Know The Unseen Risks Of Wearing Dentures


Posted on Sep 19, 2019 by William J. Claiborne, DDS MS

As an Asheville periodontist, my goal is to provide each patient with the very best so they can enjoy a healthy, confident smile. For patients who have lost one or more natural teeth, some come to me because they want to avoid ending up having to wear a full or partial denture. For those who wear one and are unhappy with the feel and function, we are sought out as specialists in the diagnosis and placement of dental implants.

Denture wearers, especially those who have worn dentures for many years, can quickly become dissatisfied with the uncomfortable rubbing and difficulty eating foods they once enjoyed. Although their ‘appliance’ may have fit well when first made, changes in the fit, over time, are due to what is taking place below the gum tissues. These changes aren’t obvious, at first.

When first made, a denture is custom-designed to fit snugly to the unique contours of the gum ridge. This ‘ridge’ is the raised arch where natural teeth were once held. Over time, denture wearers begin to notice that the denture moves while chewing certain foods. This can rub sore spots on gums. As the denture loosens more, even using denture adhesives or pastes don’t help much.

Denture patients also learn that it can be painful for something as small as a sesame seed to become trapped between their denture and gums, piercing into tender gum tissues. Some people eventually switch to a diet of soft foods that dissolve easily to avoid rigorous chewing. Because of fear of embarrassing slips, others begin to decline social invitations when they are centered around food.

The problem for a denture wearer is what is happening underneath the gums. The looser fit is not because the denture has expanded – it’s the decline of the jaw bone. This occurs with the absence of tooth roots, which once provided nourishment and stimulation to the bone that supported them.

When natural tooth roots are removed, the jaw bone begins to shrink. This decline in bone mass also contributes to changes in facial appearance, such as deep wrinkling around the mouth and the formation of jowls.

The process of bone loss continues as the gum ridge your denture was contoured to flattens. Relines may temporarily adjust the denture to accommodate some of the change. However, as the jaw bone continues to decline, the denture continues to be difficult to keep in place.

The denture itself merely adds to the problem of bone loss. The pressure of wearing a denture actually accelerates the rate of bone loss. Since a number of denture wearers also sleep in their dentures, the 24/7 pressure speeds this rate even more.

Long-time denture wearers often complain that they are not able to chew, with some admitting they have to even remove their denture to eat. Fear of embarrassment is another common complaint. Speaking, laughing and even sneezing in the presence of others can create embarrassing moments that leave lasting impressions.

The solution to these problems – dental implants. Not only do implants restore the ability to bite and chew comfortably, they halt bone loss that is associated with dentures. Because they are held by the jaw bone, just as natural tooth roots once were, implants recreate the stimulation needed by the jaw bone to maintain its mass.

Does your denture bring to mind words like rocky, wobbly and slippery? If so, the problem will only worsen over time. When people choose dental implants to replace an ill-fitting denture, they can smile, laugh and chew with confidence.

Eating a healthy diet, socializing with friends and family, and feeling confident are essential to a healthy, happy life. Call our friendly Asheville periodontal dental office: 828-254-9440 to schedule an initial appointment. (A referral is not required). During this time, I’ll explain the type of implants that may be best for your needs as well as comfort options, including oral and IV sedation (“twilight sleep”). We are also happy to discuss estimated costs and payment options.

Dental Implants – Many Types Available For Different Needs & Preferences


Posted on Jul 10, 2019 by William J. Claiborne, DDS MS

As a periodontist, an area of my dental specialty includes advanced training in the diagnosis and placement of dental implants. This specialized expertise provides implant patients with a high level of success in treatment outcome. It also offers patients a wider variety of choices when it comes to implant systems.

When dental offices offer dental implants, some general dentists refer the placement portion to a periodontal specialist. For their patient, this can mean a higher level of success, especially for complex needs.

For example, a patient who is missing a lot of bone mass (often due to missing natural teeth for many years) benefits from the specialized skills of our Asheville periodontal office. Another example is a patient who has lost teeth due to periodontal (gum) disease. Because a periodontist combines advanced skills in treating gum disease as well as in dental implants, these patients are given a ‘leg up’ when it comes to treatment success.

Dental implant diagnosis and placement skills can vary greatly when offered by general dentists. While some have taken extensive courses in implant dentistry, others may have taken a weekend course here and there. These are typically ‘hosted’ by a particular manufacturer who provides ‘training’ in a limited selection of implant types. In turn, this can limit the patient’s choices when relying on appropriate recommendations for his or her unique needs.

Now seen as the preferred option for tooth replacement, dental implants are available to accommodate various challenges and preferences. There are numerous choices available. Some of the more common include:

Traditional Dental Implants: In this process, dental implants includes a couple of stages. Implant placement is performed first. This involves small incisions in pre-selected placement points. These points are determined through computerized imaging, taking the guesswork out of the depth and angle of each implant placed. Once the implant is in proper position, the gum tissue is closed over the implant sites.
For a ‘healing period’ of 3-6 months, the bone grows around the implants to secure each in place. This process is referred to as ‘osseo-integration,’ which describes the bone growing around the implanted portion. The process is similar to a rope tied around the branch of a tree. Over time, the branch grows around the rope. Osseo-integration is similar to this but occurs at a much more rapid pace.
After several months, the implant sites are uncovered and a post is positioned inside each implant. Onto the posts, the replacement teeth are secured. Rest assured, during the healing phase, patients are able to wear their denture or partial comfortably. Once the final teeth are attached, patients can enjoy their ‘new’ smile along with the biting and chewing comfort like that of natural teeth.

Non-Removable Teeth Attached To Implants: In the past, the more affordable ‘full arch’ systems were typically those designed to support removable teeth. (An ‘arch’ replaces all upper or all lower teeth.) However, some people feel removable teeth are too similar to the denture they have (and detest). Although firmly secured, the chore of having to remove their new teeth to clean is undesirable to many people.
A number of implant systems are available, designed to provide non-removable options that are more affordable. For example, the All On 4 dental implant system is made to support non-removable teeth, often on just 4 implants. With the implanted portions placed at unique angles, these longer implants can fully distribute biting and chewing forces.
 Another advantage of All On Four is their ability to be placed in minimal bone. This is good news for people who are long-time denture wearers and were told they have too little bone to support implants. Or, they may have been advised to have bone grafts to rebuild the bone to an adequate height. This adds time and expense to implant treatment. Often, the All On 4 design is able to overcome this obstacle.

‘Same-Day’ Dental Implants: With advanced implant systems and technology, implant placement and teeth attachment can be accomplished in a single day. Advanced implant designs can position implants in the jaw bone that are ready to support replacement teeth. With the replacement teeth created prior, the teeth may be attached without delay.
 In some cases, a previously-made denture or partial can be reconfigured to attach to newly placed implants. “Implants in a day” isn’t wise for all situations, however. This option should be diagnosed and performed by a skilled, experienced professional who understands both the requirements and limitations involved. Putting your care in the hands of an experienced, skilled and highly-trained dental specialist is the best way to achieve a successful outcome. Just a note – while these quick-&-easy procedures can sound appealing, be cautious of ‘clinic’ settings who promote same-day implants. For an optimal outcome, choose care where your individual needs are a priority, rather than corporate profit goals.

Modern implant dentistry is successful, safe, dependable and can provide nearly immediate benefits. As a dental specialist who has stayed on the cutting edge of implant dentistry’s techniques, technology and materials, I am pleased to witness the transformations our patients undergo after treatment.

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

The type of dental implant best suited for you can be determined after an examination and review of x-rays (we use Cone-Beam digital imaging). Call 828-274-9440 to begin with a private, no obligation consultation to discuss your best options.

A Spot In The Mouth May Resolve On Its Own, Or Not. Know When To React.


Posted on Jul 01, 2019 by William J. Claiborne, DDS MS

Having a sore spot in the mouth occurs from time to time. Biting the inside of the cheek, foods that are highly acidic, or stress can all lead to sores.

Some viruses and other conditions can contribute to worse problems, however. It is important to know what to look for when it comes to an unusual spot in the mouth. Knowing when to watch and when to see a dentist could be a literal lifesaver.

Fortunately, most sores in the mouth resolve on their own. These include…

Canker Sores
Small ulcers with a white or gray base and a red border. Unlike cold sores, canker sores appear inside the mouth. They are not contagious but their exact cause is uncertain. Some experts believe that immune system problems, bacteria or viruses may be involved. Fatigue, stress or allergies can increase the likelihood of a canker sore. A cut caused by biting the cheek or tongue, or reactions from hot foods or beverages may contribute to canker sore development. Intestinal problems, such as ulcerative colitis and Crohn’s disease, also seem to make some people more susceptible. Canker sores usually heal on their own after a week or so. Over-the-counter topical anesthetics, steroid preparations,  and antimicrobial mouth rinses can provide temporary relief.

Cold Sores
Also called fever blisters or Herpes simplex, these are groups of fluid-filled blisters that often erupt around the lips, under the nose, or around the chin. Cold sores caused by herpes virus type 1 are very contagious. Herpes lesions look like multiple tiny fluid-filled blisters that are most common around the edge of the lips. An outbreak may follow a fever, sunburn, skin abrasions or emotional upset. Cold sore blisters usually heal in a week by themselves. Over-the-counter topical anesthetics can provide some relief. Prescription antiviral drugs may reduce the duration of these kinds of viral infections.

Leukoplakia
Leukoplakia cause one or more white patches or spots (lesions) to form inside the mouth. Most who have the condition are males between the age 50 – 70. Although leukoplakia can be caused by a rough tooth or an irregular surface on a denture or a filling, it is often associated with heavy smoking or other tobacco and heavy alcohol. In some cases, however, the cause cannot be determined. Leukoplakia is especially concerning because it can eventually develop into oral cancer.

What will NOT resolve on its own and requires prompt evaluation are changes to oral tissue that do not heal within 14 days. DO NOT DELAY! This is a symptom of Oral Cancer. Nearly 40,000 Americans are diagnosed with oral or oropharyngeal (throat) cancer each year. These cancers kill about 1 person every hour, every day.

Symptoms of Oral Cancer that are most common include:

• white or red patch of tissue
• lesion in the mouth
• difficulty or discomfort when swallowing
• persistent sore throat
• a lump or mass inside the mouth or neck
• wart-like mass
• numbness in the oral/facial region

The survival rate is one of the worst of all cancers, with only 57 percent estimated to be living 5 years from diagnosis. The death rate is higher than cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, thyroid cancer, or skin cancer (malignant melanoma).

Although the death rate has seen a slight decrease since 1980, some symptoms do not emerge until the cancer has reached advanced stages. This is because lesions or discolorations that are early warning signs are not always visible, particularly in the back portion of the mouth (the oropharynx, the tonsils, and base of tongue), which can be an obstacle to early diagnosis and treatment.

This is yet another reason that keeping your regular oral hygiene exam and cleanings is so important. During these times, your dentist and hygienist look for unusual changes in the mouth that can indicate a problem. Please remember – NEVER wait until your scheduled appointment to have anything unusual examined.

Although a stubborn canker or cold sore may not be welcome, they tend to go away in a week or ten days. Again, if an unusual spot or sore is still present after two weeks, call our Asheville periodontal office at 828-274-9440 immediately for an appointment.

Get The Most For Your Investment When Replacing Teeth.


Posted on Jun 12, 2019 by William J. Claiborne, DDS MS

Losing a natural tooth is a big deal. Its loss not only leaves a gap in the appearance of a smile, its absence can lead to movement of surrounding teeth.

Without all teeth in their proper positions, an open area can cause others to tilt and turn. Additionally, the one above or below will grow longer without having its ‘roommate.’ These issues can lead to broken, fractured, or chipped teeth.

Replacing a tooth involves decisions, and costs. While there are ‘cheap’ ways to replace a tooth, the ideal method – a dental implant – offers lifetime replacement that actually enhances the well-being and lifespan of surrounding teeth.

In dental implant treatment, the ‘implanted’ portion is positioned into the jaw bone as a tooth root replacement. This provides the teeth attached the same foundation as natural tooth roots have. A partial or bridge simply sits on top of gum tissues and relies on adjacent teeth for support.

When a tooth must serve as a support for ‘prosthetic’ teeth, its key role becomes greater. With the added pressure and stress to the natural tooth, there are also more risks to its structure on its own.

Because of the ability to restore the presence of natural teeth to such a great extent, dental implants are the preferred choice for replacement. Although the costs seem greater, over time, the benefits far outweigh the expense. This is why more and more adults are choosing implants to replace one, several, or all missing teeth.

However, there are many factors that can come into play when going forward with a dental implant. Your choice of doctor to place the implanted portion can greatly increase your potential to enjoy your dental implant for a lifetime.

As a Periodontist, my specialty encompasses treatment of all levels of gum disease, the re-contouring of gum tissues, and advanced training in the diagnosis and placement of dental implants. This includes the proper selection of the implant type best for each patient’s needs as well as placement at correct depths and angles.

The most troubling thing I see in implant dentistry is when a patient opted for a “good deal” with a less-experienced doctor, and having to remove a ‘failed’ implant.

Along with an intricate knowledge of the specific type of implant needed, proper placement angles and depth have much to do with the overall success of the implant. For optimal results, the doctor placing the implant should be skilled in the selection of the implant angles and positioning depths.

For example, an implant placed in the upper jaw in too-shallow bone can work its way into the sinus cavity. A lower implant in insufficient bone depth can reach a nerve that runs horizontally through the lower jaw (the mandible).

Additionally, the shape, size and the number of teeth to be attached to an implant have much to do with the type of implant system selected. When the placement doctor is only familiar with one or two types, disasters can occur.

In our Asheville periodontal office, we enjoy restoring the health and appearance of smiles. We also help patients who once struggled with dentures or partials to resume eating the foods they love again and laugh confidently in social gatherings.

The doctor is not the sole factor in success, however, Along with proper selection and placement, a patient must take measures to ensure proper oral hygiene at home. Oral bacteria can contribute to an infection that works its way into the bone surrounding the implant. In some cases, the only way to resolve the infection is to remove the implant.

When a patient entrusts their implant treatment to a skilled doctor and adheres to hygiene and healing guidelines, having an implant fail is very unlikely. The success rate of today’s implant dentistry is excellent – over 97 percent.

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.

Feel free to discuss your specific needs and desires before you make your decision. Call (828) 274-9440 to schedule a consultation.

 

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