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,

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!

 

How You Develop Gum Disease, And How To Avoid It.

Posted on May 29, 2019 by William J. Claiborne, DDS MS

Other than a canker sore or bite on the cheek, almost no problem in the mouth will clear up on its own. This is often because the symptoms of most oral problems don’t emerge until they are well-developed.

For example, a cavity typically doesn’t become obvious until it begins to ache. Once it causes discomfort, it is a well-established problem. It won’t repair itself, and will eventually worsen (and become even more painful) to the extent where removal becomes necessary.

As a Periodontist, I often see people who have developed periodontal disease who come (or have been referred) because they are enduring obvious problems. 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.

For some people, warning signs are ignored. Some simply don’t associate bad breath or bleeding gums with a disease of the mouth. As a matter of fact, I see may people who first arrive and proudly claim they do such a good job brushing their teeth, they spit blood in the sink.

Let’s use this time together to understand how gum disease forms and the symptoms associated with it. The typical process of how gum disease begins and progresses is:

1. Accumulation Of Oral Bacteria – We all have bacteria in our mouths. This warm, moist environment takes in an enormous amount of bacteria-laden items. Bacteria is on our food, utensils, the glass we drink from and the pencil we hold between our teeth. Of course, bacteria cannot be prevented altogether. However, the problem begins when too much bacteria accumulate.

2. Plaque Forms – Without proper brushing, flossing, saliva flow and diet, oral bacteria can reproduce rapidly. Their accumulation over the course of a day forms a sticky film you feel on teeth. This is known as plaque.

3. Development of Calculus – In just 48 hours, unremoved calculus, also known as tartar, can harden onto teeth. This is actually a cement-hard colony of oral bacteria. Like plaque, calculus will continually reproduce and grow as the bacteria feed on tooth enamel and tender gum tissues.

4. Initial Stage Gingivitis – This is actually the first stage of gum disease. At this level, gum tissues are under attack and become sore. They may bleed easily when brushing and you may experience an aching sensation in some areas. Your breath will no longer feel fresh. At this point, with proper measures, you can restore your gums to a healthy state. However, there is a fine line between being able to undo gingivitis and its progression to gum disease.

5. Periodontal (Gum) Disease – At this level, the gums are inflamed and tender. You may notice them darken in color and begin to pull away from the base of some teeth. You’ll have persistent bad breath.

6. Advanced Gum Disease – When gum disease progresses to periodontitis, your breath odor is persistently offensive. Bacteria-filled pus pockets may form on gum tissues near the base of some teeth. Chewing becomes painful and teeth can loosen, eventually requiring removal.

There are various stages of periodontitis. The Mayo Clinic does an excellent job explaining these advanced-stage levels (https://www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473):

• Chronic periodontitis is the most common type, affecting mostly adults, though children can be affected, too. This type is caused by plaque buildup and involves slow deterioration that may improve and get worse over time but causes destruction in the gums and bone and loss of teeth if not treated.
• Aggressive periodontitis usually begins in childhood or early adulthood and affects only a small number of people. It tends to affect families and causes rapid progression of bone and tooth loss if untreated.
• Necrotizing periodontal disease is characterized by the death of gum tissue, tooth ligaments and supporting bone caused by lack of blood supply (necrosis), resulting in severe infection. This type generally occurs in people with a suppressed immune system — such as from HIV infection, cancer treatment or other causes — and malnutrition.

Nearly half of American adults have some level of gum disease. Sadly, it is the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.

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. At this time, any tartar that has accumulated can be removed and signs of early gum disease can be noted.

Imagine losing your teeth and having to decide on a crown-&-bridge combination, partial, full denture or Dental Implants. These 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.

If you are experiencing symptoms of gum disease, call 828-274-9440. We’ll restore your oral wellness and develop a program to help you keep it at its best.

Bad Breath? That May Be The Least Of Your Problems!

Posted on May 23, 2019 by William J. Claiborne, DDS MS

We’ve all run into people who have bad breath. Although a tuna salad lunch or onion-laden hot dog can cause folks to pull back from close-up conversations, these forms of bad breath are temporary.

The smelly breath odor that is more concerning is that which comes from the sticky film of bacteria that coats the mouth and emits sulfuric odors (likened to rotten eggs). This film, known as plaque, coats the teeth and gums when allowed to build up.

For example, the reason you wake up with not-so-fresh breath in the morning is the result of the mouth being closed all night while bacteria reproduces and accumulates. Without brushing and due to declined saliva flow (your mouth’s natural rinsing agent) during sleep, oral bacteria amass. Thus, you wake up with the sticky film and the breath that goes with it.

For those who are mouth-breathers during sleep or who snore, dry oral tissues allow for even more bacterial growth.

Once you brush and rinse thoroughly, however, you can expect your breath to become more pleasant. Persistent bad breath, however, may be the a side effect of medication, an illness, or periodontal (gum) disease.

As a periodontal specialist, I’m very much aware of the distinct odor produced by gum disease. Although it varies slightly from person to person, it has an offensive scent than that of typical bad breath.

The best way to determine gum disease as the true source is through a periodontal exam. In addition to persistent bad breath, periodontal disease symptoms include gum tenderness, gums that bleed when brushing, and gums that are red in color rather than a healthy pink. Early stage gum disease (gingivitis) may not cause any obvious symptoms, however.

Regardless of the source of unpleasant breath odor, it is imperative to have and maintain good oral health – for reasons that can impact your overall health. Through decades of research and studies, the bacteria of gum disease has been linked to serious health problems, including heart disease, stroke, arthritis, diabetes, impotency and some cancers.

For example, rheumatoid arthritis (RA) and pneumonia are just two diseases that have a connection to gum disease. Researchers have found that RA sufferers have a higher incidence of periodontal (gum) disease compared to individuals with a healthy oral condition.

Studies have also shown that RA patients are nearly 8 times more likely to have gum disease. Although insufficient oral hygiene can certainly be a determining factor in acquiring gum disease, other parameters point to a deeper association between RA and gum disease.

Because both RA and gum disease both cause internal inflammation, a connection between the two are most prevalent when examining the joints and oral tissues. Oral tissues with the presence of periodontitis compared to tissues of RA-affected joints show a number of similarities. Research has also discovered a genetic link between the two.

And the health threats go further. One study published by Science Daily found that the bacteria present in the mouth can release toxins that can make their way into the brain. (https://www.sciencedaily.com/releases/2019/01/190123165002.htm)

Once there, they may contribute to Alzheimer’s disease. While studies on this connection continue, other studies have found a clear path of triggers traced to the inflammatory reactions caused by the bacteria of gum disease.

Once periodontal disease is established in the mouth, its pathological byproducts can enter the bloodstream, lymph fluid, and bone structures. This can lead to the spread of infection and inflammation to all areas of the body. In this way, periodontal disease has been shown to be a cause of systemic disease.

While fresh breath and a gleaming smile are important, it’s clear that oral wellness plays a leading role in helping you avoid serious, and even deadly, health conditions.

If you’re experiencing any of the symptoms of gum disease mentioned above or are past due for a dental exam, call our Asheville periodontal office at 828-274-7440. If desired, you can begin with a private consultation, where we will discuss your symptoms and health history. During this time, I’ll answer your questions, explain treatment options and discuss comfort methods.

Scared? Afraid? Simple Steps To Get Past Dental Fears.

Posted on Apr 30, 2019 by William J. Claiborne, DDS MS

If you’re one of those people who have no dread of going to see a dentist, be glad. For the large percentage of adults who do experience anxiety or fear associated with dental visits,  they are actually in the majority.

In the U.S., an estimated 70 percent of adults have some level of dental fear, unfortunately. About 5-10 percent of them can be categorized as “dental phobics.” These individuals have such an intense fear of dental visits that the mere thoughts of walking into an office causes reactions such as sweating or more rapid breathing.

As a periodontist, I’m a frequent witness to just how severe dental fears can be. Some people cry, some keep a white-knuckled grip on the arms of a dental chair (once they finally talk themselves into one), and some ask to be put to sleep for things as minor as dental cleanings.

The periodontal specialty provides patients with a dental professional who has advanced training in the diagnosis and treatment of gum disease. It also covers the diagnosis and placement of dental implants, which are the “ideal” tooth replacement. In this field, I’ve seen the repercussions of both due to dental fear.

By not receiving regular dental cleanings and exams, the risks for developing gum disease rise significantly. And, since gum disease is the leading cause of adult tooth loss, it plays a key role in one’s potential to lose natural teeth.

Dental fear leads to a vicious cycle of poor oral health and tooth loss. When people are too afraid to see a dentist for regular care and fail to have small problems repaired while treatment needs (and costs) are still minimal, the process is ongoing. As gum health declines, the risks for tooth loss increases.

No one wants to end up in dentures. While TV commercials for denture adhesives or same-day denture clinics try to come across as upbeat, life wearing a denture is anything but. Long-time denture wearers struggle to bite, chew, and even speak without worrisome, uncomfortable slips or rubbing against tender gum tissues.

Too, the uncertainty of a denture can make some people uneasy when dining out or in other social settings. It’s not unusual for denture wearers to decline invitations when food is a key centerpiece of the gathering. This is sad. It is also detrimental to one’s health. Social involvement is an important part of our overall well-being.

If you are among those who avoid dental care because of uncontrollable jitters or downright “scared” feelings, below are several steps you may wish to consider to help you move past them:

• Begin by writing down what you believe caused your fears in the first place. Was it a painful procedure? Was it a rough dentist who ignored your obvious discomfort? If you know what sparked your fear in the first place and can look-it-in-the-eye in actual words, you can begin to deal with them. This may help you bring them out of the shadows and into the light where you can begin to conquer them.

• Close your eyes and imagine your life with a healthy smile — one that makes you feel good about being close to others. Imagine conversations having fresh breath and smiling with confidence. Imagine getting compliments on your smile! Think about how you may interact more confidently with others with a smile you’re proud to share.

• If you haven’t seen a dentist on a regular basis, you may need to begin with a periodontal examination. You can do an internet search (Periodontist) in your area and get to know them through their web sites. Read the doctor’s bio and become familiar with what he or she offers in terms of technology and comfort options. When a periodontist keeps current on the techniques and technology surrounding this specialty, patient comfort is typically a leading factor among these features.

• Visit the periodontist’s office after hours. Yes, go there when they are closed so you’ll feel less intimated. Sit in the parking lot and imagine where you’d park for your visit, once scheduled. Walk up to the entrance and become familiar with the look of the entryway. This way, when your appointment is made, you’ll feel more comfortable making your way in the door.

• Call the office and be comfortable sharing your concerns. Don’t feel shy about saying, “I have a lot of dental fear and would like to begin by meeting the doctor.” Most offices have these conversations with new callers more often than you realize. As mentioned prior, dental fear and anxiety are fairly common. Most offices offer an initial consultation so you can get to know the doctor before scheduling an exam. Ask about where this consult will be held. The periodontist should have a private room available for this, where it is not part of the clinical side of the practice.

• The day of your appointment, call the office and ask about anticipated waiting time for your appointment. Most offices run on-time and your wait should be less than 15 minutes. However, unforeseen emergencies do arise that may disrupt an on-time schedule. If delayed, consider rescheduling. Having a lengthy wait time may add to your anxiety and it may be best to arrange another visit.

• When you go, take a book, newspaper, or favorite magazine for your wait time. Don’t assume that the periodontist has a selection you’ll be interested in. Some people like to work a crossword or ‘Jumble’ during their brief wait here.

• When meeting the doctor or staff, know that it is important to be straight-forward about your fear level. Don’t gloss over it. Being upfront will help the doctor tailor your care to address your fears or concerns at an appropriate level.

• Ask the doctor about comfort options, including sedation. Both oral and IV sedation (twilight sleep) should be available. Feel free to ask questions about how they are administered, recovery time, and safety monitoring measures. Your safety is as important as your comfort.

• Finally, listen to your gut. Did you feel the doctor truly ‘heard’ your concerns? Did you feel the staff was attentive? Did you feel confident in the appearance of the practice? Sometimes, the most important measure of comfort is what that “little voice” inside is telling us. If you don’t feel good about moving forward, consider a consult at another periodontal office. You should leave your consult feeling positive about moving forward.

One of the most satisfying parts of my specialty is watching a once-fearful patient transform into one with a healthy, confident smile! And, the foundation of that is a relationship of trust between the doctor and the patient.

If you are ready to get past your dental fears so you can have the smile you desire, begin by calling our Asheville periodontal office and speaking with our friendly staff at: 828-274-9440. Or, start with the steps listed above and move at a pace that feels best for you.