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.

 

 

There Are Good Reasons To Keep The Mouth Moist


Posted on May 11, 2022 by William J. Claiborne, DDS MS

Having good oral health takes a commitment. It requires us to devote time each day for oral hygiene, at least twice per day. However, it’s in-between these brushings that can impact the good that we are doing at the sink.

Nearly everything that causes problems in the mouth has to do with oral bacteria that has gone beyond manageable levels. Although the mouth is home to some very “good” bacteria, an overload of “bad” bacteria is what becomes the origin of many problems.

The reason people are advised to brush at least twice a day and floss daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, a sticky film of bacteria form, which coats the teeth and gums. This film is known as plaque. Without sufficient and frequent removal of plaque, it begins to harden at the base of teeth.

This is tartar (or calculus), which is actually a hardened mass of oral bacteria. Tartar cannot be brushed or flossed away; it requires removal by a dental professional who uses special tools during dental cleanings to scrap tartar from tooth surfaces.

Your periodic dental cleanings are important. If tartar is allowed to further amass, the bacteria can become inflamed, attacking gum tissues. As bacteria continue to reproduce, they create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth, including tooth roots, tissues, ligaments and bone.

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 research has linked it to serious diseases elsewhere in the body. These include some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency.

To help control bacteria in the mouth, saliva serves as a rinse that removes food particles from the mouth. Combined with brushing and flossing, good saliva flow helps to keep bacteria levels under control.

When saliva flow is compromised, oral bacteria are able to reproduce and multiply quickly.  As bacteria accumulate, a sticky film forms on teeth and gums from this buildup. As bacteria coat the interior of your mouth, bad breath begins. Then, the sequence of plaque, tartar and potential for gum disease (as mentioned above) begins.

Oral dryness is one of the biggest influences in developing gum disease. Even though poor oral hygiene is a key factor when it comes to bacteria overload, dry mouth is a common contributor because it has many causes.

A dry mouth can occur from:

• The aging process (affecting about 1 in every 5 adults)

• As a side effect of many medications (including prescription and OTC)

• Radiation therapy, especially for head and neck cancer

• Mouth-breathing, which may be due to nasal congestion or snoring

• Medical conditions, such as diabetes, Alzheimer’s disease, stroke and Sjogren’s syndrome

In addition to your twice daily brushing and flossing routines, it is important to know how you can support saliva flow and avoid the risks created by a dry mouth. These include:

• Drink plenty of plain water throughout the day. Leave off the lemon wedge, which is hard on tooth enamel.

• Avoid (or limit) caffeinated beverages, such as coffee, tea and colas. If you drink these beverages, rinse your mouth after or alternate with gulps of water.

• Consider using an oral rinse designed to replenish moisture in the mouth (available OTC).

• Be aware of medications that have a side effect of oral dryness. Some of the worst are antihistamines, depression and incontinence medications, and some that control blood pressure. If you take one of these, ask your doctor about options that may be less drying to the mouth. Or, increase your water intake and use a daily rinse to replenish oral moisture.

• If you snore or breath through the mouth during sleep, oral tissues are dry during these hours. Consider adjusting your sleeping position or adding a side pillow. Your physician may also have some suggestions, including an oral appliance.

• Certain health conditions can cause dry mouth, including acid reflux, sinus infections, diabetes and bronchitis . A bad cold can also force people to breathe more through their mouth. For these conditions, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.

• Alcohol (including beer and wine) are very drying to oral tissues. Wine and mixed drinks have high levels of acidity and sugar that adds extra challenges to oral tissues. You can help to dilute the severity of these by swishing with water between drinks. Or, keep a glass of water nearby for occasional gulps that wash over teeth before swallowing.

• Smoking (cigarettes, cigars, vaping) are all laden with toxic chemicals (including e-cigs). Be aware of the added risks and be highly committed to your at-home care and drinking plenty of water to keep your mouth clean and moist.

It is also important to know the signs and symptoms of periodontal (gum) disease. It begins with gingivitis, which causes the gums to become tender and swollen. When brushing, blood may be present in the sink when rinsing.

Gingivitis, at this stage, can be contained and resolved if quickly addressed.  If not, the bacteria will continue to multiply. This creates inflammation in the gums. This means the inflammation has progressed to periodontal disease, which requires treatment since it is now below the gum line.

Beneath the gum line, the bacteria continue their attack on the structures that support natural teeth. This includes the bone structures surrounding tooth roots. At this point, the gums bleed easily and breath odor is persistently bad. The gums become red and swollen and may pull away from the base of some teeth (gum recession).

If the disease is not treated, it will worsen to the stage of periodontitis. This is an advanced level of gum disease that is highly infectious and destructive. Because it leaves the gum tissues in such a weakened state, the infection can easily penetrate the gums and enter the bloodstream.

Periodontitis causes the gums to turn spongy with a putrid breath odor. Pus pockets form on the gums and it may become painful to eat. Some teeth may loosen and eventually need removal.

Periodontal disease is the nation’s leading cause of adult tooth loss. Yet, it becomes even more destructive once in the bloodstream. Researchers have linked these bacteria to a wide range of serious health problems.

The bacteria of gum disease have been correlated to heart disease, stroke, some cancers, diabetes, arthritis, preterm babies, memory loss and even impotency. This is rather telling as to the potency of this harmful bacteria and the destructive nature.

As a periodontal specialist, I find that most cases of dry mouth are due to factors that can be easily controlled with simple changes. If you have delayed or avoided dental care, call 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 making patient comfort a top priority.

 

The Hazards of Vaping Now Include Bone Health


Posted on Jan 12, 2022 by William J. Claiborne, DDS MS

If you’ve switched to vaping (e-cigarettes) as a “safer” alternative to smoking cigarettes, you may have heard that researchers have found this to be a misleading claim, in many regards.

Based on a study published in the American Journal of Preventive Medicine, people who vape have higher risk of developing asthma and chronic obstructive pulmonary disease (COPD). The European Journal of Preventive Cardiology also reports an increased risk of heart problems. Further, the American Lung Association warns that vaping causes a potentially higher cancer risk due to their dangerous mix of chemicals, including acrolein. (Acrolein is toxic to humans when inhaled, resulting in irritation to the upper respiratory tract.)

Now, another health risk has been revealed through research: bone health. In a study of over 5,500 adult users of e-cigs, it was noted that electronic cigarettes may be detrimental to bone health, even in young people. The study, published in the American Journal of Medicine Open, found that people who vape had a 46 percent greater rate of bone fractures.

To make matters worse, the study also found that people who vape in addition to smoking cigarettes have a greater fracture risk than those who are conventional smokers only.

A review in Bone Biology suggests there is negligible difference between vaping and cigarette use when it comes to bone health. It showed that nicotine exposure, regardless of the source, impairs the production of essential cells. Add to that the flavoring chemicals in e-liquids (often known as vaping juice), which are suspected to alter the body’s ability to form new bone.

https://www.thehealthy.com/addition/smoking/does-vaping-affect-your-bone-health/

How this occurs has to do with the inflammatory effects of the nicotine. To retain strength and mass, bones need a sufficient supply of minerals (such as calcium and phosphorus) and nutrients (such as vitamin D). In-depth research published by the European Journal of Clinical Nutrition revealed that smoking interferes with how the bones absorb these essentials. The result is the body’s reduced ability to maintain skeletal strength.

What is frustrating is that vaping hit the market touting itself as a “safer” option than tobacco cigarettes. In 2019, the U.S. Food & Drug Administration took issue with these claims, especially those by the vape pen manufacturer Juul, who marketed its product as a “modified risk” tobacco product, although research did not exist to back its “safer” claim. To the contrary, as research digs deeper and deeper into the risks associated with vaping, data continually stacks up as anything but.

https://www.usnews.com/news/health-news/articles/2021-10-20/switch-to-vaping-wont-help-ex-smokers-quit-for-good-study

Certainly, there are other contributing factors to compromised bone health. These include:

• Heavy alcohol use
• Being inactive
• A diet low in nutrients like calcium, phosphorus, and vitamin D
• Excessive dieting

Age, menopause, and having a family history of osteoporosis also affect your risk. Too, people with medical conditions (such as hyperthyroidism or anorexia), or taking medications (such as long-term corticosteroids) have a higher risk of bone thinning.

As a dental specialist, the findings associated with bone health are particularly concerning because teeth are enamel-covered bones that protrude above the gum line. Teeth are anchored by bone sections below the gum (tooth roots) and embedded into more bone – the upper or lower jaw bones.

For those who want to quit smoking and have turned to vaping as an aid, the odds aren’t good for successful results. Researchers found that among Americans who’d recently quit smoking, those who were using e-cigarettes were just as likely to relapse in the next year as non-users were.

Findings of one study reported that not only does vaping fail to help former smokers abstain from traditional cigarettes, the risk of relapse was actually slightly higher.

In order to maintain good oral health, it is especially important for smokers and vapers to be committed to a thorough at-home oral care regimen. This includes twice daily brushing, daily flossing and drinking plain water throughout the day. To combat dry mouth, consider using an oral rinse that is specifically formulated to replenish moisture (available OTC).

This should be coupled with having regular dental checkups and cleanings, starting with an examination by a periodontal specialist. A periodontist is a dentist who has received advanced training in the diagnosis and treatment of all stages of gum disease as well as in the placement of dental implants.

Symptoms of gum disease include tender gums that may bleed when brushing, swollen gums that turn red in color, receded gums, and persistent bad breath. As gum disease worsens, pus pockets can form on the gums at the base of teeth and the gum tissues become spongy. Teeth may loosen and may require removal.

Because the initial symptoms of gum disease are not always obvious, a periodontist can determine if gum disease does exist. If it does, he or she can discuss the most conservative treatment necessary to restore your gums to good health and then develop a program to help keep them so.

Our goal is to help each patient achieve a healthy smile for life. For patients who wish to achieve this, we work with each according to individual needs. Through a customized treatment plan, your oral health can be a positive part of your overall health. Call 828-274-9440 for an appointment.

 

E-Cigs & Oral Health


Posted on Dec 23, 2021 by William J. Claiborne, DDS MS

When it comes to vaping (using e-cigs) health risks to the heart and lungs are what tend to be the focus. However, vaping poses a number of other health risks, one being to your smile.

Risks to your oral health makes perfect sense. Think about it – the damage from vaping would naturally begin at its entry point: your mouth.

Although e-cigarettes do not contain tobacco, they are still delivery systems for nicotine. In addition to being addictive, studies show that the inhaled nicotine through vaping can alter the genetic makeup of your cells. This, in turn, stimulates the growth of cancerous cells in the body and increases your risk of developing cancer.

This can lead to tumor growth in the following types of cancer:

• Lung cancer
• Gastrointestinal cancer
• Pancreatic cancer
• Breast cancer

While much remains to be determined about the hazards surrounding this “alternative” delivery system to nicotine, more and more studies are showing unfavorable outcomes. When it comes to oral health, studies are culminating in a mountain of evidence that links e-cigarettes with poor oral health.

A study published earlier this year (iScience) showed that 43 percent of people using e-cigarettes had gum disease and oral infections. That figure jumped to 73 percent among smokers.

Nicotine (inhaled by any means) restricts blood flow to the tissues in the mouth. These tissues are moist by nature and designed to absorb moisture. Because of nicotine’s harmful contents, blood flow is restricted and oral tissues become dryer.

Today’s e-cig user is likely unaware of what’s in the fluid being inhaled. The vaping mist can contain propylene glycol, benzene, formaldehyde and other chemicals.

When the oral tissues repeatedly endure hazardous components, resulting issues can be inflammation, cavities, bone loss of the structures that support teeth, advanced gum disease (known as periodontitis), and oral cancer.

Because vaping is still a recent agent for nicotine, studies on the long-term effects are underway. Still, even without a long history of findings, early studies show concerning results.

When it comes to your oral health, studies indicate that vaping increases the risk of gum disease by causing gum inflammation and swelling. When these issues are combined with a dry mouth and higher levels of bacteria, the likelihood for developing gum disease shoots up significantly.

The common symptoms of gum disease for vapers include:

• Persistent bad breath
• Gums that bleed when brushing teeth
• Tender or swollen gums
• Loose or shifting teeth
• Receding gums

The effects of vaping on the teeth and gums can cause:

Dry mouth – Nicotine from e-cigarettes reduces the saliva in your mouth, your mouth’s rinsing agent. Too little saliva can lead to dry mouth, accumulated plaque (and subsequent development of tartar), increased bacteria, and tooth decay.

Receding gums – Nicotine restricts blood vessels, reducing blood flow to the teeth and gums. Without adequate blood flow, the gums fail to get sufficient oxygen and nutrients. This can cause the gum tissues to decline, which can lead to gum recession. This can result in tooth sensitivity, a higher risk of cavities and even tooth loss.

Bruxism and tooth damage – Nicotine acts as a muscle stimulant, which can lead to tooth grinding (bruxism) or worsen already-existing problems. Grinding or clenching can lead to tooth damage, such as chipped, fractured or broken teeth.

Oral health is a critical element of whole-body health. Two preliminary studies (presented at the American Stroke Association’s International Stroke Conference) linked gum disease with a higher rate of strokes caused by hardening of large arteries in the brain and with severe artery blockages.

A 2018 study in the American Heart Association’s journal Hypertension found that gum disease appears to worsen high blood pressure and interferes with medications to treat hypertension.

It is a misconception to believe that e-cigarettes are healthier than traditional cigarettes, or that vaping isn’t bad for your smile. If you’re a smoker or vaper, be highly committed to having regular dental cleanings and exams as well as your twice-daily oral hygiene routine at home.

If, however, signs of gum disease are already present, have a periodontal examination as soon as possible. Once underway, gum disease will only worsen without treatment. Call 828-274-9440 to schedule or to learn more. As an Asheville periodontist, I have advanced skills in treating all stages of periodontal (gum) disease and in the placement of dental implants.

Our Western NC periodontal dental office also places an emphasis on advanced technology and in comfort options, including oral and IV sedation (twilight sleep).

https://www.heart.org/en/news/2020/08/26/need-another-reason-not-to-vape-your-oral-health-is-at-risk

https://www.deltadentalwa.com/blog/entry/2018/06/ecigarettes-vaping-dental-health

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