Achieve Smile Goals With A Periodontist

Posted on Dec 11, 2023 by William J. Claiborne, DDS MS

If you’re like me, I’m usually looking at the end of each year feeling like there are several things I wanted to accomplish for the year, but kept putting them off until I ran out of time.

For some people, their oral health and appearance goals are on this list, with some who keep moving the goals to the next year and the next. These goals may include:

• Improving the appearance of a smile

• Having a “cleaner” mouth with fresh breath, etc.

• Replacing missing teeth

• Getting past fear or anxiety of dental visits

If you have one of these on your list, you may be surprised that a periodontal specialist can play a major role in helping you achieve your goals. And, because of the advanced skill level of a periodontist, your comfort, time in treatment and overall results can make the process easier for you.

Many general dentists and other dental specialists refer their patients to a for their specific skills. A periodontist is a dental specialist who is the expert in caring for the gum tissues in your mouth and in the placement of dental implants.

The majority of patients arrive because of periodontal (gum) disease. Common symptoms are red, swollen and tender gums. It often causes gum that bleed easily (often noticed when brushing teeth) and persistent bad breath.

Gum disease (sometimes referred to as ‘perio’ disease) only worsens without treatment. It is the leading cause of adult tooth loss. Additionally, it has been linked to the development or worsening of a long list of serious health problems elsewhere in the body.

Because the inflammatory bacteria disease can enter the bloodstream through diseased gums, their presence can activate conditions that are seemingly unrelated to oral health. Yet, the connection is severe. These health problems include stroke, heart attack, Alzheimer’s disease, dementia, preterm babies, some cancers, arthritis, diabetes, and erectile dysfunction (ED).

In our Asheville periodontal dental office, we are able to treat all stages of gum disease to restore your oral health and minimize the risk of tooth loss. For those who have developed gum disease because they’ve been afraid of dental visits, we offer oral and IV sedation (“twilight sleep”).

Sedation is administered safely by a doctor in anesthesia who uses advanced safety equipment. Our priority is always patient comfort with their safety equally so.

Too, our advanced technology is able to minimize treatment time with amazing results. For example, LANAP (Laser-Assisted New Attachment Procedure) combined with PERIOLASE MVP-7 is designed to efficiently and effectively treat periodontitis (advanced gum disease) with the advantages of a dental laser. This offers non-surgical treatment for patients with moderate to severe periodontal disease. LANAP treatment minimizes discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

When tooth loss has occurred (whether from gum disease, an accident, or due to genetics), our NW NC dental specialty office also works with a number of dentists in the diagnosis and placement of dental implants.

With over 40 different implant systems, the one suited best for you depends on factors that an experienced dentist must take into consideration. For example, the number of implants you need and how much jaw bone mass exists.

For individuals who have lost a great deal of bone, specific implant types may be recommended. Some, like the “All On 4” implant system, uses specially designed implants which are placed at specific angles.

Bone loss can also be overcome by incorporating a bone rebuilding process into treatment. This is done prior to implant placement and does not require a bone graft. In many cases, we can apply a bone rebuilding material that restores ample bone mass.

The same is true when the sinus cavity will be too close to the proximity. This can be remedied through a “sinus lift.” We provide complete services of these procedures as well as dental implant placement – all performed with advanced skills and technology, such as our Cone Beam 3D imaging.

These images are ideal in diagnosis and treatment planning by giving a clear view of the mandible and maxilla (upper and lower jaw). Cone beam radiographs provide images in sagittal, axial, and coronal planes. This makes it possible to locate and trace the mandibular nerve canal for pre-surgical planning for an ideal implant position. Patients are exposed to only minute levels of radiation through a process that is fast and comfortable.

When the enhanced appearance of a smile is being sought, a periodontist also plays a part in helping to create a balanced smile line. In the procedure known as “crown lengthening,” the arch of gum tissues over teeth visible in a smile can be repositioned. This is done in a procedure known as a gingivectomy.

A gingivectomy is also performed to repair a “gummy smile.” This is when too much gum tissue shows above the teeth most visible in a smile. While the condition is not detrimental to oral health, some individuals seek to have it corrected by a periodontist.

Get the coming year started with your smile goals achieved! Call our Asheville periodontal dental office to schedule a consultation. Our friendly staff can help you arrange this private time together by calling 828-274-9440.

 

A Periodontist Can Contour Gum Tissues For A More Beautiful Smile

Posted on Nov 23, 2023 by William J. Claiborne, DDS MS

During the holidays, my wife and I attend gatherings where we occasionally meet new people. A common question, as applies to most of us, is “What do you do?” When I reply that I’m a periodontist, it is often met with a look of not knowing what a periodontist is but not wanting to appear as if that’s the case.

I’d like to explain what “we” are and, from a smile enhancement basis, what we can provide. I typically find that when I say “periodontal plastic surgery” it comes across as far more familiar than “performing gingivectomies.”

A periodontist is a dental specialist who has an advanced level of understanding when it comes to diseases of the oral tissues, reshaping of gum tissues and in the selection and placement of dental implants.

The American Academy of Periodontology defines a Periodontist as:

“A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”

https://www.perio.org/consumer/what-is-a-periodontist

To reach this specialty begins with educational requirements that are extensive. First, there is completion of 4 years of college (for an undergraduate degree) followed by another 4 years in dental school (for a doctorate). To specialize in Periodontics, he or she must further their education for another 3-4 years before completing the stringent requirements for specialty certification in periodontics.

The gums are rather under-rated when it comes to the tremendous role they play in both oral health and even your overall health.

Think of the gum tissues as a protective blanket in the mouth. The gums cover over the structures that support teeth and house the tissues and bone that are vital to our health. For instance, look at the base of each tooth. You’ll see that gum tissues snugly wrap around the base of each tooth. This protective seal is what prevents bacterial penetration beneath the gum line.

When oral bacteria amass to an extent that cannot be controlled by oral hygiene measures at home, they cause inflammation in the gums. In turn, the gums loosen their tight grip around teeth, which allows entry of the now-potent bacteria. These infectious bacteria have been linked to a number of problems related to a long list of serious health problems.

Oral bacteria has been found to trigger or worsen systemic conditions, including atherosclerotic vascular (heart) disease, pulmonary (respiratory) disease, diabetes, pregnancy-related complications (including preterm births), osteoporosis (bone loss), and kidney disease. A shared trait between gum disease and these medical conditions is that they are chronic conditions that take a long time to develop.

https://www.agd.org/docs/default-source/self-instruction-(gendent)/gendent_nd17_aafp_kane.pdf

It is important to be familiar with the signs and symptoms of periodontal (gum) disease, which include:

• Red, swollen or tender gums
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that pull away from the teeth (recede) or make the teeth appear longer than normal
• Loose or separating teeth
• Pus pockets that form between gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way teeth fit together when biting
• A change in the fit of partial dentures

If you have any of these, you are urged to seek a thorough periodontal evaluation as soon as possible. This disease will only worsen without treatment. Gum disease is the nation’s leading cause of adult tooth loss.

Healthy gum tissues do more than serve in a protective role. The appearance of a smile can be greatly affected by the shape and amount of gum tissues exposed when smiling.

When a smile shows too much or too little gum tissue bordering the tops of teeth, it moves the “smile line” out of balance. For example, in a beautiful smile, the arches of gum tissues visible in a full smile flow at a similar height. These gum arches are in a complimentary line to teeth, rather than at varying levels over teeth. When the gum lime is not evenly balanced, it causes a smile to have a jumbled look.

Crown lengthening is performed to reposition the gum tissues to enhance the appearance of a smile. In addition to creating a more appealing look, crown lengthening is also performed to restore the tight seal of protection around teeth. While you enjoy the beauty of your new smile, crown lengthening gives your oral health a boost at the same time.

When the height of gum tissues that show above all teeth in a smile is too high, it is referred to as a “gummy smile.” A gummy smile is not detrimental to your oral health. However, having one does affect the appearance of a smile based on balance. For some people, it makes them “hold back” on a full smile.

This can be corrected with a gingivectomy. To begin, we numb the gum tissues and carefully trim the excess. As a Periodontist, I take specific measures to ensure a natural looking arch remains over the teeth while preserving the natural points that ‘dip’ between each tooth.

A gingivectomy is performed in our Asheville periodontal office with a dental laser. This provides patients with a number of advantages: (1) enhanced comfort; (2) precision lines; (3) minimal or no bleeding; and, (4) faster healing time.

In our Asheville NC periodontal office, we use the highly-advanced LANAP with PerioLase MVP 7 Laser-Assisted Attachment Procedure. This is an advanced protocol that efficiently and effectively treats advanced gum disease (periodontitis) with the added advantages of a dental laser. It is a non-surgical alternative for patients with moderate to severe periodontal disease, causes very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

In some cases, the crown lengthening procedure can save a tooth from removal. Typically, when a tooth fractures or breaks at the gum line, it must be removed since there is not enough tooth structure to support a crown. However, a crown lengthening procedure may be able to expose more of the tooth’s structure, essentially saving the natural tooth.

For those who have avoided gum treatment due to dental fear, we offer several sedation options, including oral and IV sedation. 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 (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. Here, anesthesia is overseen by a medical doctor (MD) who is a board certified Anesthesiologist. With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

We help patients understand that their fears and concerns are not unusual. The doctors and staff of our Asheville periodontal dental office respect each patient and provide gentle, compassionate care – at every appointment.

We believe you’ll find no better periodontal dental environment in western NC. Whatever your need for the treatment of gum disease, recontouring of gum tissues, or in the placement of dental implants, call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.

Laser Dentistry, Cone Beam Imaging Among Our Advanced Features!

Posted on Nov 15, 2023 by William J. Claiborne, DDS MS

Like your “adult” teeth, your gum tissues are irreplaceable. Without question, they deserve the care and attention that come with keeping them healthy and doing their job.

Gum tissues are designed to protect the structures underneath. These include bones, tooth roots, tendons, and muscles to prevent entry of harmful bacteria. Gums are designed to snugly wrap the base of each tooth to keep bacteria from penetrating sensitive root segments of teeth.

Without this protective seal around teeth, the potential for periodontal (gum) disease greatly increases. And gum disease is at concerningly high levels in the U.S. with an estimated 47% of adults having some level of gum disease.

I believe that this high level of gum disease is largely in part due to Americans not being fully familiar with the symptoms. Some are easily ignored or “brushed off” as normal. 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 pulling away from the base of teeth, making them appear teeth longer
• 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 biting
• A change in the fit of partial dentures

If you are experiencing any of these symptoms, you are urged to seek care with a periodontal specialist as soon as possible. This disease will only worsen without treatment.

Why should you be concerned about periodontal disease?

Gum disease is the nation’s leading cause of adult tooth loss. Additionally, research has linked the bacteria of periodontitis with serious health problems. These include heart disease, stroke, arthritis, diabetes, some cancers, preterm babies, erectile dysfunction (ED) and high blood pressure. Studies on links to Alzheimer’s disease are showing concerning correlations.

A periodontist is an expert in the treatment of all stages of gum disease, including gingivitis, periodontal disease, and the advanced form of periodontitis.

In addition to having these specific skills, I’d like to share the benefits of some of our amazing technology we make available to our Western NC patients. One with a wide range of benefits to patient care is our Dental Laser.

Nd: YAG Dental Laser: This is a small, hand-held device that eliminates or greatly minimizes bleeding during procedures. It also reduces numbing requirements, removes bacteria and easily uncovers gum tissue where dental implants have been placed.

Additionally, laser dentistry can quickly repair oral ulcers and beautifully re-contours or repairs gum tissue with a precision line. Some specific treatments that are ideal for a dental laser include:

Canker & Cold Sores: The laser is also ideal for rapid healing of canker and cold sores. Laser therapy can halt the progression of canker sores, reducing the pain in a day or so. Otherwise, they can last up to 2 weeks. When it comes to cold sores, they are best treated with our laser when the very first symptom arises. Tingling or burning sensation is the first sign that a cold sore is about to erupt. Although lasers can still treat these lesions in later stages, the treatment is most effective in initial stages. Most patients notice significant improvement in comfort after laser treatment with a much shorter duration.

Gum Disease Treatment: In our office, we also use a dental laser to destroy the bacteria of gum disease. This technology also speeds the process and heightens your comfort, saving you treatment time with faster healing.

Correcting a “Gummy Smile”: This is when a smile shows too much gum tissue above upper teeth when smiling fully. We correct this in a procedure known as crown lengthening. In this, a gingivectomy adjusts the height of gum tissues so the smile has a more even smile line. This may involve the use of a dental laser, which provides a precision line and speeds healing.

Balancing a smile line: A gingivectomy is also advised to rebalance the frame of gum tissues that arch the teeth visible in a smile. When one or two teeth have different heights of gum tissue, the smile has a jumbled look. A dental laser can even out the smile line and enhance the beauty of a smile.

Saving a tooth broken near the gum line: When a tooth breaks at or near the gum line, it often requires removal. In some cases, however, we can save the tooth by exposing enough of the structure to receive a crown. This helps the patient to avoid removal and thereby preserves the supporting jaw bone.

In our Asheville NC periodontal dental office, we feature additional technologies, some of the most advanced in the industry. These include:

LANAP Protocol Using PerioLase MVP-7: This process is designed to efficiently and effectively treat periodontitis (advanced gum disease) through laser technology. Treatment is administered with minimal (or no) discomfort and recovery time is minimal. Amazingly, this technology has also been able to stimulate bone regrowth in damaged areas.

Cone Beam 3D Imaging: These views allow us to see your jaw in 3D dimensions and to be able to view it at varying angles. This enables us to see what used to be hidden from view.

Cone Beam images are often used to assess:
• Dental Implant Positions
• Temporomandibular Joints (TMJ)
• Airway Passages
• Bone Structure Damage or Bone Loss
• Teeth, Tooth Roots and Facial Structures
• Signs Of Infections, Cysts, Or Tumors

CS 3600 Intraoral Scanner: Through this process, our patient no longer have impressions made with bulky, goopy trays held in their mouths. This technology 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 to ensure 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 needs.

Computer Imaging In Treatment Suites: Treatment suites are equipped with computers for convenient image sharing with patients.

Oral & IV Sedation: We take patient comfort very seriously in our Asheville periodontal dental office. That’s a commitment we make to every patient at every appointment. Here, patient comfort is supported by our sedation options. These include oral and I.V. sedation. Also referred to as “twilight sleep” or “sleep dentistry,” these sedatives are administered by a highly-skilled anesthesiologist who uses advanced safety monitoring equipment throughout the patient’s procedure.

My staff and I also take great pride in providing patients with an environment of respect. Some adults come to us embarrassed by the condition of their oral health or missing teeth. Here, we strive to make patients feel they are in the right hands in the right place.

If tooth loss has occurred, a periodontist also specializes in the selection and placement of all types of dental implants. Dental implants, for many reasons, are the preferred option for tooth replacement.

Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office. New patients are always welcome and a referral is not always necessary.

Common Contributors to Tooth Loss

Posted on Sep 11, 2023 by William J. Claiborne, DDS MS

Our natural teeth seem hard and solid, able to endure much over the span of a lifetime. However, as we all know, teeth can be knocked out due to accidents or injury and lost due to becoming overly decayed, fractured, infected and – the leading cause – periodontal (gum) disease.

Your gum tissues serve as protection for the tooth structures you cannot see – the tooth roots and bone and tissues supporting the roots. And, teeth need these bone structures to stay healthy and vice versa; the bone structures beneath the gums need the presence of the roots to stay healthy.

The jaw bones are kept healthy by tooth roots that provide stimulation to the bone as well as nourishment that runs 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, 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.

According to the Center for Disease Control & Prevention (CDC), 69% of adults between ages 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% are missing all of their natural teeth. That’s over one-fourth of the adult population over age 65.

Because of the strength and seemingly rock-solid presence of teeth, it may be assumed they’ll last for a lifetime. And, they can. Natural teeth can and should last a lifetime with proper maintenance and care. However, certain things can contribute to tooth loss; some of these may not be well known.

These include:

GUM DISEASE – Signs and symptoms of gum disease are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

When these indications exist, it is important to seek periodontal treatment as soon as possible. Gum disease only worsens without treatment, requiring more time and expense to rid this serious, even deadly, inflammatory disease.

NOT FLOSSING – While tooth brushing helps to keep oral bacteria levels in the mouth to manageable levels, daily flossing is also recommended as a preventative way to keep cavities and gum disease at bay. Still, 70% of the American adult population do not floss daily. Even worse, about a third of Americans admit to never flossing (39% of men and 27% of women who do not).

SMOKING – According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker. (https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)

AGING – With age, the body becomes less efficient in maintaining itself. Due to hormone changes and being less hydrated, joints wear down, skin loses subtlety and muscle mass and strength declines. The same is true with teeth, especially as gum tissues dry out. This means their tight, protective grip around the base of teeth loosens and pockets can easily for between teeth. All these factors contributor to higher risks of gum disease and tooth loss.

ORAL DRYNESS – The tissues inside the mouth need to be kept moist. Saliva flow is designed to do this. However, with age, the flow of saliva is less plentiful. Just as the skin and hair get drier with age, the mouth endures this same consequence. When saliva flow is less efficient at rinsing bacteria from the oral cavity (inside of the mouth), bacteria grow at a more rapid rate. This means bacteria accumulation occurs more frequently than twice-a-day brushing can control.

MEDICATIONS – The average adult in the 65-79 age group has over 27 prescriptions filled each year. (https://www.statista.com/statistics/315476/prescriptions-in-us-per-capita-by-age-group/). Many meds have the side effect of oral dryness or increased bleeding, including some herbal supplements. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting.

To halt the potential for tooth loss if you are already missing teeth, dental implants are recommended. They actually protect the health of neighboring teeth. In addition to helping the supportive bone structures retain bone mass, teeth supported by implants do not rely on the support of crowned (or ‘capped’) teeth on both sides. This means the integrity of adjacent teeth is preserved.

Dental implants come in over 40 different types designed to accommodate various challenges and preferences. This is one reason (of many) that a periodontist is an ideal choice for the diagnosis and placement of your implants. Our speciality understands the complete spectrum of implant systems. While some implant systems may be ideal for your needs, others may not. And, the choice of which will achieve your goals is not limited to just those types a non-specialist knows how to place.

For example, some dental implants provide you with a non-removable (“fixed”) option while others may involve removable teeth. Additionally, the proper selection of your dental implants may greatly save you in treatment fees.

For example, the All-On-4 dental implant system needs only 4 implants per arch, and can be placed in shallow bone. The treatment fees are less since the number of implants is low and the need for bone regeneration for severe bone loss may not be required. For these reasons, a periodontist may be able to help you achieve your tooth replacement goals within a budget you can manage.

Our Western NC periodontal dental office features some of the industry’s most advanced technology, which helps to optimize success rates, shorten treatment time, and enhance comfort. This includes 3-D Cone Beam imaging, which is ideal for diagnoses and treatment planning. These amazing images provide a clear view of the upper and lower jaw (including nerve canals) in a process that is quick, painless and at minimal radiation levels.

We also have a computerized Dental Implant Placement system for pre-surgical positioning of dental implants. Using a 3D model of the patient’s jaw, a template is developed for the most conservative treatment process needed, even for complex cases. This minimizes disruption of gum tissues and targets implant placement at ideal depths and angles.

Because we make patient comfort one of our highest priorities, we offer several sedation options, including oral and IV sedation. 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 (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a Medical Doctor (MD) who is a board certified Anesthesiologist.

If you have lost teeth (or struggle with a denture or partial) and are considering dental implants, begin with a consultation appointment. Call 828-274-9440. New patients are always welcome.