How You Develop Gum Disease, And How To Avoid It.

Posted on May 29, 2019 by William J. Claiborne, DDS MS

Other than a canker sore or bite on the cheek, almost no problem in the mouth will clear up on its own. This is often because the symptoms of most oral problems don’t emerge until they are well-developed.

For example, a cavity typically doesn’t become obvious until it begins to ache. Once it causes discomfort, it is a well-established problem. It won’t repair itself, and will eventually worsen (and become even more painful) to the extent where removal becomes necessary.

As a Periodontist, I often see people who have developed periodontal disease who come (or have been referred) because they are enduring obvious problems. However, I also see patients who are surprised to learn they have developed the disease. Yet, even without obvious symptoms, gum disease may exist and be fully underway.

For some people, warning signs are ignored. Some simply don’t associate bad breath or bleeding gums with a disease of the mouth. As a matter of fact, I see may people who first arrive and proudly claim they do such a good job brushing their teeth, they spit blood in the sink.

Let’s use this time together to understand how gum disease forms and the symptoms associated with it. The typical process of how gum disease begins and progresses is:

1. Accumulation Of Oral Bacteria – We all have bacteria in our mouths. This warm, moist environment takes in an enormous amount of bacteria-laden items. Bacteria is on our food, utensils, the glass we drink from and the pencil we hold between our teeth. Of course, bacteria cannot be prevented altogether. However, the problem begins when too much bacteria accumulate.

2. Plaque Forms – Without proper brushing, flossing, saliva flow and diet, oral bacteria can reproduce rapidly. Their accumulation over the course of a day forms a sticky film you feel on teeth. This is known as plaque.

3. Development of Calculus – In just 48 hours, unremoved calculus, also known as tartar, can harden onto teeth. This is actually a cement-hard colony of oral bacteria. Like plaque, calculus will continually reproduce and grow as the bacteria feed on tooth enamel and tender gum tissues.

4. Initial Stage Gingivitis – This is actually the first stage of gum disease. At this level, gum tissues are under attack and become sore. They may bleed easily when brushing and you may experience an aching sensation in some areas. Your breath will no longer feel fresh. At this point, with proper measures, you can restore your gums to a healthy state. However, there is a fine line between being able to undo gingivitis and its progression to gum disease.

5. Periodontal (Gum) Disease – At this level, the gums are inflamed and tender. You may notice them darken in color and begin to pull away from the base of some teeth. You’ll have persistent bad breath.

6. Advanced Gum Disease – When gum disease progresses to periodontitis, your breath odor is persistently offensive. Bacteria-filled pus pockets may form on gum tissues near the base of some teeth. Chewing becomes painful and teeth can loosen, eventually requiring removal.

There are various stages of periodontitis. The Mayo Clinic does an excellent job explaining these advanced-stage levels (https://www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473):

• Chronic periodontitis is the most common type, affecting mostly adults, though children can be affected, too. This type is caused by plaque buildup and involves slow deterioration that may improve and get worse over time but causes destruction in the gums and bone and loss of teeth if not treated.
• Aggressive periodontitis usually begins in childhood or early adulthood and affects only a small number of people. It tends to affect families and causes rapid progression of bone and tooth loss if untreated.
• Necrotizing periodontal disease is characterized by the death of gum tissue, tooth ligaments and supporting bone caused by lack of blood supply (necrosis), resulting in severe infection. This type generally occurs in people with a suppressed immune system — such as from HIV infection, cancer treatment or other causes — and malnutrition.

Nearly half of American adults have some level of gum disease. Sadly, it is the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.

Twice daily brushing (at least two minutes per time), daily flossing, drinking ample water and limiting sweets and caffeine are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. And, those 6-month check-ups are important. At this time, any tartar that has accumulated can be removed and signs of early gum disease can be noted.

Imagine losing your teeth and having to decide on a crown-&-bridge combination, partial, full denture or Dental Implants. These procedures and expenses can be avoided. And, contrary to what many believe, losing teeth is not a natural part of the aging process. With proper care, you can easily enjoy a smile of natural teeth all your life.

If you are experiencing symptoms of gum disease, call 828-274-9440. We’ll restore your oral wellness and develop a program to help you keep it at its best.

Scared? Afraid? Simple Steps To Get Past Dental Fears.

Posted on Apr 30, 2019 by William J. Claiborne, DDS MS

If you’re one of those people who have no dread of going to see a dentist, be glad. For the large percentage of adults who do experience anxiety or fear associated with dental visits,  they are actually in the majority.

In the U.S., an estimated 70 percent of adults have some level of dental fear, unfortunately. About 5-10 percent of them can be categorized as “dental phobics.” These individuals have such an intense fear of dental visits that the mere thoughts of walking into an office causes reactions such as sweating or more rapid breathing.

As a periodontist, I’m a frequent witness to just how severe dental fears can be. Some people cry, some keep a white-knuckled grip on the arms of a dental chair (once they finally talk themselves into one), and some ask to be put to sleep for things as minor as dental cleanings.

The periodontal specialty provides patients with a dental professional who has advanced training in the diagnosis and treatment of gum disease. It also covers the diagnosis and placement of dental implants, which are the “ideal” tooth replacement. In this field, I’ve seen the repercussions of both due to dental fear.

By not receiving regular dental cleanings and exams, the risks for developing gum disease rise significantly. And, since gum disease is the leading cause of adult tooth loss, it plays a key role in one’s potential to lose natural teeth.

Dental fear leads to a vicious cycle of poor oral health and tooth loss. When people are too afraid to see a dentist for regular care and fail to have small problems repaired while treatment needs (and costs) are still minimal, the process is ongoing. As gum health declines, the risks for tooth loss increases.

No one wants to end up in dentures. While TV commercials for denture adhesives or same-day denture clinics try to come across as upbeat, life wearing a denture is anything but. Long-time denture wearers struggle to bite, chew, and even speak without worrisome, uncomfortable slips or rubbing against tender gum tissues.

Too, the uncertainty of a denture can make some people uneasy when dining out or in other social settings. It’s not unusual for denture wearers to decline invitations when food is a key centerpiece of the gathering. This is sad. It is also detrimental to one’s health. Social involvement is an important part of our overall well-being.

If you are among those who avoid dental care because of uncontrollable jitters or downright “scared” feelings, below are several steps you may wish to consider to help you move past them:

• Begin by writing down what you believe caused your fears in the first place. Was it a painful procedure? Was it a rough dentist who ignored your obvious discomfort? If you know what sparked your fear in the first place and can look-it-in-the-eye in actual words, you can begin to deal with them. This may help you bring them out of the shadows and into the light where you can begin to conquer them.

• Close your eyes and imagine your life with a healthy smile — one that makes you feel good about being close to others. Imagine conversations having fresh breath and smiling with confidence. Imagine getting compliments on your smile! Think about how you may interact more confidently with others with a smile you’re proud to share.

• If you haven’t seen a dentist on a regular basis, you may need to begin with a periodontal examination. You can do an internet search (Periodontist) in your area and get to know them through their web sites. Read the doctor’s bio and become familiar with what he or she offers in terms of technology and comfort options. When a periodontist keeps current on the techniques and technology surrounding this specialty, patient comfort is typically a leading factor among these features.

• Visit the periodontist’s office after hours. Yes, go there when they are closed so you’ll feel less intimated. Sit in the parking lot and imagine where you’d park for your visit, once scheduled. Walk up to the entrance and become familiar with the look of the entryway. This way, when your appointment is made, you’ll feel more comfortable making your way in the door.

• Call the office and be comfortable sharing your concerns. Don’t feel shy about saying, “I have a lot of dental fear and would like to begin by meeting the doctor.” Most offices have these conversations with new callers more often than you realize. As mentioned prior, dental fear and anxiety are fairly common. Most offices offer an initial consultation so you can get to know the doctor before scheduling an exam. Ask about where this consult will be held. The periodontist should have a private room available for this, where it is not part of the clinical side of the practice.

• The day of your appointment, call the office and ask about anticipated waiting time for your appointment. Most offices run on-time and your wait should be less than 15 minutes. However, unforeseen emergencies do arise that may disrupt an on-time schedule. If delayed, consider rescheduling. Having a lengthy wait time may add to your anxiety and it may be best to arrange another visit.

• When you go, take a book, newspaper, or favorite magazine for your wait time. Don’t assume that the periodontist has a selection you’ll be interested in. Some people like to work a crossword or ‘Jumble’ during their brief wait here.

• When meeting the doctor or staff, know that it is important to be straight-forward about your fear level. Don’t gloss over it. Being upfront will help the doctor tailor your care to address your fears or concerns at an appropriate level.

• Ask the doctor about comfort options, including sedation. Both oral and IV sedation (twilight sleep) should be available. Feel free to ask questions about how they are administered, recovery time, and safety monitoring measures. Your safety is as important as your comfort.

• Finally, listen to your gut. Did you feel the doctor truly ‘heard’ your concerns? Did you feel the staff was attentive? Did you feel confident in the appearance of the practice? Sometimes, the most important measure of comfort is what that “little voice” inside is telling us. If you don’t feel good about moving forward, consider a consult at another periodontal office. You should leave your consult feeling positive about moving forward.

One of the most satisfying parts of my specialty is watching a once-fearful patient transform into one with a healthy, confident smile! And, the foundation of that is a relationship of trust between the doctor and the patient.

If you are ready to get past your dental fears so you can have the smile you desire, begin by calling our Asheville periodontal office and speaking with our friendly staff at: 828-274-9440. Or, start with the steps listed above and move at a pace that feels best for you.

Pregnant? Make Oral Health A Particular Priority!

Posted on Apr 23, 2019 by William J. Claiborne, DDS MS

With pregnancy, there seems to be a long list of do’s and don’ts for the mom-to-be. For instance, pregnant women are advised to avoid most drugs, alcohol, certain foods, and all smoking! Proper exercise, a balanced diet, and plenty of sleep help to keep both mother and baby healthy when it comes time for delivery.

Now, obstetricians are urging their pregnant patients (or those trying to become pregnant) to add a very important item to this list. They are advising particular devotion to achieving and maintaining good oral health.

The reason to keep a healthy mouth is based on decades of research and findings related to how infectious bacteria of periodontal (gum) disease can penetrate the bloodstream. Once bloodborne, the bacteria are able to activate inflammatory triggers elsewhere in the body.

A mother-to-be is especially vulnerable to gum disease due to hormonal changes during her pregnancy. Almost 50 percent develop pregnancy gingivitis, a mild form of gum disease that causes gums to become swollen, tender and bleed easily when brushing.

However, because of their susceptibility, the risk for full-blown gum disease is higher for pregnant females with nearly a third developing gum disease.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and babies of low birth weight (less than 5.5 lbs.). One study showed the preterm birth rate for females without gum disease to be approximately 11 percent compared to nearly 29 percent for pregnant women with moderate to severe periodontal disease.

It has also been shown that gum disease increases the likelihood for late-term miscarriage and pre-eclampsia. When oral bacteria reach placental membranes via the bloodstream, inflammatory reactions were found to trigger pre-eclampsia or early labor.

One study showed that pregnant women with higher blood levels of antibodies to oral bacteria also had higher incidences of preterm birth and babies of low birth weight. These elevated antibodies have been found in amniotic fluid and fetal cord blood samples of infants who were preterm or of low birth weight at birth.

When periodontal disease is present, however, successful treatment has shown to lower the risk of preterm births.

For all individuals, however, the bacteria of gum disease is coming to light as a major contributor to a number of serious health problems. It is the nation’s’ leading cause of adult tooth loss and has been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

Once the infectious bacteria of gum disease enter the bloodstream (typically through tears in weakened gum tissues), it can trigger inflammatory reactions, many serious and some that can have deadly consequences.

It is important to know the signs and symptoms of gum disease. These include gums that bleed when brushing, frequent bad breath, swollen or tender gums, gums that pull away from the base of teeth, or gums that darken in color.

While any of these should prompt an individual to seek out periodontal treatment, pregnant women have a particular need to seek care. A periodontist has specialized training in the diagnosis and treatment of all levels of gum disease – in a way that is safe for pregnant women (as well as all patients).

If you have any of the symptoms mentioned above (whether pregnant or not), you are urged to schedule an appointment at your earliest convenience. Call 828-274-9440 to arrange an examination to begin.

Oral Bacteria Research Shows Links To Pancreatic Cancer

Posted on Apr 15, 2019 by William J. Claiborne, DDS MS

According to a number of studies, the oral bacteria of periodontal (gum) disease has been linked to serious health problems, including some cancers. Apparently, the inflammation triggered by the infectious bacteria in the mouth are now suspected to be a contributing factor in the development of pancreatic cancer.

Because it is typically not diagnosed until at advanced stages, pancreatic cancer has a a long-standing reputation for its deadly track record. This year, over 50,000 people will be diagnosed with pancreatic cancer. Less than 10 percent will survive past the five year mark.

For years, researchers have been able to show that the infectious bacteria of periodontal disease are able to enter the bloodstream through tears in weakened tissues. Once bloodborne, these bacteria have been a trigger for inflammatory reactions elsewhere in the body. In addition to some cancers, research to-date has linked oral bacteria to heart disease, stroke, high blood pressure, diabetes, arthritis, preterm babies, impotency and erectile dysfunction.

In a long-term study to track oral bacteria-pancreatic cancer links, the DNA from saliva samples was analyzed from over 360 adults who eventually developed pancreatic cancer. Researchers compared these samples to the DNA in saliva of a similar number of adults who remained healthy.

Adjustments were made in both groups for considerations of age, race, sex and body mass as well as alcohol use, smoking and being diabetic. The participants who developed pancreatic cancer within two years after the DNA samples were taken were omitted to eliminate pre-existing factors that could influence statistical outcomes.

With findings from prior research, this study allowed researchers to hone in on two specific types of periodontal disease pathogens. Researchers noted that one pathogen was more prevalent in the saliva of participants who developed pancreatic cancer, noting a 59 percent greater risk of developing pancreatic cancer. The second pathogen was shown to increase this risk by 50 percent.

In early stages, the symptoms of gum disease include tender gums that bleed easily when brushing and frequent bad breath. As it worsens, the gums become sore and swollen, darken in color to red, and cause gum tissues to loosen their grip around the base of teeth. Eventually, teeth will loosen and may require removal. Because over 47 percent of American adults have some level of periodontal disease, it is no wonder that gum disease is the nation’s leading cause of adult tooth loss.

Hopefully, the general public will learn of extensive research results that show that periodontal disease bacteria is destructive and deadly. As findings from further studies continue to be revealed, it is important to be proactive when it comes to the symptoms of periodontal disease. Remember, gum disease will only worsen without treatment.

Call 828-274-9440 to begin with a thorough periodontal examination. As a periodontist, our Asheville periodontal office offers specialized treatment for all levels of gum disease. Through this, I will explain how we will determine the state of your current oral health and subsequent recommendations that will restore you to excellent oral wellness.