How A Periodontist Can Help Cancer Patients


Posted on Mar 18, 2024 by William J. Claiborne, DDS MS
For those who learn they have cancer, regardless of the type, it is a frightening diagnosis. While survival rates have been positively increasing over the years, it is a dreaded disease that requires challenging treatment regimens, even for those who have early stage cancer diagnoses.
Thanks to extensive research and advances in treatment options (including high-tech imaging that catches many cancers in their early stages) the survival statistics are climbing at a steady pace. In 2022, 69% of survivors have lived over 5 years since their diagnosis; 47% have lived over 10 years since their diagnosis; and 18% of survivors have lived over 20.
Encouraging, also, is that the number of cancer survivors is projected to increase by 24.4% by 2032.
Treatment for cancer can be very compromising to the immune system. One of the ways to support the immune system is by having excellent periodontal health. Having a healthy mouth can lower the demands on the immune system. Here’s why…
The mouth is home to millions of bacteria; some bacteria are good and some are bad. When the bad bacteria are well-managed (through proper brushing, flossing and regular dental check-ups), the gums remain healthy and protective to the structures below.
When bad bacteria over-accumulate, the immune system becomes strained as it attempts to combat their rapid reproduction. The bacteria become infectious, destroying healthy tissues. This leads to the loosening of gum tissues that snugly wrap the base of each tooth. Thus, bacteria are able to penetrate below the surface of the gums.
Here, bacteria attack the structures that support teeth, including bone. This destruction can cause teeth to loosen, leading to the need for removal in some cases.
Yet, it is not just the immune system that is challenged by the bacteria. Even for those in good overall states, having gum disease increases the risks for many health problems, such as heart disease, stroke, arthritis, diabetes, dementia and even certain cancers.
In a study by Harvard scientists from data that included almost 150,000 adults with a follow-up after 28 years, those with a history of periodontal disease were 43% more likely to develop esophageal cancer and 52% more likely to develop stomach cancer. The risk was even higher in those with gum disease severe enough to cause tooth loss (periodontitis).
Although the exact mechanism connecting gum disease and some cancers is still uncertain, studies continually show correlations. This can be in the form of triggering the onset or worsening those in development.
In one study from the late 1990s until 2012, study participants with severe gum disease showed a 24% higher risk of developing cancer. For edentulous patients (those who have no remaining natural teeth), there was an even higher risk.
As a periodontist, I have a firsthand view of how destructive the infectious bacteria of gum disease can be. Ridding any level of this can reduce the demands on the immune system. As such, we often care for cancer patients to relieve the problems in the mouth that some medications and radiation can cause (such as tissue infections and sores, pain or swelling in the mouth, and sensitivity to hot and cold). This is often done using a dental laser. Laser therapy is very comfortable and is safe for cancer patients and the process can expedite healing greatly.
I’d also like to take this opportunity to address, specifically, oral and oropharyngeal cancers since April is National Oral Cancer Awareness month. While some other cancers seem to be more present in the public eye, awareness of oral and neck/throat cancers needs to be greater. Oral cavity and oropharyngeal cancers occur most often in the following sites:
• tongue
• tonsils and oropharynx (the part of the throat behind the mouth)
• gums, floor of the mouth, and other parts of the mouth
The rest are found in the lips, the minor salivary glands (which often occur in the roof of the mouth), and other sites.
The American Cancer Society’s most recent estimates for oral cavity and oropharyngeal cancers in the U.S. are for 2024:
   – About 58,450 new cases of oral cavity or oropharyngeal cancer
   – About 12,230 deaths from oral cavity or oropharyngeal cancer
The average age of people diagnosed with these cancers is 64, but they can occur in young people. Just over 20% (1 in 5) of cases occur in people younger than 55.
Adult males are at the highest risk for oral cancer, with black males being the most susceptible. The risk also increases with age, especially after age 50. Although the risk typically peaks between the ages of 60 – 70, males between ages 50 – 59 tend to have the highest numbers.
It is important to be aware of the warning signs of oral cancer, including:
• A sore, irritation, lump or thick patch in the mouth, lip, or throat
• White or red patch inside the mouth
• Feeling something is stuck in the throat
• Difficulty chewing or swallowing
• Difficulty moving the jaw or tongue
• Numbness in the tongue or other areas of the mouth
• Unexplained swelling of the jaw
• Pain in an ear without hearing loss
While these symptoms do not always indicate oral cancer, any that do not clear up on their own within 2 weeks should be examined without delay.
This dental exam is painless. Many patients, if not told, are not aware that the dentist is performing it. During this, the dentist does a visual examination of oral tissues, checking the lips and inside of the mouth (including under the tongue). The dentist will also check the roof and floor of your mouth.
If suspicious areas are noted during the exam, the dentist will order a biopsy. In this, a small sample of tissue from the area of concern is removed and examined under a microscope. This will determine whether further tests are needed.
Unfortunately, the CDC reports that about 35% of adults over the age of 18 did not have a dental visit in 2019. This leaves those who are vulnerable or developing oral cancer at higher risk of it advancing. Those regular dental checkups go beyond the cleaning of teeth and lowering the risk of oral cancers adds greatly to the need to be committed to these appointments.
If you are experiencing symptoms of gum disease, please know that this disease will only worsen without treatment. If you have any of those listed below, please contact our Asheville periodontal dental office as soon as possible to schedule an examination.
Watch for:
Swollen or puffy gums
Bright red, dark red or dark purple gums
Gums that feel tender when touched
Gums that bleed easily
Seeing pink in the sink or toothbrush after brushing
Spitting out blood when brushing or flossing teeth
Bad breath that won’t go away
If fear has kept you from having regular dental care, our Western periodontal dental office offers both oral and I.V. sedation (twilight sleep). Feel free to call 828-274-9440 to arrange a consultation appointment to discuss any concerns you have regarding treatment or payment plans.
Sources:

Dental Implants – Advantages of Specialized Skills, Advanced Technology, Optimal Comfort


Posted on Jan 10, 2024 by William J. Claiborne, DDS MS

It wasn’t that long ago when shopping for Christmas presents was quite the time-consuming ordeal. Today, we do searches for gift ideas online, check price comparisons, and have the items show up on our doorstep within a day or so.

Advancements through computerized technology have things running more efficiently and, in many cases, culminate into superior outcomes. This is true in dentistry, especially for those who opt for dental implants to replace missing teeth.

There are many reasons for people to choose dental implants, including:

– Designed to last a lifetime

– Look, feel and function like natural teeth

– Won’t decay or need repairs

– Restore chewing and biting comfort and stability

– Enhance overall health and confidence

– Halt the process of facial bone loss

Occasionally, dental implants are occasionally offered by general dentists. As a periodontist, however, I am referred most of our dental implant patients by other dentists and dental specialists. This is because a periodontist has advanced education and skills in the diagnosis and treatment of all areas of the tissues in the mouth (including the reshaping of gum tissues).

Periodontists are also specialists when it comes to the diagnosis and placement of dental implants. They are trained to understand the intricate concepts involved in selecting the proper type of implant based on each individual. These skills include the understanding of precision placements of implants at proper depths and angles. Additionally, periodontists are able to optimize your comfort and treatment outcome.

Still, another reason we are referred patients for dental implants because we can offer patients a wider variety of choices when it comes to implant systems.

There are many types of dental implants. Various systems are designed to support one replacement tooth (the “restoration”), a bridge of two or more teeth, or a full denture supported by several strategically-placed implants. Understanding the unique advantages of all systems enables us to choose the best type for the patient’s individual needs and goals.

For example, the All On Four dental implant system is designed to support non-removable teeth on just 4 implants (per arch). With its specially-designed implanted portions, these longer implants can fully distribute biting and chewing forces.

All-On-4 is an ideal choice for people who have lost bone mass due to lengthy periods of tooth loss. Because “All On 4” implants can be placed in minimal bone, many patients are able to avoid the need for bone rebuilding procedures prior to traditional implant placement.

In the placement, a periodontist is also the best “go-to” in dental implant skills. Here’s why…

For a dental implant to serve as a lasting tooth replacement system, it must be positioned in the jaw bone to specific depths and angles. An implant that is wrongly positioned can function less efficiently and lead to the need for removal.

For example, a periodontist can incorporate bone rebuilding procedures into treatment to a proper depth for patients missing a great deal of bone mass (typically due to missing natural teeth for many years). This can help to restore bone that has occurred in the mandible (lower jaw) or maxilla (upper jaw), which may also require a sinus lift.

Another example is a patient who has lost teeth due to periodontal (gum) disease. Because a periodontist combines advanced skills in treating gum disease as well as in dental implants, these patients have an added advantage when it comes to treatment success.

When it comes to the best way to pinpoint and tackle specific issues with our health, it makes sense to see a doctor who has received specialized training in that area. This helps to take the guesswork out of diagnosis and enhances the potential for a successful outcome in an efficient process.

A periodontist also has a reputation for being able to optimize patient comfort. Because a periodontal specialist is uniquely skilled in the care of gum tissues, he or she can provide a conservative approach to the placement process. Through respectful treatment of oral tissues (in both placement and exposure for restorations), less disruption to the gums allows for faster healing and higher comfort levels.

In our Western NC periodontal dental office, we incorporate our care with the advantages of some of the most advanced technology in dentistry; many options which are not readily available in other dental offices in our region. These computerized images offer advantages to patients in helping to minimize treatment needs.

These include:

  • LANAP (Laser-Assisted New Attachment Procedure) with PerioLase MVP 7 – an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease and has even been found to stimulate bone regrowth in damaged areas.
  • Cone Beam Imaging – is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes in a process that is quick, painless and at minimal radiation levels.
  • CareStream Cone Beam Computer Tomography Imaging – is enhanced tomography that works with 3D imaging for exceptional detail and range.
  • CS 3600 Intraoral Scanner – quickly and comfortably captures digital impressions to create precision models or appliances accurately and easily (crowns, inlays, onlays, bridges, orthodontic appliances, aligners, custom abutments) without the need for bulky, goopy trays.
  • Computerized Dental Implant Placement – an advanced system for pre-surgical positioning of dental implants using a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success.

For optimal comfort, we offer several sedation options, including oral and IV sedation. Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety.

In our Western NC periodontal dental office, anesthesia is overseen by a Medical Doctor (MD) who is a board certified Anesthesiologist. With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

Our goal is to help people move forward with treatment affordably for enhanced appearance, self-confidence and sense of security.

For those who have bypassed dental implants because of cost, our payment plans are often able to help patients enjoy the benefits of their dental implants without straining their budget. Most of these payment plans require no down payment, are interest-free, and have no prepayment penalty.

If you’ve considered dental implants in the past but have held back because of obstacles that may actually be overcome, begin by calling our Asheville periodontal dental office and speaking to our friendly staff at: 828-274-9440. Many dental implant patients find they were able to achieve the healthy smile they desired once they consulted with us and learned the options based upon their individual needs.

Know How Oral Bacteria Form & Cause Damage


Posted on Nov 07, 2023 by William J. Claiborne, DDS MS

Often, once people understand how something breaks down, they are able to watch for telltale signs or take preventive measures. For example, when the grooves in a vehicle’s tires become more shallow, it’s obvious they need to make arrangements for new tires.

This is true, also, for your oral health. Knowing concerning oral signs and symptoms can help you prevent cavities, periodontal (gum) disease and tooth loss.

Oral bacteria exists in every mouth; some of it is “good” bacteria. The good bacteria are even helpful to the digestive system. However, harmful bacteria can run rampant if not kept under control.

The average mouth houses around 20 billion (that’s billion with a “b”), consisting of about 700 different types. Bacteria breed very quickly. The numbers can grow amazingly fast and their buildup produces a bacterial film that coats the teeth and gums. This is known as plaque.

Plaque is the sticky coating in your mouth, most obvious when you first wake up. When plaque is not removed regularly (through thorough brushing), the bacteria attack tooth enamel. Results include bad breath, yellowed teeth, cavities and tender gums.

Plaque formation actually begins as you chew carbohydrates, which seems to be prevalent in most of the foods we eat in today’s diet. As carbohydrates blend with saliva and existing bacteria in the mouth, an acid is created.

Plaque that is allowed to remain on teeth for about 48 hours hardens. This is known as tartar, which is a mass of bacteria that forms between and at the base of teeth.

Once in this hardened form, removal can only occur with special tools used by your dentist or dental hygienist. This is what your hygienist is scraping off during cleanings. Without tartar being removed, it causes the gums to swell, feel tender and may bleed when brushing. This is typically the initial stage of gum disease, known as gingivitis.

However, for people who brush twice a day and still have tartar formation between dental hygiene appointments, there are factors that may be contributing. Some of these are not common knowledge, which is important to know in your prevention goals. These include:


Having “dry mouth”: There are a number of reasons that some people suffer with a drier mouth than others. Unfortunately, those who have insufficient saliva flow (which continually helps to cleanse the mouth) are more susceptible to tooth decay from plaque and tartar.

Saliva protects teeth and gums by helping to manage the growth of harmful bacteria while maintaining a neutral pH in the mouth. This slows microbial growth and keeps bacteria from sticking to teeth.

Other contributors to dry mouth include aging, caffeine (including coffee, tea, sodas, and chocolate), smoking, and a wide range of medications (such as antidepressants, decongestants and diuretics).


Poor oral hygiene: Since the pandemic, normal routines have been uprooted for many people as they have adjusted their “ready for the day” tasks to more casual timetables. Unfortunately, this seems to have left the habitual brushing and flossing times to days where oral hygiene has dropped out of the twice-a-day routine.

A March 2023 poll (conducted on behalf of CeraVe) included 2,000 men between the ages of 18 – 42. They found that only 54% brush their teeth daily (with one-third admitting to only once a day when they do brush). To no surprise, a recent report by the Centers for Disease Control & Prevention reveals that nearly 26% of ages 20 – 44 have untreated dental caries.


Frequent snacking: Every time you eat or drink, an acid attack begins in the mouth. This acid flows in with saliva to begin the initial stage of digestion. However, this acid is very potent, enough to even soften tooth enamel. So, every time you take a bite of a cookie, acid flows into the mouth and remains there for about 20-30 minutes. When the mouth endures frequent acid attacks from snacking between meals, the damage to precious tooth enamel will catch up to you in the form of cavities.


In addition to the harm that oral bacteria can cause teeth, the gum tissues – essentially the protective coating to the vital structures that support teeth – endure the rigors of bacterial overload. Eventually, this catches up to most people in the form of:

• Gingivitis – As the initial stage of gum disease, inflammation is triggered by plaque buildup at the gum line. When daily brushing and flossing fail to thoroughly remove plaque, toxins form that cause irritation to the gum tissues. Once symptoms emerge, they may include seeing blood in the sink when brushing or having sore, swollen gums.

• Periodontitis – As the disease advances, the bone structures and fibers that support teeth are damaged by the destruction of infectious oral bacteria. At this stage, pockets form below the gum line, filling with bacteria-laden plaque.

• Advanced Periodontitis – In the advanced stage of gum disease, fibers and bone supporting natural teeth are destroyed. This can cause teeth to shift or loosen, requiring aggressive treatment to prevent tooth loss. Eventually, some teeth may require removal.

Proactive measures NOW can help you avoid costly repairs to teeth, tooth replacement or the treatment process to rid periodontal disease. Start now with:

  –  Brush twice daily, floss every day and maintain regular dental check-ups. Thorough at-home oral care and regular dental check-ups can help you avoid problems from occurring in the first place.

  –  Delay brushing after eating or drinking. Wait 20-30 minutes to allow the acid attack in your mouth to subside. Remember, this acid can soften tooth enamel. The abrasiveness of a tooth brush or tooth paste can wear away precious tooth enamel.

  –  Swish with water. Enjoy a cup of coffee or glass of wine but try to alter these with a glass of water, allowing it to wash over teeth before swallowing. Or, swish with water.

  –  Eat sweets only with meals. Rather than forgo a sweet indulgence as a snack, enjoy your favorites as dessert following your meal since your mouth is already enduring an acid attack. This merely prolongs an acid attack rather than trigger a new one.

A healthy mouth is important for your overall health, as research has shown. We now know that the inflammatory bacteria of periodontal (gum) disease are able to enter the bloodstream through tears in weakened gum tissues. Numerous studies have found this bacteria can trigger harmful reactions.

For example, the bacteria can cause inflammation that sets into motion risks factors connected to arthritis and diabetes. Some cancers have also been correlated to this bacteria. Heart disease, stroke and high blood pressure have been as well. Alzheimer’s is also being studied along these lines.

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).

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

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

And, if budget constraints are an obstacle, 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.

Sources:

www.todaysrdh.com/

perio.org

Missing Teeth? HOW You Replace Them Will Make the Biggest Difference.


Posted on Oct 23, 2023 by William J. Claiborne, DDS MS

I remember a time when people assumed they would lose their natural teeth as they aged. Wearing full dentures in one’s senior years was almost an expectation. However, today’s adults are less accepting of “false teeth.”

Over time, adults have learned that the removal of a natural tooth has lasting repercussions. Although the tooth may have been removed because of decay or a break, the long list of problems and associated expenses are generally far greater than what was anticipated. I’ll explain.

When a natural tooth is removed, its absence causes a reaction that begins below the gum line. Without the presence of tooth roots, the bone begins to “melt.” This process is known as resorption.

The absence of a tooth root in the upper or lower jaw bone removes stimulation to the bone mass where it was once positioned. Along with the stimulation, natural tooth roots channel nourishment needed for maintaining a healthy mass.

Resorption begins shortly after the tooth root is removed. Once it starts, it continues at an ever-increasing pace. For example, the first year after a tooth root is missing, the loss of bone may be minimal. With each passing year, the pace of loss accelerates. For people who sleep with their dentures, the 24/7 pressure on the gum ridge speeds up the pace even more.

As the bone shrinks in height, the natural tooth roots adjacent to the area of missing teeth are subject to movement and root damage. On average, the next teeth you’re most likely to lose are the ones bordering areas of missing teeth.

Obviously, it is important to replace lost teeth before bone loss begins. For the support of remaining natural teeth, it’s also important to replace missing teeth as soon as possible so adjacent teeth can retain their proper positions. Yet, merely replacing the presence of a tooth above the gum line leaves the underlying risk factors in place. Over time, problems arise for most individuals.

There are many reasons we recommend dental implants for tooth replacement, whether for one, several or a full mouth of missing teeth. Dental implants recreate stimulation to the jaw bone, thereby halting the pace of bone loss. When bone mass is maintained, neighboring teeth have a reduced risk for being lost as well.

Because dental implants are held in the jaw bone, they are able to restore a natural biting strength with dependable stability. Having the ability to bite and chew efficiently and enjoy a diet of foods you love enhances eating pleasure and proper digestion. It’s no surprise that people who wear dentures have more gastrointestinal problems than those who have their natural teeth.

Another advantage to dental implants is their longevity. When dental implants are properly selected, placed and maintained, they should last your lifetime. This is why it’s so important to have your implant treatment through a Periodontist.

A periodontal specialist has advanced training to properly diagnose and place the most appropriate dental implant system for your needs and goals. As an Asheville periodontist with over 30 years of experience in dental implants, I have a reputation for treatment that provides the most successful outcome based on each patient’s unique needs – and by the most conservative means possible. Thus, the patient avoids having more time and expense involved than is necessary.

We are also known for providing a high level of patient comfort through the administration of IV sedation (twilight sleep) with our on-site Board Certified Anesthesiologist. Additionally, diagnosis and treatment planning is backed by images from our on-site 3D Cone Beam imaging.

Our Western NC periodontal office is fully prepared for the placement of dental implants. We tend to our patients in an efficient and effective manner so treatment occurs in minimal time and to an exceptional level of comfort.

We receive many patients who have been referred by their physician, dentist, and past/present patients, often because of our advanced skills and the respectful environment we provide. Here, each patient is treated with the same respect, compassion and gentle hands that we would want for ourselves and our loved ones. We take great pride in knowing our patients experience the finest periodontal and implant care in the Southeastern U.S.

A periodontist is a dental specialist who is trained to understand the intricate concepts involved in selecting the proper type of implant and skilled at placing implants at proper depths and angles. A periodontist is also able to optimize patient comfort during treatment and throughout the healing phase.

In addition to this advanced training, our office offers some of the most advanced technology available. This aids in the diagnosis and treatment planning of dental implants, providing patients with optimized comfort and outcomes. This technology, combined with our advanced skill level, creates a comfortable, efficient experience that helps you enjoy a lifetime of confident smiles.

Dental implants are also designed to last a lifetime. I can think of very few things that provide this kind of value. With proper selection and maintenance, they will never need replacing or repair, making them an excellent investment.

If you are considering dental implants, increase your potential for a successful outcome by asking a Periodontist to join your dentist in team treatment. Most general dentists have close relationships with periodontal specialists for implant placement, gum reshaping and in the treatment of gum disease.

If you have lost natural teeth or are facing the potential of tooth removal, call 828-274-9440 to schedule a consultation. This will occur in a private, comfortable consultation room conveniently located in our Asheville periodontal dental office. During this time, we’ll discuss the implant systems that may work best for your needs and preferences. I’ll explain the treatment involved, sedation options and estimated fees.

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