Men: Gums Can Impact Erectile Dysfunction (ED) and Heart Health


Posted on Jan 24, 2023 by William J. Claiborne, DDS MS

It may be an awkward subject, but the issue of erectile dysfunction (ED) seems to appear rather frequently via TV commercials. I see ads for pills and medical clinics rather often. Agreeably, it is a problem estimated to affect a rather large percentage of men. For those ages 40 – 70, it affects over 40%. Nearly 70% of men at age 70 are affected. 

https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/erectile-dysfunction/

In no way am I wanting to dissuade a male from medications or seeking treatment. However, as an Asheville NC periodontal specialist, I want to relay an issue that may be a bigger influence in ED than many are aware.

Below are findings of several studies showing that periodontitis (advanced gum disease) to be a significant risk factor for erectile dysfunction. Rather telling is as gum disease worsens, so does erection impairment.


• In a study of 162 males ages 30 to 40, Turkish researchers found that 82 of the participants had normal erection function while 80 who complained of ED, nearly half. Some men in both groups had chronic periodontitis, but the condition was more than twice as prevalent in the ED group. Men with periodontitis accompanied by decayed or missing teeth had the greatest level of ED.


• In another study conducted at the University of Granada School of Dentistry, 80 male participants who had severe gum disease were more than twice as likely to suffer from erectile dysfunction. This was true even after adjustments were made for other issues that could distort the findings. In the study, 74% of the participants with ED also presented with chronic periodontitis. 


• Israeli researchers conducted a survey of the erection function of 305 men with an average age 40. The participants were given a thorough examination of their gums. Those with chronic periodontitis had the greatest risk of ED.


• Research has shown that men with indicators of periodontal disease such as red, swollen or tender gums as well as prostatitis (inflammation of the prostate) have higher levels of PSA than men with only one of the conditions. This means that prostate health may be associated with periodontal health, and vice versa.

Men with gum disease showed a higher risk of developing impotence due to inflammation associated with periodontal disease. This inflammation has been known to damage to blood vessels, which can lead to impotency. Men younger than 30 or older than 70 are especially at risk.


A separate study found that men with a history of gum disease are 14% more likely at risk for cancer than men with healthy gums. Specifically, men with periodontal disease are 49% more likely than women to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.

For over two decades, medical researchers have closely focused on inflammation in the body and its power to activate health problems, heart and cardiovascular diseases in particular. However, men have notably higher risks in some areas in addition to ED, one being the heart.

When it comes to ED and heart disease, the connection to periodontal disease has emerged as an independent risk factor. Cardiovascular disease raises risk for ED. Thus, anything that increases the risk for cardiovascular disease (such as smoking, obesity, chronic stress, high cholesterol, high blood pressure, and chronic sleep apnea) also raises the risk of ED.

Men, especially, need to know that they should be committed to having healthy teeth and gums. Research has found that periodontal disease is higher in men (56.4%) than in women (38.4%) – an 18% difference. https://www.perio.org/consumer/gum-disease-and-men

According to a survey by the Centers For Disease Control & Prevention (CDC), only 66% of males brush their teeth twice or more a day compared with 86% of females who do so.

This was revealed through a study of over 800 participants. Evaluation included a written questionnaire on dental knowledge and oral health habits. It also included an oral exam of each participant to detect signs of periodontal disease. (https://www.perio.org/consumer/gender-differences)

Flossing had even worse numbers, but that pertains to both sexes. Only 49% in the survey claim to floss daily. Only 1 out of 3 assumed that seeing blood in the sink when brushing is normal and unaware of it as a sign of periodontal (gum) disease.

Regardless of gender, over time an inadequate daily oral hygiene leads to an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even greater.

This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to rinse away bacteria at sufficient levels, the accumulation runs rampant.

As a Western NC periodontist, I have an up-close view of the damaging affects of insufficient oral hygiene. It often results in tooth loss, which is (contrary to many perceptions) NOT a natural part of the aging process. Having natural teeth for a lifetime is more than achievable and has even been shown to add to one’s lifespan (by up to ten years).

If you haven’t been fully committed to your oral health, there is no better time to begin than the present. Start the year with a thorough periodontal examination. Call 828-274-9440.

If dental fears have caused you to delay or avoid having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. Too, many treatments can include oral or I.V. sedation (sleep dentistry, or “twilight sleep”).

And, if financial constraints are an obstacle in receiving treatment, we offer several payment plans. Most are interest-free with no down payment required (for qualified individuals). Feel free to ask about these during your consultation.

Get Dental Fear Out Of The Way and Enjoy A Healthy Confident Smile


Posted on Jan 18, 2023 by William J. Claiborne, DDS MS

It’s a new year. Hopefully, this new beginning has given you renewed determination to conquer challenges that have held you back from living the life you want.

While some people want to lose weight and others wish to learn something new, I tend to see many people at the first of each year who wish to achieve a healthy, confident smile. A large number of these people have been less-than-successful in the past because of having dental fear.

Dental fear and high anxiety associated with dental visits is not uncommon. These fears are often borne from a traumatic incident in the patient’s past. Or, in some cases, it exists for unknown reasons. Too, certain smells, sounds or sights can trigger reactions that evoke fear at even mere thoughts of dental visits.

Oral health is an integral part of your overall health. For decades, studies have proven a direct contact between poor oral health and disease related to other organs. By neglecting dental hygiene, people are at greater risk of developing (or the worsening of) serious diseases and conditions. To avoid these risks, good dental care at home and having regular dental check-ups help empower adults in improving oral health and wellness.

As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Certainly, avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss. However, the repercussions of poor oral health can wreak havoc on one’s overall health.

It’s not uncommon for adults who avoid dental visits to feel they are doing a “good enough job” at maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass regular dental cleanings and exams. Yet, even the best of at-home dental hygiene can be insufficient.

Even people who feel they are dong a good job at the sink can easily miss areas of bacteria accumulation. Grooves in the tops of teeth and the tight nooks formed by crooked teeth become ideal hiding spots for bacteria growth.

Oral bacteria reproduce rapidly and, when at a certain point, can trigger inflammatory reactions. In addition to being the origin of cavities and periodontal (gum) disease, these reactions can extend far beyond the mouth (some of which are listed below).

Gum disease is the nation’s leading cause of adult tooth loss. The same infectious bacteria that destroy gums and structures that support natural teeth aren’t confined to the oral proximity. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.

Research has correlated oral bacteria to an extensive list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. For those who avoid dental care due to anxiety or fear, knowing this is not necessarily going to quell their anxiety. However, allowing dental fear to prevent you from achieving a healthy smile can increase health risks you may not realize.

Just how bad are the risks?

Dementia & Alzheimer’s disease: Gum disease occurs when infection of the oral tissues develops. It causes bleeding gums, putrid breath odor, loose teeth, and tooth loss. Oral bacteria and the inflammatory molecules that develop can enter the bloodstream, making their way to the brain. Previous lab studies have suggested that this is a potential risk factor in the sequence of events that lead to dementia.
https://www.nia.nih.gov/news/large-study-links-gum-disease-dementia

Alzheimer’s disease is the most common form of dementia that destroys memory, shrinks the brain, and affects the brain cells to die. It degenerates the functioning of mental health, which leads to memory loss and confusion. During Alzheimer’s, loss of appetite may worsen, eventually giving rise to oral health problems. The bacterium P. gingivalis appears to migrate from the mouth to the brain of some individuals as they age with a significant proportion of subjects developing Alzheimer’s disease.


Cardiovascular disease: A potential association exists between atherosclerosis (i.e. plaque deposition in blood vessels) and periodontal pathogens. There is a broad base of common genetic variants which increase both the risk of cardiovascular disease and the risk of periodontitis.


Endocarditis: Bacteremia (defined as the entry of bacteria into the blood stream) is a precondition for endocarditis. The vast majority of bacteremia do not cause endocarditis, even in patients at high risk. However, in high-risk patients, the more frequently and the more intensely bacteremia occurs, the greater the likelihood of endocarditis. Periodontal therapy has been shown to have a protective effect in people at risk of endocarditis.


Erectile Dysfunction: In the U.S., an estimated 18% of males have erectile dysfunction (ED). Men over the age of 70 are more likely to have ED compared to 5% between ages 20 – 40. Studies have shown an association between gum disease and pancreatic cancer. From analyzed data of five studies between 2009 – 2014, studies followed 213,000 participants aged 20 – 80.

Each study found erectile dysfunction was more common among men with chronic periodontitis, particularly for those younger than 40 and older than 59. After accounting for other health factors, erectile dysfunction was found to be 2.28 times more common for men who had advanced gum disease than for men without it.
https://www.reuters.com/article/us-health-periodontitis-erectile-dysfunc/chronic-gum-disease-tied-to-risk-of-erectile-dysfunction-idUSKBN13K1UP


Stroke: In one study of 265 stroke patients, researchers found that patients with gum disease had twice as many strokes due to thickening and hardening of brain arteries as patients without. Additionally, patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.

In a separate study of over 1,100 patients who had not experienced a stroke, researchers noted that 10% had severely blocked brain arteries. They also found that patients with gum inflammation were twice as likely to have moderately severe narrowing of brain arteries.


Arthritis: For decades, it was perceived that RA (rheumatoid arthritis) patients had such a high risk of gum disease due to poor oral hygiene because of dexterity problems with using a toothbrush. However, more recent studies now show that gum disease is actually a risk factor for arthritis.

While genetic factors certainly contribute to greater RA susceptibility, the true source has been determined to be inflammatory reactions. This inflammation is triggered primarily by bacterial infections, with oral bacteria being a significant contributor to inflammatory arthritis.

Researchers found that people with severe periodontal disease also had severe rheumatoid arthritis. Patients with the most plaque, bleeding and gum tissue breakdown had worse RA by all measures, including disease activity and inflammatory markers. Other studies have found that even with treatment, RA patients with periodontitis continue to have worse arthritis symptoms and are 50% less likely to be in remission.

The relationship between gum disease and arthritis isn’t just seen in adults. Kids with juvenile idiopathic arthritis (JIA) have inflammatory mouth bacteria not found in their healthy peers.  Different types of bacteria seem to correspond to specific aspects of JIA.

Some are associated with higher disease activity and others with a greater number of affected joints.
https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/mouth-bacteria


Diabetes: It has been known that acute inflammation may lead to poor glycemic control. This is due to the fact that infections reduce the uptake of glucose into cells, and endotoxins and inflammatory mediators reduce the efficiency of insulin. Due to these pathways, periodontitis (advanced gum disease) has long been regarded as a risk factor for poor blood glucose control in diabetes patients.


Pre-Term Babies: The elevated hormone levels during pregnancy create a higher vulnerability to gum disease; the reason about half of pregnant females experience swollen, red and tender gums that bleed while brushing. Known as Pregnancy Gingivitis, the gums are more susceptible to inflammation, thus more sensitive to the bacteria of gum disease.

Studies have shown that gum disease increases the risk for preterm delivery (before 37 weeks) and low birth weight babies. Gum disease also increases the risk for poor obstetrical outcomes, late miscarriage and pre-eclampsia. For example, the preterm birth rate for women without periodontal disease is approximately 11% compared to nearly 29% for females with moderate to severe gum disease.

Through tears in gum tissues, oral bacteria can enter the bloodstream. Once this bacteria reaches placental membranes, it can trigger inflammation that can cause preeclampsia or labor.


While these health concerns are all reasons to renew your commitment to achieving and maintaining a healthy smile, the image of having a terrific smile you want to share often is an added perk of having good oral health. As a periodontist, I have advanced skills in the treatment of all stages of gum disease as well as the placement of all types of dental implants.

If dental fear is holding you back, let us help your 2023 be the year you take your smile back! Begin by understanding that having discomfort or pain is NOT a part of today’s dentistry. In our Asheville periodontal dental office, we have advanced skills and technology that enhance comfort and minimize treatment time.

Here, we make patient comfort a priority at every visit. We have even designed our reception area to pamper you from the moment you enter.

We offer a private consultation room for patients as well. In this room, we can discuss your treatment and answer your questions in a comfortable setting. This allows patients to become better informed about their treatment needs and options versus communicating while they are seated in a treatment chair.

Our surgical suite offers a rather unique setting for a periodontal office. A large window provides beautiful mountain views, very soothing to our patients. In addition, we offer oral sedation as well as I.V. sedation (twilight sleep) for most procedures, if desired.

Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation places the patient in a deeper sedative state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are monitored with advanced safety equipment throughout treatment.

Our entire staff provide a unified team, each bringing a sincere level of compassion and commitment to excellent care. While the doctors involved in your care are top-notch, I must admit that our staff are the pros at making our patients feel truly pampered.

When patients realize that our goal is to provide exceptional care in TOTAL comfort, they relax. When they experience this, they relax even more. When they experience this more than once, a sense of trust is born. When patients trust us, they feel they no longer need to avoid dental care. Like everyone, fearful patients desire a healthy, confident smile. Once the obstacle of fear is removed, their ability to achieve that is greatly heightened.

If you or someone you know has fear that has prevented needed or desired dental care, schedule a consultation appointment. This will take place in our private consultation room. Here, we can discuss your needs and concerns and have your questions answered thoroughly. From there, you can determine what pace is best for you.

Call 828-274-9440 to learn more. Our friendly phone staff will make you feel good from the very beginning!

Boost Immune System By Investing In Gum Health


Posted on Nov 17, 2022 by William J. Claiborne, DDS MS

There is no argument that the price of about everything has gone up and up over the past couple of years. The challenges that most individuals face at this time have been significant for some people but felt by about all.

Yet, there are still reasons to “spend less now so we’re not spending more later.” This is true with things such as auto maintenance, home repairs and taking good care of our health. A signifiant part of maintaining good overall health is having good oral health. The key, however, is to make the investment while the costs are still low, and avoid the big expenses later to pay for repairs and more extensive treatment.

I’d like to point out the need to bolster our immunity system, brought front-&-center during the pandemic, is actually supported by your oral health. Although the Covid virus continues to be a threat, the experience has made populations more aware of the benefits of vaccines and healthy habits such as hand-washing. Still, it is in our immune system that makes people more or less vulnerable.

By investing in having healthy gums, the immune system is actually supported more than is largely known. I’ll explain.

The bacteria in the mouth, or “oral cavity,” is intricately connected to your overall health; so much so that “bad” oral bacteria can disrupt the healthy balance in the digestive system. This bacteria comes from oral plaque, which is a cesspool of sorts formed from bacteria accumulation.

As a layer of biofilm, plaque coats teeth and gums. It is the sticky coating you feel in your mouth when you wake up, during which time the bacteria has had an opportunity to amass during sleep. Plaque, mot removed, becomes tartar. This hardened mass of oral bacteria continues to grow, doing damage in the mouth and far beyond.

Researchers have tracked oral bacteria as it enters the bloodstream. This occurs through weakened gum tissues, allowing the bacteria to travel throughout the body. Studies have shown that the bacteria are able to activate or worsen the development of a number of serious health problems.

These include heart disease, stroke, arthritis, diabetes, preterm babies, some cancers, erectile dysfunction and dementia. Research is currently being conducted to further the connections suspected between periodontitis to Alzheimer’s disease.

How does oral bacteria become destructive? Gingivitis is the initial stage of gum disease. Symptoms typically include gums that are tender in spots and some bleeding when you brush. These are warning signs that signal an immediate need for attention.

Periodontal (gum) disease and (often) its subsequent tooth loss are, simply put, products of bacterial overload in the mouth. The mouth is constantly being supplied with sustenance for these organisms. Bacteria are able to thrive through food that enters, especially sugars, and other bacteria-laden items put into the mouth.

The bacteria that cause cavities that feeds on sugar from the foods and drinks you consume. This weakens tooth enamel due as bacteria convert sugar into acids. As bacteria thrive, they are able to reproduce very rapidly.

When bacteria levels become more than the immune system can tackle, infection can set in. Accumulation of bacteria can evolve into gum disease, which is an inflammation that attacks teeth, oral tissues and the bone structures that support tooth roots.

Gum disease symptoms are those more prominent than gingivitis. These include sore gums that bleed when brushing, persistent bad breath, gums that pull away from the base around teeth, gums that darken in color.

As it worsens to the stage known as periodontitis, pus pockets may form on the gums at the base of some teeth. In advanced stages, gum disease causes teeth to loosen and eventually require removal.

The reason that 6-month dental check-ups and dental cleanings is to remove tartar buildup before damage can occur. Your hygienist and dentist can look for signs of gum disease so measures can be taken before the disease explodes into the need for more costly treatment to resolve the problem. Since gum disease is the nation’s leading cause of adult tooth loss, the associated expenses of replacing teeth can also be avoided by maintaining good oral health.

Prevention begins at home: Begin by twice daily brushing with a soft bristle tooth brush and use a fluoridated tooth paste. Brush for at least two minutes each time. Floss daily. Be sure not to pop the floss between teeth to avoid damaging tender gums. Move the floss in a back-&-forth motion between teeth to ease it down so you can scrape the sides of each tooth.

You can remove a tremendous amount of oral bacteria by using a tongue scrapper daily. Or, brush your tongue with your tooth brush at the end of each brushing. This helps to dislodge bacteria that is embedded in the grooves of the tongue.

Drink lots of water during the day. This will help keep saliva flow at ample levels. Saliva is designed to move oral bacteria from the mouth on a consistent basis. Oral dryness is the enemy. Avoid foods and beverages that are drying to oral tissues such as caffeine, alcohol, and spicy foods. Also, try to minimize the amount of sugar and carbohydrates you consume. These foods amplify the reproduction of oral bacteria.

Oral dryness gives bacteria a favorable environment for reproduction. The chemicals in cigarette smoke are very drying to oral tissues. If you smoke, consider using an oral rinse that replenishes moisture in the mouth. Some oral rinses are specifically designed for moisture.

Lowering treatment costs begins with early care: If you have delayed or avoided regular dental care, it is recommended that you begin by having a periodontal examination. A periodontist is a dental specialist who can determine your precise level of gum disease and the most appropriate treatment to restore good oral health. We can detect all stages of gum disease and provide comfortable, thorough treatment to restore your gums to a health state.

If you have lost teeth due to periodontal disease, a periodontist also specializes in the diagnosis and placement of dental implants. This ideal method to replace teeth provides a lifetime solution, making them an excellent investment.

Call 828-274-9440 if you have questions about your gums or if you are experiencing any symptoms associated with gum disease. Also, visit our web site to learn more about our sedation options (including “twilight sleep”) and advanced technology, which often reduces treatment time while enhancing comfort.

Visit: https://www.biltmoreperiodontics.com/

 

Does Obesity Lead To Gum Disease?


Posted on Sep 21, 2022 by William J. Claiborne, DDS MS

What are the two most common diseases in the U.S. today? Obesity and gum (periodontal) disease. Studies are now showing that these two conditions may be related.

However, tracking down “cause and effect” have not been achieved as yet. What is known, however, is that changes in body chemistry affect metabolism, which, causes inflammation, a common element they share. People who have periodontal disease are more susceptible to inflammation, which in turn makes them more susceptible to obesity.

One new study analyzed data from population subsets at one point in time in order to explore potential connection of pathways between obesity and gum disease. Researchers noted an increased risk to develop gum disease for those with higher body mass index (BMI), waist circumference and percentage of body fat.

Certainly, there are a number of risk factors for developing periodontal disease. These include:

• Smoking or chewing tobacco
• Poor oral hygiene and lack of dental care
• Consumption of sugar and other foods that increase oral acid levels
• Aging
• Being diabetic
• Many medications (including steroids, antidepressants, cancer therapy drugs, some calcium channel blockers and oral contraceptives)
• Improper fitting of dental appliances (dentures or partials)
• Pregnancy

Common signs and symptoms of gum disease are:

Gums that bleed easily
Red, swollen, tender gums
Persistent bad breath
Gums that pull away from the teeth (recede)
Changes in the way teeth fit together when biting
Changes in the fit of partial dentures
Permanent teeth that loosen or separate

Initially, gum disease begins with plaque accumulation. Plaque is the sticky film that coats teeth and gums that is usually most obvious when first waking in the morning. The film consists of bacteria, which can penetrate below the gum line. If not removed on a regular basis (preferably daily), plaque will harden into a bacterial mass known as tartar.

Plaque and tartar bacteria cause the gums to become inflamed. The tight grip around the base of teeth (which helps to seal out bacteria) will loosen. Thus, “pockets” of bacteria are able to form between the teeth and gums that become infected. As the disease worsens, these pockets deepen and gum tissues and the structures that support teeth are destroyed. Teeth can become loose and may have to be removed.

Gum disease is the nation’s leading cause of tooth loss. Research has also found links between the infectious bacteria of gum disease to other diseases affecting overall health. These include an increased risk of heart disease and stroke, diabetes, respiratory disease and preterm babies.

The prevalence of gum disease in the U.S. is at an alarming rate – affecting up to 50% of the adult population (ages 30-70) and 90% of adults over the age of 70. Yet, the obesity rates in America are at concerning rates as well.

According to the Centers for Disease Control & Prevention, U.S. obesity prevalence increased from 30.5% to 41.9% from 2000 – 2020. The highest percentage was among adults aged 40 to 59 years – 44.3%. (North Carolina ranks at 33.6%.) A healthy BMI is 18.5 – 24.9.

But, back to the gum disease-obesity connection…

A 2009 study showed that individuals with excess weight had twice the rate of periodontitis (advanced gum disease) and triple the rate for individuals with severe obesity. This was shown even after adjustments for other risk factors such as smoking, age and other medical conditions.

A leading factor lies in the fat cells, which were previously thought of as storage for energy. Now science has determined that fat cells produce a number of chemical signals and hormones, substances that lead to higher inflammation in the body. This, in turn, hampers the ability of immune system effectiveness. The inflammation add to the likelihood of periodontal disease.

As a periodontist in Asheville NC, I utilize some of the most advanced technology in the region to detect all stages of gum disease and restore the gums to a healthy state. This is true for all stages of gum disease, even the advanced level of periodontitis.

Depending on the level of disease, we can restore the tooth supporting structures (bone, gum tissue and ligaments) through thorough cleaning, tartar and plaque removal, and treating the deep pockets of infected tissue. Treatment is performed safely and comfortably, with oral and I.V. sedation (twilight sleep) available as needed.

When the severity of the disease requires surgical measures, we are fully skilled and equipped to restore oral health. We also assist restored patients with maintenance of proper oral hygiene for long-term success.

Understanding the relationship between obesity and risk factors that lead to periodontal disease is very important. If you have signs or symptoms of gum disease, please know that this condition will only worsen without treatment. The earlier your treatment, the less complex the treatment will be.

Call 828-274-9440 or visit: https://www.biltmoreperiodontics.com/services/periodontal-gum-treatment/

 

Sources:

https://www.colgate.com/en-us/oral-health/threats-to-dental-health/periodontal-disease-and-obesity

https://www.obesityaction.org/resources/obesity-and-periodontal-disease/

https://www.sciencedaily.com/releases/2019/12/191203082858.htm

https://www.cdc.gov/obesity/data/adult.html

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