Tooth Loss Cause of Shrinking Face, Sunken-In Mouth
Posted on Jan 14, 2021 by William J. Claiborne, DDS MS
The aging process is not an easy one. Joints begin to creak, muscles are more easily strained, skin dries out, eyesight wanes and hearing declines.
Yet, throughout the aging process, some adults seem to go through it as less of an ordeal than others. Although diseases and certain health conditions can occur regardless of how well some people manage, some people take a number of steps that can have a significant impact on aging well and “getting old.”
The basics of good health include a diet low in sugar, alcohol and unhealthy fats. NOT smoking is a big factor in maintaining a healthy body. Regular exercise, sufficient sleep and regular physicals and dental check-ups are all beneficial.
A factor that plays a bigger role in having good overall health is having natural teeth. Having the ability to comfortably bite and chew food is important to effective digestion, since the digestive process begins in the mouth. When adults struggle to eat with a denture or partial, the efficiency of this initial stage of digestion is compromised.
It’s not unusual for adults who have “rocky” or “slippery” dentures to opt for soft foods that dissolve easily in the mouth. These are often carb heavy and lack the nutritional value of a diet that combines healthy proteins, fruits and vegetables. However, missing teeth or dentures that move when eating can cause other detrimental problems.
When people sense their dentures may cause embarrassment when eating, speaking or laughing with others, social involvement can take a hit. According to a 2012 statement by the World Health Organization:
Oral health is essential to general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psycho-social well-being.
An extensive study on “The Link Between Teeth and Emotions” was published by Clinical Psychology of Oral Health (https://journals.sagepub.com/doi/full/10.1177/2158244017728319) in 2017.
In the study, the concept of quality of life was categorized in five dimensions: physical well-being, material well-being, social well-being, emotional well-being, and development and activity”.
The authors found that oral health is “an integral part of general health and well-being” and examined how oral disorders may impair at least three of the five dimensions: the physical, emotional, and social well-being.
The authors found also an association between oral health and late life depression (LLD) in older adults, who experienced “compromised social function and impaired self-maintenance skills (e.g., bathing, dressing, hygiene).” This depression can cause a loss of pleasure and interest for daily life activities, and even in the interest in personal oral hygiene.
Oral health not only has an impact on the psychological well-being of older adults, the physical changes attributed to tooth loss are of equal concern to many denture wearers.
Let’s look at your oral anatomy for a moment…
Your natural teeth are supported by your upper and lower jaw bone, known respectfully as the Maxilla and Mandible. With these strong, study bones, tooth roots are held securely. Thus, biting and chewing occurs comfortably.
The jaw bones are actually kept healthy by the presence of tooth roots. These roots provide stimulation to the bone as well as nourishment that feeds through the tooth’s interior.
When a tooth is removed, so is the stimulation and nourishment to that area of the jaw bone. Without it, the bone begins to shrink. As it declines in height, the adjacent teeth are more vulnerable to loss. Statistics show that teeth adjacent to areas where natural teeth are missing will be the most likely to be lost next.
This has a domino effect. Partials can replace the presence of teeth above the gum line, but there is nothing to benefit the jaw bones below. Thus, tooth loss continues and can go from a few missing teeth to losing all teeth (being “edentulous”).
According to the Center for Disease Control & Prevention (CDC), 69 percent of adults between the ages of 35 – 44 have lost at least one permanent tooth. By age 50, Americans are missing an average of 12 teeth. For adults between the ages of 65 – 74, 26 percent are missing all of their natural teeth. That’s over one-fourth of the adult population over age 65.
Although dentures and partials mimic the presence of teeth, the jaw bones below are shrinking away, and at a rather rapid pace. The pressure of wearing a denture or partial actually speeds this process up, known as “resorption.”
As these bones decline in mass, deep wrinkles form around the mouth. The corners of the mouth turn downward. The chin takes on a more pointed form and the mouth sinks into the face. The nose seems to get closer to the chin as the jaw bones thin. Jowls form as facial muscles detach from shrinking bone structure.
Dental implants were designed to recreate the presence of natural teeth both above and below the gum line. Because teeth attached to the implants are supported by the jaw bones, the study foundation restores the ability to bite and chew without movement or fear of embarrassing slips.
For patients who are missing a great deal of bone, we offer bone rebuilding that does not require a bone graft. We also perform sinus lifts (when the upper jaw has declined to a significant level) to restore sufficient bone distance between vital structures.
For many of our dental implant patients, their lives become more active with the restored confidence. They become more socially involved, have more self-confidence and higher self-esteem.
Although dentures and partials may seem to be a less-expensive way to replace teeth, the savings is hardly worth the detrimental repercussions associated with them. Too, the upkeep required for dentures over time is actually high, considering replacement, relines and repairs.
As a periodontal specialist serving Western NC, I take great pride in the diagnosis and placement of dental implants. Each is selected based upon the patient’s individual needs and goals. We provide oral or I.V. sedation to ensure a comfortable experience and a friendly, respectful environment.
Begin with a friendly conversation in our private consultation room. In this comfortable setting, we’ll discuss your options and I’ll answer your questions. For many people, they are able to make a decision on how they wish to proceed after this conversation, even if it’s to go forward with dentures. We are supportive of each person’s preferences.
Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office. I think you’ll feel especially confident in learning about our specialized skills and highly-advanced technology, not available in many dental offices in this area.
Ask Santa To Make The Toothbrush Under The Tree Electric!
Posted on Dec 16, 2020 by William J. Claiborne, DDS MS
Although your Christmas wish list probably doesn’t include an electric toothbrush, it should. Studies have shown that brushing teeth with an electric version promotes better gum health and slower progression of periodontal (gum) disease. Electric tooth brushing is also helpful in reducing tooth loss, by 20 percent (compared to those who brush with manual toothbrushes).
If you use an electric toothbrush, most people think of its benefits in giving fresh breath and a bright smile. As an Asheville periodontist for over three decades, I have a firsthand view of how a thorough at-home oral hygiene regimen can help significantly in preventing gum disease and tooth loss.
An electric toothbrush can be an important tool in daily oral hygiene. Findings of an 11 year study published in the Journal of Clinical Periodontology tracked the oral health of over 2800 adults. The use of electric toothbrushes was monitored to watch for periodontal disease, cavities, and the number of natural teeth.
From 2002 – 2006, participants were examined with follow ups conducted after 6 and 11 years. Eighteen percent of the participants were electric tooth brush users. At the time of their 11 year follow up, 37 percent had switched to using electric toothbrushes.
Although more adults are using them, the long-term effectiveness of electric tooth brushes has not been proven to be significant. It is suspected that this is due to the technique used rather than due to the brushing tool itself. For manual users, a significant challenge with brushing this way is in the choice of bristles. Stiff, hard bristles can be very damaging.
A hard bristled tooth brush can actually damage tooth enamel and gum tissues. To the detriment of teeth, people tend to press down too firmly as they brush, scrubbing with a ‘back & forth’ motion. They may feel this is the way to do a good job brushing. However, this action can wear down the protective coating of tooth enamel, leaving teeth more vulnerable to decay.
Another problem with a hard bristle tooth brush is its ability to damage tender gum tissues. These can thin out the protective seal that gums have around the base of each tooth. This increases the potential for bacterial entry of the sensitive tooth root area of teeth.
Hint: If the bristles on your toothbrush are fanned out after a couple of months, you are applying too much pressure when brushing.
The ideal technique for brushing teeth is to use gentle pressure with a swirling motion. By using a circular pattern over both sides of each tooth and along the tops, teeth are cleansed without wearing away gum tissues or wearing down precious tooth enamel.
This is where electric toothbrushes can help greatly. Many of the newer models include a beep when too much pressure is being applied. Most also have timers to indicate the time needed for each quadrant, which is your teeth divided into 4 sections. The timers are good aids in helping you to brush at least two minutes.
As devastating as tooth loss can be to one’s overall health, we now know that the bacteria of gum disease can enter the bloodstream. Research has shown this infectious bacteria can trigger inflammatory reactions elsewhere in the body. It has been linked to heart disease, stroke, high blood pressure, some cancers, diabetes, arthritis, impotency, preterm babies and more.
Whether using a manual or electric tooth brush, it is necessary to brush twice a day to effectively remove plaque. Plaque is the sticky film you feel on teeth when you wake up or at the end of the day.
Plaque is a buildup of oral bacteria that coats teeth and gums. If not removed daily, it forms a hardened mass of calculus (or tartar) that attaches to teeth. This is what you may feel your hygienist scraping off teeth during cleanings since it cannot be brushed or flossed away.
Another place that oral bacteria can thrive are in the grooves in the tongue. These offer a dark, warm and moist environment for bacterial reproduction. To uproot these icky organisms, use your toothbrush to brush your tongue after brushing teeth. Be sure to reach the back of the tongue where the majority of oral bacteria are embedded. Swish with water several times after.
Flossing is another way to improve gum health, lower cavity risk and prevent tooth loss. It is estimated that only 31 percent of American adults floss on a daily basis. Flossing removes trapped bits of food remain in the mouth, which feeds oral bacteria and allows them to quickly multiply. Because brushing cannot dislodge all food particles caught between teeth, daily flossing should be a part of oral hygiene routines.
Proper flossing is easy for those who are in the habit and takes only a minute each day. For those who have difficulty with manual dexterity or find the maneuver awkward, water flossers are effective alternatives and easy to use. (This is another good item to add to your wish list!)
Practice these recommended techniques and you’ll not only do a better job at having a clean mouth, you’ll find your time at the sink requires less effort. If you feel you may be experiencing symptoms of periodontal disease, act promptly. You should be seen at your earliest convenience for treatment since this disease will only worsen over time.
Signs of gum disease include tender gums that bleed easily when brushing, gums that darken in color to red (versus a healthy pink), frequent bad breath, and gums that pull away from teeth (receded gums) and expose darker root areas of the tooth.
As a periodontal specialist, I have advanced skills in the treatment of all stages of gum disease (as well as in the placement of dental implants). Our office features some of the most advanced technology available in dentistry to optimize patient outcomes and comfort.
Here, we will help you achieve the healthy smile you want and prevent tooth loss to the greatest extent possible. If you’ve already lost teeth, we’ll discuss their replacement through dental implants. Dental implants are the closest thing to natural teeth, restoring biting and chewing strength and stability.
Call 828-274-9440 to learn more or to schedule a consultation to discuss how you can achieve excellent oral health.
If Your Mouth Is Frequently Dry, You Have Higher Risk For Gum Disease
Posted on Dec 02, 2020 by William J. Claiborne, DDS MS
Our bodies are home to trillions of micro-organisms. This includes micro ‘ponds’ of viruses, fungi, and bacteria. As we’ve learned over the years, some of this bacteria is highly beneficial to how our systems operate.
Although the thoughts of bacteria often conjure up images of infectious organisms, the mouth is home to some very “good” bacteria. For bacteria that are present under normal circumstances, they do not cause disease and actually have a purpose. It’s the “bad” bacteria I want to focus on for now.
Oral bacteria is the source of nearly every problem that develops in the mouth. The oral cavity (mouth) is structured to manage a certain level of bacteria. As the entry point of most of the bacteria we add to our bodies, it can process a “normal” amount on a day-to-day basis. It is the overload of bacteria that becomes the origination source of problems.
The reason people are advised to brush at least twice a day and floss daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, a sticky film of bacteria form that coats the teeth and gums. This film is known as plaque. Without sufficient and frequent removal of plaque, it begins to harden at the base of teeth.
This is tartar (or calculus), which is actually a cement-hard mass of oral bacteria. Tartar cannot be brushed or flossed away; it requires removal by a dental professional. During your dental cleanings, you probably notice when your hygienist is scraping away at teeth. It is tartar that she is trying to remove.
Your periodic dental cleanings are important. If tartar is allowed to further amass, the bacteria can become inflamed, attacking gum tissues. As bacteria continue to reproduce, they create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth, including tooth roots, tissues, ligaments and bone.
Periodontal disease is the leading cause of adult tooth loss. The advanced stage of gum disease, known as periodontitis, creates a bacteria so potent that research has linked it to serious diseases elsewhere in the body. These include some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency.
Saliva is the mouth’s natural rinse that helps cleanse oral bacteria from the mouth. This keeps bacteria levels to a minimum and lowers their ability to cause problems. When saliva flow is depleted, however, bacteria remain in the mouth longer – and multiply rapidly.
Saliva helps to continually cleanse your mouth, removing particles that can rot and cause bad odors. A condition called “dry mouth” (known as Xerostomia) is when production of saliva is decreased.
When the “dry mouth” condition is continual, the problem may be due to low salivary gland production or some diseases. Dry mouth naturally occurs during sleep and in people who breathe through their mouth. However, as a periodontal specialist, I find that most cases are due to factors that can be easily controlled with simple changes.
To support saliva flow and reduce “bad” bacteria in the mouth, twice daily brushing and flossing help. However, knowing contributors to a dry mouth can help you better manage or control oral bacteria levels. These include:
The aging process – Aging causes the skin, cartilage, and tissues to become less supple, drier. We can’t stop the aging process but can help protect our oral health by drinking plenty of water throughout the day. Coffee, tea and colas don’t count. Also, consider using an oral rinse designed to replenish moisture in the mouth.
Medications – Many over-the-counter and prescribed medications today have a side effect of oral dryness. Some of the worst culprits are antihistamines, depression and incontinence medications, and some that control blood pressure. If you take one of these, ask your doctor about options that may be less drying to the mouth. Or, increase your water intake and use a daily rinse to replenish oral moisture.
Sleep habits – To dry something out, a flow of air is just the thing. This also applies to the mouth. Snoring or breathing through the mouth during sleep create added dryness to oral tissues. Talk to your doctor about ways to resolve these problems. It may be as easy as adjusting your sleeping position or adding a side pillow.
Medical conditions – Having acid reflux, sinus infections, diabetes and bronchitis can cause dry mouth. A bad cold can also force people to breathe more through their mouth. For these conditions, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.
Caffeinated beverages – Caffeine has a drying effect on oral tissues and therefore depletes the helpful rinsing benefits of saliva. Most colas contain caffeine, which is drying to oral tissues. Add to that the high acidity level in colas (also harmful to tooth enamel). Also drying are coffee and tea. Like colas, these drinks contain acid added to caffeine. If you drink these beverages, be sure to rinse your mouth after or alternate with gulps of water.
Alcohol (including beer and wine) – Mixed drinks, wine and beer are all drying to oral tissues. Add the acidity and sugar levels that exist in wine or mixers and these drinks pack a double-whammy to oral tissues. Again, swish with water between drinks or have a glass of water nearby to dilute the impact of these.
Smoking (cigarettes, cigars, vaping) – People who have smoked for years often have dry skin that ages their appearance far beyond their actual years. The same is occurring inside the mouth. Cigarette and cigar smoke is laden with toxic chemicals, which is true for e-cigs as well. Just be aware at your added risk and the drying effects and take added measures to keep your mouth clean and moist.
If you have delayed or avoided dental care, call 828-274-9440 to request a consultation, or begin with a thorough examination in our Asheville periodontal office. We offer the latest techniques, technology, and skills while always making patient comfort a top priority.
Amazing Dentistry In Our Asheville Periodontal Dental Office
Posted on Oct 06, 2020 by William J. Claiborne, DDS MS
A periodontist, for most individuals, isn’t a doctor that is a regular part of their dental care. We are often a “behind the scenes” specialist, working with general dentists and perhaps other dental specialists.
Like a cardiologist or a urologist, however, you’ll hopefully never need us. If you do, you may be surprised at our Asheville periodontal dental office’s advanced and multi-faceted features.
To define our role, a periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants.
Periodontists receive extensive training, including three additional years of education beyond dental school. They are able to treat more problematic periodontal cases, such as people with severe gum disease or those having a complex medical history.
In addition, a periodontal specialist is trained in performing cosmetic procedures that involve gum tissues, such as correcting a “gummy smile”.
It is a busy specialty. It is estimated that over 47 percent of American adults have some level of periodontal disease (also known as “gum disease”). Because this disease can begin without obvious warning signs, many are unaware of its presence.
Gum disease begins with gingivitis, with some symptoms that may be easily ignored. However, when symptoms involve discomfort, the disease can be approaching more advanced levels.
This is why it is important to be familiar with the signs and symptoms, which include:
• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding (pulling away from the teeth) or make the appear teeth longer than normal
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures
If you notice any of these symptoms, be sure to contact your dentist or periodontist without delay. Gum disease will only worsen without treatment. It is the nation’s leading cause of adult tooth loss.
For specialized needs, we offer an advanced care environment where patients are comfortable and experience a restoration of their smiles with the support of advanced technology. These features include:
• LANAP Protocol Using PerioLase MVP-7 – Efficiently and effectively treats periodontitis (advanced gum disease) with laser technology. It causes very little discomfort and has a quick recovery time. This has also been found to stimulate bone regrowth in damaged areas.
• Dental Radiology With 3-D Cone Beam Technology – This imaging is ideal for diagnosis and treatment planning. The imaging covers the entire dentition area with clear views of the mandible and maxilla (upper and lower jaw).
• CareStream Cone Beam Computer Tomography Imaging – This computerized tomography provides imaging in exceptional detail and range.
• CS 3600 intraoral scanner – Patients no longer have to endure having impressions made with bulky, glopy trays held in their mouths! This quickly and comfortably scans the mouth’s interior for digital impressions using a small, handheld scanner. It can also reach difficult–to–access areas in the patient’s mouth with improved patient comfort.
• Simplant Dental Software for Computerized Dental Implant Placement – This system helps in pre-surgical positioning of dental implants on the computer, using a 3D model of the patient’s jaw. This aids in the selection of the implant type that ensures a precision fit.
• Intraoral Camera Technology – This provides outstanding quality of images within the mouth. These images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment issues.
• Computer Imaging In Treatment Suites – Treatment suites are equipped with computers for convenient image sharing with patients.
• Advanced Sterilization – Our custom sterilization unit adheres to (or exceeds) CDC guidelines for instrument processing protocols, particularly in the cleaning of instruments.
• Fully-Equipped Surgical Suites – Relax during treatment while surrounded by beautiful mountain views of Asheville.
Periodontal (gum) disease is the result of an accumulation of oral bacteria and the leading cause of adult tooth loss. Have you avoided seeing a dentist for years? You are not alone. An estimated 70 percent of adults admit to having some level of anxiety or fear associated with dental care.
Our office is structured to attend to your specific needs, gently and respectfully. We offer a private consultation room to discuss treatment in a comfortable setting versus communicating with patients while they are seated in a treatment chair.
For patients who desire a “sleep” state, we offer oral sedation as well as I.V. sedation (twilight sleep). 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 (twilight sleep), 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.
Patients also find our entire staff to be a unified team, each bringing a sincere level of compassion and commitment to excellent care.
For people in need of gum recontouring, a periodontist is THE expert in the shaping of oral gum tissues. Here, Dr. Jennifer Boyland and I have advanced training to create gum tissue contours with a natural appearance. We are also able to ensure healthy seals around teeth to protect the structures beneath the gums from bacteria penetration.
Our specialty is ideal for those who have a “gummy smile.” This is when too much gum tissue shows above upper teeth most visible in a full smile. While this trait does not interfere with the ability to have and maintain a healthy smile, for many, it causes them to ‘hold back’ rather than smile fully. Some people cover their smiles with a hand or try to smile with lips only.
Gum re-contouring is also done in crown lengthening procedures. This evens out the amount of gum tissues that arch teeth for a beautiful, balanced smile line.
Having healthy gums is so important. As research continually shows, gum health is intricately connected to overall health. Oral bacteria of periodontal disease has been linked as a trigger for serious diseases, including heart disease, some cancers, stroke, memory loss, diabetes, and arthritis.
If you are experiencing any of the symptoms associated with periodontal disease, a referral is not required. Call 828-274-9440 and we will be happy to assist you.