Keep The Mouth Moist To Minimize Bacterial Growth


Posted on Jul 22, 2021 by William J. Claiborne, DDS MS

When you think of an environment of a warm, dark, moist space, it would seem to be a perfect breeding ground for bacteria growth. For homeowners, the worry over this is often how easily mold forms in such places.

According to FEMA (Federal Emergency Management Agency), molds are microscopic organisms that thrive anywhere there is a moist environment. Growth can start on a damp surface within 24 to 48 hours.

Molds digest organic material, eventually destroying the material they grow on, and then spread to destroy adjacent organic material. (https://www.fema.gov/pdf/rebuild/recover/fema_mold_brochure_english.pdf)

As an Asheville periodontist, I can’t help but think of the similarities to the mouth. Bacteria in the mouth, when not removed, can multiply and form the sticky film that coats teeth and gums. This is known as plaque.

Like molds, plaque must to be removed to prevent its spread and destructive nature. This is what your twice-daily brushing and flossing regimen is intended to do. When plaque remains in the mouth for roughly 48 hours, it hardens onto teeth. This is tartar and typically forms between teeth or in chunks at the base of teeth.

Essentially, tartar is a hardened mass of bacteria. Like mold, tartar continues to grow if not removed. And, like mold, tartar can cause damage to what it is growing on and spread to surrounding structures.

In addition to a brushing and flossing routine, the mouth has a particular advantage in its ability to control bacteria growth. Saliva is a continual rinsing agent that moves bacteria out of the mouth before the reproductive ability begins or accumulation runs rampant.

However, a dry mouth, which can be the result of a number of factors, means saliva is operating at quite a disadvantage to oral health.

Oral dryness is a natural part of the aging process. It affects about one in five older adults. A dry mouth can also occur from:

• 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

Mold has an odor. So does oral dryness, which reveals itself through bad breath.

Just as mold can destroy things like drywall, carpets and insulation, an overload of bacteria in the mouth can be destructive to teeth and gums. These living and breeding organisms thrive on gum tissues.

Although saliva is an aid in bacteria control, there is a limit to what the flow is able to manage. When oral bacteria reach a certain level, they cause inflammation in oral tissues. The early stage of this, known as gingivitis, causes the gum 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).

Resolving gum disease at this point requires a procedure known as scaling & root planing. This allows the dental professional to reach below the gum’s surface to remove the bacteria. More extensive than a dental cleaning, the gum tissues are numbed and the process may require more than one visit to complete.

If the disease is not treated, it will reach the stage of periodontitis. This is an advanced stage 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 beyond the gums and enter the bloodstream.

Symptoms of periodontitis are very uncomfortable. Gums turn spongy and breath odor is putrid. Pus pockets appear on the gums and it may become painful to eat. Some teeth may loosen and eventually need removal.

This is where the damage of periodontal disease bacteria becomes even more destructive. As bad as tooth loss is, hold onto your hat…

Because these bacteria can trigger inflammatory reactions elsewhere in the body, researchers have linked them to a wide range of serious health problems.

The bacteria of gum disease have been correlated to heart disease, stroke, some cancers, diabetes, arthritis, and preterm babies. This is rather telling as to the potency of this harmful bacteria and the destructive nature.

When mold in a house that began in one spot is ignored, the destruction spreads. That’s a pretty good reason to tend to the problem before it gets out of hand, right? Proper care for oral health is worth the minor investment of time and money to avoid the destruction that can occur, including keeping the mouth moist to support sufficient saliva flow.

Here are a few pointers to help you maintain oral moisture:

• Keep the mouth moist by drinking plenty of water throughout the day. Watch your limit of caffeine, including coffee, tea and colas.
• If you take medications that have a side effect of oral dryness, 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 your mouth during sleep, talk to your doctor about ways to resolve these problems. It may be as easy as adjusting your sleeping position or adding a side pillow. Or, an oral appliance may be advised.
• When medical conditions (acid reflux, sinus infections, diabetes, bronchitis) contribute to a dry mouth, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.
• Know that alcohol (including beer and wine) are drying to oral tissues. Try to swish with water between drinks or have a glass of water nearby to periodically dilute the drying impact.
Smoking (cigarettes, cigars, vaping) delivers toxic chemicals into the mouth, with the gums taking the first brunt. Be aware of this added risk to the drying effects and take added measures to keep your mouth clean and moist.

I hope you never need the specialty care of a periodontist. However, should you find yourself in need of our care, we place a priority on comfort and ensure a respectful, compassionate approach to each individual.

In our Asheville periodontal office, we provide sedation (“twilight sleep”) for patients during many procedures, if desired. Our office also features some of the most advanced technology available in dentistry, including cone beam imaging, laser dentistry, and computerized guidance for dental implants and other procedures.

Begin with a consultation appointment by calling (828) 274-9440. New patients are always welcome and a referral is not always needed.

Oral Bacteria Can Put An Immune System At A Disadvantage


Posted on May 20, 2021 by William J. Claiborne, DDS MS

Long before the COVID pandemic, it was widely known in the medical/dental and scientific communities that the bacteria in the mouth was intricately connected to the body’s overall health.

The oral cavity (interior of the mouth) contains some of the most varied and vast flora in the human body. It is the entryway for two systems vital to human function and physiology, the gastrointestinal and respiratory systems. Therefore, specific infections in the oral cavity may contribute to infection that can affect systemic health.

Systemic health refers to issues that affect the entire body, rather than a single organ or body part. An example of a systemic disorder is high blood pressure, which affects the body as a whole.

Research demonstrates that inflammation is a likely trigger for the systemic connection. For this reason, researchers have studied inflammation in the oral tissues caused by periodontal (gum) disease as a contributing factor of continual inflammation in the body.

Hundreds of diseases and medications impact the oral cavity. Although the precise point of activation remains to be determined with some health problems, there is a more obvious association between oral bacteria and certain conditions.

For instance, diabetes has a clear relationship with periodontal disease. Strong evidence shows that treating one condition positively impacts the other. By the same token, uncontrolled inflammation levels of one can worsen inflammation levels in the other.

Therefore, treating inflammation may not only help manage periodontal diseases but may also help manage other chronic inflammatory conditions.

Oral bacteria has been found to trigger or worsen other systemic conditions, including atherosclerotic vascular (heart) disease, pulmonary (respiratory) disease, diabetes, pregnancy-related complications, osteoporosis (bone loss), and kidney disease. A shared trait between gum disease and these medical conditions is that they are chronic conditions that take a long time to develop.

https://www.agd.org/docs/default-source/self-instruction-(gendent)/gendent_nd17_aafp_kane.pdf

According to the Centers of Disease Control & Prevention (CDC), nearly half of American adults ages 30 and over have gum disease – a whopping 47 percent. In a recent study, they found that about 9 percent have mild levels of gum disease, 30 percent have moderate levels and 8.5 percent have severe gum disease (periodontitis).

Researchers of a recent study found that 64 percent of adults ages 65 and older had either moderate or severe periodontitis. Gum disease rates were highest in males, Mexican Americans, adults with less than a high school education, adults below the poverty line and current smokers.

Although the initial stages of gum disease may be concealed behind the lips and cheeks, the interior of the mouth can signal the presence of periodontal disease at nearly every stage. For example, sore and swollen areas can indicate gingivitis, an early form of gum disease.

Worsening levels of gum disease can cause redness, tenderness, bad breath, bleeding when brushing, and receding gums. Progressive gum disease can lead to persistent bad breath, pus pockets forming around teeth, loosening teeth and painful chewing.

In your regular dental check-ups, your dental hygienist uses a “probe” to measure “pockets” along the base of teeth. During the exam, he or she measures the gum depth along each tooth – front, back and in-between. These depth measurements indicate areas where gum tissues have loosened from the base of teeth, and to what extent. The higher the number, the deeper the pocket.

For example, healthy gums will measure 1 or 2. In some areas that are harder to reach when brushing or flossing, a 3 may be measured. However, a 4 or higher number indicates the gums are loosening their protective grip from the tooth. This leaves the tooth at risk for bacterial penetration below the gums.

Healthy gums wrap snugly around the base of each tooth. This prevents the entry of bacteria, which can cause damage to the tissues and bone structures supporting tooth roots. Gum disease, to no surprise, is the nation’s leading cause of adult tooth loss.

However, infectious bacteria of gum disease don’t necessarily remain confined to the mouth. Through tears in diseased gum tissues, the bacteria are able to enter the bloodstream. Traveling through the body, these potent organisms can trigger reactions that activate or worsen serious health conditions.

For example, studies have indicated a relationship between periodontal disease and stroke. In one study focused on oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia showed a higher likelihood for having an oral infection than those who had healthy gums. (https://www.perio.org/consumer/gum-disease-and-heart-disease)

Along similar lines, men with gum disease have been found to be 49 percent more likely to develop kidney cancer, 54 percent more likely to develop pancreatic cancer, and 30 percent more likely to develop blood cancers.

Having healthy gums is actually easy – and rather inexpensive. Adults should brush thoroughly (at least 2 minutes) twice a day and floss daily. Snacking and sugar should be limited. The mouth should be kept moist throughout the day by drinking plenty of water (coffee, colas and tea doesn’t count). Moisture can also be replenished by the use of specially formulated oral rinses (available over-the-counter at many drug stores). By all means, drink alcohol moderately and avoid smoking.

Additionally, adults should maintain their 6-month dental check-ups and cleanings. These appointments help to remove any build-up of plaque or tartar on teeth so they are easier to maintain between visits. Too, your hygienist can point out areas of risk so you can concentrate appropriately during your at-home oral hygiene regimen.

If you’ve delayed (or avoided) regular dental care, your likelihood of having some level of gum disease is pretty high, even though you may not have obvious symptoms in early stages. Gum disease, once underway, does not go away on its own. It will gradually worsen and become a source of infectious bacteria that strains your immune system and increases your risks for serious health problems.

Begin with an examination appointment by calling our beautiful Asheville periodontal dental office at 828-274-9440. Here, we treat our patients with compassion, respect and with comfort a priority at all times. And, we provide patients with decades of experience and advanced skills — along with exceptional dental technology – so your treatment is successful and performed efficiently and effectively in minimal time.

While your smile is greatly important to your appearance, it’s what you can’t see that may harbor a rather ugly presence. Let’s get your smile in great shape!

 

Your Tongue Is A Multi-Tasker!


Posted on May 05, 2021 by William J. Claiborne, DDS MS

With the tongue occupying such a large area inside the mouth (or ‘oral cavity’), you’d think its anatomy would be common knowledge. Because this muscle functions continually without tiring, it tends to be taken for granted. It’s importance to your overall health, however, is unbounded.

To correct a common misconception about the tongue, it is not the strongest muscle in the body. Although it ranks in the top 5 or so, the muscles surrounding the eyes actually have that supremacy. The heart, deemed the hardest working muscle in the body, and the masseter (jaw muscle) are also among those that are the body’s stand-outs.

The tongue does many things. It provides our sense of taste, is vital in pronunciation, moves food around as we chew, and aids in swallowing while helping to prevent certain things from being swallowed.

Not one muscle but a combination of 8, the tongue is coated with papillae. These are the tiny, bumpy protrusions on its surface. They help in various ways but are mostly credited for our sense of taste.

Different areas of the tongue are more sensitive to certain tastes. For example, the tip of the tongue detects sweet to the greatest extent while the sides detect sour.

Papillae also sense touch so that we can feel the form and texture of food.

Saliva helps to keep the tongue moist so it can move around the oral cavity freely. Saliva is also helpful to the tongue by moving bacteria from its surface. However, saliva cannot keep the tongue bacteria-free.

Saliva and food residue can get stuck in the grooves between the papillae, especially on the last third of the tongue. This can create areas for bacterial growth. These bacteria thrive on remains of protein-rich food like fish, cheese or milk.

Here is where, as an Asheville periodontist, I have a particular interest in the tongue. As bacteria accumulate, a whitish film covers the tongue, which also causes bad breath. Keeping bacteria in the mouth to manageable levels is greatly supported by saliva flow.

The tongue’s underside covers two salivary glands of the lower jaw (submandibular glands). These ducts are located where the tongue meets the floor of the mouth.

If you’ve read some of my previous articles, you’ll recall that I’m constantly reminding readers of the hazards of having a dry mouth. Smoking, consumption of alcohol and caffeine, and many medications are all obstacles to the salivary glands being able to function efficiently.

A dry mouth provides a breeding ground for bacteria reproduction. When you consider the amount of bacteria embedded in the tongue’s surface, oral bacteria levels in the mouth can run rampant.

Because the tongue’s surface color can indicate too much oral bacteria, it should be looked at during at-home oral hygiene regimens. It is advised that, after brushing teeth, using the toothbrush to brush the tongue. This can dislodge an enormous amount of bacteria.

Although brushing the tongue tends to be done on the front area, it’s helpful to brush towards the back of the tongue where most bacteria exist (hence, the whiter color and smoother surface). Gagging will stop you from going too far so use that as a guide.

Some toothbrushes have a tongue scraper surface on the back side of the bristles. There are also tongue scrapers available for purchase. These are flexible strips that should be used to scrape from back to front 3 or more times after brushing. Rinsing the scraper is advised after each pass.

To provide even more support in helping the oral cavity control bacteria, an oral rinse can be very helpful. After brushing (for a minimum of 2 minutes) and flossing, swish for 30 or more seconds with an alcohol-free mouthwash. While the intensity of the mouthwash may be greater with initial use, most people notice its easier to swish around the mouth within a week or so.

Low bacteria levels in the mouth make for fresh breath and reduced risk of developing cavities and gum disease. Periodontal disease begins with gingivitis, which causes gum tissues to be tender and bleed when brushing.

Periodontitis, an advanced stage of gum disease, causes red, sore, spongy gums. Other symptoms are persistent bad breath, bleeding easily, gums that loosen from the base of teeth, and teeth that loosen.

Periodontitis can also cause health risks far beyond the mouth. Because these infectious bacteria can enter the bloodstream through tears in the gum tissues, it has been shown to trigger or worsen the development of serious health problems. Some of these are stroke, heart disease, arthritis, Alzheimer’s disease, some cancers, and diabetes.

When it comes to the tongue, remember its important role to your oral and overall health. Keep the mouth moist and its surface clean and your reward will be sweet (without the calories!).

If you are experiencing any signs of gum disease, call 828-274-9440 for an appointment. Gum disease does not go away on its own and will progressive worsen without treatment. Remember – it is the number one cause of adult tooth loss in the U.S.

 

Know The Qualifications of Who Places Your Dental Implants.


Posted on Apr 05, 2021 by William J. Claiborne, DDS MS

When someone has lost a natural tooth, the word that stands out for me is “lost”. A missing tooth means a lot can be lost.

Tooth loss not only leaves a gap in the appearance of a smile, its absence can lead to movement of surrounding teeth.

For example, some people assume that a lost back tooth that is not visible doesn’t need replacing. This is an incorrect assumption. Without all teeth in their proper positions, a gap can cause others to tilt and turn. Additionally, the one above or below will grow longer. These misalignment issues can lead to broken, fractured, or chipped teeth.

Misaligned teeth can also lead to strain on the TMJ, or jaw joints. These joints, located on each side of the head just in front of the ears, are hinges that connect the lower jaw bone to the skull. They are in motion almost constantly.

When the jaw joints experience frequent strain from misaligned teeth, they can cause pain that extends out to head, neck and shoulder muscles. TMJ-related pain can be the source for headaches, migraines, facial pain, ear ringing, dizziness, pain when chewing and difficulty opening the mouth fully.

Obviously, replacing teeth is important. Because of many factors, a dental implant is the superior choice in tooth replacement. A dental implant is a lifetime replacement option. Dental implants restore the ability to bite, chew, speak and laugh confidently without worry. The security of their strength and stability can also be greatly beneficial to one’s self-esteem and self-confidence.

Too, dental implants actually enhance the well-being and lifespan of surrounding teeth. They are an exceptional value when considering their ability to restore the most natural look, feel and function.

In dental implant treatment, the implanted portion is positioned in the jaw bone as a tooth root replacement. This provides attached teeth with the same foundation as natural tooth roots. A partial or bridge simply sits on top of gum tissues and relies on adjacent teeth for support.

Yet, it can be in WHO is involved in your dental implant diagnosis and placement that can provide you with optimal comfort and lifelong success.

When dental offices offer dental implants, many general dentists refer the placement portion to a periodontal specialist. For their patient, this can mean a higher level of comfort and success, especially for complex needs.

However, some dentists offer dental implant placement in their offices. While some have taken extensive courses in implant dentistry, others may have taken a weekend course here and there. These quick courses are typically hosted by an implant manufacturer who trains attendees with a limited selection of implant types. This can limit the patient’s choices when relying on appropriate recommendations for his or her unique needs.

Although there are many factors to go forward with a dental implant, your choice of doctor to place the implanted portion can greatly increase your potential to enjoy your dental implant for a lifetime.

As a periodontist, an aspect of the specialty is the advanced training in the diagnosis and placement of dental implants. This specialized expertise affords patients with a wider variety of choices when it comes to implant systems as well as success in treatment outcome.

For example, consider a patient who is missing a lot of bone mass (often due to missing natural teeth for many years). An implant placed in the upper jaw in too-shallow bone can work its way into the sinus cavity. A lower implant in insufficient bone depth can reach a nerve that runs horizontally through the lower jaw (the mandible).

Additionally, the shape, size and the number of teeth to be attached to an implant have much to do with the type of implant system selected. When the placement doctor is only familiar with one or two types, the limitation may pose problems for the patient in the future.

Along with an intricate knowledge of the specific type of implant needed, proper placement angles and depth have much to do with the overall success of the implant. For optimal results, the doctor placing the implant should be skilled in the selection of the implant angles and positioning depths.

In our Asheville periodontal office, we restore the well-being of smiles. We also help patients replace bothersome dentures or partials so they can resume eating the foods they love and laugh confidently in social gatherings.

The doctor is not the sole factor in success, however, Along with proper selection and placement, a patient must take measures to ensure proper oral hygiene at home. Oral bacteria can contribute to an infection that works its way into the bone surrounding the implant. In some cases, the only way to resolve the infection is to remove the implant.

The most troubling thing I see in implant dentistry is when a patient opted for a “good deal” with a less-experienced doctor, and having to remove a ‘failed’ implant.

When a patient entrusts their implant treatment to a skilled doctor and adheres to hygiene and healing guidelines, having an implant fail is very unlikely. The success rate of today’s implant dentistry is excellent – over 97 percent.

Today’s implant dentistry is successful, safe, dependable and can provide nearly immediate benefits. As a dental specialist who has stayed on the cutting edge of implant dentistry’s techniques, technology and materials, I am pleased to witness the transformations our patients undergo after treatment.

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.

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