Is Your Insurance Ruining Your Oral Health?

Posted on Nov 26, 2019 by William J. Claiborne, DDS MS

A necessary ‘evil.’

These days, insurance coverage seems to be an ever-expanding chunk out of paychecks. Even so, coverages seem to be getting more and more limited.

Yet, health insurance is an investment that provides peace of mind and reminds us that we need to do all we can to stay healthy – and NOT need it! Deductibles, uncovered items, and prescriptions can drain the wallet in spite of what is shelled out for monthly premiums.

Regardless of the insurance coverage you have, taking full advantage of its benefits is an annual goal. Some people have Health Savings Accounts (HSA) to give some padding for certain expenses not covered by insurances.

Because of out-of-pocket expenses, dental patients sometimes make decisions on accepting treatment based on what their insurance covers. This can be detrimental to the patient.

Dental insurance was developed to give people some help for basic annual expenses. For many, this includes twice-a-year dental exams and cleanings. Some policies include assistance for an annual crown or filling, and some coverage for periodontal (gum) therapy to treat gum disease.

Although adults may see these coverages as ample, they can be far from sufficient some years. For aging adults or people who have conditions such as diabetes or take medications that have an oral dryness side effect, basic insurance coverage can be far from what is in your best interest.

Keep in mind that insurance companies are for-profit businesses. What these companies deem coverage-worthy may be far from what is best for a patient’s long term oral health.

Think about this … As of Aug. 2, 2018, publicly traded health care companies amassed $47 billion in profit.  (https://www.axios.com/health-care-industry-on-track-massive-q2-profits-1533226387-dacec8f8-c9f5-406c-a49e-1103e3316c64.html) That’s BILLION.

Sadly, insurance companies tend to serve as judge and jury for some people when it comes to treatment decisions. If an insurance company overrules what a dentist or dental specialist advises, it can leave the patient with an even more-complex situation.

They also use additional limiting terms such as “usual and customary.” This means that it is the insurance company that determines what is reimbursed for the treatment rather than the skill level and reputation of the provider.

Another dilemma for today’s insured patient has to do with the treatment recommended. For instance, when I consult with a patient who is missing teeth, I typically advise dental implants. My recommendation is based upon what will provide the patient with a lifelong solution for missing teeth as well as other benefits.

I look at a dental implant as the ideal in tooth replacement, since it is held in the jaw bone just as natural tooth roots. An implant restores the dependable foundation necessary for biting and chewing, enabling the patient to eat a healthy diet and chew foods comfortably, which supports the digestive system and overall health.

Dental implants are a more expensive option (initially) than crown-&-bridge combinations, dentures, or partials. They are designed to last a lifetime; often far beyond the span of time an average policy holder would stick with the insuring company.

As beneficial as they are to your overall health, dental implants are often deemed as ‘elective’ by insurance companies. This is where the patient must decide: “Is protecting my overall health and smiling confidence a priority to me or should I go with what my insurance coverage allows?”

What it comes down to is, essentially, how we perceive insurance coverage. While major medical insurance gives us peace of mind should we experience a health challenge that would otherwise drain us financially, dental insurance coverages are different.

Dental insurance, for the most part with most policies, is structured as a ‘support’ for helping those covered to maintain a healthy mouth. For people who already have good oral health and are able to tend to it sufficiently between checkups, this is fine. However, for most American adults, tooth repair, tooth loss and gum problems are a fact of life, particularly as we age.

For most of us, the decisions we make today will affect us in the years to come. When it comes to your oral health, don’t let your long-term oral wellness, the longevity of your teeth, the comfort of healthy eating, or the confidence of smiling and laughter be dictated by what insurance coverage allows.

When it comes to your smile, put your needs first.

If you trust your dentist and others involved to guide you towards good oral health and maintaining your smile, consider their recommendations and ask questions. Be an informed consumer. But, most importantly, make decisions that are in your best interest rather than that a for-profit insurance company deems is worthy for your smile.

If you don’t have regular dental care and would like recommendations, feel free to contact us at 828-274-9440. We work with exceptional general dentists in Western North Carolina and will be proud to connect you. Or, feel free to begin with a thorough periodontal exam here. We will make recommendations based upon your unique needs and goals.

Obesity Increases Risk Of Gum Disease.

Posted on Nov 20, 2019 by William J. Claiborne, DDS MS

Imagine one-third of your body being made up of maple syrup.

Sounds pretty absurd, doesn’t it? Yet, for Americans who are categorically obese, this imagery is actually a good description.

Obesity is when fat makes up over thirty percent of body mass. According to the Centers For Disease Control & Prevention (CDC), adults in the U.S. who are categorized as obese is at nearly 40 percent! Another 30 percent are categorized at overweight. That’s two-thirds of adults in the U.S. who have too much fat makeup.

And it’s not just adults over the age of 20 who have this problem. Sadly, nearly 30 percent of children are overweight or obese as well.

In North Carolina, over 63 percent of adults are either overweight or obese, according to a study by the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.  (https://onlinelibrary.wiley.com/doi/full/10.1002/oby.20451)

The problems associated with being overweight and obese are many, and can be deadly. Obesity seems to trigger a predisposition to a variety of serious health conditions and diseases. These include increased risk of stroke, certain cancers, coronary artery disease, and type 2 diabetes.

In addition to the added and unnecessary load that strains the back, knees and ankles, the challenges continue. Obesity decreases lifespan, up to an estimated 20 percent of people who are severely obese. (https://www.nejm.org/doi/full/10.1056/NEJMsr043743)

As 2019 holiday indulgences (often sugary and carb-laden) are before us, many of us also follow the season with with the traditional new year’s resolution of “lose weight” at the top of the list. Along with improved health and greater confidence in overall appearance, we’d like to add another reason to reach your goal.

Chronic inflammation is a known side effect obesity. Why does this matter to a Periodontist? Obesity is also known to exacerbate other inflammatory disorders, including periodontitis (advanced gum disease).  To be clear, periodontal disease is also the nation’s leading cause of adult tooth loss.

Research has shown that obese adults have a 6 times higher potential to develop periodontal (gum) disease. As a periodontal specialist my goal is always to help patients achieve optimal oral health. Although discussing the risks of periodontal disease with obese patients can be a sensitive issue, this is without judgement of why they are overweight but rather how we can help them enjoy a healthier smile.

Most of us know – losing weight is not a process that is either easy or quick. Add to this that research has shown that factors such as sleep quality and what we eat (as much as how much we eat) can cause the brain to make the challenges of weight loss even greater.

For one, studies have shown that sugar can be addictive. Sugar consumption even activates the same regions in the brain that react to cocaine. For individuals who admit to having a “sweet tooth,” trying to stay within the recommended 6 teaspoons per day limit can be a battle when we are truly “addicted.”  (https://www.brainmdhealth.com/blog/what-do-sugar-and-cocaine-have-in-common/)

Insufficient sleep also complicates the brain’s ability to regulate hunger hormones, known as ghrelin and leptin. Ghrelin stimulates the appetite while leptin sends signals of feeling full. When the body is sleep-deprived, the level of ghrelin rises while leptin levels decrease. This leads to an increase in hunger.

The National Sleep Foundation states that “people who don’t get enough sleep eat twice as much fat and more than 300 extra calories the next day, compared with those who sleep for eight hours.” (https://www.sleepfoundation.org/sleep-topics/the-connection-between-sleep-and-overeating)

As difficult as losing weight can be, it is important to be aware of risk factors that can make you more suspectible to gum disease. Initial symptoms include gums that are tender, swollen, and may bleed when brushing. This stage, known as gingivitis, is actually reversible with prompt, thorough oral hygiene.

As gum disease worsens, however, the inflammation of oral bacteria can lead to persistent bad breath, receded gums that expose sensitive tooth roots, and gums that darken in color. If untreated, pus pockets can eventually form and the base of some teeth and tooth loosening can require removal.

Armed with this information, we want to help all patients, with overweight or obese adults especially, to take added precautions to maintain good oral health, both at home and through regular dental check-ups.

Avoiding periodontal disease is particularly important since its infectious bacteria have been linked to serious health problems. These include heart disease, diabetes, arthritis, some cancers, preterm babies, impotency, and Alzheimer’s disease.

If you are experiencing symptoms of gum disease, however, it is vital to be seen by a periodontist as soon as possible to halt further progression. A periodontist is a dental specialist who has advanced training in treating all stages of gum disease as well as in the placement of dental implants. The earlier the treatment, the less involved treatment requirements will be. Gum disease will not improve without professional care.

Call 828-274-9440 to schedule an initial examination or begin with a consultation.

Missing Teeth Should Be Replaced For The GOOD Of Overall Well-Being.

Posted on Oct 22, 2019 by William J. Claiborne, DDS MS

Sometimes, it’s what we can’t see that can do the most harm.

A surprising example of that is wearing dentures. While dentures and partial dentures do replace the presence of teeth, they actually have a detrimental effect on what lies beneath.

If you remove your denture, you can actually SEE what’s going on.

For people who have worn dentures or partials for ten years or more, the appliance has applied pressure to the bone ‘ridge’ that once supported natural teeth. And, without the stimulation of tooth roots in the bone, the jaw begins to decline in mass.

Without the denture in place to “fluff up” the shape of the mouth, a look in the mirror can reveal signs of bone loss. These include:

• Deep wrinkles around your mouth.
• The corners of your mouth turn downward, even in a smile.
• The mouth seems sunken in. Jowls have formed on the sides of the face.
• The chin seems more pointed than in your youth.
• The chin may also seem closer to the nose.

This decline in bone occurs when a tooth root is removed from the jaw bone. Without natural tooth roots to nourish and stimulate the root, the process of ‘resorption’ begins.

Additionally, resorption increases risks for tooth loss to neighboring natural teeth. As the jaw bone declines in an area to adjacent tooth roots, these teeth are more vulnerable to cavities, gum disease, and fractures.

It is a fact that when a tooth is lost, the one next to the one missing is most likely the next to be lost.

For people who opt to replace a tooth (or teeth) with a crown-&-bridge, they can also expect bone loss. Over time, this is visible by a gap that seen between the base of the bridge and the natural gum tissues.

As a periodontist, the most common complaint I hear from those who wear dentures or partials is having discomfort while eating. Many long-time denture and partial wearers experience sore spots on tender gum tissues. This occurs because their appliances move when chewing certain foods.

This movement is the result of the declined bone mass that supports the denture. This gum-covered ‘ridge’ where teeth were once held flattens as the jaw bone declines in height and mass. Because a denture or partial is made to contour to this ridge, it begins to slip as the bone shrinks. This is when people tend to use denture adhesives and pastes more frequently.

To avoid discomfort when eating, denture wearers begin to alter their food selections, opting for soft foods that dissolve quickly in the mouth without having to chew. In many cases, these choices lack the fiber, vitamins, minerals and protein needed for proper nutrition.

To no surprise, denture wearers are known to take more medications and have more gastrointestinal problems than non-denture wearers. Yet, the problems of “slippery” or “wobbly” dentures can affect social involvement as well.

Due to fear of embarrassing slips, denture wearers begin to decline social gatherings where food is the centerpiece. Social involvement is a healthy part of keeping our brains and bodies active, which is a positive part of aging.

It stands to reason that there is a need to replace more than the mere presence of teeth. This is why so many dentists and dental specialists now recommend dental implants. For decades now, they have been a dependable option to replace missing natural teeth.

There are many advantages to dental implants. From a health standpoint, I see their ability to halt bone loss as a leading benefit. Dental implants are placed in the jaw bone, recreating the stimulation of tooth roots. This helps to preserve the strength of the jaw bone while restoring biting strength and chewing stability.

I also like that dental implants are self-supporting since they use the jaw bone for support. They do not rely on having otherwise-healthy, natural teeth crowned for the mere purpose of supporting replacement teeth (as in crown-&-bridge combinations).

From a value perspective, dental implants are an excellent investment. With proper selection, placement and care, they are designed to last your lifetime. And, it’s an investment you’ll enjoy every day as you comfortably eat foods you love, smile and laugh without worry, and wake up with a smile!

There is much to know as to why keeping your natural teeth is so important. However, when tooth loss does occur, you can protect your health and well-being by replacing them with implants. With dental implants, you are able to avoid the long-term repercussions of bone loss.

When extreme bone loss has occurred, we can restore bone mass through several methods. One uses a bone-rebuilding material that generates new growth. For some patients who have lost bone due to gum disease, our Asheville periodontal dental office also offers LANAP technology (Laser-Assisted New Attachment Procedure). This advanced technology has been found to stimulate bone regrowth in damaged areas.

Ask about dental implants to restore a natural look and feel while you protect surrounding teeth and bone structure. As a periodontist with advanced training in the diagnosis and placement of all types of implant systems, I can recommend options that will work best for your individual situation.

Call 828-274-9440 to learn more or ask for a consultation to personally discuss your needs and preferences.

Rheumatoid Arthritis (RA) Linked To Periodontal Disease

Posted on Oct 02, 2019 by William J. Claiborne, DDS MS

As a periodontist, I specialize in the treatment of all stages of periodontal (gum) disease. Although this particular dental specialty is not as visible as a general dentist, we are very-involved members of the medical and dental community. According to the Centers for Disease Control & Prevention (CDC), over 47 percent of American adults have some level of gum disease.

Like the formation of cancer, many individuals are unaware when periodontal disease becomes active. When early symptoms appear (such as bleeding gums when brushing, bad breath and gum tenderness), many people shrug them off as temporary.

However, gum disease only progresses once underway. Eventually, gums become red in color and pus pockets form at the base of teeth. In advanced stages, teeth loosen and may require removal. Gum disease, to no surprise, is the nation’s leading cause of adult tooth loss.

The potent bacteria of periodontal disease can enter the bloodstream through tears in weakened gum tissues. This allows it to travel throughout the body. Research has shown it is able to trigger a number of serious health problems, including heart disease, stroke, diabetes, memory loss, and impotency.

Rheumatoid arthritis (RA), a condition seemingly unrelated to gum disease, is a debilitating disease that destroys joints. It is disabling and painful. In most cases, RA emerges gradually, often beginning with morning stiffness along with weak and aching muscles. Joint pain follows, with joints feeling sore and stiff. RA is typically found in the fingers, wrists, elbows, hips, knees, ankles, toes, shoulder and neck.

As inflammation from RA increases, joints become swollen with symptoms including fever, disfiguring of hands and feet, numbness and tingling. There is no cure for RA and lifelong treatment is required. Treatment may consist of medications, physical therapy, or even surgery.

Yet, like RA, gum disease causes pain, swelling, and tenderness. As it worsens, the associated inflammation can lead to destruction of the bone that supports teeth along with surrounding tissues. And, the similarities go much deeper.

Both gum disease and RA share a genetic likeness in clinical makeup and structures. This has been particularly apparent in pathogens, which are agents in the body that lead to disease or illness. The pathological processes that occurs in both gum disease and RA are almost identical.

Too, the particular species of bacteria found in gum-diseased oral tissues and tissues that surround joints in those who suffer with RA. Equally concerning is, while both conditions clearly cause chronic inflammation in tissues connected to bone, researchers have found the two diseases share a similar inflammatory trigger.

In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis. It has also been shown that, by treating periodontal disease in RA patients, RA symptoms often improve ( likely due to the system’s reduced burden of oral inflammation).

These findings reveal just how closely our oral health correlates

to our overall health. This information should send up alarms that the presence of gum disease can greatly increase your risk for serious health conditions. Clearly, people who have RA should be particularly diligent when it comes to their oral health.

If you are experiencing symptoms of gum disease (as mentioned above), seek treatment at your earliest convenience. You can begin with a consultation appointment in our  comfortable Asheville periodontal office. A referral is not needed.

Call 828-274-9440 to learn more.