We Are Seeing Patients Again With New Appointment Protocols


Posted on May 20, 2020 by William J. Claiborne, DDS MS

Lately, when people see a hospital worker on television news, healthcare workers have on layers of garb that we’re unaccustomed to seeing. Hopefully, in time, all this protective layering won’t be needed. For now, it’s in line with proper precautions for the safety of both patients and staff.

We are seeing patients again!

As established periodontists in Asheville, it has been a pleasure for Dr. Boyland and I to be able to open our doors again for patient care. And, our schedule is full! Patients in need of treatment have been patiently (but anxiously) waiting to resume periodontal therapy and dental implant placement.

However, our reopening brings some new protocols in addition to our already-stringent infection-control measures. Some new steps that patients may notice now in the flow of the appointment, from the check-in process to check-out. Too, patients will see us attired in more layers than before.

As a heads up, our doctors and staff are wearing protective equipment (N95 masks, gowns, face shields, etc.). This protective gear does not interfere with patient communication nor the exceptional care we have always provided.

Other than our “new look,” however, patients will also go through a few new steps, which include:

  • Once patients arrive for scheduled appointments, they are asked to call our main number (828-274-9440) from their vehicles. Our receptionist will provide the patient with a pre-appointment questionnaire.
  • After we retrieve the completed form, a staff member will escort the patient into the office. (For now, only appointed patients are allowed unless accompanying a child or disabled patient.)
  • Once inside, patients will have their temperature taken and a staff member will escort them to a treatment suite.
  • After care is completed, a staff member will walk the patient to our check-out desk.

In addition, patients can have the peace of mind that our Asheville periodontal office has always adhered to the highest standards of infection control in dentistry. Typical steps that have always been in place include are the sterilization process used on the instruments used in patient care (such as probes).

These pieces are heat sterilized at high temperatures for up to 40 minutes, killing bacteria, viruses and infectious micro-organisms. Once sterile, the instruments are carefully packaged until ready to unwrap for use in the treatment room.

Even the water used (for rinsing or as a spray to manage air particles) comes through water lines that undergo a special “flushing” process. This cleansing process dislodges and eliminates biofilm that can occur when minuscule particles attach to the interior of these lines. Thus, the water sprayed in your mouth during certain procedures is delivered so bacteria levels are at such a low point they are virtually non-existent.

After each patient is seen, treatment chairs, lighting, and any equipment the patient or staff come in contact with are thoroughly wiped down.

These steps have always been done to ensure the safety and well-being of our patients as well as our doctors and staff. Yet, now more than ever, we have a unique mindset in everything we do.

While the vast majority of patients seen feel very comfortable in our office and infection control steps being taken, we encourage questions or concerns so we can explain, reassure or even reschedule those who are still uneasy about close contact. Just call us at 828-274-9440. Our friendly front staff will be happy to assist you.

What’s most important is that you stay safe while keeping your oral health at its best. The progression from poor oral hygiene to gingivitis to full-blown periodontal disease is faster than many people realize.

Be sure to brush at least twice a day for at least minutes per brushing. Brush your tongue with your toothbrush once a day (especially towards the back where most bacteria hide out) and floss daily. Keep your mouth moist and limit sugar. Use an oral rinse that contains no alcohol as an added measure to minimize oral bacterial buildup.

Let’s all emerge from this odd time in our history with smiles that are healthy, accompanied by hugs!

 

 

The 1-2-3’s Of Dental Implants


Posted on Apr 29, 2020 by William J. Claiborne, DDS MS

Over time, certain things are often referred to in catchphrases that simplify what is being described. For example, “Kleenex” is actually a brand name that refers to tissues. “Clorox” is commonly used as a generic for bleach, even though it’s a specific brand. And, “Uber” has become a way to describe a paid means of auto transportation, even if a taxi or Lyft is being used.

This is why the term “dental implant” may be confusing to some people. This implies the replacement of a missing tooth or teeth with a base that is implanted  into the jaw bone. However, to be clear, a dental implant is not an entire structure. Let’s look at the various components of a complete dental implant system.

Although there are different types of implant systems (designed to accommodate specific needs), all work in in a similar fashion. The actual “implant” is a hollow, screw-like cylinder. This is the portion that is actually “implanted” in the jaw bone at a strategic angle and depth.

Once placed, the implant is covered over with gum tissue. For several months after, the implant goes through a process known as “osseointegration.” In this, the bone grows around the implanted portion, which secure it in place. This restores the foundation like that of natural teeth for dependable and comfortable biting and chewing stability.

This stage, often referred to as the “healing” process, typically takes several months. However, a denture or temporary can be worn comfortably so going without teeth is not a worry.

Once healing is complete, a post is secured inside the hollow core of the implant. This post will support your final replacement tooth or teeth. Most replacement teeth are made of porcelain, which provides the most durable of all materials used in dental restorations.

Porcelain is an ideal material for replacement teeth. It is less resistant to stains and provides an exceptionally natural look and feel, even reflecting light as a natural tooth.

A successful outcome in any Dental Implant treatment begins with the selection and placement process. A Periodontist has specialized training in the diagnosis and placement of all types of implant systems. This means the implant system recommended for you will be the type most suited to your individual needs and goals.

An important aspect of implant success also relies on the assessment of bone mass. When the upper or lower jaw has insufficient bone to support the implant being placed, there is a risk of failure. This can occur in implants placed too close to the sinus cavity (for upper implants) or a nerve that runs through the mandible (lower jaw).

Too, an implant requires careful selection and placement in order to adequately support the replacement teeth being attached. In some cases, as few as 4 – 6 implants can support a complete arch of teeth. This decision is best left in the hands of a periodontal specialist.

In cases of severe bone loss, a periodontist can also perform bone rebuilding procedures prior to implant placement. This is sometimes through bone grafting but most commonly the application of a bone-rebuilding material. Additionally, some implant systems, such as the “All On 4” utilize unique angles to provide support in minimal bone depth with no bone rebuilding necessary.

The best implant system for you can be determined after an examination. During this time, I can discuss options best for you and explain the process. Call 828-274-9440 to schedule an appointment. Or, ask to begin with a Consultation.

We also encourage you to share any concerns about comfort options or treatment fees. Many people avoid looking into dental implant treatment because they are afraid of the procedure or fear they cannot manage the fees. Rather than assume these are obstacles, share your concerns so we can address them head on!

 

Be In-The-Know To Avoid Cavities, Gum Disease


Posted on Apr 02, 2020 by William J. Claiborne, DDS MS

During this highly unusual time, people are relying on the internet for communication (work and social), information, and entertainment. Computers, tablets and smart phones are keeping us connected as we ‘shelter in place’ until this global pandemic is under control.

A lot of Americans are using their “stuck inside” time to expand their minds. Whether it’s to enjoy an audio book, watch PBS specials, or learn how to do something on YouTube, using the time positively is helping people avoid getting mired down in worry and anxiety.

As a periodontal specialist in Asheville, NC, I hope adults will use some of their time to become more aware of the hazards of gum disease. The damage that periodontal disease (‘perio’) can have far reaching consequences, affecting the health inside and mouth and overall health, as I’ll explain.

People are often surprised to hear that they have developed gum disease since it is often without obvious symptoms in early stages. Once it’s fully underway, however, many people ignore the warning signs or assume they’ll “go away”.

In my dental specialty, I believe that by keeping Americans informed of how the progression of gum disease occurs could help to greatly reduce the extent of this disease, which plaques over 47 percent of adults.

Let’s begin by looking at the process of gum disease:

•  Oral Bacteria: The mouth is a warm, dark and moist environment — perfect for harboring bacteria. The mouth is the first point of contact for a large extent of the bacteria that enters the body. Bacteria is on food, utensils, lip gloss and even your tooth brush. All mouths have bacteria, some of it are beneficial. Although bacteria in the mouth are perfectly ‘normal’, the problem begins when too much bacteria accumulate.

•  Plaque: Without proper brushing, flossing, saliva flow and diet, oral bacteria can reproduce rapidly. For an example of just how quickly these bacteria accumulate, run your tongue over your teeth after brushing in the morning. They should feel slick and clean. Then, before brushing at bedtime, run your tongue over your teeth again. The accumulation of oral bacteria over the mere course of a day has likely formed a sticky film on teeth. This is known as plaque. This film is actually a coating of bacteria.

•  Tartar (or Calculus): In just 48 hours, unremoved plaque can harden into tartar. These ‘chunks’ are colonies of oral bacteria and typically attach to the base of teeth near the gum line. These cement-hard masses can no longer be brushed or flossed away. They must be removed by a dentist or hygienist with special tools. If allowed to remain, like plaque, tartar will continue to multiply as these bacterial colonies feed on tooth enamel and tender gum tissues.

•  Gingivitis: This is the first stage of gum disease. At this level, gum tissues are under attack and become sore. They may bleed easily when brushing and you may experience an aching sensation in some areas. Breath odor is stronger, even soon after brushing. At this point, with proper measures, you can restore your gums to a healthy state. However, the window of opportunity to combat gingivitis is brief.

•  Periodontal (Gum) Disease: At this stage, the gums are inflamed and tender. They begin to darken in color and the seal of gum tissues surrounding teeth begins to loosen. The breath is persistently bad. As this stage of gum disease worsens, it can lead to severe health risks elsewhere in the body.

•  Periodontitis: This is the advanced stage of gum disease. The gums are so tender that eating becomes difficult. Breath odor is putrid, as it reflects the rotting state in your mouth. The gum tissues are highly inflamed. Pus pockets may form on the gums near the base of teeth. Eventually, teeth will loosen as the gum tissues and bone structures that support them are destroyed. Tooth removal at this stage is not uncommon.

To no surprise, gum disease is the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.

An even more concerning aspect of gum disease is its ability to enter the bloodstream. Once bloodborne, these infectious bacteria can trigger inflammatory reactions elsewhere in the body. Gum disease bacteria has been linked to heart disease, diabetes, arthritis, stoke, memory loss, preterm babies, impotency, some cancers and even Alzheimer’s disease.

This is why we want you to be aware of the importance of having a healthy mouth. We realize there are financial obstacles for some people. However, most dental and specialty offices offer payment plans, many are interest free with no down payment required.

Some people avoid dental visits because they have anxiety or fears. Dental fear is fairly common, even in America where dental care is so advanced (in most practices). If deep fear or anxiety has prevented you from regular dental visits or having much-need treatment, finding a dentist who is experienced in caring for fearful patients is easier today.

Using advanced technology, such as laser dentistry, cone beam imaging, and other features, we are able to diagnose problems more precisely, which helps to minimize treatment. Many options enhance patient comfort and speed healing time.

For many fearful patients, we also offer oral or IV sedation (“twilight sleep”). We are fully equipped for the safety and comfort of administering sedatives for our patients for treatment in our office. Here, patients know us for our gentle touch and respectful, attentive care for each individual.

Occasionally, I hear a patient relay their impression of tooth loss being “just part of growing older.” That is far from the truth. The human body does ‘break down’ here and there but keeping your teeth for a lifetime is a reasonable expectation with proper measures.

Having healthy gums that support teeth can be achieved with an involved relationship with a dentist and a committed oral hygiene routine at home. With proper care, you can easily enjoy a smile of natural teeth all your life.

Twice daily brushing (at least two minutes per time), daily flossing, drinking ample water and limiting sweets and caffeine are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. And, those 6-month check-ups are important. At this time, any tartar that has accumulated can be removed and signs of early gum disease can be noted.

Losing teeth due to gum disease leads to expensive and lifelong upkeep with crown-&-bridge, partials, full denture or dental implants. These tooth replacement needs can be avoided.

If you are experiencing symptoms of gum disease, call 828-274-9440. If fear is an obstacle to having a healthy, confident smile, begin with a consultation to discuss your needs.

 

Are Dentures Or Partials Causing Your Face To ‘Melt’?


Posted on Feb 12, 2020 by William J. Claiborne, DDS MS

Occasionally, I’ll unexpectedly walk by a mirror and notice an old man looking at me, only to realize “that’s ME!”

As we age, hopefully most people don’t “feel” their actual age, although the person in the mirror isn’t quite the image we want to have. Most of us “see” ourselves as looking ten or so years younger (and probably 10 or so pounds lighter!).

Aging gracefully is a positive part of our lives. At any age, as long as we look and feel like we’ve taken pretty good care of ourselves, each birthday should cause more smiles than not. However, for people who are long-time denture or partial wearers, the signs and challenges of aging are more obvious.

Wearing a full denture or a partial denture appears, visually, to replace missing teeth. While the gum based that supports these replacement teeth “plumps up” the face when they are in place, this fullness can be deceiving.

What is really taking place – that you can’t see – is the loss of bone mass, or resorption.

Resorption describes a melting away of bone. For the upper or lower jaw, the areas where natural tooth roots no longer exist experience this almost immediately after they are removed.

Resorption occurs when tooth roots are no longer providing stimulation and nourishment to the bones that support them. This causes the bone “ridge” that holds the denture or partial to flatten out.

Bone loss begins almost immediately after teeth are removed. The pressure on the ridge while wearing dentures or partials actually accelerates the rate of bone loss. For people who sleep in their dentures, this increases the process even more.

In addition to appearance changes, bone loss is the reason that dentures slip or rub. This is because the denture was conformed to the ridge when it was first made. As the ridge flattens, the denture no longer ‘hugs’ the surface it was designed for.

As resorption continues, changes in facial appearance are occurring as wel. The best way to detect bone loss is to remove your ‘appliance’ and look in the mirror. However, even with the denture in place, certain facial changes may be obvious.

Jowls form on the sides of face as facial muscles detach from the declining bone mass. Deep wrinkles form around the lips and the corners of the mouth turn down, even in a smile.

As resorption worsens, the mouth seems to collapse into the face. The chin becomes more pointed and the nose and chin move closer together. This appearance is referred to as a “granny look,” aging one’s appearance far beyond their actual years.

How do you avoid a ‘melting face’?

One of the many advantages of dental implants is their ability to halt bone loss. The implanted portion restores stimulation to the jaw bone and provides a natural biting and chewing stability.

As a periodontist, an area of this advanced dental specialty is the diagnosis and placement of dental implants. Because there are many different types of implant systems, having a specialist select and place the one best for you will enhance your overall outcome.

In our Asheville periodontal office, we also offer oral and IV sedation (twilight sleep). These are administered by a board certified Anesthesiologist. This is a medical doctor (MD) who ensures safety and comfort are priorities throughout your procedure.

With dental implants, you can improve your appearance and health. Learn more about the lifelong benefits of dental implants by visiting our web site or calling 828-274-9440.

 

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