Our Asheville Periodontal Dental Office Offers Some Unique Services
Posted on Jun 13, 2022 by William J. Claiborne, DDS MS
As a Periodontist in Asheville, I’ve helped hundreds of patients overcome periodontal (gum) disease and the many repercussions that come with tooth loss. Helping to save teeth that were on the verge of requiring removal has also been a victory for the patient as well as me.
I take great pride in being a part of the transformations of patients who achieve healthy, confident smiles. This is why I’ve created an environment that affords every patient with the most advanced options available for restoring oral health and replacing lost teeth with dental implants.
Let me begin by clarifying the benefits our periodontal office brings…
• A periodontist has advanced training to properly diagnose and treat all stages of gum disease.
• We are known for never over-treating or under-treating with a commitment to provide the most successful treatment for each patient’s specific needs.
• Our periodontal office is specially equipped for the diagnosis and treatment of all stages of gum disease as well as placement of dental implants.
• Diagnosis and treatment planning is backed by an immense array of advanced technology, including:
- 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.
- 3-D 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 accurately and easily create precision models or appliances (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.
• A commitment to comfort including I.V. sedation (twilight sleep) as well as oral sedation for total relaxation. On our team is a Board Certified Anesthesiologist to provide sedation and anesthesia for optimal comfort and safety.
Treatment options in our specialty dental office also include reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession); diagnosis and placement of dental implants; and treatment of lesions or cysts in oral tissues.
With specialized skills, a periodontist is especially respectful to oral tissues as tender layers that significantly affect the appearance of a smile and the health of teeth. Utilizing special skills to minimize incisions while effectively treating each area in the mouth, a periodontist is your expert.
Call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.
How Losing Natural Teeth Can Lead To Changes In Facial Appearance
Posted on Jun 01, 2022 by William J. Claiborne, DDS MS
If you’ve worn dentures or partials for five or more years, take a moment to literally see how your facial appearance is changing.
Look in the mirror without your denture in place. Your mouth may appear sunken-in with your chin more pointed than before tooth loss.
Other signs of bone loss may include deep wrinkling around the mouth, the corners of the mouth turning downward (even when smiling), and jowls that are forming as facial muscles detach.
These are the telling signs of bone loss as the jaw bone declines in mass.
Natural tooth roots provide stimulation to the jaw bone, which preserves its ability to maintain a healthy mass. When tooth roots are no longer present, the jaw bone loses the stimulation needed to keep blood flow active. Over time, this results in ‘resorption,’ or a shrinking of bone.
Over time, the resorption process causes the gum ridge to flatten. The pressure on the gum ridge from wearing dentures actually accelerates the rate of bone loss. For those who sleep in their dentures, this 24/7 pressure speeds the rate of bone loss even more.
When a denture is first made, it is designed to conform to the unique contours of the bone ‘arch’ where tooth roots were once positioned. The reason that denture wearers commonly experience movement or slips is because the denture’s foundation is changing. Even with frequent application of adhesives or pastes, this dwindling foundation means a denture is likely to move while eating.
A new denture may fit securely for the first five years. However, as the jaw bone continues to lose height, relines may be needed. Eventually, these are more and more temporary with relines needed at more frequent intervals each time.
One year after natural teeth have been extracted, denture wearers average losing about 25 percent of this bone ridge. After three years, the average decline in bone is approximately 60 percent.
Biting becomes overshadowed by concerns of uprooting the denture’s position. Chewing is more difficult, and to no wonder. The biting force of natural teeth is about 250 lbs. while an average denture wearer is able to apply about 5 lbs. of force.
To avoid discomfort when eating, denture wearers may adjust their diets to consist of soft foods that dissolve easily in the mouth. In many cases, these diets lack the nutritional benefits of fiber, vitamins and protein necessary for a healthy body.
These problems begin to affect people on a social scale, also. Due to fear of embarrassing slips, people also begin to avoid social gatherings where food is the centerpiece. It has been shown that denture wearers are less likely to dine out and wear less makeup.
Bone resorption even leaves adjacent teeth susceptible to the effects of bone loss. As the area of bone declines in height and width, neighboring teeth are at a greater risk of cavities, gum disease, and tooth fractures. It is a fact that when a tooth is lost, the one next to the one missing is most likely the next to be lost.
It’s not just denture or partial wearers who can anticipate the hazards of bone resorption. For people who opt to replace a tooth (or teeth) with a crown-&-bridge, they can also expect bone loss. Over time, this can be detected through a gap that appears between the bridge and gums. In a smile, this gap may be visible.
It stands to reason that there is a need to replace more than the presence of teeth. This is why so many dentists and dental specialists now recommend Dental Implants. Over the years, they have proven to be a successful alternative to dentures and partial dentures.
There are many advantages to Dental Implants. From a health standpoint, I see their ability to halt bone loss as a leading benefit. Dental implants are placed in the jaw bone, recreating the stimulation of tooth roots. This helps to preserve the strength of the jaw bone while restoring biting strength and chewing stability.
I also like that Dental Implants are self-supporting since they use the jaw bone for support. They do not rely on having otherwise-healthy, natural teeth crowned for the mere purpose of supporting replacement teeth (as in crown-&-bridge combinations).
From a value perspective, Dental Implants are an excellent investment. With proper selection, placement and care, they are designed to last a lifetime. And, it’s an investment you’ll enjoy every day as you comfortably eat foods you love, smile and laugh without worry, and wake up with a smile!
There is much to know as to why keeping your natural teeth is so important. However, when tooth loss does occur, you can protect your health and well-being by replacing them with Dental Implants. With Dental Implants, you are able to avoid the long-term repercussions of bone loss.
A Periodontist specializes in the treatment of gum tissues as well as the diagnosis and placement of Dental Implants. Although the failure rate of Dental Implants is rather low, having a successful outcome can greatly depend on the Doctor who selects and places your implants.
Begin with a consultation by calling our Asheville periodontal dental office at 828-274-9440. I’ll be happy to answer your questions and discuss our many comfort options, including Oral and I.V. Sedation.
Many Reasons To Repair Gum Recession
Posted on May 19, 2022 by William J. Claiborne, DDS MS
If you are occasionally experiencing sensitivity around one or more teeth, especially when eating ice-cream or drinking hot coffee, this is likely due to receded gums.
While using a sensitivity toothpaste can somewhat minimize these sensations (which can become painful jolts), the problem will remain. The source of sensitivity, most often, is because the highly-sensitive tooth’s root area has been exposed by the pulling away of gum tissues.
The gum tissues are designed to provide a tight seal around the base of each tooth, which blocks bacterial entry to the sensitive tooth root area. In addition to sensitivity, recession means oral bacteria can penetrate beneath the gum’s surface. Once beneath the surface, the accumulating presence of this bacteria can lead to inflammation of the gums.
Eventually, the infectious bacteria attack the structures that support natural teeth. This bacteria indicates the presence of periodontal (gum) disease. Signs and symptoms of gum disease in its first stage include:
• Gum tissues that turn red
• Gums that become tender or swollen
• Gums that bleed when brushing
• Persistent bad breath
Obviously, it’s important to ensure the gums are healthy so the grip they have around teeth is snug. It’s also important to be aware of the causes of gum recession. These are:
The aging process – As people age, their gums become drier. This causes them to shrink and be less capable of keeping a secure grip around the base of teeth.
Periodontal (gum) disease – As mentioned above, gum disease destroys oral tissues and the bone that supports natural tooth roots. A sign of periodontal disease is gum recession. Gum disease is also the nation’s leading cause of adult tooth loss.
Poor dental hygiene – When twice-daily brushing, daily flossing, and keeping the mouth moist are insufficient to rid the mouth of bacteria, their accumulation can result in the sticky film you feel on teeth. This is plaque. In just a day or so, plaque can harden on teeth into tartar. This is a cement-hard bacterial colony that cannot be removed by brushing or flossing . It can only be removed during a professional tooth cleaning. If not removed, teeth, gums and the structures below the gum line can be damaged.
Brushing too hard – Brushing teeth rigorously doesn’t mean you are doing a good job. Using a scrubbing, back-&-forth motion can wear away tooth enamel and cause the gums to recede. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.
Hormones – Females experience fluctuations in estrogen levels during puberty, menstrual periods, pregnancy and menopause. During these times, the gums can be more sensitive and vulnerable to gum recession.
Tobacco use – In addition to the many health hazards smokers risk, they are more likely to develop plaque due to the oral drying effects of smoking. This dryness can lead to gum recession (not to mention brown teeth and bad breath).
Bite misalignment – When teeth don’t come together evenly, too much force can be exerted on the gums and surrounding bone, allowing gums to recede. Bite misalignment can also lead to grinding or clenching teeth. These harsh forces on teeth can cause the gums to loosen their grip.
If you have mild sensations of sensitivity, desensitizing toothpastes can help soothe the nerves by forming a protective barrier over teeth while blocking sensitivity signals. Although this type of toothpaste can be helpful, it should be used as a temporary aid.
The goal should be to repair recession and halt the problem from recurring. To do this, we begin by determining why the gum recession is occurring. The next step is to restore the gums to their proper positions.
The corrective procedure most often performed is a “gingivectomy” performed by a periodontal specialist. In addition to treating all stages of gum disease, a periodontist specializes in contouring gum tissues. Using advanced skills, a periodontist is able to create a natural look and restore your oral health.
A gingivectomy can reposition or graft gum tissues over the area of recession to restore a healthy seal and protect the tooth structures below the surface.
Another advantage of a gingivectomy is to help save a natural tooth. When a tooth breaks near the gum line, a “crown lengthening” procedure may be advised. In this, a periodontist may be able to expose enough of the tooth structure for the placement of a crown.
A crown lengthening procedure is an ideal accompaniment to many cosmetic dentistry treatments. When there are different heights of gum tissues framing the teeth most visible in a smile. This tends to create a jumbled looking smile, when when the teeth are straight.
Crown lengthening rebalances the height of gum tissues that arch the teeth to restore a smile that is balanced. From this, the eye is drawn to the smile as a whole rather than one or two teeth with varying heights of gum tissue.
A gingivectomy is also performed for individuals who wish to correct a “gummy smile.” This is when a smile shows too much gum tissue above upper teeth when smiling fully.
Gingivectomies are performed while the patient is comfortably numbed. For some people, sedation may be a preference for enhanced relaxation. Oral sedation is available in pill form, which allows patients to ‘doze’ through procedures. I.V. sedation, also known as “twilight sleep”, is available for patients who prefer a deeper level of sedation.
Both sedations are administered by fully trained team members who use advanced safety monitoring equipment. We believe your safety is as important as your comfort.
In our Asheville periodontal dental office, we also offer a wide array of technology. This often saves the patient time in treatment, enhances comfort, and speeds healing. For example, our dental laser can seal tissues as it contours it. This eliminates or greatly minimizes bleeding.
Pain is how the body indicates that something is wrong. When the gum tissues have receded, they are not going to repair on their own. Let’s discuss your particular needs, whether for improved oral health or to enhance the appearance of your smile (or both) during a consultation appointment.
Call 828-274-9440 to schedule a time.
Dental Implants – Lower Risks Of Failure With These Tips
Posted on Apr 21, 2022 by William J. Claiborne, DDS MS
In our Asheville periodontal dental office, we believe our patients appreciate being fully informed about their oral health status and understanding their options for treatment. For those who have lost natural teeth, our specialty dental services include the diagnosis and placement of dental implants.
The specialized skills of a periodontist provides implant patients with a high level of success in treatment outcome. It also offers patients a wider variety of choices when it comes to implant systems.
This is why many general dentists who offer dental implants refer the placement portion to a periodontal specialist. For their patient, this can mean a higher level of success, especially for complex needs.
For example, a patient who is missing a lot of bone mass (often due to missing natural teeth for many years) benefits from the specialized skills of our Asheville periodontal office. 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 are given a ‘leg up’ when it comes to treatment success.
In making your decision to opt for dental implants vs. crown-&-bridge, dentures or partials, it is important to understand the basics of how dental implants work. Although there are different types of implant systems, all work in in a similar fashion.
An implant is similar to a screw-like cylinder that is hollowed out in the center. This segment is what is placed into the bone to serve as a tooth root replacement.
Selecting the most appropriate type of implant and how many are needed is based on specific needs and goals. Our Western NC periodontal office plans for your placement procedure using computerized technology to determine the precise angles and depths for each implant before the placement procedure begins. This minimizes disruption to the gum tissues and bone structures, which in turn reduces healing time and optimizes comfort.
Once placed, each implant is covered over with gum tissue. For several months after, the implant goes through a process known as “osseo-integration.” During this phase, the bone grows around the implant, securing it into the bone. This recreates the foundation of natural tooth roots to give biting and chewing stability. Throughout this time, you can wear a denture or temporary so you are never without teeth.
Once healing is complete, a post is secured inside the hollow core of the implant. This post (or “abutment”) will support your final replacement tooth or teeth.
An important aspect of implant success also relies on the proper 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.
Again, an implant requires careful selection and placement to be able to 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.
Severe bone loss can require bone rebuilding procedures prior to implant placement. This can be done by bone grafting or the application of a bone-rebuilding material. In some cases, dental implant systems designed with unique angles (such as the “All On 4”) can support a fulll arch of upper or lower teeth using minimal bone depth with no bone rebuilding necessary.
Another perk of the All On 4 is the forces of chewing and biting require only 4 implants on the upper and/or lower. Because implant costs are largely based on the number of implants placed, this can be a great savings for people who are candidates.
Why does successful placement rely so greatly on assessing bone mass? An implant must be placed in adequate bone that does not risk interfering with adjacent structures.
Without proper placement in sufficient bone, an implant risks coming in contact with a nerve that extends horizontally through the lower jaw. Upper implants placed too close to the sinus cavity can, over time, penetrate that area. Removing an implant in either of these situations, of course, is no simple task.
The ability to select the proper implant type for available bone depth is equally important.
Dental implant diagnosis and placement skills can vary greatly from one dentist to another. While some have taken extensive courses in implant dentistry, others may have taken a weekend course here and there. These are typically ‘hosted’ by a particular manufacturer who provides ‘training’ in a limited selection of implant types. In turn, this can limit the patient’s choices when relying on appropriate recommendations for his or her unique needs.
Obviously, a qualified doctor can enhance your potential for a successful outcome, which is where a periodontal specialist is a wise choice. A Periodontist has particular expertise in the diagnosis and placement of all types of Dental Implants. As a matter of fact, many general dentists prefer to have a Periodontist place implants in their patients. The patient then returns to their dentist for the attachment of teeth to the implants.
Rest assured – in our office, comfort is always a priority. For our patients, we offer oral or I.V sedation to accompany many procedures. While both are beneficial to calm anxiety, tension, stress or even intense feelings of fear, each has its advantages as well as limitations.
Oral sedation is in pill form and provides a fully relaxed state. It often erases most memory of the procedure after and has a quick recovery.
While oral sedation provides a very relaxed state, I.V. sedation puts you in a complete sleep state. This is sometimes referred to as “twilight sleep.” I.V. sedation is ideal for people with dental fear or phobia. This sedation is delivered through an I.V. drip, or intravenously. It takes effect rather quickly and patients nod off within minutes. This sedative erases memory of treatment afterward.
Whether given oral or I.V. sedation, comfort and safety are important to us at all times. And, while sedation is helpful when fear or anxiety exist, some people who have no fears at all request sedation for its ability to relax them during lengthy appointments.
While the doctor involved in your treatment is important, much of the potential for a successful result falls into the patient’s hands after the placement process. As a patient, having a successful outcome begins as soon as your implants are placed.
First, closely follow your post-placement instructions. For a few days following placement, most patients are advised to eat only cool, soft foods. This helps to minimize swelling and bleeding, which helps gum tissues to more quickly seal incision sites. This can lower your risk for infection.
Once home, other factors can also place your implants at risk. For example, smokers have a higher risk for implant failure. Because the chemicals in cigarette smoke are very drying to oral tissues, the healing process takes longer. Delayed healing creates a greater risk for infection to occur.
An element of risk that may surprise you is grinding or clenching teeth during sleep, which is typically a symptom of a misaligned bite. Some clenching is so intense the force can be likened to that used to crack a walnut. A sign of night-time clenching or grinding may be worn, chipped or broken teeth. However, even without signs, if you suspect you grind or clench, mention this to your implant dentist prior to treatment. This way, proactive measures can be taken to resolve the problem before complications result.
Most important of all is the patient’s commitment to maintaining good oral hygiene. Although Dental Implants themselves do not experience decay, the gum tissues and bone supporting the implants are as susceptible to oral bacteria as before. When oral bacteria infection (gum disease) penetrates to the implant site positions, the only way to treat the infection may require removing the implant.
In addition to being highly committed to your oral hygiene at home, your dental check-ups may be scheduled for every four months rather than twice a year. During these visits, a hygienist will remove accumulated oral bacteria to reduce risk to your Dental Implants. The condition of your gums will also be assessed.
Dental implants are designed to last a lifetime and are the closest thing to the natural teeth you once had. Too, the restored ability to bite, chew, speak and laugh without worry can be a tremendous boost to one’s self-esteem and self-confidence.
The type of dental implant best suited for you can be determined after an examination and review of x-rays (we use Cone-Beam digital imaging). Call 828-274-9440 to begin with a private, no obligation consultation to discuss your best options.