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
• 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)
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/
Dental Pain Relief With Patient’s Well-Being In Mind
Posted on Aug 19, 2022 by William J. Claiborne, DDS MS
The body relies on a nervous system for many reasons; one reason being to alert us that something is wrong. For example, when we burn our finger on the stove, the brain quickly sends pain sensations so we can remove the finger and take action to help it repair.
As a periodontal specialist in Asheville NC, I know how sensitive the gums can be, as well as teeth. A toothache or a cut in the mouth can be miserable for days. As a periodontist, ideally my skills allow patients to avoid being in pain by keeping their mouths healthy. When an individual maintains a clean mouth that has a low level of bacteria, they can avoid developing cavities and gum disease, which can both result in a significant amount of constant pain.
Yet, caregivers in the American healthcare system are very much aware of the opioid epidemic. We don’t want to deny legitimate patients the medications they need to get them out of pain, however, neither do we want to be a catalyst or contributor to an individual who becomes dependent on these or is trying to feed an already existing habit.
The dental profession has been very careful in this regard, according to the American Journal of Preventive Medicine. In 2012, dentists in the U. S. prescribed only 6.4% of the total opioid prescriptions. For procedures such as root canals or extractions, they help patients get through the initial part of recovery when pain levels are most extreme.
As opioid abuse became such a significant problem, dentists became more sensitive to prescribing these medications. In 2016, American Dental Association (ADA) issued a Statement on the Use of Opioids in the Treatment of Dental Pain.
“Dentists should consider non-steroidal anti-inflammatory analgesics as the first-line therapy for acute pain management … [and]should recognize multimodal pain strategies for management for acute postoperative pain as a means for sparing the need for opioid analgesics.”
Non-steroidal anti-inflammatory analgesics are commonly known as NSAIDs. These are typically over-the-counter meds, such as Advil, Aleve, Motrin, etc. These are non-opioid, oral medications for temporary relief of acute dental pain.
NSAIDs work to provide effective pain relief by reducing inflammation in the bone, dental pulp, and gum tissues. The ADA encourages dentists to consider NSAIDs as the preferred go-to method for managing acute pain. When NSAIDs are taken after a dental procedure, they have been shown as effective as opioids for reducing pain intensity. For some pain levels, the dentist may prescribe a higher dose (by prescription).
Although NSAIDs are effective and less likely to cause dependency, they can also inhibit the an enzyme responsible for producing other prostaglandins that provide numerous beneficial effects. This includes those that protect the gastrointestinal mucous lining, blood flow to the kidneys, and blood clotting.
NSAIDs could also heighten the risks for serious cardiovascular issues, including heart attack and stroke. NSAIDs gave the potential to trigger issues that complicate the effects of low-dose aspirin.
Another option for managing dental pain is the use of Acetaminophen (such as Excedrin and Tylenol). Acetaminophen is an internal analgesic available in over-the-counter medicines for the temporary relief of minor aches and pains and helping to reduce fever. It can also be found in medicines that contain more than one active ingredient to treat migraines.
Acetaminophen is often used for things like headaches, muscle aches and menstrual cramps. It can also be an ingredient in other medicines.
Please know that I want no less for my patients’ comfort than I would want for myself or loved ones. Pain can be an overwhelming problem, although gum disease and cavities are highly preventable. With proper at-home oral hygiene and regular dental check-ups, an individual can keep a healthy smiles and prevent tooth loss (to a signifiant degree).
Even so, the Agency for Healthcare Research & Quality shared that there were more than 615 emergency room visits for every 100,000 people in the U.S. in 2018. The statistic is much higher for low-income and minority groups.
Let’s work together to protect our population from the impact it has endured from opioid addiction. Prior to treatment, we will discuss the potential for discomfort or pain afterward and standard treatment options to help ease you through recovery.
If you are experiencing sore, tender gums that bleed easily when brushing or a deep ache like a toothache, do not delay in seeking dental care. When something is wrong in the mouth, there are very few instances that will go away on their own. Most problems worsen over time, leading to higher levels of discomfort and more-involved treatment to resolve the problem.
In our Asheville eriodontal dental office, we offer some of the most advanced technology available in dentistry, including ConeBeam 3D imaging, laser dentistry, and computerized dental implant placement technology. Additionally, we provide oral and I.V. sedation, safely and monitored closely.
Call 828-274-9440 or tap here to arrange an appointment.
Pregnancy Gingivitis Can Affect More Than The Mother’s Health
Posted on Jul 14, 2022 by William J. Claiborne, DDS MS
Is there any other time in a female’s life when they must be as health conscious as during pregnancy?
Pregnant women, it seems, are given a long list of guidelines to follow… What they should not eat or drink, what medications to avoid, and even down to what beauty products to give up. Yet, the 9 months of discipline is well worth the greater potential to bring a healthy baby into the world.
Along with the other health guidelines, obstetricians are now urging pregnant women to pay particular attention to their oral health. For decades, research has tracked a correlation between inflammatory bacteria in the mouth to a number of serious health problems, including many far beyond the mouth.
Once the infectious bacteria of gum disease enter the bloodstream (typically through tears in weakened gum tissues), it can trigger inflammatory reactions, many serious and some that can have deadly consequences. It is the nation’s’ leading cause of adult tooth loss and has been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.
However, because of their susceptibility, the risk for full-blown gum disease is higher for pregnant females with nearly a third developing gum disease. Yet, it’s not just the oral (and overall) health of the mother that can be affected.
Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and babies of low birth weight (less than 5.5 lbs.). One study showed the preterm birth rate for females without gum disease to be approximately 11% compared to nearly 29% for pregnant women with moderate to severe periodontal disease.
One study showed that pregnant women with gum disease were 4 – 7 times more likely to deliver prematurely (before week 37) and underweight babies than mothers with healthy gums. Too, the women with the most severe periodontal (gum) disease delivered most prematurely, at 32 weeks.
Other findings show that gum disease increases the risks of late-term miscarriage and pre-eclampsia. When oral bacteria reach placental membranes via the bloodstream, inflammatory reactions can trigger pre-eclampsia or early labor.
In one study, for example, pregnant females with higher blood levels of antibodies to oral bacteria also had higher rates of preterm birth and babies of low birth weight. These elevated antibodies have been found in amniotic fluid and fetal cord blood samples of infants who were preterm or of low birth weight at birth.
Oral problems in pregnant females can begin even when the mother-to-be is following the same oral hygiene routine as they have previously. The greater susceptibility can be blamed on fluctuating hormone levels during pregnancy. These changes increase the risk for gingivitis (inflammation of the gums) and periodontal disease.
This is why approximately 40% of women develop gingivitis during pregnancy, known as pregnancy gingivitis. Pregnancy gingivitis is a mild form of gum disease that causes gums to become swollen, tender and bleed easily when brushing.
This is the result of an increased level of progesterone in pregnancy, which makes oral bacterial growth easier. Progesterone also makes gum tissues more sensitive to plaque. For those who have significant gum disease prior to pregnancy, being pregnant can make the condition worse.
Gum inflammation typically appears between months 2 and 8 of pregnancy. Signs of pregnancy gingivitis range from gums that are red rather than a healthy pink. Gums will often bleed when brushing teeth and be swollen and tender in spots.
The goal is to prevent pregnancy gingivitis before it occurs. Be committed to a thorough oral hygiene regimen at home, which includes brushing twice a day, flossing daily and swishing with an antimicrobial mouth rinse. Be sure to keep your 6-month cleanings and exams. These will remove any plaque buildup that has occurred between visits.
A periodontist has specialized training in the diagnosis and treatment of all levels of gum disease – in a way that is safe for pregnant women (as well as all patients). Signs and symptoms of gum disease include gums that bleed when brushing, frequent bad breath, swollen or tender gums, gums that loosen or pull away from the base of teeth, or gums that darken in color.
If you have any of these symptoms (whether pregnant or not), you are urged to schedule an appointment at your earliest convenience. Call our Asheville periodontal dental office at 828-274-9440 to arrange an examination to begin.
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.