, the phrase “older and wiser” is one of truth. In all honesty, many adults “of a certain age” worry about being more forgetful, being less energetic and having less stamina. True or not, the aging process forges on for us all!
Aging, of course, comes with certain health challenges. However, these may bring seniors more determination to “age gracefully.” Today’s older adult seems to be more active and health-conscious than that of our ancestors. Aging adults now have greater knowledge of contributors to poor health. Most try to eat healthier, have periodic physicals and screenings, and include physical activity in daily regimens.
Over the years, all ages have had access to the findings of research reporting on how the health of the mouth plays a significant role in overall health. For example, the bacteria of periodontal (gum) disease are shown to potentially activate or worsen the development of a number of serious health problems.
For seniors, these health problems are especially challenging since a major one affected is that of the immune system. This is of high concern for seniors since their immune systems are typically operating at less-than-peak levels (often complicated by other health problems, such as arthritis or high blood pressure).
Over 70% of our immune response comes from the cells within the gut. The “good” bacteria in the gut is crucial to efficient digestion. Yet, it can be compromised due to the presence of gum disease bacteria.
We now know that the inflammatory nature of infectious oral bacteria can interfere with the healthy bacteria in the gut. This causes the gut (and well as other systems in the body) to function less efficiently. Research has correlated gum disease bacteria to heart disease, stroke, high blood pressure, diabetes, arthritis, some cancers, erectile dysfunction and even Alzheimer’s disease.
According to the Centers of Disease Control & Prevention (CDC), over 47% of American adults over age 30 have gum disease. It is estimated that 64% of adults ages 65 and older have either moderate or severe periodontitis.
Gum disease, an inflammatory disease, which can trigger inflammation elsewhere in the body. Studies have shown that by reducing the level of these bacteria, however, can improve other inflammation-based health conditions (such as arthritis, prostatitis, and psoriasis).
For instance, diabetes has a clear relationship with periodontal disease. Studies show that treating one condition positively impacts the other. By the same token, uncontrolled inflammation levels of one can worsen inflammation levels in the other.
Therefore, treating inflammation may help manage periodontal diseases and also help manage other chronic inflammatory conditions.
For seniors, oral dryness is one of the biggest influences in developing gum disease. Like the skin and joints, the body’s moisture and lubrication wanes with age. Although poor oral hygiene is a key factor when it comes to bacteria in the mouth, a dry mouth is a common contributor to bacterial growth.
In addition to aging, dry mouth is particularly challenging for seniors because it has many causes, including:
• A side effect of many medications (including prescription and OTC)
• Radiation therapy, especially for head and neck cancer
• Mouth-breathing, which may be due to nasal congestion or snoring
• Medical conditions, such as diabetes, Alzheimer’s disease, stroke and Sjogren’s syndrome
While important for all ages, older adults should be especially committed to their oral hygiene, including twice daily brushing and daily flossing. In addition, you can support saliva flow by:
• Drinking plenty of plain water throughout the day
• Avoiding (or limiting) caffeinated beverages, such as coffee, tea and colas
• Using an oral rinse designed to replenish moisture in the mouth (available OTC)
• Being aware of medications that have an oral dryness side effect (increase your water intake and use a daily rinse to replenish oral moisture)
• Taking steps if you snore or breath through the mouth during sleep (ask your physician for suggestions)
• During a cold or sinus condition that increases mouth-breathing, be especially committed to your oral hygiene routine at home (brushing and flossing) and increase water intake
• Following each alcoholic drink (including beer and wine) with gulps of water as these are very drying to oral tissues
• Taking all steps mentioned above if you smoke cigarettes, “chew”, or vape
It is also important to know the signs and symptoms of periodontal (gum) disease. It begins with gingivitis, which causes the gums to become tender and swollen. When brushing, blood may be present in the sink when rinsing. Bad breath becomes persistent and the gums may turn red in color.
As an Asheville periodontist, I believe that the first step for adults who want to improve their oral health is by being informed patients. This generally leads to an individual who is committed to achieving and maintaining a healthy smile.
A good resource on maintaining good oral health is the web site of the American Academy of Periodontology: www.perio.org (go to Patient Resources). If you are experiencing any of the symptoms associated with gum disease as mentioned above, call our Asheville periodontal dental office at 828-274-9440. Gum disease will only worsen without treatment. (A referral is not necessary.)