What’s Keeping You From The Dentist’s Office?
Posted on Oct 19, 2021 by William J. Claiborne, DDS MS
As an Periodontist in Asheville NC, I’ve treated many patients who, to no surprise, developed periodontal (gum) disease because of NOT going to a dentist on a regular basis.
According to the Centers for Disease Control & Prevention (CDC), nearly 65 percent of adults aged 18 and over had at least one dental visit in the past year (based on 2019).
Unfortunately, that leaves 35 percent of adults who did not.
The reason it is recommended to see a dentist for exams and cleanings TWICE A YEAR is because tartar, which is hardened plaque, can cause cavities and gum disease. One plaque hardens into tartar, it can no longer be brushed or flossed away. It must be removed by a dentist or hygienist using special tools.
Tartar is actually a mass of oral bacteria, which has attached itself to the base of (or in-between) teeth. Tartar (also referred to as calculus), is a colony of bacteria that thrive on oral tissues. Bacteria are living organisms and reproduce rapidly. And, the more there are, the more rapidly they amass.
So, what are the common excuses for avoiding regular dental care? See if you’ve been guilty of one or more:
COST – Some individuals feel dental cleanings and exams are expensive. Actually, there is a great deal of time and training that goes into your individualized care. In addition to the measures of sterilization and instruments, hygienists and dentists are highly-trained, educated, and must stay board certified. As for the investment, these visits are what help you avoid the need for a filling, gum disease, potential damage to teeth due to bite misalignment, and even catch oral cancer at early stages. If dental insurance is not possible, ask if payment plans are available. Many dental offices offer these, most of which are interest-free with no down payment required.
DENTAL FEAR – If fear or anxiety keeps you away from a dental chair, you are not alone. It is estimated that over 70 percent of American adults have some level of this. Sometimes the fear exists because of a traumatic experience in the past or feeling helpless in the chair. Some people react to certain smells and sounds. A few have no idea what prompted their fear, but know it is beyond their control. For these, we advise seeking dental care in a modernized office. Today’s advanced technology has greatly enhanced the level of comfort during care as well as reduced treatment time. Too, offices such as our Asheville periodontal dental office offer oral sedation as well as IV sedation (twilight sleep). These are administered by highly-skilled professionals who oversee the patient using advanced safety monitoring equipment. Ask for a consultation and tour before choosing the office that is reassuring to your unique needs.
DREAD OF BEING LECTURED – If it’s been years since you’ve seen a dentist, you may be expecting a lecture from the dentist or hygienist (or both!). My staff and I believe that is a sure way to deter someone from cultivating a positive attitude towards their dental relationship. We all want to feel respected and having a caregiver talk “down” to you is unfair, especially because no one knows the story behind your delay or avoidance. If you feel that’s going to be a problem, say so. Be upfront with “a lecture is not going to help me.” If you feel it’s a recurring problem, ask to have your records transferred to an office where you are treated more appropriately.
FEAR OF EMBARRASSMENT – Some adults feel awkward having their denture or partial removed at the dentist’s office. Some people fear they’ll gag during care, which can trigger coughing and even throwing up. Some feel their mouths are so “bombed out” that it’s embarrassing to have a dentist see how much damage has occurred. To reassure you, there is nothing we haven’t seen or experienced. Dentists have quite a lot thrown at us during dental school. As a specialist in periodontics, my additional training covered even more in-depth and complex damage or disease. DO NOT worry about your caregivers. They WANT you to rely on them to help you. Almost any dentist or specialist will tell you that our greatest joy comes from taking a patient from a “hopeless” mouth to a patient who has a healthy, confident smile!
TIME IN TREATMENT – Today’s advanced technology has greatly condensed the time needed to accurately diagnose and treatment plan almost any dental problem. Many treatments can be completed in just one or two visits. For those who have more extensive needs, dentists can sometimes combine several appointments into one long one. This is made much easier for the patient with the addition of oral sedation. Oral sedation creates a totally relaxed state so the patient can “doze” in and out of treatment. It has a quick recovery and sedated patients are carefully monitored for safety and comfort throughout treatment.
Regardless of WHY you’ve avoided the dentist, your smile is worth it! Having an appealing smile you feel joyful in sharing adds to your mood, enhances appearance and makes a positive impression to others.
If you’ve avoided dental care for years (or even decades), you may have signs or symptoms of periodontal disease. These include tender gums that may bleed when brushing, gums that recede from the base of some teeth, gums that turn red in color, and frequent bad breath. Gums are the foundation for teeth, so without healthy gums, your teeth will not be healthy, either.
Too, gum disease will only worsen without treatment. If you are a reader of my articles, you may have read the findings of research that correlates the bacteria of gum disease with serious health conditions. These include stroke, heart disease, preterm babies, some cancers, arthritis, diabetes, and erectile dysfunction.
Let us help you feel the positive aspects of achieving a healthy smile. Begin with a consultation by calling 828-274-9440.
Postponing Dental Care Can Be Expensive
Posted on Sep 29, 2021 by William J. Claiborne, DDS MS
Most of us have seen the movie, “Gone With The Wind,” It’s pretty hard to forget the last line of Scarlet O’Hara: “I’ll think about that tomorrow.”
Procrastination is something we all do, some more than others. We all tend to “back burner” things we don’t want to do. As a periodontal dental specialist, I’m guilty of this on occasion.
However, I see a number of patients who have developed periodontal (gum) disease because they delayed or postponed dental care; care that would have easily helped them avoid the problems associated with it.
The reason 6-month dental check-ups are so beneficial is in their ability to give patients a twice-a-year clean slate in oral wellness. During this time, the dentist and hygienist can examine the mouth for signs of abnormal wear, bite alignment, and point out areas that need extra attention in oral hygiene routines at home. (This is especially true for people who have crowded or crooked teeth, as bacteria can easily accumulate in these tight angles.)
This dental appointment also allows the hygienist to remove plaque or tartar that has formed since the patient’s last check-up. Both are accumulations of oral bacteria, which will continue to reproduce rapidly without regular removal.
Plaque starts the process. It is the sticky film you probably feel on teeth when you first wake up. This film is actually a layer of bacteria that has rapidly reproduced during the night. (If you snore or breathe through your mouth during sleep, oral dryness can accelerate the rate of reproduction even more.)
Although it is more obvious on teeth, the film of plaque also coats the gum tissues and tongue. If not thoroughly removed within 48 hours, these bacteria amass to such a level that the plaque hardens. This is known as tartar.
Tartar typically forms between teeth and at the base of teeth. This is why daily flossing is helpful. It scrapes off plaque in areas the toothbrush may not reach, or may not be cleaning sufficiently.
Once tartar forms, however, it can no longer be removed by brushing and flossing. This is what the hygienist is picking at and scraping off teeth during dental cleanings. If not removed, these bacterial colonies continue to grow. And bacteria breed at an amazingly fast pace.
Just how quickly can these oral bacteria amass?
According to information shared by RDH Magazine: (https://www.rdhmag.com/infection-control/water-safety/article/16404976/oral-bacteria-how-many-how-fast)
“some species of oral bacteria can double their numbers every 20 minutes under ideal conditions in a Petri dish.”
This means that one million bacteria can grow to 14 million within an hour. Accumulated bacteria can even be seen in the mouth as a white coating on the tongue. The back of the tongue is typically whiter in color since tooth brushing doesn’t reach there and dislodge embedded bacteria. (This is why it’s important to brush your tongue every day when toothbrushing, or use a tongue scraper.)
Tartar holds such a high number of bacteria that these organisms can cause damage to teeth. They bore into tooth enamel and eat away at oral tissues.
Bacteria are ramped up by foods we eat. They especially love lingering food particles caught between teeth and foods containing sugar. (This is yet another reason to floss daily.)
Initially, gum disease causes tender gums that may be swollen. They may bleed when brushing, which is typically noticed when spitting. Symptoms may also include frequent bad breath, gums that are more red in color than a healthy pink, and soreness when brushing or flossing.
Keep in mind, this is just the beginning. This stage is known as Gingivitis and is just a prelude of what’s to come. If prompt measures are taken as soon as these symptoms arise, Gingivitis may be overcome without requiring dental treatment. Thorough brushing (twice a day, at least), daily flossing, and keeping the mouth moist with plain water may be effective in overcoming Gingivitis.
If not resolved, Gingivitis can progress to periodontal disease. During this level of gum disease, breath odor is persistently bad. The gums bleed easily when brushing and are more red in color. Gums are sore and tender. As the disease worsens, the gums become spongy and pus pockets may form at the base of teeth.
Eventually, the bone tissues and gums become so damaged by periodontal bacteria that some teeth may loosen. This stage is periodontitis and is an infectious disease that can cause devastation far beyond the mouth.
Periodontal disease is the nation’s number one cause of adult tooth loss.
These potent bacteria can enter the bloodstream, creating inflammatory reactions that can activate or worsen a number of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, preterm babies, some cancers, impotency, erectile dysfunction, and Alzheimer’s disease.
That’s a pretty serious list. As research continues to study the far-reaching effects of these infectious bacteria, the list seems to lengthen more.
Have you been putting off dental care? Treating advanced gum disease and replacing teeth are both pretty involved procedures.
In many cases, I’ve found patients avoid or delay dental care due to feeling it is too expensive or having fear associated with dental visits. Yet, the price (in time and money) from not properly caring for oral health is steep in many ways.
The devastation caused by these bacteria can be easily avoided with simple measures at home and 6-month dental visits. An at-home dental care regimen should only require about 5 minutes per day. A dental check-up usually takes about an hour.
If you are very uncomfortable during dental cleanings, tell your hygienist. He or she may be able to provide a pre-treatment rinse or a topical swab for more sensitive areas. (Just know that until your gums get into healthier shape, it is the inflammation caused by oral bacteria that makes them more sensitive.)
The obstacles that typically prevent patients from receiving the care they need are:
Cost: Most dental practices offer payment plans that are interest-free with no down payment required. If you don’t have dental insurance, ask about any discounts they may offer or consider using a credit card.
Dental fear: In our Asheville periodontal dental office, we offer both oral and I.V. sedation (“twilight sleep”), if desired. We understand that many adults have anxiety or fear when it comes to dental treatment. Our entire staff is committed to providing all patients with a gentle touch, a respectful environment, and compassionate care.
Embarrassment or feeling a smile is “hopeless”: We see many adults who have “bombed out” mouths. This can happen for a number of reasons. Here, we are a “judgement-free” perio office and treat every patient as we would want our loved ones treated. And, no smile is hopeless. We have a great many patients who are testaments to that!
For patients who have lost natural teeth, for whatever reason, a periodontist has advanced skills in the diagnosis and placement of dental implants. Once your gums are restored to a healthy state, we can discuss that tooth replacement option, if you like.
As with most things in life, delaying care is a sure recipe to get deeper in the problem. Be committed to your daily oral care routine and keeping regular dental appointments. If you are having symptoms associated with any stage of gum disease, however, I am a dental specialist in treating even advanced levels.
Call 828-274-9440. A referral is not needed.
Understanding Dental Implants & Their Benefits
Posted on Nov 03, 2020 by William J. Claiborne, DDS MS
When you lose a natural tooth, even one that isn’t visible when you smile, its absence causes a reaction that takes place below the gum line. Many people are unaware of what occurs – at first. When it becomes obvious, it leads to problems that are not only bothersome, they are detrimental to your overall health.
The absence of a tooth root in the upper or lower jaw bone is a loss of stimulation the bone mass where it was once positioned. These roots provide stimulation and nourishment that enables the bone to maintain a healthy mass. Without the presence of tooth roots, the bone begins to “melt away.” The term for this process is known as resorption.
Resorption begins shortly after the tooth root is removed. Once it begins, 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 rate of loss accelerates.
As the bone shrinks in height, the natural tooth roots adjacent to the area of missing teeth are vulnerable to movement and root damage. On average, the teeth most likely to be lost are the ones next to areas of tooth loss.
For the support of remaining natural teeth, it’s important to replace missing teeth as soon as possible so adjacent teeth can retain their proper positions. It is even more important to replace missing teeth before bone loss begins. And, it’s HOW you replace them that’s most important.
Because dental implants replace the tooth above the gum line AND the root portion below it, the bone is able to retain its mass. Dental implants are designed to restore the look, feel and chewing stability like that of natural teeth.
As the advantages of dental implants become more familiar for natural tooth replacement, there are still some misconceptions among the general population. The following will hopefully clear up some of the confusion.
First, Dental Implants are a term that describes 3 components. The “implanted” portion is placed in your jaw bone where a tooth root was once held. The “implant” is not what holds the tooth. It serves to anchor an attached tooth (or bridge of two or more teeth).
Made from titanium, this metal bonds to living bone successfully. As a matter of fact, dental implants have one of the highest success rates of any implant-in-bone procedures.
The implanted portion becomes anchored in the jaw bone through a process known as ‘osseo-integration.’ Once the implant has been secured by the bone, a post is inserted into the center of the implant. This post is known as an abutment.
The replacement tooth (or teeth) is usually made of porcelain. This is the portion that you see and looks just like a natural tooth. This is known as a restoration or crown. It is attached securely to this post.
Porcelain is commonly used to create the restorations because they provide the most durable material possible and have the look and feel of a natural tooth. Porcelain has a luminosity of natural teeth and even reflects light as a natural tooth would. Porcelain is also very resistant to staining.
When missing more than one tooth in one area, an implant is not always necessary to replace each one. As mentioned prior, one implant can often hold two or a bridge of teeth. Several strategically-placed implants may also be used support a full arch of teeth.
When people can chew properly and eat a healthy diet, their overall health is better. And, without the fear of embarrassing slips or clicks (often associated with denture wear), being socially active can continue to be a positive part of a happy life.
Dental implants restore the ability to eat with stability, chew comfortably, laugh and speak with confidence. Dental implants do not decay and will never need root canals. And, with proper care, they’ll last your lifetime.
There are many types of implants, each designed to accommodate specific needs. Many dental implants are chosen and placed by a Periodontist. This is a dental specialist who has extensive and specialized training in the diagnosis and placement of all types of dental implants. He or she can select the one that will work best for you.
Proper placement and support in caring for implants is an important part of a successful outcome. Dental Implants CAN fail. This is why a periodontal specialist can be an asset to your investment.
If infection sets in and reaches the implanted portion, the implant may need to be removed so treatment can resolve the problem. Your periodontist can assess gum health prior to placement and monitor your healing process to help minimize this risk.
There are other threats to dental implant success. Clenching or grinding teeth can also contribute to implant failure. Smoking complicates and delays the healing process and is also a known contributor to implant failure. Again, a periodontist can oversee your care to optimize your ability to enjoy a lifetime of confident smiles.
Call 828-274-9440 to arrange a consultation. During this time, we can discuss treatment that can achieve your needs and goals as well as the process and anticipated costs. If dental fear is a concern, I’ll also explain sedation options. We offer both oral sedation and IV sedation, if a “twilight sleep” state is preferred. Here, you’ll find your comfort is always a priority.
Is Your Insurance Ruining Your Oral Health?
Posted on Nov 26, 2019 by William J. Claiborne, DDS MS
A necessary ‘evil.’
These days, insurance coverage seems to be an ever-expanding chunk out of paychecks. Even so, coverages seem to be getting more and more limited.
Yet, health insurance is an investment that provides peace of mind and reminds us that we need to do all we can to stay healthy – and NOT need it! Deductibles, uncovered items, and prescriptions can drain the wallet in spite of what is shelled out for monthly premiums.
Regardless of the insurance coverage you have, taking full advantage of its benefits is an annual goal. Some people have Health Savings Accounts (HSA) to give some padding for certain expenses not covered by insurances.
Because of out-of-pocket expenses, dental patients sometimes make decisions on accepting treatment based on what their insurance covers. This can be detrimental to the patient.
Dental insurance was developed to give people some help for basic annual expenses. For many, this includes twice-a-year dental exams and cleanings. Some policies include assistance for an annual crown or filling, and some coverage for periodontal (gum) therapy to treat gum disease.
Although adults may see these coverages as ample, they can be far from sufficient some years. For aging adults or people who have conditions such as diabetes or take medications that have an oral dryness side effect, basic insurance coverage can be far from what is in your best interest.
Keep in mind that insurance companies are for-profit businesses. What these companies deem coverage-worthy may be far from what is best for a patient’s long term oral health.
Think about this … As of Aug. 2, 2018, publicly traded health care companies amassed $47 billion in profit. (https://www.axios.com/health-care-industry-on-track-massive-q2-profits-1533226387-dacec8f8-c9f5-406c-a49e-1103e3316c64.html) That’s BILLION.
Sadly, insurance companies tend to serve as judge and jury for some people when it comes to treatment decisions. If an insurance company overrules what a dentist or dental specialist advises, it can leave the patient with an even more-complex situation.
They also use additional limiting terms such as “usual and customary.” This means that it is the insurance company that determines what is reimbursed for the treatment rather than the skill level and reputation of the provider.
Another dilemma for today’s insured patient has to do with the treatment recommended. For instance, when I consult with a patient who is missing teeth, I typically advise dental implants. My recommendation is based upon what will provide the patient with a lifelong solution for missing teeth as well as other benefits.
I look at a dental implant as the ideal in tooth replacement, since it is held in the jaw bone just as natural tooth roots. An implant restores the dependable foundation necessary for biting and chewing, enabling the patient to eat a healthy diet and chew foods comfortably, which supports the digestive system and overall health.
Dental implants are a more expensive option (initially) than crown-&-bridge combinations, dentures, or partials. They are designed to last a lifetime; often far beyond the span of time an average policy holder would stick with the insuring company.
As beneficial as they are to your overall health, dental implants are often deemed as ‘elective’ by insurance companies. This is where the patient must decide: “Is protecting my overall health and smiling confidence a priority to me or should I go with what my insurance coverage allows?”
What it comes down to is, essentially, how we perceive insurance coverage. While major medical insurance gives us peace of mind should we experience a health challenge that would otherwise drain us financially, dental insurance coverages are different.
Dental insurance, for the most part with most policies, is structured as a ‘support’ for helping those covered to maintain a healthy mouth. For people who already have good oral health and are able to tend to it sufficiently between checkups, this is fine. However, for most American adults, tooth repair, tooth loss and gum problems are a fact of life, particularly as we age.
For most of us, the decisions we make today will affect us in the years to come. When it comes to your oral health, don’t let your long-term oral wellness, the longevity of your teeth, the comfort of healthy eating, or the confidence of smiling and laughter be dictated by what insurance coverage allows.
When it comes to your smile, put your needs first.
If you trust your dentist and others involved to guide you towards good oral health and maintaining your smile, consider their recommendations and ask questions. Be an informed consumer. But, most importantly, make decisions that are in your best interest rather than that a for-profit insurance company deems is worthy for your smile.
If you don’t have regular dental care and would like recommendations, feel free to contact us at 828-274-9440. We work with exceptional general dentists in Western North Carolina and will be proud to connect you. Or, feel free to begin with a thorough periodontal exam here. We will make recommendations based upon your unique needs and goals.