Smoking, Vaping Lead To Gum Disease, Tooth Loss.
Posted on Sep 15, 2020 by William J. Claiborne, DDS MS
With all good intentions, adults occasionally trade one bad habit for another. For instance, a commitment to exercise more often for weight loss can easily backfire when justifying a thick smoothie as a daily reward.
This is what worries me about Vaping. Vaping, the use of e-cigarettes, hit the market around 2007. It is designed to deliver nicotine through a vapor. Although the vapor is generally not labeled as harmful (it’s not “safe”, either), its nicotine is no less harmful to the user as that delivered via cigarette smoke.
Unfortunately, many cigarette users switched to vaping based on the perception that “e-cigs” were a safer alternative. For those who wanted to wean themselves off of cigarettes through this switch, very few achieve that goal as a result.
A 2018 report by the National Academy of Sciences, Engineering, and Medicine concluded there was “evidence that e-cigarette use increases the frequency and intensity of cigarette smoking in the future.”
Teens have been most susceptible to the hazards of vaping. It is the most commonly used tobacco product among U.S. youth. E-cigarette use among middle and high school students increased 900 percent during 2011-2015. According to the Surgeon General, 1 in 5 high school students and 1 in 20 middle school students were using e-cigarettes in 2018.
Unfortunately, nicotine exposure can harm the brain as it develops, until about age 25. During adolescence, nicotine use can affect learning, memory and attention span as well as increase their risk for future drug addictions. (https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf)
As a periodontist in Asheville, NC, my concern when it comes to oral health is what many cigarette smokers and vapers don’t realize when it comes to high risks to their smiles.
In our periodontal dental office, I’ve seen how significantly the habit of cigarette smoking can have on one’s smile. It’s no secret that smoking cigarettes can stain teeth and cause bad breath. However, nicotine in any form is a hazardous force in the mouth.
According to the American Dental Association (ADA), smoking can cause the gums to recede from teeth, exposing vulnerable tooth root sections. This enables easier entry of oral bacteria into the structures that support tooth roots. Smoking can also delay healing following periodontal therapy, extractions or implant placement. The longer it takes oral tissues to heal, the greater the risks for infection to develop.
Additionally, smoking increases the risks of oral cancer, lesions inside the mouth, periodontal (gum) disease, enamel erosion and tooth loss. It greatly reduces saliva flow in the mouth, which is a tremendous aid in removing bacteria and food particles from the mouth, helping to control bacteria levels. The condition of “dry mouth” also causes bad breath.
Because of the vape’s moist presence in the mouth, the assumption with vaping over smoking cigarettes is the “benefit” of oral dryness. However, this is easily dispelled when looking at the true facts.
While there are more than 7,000 chemicals found in the smoke of tobacco products, (including nicotine, tar, carbon monoxide, acetaldehyde and N-nitrosamines), nicotine is the primary addicting component. A study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, as well as potentially toxic metal particles from the device itself.
The e-liquids delivered by these devices typically contain nicotine, propylene or polyethylene glycol, glycerin, and additives. Sound safe? Not at all.
According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker. (https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)
When a patient is diagnosed with advanced periodontal disease (periodontitis), they must make a commitment of time and expense to rid this inflammatory disease from their mouths. For those who ignore its presence or assume it will get better on its own, the disease will simply progress further.
Gum disease begins with sore gums that may bleed while brushing teeth. Or, it may cause no noticeable symptoms at all in early stages.
As it worsens, gum disease will cause frequent bad breath, tender gums that turn red, gum recession, and gums that bleed easily when brushing. Pus pockets may form on the gums. As it attacks the structures beneath the gum line, teeth may loosen or shift.
As the nation’s leading cause of adult tooth loss, it brings the hard decisions (and expense) for replacement. After all, you need teeth for eating and speaking. Do you go with dental implants? Or, do you take on the challenges that come with dentures and partials? As hard as the decisions of replacing teeth can be, gum disease can bring even more devastation with it.
Research has linked the bacteria of gum disease to serious health problems. These include heart disease, stroke, preterm babies, arthritis, diabetes, impotency, some cancers and even Alzheimer’s disease. These connections occur through the infectious bacteria of gum disease entering the bloodstream through tears in diseased gum tissues.
Once in the bloodstream, the bacteria can travel throughout the body and create inflammatory reactions. This “systemic inflammation” is able to trigger the onset of some diseases and conditions or even further the development of others.
Certainly, we all have the right to determine what is in our best interest as far as our own health goes. However, I believe that many individuals end up in our office with serious gum problems and facing tooth loss because of what they did not know. Having factual information allows us to make wise decisions for our health and well-being.
As a periodontist, I have advanced skills in the treatment of all stages of periodontal (gum) disease. My dental specialty also includes the diagnosis and placement of dental implants. Here, our patients can relax under Oral or IV sedation (“twilight sleep”) while having their smiles restored. We also create a customized care program that allows each person to maintain good oral health once their treatment is complete.
If you smoke or vape, don’t assume “that won’t happen to me.” The reason we wear seat belts in cars is because there are great risks when we do not. The risks for losing your teeth and having potent bacteria running rampant through your system is something you can take easy measures to prevent.
Experiencing symptoms associated with gum disease? We urge you to schedule an examination appointment as soon as possible. Call our beautiful, comfortable Asheville office at 828-274-9440. A referral is not necessary.
Tissue Regeneration In Dentistry Is Here & Now!
Posted on Jan 31, 2020 by William J. Claiborne, DDS MS
It may sound far-fetched to think of repairing the urethra by regenerating tissues from the mouth. Yet, it’s being done – with the help of advanced technology.
Stricture of the urethra (the duct that carries urine out of the bladder) affects about 1 percent of the male population. For the one percent who suffer with it, urethral stricture contributes to a severely diminished quality of life.
The condition causes patients to be chronically ill, have low urine flow, pain, urinary infections, urinary stones and can lead to failure of the urinary system. Untreated, life-threatening urinary retention can occur.
Recently, a breakthrough in the surgical treatment of male urethral stricture was reported when over 81 percent of patients with urethral strictures were successfully treated with MukoCell.
MukoCell is a method for tissue-engineered oral mucosa transplantation. It takes a small area of oral mucosa (the secreting tissues in the mouth) that is easily accessible in any patient. (https://www.healtheuropa.eu/treatment-of-mens-disease-with-regenerative-medicine/96925/)
In the past, the most successful treatment for urethral reconstruction was through an oral mucosa graft. However this process requires harvesting a large area of oral tissues. The repercussions can leave patients with persistent pain, bleeding, swelling, sensory loss and oral numbness.
Removing large segments of tissues in the mouth can also cause impaired ability to drink, eat and speak. It can lead to periodontal (gum) disease,tooth loss and dental implant failure along with an increased risk of oral cancer.
MukoCell is a method for a tissue-engineered oral mucosa transplant with even better success rates that the standard grafting procedure. Like our LANAP technology, MukoCell can regenerate tissues, although MukoCell regeneration is through a tissue factory that uses a small piece of the patient’s oral mucosa.
In our Asheville Periodontal dental office, tissue regeneration can be successfully performed in the patient’s mouth. Through our LANAP technology (Laser-Assisted New Attachment Procedure) this highly-advanced method efficiently and effectively treats periodontitis (advanced gum disease).
When it comes to oral structure loss, our LANAP technology is able to stimulate bone regrowth in damaged areas. It can regrow periodontal ligament, alveolar bone (the bony ridge that supports the upper teeth), and regrow the bony film that adheres teeth to the jaw.
LANAP includes a minimally invasive (essentially ‘non-surgical’) PerioLase laser that treats patients with moderate to severe periodontal disease – in as little as one session. It is safe for people with conditions such as diabetes, heart disease, and hemophilia.
LANAP’s laser also eliminates the need for cutting into gum tissues with a scalpel. There are no stitches and patients have minimal discomfort following the procedure.
The advanced technology of LANAP offers a simple yet successful way to rid the infectious bacteria of advanced gum disease. By combating this inflammatory disease, the body is at less risk for systemic inflammation that has been shown to contribute to serious and even deadly health problems.
Overcoming gum disease can help patients to save natural teeth. This means the trauma of tooth loss and decisions for replacement can be avoided.
While we applaud astounding developments in tissue regeneration, MukoCell’s progress reinforces the importance of having a healthy ‘oral cavity’. This is why we committed to include the LANAP protocol into our periodontal dental office, making this cutting edge technology accessible to people all across Western North Carolina.
Although people often think of their smile as ‘teeth,’ the tissues in the mouth are a vital part of your smile, your oral health, and your overall health. They are your blanket of protection that shields vulnerable structures beneath from bacterial destruction. When this covering of gum tissues becomes damaged, LANAP offers an efficient and effective method to restore the healthy state of what was lost.
If you suffer with symptoms of gum disease (tender gums that bleed when brushing, persistent bad breath, or gums that have turned red in color), call our office promptly at 828-274-9440. The condition will only worsen without treatment and could result in tooth loss as well as the release of potent bacteria into the bloodstream.
A Spot In The Mouth May Resolve On Its Own, Or Not. Know When To React.
Posted on Jul 01, 2019 by William J. Claiborne, DDS MS
Having a sore spot in the mouth occurs from time to time. Biting the inside of the cheek, foods that are highly acidic, or stress can all lead to sores.
Some viruses and other conditions can contribute to worse problems, however. It is important to know what to look for when it comes to an unusual spot in the mouth. Knowing when to watch and when to see a dentist could be a literal lifesaver.
Fortunately, most sores in the mouth resolve on their own. These include…
Small ulcers with a white or gray base and a red border. Unlike cold sores, canker sores appear inside the mouth. They are not contagious but their exact cause is uncertain. Some experts believe that immune system problems, bacteria or viruses may be involved. Fatigue, stress or allergies can increase the likelihood of a canker sore. A cut caused by biting the cheek or tongue, or reactions from hot foods or beverages may contribute to canker sore development. Intestinal problems, such as ulcerative colitis and Crohn’s disease, also seem to make some people more susceptible. Canker sores usually heal on their own after a week or so. Over-the-counter topical anesthetics, steroid preparations, and antimicrobial mouth rinses can provide temporary relief.
Also called fever blisters or Herpes simplex, these are groups of fluid-filled blisters that often erupt around the lips, under the nose, or around the chin. Cold sores caused by herpes virus type 1 are very contagious. Herpes lesions look like multiple tiny fluid-filled blisters that are most common around the edge of the lips. An outbreak may follow a fever, sunburn, skin abrasions or emotional upset. Cold sore blisters usually heal in a week by themselves. Over-the-counter topical anesthetics can provide some relief. Prescription antiviral drugs may reduce the duration of these kinds of viral infections.
Leukoplakia cause one or more white patches or spots (lesions) to form inside the mouth. Most who have the condition are males between the age 50 – 70. Although leukoplakia can be caused by a rough tooth or an irregular surface on a denture or a filling, it is often associated with heavy smoking or other tobacco and heavy alcohol. In some cases, however, the cause cannot be determined. Leukoplakia is especially concerning because it can eventually develop into oral cancer.
What will NOT resolve on its own and requires prompt evaluation are changes to oral tissue that do not heal within 14 days. DO NOT DELAY! This is a symptom of Oral Cancer. Nearly 40,000 Americans are diagnosed with oral or oropharyngeal (throat) cancer each year. These cancers kill about 1 person every hour, every day.
Symptoms of Oral Cancer that are most common include:
• white or red patch of tissue
• lesion in the mouth
• difficulty or discomfort when swallowing
• persistent sore throat
• a lump or mass inside the mouth or neck
• wart-like mass
• numbness in the oral/facial region
The survival rate is one of the worst of all cancers, with only 57 percent estimated to be living 5 years from diagnosis. The death rate is higher than cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, thyroid cancer, or skin cancer (malignant melanoma).
Although the death rate has seen a slight decrease since 1980, some symptoms do not emerge until the cancer has reached advanced stages. This is because lesions or discolorations that are early warning signs are not always visible, particularly in the back portion of the mouth (the oropharynx, the tonsils, and base of tongue), which can be an obstacle to early diagnosis and treatment.
This is yet another reason that keeping your regular oral hygiene exam and cleanings is so important. During these times, your dentist and hygienist look for unusual changes in the mouth that can indicate a problem. Please remember – NEVER wait until your scheduled appointment to have anything unusual examined.
Although a stubborn canker or cold sore may not be welcome, they tend to go away in a week or ten days. Again, if an unusual spot or sore is still present after two weeks, call our Asheville periodontal office at 828-274-9440 immediately for an appointment.
Cancer Risk And Gum Health
Posted on Feb 05, 2019 by William J. Claiborne, DDS MS
I know of no one who hasn’t lost someone dear to them – family member or close friend – to cancer. The disease, although now more survivable than ever thanks to advancements in early detection and treatment – remains a dreaded diagnosis.
Still, a cancer diagnosis often drags entire families through the battle. Treatment can be lengthy and time-consuming as well as financially and emotionally draining. Some diagnoses are considered ‘death sentences,’ with terribly low survival rates. For instance, pancreatic cancer’s 5-year survival rate, depending on the type, ranges between 3 – 9 percent. (https://www.pancan.org/facing-pancreatic-cancer/about-pancreatic-cancer/survival-rate/)
Decades of research has resulted in improved measures, and many cancers once thought dooming are now very treatable. Success rates are improving with most survivors going on to live normal, healthy, active lives.
Preventing cancer isn’t a simple matter. We know that a healthy lifestyle can help but isn’t a guarantee for avoiding it. Cancer can result from a number of triggers. For example, smoking is a known contributor to oral and lung cancer. The toxic chemicals delivered through cigarette smoke are proven activators in some cancer development.
As research has been able to go deeper into the cause-&-effect of various cancers, the health of periodontal tissues are coming to light as having an intricate role in your overall health, including your risk for developing some cancers.
Periodontal disease, often referred to as gum disease, runs rampant in the U.S. According to the Centers for Disease Control & Prevention (CDC), over 47 percent of adults over the age of 30 have some level of gum disease. For adults over the age of 65, this figure increases to 70 percent.
This is a frightening statistic considering the devastation that infectious bacteria of periodontal disease can cause. While it is the nation’s leading cause of adult tooth loss, research has also revealed links to increased risk of heart disease, stroke, arthritis, diabetes, preterm babies, high blood pressure, and erectile dysfunction (ED).
Yet, much progress is being made in tracking down activators of cancer in the body. For instance, research shared in a January 2018 article in Medical News Today revealed exciting progress along these lines. (https://www.medicalnewstoday.com/articles/320634.php)
Researchers found that some gastrointestinal cancers, such as pancreatic cancer, share an enzyme. This enzyme, typically found in the mouth, serves as the “boosting” agent in the development of gum disease. They noted that the enzyme was also present in certain cancerous tumors.
In additional research shared by the AACR (American Association For Cancer Research), cited that previous research has revealed gum disease as a risk factor for breast, oral, and esophageal cancers. (https://www.aacrfoundation.org/Science/Pages/assessing-gum-disease-cancer-risk.aspx). The warn that women, especially, should be urged to maintain good periodontal disease to lower their risk of additional types of cancer.
One study showed that post-menopausal females were more susceptible to several cancers.
Between 1999 – 2003, researchers monitored cancer outcomes of female participants ages 54 to 86 through self-reported questionnaires onn periodontal disease. The study showed that: “a history of gum disease was associated with a 14 percent higher risk of developing any cancer”.
The greatest association was for cancer of the esophagus, which was more than 3 times more likely in women with periodontal disease than women who did not list having periodontal disease. Lung cancer, gallbladder cancer, melanoma, and breast cancer were also associated with higher risk.
Although women who smoked had higher risks for breast cancer, lung cancer, and gallbladder cancer, non-smokers with gum disease also had increased risks of these cancers.
Still not fully understood, it is suspected that gum disease bacteria are able to enter the bloodstream through diseased gum tissues. This allows them to reach other body sites and contribute to “carcinogenesis”, the process where normal cells are transformed into cancer cells, leading to the formation of cancer.
Because the study consisted of self-reported data, the study’s authors suspect the prevalence of periodontal disease may have been under-reported. This would make the percentages even higher. While further research is needed through more precise assessments of periodontal disease, these statistics are helpful in confirming the link between periodontal disease and cancer.
This study also reinforces previous findings that show our oral health is more closely related to our overall health than most are aware. As a periodontal specialist, I urge you to be aware of the signs and symptoms associated with all stages of gum disease. These include tender gums that bleed easily when brushing, gums that turn red in color, frequent bad breath, and gums that loosen their grip around teeth.
For more, you may find it helpful to visit the web site of the American Academy of Periodontology: www.perio.org.
A periodontist is a dental specialist with advanced training in the diagnosis and treatment of all stages of gum disease. This advanced care is your wisest choice for tackling gum disease and having good oral health at any age. For more information or to schedule an appointment, call 828-274-9440 or tap here to begin.