Keep The Mouth Moist To Minimize Bacterial Growth
Posted on Jul 22, 2021 by William J. Claiborne, DDS MS
When you think of an environment of a warm, dark, moist space, it would seem to be a perfect breeding ground for bacteria growth. For homeowners, the worry over this is often how easily mold forms in such places.
According to FEMA (Federal Emergency Management Agency), molds are microscopic organisms that thrive anywhere there is a moist environment. Growth can start on a damp surface within 24 to 48 hours.
Molds digest organic material, eventually destroying the material they grow on, and then spread to destroy adjacent organic material. (https://www.fema.gov/pdf/rebuild/recover/fema_mold_brochure_english.pdf)
As an Asheville periodontist, I can’t help but think of the similarities to the mouth. Bacteria in the mouth, when not removed, can multiply and form the sticky film that coats teeth and gums. This is known as plaque.
Like molds, plaque must to be removed to prevent its spread and destructive nature. This is what your twice-daily brushing and flossing regimen is intended to do. When plaque remains in the mouth for roughly 48 hours, it hardens onto teeth. This is tartar and typically forms between teeth or in chunks at the base of teeth.
Essentially, tartar is a hardened mass of bacteria. Like mold, tartar continues to grow if not removed. And, like mold, tartar can cause damage to what it is growing on and spread to surrounding structures.
In addition to a brushing and flossing routine, the mouth has a particular advantage in its ability to control bacteria growth. Saliva is a continual rinsing agent that moves bacteria out of the mouth before the reproductive ability begins or accumulation runs rampant.
However, a dry mouth, which can be the result of a number of factors, means saliva is operating at quite a disadvantage to oral health.
Oral dryness is a natural part of the aging process. It affects about one in five older adults. A dry mouth can also occur from:
• As 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
Mold has an odor. So does oral dryness, which reveals itself through bad breath.
Just as mold can destroy things like drywall, carpets and insulation, an overload of bacteria in the mouth can be destructive to teeth and gums. These living and breeding organisms thrive on gum tissues.
Although saliva is an aid in bacteria control, there is a limit to what the flow is able to manage. When oral bacteria reach a certain level, they cause inflammation in oral tissues. The early stage of this, known as gingivitis, causes the gum to become tender and swollen. When brushing, blood may be present in the sink when rinsing.
Gingivitis, at this stage, can be contained and resolved if quickly addressed. If not, the bacteria will continue to multiply. This creates inflammation in the gums. This means the inflammation has progressed to periodontal disease, which requires treatment since it is now below the gum line.
Beneath the gum line, the bacteria continue their attack on the structures that support natural teeth. This includes the bone structures surrounding tooth roots. At this point, the gums bleed easily and breath odor is persistently bad. The gums become red and swollen and may pull away from the base of some teeth (gum recession).
Resolving gum disease at this point requires a procedure known as scaling & root planing. This allows the dental professional to reach below the gum’s surface to remove the bacteria. More extensive than a dental cleaning, the gum tissues are numbed and the process may require more than one visit to complete.
If the disease is not treated, it will reach the stage of periodontitis. This is an advanced stage of gum disease that is highly infectious and destructive. Because it leaves the gum tissues in such a weakened state, the infection can easily penetrate beyond the gums and enter the bloodstream.
Symptoms of periodontitis are very uncomfortable. Gums turn spongy and breath odor is putrid. Pus pockets appear on the gums and it may become painful to eat. Some teeth may loosen and eventually need removal.
This is where the damage of periodontal disease bacteria becomes even more destructive. As bad as tooth loss is, hold onto your hat…
Because these bacteria can trigger inflammatory reactions elsewhere in the body, researchers have linked them to a wide range of serious health problems.
The bacteria of gum disease have been correlated to heart disease, stroke, some cancers, diabetes, arthritis, and preterm babies. This is rather telling as to the potency of this harmful bacteria and the destructive nature.
When mold in a house that began in one spot is ignored, the destruction spreads. That’s a pretty good reason to tend to the problem before it gets out of hand, right? Proper care for oral health is worth the minor investment of time and money to avoid the destruction that can occur, including keeping the mouth moist to support sufficient saliva flow.
Here are a few pointers to help you maintain oral moisture:
• Keep the mouth moist by drinking plenty of water throughout the day. Watch your limit of caffeine, including coffee, tea and colas.
• If you take medications that have a side effect of oral dryness, ask your doctor about options that may be less drying to the mouth. Or, increase your water intake and use a daily rinse to replenish oral moisture.
• If you snore or breath through your mouth during sleep, talk to your doctor about ways to resolve these problems. It may be as easy as adjusting your sleeping position or adding a side pillow. Or, an oral appliance may be advised.
• When medical conditions (acid reflux, sinus infections, diabetes, bronchitis) contribute to a dry mouth, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.
• Know that alcohol (including beer and wine) are drying to oral tissues. Try to swish with water between drinks or have a glass of water nearby to periodically dilute the drying impact.
• Smoking (cigarettes, cigars, vaping) delivers toxic chemicals into the mouth, with the gums taking the first brunt. Be aware of this added risk to the drying effects and take added measures to keep your mouth clean and moist.
I hope you never need the specialty care of a periodontist. However, should you find yourself in need of our care, we place a priority on comfort and ensure a respectful, compassionate approach to each individual.
In our Asheville periodontal office, we provide sedation (“twilight sleep”) for patients during many procedures, if desired. Our office also features some of the most advanced technology available in dentistry, including cone beam imaging, laser dentistry, and computerized guidance for dental implants and other procedures.
Begin with a consultation appointment by calling (828) 274-9440. New patients are always welcome and a referral is not always needed.
Arthritis? Recommit Yourself To Having Good Oral Health.
Posted on Jun 20, 2021 by William J. Claiborne, DDS MS
According to the Centers For Disease Control & Prevention (CDC), over 47 percent of American adults are living with some level of gum disease. For those age 65 and older, this figure jumps to 70 percent.
These concerning statistics are nothing to ignore. Although gum disease is so common, it increases risks that go far beyond the mouth. Over the years, research has tracked many diseases and conditions that correlate with gum disease bacteria. The inflammatory reactions triggered by these infectious bacteria have been linked to heart disease, stroke, some cancers, diabetes, preterm babies, and impotency.
Research has also shown a notably close relationship between gum disease and rheumatoid arthritis (RA). These studies have been ongoing for many years, and the findings should be concerning to all adults.
RA is a debilitating, painful disease that destroys joints. RA often emerges gradually, initially causing morning stiffness and weak, sore muscles. As inflammation from RA worsens, joints become swollen. Joints become achy and stiff most often in the fingers, wrists, elbows, hips, knees, ankles, toes and neck. Unfortunately, there is no cure for RA.
On a positive note, studies have shown that treating RA patients who have periodontal disease helps to improve RA symptoms. It is felt that this occurs because of a lighter burden of oral inflammation to the body’s immune system.
Below are some of the findings you may want to review. First, however, it’s important to understand how gum disease begins and some signs and symptoms.
In the initial stage of periodontal (gum) disease, known as gingivitis, the gums may bleed when brushing. Bad breath is more frequent and the gums may be tender or swollen. As the disease progresses, the gums turn red and may pull away from the base of some teeth.
Bad breath becomes persistent and pus pockets may form at the base of some teeth. As the infectious bacteria attack the bone structures that support tooth roots, teeth will begin to loosen and may need removal. Gum disease is the leading cause of adult tooth loss in the U.S.
In addition to the devastating damage in the mouth, the infectious bacteria of gum disease can enter the bloodstream through diseased gum tissues, causing the inflammatory triggers that activate serious health problems, such as RA.
Years ago, researchers noticed an RA-perio trait among people with rheumatoid arthritis. While RA sufferers had gum disease more often, they observed that people with gum disease tended to have RA more often.
As researchers delved deeper into the connection, it appeared that the association is much more complicated than previously thought. Findings now suggest that oral bacteria could actually be a cause of rheumatoid arthritis.
In the past, doctors felt that periodontal disease was a result of RA itself since stiff, painful hands make it challenging to maintain good oral hygiene. They also suspected that medications prescribed to treat RA could be a factor since the drugs, which suppress the immune system, inhibited the body’s ability to fight harmful oral bacteria.
Both conditions cause chronic inflammation in tissues that connect to bone with both diseases having a similar inflammatory trigger. Even more similar is the particular species of bacteria found in periodontally-diseased tissues when compared with tissues around arthritic joints. In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis.
In 2017, study findings were released by Johns Hopkins University Division of Rheumatology, which noted evidence that the tissues in the mouth of a periodontally-compromised individual and the tissues of the joint in RA have a number of likenesses. Research has also shown a genetic link between the two.
Above all, these findings reinforce how oral health correlates closely to our overall health. When you consider how the presence of gum disease can significantly increase your risk for serious health conditions, having good oral health should be a priority for every American.
What can you do to lower your risks for tooth loss and contributing to (or worsening) serious health problems? Recommit yourself to thorough oral hygiene at home and having twice-a-year exams and cleanings.
If you have signs of gum disease, have treatment at your earliest convenience. Gum disease will only worsen and requires more treatment time and expense as it progresses.
Call 828-274-9440 to schedule an examination, or begin with a consultation to discuss your needs.
Your Tongue Is A Multi-Tasker!
Posted on May 05, 2021 by William J. Claiborne, DDS MS
With the tongue occupying such a large area inside the mouth (or ‘oral cavity’), you’d think its anatomy would be common knowledge. Because this muscle functions continually without tiring, it tends to be taken for granted. It’s importance to your overall health, however, is unbounded.
To correct a common misconception about the tongue, it is not the strongest muscle in the body. Although it ranks in the top 5 or so, the muscles surrounding the eyes actually have that supremacy. The heart, deemed the hardest working muscle in the body, and the masseter (jaw muscle) are also among those that are the body’s stand-outs.
The tongue does many things. It provides our sense of taste, is vital in pronunciation, moves food around as we chew, and aids in swallowing while helping to prevent certain things from being swallowed.
Not one muscle but a combination of 8, the tongue is coated with papillae. These are the tiny, bumpy protrusions on its surface. They help in various ways but are mostly credited for our sense of taste.
Different areas of the tongue are more sensitive to certain tastes. For example, the tip of the tongue detects sweet to the greatest extent while the sides detect sour.
Papillae also sense touch so that we can feel the form and texture of food.
Saliva helps to keep the tongue moist so it can move around the oral cavity freely. Saliva is also helpful to the tongue by moving bacteria from its surface. However, saliva cannot keep the tongue bacteria-free.
Saliva and food residue can get stuck in the grooves between the papillae, especially on the last third of the tongue. This can create areas for bacterial growth. These bacteria thrive on remains of protein-rich food like fish, cheese or milk.
Here is where, as an Asheville periodontist, I have a particular interest in the tongue. As bacteria accumulate, a whitish film covers the tongue, which also causes bad breath. Keeping bacteria in the mouth to manageable levels is greatly supported by saliva flow.
The tongue’s underside covers two salivary glands of the lower jaw (submandibular glands). These ducts are located where the tongue meets the floor of the mouth.
If you’ve read some of my previous articles, you’ll recall that I’m constantly reminding readers of the hazards of having a dry mouth. Smoking, consumption of alcohol and caffeine, and many medications are all obstacles to the salivary glands being able to function efficiently.
A dry mouth provides a breeding ground for bacteria reproduction. When you consider the amount of bacteria embedded in the tongue’s surface, oral bacteria levels in the mouth can run rampant.
Because the tongue’s surface color can indicate too much oral bacteria, it should be looked at during at-home oral hygiene regimens. It is advised that, after brushing teeth, using the toothbrush to brush the tongue. This can dislodge an enormous amount of bacteria.
Although brushing the tongue tends to be done on the front area, it’s helpful to brush towards the back of the tongue where most bacteria exist (hence, the whiter color and smoother surface). Gagging will stop you from going too far so use that as a guide.
Some toothbrushes have a tongue scraper surface on the back side of the bristles. There are also tongue scrapers available for purchase. These are flexible strips that should be used to scrape from back to front 3 or more times after brushing. Rinsing the scraper is advised after each pass.
To provide even more support in helping the oral cavity control bacteria, an oral rinse can be very helpful. After brushing (for a minimum of 2 minutes) and flossing, swish for 30 or more seconds with an alcohol-free mouthwash. While the intensity of the mouthwash may be greater with initial use, most people notice its easier to swish around the mouth within a week or so.
Low bacteria levels in the mouth make for fresh breath and reduced risk of developing cavities and gum disease. Periodontal disease begins with gingivitis, which causes gum tissues to be tender and bleed when brushing.
Periodontitis, an advanced stage of gum disease, causes red, sore, spongy gums. Other symptoms are persistent bad breath, bleeding easily, gums that loosen from the base of teeth, and teeth that loosen.
Periodontitis can also cause health risks far beyond the mouth. Because these infectious bacteria can enter the bloodstream through tears in the gum tissues, it has been shown to trigger or worsen the development of serious health problems. Some of these are stroke, heart disease, arthritis, Alzheimer’s disease, some cancers, and diabetes.
When it comes to the tongue, remember its important role to your oral and overall health. Keep the mouth moist and its surface clean and your reward will be sweet (without the calories!).
If you are experiencing any signs of gum disease, call 828-274-9440 for an appointment. Gum disease does not go away on its own and will progressive worsen without treatment. Remember – it is the number one cause of adult tooth loss in the U.S.
Flossing – A Valuable Step In Avoiding Gum Disease & Tooth Loss
Posted on Mar 17, 2021 by William J. Claiborne, DDS MS
Adults who wish to stay healthy and active as they age often workout daily, walk at least 30 minutes per day, try to get 7 – 8 hours of sleep each night, and brush their teeth twice a day.
Tooth brushing helps to keep oral bacteria levels in the mouth to manageable levels. With the help of saliva, which is a rinsing agent for the mouth, these bacteria are generally kept under control. By preventing rampant growth, the ‘oral cavity’ (interior of the mouth) is able to avoid a destructive onslaught caused by these icky organisms.
A study shared by Dental Dental showed that about 70 percent of American adults brush their teeth twice a day. Unfortunately, this leaves more than a fourth of adults who do not.
Daily flossing is also recommended by the American Dental Association (ADA) as a preventative way to keep cavities and gum disease at bay. Still, an estimated 30 percent are committed to daily flossing – less than a third.
This means that a whopping 70 percent do not include flossing in their daily oral hygiene regimens. Too, about a third of Americans admit to never flossing, with 39 percent of men and 27 percent of women who do not.
Yet, the devotion of twice daily brushing and daily flossing requires only about 5 minutes of time – total. It is recommended to spend two minutes brushing teeth in the morning and before bed. A practiced flosser requires about a minute to floss. (Consider that five minutes is about the amount of time for a commercial break between TV programs.)
Yet, if you could see what I see…
As a periodontist, my specialty includes advanced training in the treatment of gum disease. I know the destructive nature of infectious oral bacteria. I have a bird’s eye view of what can occur without a committed oral hygiene routine at home. When an overload of bacteria accumulate in the mouth, cavities are able to form and gum tissues become food for living and breeding bacteria.
While brushing twice a day is important, the bristles of a toothbrush are typically unable to dislodge food particles caught between teeth. Left behind, these particles begin to rot rather quickly, leaving even more sustenance for bacterial growth and reproduction.
To see just how much your toothbrush misses, brush your teeth thoroughly for the recommended two minutes at the end of the day. Rinse and spit a couple of times. Then, using a strand of floss, move gently between teeth, easing up and down to reach the sides of all teeth. Move the floss just slightly beneath the gums at the base of each tooth. After all teeth are flossed, rinse and spit again. Most people are shocked at just how much their toothbrush failed to remove.
When oral bacteria amass past the point that is manageable by the immune system, these bacteria become infectious. This causes inflammation in the gum tissues, which can lead to the formation of periodontal (gum) disease. This begins with gingivitis, which has mild symptoms. Untreated, it worsens to periodontal disease and the advanced level of periodontitis.
It begins when oral bacteria accumulation creates a sticky film in the mouth known as plaque. When not removed thoroughly and frequently, plaque can form cement-hard bacteria colonies that attach to teeth. This hardened form of bacteria is known as tartar and, once formed, can no longer be brushed or flossed away.
As a Periodontist, I often see people who have developed periodontal disease who come (or have been referred) because they have obvious symptoms, such as red, swollen gums. However, I also see patients who are surprised to learn they have developed the disease. Yet, even without obvious symptoms, gum disease may exist and be fully underway.
Nearly half of American adults have some level of gum disease (over 47 percent in recent estimates). Periodontal (gum) disease is the nation’s leading cause of adult tooth loss even though it’s one of the most preventable of all diseases with simple measures.
Losing natural teeth leaves an individual with having to make decisions for replacement – crown-&-bridge combination, partial denture, full denture or Dental Implant. These time-consuming procedures and expenses can be avoided. And, contrary to what many believe, losing teeth is not a natural part of the aging process. With proper care, you can easily enjoy a smile of natural teeth all your life.
It is often surprising to people to learn that oral health is an integral part of overall health. Inflammation in the mouth doesn’t simply remain in the mouth. Through tears in diseased gum tissues, the oral bacteria of gum disease are able to enter the bloodstream. As the bacteria travel throughout the body, their toxic nature can activate inflammatory effects elsewhere.
Infectious gum disease bacteria have been the focus of a numerous amount of research over the years. Studies have found that the bacteria of gum disease can trigger or worsen heart disease, stroke, preterm babies, arthritis, diabetes, some cancers, Alzheimer’s disease, erectile dysfunction (ED) and impotency. As research continues, even more serious (and deadly) connections are being made.
They key is to keep oral bacteria levels to a minimum, which is why brushing and flossing are an important part of your daily care routine. Neither step should be taken for granted. Yet, as a periodontal specialist, I understand how it can be difficult to get into the habit of daily flossing.
For some, the tight floss around fingers is uncomfortable. For others who have large fingers or problems with manual dexterity, the act of flossing is awkward or challenging. However, for those who floss on a daily basis, it becomes a maneuver that is as simple as brushing teeth.
For individuals who are challenged by manual flossing, there are some excellent water flossers on the market. These are affordable and can be just as effective as ‘string’ flossing when used properly – and daily.
Twice daily brushing (at least two minutes per time), daily flossing, drinking ample water and limiting sweets and caffeine are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. And, those 6-month check-ups are important. During these visits, tartar that may have formed can be removed and signs of early gum disease can be addressed.
If you are experiencing symptoms of gum disease, call 828-274-9440. In our state-of-the-art Asheville periodontal dental office, our patients are treated with respect, compassion and a gentle touch. Here, you’ll never be lectured. Our goal is to restore your smile to a healthy state and develop a program to help you keep it at its best.
New patients are always welcome. A referral is not needed to become a patient.