Many Reasons To Repair Gum Recession


Posted on May 19, 2022 by William J. Claiborne, DDS MS

If you are occasionally experiencing sensitivity around one or more teeth, especially when eating ice-cream or drinking hot coffee, this is likely due to receded gums.

While using a sensitivity toothpaste can somewhat minimize these sensations (which can become painful jolts), the problem will remain. The source of sensitivity, most often, is because the highly-sensitive tooth’s root area has been exposed by the pulling away of gum tissues.

The gum tissues are designed to provide a tight seal around the base of each tooth, which blocks bacterial entry to the sensitive tooth root area. In addition to sensitivity, recession means oral bacteria can penetrate beneath the gum’s surface. Once beneath the surface, the accumulating presence of this bacteria can lead to inflammation of the gums.

Eventually, the infectious bacteria attack the structures that support natural teeth. This bacteria indicates the presence of periodontal (gum) disease. Signs and symptoms of gum disease in its first stage include:

• Gum tissues that turn red

• Gums that become tender or swollen

• Gums that bleed when brushing

• Persistent bad breath

Obviously, it’s important to ensure the gums are healthy so the grip they have around teeth is snug. It’s also important to be aware of the causes of gum recession. These are:

The aging process – As people age, their gums become drier. This causes them to shrink and be less capable of keeping a secure grip around the base of teeth.

Periodontal (gum) disease – As mentioned above, gum disease destroys oral tissues and the bone that supports natural tooth roots. A sign of periodontal disease is gum recession. Gum disease is also the nation’s leading cause of adult tooth loss.

Poor dental hygiene – When twice-daily brushing, daily flossing, and keeping the mouth moist are insufficient to rid the mouth of bacteria, their accumulation can result in the sticky film you feel on teeth. This is plaque. In just a day or so, plaque can harden on teeth into tartar. This is a cement-hard bacterial colony that cannot be removed by brushing or flossing . It can only be removed during a professional tooth cleaning. If not removed, teeth, gums and the structures below the gum line can be damaged.

Brushing too hard – Brushing teeth rigorously doesn’t mean you are doing a good job. Using a scrubbing, back-&-forth motion can wear away tooth enamel and cause the gums to recede. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.

Hormones – Females experience fluctuations in estrogen levels during puberty, menstrual periods, pregnancy and menopause. During these times, the gums can be more sensitive and vulnerable to gum recession.

Tobacco use – In addition to the many health hazards smokers risk, they are more likely to develop plaque due to the oral drying effects of smoking. This dryness can lead to gum recession (not to mention brown teeth and bad breath).

Bite misalignment – When teeth don’t come together evenly, too much force can be exerted on the gums and surrounding bone, allowing gums to recede. Bite misalignment can also lead to grinding or clenching teeth. These harsh forces on teeth can cause the gums to loosen their grip.

If you have mild sensations of sensitivity, desensitizing toothpastes can help soothe the nerves by forming a protective barrier over teeth while blocking sensitivity signals. Although this type of toothpaste can be helpful, it should be used as a temporary aid.

The goal should be to repair recession and halt the problem from recurring. To do this, we begin by determining why the gum recession is occurring. The next step is to restore the gums to their proper positions.

The corrective procedure most often performed is a “gingivectomy” performed by a periodontal specialist. In addition to treating all stages of gum disease, a periodontist specializes in contouring gum tissues. Using advanced skills, a periodontist is able to create a natural look and restore your oral health.

A gingivectomy can reposition or graft gum tissues over the area of recession to restore a healthy seal and protect the tooth structures below the surface.

Another advantage of a gingivectomy is to help save a natural tooth. When a tooth breaks near the gum line, a “crown lengthening” procedure may be advised. In this, a periodontist may be able to expose enough of the tooth structure for the placement of a crown.

A crown lengthening procedure is an ideal accompaniment to many cosmetic dentistry treatments. When there are different heights of gum tissues framing the teeth most visible in a smile. This tends to create a jumbled looking smile, when when the teeth are straight.

Crown lengthening rebalances the height of gum tissues that arch the teeth to restore a smile that is balanced. From this, the eye is drawn to the smile as a whole rather than one or two teeth with varying heights of gum tissue.

A gingivectomy is also performed for individuals who wish to correct a “gummy smile.” This is when a smile shows too much gum tissue above upper teeth when smiling fully.

Gingivectomies are performed while the patient is comfortably numbed. For some people, sedation may be a preference for enhanced relaxation. Oral sedation is available in pill form, which allows patients to ‘doze’ through procedures. I.V. sedation, also known as “twilight sleep”, is available for patients who prefer a deeper level of sedation.

Both sedations are administered by fully trained team members who use advanced safety monitoring equipment. We believe your safety is as important as your comfort.

In our Asheville periodontal dental office, we also offer a wide array of technology. This often saves the patient time in treatment, enhances comfort, and speeds healing. For example, our dental laser can seal tissues as it contours it. This eliminates or greatly minimizes bleeding.

Pain is how the body indicates that something is wrong. When the gum tissues have receded, they are not going to repair on their own. Let’s discuss your particular needs, whether for improved oral health or to enhance the appearance of your smile (or both) during a consultation appointment.

Call 828-274-9440 to schedule a time.

 

 

Optimize Your Dental Implant Experience, Results.


Posted on Jan 24, 2022 by William J. Claiborne, DDS MS

I recently had to return a small appliance at a “big box” store. I didn’t have the receipt but hoped I could at least get a store credit. When I explained this to the customer service rep, she said a receipt wasn’t necessary. She scanned the bar code and asked me if I wanted the refunded amount applied to the credit card I used to purchase it. No receipt needed, no credit card, and I was in and out of the line in no time.

With today’s technology, many processes that were once time-consuming and complicated are now simple and “painless.” Less time is required with better results. Technology has made this true, too, in dentistry.

As a periodontist, I specialize in the prevention, diagnosis, and treatment of all stages of periodontal (gum) disease. I also have advanced training and skills in the selection and placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures.

As an Asheville periodontal specialist for over 30 years, I’ve treated a variety of needs that involve the gum tissues. These include:

– Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)

– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)

– Diagnosis and placement of dental implants

– Treatment of lesions or cysts in oral tissues

To receive the extensive, additional 3 years of training after dental school to become a periodontist, (I believe) an individual must be passionate about the specialty. I certainly am, which is why I’m so committed to stay on top of the latest developments in the field.

This includes incorporating some of the most advanced technology available for the betterment of our Western North Carolina patients.

Our periodontal dental office features cutting edge technology, much of which is not available in other dental or periodontal offices in this region. These features help to diagnose with precision, treatment plan with superior accuracy and reduces the patient’s treatment time while optimizing comfort.

For our dental implant patients, these options have been significantly beneficial in maximizing results. Some specifically helpful in dental implant diagnosis and planning are:

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. For patients who are preparing for dental implant placement, resolving gum disease prior to treatment is mandatory. LANAP offers a non-surgical alternative for patients with moderate to severe periodontal disease with very little discomfort and a quick recovery time.

Cone Beam Imaging – These amazing 3D “x-rays’ are ideal for diagnosing and treatment planning. The highly-detailed images provide a clear view of the upper and lower jaw. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The images are captured in a quick, painless process and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging – This enhanced tomography works with 3D imaging for exceptional detail and range.

Computerized Dental Implant Placement – This system provides the futuristic ability to position dental implants before the process actually begins. Through computerized technology, the implants are selected and “ideally positioned” on a 3D model of the patient’s jaw. From this, a template is developed for optimal treatment success, even for complex cases.

CS 3600 Intraoral Scanner – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily. These are used to create precision models or appliances (dental implant crowns, bridges, or full arches). The scanner can also reach hard–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Sedation – Our Asheville periodontal practice is known for its environment of comfort and respectful care. We understand that over 70 percent of the adult population have some level of dental fear or anxiety. For optimal comfort and relaxation, 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.
With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

When it comes to placement of dental implants, a periodontist has a unique understanding of the tender layers of gum tissues. Using gentle and precise skills when it comes to any treatment involving oral tissues, the patient experiences less disruption and incisions. When it comes to the gums, less is definitely more. We strive to optimize comfort levels and speed the healing process.

If you are considering dental implants, you may wish to begin with a consultation appointment. During this time, we can explain the vast difference in comfort, treatment time, and success available through our specialized skills and extensive technology.

Call 828-274-9440 to schedule. New patients are always welcome and a referral is not required.

Mouth Sores – What Is Harmless & What To Watch Closely


Posted on Nov 04, 2021 by William J. Claiborne, DDS MS

As the holiday season approaches, our risk for illness goes up. Our chances for picking up colds or the flu increases, which is worrisome on its own. Add that to already-high concerns surrounding exposure to COVID, and we’re all taking added precautions to protect our health.

As in any year, colder months mean we’re more confined to the indoors and in closer proximity to others. With heightened potential for illness, the holidays simply create more stress to our lives. Stress is a contributor to our health as it compromises the immune system. This, in turn, lowers our resistance to fight off illness.

After the holiday mingling constraints endured in 2020, people are trying to take added precautions in 2021 so our “togetherness” is not overshadowed with worries about exposure to illness. To bolster our resistance, many people have had their Covid booster and flu vaccines, practice frequent hand washing, take vitamin supplements such as C, and are trying to stay active physically inside and out-of-doors.

Certainly, we applaud the health safety efforts taken by our Northwest NC population. As an Asheville periodontist, just a added tip for your overall health and well-being: Don’t forget to monitor the inside of your mouth while being committed to the other health measures you’re taking. You may be surprised at what your mouth reveals.

In busy times of year like the holiday season, we see a greater number of individuals who develop canker and cold sores.  As stress goes up, your likelihood of getting a cold or canker sore increases as well.

The difference between Canker and Cold sores is:

Canker Sores
These are small ulcers that typically have a white or gray base and red border. Unlike cold sores, canker sores appear inside the mouth and are not contagious. The exact cause of canker sores is uncertain but fatigue, stress or allergies can increase the likelihood of a canker sore. Some experts suspect immune system problems, bacteria or viruses can also spurn eruption. A cut caused by biting the tongue or inside of the cheek as well as hot foods or beverages may contribute to canker sore development. Canker sores usually heal on their own in a week or two. Over-the-counter topical anesthetics, steroid preparations,  and antimicrobial mouth rinses can provide temporary relief. As a holistic method, you may try swishing with plain, sugar-free yogurt for a minute or so. This helps to restore a healthy bacteria balance in the mouth while soothing discomfort.

Cold Sores
These are also referred to as fever blisters or Herpes simplex and are located around the lips, under the nose or on the chin. Caused by herpes virus type 1, cold sores are very contagious. These are clusters of fluid-filled blisters that often erupt since are they are most commonly found around the edge of the lips. Cold sores are Herpes lesions that may follow a fever, sunburn, skin abrasions or emotional upset. Because cold sore blisters are on the outside of the mouth, they can be embarrassing and uncomfortable. Although they usually heal in a week, over-the-counter topical anesthetics may speed the process while providing some relief. In our office, we can use a dental laser to hasten healing, often within a couple of days. If occurrences are frequent, ask about prescription drugs that can help reduce the duration of these viral infections.

Other issues your mouth’s interior can reveal include:

White Coating On Tongue
The tiny, bumpy protrusions on the tongue’s surface are papillae. Papillae are our source for taste and touch, allowing for feeling food’s form and texture. Saliva and food residue can become embedded in the grooves between the papillae, especially on the back portion of the tongue. This can create areas for rapid bacterial growth. As bacteria accumulate, a whitish film coats the tongue, which leads to bad breath. Let your white tongue be a warning sign of too much bacteria and take measures to manage it before cavities and gum disease develop. It’s important to keep the mouth moist since a dry mouth provides a breeding ground for bacteria reproduction. Drying sources, in addition to age, include smoking, alcohol consumption, caffeinated foods and beverages, and many prescription and OTC medications. Uproot bacteria in the tongue daily by brushing the tongue with your toothbrush after brushing teeth. Some toothbrushes have a tongue scraper on the back side of the bristles or you may want to purchase a tongue scraper. These are flexible strips you use to scrape over the tongue’s surface in a back to front motion.

Cheek Biting
Cheek biting can occur from a minor accident, such as during a fall. It can also occur from careless chewing or talking while eating. Cheek bites can occur more frequently due to a bite that is misaligned. A disparity in the bite can disrupt the harmonious congruency of upper and lower teeth while chewing and speaking. Cheek biting can be a symptom of bite misalignment. Other signs may indicate temporomandibular joint (or TMJ) disorders, which often result from a misaligned bite. Thus, cheek biting can be related. Too, TMJ disorders can cause night-time clenching or grinding of teeth. During these actions, you may be unknowingly biting the inside of your cheek while asleep. Cheek biting can cause inflammation at the location of the bite and can also result in canker sores. Chronic cheek biting can result in redness, painful sores, and tears in the mouth’s inner lining. Repeated bites can cause the oral tissues to become thick, scarred, and paler in the affected area. This surface can prompt the individual to continue biting in an attempt to create a smooth surface. If cheek biting has become habitual, there may be an emotional cause, such as  stress, anxiety, depression, or even genetics. This should be discussed with your primary care physician.

Oral Cancer
It is important to pay close attention to any change to oral tissue that does not heal within 10-14 days. When oral tissue does not repair on its own in a week or so, it should be examined by your dentist or periodontist without delay. Some of these spots can be a symptom of oral cancer.
Oral cancer has one of the worst survival rates of all cancers. Because symptoms can mimic a bite on the inside of your cheek, more obvious symptoms often do not emerge until the cancer has reached advanced stages. Of those who acquire oral cancer, only 57% are estimated to still be alive 5 years later. Know the signs of oral cancer, which include:

• white or red patch of tissue
• unusual lesion in the mouth
• difficulty or discomfort when swallowing
• persistent sore throat or feeling something is stuck in the throat
• a lump or mass inside the mouth or neck
• wart-like mass
• numbness in the mouth or face

Lesions or discolorations that are early warning signs are not always visible, particularly in the back portion of the mouth. Because symptoms emerge slowly, the delay in early diagnosis and treatment can have deadly consequences. This reinforces the need to maintain regular oral hygiene exams and cleanings every six months. During these times, unusual changes in the mouth can be noted and, if concerning, further steps can be taken. Remember, never wait until your next dental check-up appointment to have anything unusual examined.

Bleeding Gums
Contrary to what some people believe, having gums bleed at any time is not normal. Seeing blood in the sink when you brush is not a sign you’re doing a good job. It’s a sign that the gum tissues are either being scrubbed too harshly or the gum tissues are infected by accumulated oral bacteria. If you notice bleeding – at all – take extra measures to maintain excellent oral hygiene at home. This includes twice daily brushing, daily flossing, using an oral rinse, keeping the mouth moist (ideally by drinking plain water), and limiting sugar. If bleeding continues for more than a couple of days, make a dental appointment. You may have developed Gingivitis, which is an early stage of gum disease. Halting this in its tracks early can save you greatly in treatment time and expenses.

The interior of your mouth can be a great indicator of your health in other areas. Just be sure to look inside and stay proactive on steps needed to keep the interior “in the pink”. Again, if an unusual spot or sore is still present after two weeks, call 828-274-9440 immediately for an appointment.

Contour of Gum Tissues Is Important To A Smile’s Appearance


Posted on Oct 28, 2021 by William J. Claiborne, DDS MS

When people think of their smile, they tend to think primarily of their teeth. Certainly, having white, straight teeth are a major part of a smile’s appearance. In today’s cosmetic dentistry, porcelain veneers and crowns give an exceptionally natural appearance with excellent longevity and durability. However, the gum line that borders teeth can greatly affect a smile’s appearance, perhaps more than you’ve considered.

People with unflattering smile traits tend to “hold back” when smiling. They may smile with lips only or hold a hand in front of their mouths. Some men even admit to growing a mustache that extends down over the top lip to hide the teeth visible in a smile.

In addition to placing dental implants and treating all stages of gum disease, a Periodontist specializes in the treatment of the soft tissues of the mouth. As an expert in oral tissues, my advanced training enables me to contour gum tissues to provide a natural appearance and healthy seals around the base of teeth.

For several reasons, gum tissues can pull away from the base of teeth. This can occur from gum tissues becoming drier with age or over-zealous tooth brushing. Gums can also loosen their grip around teeth when teeth tilt out of their proper positions.

When the tight seal around the base of teeth is compromised, the tooth becomes more vulnerable to oral bacteria. Darker, sensitive tooth root segments may be exposed. This not only causes sensitivity, these areas become susceptible to bacterial penetration. As an entry point for oral bacteria, the tooth roots and bones that support teeth are more vulnerable to damage as well.

In cases when a tooth breaks near the gum line, a procedure known as crown lengthening may be able to expose enough of the tooth structure so a crown can be placed. This means the natural tooth can be saved rather than require removal. Once a natural tooth is removed, it brings with it a long list of decisions and associated costs.

Although protecting and saving teeth is the priority, gum contouring procedures, such as crown lengthening are also performed to enhance the appearance of a smile. Gum re-contouring is typically referred to as a “gingivectomy”. It is performed to remove the excess gum tissue that arches over the teeth most visible in a smile.

For example, for people who have a “gummy smile,” too much gum tissue is visible above upper teeth in a full smile. A periodontist can use his or her specialized skills to reshape the tissues to provide a more balanced smile line.

In this, crowns are typically placed in addition to having the gum height adjusted. The result? A smile is greatly improved when the gum line is contoured to blend attractively with gum tissue bordering neighboring teeth.

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

It’s normal to experience some tenderness or swelling after the procedure. However, most patients do fine by applying an ice pack off and on for the first day. In most cases, over-the-counter pain medications are sufficient, however, we make prescription strength options available to ensure comfort during the healing process. Many patients tell us they needed no medication at all.

Healing time depends on each individual and can vary from a few days to a few weeks. The dental laser we use helps to reduce the amount of time needed for healing. For patients who smoke, healing times are longer due to smoking’s drying effect on gum tissues.

Most gingivectomies are followed by porcelain veneers or crowns to give a beautiful, even smile line.

For those who have avoided gum recontouring 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.

IV 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 doctor of anesthesiology for optimal comfort and safety. In our Asheville office, 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. Our doctors and staff respect each patient and provide gentle, compassionate care – at every appointment.

Treatment fees depend on the extent of the condition and whether crowns or veneers will be applied following treatment. In either case, beautiful results can occur, helping the individual who once ‘held back’ on smiling confidently.

A healthy smile is a benefit to our overall health. An attractive, confident smile is also an asset when it comes to self-image, helping us to feel good from the inside out! Call 828-274-9440 for a consultation to discuss a gingivectomy and what may be recommended for your specific needs.

 

 

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