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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.

Why Missing Teeth Cause Changes To Facial Appearance


Posted on Sep 30, 2022 by William J. Claiborne, DDS MS

The shape of our face is made by the bone structures beneath the skin. Essentially, we inherit our facial appearance from our ancestors. You may have your mom’s nose or your dad’s chin, but how you look is thanks to your genes.

However, facial appearance can also change due to a decline of bone mass. In dentistry, this is typically based on the presence, or absence, of natural teeth. Losing teeth – even when replaced by a denture, partial, or crown & bridge – leaves the upper and/or lower jaw bone susceptible to bone shrinkage. This is known as resorption.

The presence of natural teeth is vital to the health of upper and lower jaw bones. Tooth roots provide stimulation to the bone, stimulating blood flow that helps the jaws to maintain a healthy mass. Without tooth roots, the lack of stimulation causes the bone(s) to slowly decline.

Resorption causes the gum ridge to flatten out over time, giving your denture a continually-declining foundation. Application of denture adhesive becomes more frequent to prevent the denture from moving while eating, which causes uncomfortable rubbing. Laughing and speaking becomes overshadowed by the fear of embarrassing slips.

When dentures are first made, they may feel secure for the first five or so years. However, as resorption continues, relines help only on a temporary basis. As bone loss progresses, relines will last at less frequent intervals each time.

On average, denture wearers experience a 25% bone loss one year after natural teeth have been extracted. Three years later, 60% of the bone is gone. While natural teeth provide a biting force of 250 pounds, the average denture wearer bites with about 5 pounds of force.

Denture wearers are often surprised to learn that the pressure of wearing them actually accelerates resorption. For people who sleep in their dentures, the 24/7 pressure speeds the process of resorption even more.

To see the extent of bone loss you’ve experienced, remove your denture and look in the mirror. You may see deep wrinkles around the mouth and notice the corners of your mouth turn downward. If bone loss is severe, our mouth may appear to be collapsed inward with a pointed chin. Jowls may have formed on the sides of your face as facial muscles detect from the shrinking bone.

As a periodontist, I specialize in the treatment of all stages of periodontal (gum) disease as well as in the diagnosis and placement of dental implants. And, we are adept at placement of all types of dental implants. With over 40 different implant types, each designed to accommodate various needs, understanding the best type – and correct placement of it – can have a significant impact on your overall success rate.

For example, new designs in dental implant systems can overcome even severe bone loss. The All-On-4 dental implant can be placed in minimal bone using just four implants. Using specific angles, All-On-4 can support a full denture that is non-removable. And, because it is supported by implants placed in bone (just as natural tooth roots), biting and chewing stability is restored.

A periodontist can also assist patients prior to implant placement when severe bone loss has occurred. To ensure a sufficient level of bone mass to support the implanted portions, procedures such as bone generating materials or a “sinus lift” may be advised (to increase bone mass between the upper jaw and sinus cavity).

Our Asheville periodontal dental office is also known for our advanced technology and features (including our on-site 3D Cone Beam and laser). Additionally, our patients enjoy a high level of patient comfort through the administration of IV sedation (twilight sleep). This is administered by a Board Certified Anesthesiologist for optimal safety and comfort.

As dental implants have become a more practical and popular option, adults are turning away from dentures, partials, or bridges. In addition to restoring biting and chewing comfort and stability, implants offer a lifetime replacement option that actually enhances the well-being and lifespan of surrounding teeth.

Because of their ability to restore the presence of natural teeth to such a great extent, the dental profession now sees dental implants as the preferred choice for replacement for most patients. Although the overall treatment costs may seem greater initially, over time, it becomes obvious that the benefits far outweigh the expense.

When you consider that dental implants are designed to last a lifetime, the investment is a wise one. There are very little things in this day and age that will last as long as we do!

If you are considering dental implants, increase your potential for a successful outcome by asking a Periodontist to join your dentist in team treatment. Most general dentists have close relationships with periodontal specialists for implant placement and in treating gum disease.

Before you make your decision, you may wish to schedule a consultation to discuss your specific needs and desires. We are always happy to welcome new patients and being referred is not required. Call 828-274-9440.

Overcome Obstacles To Achieve A Confident Smile


Posted on Sep 12, 2022 by William J. Claiborne, DDS MS

It’s not unusual to see a new patient who has delayed seeking advanced dental care for many years because of perceived obstacles. I say “perceived” because many of these obstacles are not nearly so daunting once people actually learn more there are solutions for about any dilemma.

For example, a bride-to-be with a “gummy smile” realizes, after years of postponement, that she can have her gum line corrected through laser treatment that provides quick recovery with an easy payment plan.

Or, an individual who has worn a self-described “wobbly” denture for many years and overcame misperceptions about the need for pre-placement bone rebuilding. Through specially-designed and uniquely placed dental implants (“All-On-4”), patients may be able to bypass the extended treatment time and added expense to restore bone mass.

In a conversation once, a friend reminded me “we don’t know what we don’t know.” How true. Often, once we learn the details surrounding a big decision in our lives, moving forward becomes an easier process. Achieving goals gets closer and closer.

Below are a few of the common barriers that patients can often overcome when it comes to periodontal treatment or dental implants…

COST: There are few things in life that last a lifetime. When it comes to cosmetic gum enhancement and dental implants, the lasting benefits make these procedures an excellent investment. However, treatment cost can seem challenging to some budgets. For people who wish to enjoy the benefits of their results without straining their budget, payment plans can be the solution.

There are a number of these financial options, most requiring no down payment, are interest-free, and have no prepayment penalty. For some people who see the total treatment fee at first, vocalizing their concerns regarding payment is an uneasy thing to do. Yet, once we are made aware of the need for budget-friendly options, we are able to help many people move forward with treatment that can enhance physical appearance, self-confidence and emotional security. Those are pretty priceless benefits!

DENTAL FEAR: Dental fear and high anxiety associated with dental visits is not rare. As a matter of fact, some estimates rank this as affecting up to 60% of U.S. adults. There are a number of reasons that lead to these fears. For some people, they are able to overcome these fears once in the hands of a gentle, caring dentist. For those whose fears are so deeply embedded they cannot, we offer a special team who administer and oversee the safety of oral and IV sedation (twilight sleep).

In our office, we employe the skills of a a medical doctor to provide sedation and anesthesia for our patients. Dr. Stone has published several articles on techniques and safety in anesthesia as well as a book contribution on intravenous access.

TIME IN TREATMENT: We all live lives that are busy. Schedules seem to be overloaded so much of the time. This is why time in treatment can seem “too much” to add to one’s schedule. However, the advanced skills of a periodontal specialist, coupled with our immense array of advanced technology means we are able to alleviate many of these worries for our patients.

Once the patient’s imaging and treatment plan is in hand, we are often able to schedule patients soon thereafter. With the relaxation provided by our sedation options, we can perform long procedures in a single appointment rather than have the patient return for several appointments to complete treatment. Too, using our advanced imaging and computerized technology, treatment is more precise, often more conservative, and healing time improved.

TREATMENT SATISFACTION: The best way to make a decision that works to achieve your meeds and goals is through a consultation appointment. During this time, we can discuss what options are best for your individual needs, estimated treatment time, costs, and comfort options. This is a time when you can get to know us and we can give you the information that is factual and applicable to you. And, this is where trust is formed. I have a long-standing reputation for my commitment to patient excellence.

Begin by calling our Asheville periodontal dental office and speaking to our friendly staff at: 828-274-9440. Or, tap here to see our beautiful Western NC location.

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