Pregnancy & Your Gum Health


Posted on Jul 09, 2020 by William J. Claiborne, DDS MS

Today’s American female has a long list of guidelines that enhance the potential to have a healthy, full-term baby. Even so, pre-term births in this country occur at a rather high rate for the advanced health care available to most.

According to data released in 2017 by the National Center for Health Statistics (NCHS), the U.S. preterm birth rate actually rose from 2015 -2016, from 9.6 percent of births to 9.8 percent.

There seems to be a rather close connection between gum disease and preterm babies, as unrelated as the two may seem. First, consider the risks cited by the Centers for Disease Control & Prevention (CDC). As far back as the year 2000, the Surgeon General warned that pregnant females who had gum disease had a far greater risk of a pre-term, low birth weight baby.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and low birth weight babies (less than 5.5 lbs.).

“Studies have found that expectant mothers with periodontal disease are up to seven times more likely to deliver premature, low birth weight babies.” (https://www.adha.org/resources-docs/7228_Oral_Health_Total.pdf)

One study showed the preterm birth rate for pregnant women with moderate to severe periodontal disease to be nearly 29%.

Estimates are that over half of pregnant women have some form of gingivitis (gum inflammation, an early stage of gum disease) or periodontitis (infectious, advanced gum disease). Nearly a third of pregnant females will acquire gum disease because of their higher vulnerability to inflammation.

Infections in the mother have been identified as increasing the risk for pregnancy complications. Due to varying hormone levels, nearly all females will develop gingivitis during their pregnancy.

Referred to as pregnancy gingivitis, symptoms include swollen, tender gums that bleed easily when brushing. The goal is to halt the inflammation before it progresses to a more infectious stage.

Most obstetricians now urge their pregnant patients (or those trying to conceive) to have a thorough periodontal examination. Even with no obvious signs, gum disease can still exist. It lies beneath the surface of the gum tissues and should be resolved before it worsens and is able to seep into the bloodstream.

Symptoms of gum disease include gums that bleed when brushing, swollen or tender gums, receded gums or gums that darken in color.

When periodontal disease is present, successful treatment has shown to lower the risk of preterm births. A periodontal specialist is trained to treat all levels of disease in a way that is safe for pregnant women (as well as all patients).

Pregnancy is not the sole risk factor for developing gum disease, of course. Most adults of both genders have at least one factor that heightens susceptibility to this oral infection. Among these are stress, poor diet with high sugar intake, smoking, obesity, age, and poor dental hygiene can all contribute to an increased potential for developing periodontal disease.

Other risk factors include clinching or grinding teeth, predisposition due to genetics, diseases such as diabetes or cancer, some medications, and changes in female estrogen levels (puberty, pregnancy, menopause).

Gum disease bacteria is obviously a potent threat to any individual. As the nation’s leading cause of adult tooth loss, oral bacteria of this disease have been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

If you have symptoms associated with gum disease, schedule an appointment at your earliest convenience by calling 828-274-9440. Gum disease will only worsen without treatment.

Avoid Snacking As You ‘Shelter-In-Place’ For Your Waistline AND Your Smile!


Posted on May 07, 2020 by William J. Claiborne, DDS MS

Americans love their great outdoors. Our country is so blessed to have beautiful parks, patios, backyards, and trails that enable us to get much needed exercise, sunshine and fresh air.

While these wide-open spaces are good for us, our lives have been turned upside down since March. Stay-at-home mandates have left us struggling in this area and now our indoor time has increased greatly.

Fortunately, social interactions have been possible through tele-conferencing for work, church services online and visiting with family and friends through Zoom or Skype. However, what many people are finding is too-easy access to the pantry and refrigerator!

Lately, many of us are a little surprised when we step on the bathroom scales. If we really stop to think about it, though, it’s no wonder the needle is moving upwards.

Since the ‘shut down’ began, the only “essential” establishments that have been dependably open are grocery stores or places that sell food. Combine that with our open time that has us experimenting with new recipes and Ta-Da!, you have more time to cook, eat, and repeat.

Having three healthy meals a day is not the problem, when it comes down to it. It’s what we eat and how often we eat that becomes the issue, and not just to the detriment of our weight.

Every time you eat or drink something (other than plain water), an acid flows into the mouth through saliva. This acid begins the first stage of digestion and is designed to break foods down so they can continue on the journey once you swallow, giving more efficiency to the body’s ability to utilize what is consumed for its own good. (This is also why your Mom always said to chew your food well. It gives these acids more time to do their job.)

While this acid is beneficial to digestion, it is not good for teeth. As a matter of fact, this acid is so potent that it can soften tooth enamel for a period of about 20 – 30 minutes. And, that’s for every bite.

So, once you pop that first pretzel in your mouth, the acid attack begins and will continue for a half an hour after the last sip of cola you’re washing those pretzels down with. Yes, an acid attack is triggered by beverages as well.

This is why colas are so harmful to teeth, and wine, and coffee — anything that is sipped over extended periods of time. For example, people tend to drink a glass of wine slowly, perhaps over the course of 30 or so minutes. So, from the initial sip to 30 minutes after the last sip, your teeth have endured an acid onslaught for a full hour!

When tooth enamel is softened, it is more vulnerable to wearing away or bacterial penetration. Enamel is the protective coating for the interior structure of teeth. Once it is worn down, your teeth are forever at risk.

As far as wine, caffeinated colas, tea and coffee, these beverages are also very drying to oral tissues. This makes saliva less efficient and less capable of rinsing bacteria out of the mouth as you swallow. Add sugar to the mix, and you have quite the ‘cocktail’ of challenges for your smile.

Sugar changes the Ph balance in the mouth, which adds an even greater burden by ramping up the reproductive pace of oral bacteria. Think of sugar as creating oral bacteria on steroids. When bacteria are super-charged for reproduction, saliva can only manage a certain portion and the rest are left to riot their way through the mouth.

Rampant bacteria levels are the reason for periodontal disease. Referred to as gum disease (and sometimes ‘perio’), this is an inflammatory disease that destroys gum tissues and the bone structures that support teeth. Now, that’s serious bacteria!

Gum disease is from an overload of bacteria that the immune system cannot manage. It is infectious and gets “into” the gums, going below the surface. It can no longer be brushed or flossed away nor treated with a basic dental cleaning.

And, this harmful bacteria doesn’t necessarily remain in the area of the mouth. Through tears in diseased gum tissues, the bacteria can enter the bloodstream and travel throughout the body, continuing on its path of destruction.

Research has found links of this bacteria to a long list of serious health conditions. Heart disease, stroke, high blood pressure, some cancers, preterm babies, arthritis, diabetes, and impotency are just some. Studies are being conducted to track down its connections to Alzheimer’s disease, psoriasis, and more.

Body weight aside, all this should give you reason to relook at what you’re eating and the frequency for the well-being of your smile. Hopefully, this knowledge will start a new way of thinking for simple rules and guidelines that support your overall AND oral health.

Begin by being aware of the signs and symptoms of gum disease:

Red, swollen or tender gums
Bleeding while brushing, flossing, or when chewing rigorously
Sores in your mouth
Persistent bad breath
Receded gums that reveal darker areas of teeth or that cause teeth to look longer
Loose or separating teeth
Pus between your gums and teeth
A change in your bite when teeth are together
A change in how partial dentures fit

Keep in mind that some people are also more susceptible to oral bacteria. However, all individuals can maintain healthy teeth and gums by limiting snacking and caffeine, avoiding sugar, brushing at least twice a day, flossing daily, and drinking plenty of water to keep the mouth moist.

Just one last pointer: Comfort food is great during times of stress. After all, a large serving of Grandma’s rich and gooey Mac ‘N Cheese seems to satisfies both body and soul sometimes. But, keep in mind that carbohydrates (typically a big part of comfort foods) actually break down as sugar in the mouth. They just don’t come with the sweet taste.

As our nation gets back to normal and your dental visits resume on schedule, take pride in knowing that you are in control of what can impact the well-being of your smile. This knowledge will hopefully save you time and money in the future by helping you avoid the need for dental repairs.

If you are experiencing gum disease symptoms, our Asheville periodontal office will be happy to discuss your needs or concerns. Call us at 828-274-9440.

Why Floss?


Posted on Apr 14, 2020 by William J. Claiborne, DDS MS

As a periodontist, I treat all stages of periodontal (gum) disease. Over the years, I’ve helped patients save natural teeth and restoring their ability to enjoy healthy, confident smiles.

When people come close to losing their teeth or find themselves in need of replacing them with something more dependable than dentures or partials, I hear nearly every one express the same regrets: “I wish I’d taken better care of my teeth when I could.”

Signs of gum disease

Hindsight may be 20-20, but it’s never too late. I know patients can go from having gum disease and losing teeth because of it to having excellent oral health – and end up having a renewed commitment to their smiles.

In my dental specialty, I know it begins by helping patients to understand how the problem starts in the first place. When people know the HOW, they can implement measures to bypass the repercussions of gum disease.

I’ve found that most people actually have very little awareness of how the inside of their mouth looks. We smile with lips and front teeth that show very little (if any gums). So, it stands to reason that, if a smile looks good, it’s probably healthy.

Until dental offices began using intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for a condition that didn’t hurt. There were not obvious signs initially, so nothing is wrong – right?

Intra-oral cameras are able to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual has this firsthand view of spongy, receded gums, the decision to treat often go from IF to WHEN.

Although it helps to be able to show patients the signs of gum disease, these emerged signs are indications of long-standing periodontal disease. By the time these signs appear, the early stage of gum disease, gingivitis, is past.  This is unfortunate, since early-stage gum disease can be halted with prompt measures.

Gingivitis causes the gums to become tender and swollen in some areas. You may see blood in the sink when brushing. These signs indicate that oral bacteria has accumulated in the mouth beyond the means of your immune system’s ability to manage it.

Twice daily brushing and flossing are important steps in keeping bacteria levels in the mouth under control. Brushing sweeps away built up bacteria on the surface of teeth, which is a sticky film known as plaque. Plaque, just over the course of a couple of days, can harden on teeth where build up is allowed to remain. This cement hard mass of bacteria is tartar, or also known as calculus.

The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.

Yet, try as we might, there are simply angles in the mouth that are difficult to reach with a toothbrush, manual or electric. Say you have an area of jumbled or crooked teeth. Even as you adjust the angle of the toothbrush differently to maneuver the bristles into these areas, it is often difficult to continually keep these areas clean.

This is where flossing comes in, and important step in daily, oral hygiene.

Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.

If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a jolting view of exactly what you do NOT want crawling around and breeding in your mouth. These living and breeding organisms can be highly destructive as they amass.

As research has shown for many years, your overall health is intricately linked to your oral health. The bacteria of gum disease has been linked to a long list of serious health problems, including heart disease, stroke, arthritis, some cancers, diabetes, and preterm babies. Studies are underway to track gum disease bacteria to the path of Alzheimer’s disease.

Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.

Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits): “Only four of 10 Americans floss at least once a day, and 20 percent never floss.”

Perhaps this is one reason why over 47 percent of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.

Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued.

It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.

Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. For our patients, we help them develop an at-home care regimen to maintain a healthy mouth and fresh breath between regular dental check-ups.

Be aware of the signs and symptoms of periodontal disease. Knowing them will allow you to react quickly to minimize the extent of damage and treatment needed to rid it. They include:

  • Tender or swollen gums
  • Gum tissues that turn red
  • Gums that are tender to the touch
  • Gums that bleed easily
  • Spitting out blood when brushing or flossing your teeth
  • Frequent bad breath
  • Pus pockets that form between teeth and gums
  • Teeth that loosens or shift
  • Painful chewing
  • Gums that pull away from your teeth (recede), making your teeth look longer than normal

These are all warning signs that bacteria overload is occurring in your mouth. It is a disease, and will only worsen without treatment.

If you suspect you have any stage of gum disease, call 828-274-9440 to schedule a thorough periodontal examination.

 

 

Could Poor Gum Health Increase Stroke Risk?


Posted on Mar 12, 2020 by William J. Claiborne, DDS MS

The human body is a complex structure on the inside and out. Each body is built for movement and action, its parts governed by a central control system – the brain.

Like any complex machine with its many intricate parts, there is a delicate balance. Working together, the body stays interconnected and functioning properly.

When any part malfunctions, the problem seldom stays within its own realm. Other areas are typically affected, which is what research is finding when it comes to the health inside your mouth, or your oral health.

For decades, it has been shown that the bacteria of periodontal (gum) disease can enter the bloodstream through tears in weakened gum tissues. Research has found that this bacteria can trigger harmful reactions.

For example, the bacteria can trigger inflammation that sets into motion risks factors connected to arthritis and diabetes. Some cancers have also been correlated to this bacteria. Heart disease and high blood pressure been as well.

Stroke, too, is among the long list of serious health problems associated with the potent bacteria of gum disease. While there is no clear pathway to verify gum disease bacteria are the “cause” of these serious conditions, research has continually shown they are linked, which can greatly increase one’s potential for having these problems develop (or worsen).

Say the word “stroke” and people immediately think of a deadly or debilitating, disfiguring episode that may never be recoverable. Strokes are the third leading cause of death in the United States.

There are several types of strokes. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. These cause death in about 50 percent of cases.

However, most strokes are Ischemic strokes, caused by an abrupt blockage of arteries leading to the brain. These occur when the brain’s blood vessels become narrowed or blocked, severely reducing blood flow.

Blocked or narrowed blood vessels are caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through your bloodstream and lodge in the blood vessels in your brain.

https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

In one study, 265 patients who experienced a stroke between 2015 and 2017 were followed. Researchers noted that large artery strokes – those located inside the brain – were twice as common in patients with gum disease as in those without gum disease.

https://www.health.harvard.edu/heart-health/gum-disease-and-heart-disease-the-common-thread

What connection could gum disease bacteria have with arteries in the brain?

Let’s step back and look at the makeup of bacteria found within gum disease.

It all begins when plaque, the sticky film that builds up around teeth, is allowed to remain and multiply. In the meantime, the  plaque found in blood can accumulate inside arteries. Known as atherosclerosis, this fatty plaque is the hallmark of coronary artery disease.

People with gum disease have 2 – 3 times the risk of having a heart attack, stroke, or other cardiovascular event. Still, finding a direct connection has yet to be determined. Although researchers have taken into consideration factors like smoking or a poor diet, there is an emerging concern that gum disease may be a factor – on its own – when it comes to heart disease.

Gum disease is an inflammatory disease that starts as gingivitis, the initial stage of periodontal disease. This causes gum tissues to turn red, swell and bleed sometimes when brushing. Untreated, gingivitis will progress to periodontitis, advanced gum disease.

The inflammation of periodontitis can destroy tissue and bone in the mouth, causing gums to separate from the teeth. This separation allows bacteria to infect the gums, and, over time, can lead to tooth loss.

Although we recommend that people react promptly to signs of gum disease, we also felt it beneficial to provide the signs and symptoms of stroke (for you or someone else). These include:

• Trouble speaking and understanding what others are saying. This may include confusion, slurring or having difficulty understanding speech.
• Paralysis or numbness of the face, arm or leg, typically on one side of the body.
• Vision problems in one or both eyes. This may cause blurred or blackened vision in one or both eyes, or seeing double.
• Headache, which may be sudden and severe. This may cause vomiting and/or dizziness.
• Trouble walking, sudden dizziness or loss of coordination.

Some studies indicate that treating gum disease (with other stroke risk factors) could reduce your risk for stroke.

While the direct path of gum disease to stroke may not be known at this time, research has clearly shown that the bacteria of periodontitis is harmful far beyond the mouth.

If you would like a periodontal evaluation, call our Asheville periodontal dental office at 828-274-9440. As a periodontist, my specialty is the treatment of all stages of gum disease. Through our advanced skills and technology, we can restore your smile to a healthy state and give your overall health a leg up!

 

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