Stroke Risk Higher Due To Gum Disease

Posted on Mar 07, 2018 by William J. Claiborne, DDS MS

Ischemic stroke happens because of a blocked artery to the brain. Because the brain relies on oxygen and nutrients carried through blood, a blocked artery means the brain cells struggle. Thus, a blocked artery can eventually lead to dying brain cells and stroke.

Ischemic stroke is the most common kind of stroke and about 88 percent of all strokes. Most people with ischemic strokes are over the age of 60 and the risk goes up with each year. Certain conditions increase one’s risk for stroke, including high blood pressure, heart disease, smoking, and diabetes.

Having certain health conditions also make an individual more susceptible to stroke. These include narrowing of the arteries, an irregular heartbeat (a-fib), heart attack, abnormal heart valves, injury to blood vessels in the neck, or blood clots.

The very word ‘stroke’ conjures up the image of an individual with a droopy face and a dangling arm that fails to function. Some of us can remember a grandparent going from a busy, self-sufficient person to one who became bed-ridden or was never the same because of a stroke.

Although stroke recovery today is more successful, it remains a dreaded episode with life-altering outcomes in many instances. Of course, the goal is to prevent a stroke from ever occurring. There are a number of ways that today’s adults can lessen the risk, one being good oral health. Does that surprise you?

The oral health-overall health connection has become more front-&-center in scientific research. About half of Americans aged 30 years or older have periodontitis, which is an advanced level of gum disease. Obviously, this has given cause to a diligent pursuit in finding paths of its associated hazards.

Gum disease is actually an inflammatory disease, which has a strong association to one’s risk for stroke. Periodontal disease occurs when oral bacterial accumulate, eventually attacking the soft and hard structures that support teeth. Think of the inflammatory triggers of gum disease as similar to those of high blood pressure, for instance.

Periodontal disease is an inflammatory disease of the oral gum tissues. It can be mild or severe and begins with swollen, tender gums that may eventually lead to tooth loss. The oral bacteria of gum disease has been linked to a wide array of serious health conditions through past research.

These include heart disease, some cancers, Alzheimers disease, diabetes, preterm babies, arthritis and erectile dysfunction (ED). These are in addition to already-established links between gum disease and heart disease, high blood pressure and stroke.

Prior studies have also shown an association between periodontal disease and incident stroke risk. While a recent, U.S. based study reinforces the link between gum disease and the risk for stroke, it also shows that regular dental care may actually lower the risk for stroke. (https://www.diabetesdaily.com/blog/research-shows-link-between-periodontal-disease-and-stroke-538122/)

Researchers in the ARIC study (Atherosclerosis Risk in Communities), beginning in the 1980s, analyzed data from 10,362 middle-aged adults. None had experienced a previous stroke and participants were given dental evaluations and regular follow-up.

All were screened on their level of dental care and classified as either ‘regular’ (having routine dental visits more than once a year) or ‘episodic’ (those who saw a dentist only when something hurt, required repair, or didn’t see a dentist at all).

Researchers noted that the relationship between gum disease and myocardial infarction has been shown through previous studies as well as an association between gum disease and stroke.

So, could having good periodontal health reduce the stroke risk?

During the 15-year follow-up period, 584 participants had an incident ischemic stroke. The results indicated that adults who had regular dental care had half the stroke risk of those in the episodic category.

The study also showed that the more severe the periodontal disease was present, the higher the risk of future stroke.

Researchers surmised that a proper dental hygiene regimen combined with regular dental care can lower the risk of heart disease and stroke. (https://www.medscape.com/viewarticle/891550#vp_2)

Even after adjustments were made for race, age, sex, body mass index, hypertension, being diabetic, smoking, and education, those receiving regular dental care showed lower rates of ischemic stroke. The highest rate of stroke was seen among those who developed the more advanced levels of gum inflammation.

We all want to avoid health problems, especially something with consequences as severe as stroke. That’s why we have annual physicals, periodic screenings, and tests that can catch problems at early stages so only minimal treatment is needed.

Apparently, regular dental checkups play a major role in helping you avoid problems far beyond the mouth. As a periodontist, I have a unique understanding for how intricately the health of your mouth effects the health of your body.

When it comes to your overall health, good oral health obviously gives you a ‘leg up’ for whole-body health. If you’re behind on having 6-month dental checkups and cleanings, call 828-274-9440 to schedule a complete periodontal exam. Or, begin with a consultation. I’ll be happy to answer your questions and discuss treatment and comfort options during this time.

Dental Fears And Periodontal Disease – Likely Partners.

Posted on Mar 01, 2018 by William J. Claiborne, DDS MS

I’m not afraid of spiders. I don’t necessarily welcome them into my home but seeing one doesn’t ‘freak me out,’ either. However, I know several people who have a fear of spiders that goes beyond simply feeling creeped out by them.

Most of these individuals aren’t certain when or why their fear of spiders began. They just know they have it. For some people, it’s the same with fear of dentistry. While some adults can track back to precisely when and why their dental fears began, others aren’t quite sure.

In a dental office, some people react negatively but uncontrollably to sounds, smells and sights. However, when dental fears exist because of a traumatic experience in a dental chair (often as a child), we know the element of trust between the individual and his/her dentist was broken.

A dentist who continues a procedure on a patient while the patient is uncomfortable – whether an adult or child – can create an everlasting fear associated with dental visits. This moment is forever in the corners of a patient’s mind, evoking anxiety or fearful sensations every time a dental visit is considered. It’s the body’s way of triggering its ‘fight or flight’ response. Like shivering in the cold, it’s a reaction that is not easily controlled.

Although we cannot erase traumatic moments from one’s subconscious, we can help patients get past their fears and achieve healthy, confident smiles. And, the need for a healthy mouth is rising to the top as one of the most important aspects of having good, overall health based on a remarkable amount of research.

Research has found that certain strains of oral bacteria from gum disease create reactions in the body that can trigger systemic inflammation. Thus far, research findings have shown a correlation between periodontal disease bacteria and some cancers (including pancreatic and lung), Alzheimer’s disease, pre-term babies, heart disease, stroke, diabetes, arthritis and erectile dysfunction (ED).

As if all that weren’t bad enough, one study suggests that gum disease relates to a reduction in one’s quality of life: “Periodontal disease has been linked to lower quality of life.” “Quality of life encompasses several domains, including psychological functioning and social relationships among others. Oral health-related quality of life has been shown to be reduced in patients with periodontal disease.” (https://www.hindawi.com/journals/prm/2017/5491923/)

While estimates show about 75 percent of American adults have some degree of dental fear or anxiety, over 47 percent have some level of periodontal disease. As a periodontist, both are alarming numbers. Nearly half our nation is walking around with a potentially life-threatening disease in their mouths. Yet, many are unaware of its presence.

The symptoms of gum disease begin silently. When they do emerge, some people ignore them, such as seeing blood in the sink when brushing. There is a misconception that this is a sign of brushing thoroughly. (Wrong! See below for helpful tips for proper brushing.*) Other symptoms, such as sore, swollen gums and frequent bad breath may be assumed to be temporary problems.

If dental fears or anxiety have kept you from regular dental checkups for a year or more, it would be rare to NOT have some level of gum disease. Quite frankly, some people with high fear levels avoid seeing a dentist for decades. Those visits are vital in one’s ability to have healthy gums.

While twice daily brushing and daily flossing are necessary components for having good oral health, the routine alone isn’t enough to combat a number of additional factors that make one vulnerable to the disease.

For example, snacking on sweets or carbohydrates super-charges the oral bacteria in your mouth. And, these between-meal munchies set off an added acid attack in the mouth (as occurs any time we eat or drink as part of the digestive process). Couple this oral acid with sugar-loving bacteria and perhaps the extra acidity of a cola or catsup and WHALLAH you have a perfect recipe for destructive bacteria in the mouth.

What creates even more vulnerability is the lack of proper brushing techniques. A number of people swipe a toothbrush over easy-to-reach teeth, do a quick swish, and they’re done. And, as a study by Delta Dental revealed, only 7 out of 10 adults are brushing twice a day. This means that 30 percent aren’t brushing enough. (https://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits)

Like anything, using proper measures makes all the difference.

* Begin with a soft to medium bristle toothbrush and a fluoridated toothpaste. Pretend your mouth is divided into four sections and spend 30 seconds in each area. Swirl the toothbrush around all sides of your teeth, including the tops that have deep pits and crevices where bacteria can hide.

Hint: if your bristles are bent to the sides after a month or so, you’re pressing down too hard. Lighten up so the tips of the bristles swipe over the surface.

Floss daily to dislodge food particles caught between teeth. These bits can rot quickly and add to bacteria levels in the mouth. What’s that? Flossing is a pain? Electronic water flossers are affordable, easy to use, and do an effective job.

Once your teeth are brushed, brush the tongue to remove oral bacteria that burrow into its grooves. Be sure to reach the back portion where the majority exist. Swish and spit several times.

Hint: Consider purchasing a toothbrush that has a tongue scraping section (typically the reverse side of the bristles). For some people, this is more comfortable than brushing.

If you are one of the 75 percent who have dental fear or anxiety OR one of the 47 percent who have some type of periodontal disease OR – even worse – have BOTH, please call us to schedule a consultation to discuss restoring the health and appearance of your smile.

In addition to providing a specialized environment for treating all stages of gum disease, we are also experienced in helping fearful adults achieve good oral health and smiling confidence. We offer a respectful, compassionate staff, an inviting office setting as well as Oral and I.V. sedation (twilight sleep), if desired.

Call 828-274-9440.

Men Have Room For Improvement When It Comes To Caring For Their Smile!

Posted on Feb 20, 2018 by William J. Claiborne, DDS MS

Guys – when it comes to the battle of the sexes, you’re losing when it comes to your smile!

According to a survey by the Centers For Disease Control & Prevention (CDC), only 66 percent of males brush their teeth twice or more a day compared with 86 percent of females who do so.

The study of over 800 participants included completion of a written questionnaire on dental knowledge and oral health habits. The study, shared by the Journal of Periodontology, also included an oral exam of each participant to detect signs of periodontal disease. (https://www.perio.org/consumer/gender-differences)

Things don’t get much better when it comes to flossing, but that pertains to both sexes. Only 49 percent in the survey stated they floss on a daily basis. Even worse,1 out of 3 assumed that seeing blood in the sink when brushing is normal and were unaware it is a sign of periodontal (gum) disease.

The study also showed women as twice as likely to see their dentist for regular dental check-ups and more likely to follow through with recommended dental treatment. As a result, it was no surprise that the study revealed women had better levels of gum health with less dental plaque, calculus, and bleeding.

Men – remember that gum disease is the nation’s leading cause of adult tooth loss. If the thoughts of enduring tooth extractions and replacement decisions don’t motivate you to brush and floss more, try this image. Oral bacteria are living, breathing and eating creatures that live in our mouths. Like any living thing, what is eaten is then released through defecation. Yes, these organisms do this in your mouth! If you’ve ever wondered about bad breath, keep this vision in mind and, if nothing else, that alone should motivate you to brush more often!

Also, be aware of the signs and symptoms of gum disease, which is an over-accumulation of bacteria in the mouth. Initial symptoms are tender or swollen gums, seeing blood in the sink when brushing, and frequent bad breath. However, keep in mind that some signs don’t emerge until gum disease is running rampant.

As the disease worsens, you may experience persistent bad breath, gums that turn red in color (versus a healthy pink) and pus-filled pockets that form at the base of teeth. Untreated, you’ll eventually experience gums that pull away from teeth and teeth that loosen and may require removal.

It takes mere minutes each day to avoid this disease. And it’s easy and inexpensive. Use a soft to medium toothbrush and brush for two minutes twice daily. Brush in a swirling motion rather than scrub back and forth, which wears down tender gum tissues. After brushing teeth, brush your tongue to remove hoards of oral bacteria embedded in the tongue. Swish and spit several times.

You should also floss daily to remove food particles caught between teeth that a toothbrush can’t dislodge. If you find flossing too awkward or uncomfortable, purchase a water flosser. These are easy to use and equally as effective.

Last but not least, see your general dentist twice a year. These appointments remove calculus (also referred to as tartar), which are hardened forms of oral bacteria that eat away at tooth enamel and gum tissues.

It is important to have a healthy mouth, which research has shown also supports a healthy body. It has been found that the toxic bacteria of gum disease can trigger inflammatory reactions elsewhere in the body. A growing number of health problems have been linked to gum disease, including some cancers, heart disease, stroke, arthritis, diabetes, preterm babies, erectile dysfunction (ED) and impotency.

If you are behind on dental visits or are experiencing any of the signs of gum disease, call 828-274-9440 to schedule an appointment. I’ll discuss ways to restore your mouth to a healthy state and easy ways to help you maintain good oral health between visits. We will also be happy to discuss comfort options and financial plans, if desired.

Senior Years Add To Challenges Of Enjoying A Healthy Smile

Posted on Feb 06, 2018 by William J. Claiborne, DDS MS

Every age has its challenges. As a teen, I longed to have more freedom. As a twenty-something, I wanted to feel more established and confident in my career. In my thirties and forties, I craved more downtime as I juggled a jam-packed schedule with a home, children, a periodontal practice, and friends.

With each decade, I think we find ourselves with similar challenges. Now, like others who have entered their ‘mature’ years, health challenges seem to be more prominent in my life.

Although senior age may have its challenges, from an oral health standpoint, today’s senior is in a far better position than that experienced by our grandparents.

Most of us can recall seeing our grandparents’ dentures soaking in a glass by the bathroom sink each night. Today’s senior knows that keeping their natural teeth all their life is very possible (and highly beneficial to their overall health).

I’d like to address some of the challenges that the senior smile faces today and how they can decrease the risk for developing problems or losing teeth.

• Dry Mouth: The aging process leaves us less, well… supple. It causes our skin to sag, leads to more susceptibility for skin problems, and produces less moisture in our mouths. As saliva production declines, there is less of a rinsing agent to move bacteria and food particles from the mouth. This increases the risk for oral bacteria accumulation. It is no wonder that seniors have a higher incidence of gum disease – over 70 percent for those over the age of 65 (compared to 47.2 percent for ages 30 and over). (https://www.perio.org/consumer/cdc-study.htm)

• Poor Manual Dexterity: The aging process may cause some people to have achy joints or dexterity difficulties. When it becomes difficult to brush and floss thoroughly, the potential for bacteria accumulation in the mouth increases. As oral bacteria amass, the overload can lead to decay and gum disease.

• Tooth Loss: Many people lose one or several teeth before reaching their senior years. This may be due to accidents, health problems or gum disease (the number one cause for adult tooth loss). However, it is important to know that losing a natural tooth sets off a domino effect. Statistics show the tooth most likely to be lost next is a tooth adjacent to the missing area.

• Financial Limitations: Some of us joke about elders rushing to ‘early bird specials’ or sneaking sugar packets into purses, but the truth is, people who are retired must live on tighter budgets. When health coverages are no longer available through one’s employer, managing increased expenses for doctors’ visits, medications and unexpected problems can mean sacrifices in other areas. For some people, they forgo their 6-month dental checkups, assuming that “if nothing hurts, then nothing is wrong.” However, the lack of preventive measures when it comes to oral health can catch up to a senior in other, rather expensive ways.

• Accessibility To Care: For those of us who drive, getting to a dental office for a cleaning or to treat a problem is far simpler than those who no longer drive. When a senior has to recruit a friend or family member to accomplish these needs, the frequency in dental care can take a back seat.

• Diet: Cooking for one or two can mean a rather altered blend of nutritious foods. It may seem so much easier and even more economical to open a can rather than put a pot on to boil. Fresh foods also require more frequent visits to the grocery store. For those who rely on others for transportation, this may lead to greater consumption of processed foods laden in sugar or starchy fillers. This increases the bacteria level in the mouth.

So, how does a senior avoid tooth decay, tooth loss and gum disease? Here are some recommendations:

– Nothing is as effective or as economical as prevention. Be committed to twice-a-day brushing and daily flossing. Brush for at least two minutes each time and finish up by brushing the tongue, where millions of oral bacteria hide. If brushing is difficult, use an electronic toothbrush or wrap the foam from a hair roller around the handle for a better grip. If flossing is awkward, use a water flosser. These are just as effective as flossing and easy to use.

 – Although money may be tighter on a retired budget, look at your 6-month dental checkups for the savings they provide. These visits remove plaque and tartar buildup that can lead to cavities and gum disease. Liken these visits to having your vehicle’s oil changed. You don’t have to do it, but it will eventually cost you big-time if you don’t.

 – Be conscious of what you eat and how often you eat. Try to steer clear of sweets and carbs, opting for fresh fruits and veggies. Limit snacking or sipping colas over an extended period of time. Remember — every time you eat or drink (other than water), an acid attack begins in your mouth. If you like a sweet treat during the day, have it for dessert after a meal when an acid attack is already underway. This will keep a new one from bombarding your precious tooth enamel with this harsh acid.

 – Keep your mouth moist. Drink pure, filtered water throughout the day. This will keep your mouth fresher and hydrates the entire body at the same time. Try to limit things that are drying to the mouth. This includes caffeinated beverages (coffee, tea, hot chocolate) and spicy foods. If you take medications that are drying to the mouth, consider using an over-the-counter oral rinse designed to replenish oral moisture. If you smoke, you have special challenges with drying. Be very conscious of the moistness level in your mouth.

 – If you are missing teeth, it is important to replace them with an option that is comfortable, secure and stable. I’ve had patients who avoided dining with friends for years because of unstable dentures. I’ve also had patients who developed health problems because their diet consisted of soft foods that dissolved easily in the mouth. Dental implants restore the ability to eat a healthy diet comfortably and laugh with friends without worry. The investment of implants will last your lifetime and bring you everyday pleasure. I’ve never had a dental implant patient who didn’t say, “It’s the best investment I’ve ever made.” That’s well-worth looking into.

Be a senior who smiles and enjoys the confidence and pleasures of growing older! Call 828-274-9440 to schedule a consultation. During this time, we’ll discuss your individual needs and the options that may be best for you. And, if financial challenges exist, we’ll have our Financial Coordinator discuss easy payment options.