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Common Contributors to Tooth Loss


Posted on Sep 11, 2023 by William J. Claiborne, DDS MS

Our natural teeth seem hard and solid, able to endure much over the span of a lifetime. However, as we all know, teeth can be knocked out due to accidents or injury and lost due to becoming overly decayed, fractured, infected and – the leading cause – periodontal (gum) disease.

Your gum tissues serve as protection for the tooth structures you cannot see – the tooth roots and bone and tissues supporting the roots. And, teeth need these bone structures to stay healthy and vice versa; the bone structures beneath the gums need the presence of the roots to stay healthy.

The jaw bones are kept healthy by tooth roots that provide stimulation to the bone as well as nourishment that runs through the tooth’s interior.

When a tooth is removed, so is the stimulation and nourishment to that area of the jaw bone. Without it, the bone begins to shrink. As it declines in height, adjacent teeth are more vulnerable to loss. Statistics show that teeth adjacent to areas where natural teeth are missing will be the most likely to be lost next.

According to the Center for Disease Control & Prevention (CDC), 69% of adults between ages 35 – 44 have lost at least one permanent tooth. By age 50, Americans are missing an average of 12 teeth. For adults between the ages of 65 – 74, 26% are missing all of their natural teeth. That’s over one-fourth of the adult population over age 65.

Because of the strength and seemingly rock-solid presence of teeth, it may be assumed they’ll last for a lifetime. And, they can. Natural teeth can and should last a lifetime with proper maintenance and care. However, certain things can contribute to tooth loss; some of these may not be well known.

These include:

GUM DISEASE – Signs and symptoms of gum disease 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.

NOT FLOSSING – While tooth brushing helps to keep oral bacteria levels in the mouth to manageable levels, daily flossing is also recommended as a preventative way to keep cavities and gum disease at bay. Still, 70% of the American adult population do not floss daily. Even worse, about a third of Americans admit to never flossing (39% of men and 27% of women who do not).

SMOKING – According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker. (https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)

AGING – With age, the body becomes less efficient in maintaining itself. Due to hormone changes and being less hydrated, joints wear down, skin loses subtlety and muscle mass and strength declines. The same is true with teeth, especially as gum tissues dry out. This means their tight, protective grip around the base of teeth loosens and pockets can easily for between teeth. All these factors contributor to higher risks of gum disease and tooth loss.

ORAL DRYNESS – 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.

MEDICATIONS – 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/). Many meds have the side effect of oral dryness or increased bleeding, including some herbal supplements. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting.

To halt the potential for tooth loss if you are already missing teeth, dental implants are recommended. They actually protect the health of neighboring teeth. In addition to helping the supportive bone structures retain bone mass, teeth supported by implants do not rely on the support of crowned (or ‘capped’) teeth on both sides. This means the integrity of adjacent teeth is preserved.

Dental implants come in over 40 different types designed to accommodate various challenges and preferences. This is one reason (of many) that a periodontist is an ideal choice for the diagnosis and placement of your implants. Our speciality understands the complete spectrum of implant systems. While some implant systems may be ideal for your needs, others may not. And, the choice of which will achieve your goals is not limited to just those types a non-specialist knows how to place.

For example, some dental implants provide you with a non-removable (“fixed”) option while others may involve removable teeth. Additionally, the proper selection of your dental implants may greatly save you in treatment fees.

For example, the All-On-4 dental implant system needs only 4 implants per arch, and can be placed in shallow bone. The treatment fees are less since the number of implants is low and the need for bone regeneration for severe bone loss may not be required. For these reasons, a periodontist may be able to help you achieve your tooth replacement goals within a budget you can manage.

Our Western NC periodontal dental office features some of the industry’s most advanced technology, which helps to optimize success rates, shorten treatment time, and enhance comfort. This includes 3-D Cone Beam imaging, which is ideal for diagnoses and treatment planning. These amazing images provide a clear view of the upper and lower jaw (including nerve canals) in a process that is quick, painless and at minimal radiation levels.

We also have a computerized Dental Implant Placement system for pre-surgical positioning of dental implants. Using a 3D model of the patient’s jaw, a template is developed for the most conservative treatment process needed, even for complex cases. This minimizes disruption of gum tissues and targets implant placement at ideal depths and angles.

Because we make patient comfort one of our highest priorities, we offer several sedation options, including oral and IV sedation. 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 (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a Medical Doctor (MD) who is a board certified Anesthesiologist.

If you have lost teeth (or struggle with a denture or partial) and are considering dental implants, begin with a consultation appointment. Call 828-274-9440. New patients are always welcome.

Six Reasons To Have Your Dental Implants Placed By A Periodontist


Posted on Jul 12, 2023 by William J. Claiborne, DDS MS

A periodontist is a dental specialist who is often in the background of various dental procedures. Yet, we are in the forefront when it comes to specialized skills that support specific treatment needs.

Most patients are referred to our Asheville periodontal dental office by general dentists and dental specialists to provide certain aspects of dental treatment, which may involve our skills in cosmetic dentistry, dental implants, and treating all stages of gum disease.

A periodontist has advanced training to properly diagnose and treat all stages of periodontal (gum) disease (including gingivitis and periodontitis) as well as placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures to repair gum-related disparities such as a “gummy smile” or varying gum arches that “jumble” a smile line.

A periodontist receives an additional 3 years of training after 4 years of undergraduate school and 4 years of dental school. This long, rigorous pursuit of the periodontal specialty requires the individual to be highly committed to the advanced care he or she will provide. It is our goal to help people achieve good oral health, a confident smile they love to share, and prevent tooth loss that can result from diseases of the gums.

Dental implants are now seen as the preferred option for tooth replacement. They come in over 40 different types designed to accommodate various challenges and preferences. But, why should you have your dental implants chosen and placed by a periodontist? After all, some dentists perform this in addition to their general dentistry services.

Below are 6 reasons our dental implant patients have particular advantages…

(1). With specialized skills, a periodontist is especially respectful to oral tissues as sensitive layers that have an important role in the appearance of a smile and the health of teeth. Utilizing these skills, a periodontist can help to minimize incisions while effectively treating each area in the mouth.

(2). Rather than be limited to just one or two dental implant systems that were taught in a “crash course” by the implant manufacturers, our speciality understands the complete spectrum of implant systems. Some may be ideal for your needs while others may not. Some provide you with a non-removable (“fixed”) option while others may involve removable teeth. Our specialized skills give you the best choices you should have.

(3). Additionally, the proper selection of your dental implants may greatly save you in treatment fees. For example, the All-On-4 dental implant system needs only 4 implants per arch, and can be placed in shallow bone. The treatment fees are less since the number of implants is low and the need for bone regeneration for severe bone loss may not be required. For these reasons, a periodontist may be able to help you achieve your tooth replacement goals within a budget you can manage.

(4). In our Western NC periodontal dental office, our advanced technology includes 3-D Cone Beam Imaging. This is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes. The imaging process is quick, painless and at minimal radiation levels.

(5). Another feature is our Computerized Dental Implant Placement system. This advanced technology is designed for pre-surgical positioning of dental implants that uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases. This minimizes disruption of gum tissues and targets implant placement at ideal depths and angles. Thus, treatment success rates are higher with faster (and more comfortable) healing time.

(6). Optimal comfort for our patients has always been a priority. For many, a desired level of comfort and relaxation includes sedation options. Here, we offer several sedation options, including oral and IV sedation.

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. IV sedation (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a Medical Doctor (MD) who is a board certified Anesthesiologist.

With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

If you are considering dental implants, you may wish to begin with a consultation appointment. During this time, we can explain the vast difference in comfort, treatment time, and success available through our specialized skills and extensive technology.

Call 828-274-9440 to schedule. New patients are always welcome and a referral is not always required.

Avoid An Aged Appearance By Keeping Facial Bone Structures Healthy


Posted on Jun 21, 2023 by William J. Claiborne, DDS MS

The aging process can, unfortunately, take quite a toll on appearance. Shoulders may slump, waistlines may widen, and hair may turn gray. As a periodontist in Western NC, I see another telltale sign of aging – resorption. This is the process of bone loss when natural tooth roots are missing from the jaw bones. Facial features affected by resorption can reveal quite a lot, and not in a flattering light.

A natural tooth is held by the upper or lower jaw bone by its roots. Around the base of each tooth, gum tissues wrap snugly to prevent entry of bacteria and protect sensitive tooth roots. These roots help to keep the tooth ‘alive’ by supplying blood and other nutrients to the bone supporting the tooth. Through the presence of these roots, the jaw bones also receive valuable stimulation, which helps the bone retain its mass. 

Losing a tooth can trigger a domino effect, of sorts. Statistics show that tooth loss is most likely to occur in an area next to that of a missing tooth. Without the stimulation of tooth roots, the bone in that area will begin to resorb, or shrink in mass. This increases risks for adjacent teeth.

The process of resorption begins slowly the first year. However, the rate of bone loss accelerates more and more each year. For people who wear a denture or partial, the pressure of wearing these appliances can speed up the rate bone loss even more. Eventually, facial features change due to the declining bone structure, changes that tend to age one’s appearance far beyond their actual age.

Initially, the changes may be subtle, such as deep wrinkles around the mouth. The corners of the mouth begin to turn downward, even when smiling. Jowls form as facial muscles detach from shrinking bone structures. As the bone declines further, the chin becomes more pointed and the mouth seems to collapse into the face. The chin moves closer to the nose, creating what’s referred to as a ‘granny look.’

Dental function also takes a hit when it comes to tooth loss. The strength of the bite becomes challenged. Jaw bone breaks are more likely. Wearing a denture or partial becomes challenging due to its declining ‘ridge’ that is relied upon for support. Dental prosthetics begin to slip while eating, or even speaking. Eventually, frequent applications of denture pastes and adhesives are needed. After a time, even relines help very little.

As a periodontal specialist, one of my advanced skills (in addition to the treatment of all stages of gum disease) is in the diagnosis and placement of dental implants. For adults who are missing one or more natural teeth, we recommend dental implants for a number of reasons. 

Why should you have your dental implants placed by a periodontist?

There are over 40 different implant systems, each designed to accommodate various needs and goals. For example, one consideration in determining the type of dental implant is in the assessment of jaw bone mass.

An implant needs a particular amount of bone structure to support it. After several years of missing tooth roots, the amount of existing bone may eliminate some types of dental implants or indicate the need for additional procedures prior to placement.


With adequate bone mass to support the implant(s), the choice of implant can be made based upon your needs and preferences. Without the necessary bone mass, we may advise a bone rebuilding process prior to implant placement. Typically, this does not require a bone graft. In many cases, we are able to apply a bone rebuilding material that regenerates ample bone mass. Or, we may advise an implant system that uses unique implant lengths and placement angles (the “All-On-4”) that can function dependably in minimal bone.

The benefits of dental implants are many. These include:

A lifetime solution – When properly selected and placed, dental implants are designed to last a lifetime. This is why a periodontist is an ideal choice for your selection and placement. 

A healthy choice for remaining teeth – Although each natural tooth seems to “stand alone”, individually, they provide support for the teeth on each side and the one above or below. This helps to keep teeth in their proper positions. However, dental implants provide stimulation to the bone to help retain bone mass. And, teeth supported by implants do not rely on the support of crowned (or ‘capped’) teeth on both sides. Thus, preserving the integrity of adjacent teeth.

Restoring biting and chewing stability – Because dental implants are anchored by the jaw bone, biting and chewing stability is restored. People who have dental implants are able to eat healthy, fibrous, and chewy foods once avoided due to ill-fitting dentures or partials. 

The feel of your “own teeth” – Rather than have clunky dental prosthetics in your mouth, dental implants act like your own teeth. You can brush them in your mouth and eat foods you love and laugh with friends. Unlike dentures or partials, no more sore spots rubbed on tender gum tissues and no more piercing seeds caught between the gums and denture base.

A wise investment – Dental implants, unlike crown-&-bridge, dentures or partials, will not break, develop a cavity, require periodic “relines,” or need a root canal. Made of titanium, an implant will last your lifetime without requiring the upkeep of other types of restorative options.

In our Asheville periodontal dental office, we offer some of the most advanced dental technology available. This allows our patients to enjoy optimal comfort with minimal treatment time. We are also committed to patient comfort through oral and I.V. sedation (“twilight sleep”). These are administered safely with continual monitoring by trained team members.

If you are considering dental implants to replace missing teeth, begin with a consultation appointment. This will take place in a private room where we can discuss your needs and concerns. Call 828-274-9440 to schedule, or tap here for contact information.

Dental Implants – Proper Implant System & Precision Placement


Posted on Dec 13, 2022 by William J. Claiborne, DDS MS

A periodontist specializes in the diagnosis and placement of dental implants, in addition to the treatment of all stages of periodontal disease.

In our Asheville periodontal dental office, many general dentists refer patients to us for dental implants. With our specialized skills and advanced technology, we can diagnose and place the implanted portion for optimal comfort and success in treatment outcome.

We are also able to offer patients a wider variety of choices when it comes to implant systems.

There are many types of dental implants. Various systems are designed to support one replacement tooth (the “restoration”), a bridge of two or more teeth, or a full denture supported by several strategically-placed implants. Understanding the unique advantages of all systems enables us to choose the best type for the patient’s individual needs and goals.

For example, the All On 4 dental implant system is designed to support non-removable teeth on just 4 implants (per arch). With its specially-designed implanted portions, these longer implants can fully distribute biting and chewing forces.

The All-On-4 option is an ideal choice for people who have lost bone mass due to lengthy periods of tooth loss. Because All On Four can be placed in minimal bone, many patients are able to avoid the need for bone rebuilding procedures prior to traditional implant placement.

However, it is not just in selection of the implant that a periodontist offers, it is in the placement skills. For a dental implant to serve as a lasting tooth replacement system, it must be positioned in the jaw bone to specific depths and angles. An implant that is mis-positioned can function less efficiently and lead to the need for removal.

Patient comfort can also be enhanced through the specialized care of a periodontist.

Because a periodontal specialist is uniquely skilled in the care of gum tissues, he or she is able to provide a conservative approach to the placement process. Through respectful treatment of oral tissues (in both placement and exposure for restorations), less disruption to the gums allows for faster healing and higher comfort levels.

In our Western NC periodontal dental office, we also feature some of the most advanced technology in dentistry; many options which are not readily available in other dental offices in our region. These computerized images offer advantages to patients in helping to minimize treatment needs.

Some features include:

Computerized Dental Implant Placement – This advanced system for pre-surgical positioning of dental implants uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases.

3-D Cone Beam Imaging – Ideal for diagnoses and treatment planning, these images provide a clear view of the upper and lower jaw, used for: intricate review of tooth roots; periodontics; orthodontics; dental implants: TMJ; and prosthodontics, as well as dental and maxillofacial surgery. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The process is quick, painless and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging – This enhanced tomography works with 3D imaging for exceptional detail and range.

LANAP With PerioLase MVP 7 (Laser-Assisted New Attachment Procedure) – Is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease. LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

CS 3600 Intraoral Scanner – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily for creating precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments). The scanner can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.

When it comes to comfort, we are able to offer patients the highest level of relaxation through I.V. sedation (“twilight sleep”). Also available is oral sedation, which is in pill form for enhanced relaxation. While both options have an amnesiac effect, I.V. sedation places the patient in a deeper sedative state. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are closely monitored with advanced safety equipment throughout treatment.

We know that dental fear is often the foundation of tooth loss, causing many adults to delay or avoid dental care for years. Here, our entire team are sincerely committed to patients in a compassionate and respectful manner.

After placement and restoration, it is important for dental implant patients to be highly committed to maintaining good oral hygiene. Although Dental Implants themselves do not experience decay, the gum tissues and bone supporting the implants are as susceptible to oral bacteria as before. When oral bacteria infection (gum disease) penetrates to the implant site positions, the only way to treat the infection may involve removal of the implant.

For a lifetime of confident smiles with your implants, we will work with your general dentist to help you maintain ideal oral health. This may involve instructions for thorough oral hygiene at home and dental check-ups scheduled for every four months rather than twice a year. During these visits, the condition of your gums will be assessed and a hygienist will remove accumulated oral bacteria to reduce risk to your implants.

Dental implants are designed to last a lifetime and are the closest thing to the natural teeth you once had. Too, the restored ability to bite, chew, speak and laugh without worry can be a tremendous boost to one’s self-esteem and self-confidence.

If you are considering dental implants to replace missing teeth, we invite you to begin with a consultation appointment. This will take place in a private room where we can discuss your needs and concerns. From there, you can determine what pace is best for you.

Call 828-274-9440 to schedule, or tap here for more contact information.

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