Older Adults Should Make Oral Health VERY High Priority.

Posted on Feb 17, 2019 by William J. Claiborne, DDS MS

Whoever said, “Growing old is not for sissies!” surely knew what he or she was talking about. That statement seems to describe the process pretty accurately, for those who endure it!

While the visual signs of growing old – hair thinning (or loss), wrinkles, sagging skin, age spots, and shifting fat – is apparent, those are minor in comparison to the aches, pains, and challenges that persist ‘below the surface.’

From aching joints to loss of muscle strength to poor eyesight to memory decline (and a long list in-between), the aging process adds health challenges that seem to grow in number and severity with each passing year. Sadly, increased risk of tooth loss seems to be part of the process.

A five-year study by the National Health & Nutrition Examination Survey showed that Americans ages 65 and over have lost an average 19 natural teeth with over 27 percent having no remaining teeth (known as being edentulous).

While tooth loss is often perceived as a normal part of the aging process, it is not. Keeping one’s teeth throughout a lifetime is very possible. And, maintaining one’s natural teeth have been associated with living a longer life.

Healthy teeth begin with a health foundation — your gums. Good oral health has been shown to reduce risks for serious health conditions (including heart disease, stroke, and some cancers) elsewhere in the body. In addition to being able to keep your teeth, natural teeth are a bonus to biting, proper chewing, and nutritional intake.

It has also been shown that wearing dentures is a poor method of ‘replacing’ them. Even though they recreate the appearance of teeth and restore function (to varying extents), they can actually contribute to long-term problems.

Without natural tooth roots, which help to nourish and stimulate the jaw, supporting bone structures begin to shrink. Known as “resorption,” this process of bone mass decline can eventually lead to tooth loss. Once resorption begins, unfortunately, it continues. Statistics show that adjacent teeth beside an area of tooth loss have the highest risk for being the next to be lost.

The ‘gum-colored’ base of dentures is also porous. This surface provides oral bacteria with tiny ‘homes’ that become breeding grounds for high levels of bacteria. Denture wearers have higher incidences of repiratory problems, including susceptibility to pneumonia.

RDH (registered dental hygiene) Magazine (https://www.rdhmag.com/articles/print/volume-34/issue-12/columns/infection-control/dentures-and-aspiration-pneumonia.html) shares one study of senior adults and the higher risks for those who also sleep in their dentures.

Too, with the aging process also comes the condition of ‘dry mouth.’ Saliva plays an important role in maintaining good oral health. A healthy saliva flow makes it easy to talk, swallow, taste, and digest food.

A reduction in saliva flow can increase plaque accumulation as well as the risk of developing periodontal disease. Referred to as gum disease, this can lead to tooth decay, mouth sores ,and oral infections. Inadequate saliva can contribute to bad breath, dry and cracked lips, cause the fit of dentures to become uncomfortable, and result in higher oral infection risk.

Almost half of Americans take at least one prescription daily. For adults over the age of 65, nearly 90 percent take one or more. While a number of both prescribed and OTC medications include the side effect of oral dryness for any age, age-related reductions in salivary production causes irritation to oral tissues.

Medications including antihistamines, blood pressure medications, decongestants, pain medications, diuretics and antidepressants typically cause dry mouth, which can create inflammation and higher susceptibility to infection.

Older adults obviously need to make their oral health one of their highest priorities. Fortunately, good oral health is easy to achieve. Daily brushing and flossing and regular 6-month exams and cleanings can help to minimize problems and address those that do occur at their earliest stages.

It is also important to keep your mouth moist. Drink plenty of water throughout the day. Limit foods and beverages that are caffeinated, which are drying to oral tissues. These include coffee, tea, colas and chocolate as well as spicy foods. If you take medications that have drying side effects, use an oral rinse designed to replenish moisture. Also, chew sugarless gum to help promote saliva flow.

Your diet is an important part of a healthy mouth. Evaluate your food intake carefully. Begin by limiting carbs and sugar. While all foods trigger an acid attack in the mouth for nearly 30 minutes after eating, sugar and carbs super-charge the reproduction of oral bacteria.

When teeth are lost, adults encounter a complicated set of issues – and costly challenges that can reach far beyond the mouth. As a Periodontal specialist, I’ve seen how simple measures can save people greatly in treatment time and expense AND prevent problems like gum disease, cavities and tooth loss.

If you have started to lose natural teeth already, let us help you halt the process! Call 828-274-9440 to schedule a consultation so we can discuss how you can regain your oral health for a lasting, healthy smile!

Dental Implants Overcome The Problems Of Missing Teeth.

Posted on Jan 28, 2019 by William J. Claiborne, DDS MS

Advanced periodontal (gum) disease is the number one cause of adult tooth loss in the U.S., affecting nearly 48 percent of American adults. Although teeth play an important role in our overall health, there is a misconception with some adults that tooth loss is a natural part of the aging process.

Hopefully, this is changing.

In 1957-58, it was estimated that over 55 percent of adults over the age of 65 were totally edentulous (having no natural teeth). In 1971, a survey by the National Center For Health Statistics found that the percentage had dropped to 45.  By the year 2024, it is estimated that only 10 percent of Americans between ages 65 – 74 will be without teeth.

Teeth are more than just what you use to smile, bite, and chew. They play an important role below the gumline as well.

Tooth roots provide nourishment and stimulation to the upper or lower jaw bone. This helps the bone to maintain its mass. Without tooth roots, the jaw bone begins to shrink in a process known as resorption. Dentures wearers often notice first signs of this when their once-snug ‘appliance’ begins to move or slip when chewing.

Here’s why that is occurring…

A denture, when first made, is designed to conform to the unique contours of an existing ‘ridge.’ This is the gum-covered arches in your mouth where natural teeth were once held. Without the stimulation of tooth roots to the bone, resorption causes the ridge to gradually flatten. As it loses height, the denture becomes “slippery” or “wobbly,” as patients often describe.

When dentures slip and rub sore spots on tender gums, denture wearers quickly learn which foods are too challenging for their unstable denture. They may use denture pastes or adhesives more frequently. Eventually, many switch to a diet of soft foods that dissolve easily in the mouth.

When a diet is deficient in the fiber and nutritional components of a healthy makeup, overall health suffers. Because the act of chewing and acids in saliva flow are the first stage of digestion, denture wearers are known to take more medications and have more gastro-intestinal problems than those who still have natural teeth.

Also at risk is social involvement, now shown to be an important part of being healthy. Because of fear of embarrassment, it’s fairly common for longtime denture wearers to avoid these gatherings, especially those centered around food. (And, try to think of many social activities that don’t – at some point – include food!)

One survey of over 20,000 dentists (by the Academy of General Dentistry) showed that having a tooth removed causes many patients to feel socially embarrassed and less likely to participate in functions that are psychologically beneficial.

Psychological issues related to tooth loss are also associated with feelings of depression and being less goal-oriented in the workplace.

The decline of bone mass can even be seen, contributing to changes in facial appearance. As bone height declines, deep wrinkles form around the mouth. Even when smiling, the corners of the mouth turn downward. Jowls form as facial muscles detach. The chin becomes pointed and the mouth appears to be collapsed into the face (often described as a ‘granny look’).

To see the extent of bone loss, a denture wearer should look in the mirror without the denture in place. Because a denture ‘plumps up’ the face, it can be deceiving as to just how much bone loss has been experienced.

For those who have already experienced tooth loss, I highly recommend dental implants for replacement. There are many types of implant systems, each designed to accommodate specific needs. A Periodontist, a dental specialist, has advanced training in the diagnosis and placement of all types of implants. The type that is best for you depends on many factors that a periodontal specialist takes into consideration.

There are even implant types that can be successful for people who have already experienced a great deal of resorption. In many cases, bone rebuilding procedures can restore the height of the jaw bone with a bone graft not needed,.

Dental implants restore the look, feel and function of natural teeth while boosting one’s ability to feel confident and eat comfortably. Another bonus? Dental implants do not rely on adjacent teeth for support as with partial dentures or crown-&-bridge combinations.

The implanted portion is held by the jaw bone, just as the natural tooth roots you once had. This helps to halt the process of bone loss. Dental implants are also designed to last a lifetime, making them a wise investment.

For those who feel they are “too old” for dental implants, I remind them that many of our implant patients are well into their 80’s or 90’s.  Keep in mind that today’s adults are staying in the workplace longer, staying active in senior years, and living longer.

Since 1950, Americans added over 11 years to average life expectancy, to over age 79, according to 2013 statistics. Although females were once living an average of seven years longer than males, that gap has now narrowed to less than five.

When an adult, at any age, expresses frustration with feeling they are caught in a dental office’s revolving door, an examination typically reveals that they have some level of periodontal (gum) disease. Like most diseases that form in our bodies, gum disease begins silently. When symptoms do emerge, they include tender gums that bleed when brushing, persistent bad breath, and gums that pull away from teeth (known as gum recession).

Amazingly, so many adults have gum disease even though it is completely avoidable. Proper brushing and flossing, minimizing sugar intake, avoiding smoking, and having regular dental checkups can help curtail the cycle of dental problems.

First, you must establish a healthy foundation, which begins with healthy gums. The first step is to have a periodontal exam to determine your current gum condition. If signs of gum disease exists, we will explain the process needed to restore your gums to a healthy state. We will also make home care recommendations to help you maintain good gum health between dental checkups.

While adults are getting better at keeping their natural teeth, we still have a long way to go. I believe many adults would be more determined to keep their natural teeth if they had a better understanding of their value. Hopefully, this has helped your appreciation of what supports those pearly whites!

For more information, contact us at 828-274-9440 or tap here to being.

 

http://www.cdc.gov/nchs/products/databriefs/db197.htm

You CAN Avoid Gum Disease – Know How It Forms & Easy Prevention Tips

Posted on Dec 14, 2018 by William J. Claiborne, DDS MS

I know of so many friends and family members who have avoided or minimized serious health problems (and perhaps even death) by taking preventive measures when it comes to their health. Annual screenings (such as mammograms, prostate checks, pap smears, and colonoscopies, to name a few) have enabled countless people to simply treat or avoid serious conditions and get back to their lives and loved ones.

When we “take charge” of our health, we can also avoid the time and expense required for treating problems that could have been prevented in the first place. For example, not smoking helps us avoid the risk of many cancers and respiratory diseases. Eating a healthy diet and regular exercise lowers our risk for heart disease.

I believe that when people know what to do to avoid problems, they can be proactive in their health. This is especially true for periodontal (gum) disease. What I find is that many individuals are simply not familiar with effective prevention measures nor the signs and symptoms of this infectious disease.

People are often surprised to learn that gum disease first begins without obvious symptoms. Even when it’s fully underway, the warning signs are often ignored or deemed “normal.” For instance, seeing blood in the sink when brushing is a sign that the gums are weak and inflamed, even though some people assume this means they’re doing a good job. (BTW, you should NEVER see blood in the sink when brushing!)

The path that leads to gum disease can easily be bypassed, however. The process of how it forms and progresses is:

•  Oral Bacteria Overload: Bacteria in our mouths is unavoidable. It is on our food, utensils, the glasses we drink from and the pencil we hold between our teeth. Because the mouth is a warm, dark, and moist environment, it offers an ideal setting for bacterial growth. Although certain bacteria levels are manageable through brushing, flossing, and saliva flow, problems begin when too much bacteria accumulate and remain in the mouth.

•  Plaque: Without regular brushing, flossing, sufficient saliva flow, and low-sugar diet, oral bacteria can reproduce rapidly. Their accumulation can quickly form a sticky film that you feel on teeth (a ‘fuzzy’ feeling), known as plaque.

•  Tartar (or Calculus): In just 48 hours, plaque can harden on teeth. This is known as tartar (or calculus) and is actually a cement-hard mass of oral bacteria. Like plaque, tartar will continually grow as the bacteria reproduce. Their destruction includes boring into tooth enamel and eating away at gum tissues.

•  Gingivitis: This is actually the first phase of gum disease. At this stage, gum tissues are under attack and become sore. It can cause the gums to bleed when brushing and gum tenderness. You may experience an aching sensation in some areas. Your breath will be bad more often. By taking proper measures as soon as you notice these symptoms, the gums can be restored to a healthy state. However, there is a fine line between being able to undo gingivitis and its progression to gum disease.

•  Gum Disease: At this level, the gums are inflamed and tender and red rather than a healthy pink color. Your breath will be unpleasant on a consistent basis. The gums may also begin to pull away from the base of some teeth, exposing sensitive tooth root areas. As the inflammation progresses, pus pockets may form at the base of some teeth. Without treatment, teeth will loosen as the bacteria destroy the structures that support tooth roots. Eventually, tooth removal may be required.

Almost half of American adults have some level of periodontal disease, which is also the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.

It has also been found that the bacteria of gum disease can enter the bloodstream, triggering systemic inflammation. Gum disease has been linked to a long list of serious health problems. These include heart disease, some cancers (including prostate, lung, and pancreatic cancers), stroke, preterm babies, arthritis, diabetes, Alzheimer’s disease and erectile dysfunction (ED).

Twice daily brushing (at least two minutes each time), daily flossing, drinking plenty of water, and limiting sweets and caffeine (including colas, tea, and coffee) are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. Remember that your 6-month check-ups are very important. During these visits, any tartar that has accumulated can be removed and signs of early gum disease can be noted – and promptly resolved.

These simple steps can help you avoid the discomfort of gum disease as well as the devastation of losing your teeth and having to decide on replacement. These procedures – and the expense – can be avoided. And, contrary to what some people believe, losing teeth is NOT a natural part of the aging process. With proper care, you can easily enjoy a smile of natural teeth throughout your lifetime.

If you are experiencing symptoms of gingivitis or periodontal disease, call our Asheville periodontal office at 828-274-9440. As a periodontist, I have specialized skills to restore your oral health and customize a program to help you keep it at its best.

Have GOOD Breath For The Holidays! And Ban BAD Breath Forever!

Posted on Dec 05, 2018 by William J. Claiborne, DDS MS

The holidays are a time when friends and family bring us closer together. Whether sitting side-by-side at the table or in close conversations at cocktail parties, we find ourselves a little more conscious about our breath odor than perhaps we normally would be.

Of course, we’ve all encountered that individual who has the memorable bad breath. And, what a terrible impression that leaves, which tends to be forever associated with that person. Fortunately, there are easy ways to avoid having bad breath in these situations and to have fresher breath throughout the year.

It is important to know that bad breath is typically the result of accumulated oral bacteria. It’s as simple as that. And, it’s as difficult as that. Like aging garbage, bacteria in the mouth that amass to high numbers create an odor — a stinky odor.

There are a number of things that contribute to the ability of these icky organisms’ ability to reproduce. One that may surprise you is having a dry mouth.

A dry mouth may seem less inviting as a breeding ground for bacteria since they typically thrive in environments that are warm, moist, and dark. However, when saliva flow is unable to efficiently cleanse bacteria buildup from the mouth, they are easily able to reproduce.

A dry mouth is rather common today. A large percentage of common medications (including anti-depressants, decongestants, and anti-histamines) have a side effect of oral dryness. Too, many beverages contribute to a dry mouth. These include colas, coffee, tea, and those containing alcohol.

Another way that oral bacteria can run rampant has to do with our oral hygiene routines. To be truly thorough in cleaning tooth surfaces, it is recommended to spend two minutes per brushing, twice a day. That applies to both manual and electronic toothbrushes.

Even so, it is estimated that nearly one-third of American adults brush their teeth for an insufficient amount of time. Even worse, about that same amount fail to brush twice a day. This means that a frightening number of bacteria are left to grow and thrive in these mouths.

When you factor in that brushing only tackles about half the amount of bacteria in the mouth, you’re left with a tremendous amount that are able to grow and thrive. You may be surprised to learn that the tongue harbors anywhere from 58 to 65 percent of the bacteria in your “oral cavity.”

Oral bacteria love to embed in the tiny bumps and grooves of the tongue since they are not easily dislodged. Thus, it’s necessary that the tongue be involved in your oral hygiene regimen at home to keep bacteria levels under control.

Some toothbrushes have a “tongue scraper” on the reverse side of the bristles that’s an effective option. Or, you can just brush your tongue with the bristles after you’re teeth are brushed. Be sure to reach towards the back of the tongue where the majority of bacteria exist.

Another challenge for maintaining control of oral bacteria have to do with the eating habits of the American population. While “three squares” were once the norm, today’s American has more of a “grazing” schedule.

For example, your “average Joe” may have breakfast, a mid-morning latte, lunch, a mid-afternoon snack, dinner, and a bowl of popcorn or ice-cream while watching television. Throw in coffee, colas, and tea in with this consumption, you have a pattern that works against your smile.

Although saliva is designed to rinse the mouth consistently during the day, this frequency in eating poses more of a challenge than it is capable of handling. Too, food has more opportunities to becomes stuck between teeth. For those who do not floss daily, these bits are left to rot, adding to bacterial growth.

So, how do you avoid being “the one who has bad breath”? It begins with your time at the sink. Slow down! Spend at least two minutes each time you brush. Don’t scrub your teeth but allow the brush to sweep over them, especially near the gum line. Spend extra time, too, going over the tops of large teeth that have deep grooves.

Tend to your tongue. Either brush your tongue or use a tongue scraper. You’ll be removing a tremendous amount of bacteria that can form bad breath.

Floss daily. If it’s difficult for you, ask our hygienist to work with you on your technique so it is comfortable and efficient. You can also purchase an electronic flosser (water flosser). These are affordable and proven to be just as effective as manual flossing.

Drink plenty of water throughout the day. If you take medications that are drying, consider using an oral rinse formulated to replenish moisture (available over-the-counter). If you’re having a beverage that contains alcohol, drink a glass of plain water between each drink. This not only adds moisture to the mouth, it will dilute the acids in the mouth for less potential damage to tooth enamel (and lessen staining).

Not mentioned prior but very important to avoiding oral bacteria buildup – keep your six-month dental cleanings and exams without fail! These visits remove plaque and calculus (or tartar), which are nothing more than gathered bacteria.

These small measures will help you avoid cavities, gum disease, AND be the one who’s easy to get close to at any gathering! If you have tender gums, gums that bleed when brushing, or frequent bad breath, however, you should arrange to see a periodontal specialist as soon as possible.

A periodontist is a dental specialist who has advanced training in the diagnosis and treatment of all stages of periodontal (gum) disease. He or she is your best way to have a confident, “get close” smile! Call our Asheville periodontal office at 828-274-9440 to learn more.