Get Dental Fear Out Of The Way and Enjoy A Healthy Confident Smile
Posted on Jan 18, 2023 by William J. Claiborne, DDS MS
It’s a new year. Hopefully, this new beginning has given you renewed determination to conquer challenges that have held you back from living the life you want.
While some people want to lose weight and others wish to learn something new, I tend to see many people at the first of each year who wish to achieve a healthy, confident smile. A large number of these people have been less-than-successful in the past because of having dental fear.
Dental fear and high anxiety associated with dental visits is not uncommon. These fears are often borne from a traumatic incident in the patient’s past. Or, in some cases, it exists for unknown reasons. Too, certain smells, sounds or sights can trigger reactions that evoke fear at even mere thoughts of dental visits.
Oral health is an integral part of your overall health. For decades, studies have proven a direct contact between poor oral health and disease related to other organs. By neglecting dental hygiene, people are at greater risk of developing (or the worsening of) serious diseases and conditions. To avoid these risks, good dental care at home and having regular dental check-ups help empower adults in improving oral health and wellness.
As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Certainly, avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss. However, the repercussions of poor oral health can wreak havoc on one’s overall health.
It’s not uncommon for adults who avoid dental visits to feel they are doing a “good enough job” at maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass regular dental cleanings and exams. Yet, even the best of at-home dental hygiene can be insufficient.
Even people who feel they are dong a good job at the sink can easily miss areas of bacteria accumulation. Grooves in the tops of teeth and the tight nooks formed by crooked teeth become ideal hiding spots for bacteria growth.
Oral bacteria reproduce rapidly and, when at a certain point, can trigger inflammatory reactions. In addition to being the origin of cavities and periodontal (gum) disease, these reactions can extend far beyond the mouth (some of which are listed below).
Gum disease is the nation’s leading cause of adult tooth loss. The same infectious bacteria that destroy gums and structures that support natural teeth aren’t confined to the oral proximity. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.
Research has correlated oral bacteria to an extensive list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. For those who avoid dental care due to anxiety or fear, knowing this is not necessarily going to quell their anxiety. However, allowing dental fear to prevent you from achieving a healthy smile can increase health risks you may not realize.
Just how bad are the risks?
Dementia & Alzheimer’s disease: Gum disease occurs when infection of the oral tissues develops. It causes bleeding gums, putrid breath odor, loose teeth, and tooth loss. Oral bacteria and the inflammatory molecules that develop can enter the bloodstream, making their way to the brain. Previous lab studies have suggested that this is a potential risk factor in the sequence of events that lead to dementia.
Alzheimer’s disease is the most common form of dementia that destroys memory, shrinks the brain, and affects the brain cells to die. It degenerates the functioning of mental health, which leads to memory loss and confusion. During Alzheimer’s, loss of appetite may worsen, eventually giving rise to oral health problems. The bacterium P. gingivalis appears to migrate from the mouth to the brain of some individuals as they age with a significant proportion of subjects developing Alzheimer’s disease.
Cardiovascular disease: A potential association exists between atherosclerosis (i.e. plaque deposition in blood vessels) and periodontal pathogens. There is a broad base of common genetic variants which increase both the risk of cardiovascular disease and the risk of periodontitis.
Endocarditis: Bacteremia (defined as the entry of bacteria into the blood stream) is a precondition for endocarditis. The vast majority of bacteremia do not cause endocarditis, even in patients at high risk. However, in high-risk patients, the more frequently and the more intensely bacteremia occurs, the greater the likelihood of endocarditis. Periodontal therapy has been shown to have a protective effect in people at risk of endocarditis.
Erectile Dysfunction: In the U.S., an estimated 18% of males have erectile dysfunction (ED). Men over the age of 70 are more likely to have ED compared to 5% between ages 20 – 40. Studies have shown an association between gum disease and pancreatic cancer. From analyzed data of five studies between 2009 – 2014, studies followed 213,000 participants aged 20 – 80.
Each study found erectile dysfunction was more common among men with chronic periodontitis, particularly for those younger than 40 and older than 59. After accounting for other health factors, erectile dysfunction was found to be 2.28 times more common for men who had advanced gum disease than for men without it.
Stroke: In one study of 265 stroke patients, researchers found that patients with gum disease had twice as many strokes due to thickening and hardening of brain arteries as patients without. Additionally, patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.
In a separate study of over 1,100 patients who had not experienced a stroke, researchers noted that 10% had severely blocked brain arteries. They also found that patients with gum inflammation were twice as likely to have moderately severe narrowing of brain arteries.
Arthritis: For decades, it was perceived that RA (rheumatoid arthritis) patients had such a high risk of gum disease due to poor oral hygiene because of dexterity problems with using a toothbrush. However, more recent studies now show that gum disease is actually a risk factor for arthritis.
While genetic factors certainly contribute to greater RA susceptibility, the true source has been determined to be inflammatory reactions. This inflammation is triggered primarily by bacterial infections, with oral bacteria being a significant contributor to inflammatory arthritis.
Researchers found that people with severe periodontal disease also had severe rheumatoid arthritis. Patients with the most plaque, bleeding and gum tissue breakdown had worse RA by all measures, including disease activity and inflammatory markers. Other studies have found that even with treatment, RA patients with periodontitis continue to have worse arthritis symptoms and are 50% less likely to be in remission.
The relationship between gum disease and arthritis isn’t just seen in adults. Kids with juvenile idiopathic arthritis (JIA) have inflammatory mouth bacteria not found in their healthy peers. Different types of bacteria seem to correspond to specific aspects of JIA.
Some are associated with higher disease activity and others with a greater number of affected joints.
Diabetes: It has been known that acute inflammation may lead to poor glycemic control. This is due to the fact that infections reduce the uptake of glucose into cells, and endotoxins and inflammatory mediators reduce the efficiency of insulin. Due to these pathways, periodontitis (advanced gum disease) has long been regarded as a risk factor for poor blood glucose control in diabetes patients.
Pre-Term Babies: The elevated hormone levels during pregnancy create a higher vulnerability to gum disease; the reason about half of pregnant females experience swollen, red and tender gums that bleed while brushing. Known as Pregnancy Gingivitis, the gums are more susceptible to inflammation, thus more sensitive to the bacteria of gum disease.
Studies have shown that gum disease increases the risk for preterm delivery (before 37 weeks) and low birth weight babies. Gum disease also increases the risk for poor obstetrical outcomes, late miscarriage and pre-eclampsia. For example, the preterm birth rate for women without periodontal disease is approximately 11% compared to nearly 29% for females with moderate to severe gum disease.
Through tears in gum tissues, oral bacteria can enter the bloodstream. Once this bacteria reaches placental membranes, it can trigger inflammation that can cause preeclampsia or labor.
While these health concerns are all reasons to renew your commitment to achieving and maintaining a healthy smile, the image of having a terrific smile you want to share often is an added perk of having good oral health. As a periodontist, I have advanced skills in the treatment of all stages of gum disease as well as the placement of all types of dental implants.
If dental fear is holding you back, let us help your 2023 be the year you take your smile back! Begin by understanding that having discomfort or pain is NOT a part of today’s dentistry. In our Asheville periodontal dental office, we have advanced skills and technology that enhance comfort and minimize treatment time.
Here, we make patient comfort a priority at every visit. We have even designed our reception area to pamper you from the moment you enter.
We offer a private consultation room for patients as well. In this room, we can discuss your treatment and answer your questions in a comfortable setting. This allows patients to become better informed about their treatment needs and options versus communicating while they are seated in a treatment chair.
Our surgical suite offers a rather unique setting for a periodontal office. A large window provides beautiful mountain views, very soothing to our patients. In addition, we offer oral sedation as well as I.V. sedation (twilight sleep) for most procedures, if desired.
Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation places the patient in a deeper sedative state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are monitored with advanced safety equipment throughout treatment.
Our entire staff provide a unified team, each bringing a sincere level of compassion and commitment to excellent care. While the doctors involved in your care are top-notch, I must admit that our staff are the pros at making our patients feel truly pampered.
When patients realize that our goal is to provide exceptional care in TOTAL comfort, they relax. When they experience this, they relax even more. When they experience this more than once, a sense of trust is born. When patients trust us, they feel they no longer need to avoid dental care. Like everyone, fearful patients desire a healthy, confident smile. Once the obstacle of fear is removed, their ability to achieve that is greatly heightened.
If you or someone you know has fear that has prevented needed or desired dental care, schedule a consultation appointment. This will take place in our private consultation room. Here, we can discuss your needs and concerns and have your questions answered thoroughly. From there, you can determine what pace is best for you.
Call 828-274-9440 to learn more. Our friendly phone staff will make you feel good from the very beginning!
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.
Flu Season, Covid Worries Bring Dentures To A Worrisome Light
Posted on Nov 28, 2022 by William J. Claiborne, DDS MS
With the flu season now underway, 2022-23 seems especially concerning. The severity of flu for certain population segments is coupled with added concerns about increasing cases of the Covid virus. This has older adults, in particular, taking added precautions with mask wearing, limiting public outings, and ensuring vaccines are up to date.
When it comes to contributors to acquiring the flu, however, oral health is one that is often overlooked. Things like wearing dentures and having gum disease can create higher susceptibility to developing the flu (as well as other health problems) than many are aware.
Losing teeth in a lifetime happens. However, it is most prominent in adults as they age. Over a life span, teeth take an enormous brunt of wear and tear. More than 13% of adults between ages of 65 – 74 have lost all of their teeth with this percentage doubling after age 75. (https://www.cdc.gov/oralhealth/basics/adult-oral-health/adult_older.htm)
Because older adults comprise a significant portion of the population, tooth loss is an especially troubling health concern. According to the Centers for Disease Control & Prevention (CDC), the number of U.S. adults ages 65 and older is expected to reach nearly one-fourth of the overall population by the year 2060.
While replacing teeth can be done rather inexpensively through dentures, replacing the presence of teeth is very different from replacing their function. Dentures do very little to support the ability to bite confidently and chew thoroughly. Here’s why…
When dentures are first made, they are conformed to fit the specific curves and arches of the existing bone ridge where teeth were once held. Without natural tooth roots in the jaw bone (where natural teeth were once supported), the bone begins to shrink, or “resorb.”
As resorption progresses, the arch where teeth were held begins to flatten. Thus, the foundation of the denture becomes less and less. This results in dentures that slip when eating or rub uncomfortable sore spots on tender gums. At first, more-frequent applications of denture pastes help somewhat. Eventually, they are of little help.
Dentures are hardly supportive to good digestion or nutritional health. Long-time denture wearers often alter their food choices to accommodate their less-than-dependable ability to chew. Fresh fruits and vegetables are bypassed for softer, cooked versions. Pasta is chosen over protein-rich meats. Grains and seeded foods conjure up the fear of seeds being caught under the denture, piercing into tender gums.
In addition to lacking to meet nutritional needs, there are concerns surrounding the cleanliness of dentures. Their gum-colored base is made up of a porous material, capable of housing millions of bacterial organisms. It’s no wonder bad breath is a common problem for denture wearers.
According to RDH magazine, “research has isolated Staphylococcus aureus, Streptococcus mutans, Klebsiella pneumoniae, Escherichia coli, and hundreds of other garden-variety germs in acrylic dentures.” (https://www.rdhmag.com/patient-care/xerostomia/article/16407070/5-things-you-should-know-about-dentures)
Aging adults should also be aware that dentures can literally make you sick. In a study of 524 seniors (with an average age of 88), Japanese researchers noted higher incidences of pneumonia-associated events occurred among the 453 participants who were denture wearers. Nearly 41 percent wore their dentures during sleep and showed higher risk for pneumonia than those who removed their dentures at night. (https://www.rdhmag.com/infection-control/article/16404123/dentures-and-aspiration-pneumonia)
Certainly, having good oral health has proven to support good overall health. However, the appearance of a smile is also important. Because of the accelerated pace of bone loss from wearing dentures, facial changes begin to show through. At first, there may be deep wrinkles around the mouth. The corners of the mouth turn downward, even in a smile.
As bone loss continues, jowls form from the detachment of facial muscles. The chin takes on a pointed look and the mouth seems to collapse into the face. These changes tend to project a facial appearance that is far older than one’s actual years. For many people, looking old makes them feel old.
The choice of dentures, for most patients, is made because they provide the cheapest option to replace teeth. With all the arguments against dentures, we also understand the patient’s preference to save money. However, once you factor in all the health risks associated with dentures, dental implants stand out as being an important part of avoiding life-threatening illness. And, since dental implants are designed to last a lifetime, they are an excellent investment.
One way to enjoy the advantages of dental implants while keeping costs down is to secure a denture to dental implants. In this, only 6 or 8 dental implants are often sufficient to securely support a full denture.
This means that a “wobbly” or “slippery” denture can be firmly secured (even using the patient’s existing denture in some cases). This implant-supported denture halts resorption and restores biting and chewing strength.
The first step is to discuss options for tooth replacement that are appropriate for your specific needs and goals. As an Asheville periodontist, I know that many people are pleased to learn that dental implants are affordable through easy, monthly payment plans. Treatment can also include oral or I.V. sedation (twilight sleep).
Support your overall health by ensuring your oral health is at its best. Begin by scheduling a consultation appointment by calling 828-274-9440 or visit: https://www.biltmoreperiodontics.com/locationcontact-us/
And, visit our site’s technology page to learn the advantages of these features:
Boost Immune System By Investing In Gum Health
Posted on Nov 17, 2022 by William J. Claiborne, DDS MS
There is no argument that the price of about everything has gone up and up over the past couple of years. The challenges that most individuals face at this time have been significant for some people but felt by about all.
Yet, there are still reasons to “spend less now so we’re not spending more later.” This is true with things such as auto maintenance, home repairs and taking good care of our health. A signifiant part of maintaining good overall health is having good oral health. The key, however, is to make the investment while the costs are still low, and avoid the big expenses later to pay for repairs and more extensive treatment.
I’d like to point out the need to bolster our immunity system, brought front-&-center during the pandemic, is actually supported by your oral health. Although the Covid virus continues to be a threat, the experience has made populations more aware of the benefits of vaccines and healthy habits such as hand-washing. Still, it is in our immune system that makes people more or less vulnerable.
By investing in having healthy gums, the immune system is actually supported more than is largely known. I’ll explain.
The bacteria in the mouth, or “oral cavity,” is intricately connected to your overall health; so much so that “bad” oral bacteria can disrupt the healthy balance in the digestive system. This bacteria comes from oral plaque, which is a cesspool of sorts formed from bacteria accumulation.
As a layer of biofilm, plaque coats teeth and gums. It is the sticky coating you feel in your mouth when you wake up, during which time the bacteria has had an opportunity to amass during sleep. Plaque, mot removed, becomes tartar. This hardened mass of oral bacteria continues to grow, doing damage in the mouth and far beyond.
Researchers have tracked oral bacteria as it enters the bloodstream. This occurs through weakened gum tissues, allowing the bacteria to travel throughout the body. Studies have shown that the bacteria are able to activate or worsen the development of a number of serious health problems.
These include heart disease, stroke, arthritis, diabetes, preterm babies, some cancers, erectile dysfunction and dementia. Research is currently being conducted to further the connections suspected between periodontitis to Alzheimer’s disease.
How does oral bacteria become destructive? Gingivitis is the initial stage of gum disease. Symptoms typically include gums that are tender in spots and some bleeding when you brush. These are warning signs that signal an immediate need for attention.
Periodontal (gum) disease and (often) its subsequent tooth loss are, simply put, products of bacterial overload in the mouth. The mouth is constantly being supplied with sustenance for these organisms. Bacteria are able to thrive through food that enters, especially sugars, and other bacteria-laden items put into the mouth.
The bacteria that cause cavities that feeds on sugar from the foods and drinks you consume. This weakens tooth enamel due as bacteria convert sugar into acids. As bacteria thrive, they are able to reproduce very rapidly.
When bacteria levels become more than the immune system can tackle, infection can set in. Accumulation of bacteria can evolve into gum disease, which is an inflammation that attacks teeth, oral tissues and the bone structures that support tooth roots.
Gum disease symptoms are those more prominent than gingivitis. These include sore gums that bleed when brushing, persistent bad breath, gums that pull away from the base around teeth, gums that darken in color.
As it worsens to the stage known as periodontitis, pus pockets may form on the gums at the base of some teeth. In advanced stages, gum disease causes teeth to loosen and eventually require removal.
The reason that 6-month dental check-ups and dental cleanings is to remove tartar buildup before damage can occur. Your hygienist and dentist can look for signs of gum disease so measures can be taken before the disease explodes into the need for more costly treatment to resolve the problem. Since gum disease is the nation’s leading cause of adult tooth loss, the associated expenses of replacing teeth can also be avoided by maintaining good oral health.
Prevention begins at home: Begin by twice daily brushing with a soft bristle tooth brush and use a fluoridated tooth paste. Brush for at least two minutes each time. Floss daily. Be sure not to pop the floss between teeth to avoid damaging tender gums. Move the floss in a back-&-forth motion between teeth to ease it down so you can scrape the sides of each tooth.
You can remove a tremendous amount of oral bacteria by using a tongue scrapper daily. Or, brush your tongue with your tooth brush at the end of each brushing. This helps to dislodge bacteria that is embedded in the grooves of the tongue.
Drink lots of water during the day. This will help keep saliva flow at ample levels. Saliva is designed to move oral bacteria from the mouth on a consistent basis. Oral dryness is the enemy. Avoid foods and beverages that are drying to oral tissues such as caffeine, alcohol, and spicy foods. Also, try to minimize the amount of sugar and carbohydrates you consume. These foods amplify the reproduction of oral bacteria.
Oral dryness gives bacteria a favorable environment for reproduction. The chemicals in cigarette smoke are very drying to oral tissues. If you smoke, consider using an oral rinse that replenishes moisture in the mouth. Some oral rinses are specifically designed for moisture.
Lowering treatment costs begins with early care: If you have delayed or avoided regular dental care, it is recommended that you begin by having a periodontal examination. A periodontist is a dental specialist who can determine your precise level of gum disease and the most appropriate treatment to restore good oral health. We can detect all stages of gum disease and provide comfortable, thorough treatment to restore your gums to a health state.
If you have lost teeth due to periodontal disease, a periodontist also specializes in the diagnosis and placement of dental implants. This ideal method to replace teeth provides a lifetime solution, making them an excellent investment.
Call 828-274-9440 if you have questions about your gums or if you are experiencing any symptoms associated with gum disease. Also, visit our web site to learn more about our sedation options (including “twilight sleep”) and advanced technology, which often reduces treatment time while enhancing comfort.