Pregnancy & Your Gum Health


Posted on Jul 09, 2020 by William J. Claiborne, DDS MS

Today’s American female has a long list of guidelines that enhance the potential to have a healthy, full-term baby. Even so, pre-term births in this country occur at a rather high rate for the advanced health care available to most.

According to data released in 2017 by the National Center for Health Statistics (NCHS), the U.S. preterm birth rate actually rose from 2015 -2016, from 9.6 percent of births to 9.8 percent.

There seems to be a rather close connection between gum disease and preterm babies, as unrelated as the two may seem. First, consider the risks cited by the Centers for Disease Control & Prevention (CDC). As far back as the year 2000, the Surgeon General warned that pregnant females who had gum disease had a far greater risk of a pre-term, low birth weight baby.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and low birth weight babies (less than 5.5 lbs.).

“Studies have found that expectant mothers with periodontal disease are up to seven times more likely to deliver premature, low birth weight babies.” (https://www.adha.org/resources-docs/7228_Oral_Health_Total.pdf)

One study showed the preterm birth rate for pregnant women with moderate to severe periodontal disease to be nearly 29%.

Estimates are that over half of pregnant women have some form of gingivitis (gum inflammation, an early stage of gum disease) or periodontitis (infectious, advanced gum disease). Nearly a third of pregnant females will acquire gum disease because of their higher vulnerability to inflammation.

Infections in the mother have been identified as increasing the risk for pregnancy complications. Due to varying hormone levels, nearly all females will develop gingivitis during their pregnancy.

Referred to as pregnancy gingivitis, symptoms include swollen, tender gums that bleed easily when brushing. The goal is to halt the inflammation before it progresses to a more infectious stage.

Most obstetricians now urge their pregnant patients (or those trying to conceive) to have a thorough periodontal examination. Even with no obvious signs, gum disease can still exist. It lies beneath the surface of the gum tissues and should be resolved before it worsens and is able to seep into the bloodstream.

Symptoms of gum disease include gums that bleed when brushing, swollen or tender gums, receded gums or gums that darken in color.

When periodontal disease is present, successful treatment has shown to lower the risk of preterm births. A periodontal specialist is trained to treat all levels of disease in a way that is safe for pregnant women (as well as all patients).

Pregnancy is not the sole risk factor for developing gum disease, of course. Most adults of both genders have at least one factor that heightens susceptibility to this oral infection. Among these are stress, poor diet with high sugar intake, smoking, obesity, age, and poor dental hygiene can all contribute to an increased potential for developing periodontal disease.

Other risk factors include clinching or grinding teeth, predisposition due to genetics, diseases such as diabetes or cancer, some medications, and changes in female estrogen levels (puberty, pregnancy, menopause).

Gum disease bacteria is obviously a potent threat to any individual. As the nation’s leading cause of adult tooth loss, oral bacteria of this disease have been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

If you have symptoms associated with gum disease, schedule an appointment at your earliest convenience by calling 828-274-9440. Gum disease will only worsen without treatment.

Considering Dental Implants? Why A Specialist Should Be Your Choice.


Posted on Jun 22, 2020 by William J. Claiborne, DDS MS

With added safety precautions and appointment protocols, our Asheville periodontal dental office has resumed a full schedule. And, we are busy!

In spite of the challenges surrounding a global pandemic, people are still in need of treatment for gum disease. Especially now. Gum disease is an inflammatory disease that is an added burden to the immune system. Because our immune systems need to be operating at peak levels to fight infection, healthy gums are being given renewed recognition.

As a periodontist, I also specialize in the diagnosis and placement of dental implants. We continue to provide this much needed option to patients in need of replacing teeth. After all, regardless of the challenges people face, they still need to be able to bite, chew, and speak.

When it comes to a partial or bridge to replace teeth, a patient faces future risks. Because a partial or bridge rely on adjacent teeth for support, the natural tooth (teeth) that serve to support these appliances bring on a significant challenge.

These dental prosthetics place added pressure and stress to the supporting natural teeth. Thus, there is a greater potential for damage to the structure of the natural teeth. This places those “crowned” teeth at risk for being the next to be lost.

Americans are coming to know that a denture creates a great many challenges. One of the most common complaints has to do with dentures that begin to move or ‘slip’ when eating or even speaking. This is due to bone loss that is occurring under the denture.

Without stimulation to the jaw bone where tooth roots were once supported, the bone begins to shrink. This is known as resorption. As resorption continues, the denture that was designed to the unique shape and height of this gum-covered ‘arch’ no longer provides a snug fit.

Because of this, denture wearers come to rely on denture adhesives and pastes. However, over time even frequent applications of these products are of little help. Relines, another option, can be done to reshape the denture’s base to conform to the shrinking arch. Eventually, even relines provide minimal improvement.

Bone loss also shows up in facial appearance. As the bone structures that give our face its shape start to shrink, deep wrinkles form around the mouth. Eventually, the corners of the mouth will turn downward, even when smiling. Jowls form on each side of the face as facial muscles detach from the declining bone structure.

As the jaw bone continues to shrink, the chin becomes more pointed and the nose seems to move closer to it. This leads to a collapsed mouth, sometimes referred to as a ‘granny look.’ This look ages the appearance of an individual that is far beyond their actual years.

However, the greatest challenge is when eating becomes a struggle. Because of movement and resulting sore spots on tender gum tissues, foods that require biting and rigorous chewing are often set aside for softer foods that dissolve quickly in the mouth.

Unfortunately, these food choices often offer less-than-ideal nutritional benefits, and typically very little fiber. It’s no wonder that denture wearers tend to have more gastrointestinal problems than people who are able to chew sufficiently and comfortably.

To me, what is especially troubling for long-time denture wearers is the avoidance of social gatherings. Studies have shown that being socially involved helps adults be more active both physically and mentally.

In a February 2019 article, Science Daily shared, “Researchers at The University of Texas at Austin have found that older adults who spend more time interacting with a wide range of people were more likely to be physically active and had greater emotional well-being.” (https://www.sciencedaily.com/releases/2019/02/190220074610.htm)

When adults fear embarrassing slips, clicks, or uncomfortable food pieces that become trapped between the gums and denture, declining social invitations becomes more and more frequent. Since many social gatherings include food or are centered around meals, denture-wearing adults have difficult choices to make. Go and hope for the best or risk an embarrassing moment?

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.

In dental implant treatment, the ‘implanted’ portion is positioned into the jaw bone as a tooth root replacement. This provides the attached teeth the same foundation as natural tooth roots have. This also recreates stimulation to the bone, halting the process of bone loss.

So, why should you search out a periodontist for your dental implant treatment? With so many one-stop clinics and online implant “special price today only!”, is the care of a periodontal specialist really needed?

Below are some reasons to consider how your dental implant treatment begins. Because, in the long run, it is a significant factor in the end result.

• Proper diagnosis: A periodontal specialist has advanced training to properly diagnose and place the most appropriate dental implant system for your needs and goals.
• Appropriate treatment: I have a reputation for never over-treating or under-treating. We structure treatment to provide the most successful outcome based on each patient’s unique needs by the most conservative means possible. Thus, the patient avoid having more time and expense than is necessary.
• Proper tools & equipment: As a periodontal office, we are fully prepared for the diagnosis and treatment of all stages of gum disease as well as the placement of dental implants. As such, we can tend to our patients in an efficient and effective manner. This also enables us to provide treatment in minimal time and to an exceptional level of comfort.
• Advanced features: In addition to trust, one of the reasons we receive so many referrals from physicians, dentists, and past/present patients has to do with the advanced technology and features we provide. We are also known for providing a high level of patient comfort through the administration of IV sedation (twilight sleep) with our on-site Board Certified Anesthesiologist. Additionally, diagnosis and treatment planning is backed by images from our on-site 3D Cone Beam technology.
• A respectful environment: We treat each patient with the same respect, compassion and gentle hands that we would want for ourselves and our loved ones. We take great pride in knowing our patients experience the finest periodontal and implant care available in the Southeastern United States.

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.

The 1-2-3’s Of Dental Implants


Posted on Apr 29, 2020 by William J. Claiborne, DDS MS

Over time, certain things are often referred to in catchphrases that simplify what is being described. For example, “Kleenex” is actually a brand name that refers to tissues. “Clorox” is commonly used as a generic for bleach, even though it’s a specific brand. And, “Uber” has become a way to describe a paid means of auto transportation, even if a taxi or Lyft is being used.

This is why the term “dental implant” may be confusing to some people. This implies the replacement of a missing tooth or teeth with a base that is implanted  into the jaw bone. However, to be clear, a dental implant is not an entire structure. Let’s look at the various components of a complete dental implant system.

Although there are different types of implant systems (designed to accommodate specific needs), all work in in a similar fashion. The actual “implant” is a hollow, screw-like cylinder. This is the portion that is actually “implanted” in the jaw bone at a strategic angle and depth.

Once placed, the implant is covered over with gum tissue. For several months after, the implant goes through a process known as “osseointegration.” In this, the bone grows around the implanted portion, which secure it in place. This restores the foundation like that of natural teeth for dependable and comfortable biting and chewing stability.

This stage, often referred to as the “healing” process, typically takes several months. However, a denture or temporary can be worn comfortably so going without teeth is not a worry.

Once healing is complete, a post is secured inside the hollow core of the implant. This post will support your final replacement tooth or teeth. Most replacement teeth are made of porcelain, which provides the most durable of all materials used in dental restorations.

Porcelain is an ideal material for replacement teeth. It is less resistant to stains and provides an exceptionally natural look and feel, even reflecting light as a natural tooth.

A successful outcome in any Dental Implant treatment begins with the selection and placement process. A Periodontist has specialized training in the diagnosis and placement of all types of implant systems. This means the implant system recommended for you will be the type most suited to your individual needs and goals.

An important aspect of implant success also relies on the assessment of bone mass. When the upper or lower jaw has insufficient bone to support the implant being placed, there is a risk of failure. This can occur in implants placed too close to the sinus cavity (for upper implants) or a nerve that runs through the mandible (lower jaw).

Too, an implant requires careful selection and placement in order to adequately support the replacement teeth being attached. In some cases, as few as 4 – 6 implants can support a complete arch of teeth. This decision is best left in the hands of a periodontal specialist.

In cases of severe bone loss, a periodontist can also perform bone rebuilding procedures prior to implant placement. This is sometimes through bone grafting but most commonly the application of a bone-rebuilding material. Additionally, some implant systems, such as the “All On 4” utilize unique angles to provide support in minimal bone depth with no bone rebuilding necessary.

The best implant system for you can be determined after an examination. During this time, I can discuss options best for you and explain the process. Call 828-274-9440 to schedule an appointment. Or, ask to begin with a Consultation.

We also encourage you to share any concerns about comfort options or treatment fees. Many people avoid looking into dental implant treatment because they are afraid of the procedure or fear they cannot manage the fees. Rather than assume these are obstacles, share your concerns so we can address them head on!

 

Why Floss?


Posted on Apr 14, 2020 by William J. Claiborne, DDS MS

As a periodontist, I treat all stages of periodontal (gum) disease. Over the years, I’ve helped patients save natural teeth and restoring their ability to enjoy healthy, confident smiles.

When people come close to losing their teeth or find themselves in need of replacing them with something more dependable than dentures or partials, I hear nearly every one express the same regrets: “I wish I’d taken better care of my teeth when I could.”

Signs of gum disease

Hindsight may be 20-20, but it’s never too late. I know patients can go from having gum disease and losing teeth because of it to having excellent oral health – and end up having a renewed commitment to their smiles.

In my dental specialty, I know it begins by helping patients to understand how the problem starts in the first place. When people know the HOW, they can implement measures to bypass the repercussions of gum disease.

I’ve found that most people actually have very little awareness of how the inside of their mouth looks. We smile with lips and front teeth that show very little (if any gums). So, it stands to reason that, if a smile looks good, it’s probably healthy.

Until dental offices began using intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for a condition that didn’t hurt. There were not obvious signs initially, so nothing is wrong – right?

Intra-oral cameras are able to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual has this firsthand view of spongy, receded gums, the decision to treat often go from IF to WHEN.

Although it helps to be able to show patients the signs of gum disease, these emerged signs are indications of long-standing periodontal disease. By the time these signs appear, the early stage of gum disease, gingivitis, is past.  This is unfortunate, since early-stage gum disease can be halted with prompt measures.

Gingivitis causes the gums to become tender and swollen in some areas. You may see blood in the sink when brushing. These signs indicate that oral bacteria has accumulated in the mouth beyond the means of your immune system’s ability to manage it.

Twice daily brushing and flossing are important steps in keeping bacteria levels in the mouth under control. Brushing sweeps away built up bacteria on the surface of teeth, which is a sticky film known as plaque. Plaque, just over the course of a couple of days, can harden on teeth where build up is allowed to remain. This cement hard mass of bacteria is tartar, or also known as calculus.

The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.

Yet, try as we might, there are simply angles in the mouth that are difficult to reach with a toothbrush, manual or electric. Say you have an area of jumbled or crooked teeth. Even as you adjust the angle of the toothbrush differently to maneuver the bristles into these areas, it is often difficult to continually keep these areas clean.

This is where flossing comes in, and important step in daily, oral hygiene.

Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.

If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a jolting view of exactly what you do NOT want crawling around and breeding in your mouth. These living and breeding organisms can be highly destructive as they amass.

As research has shown for many years, your overall health is intricately linked to your oral health. The bacteria of gum disease has been linked to a long list of serious health problems, including heart disease, stroke, arthritis, some cancers, diabetes, and preterm babies. Studies are underway to track gum disease bacteria to the path of Alzheimer’s disease.

Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.

Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits): “Only four of 10 Americans floss at least once a day, and 20 percent never floss.”

Perhaps this is one reason why over 47 percent of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.

Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued.

It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.

Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. For our patients, we help them develop an at-home care regimen to maintain a healthy mouth and fresh breath between regular dental check-ups.

Be aware of the signs and symptoms of periodontal disease. Knowing them will allow you to react quickly to minimize the extent of damage and treatment needed to rid it. They include:

  • Tender or swollen gums
  • Gum tissues that turn red
  • Gums that are tender to the touch
  • Gums that bleed easily
  • Spitting out blood when brushing or flossing your teeth
  • Frequent bad breath
  • Pus pockets that form between teeth and gums
  • Teeth that loosens or shift
  • Painful chewing
  • Gums that pull away from your teeth (recede), making your teeth look longer than normal

These are all warning signs that bacteria overload is occurring in your mouth. It is a disease, and will only worsen without treatment.

If you suspect you have any stage of gum disease, call 828-274-9440 to schedule a thorough periodontal examination.

 

 

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