Rheumatoid Arthritis (RA) Linked To Periodontal Disease


Posted on Oct 02, 2019 by William J. Claiborne, DDS MS

As a periodontist, I specialize in the treatment of all stages of periodontal (gum) disease. Although this particular dental specialty is not as visible as a general dentist, we are very-involved members of the medical and dental community. According to the Centers for Disease Control & Prevention (CDC), over 47 percent of American adults have some level of gum disease.

Like the formation of cancer, many individuals are unaware when periodontal disease becomes active. When early symptoms appear (such as bleeding gums when brushing, bad breath and gum tenderness), many people shrug them off as temporary.

However, gum disease only progresses once underway. Eventually, gums become red in color and pus pockets form at the base of teeth. In advanced stages, teeth loosen and may require removal. Gum disease, to no surprise, is the nation’s leading cause of adult tooth loss.

The potent bacteria of periodontal disease can enter the bloodstream through tears in weakened gum tissues. This allows it to travel throughout the body. Research has shown it is able to trigger a number of serious health problems, including heart disease, stroke, diabetes, memory loss, and impotency.

Rheumatoid arthritis (RA), a condition seemingly unrelated to gum disease, is a debilitating disease that destroys joints. It is disabling and painful. In most cases, RA emerges gradually, often beginning with morning stiffness along with weak and aching muscles. Joint pain follows, with joints feeling sore and stiff. RA is typically found in the fingers, wrists, elbows, hips, knees, ankles, toes, shoulder and neck.

As inflammation from RA increases, joints become swollen with symptoms including fever, disfiguring of hands and feet, numbness and tingling. There is no cure for RA and lifelong treatment is required. Treatment may consist of medications, physical therapy, or even surgery.

Yet, like RA, gum disease causes pain, swelling, and tenderness. As it worsens, the associated inflammation can lead to destruction of the bone that supports teeth along with surrounding tissues. And, the similarities go much deeper.

Both gum disease and RA share a genetic likeness in clinical makeup and structures. This has been particularly apparent in pathogens, which are agents in the body that lead to disease or illness. The pathological processes that occurs in both gum disease and RA are almost identical.

Too, the particular species of bacteria found in gum-diseased oral tissues and tissues that surround joints in those who suffer with RA. Equally concerning is, while both conditions clearly cause chronic inflammation in tissues connected to bone, researchers have found the two diseases share a similar inflammatory trigger.

In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis. It has also been shown that, by treating periodontal disease in RA patients, RA symptoms often improve ( likely due to the system’s reduced burden of oral inflammation).

These findings reveal just how closely our oral health correlates

A relaxing and comfy environment.

to our overall health. This information should send up alarms that the presence of gum disease can greatly increase your risk for serious health conditions. Clearly, people who have RA should be particularly diligent when it comes to their oral health.

If you are experiencing symptoms of gum disease (as mentioned above), seek treatment at your earliest convenience. You can begin with a consultation appointment in our  comfortable Asheville periodontal office. A referral is not needed.

Call 828-274-9440 to learn more.

Men Have Greater Risks For Dental Problems.


Posted on Aug 20, 2019 by William J. Claiborne, DDS MS

Research has found that periodontal disease is higher in men (56.4 percent) than in women (38.4 percent). https://www.perio.org/consumer/gum-disease-and-men

The reason for this significantly higher number may be due to some findings revealed through some unsettling findings. According to a survey by the Centers For Disease Control & Prevention (CDC), only 66 percent of males brush their teeth twice or more a day compared with 86 percent 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 percent in the survey stated they floss on a daily basis. Only 1 out of 3 assumed that seeing blood in the sink when brushing is normal and were unaware it is a sign of periodontal (gum) disease.

While women were as twice as likely to see their dentist for regular dental check-ups, they were also more likely to follow through with recommended dental treatment than men. As a result, the study revealed women had better levels of gum health with less dental plaque, calculus, and bleeding.

The Journal of Periodontology shared nine risk factors for tooth loss due to periodontal (gum) disease, including …

• Being over age 35
• Being male
• Not having professional dental care
• Not brushing teeth
• Smoking
• Being diabetic
• Having high blood pressure
• Having RA (rheumatoid arthritis)

Although age and gender are unchangeable, decisions to not brush your teeth or to smoke, for example, are something you can control. As of 2017, 18.6 percent of American men smoke, compared with 14.3 percent of women. (https://www.edrugstore.com/blog/current-health-news/men-smoke-more/) Because more males smoke cigarettes (or use tobacco in other forms), they are more likely to develop gum disease.

Why should you worry about gum disease? In addition to causing tooth loss, oral bacteria can enter then bloodstream through tears in diseased tissues in the mouth. Once in the bloodstream, this bacteria can trigger inflammatory reactions elsewhere in the body.

The bacteria of gum disease has been linked to heart disease, stroke, memory loss, preterm babies, arthritis, diabetes, and even impotency. According to the American Academy of Periodontology (perio.org), men who fail to maintain good oral health are also at higher risk for:

PROSTATE PROBLEMS – Prostate-specific antigen (PSA) is an enzyme created in the prostate that is normally secreted in very small amounts. However, when the prostate becomes inflamed, infected, or affected by cancer, PSA levels rise. 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.

HEART DISEASE – Research indicates that periodontal disease and cardiovascular disease are associated; having periodontal disease may actually increase your risk of cardiovascular disease. Both diseases are chronic inflammatory conditions, and researchers believe that inflammation is the connection between gum disease and heart disease. Since men are already more likely to develop heart disease than women, maintaining periodontal health is another way to reduce this risk.

IMPOTENCE – Men with periodontal disease, especially those younger than 30 or older than 70, are at increased risk of developing impotence, according to research. Researchers believe that inflammation may be the link between the two conditions; prolonged chronic inflammation (the same type of inflammation that is associated with periodontal disease) can damage blood vessels leading to impotence.

CANCER – Research has found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. Specifically, men with periodontal disease may be 49 percent more likely than women to develop kidney cancer, 54 percent more likely to develop pancreatic cancer, and 30 percent more likely to develop blood cancers.

If you aren’t concerned about losing teeth, these overall health risks should get your attention. Treating gum disease before it becomes severe can be done comfortably and affordably. In our Asheville periodontal dental office, we use the latest technology and offer I.V. sedation for those who desire a “twilight sleep” state during treatment.

Gum disease will only worsen without treatment. Call (828) 274-9440 if you have tender, sore gums or see blood in the sink when brushing. You need to be seen promptly.

Protect Your Heart. Start With Your Smile!


Posted on Jul 17, 2019 by William J. Claiborne, DDS MS

According to a report on the health of Americans (published by the Centers for Disease Control & Prevention, or ‘CDC’), it is estimated that over 47 percent have some form of gum disease. Although we all aspire to have a smile that is appealing, it is what lies beneath the teeth and gums that can reek havoc on one’s overall health.

Signs of gum disease

Over time, inadequate daily oral hygiene enables an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even more susceptible to this bacterial buildup.

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 ‘wash away’ bacteria at sufficient levels, the accumulation runs rampant.

Oral bacteria are living, eating, and reproducing organisms. They thrive on rotting food particles caught between teeth. They attack gum tissues and tooth enamel. Eventually, they can work their way down tooth roots and attack the bones and tendons that support teeth.

What’s even scarier is the fact that these infectious critters can enter the bloodstream. This potent bacteria are now associated with a number of serious health conditions due to their ability to trigger systemic inflammation.

When the gum tissues can no longer combat the onslaught of bacteria, there can be very few signs of periodontal (gum) disease initially. Signs that emerge are typically frequent bad breath along with swollen, tender and beefy red gums that bleed when you brush. As they grow in number, the gum tissues become weaker and they can penetrate the bloodstream.

According to the American Academy of Periodontology (www.perio.org),
“Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.
“Scientists believe that inflammation caused by periodontal disease may be responsible for the association.
“Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.”

For this reason, cardiologists are more often advising their patients to be evaluated by a periodontist prior to heart surgery. As mentioned above, gums that bleed are a sign of gum disease. These oral bacteria, given an opportunity to enter the bloodstream, are able to travel anywhere, including the heart. They can reach the heart muscle and cause a severe infection.

For decades, researchers have probed the link between gum disease and cardiovascular health. People with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke or other serious cardiovascular event.

Acting as a contributing factor to heart disease is highly serious. Yet, the risks associated with gum disease don’t stop there. Research has shown this potent oral bacteria can set a path of destruction into motion. It has been linked to some cancers, stroke, diabetes, arthritis, preterm babies, impotency, and even Alzheimer’s.

Twice-daily brushing and daily flossing takes mere minutes and is inexpensive to do. Seeing a dentist every 6 months for oral exams and cleanings saves an individual far more by preventing problems than they cost. Yet, too many adults fail to devote the investment to this necessary part of a healthy lifestyle.

An estimated 65 percent of adults ages 18 – 64 see a dentist only once a year. Approximately 55 percent of adults brush their teeth twice a day, which is too little. (https://www.reference.com/health/many-times-day-people-brush-teeth-34d1104798029b7a) I believe it would be jolting to most adults to view dental floss under a microscope after their teeth have been flossed.

As an Asheville periodontal specialist, I have an up-close view of the damaging affects of insufficient oral hygiene. It often results in tooth loss, which is not a natural part of the aging process, as some people believe. Having your 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’ve failed to be fully committed to your oral health, there is no better time to begin than the present. Start with a thorough periodontal examination. Call 828-274-9440.

If dental fears have prevented you from 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. This will be a friendly, informative conversation and you will not be asked to sit in a treatment chair during this visit.

Let’s protect you, top to bottom, beginning with your smile!

A Dry Mouth Can Have Many Causes And Lead To A Number Of Oral Health Problems


Posted on Jun 21, 2019 by William J. Claiborne, DDS MS

Our lips and teeth – our smile – is a stage curtain to what is actually going on inside the mouth. As an Asheville periodontist, I have a daily view of  the hazards that exist beyond the veil.

Oral bacteria is the root source of most problems that occur in the mouth. Their presence is normal, of course. The mouth (or “oral cavity”) is designed to be able to manage a certain level of oral bacteria. It is the over-accumulation of this bacteria that is the origination source of many problems.

Although certain foods, such as a garlicky shrimp or onion-laden hot dogs, can create “stand-offish” bad breath, this breath odor is temporary. The bad breath that is truly offensive and occurs on a more consistent basis comes from an overload of oral bacteria.

The reason we’re advised to brush at least twice a day and floss our teeth daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, the bacteria form a sticky film that coats the teeth and gums. This film is known as plaque.

Keep in mind that bacteria are living, eating, and reproducing organisms. Because they eat, they also create waste – in our mouths! Although that in itself should be reason enough to be committed to brushing and flossing, without pain, people assume that all is well.

Yet, an over-accumulation of oral bacteria can lead to far worse than bad breath. Because oral bacteria critters eat, they look to the gum tissues. As they amass, they can create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth.

Periodontal disease is the leading cause of adult tooth loss. The advanced stage of gum disease, known as periodontitis, creates a bacteria so potent that it has been linked to a wide array of conditions and diseases elsewhere in the body.

The oral bacteria of advanced-stage gum disease has been associated with some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency. As research continues, more and more health problems are being correlated to this bacteria.

The saliva in the mouth is designed to move bacteria out. Twice daily brushing and flossing help. However, certain contributing factors complicate the ability to keep oral bacteria levels to manageable levels. These include:

• Colas/Sodas: Not only is the acidity level in these drinks harmful to tooth enamel, it can make oral tissue to dry out. Downing these beverages because you feel you are replenishing moisture is the last thing they do; refreshing they are not. Drink plain, filtered water instead. It’s much better for your mouth and hydrating to the entire body.

• Coffee/Tea: Like colas, these drinks contain acid added to caffeine. Even green tea often contains caffeine. Caffeine has a drying effect on oral tissues and therefore depletes the helpful rinsing benefits or saliva.

• Alcohol (including beer and wine): Mixed drinks, “shots,” wine and even beer are all drying to oral tissues. Add the acidity and sugar levels that exist in wine or mixers and these drinks pack a double-whammy to oral tissues. If you imbibe, alter your drink with a glass of water in-between to neutralize acids and wash sugars from the mouth.

• Smoking (cigarettes, cigars, vaping, cannabis): People who have smoked for years often have dry skin that has an aged appearance far beyond their actual years. The same is occurring inside the mouth. The smoke of cigarettes and cigars is laden with toxic chemicals; true for e-cigs as well. Vaping doesn’t keep your mouth much safer than cigarettes. Even marijuana has been found to have a negative impact on oral tissues.

• Aging: Through aging, our skin, cartilage, and tissues are less supple. Our bodies simply dry out more and more with each decade. Although there’s nothing we can do to halt the aging process, we can take measures to minimize the damage to our oral health. We recommend drinking plenty of water throughout the day, using an oral rinse designed to replenish moisture in the mouth, and limit sugar and caffeine.

As a periodontist, I also urge people to be familiar with the signs and symptoms of periodontal disease, which begins with gingivitis. In this early-stage of gum disease, the gums may feel tender and swollen in one area. You may notice some bleeding when brushing your teeth. Your breath may feel less-than-fresh more often. However, some people experience no symptoms at all at this early stage.

If not treated, gingivitis can progress to periodontal disease, where symptoms are more obvious. The gum tissues are sore and bleed easily when brushing. Your breath will be bad more frequently. The gum tissues may swell in some areas and turn red.

As gum disease advances, the gums can begin to pull away from their tight grip around the base of some teeth, exposing darker, more sensitive areas of the tooth’s root. The gums will ache often and pus pockets may form at the base of some teeth. The breath is foul, even after brushing. And, tooth brushing is very uncomfortable with blood in the sink each time.

Eventually, the disease will have penetrated the supportive bone and ligaments that support teeth. In advanced cases, the teeth will begin to move and some may require removal.

All of this devastation to the mouth can be avoided, however. When people respond to early signs of gum disease by seeing a periodontal specialist, they can avoid the time and expense required. In addition to preventing the loss of natural teeth,

Enjoy beautiful, relaxing views from our surgical suite.

research now shows that serious health problems far beyond the body can be avoided as well.

If you have delayed or avoided dental care, begin with a consultation to learn about your options to have a healthy smile that is worry-free. Regardless of your love of coffee, your smoking habit, or your age, we can develop a program that allows you to have good oral health.

Begin by calling 828-274-9440 to request a consultation, or begin with a thorough examination in our Asheville periodontal office. We offer the latest techniques, technology, and skills while always putting patient comfort at the top of the list!

 

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