Dementia Adds To Periodontal Disease Risk For Aging Population

Posted on Aug 08, 2017 by William J. Claiborne, DDS MS

Our population is getting older, and not just that of the U.S.  Globally, nations are looking at an aging population and how to address the diminished physical and cognitive abilities facing them.

In Stockholm, Sweden, for example, researchers from the Karolinska Institute examined the data of over 58,000 persons between 2007 and 2015, including dental health data. Common problems associated with aging include xerostomia (dry mouth), root and tooth decay, and periodontal disease along with increased sensitivity to local anesthetics.

Researchers found that a reduction in the utilization of dental health services was more predominant in patients with neuro-degenerative diseases such as dementia and Alzheimer’s, a particular form of dementia. Those who experienced diminished cognitive function were at higher risk of developing several oral conditions, including periodontal disease. (http://www.dental-tribune.com/articles/news/europe/35704_frequency_of_dental_visits_dramatically_decreases_after_dementia_diagnosis.html)

Although forgetting twice-daily brushing and flossing and having regular dental visits may seem less urgent than tending to other health care issues, research is continually linking serious, and even deadly, diseases and conditions to the oral bacteria of periodontal disease. These include heart attack, stroke, diabetes, arthritis, high blood pressure, preterm babies, impotency, some cancers, and erectile dysfunction (ED).

The massive Swedish study is a reminder that older adults may need added assistance when it comes to making their oral health a priority. This applies to at-home oral care routines and having periodic dental check-ups. For those in the U.S., the need is now and only becoming more dire with each passing year.

According to the U.S. Census (https://www.census.gov/newsroom/facts-for-features/2017/cb17-ff08.html), “By 2060, people age 65 and older will comprise nearly one in four U.S. residents. Of this number, 19.7 million will be age 85 or older.”

And, the Centers For Disease Control & Prevention adds that life expectancy is nearing the age 100 mark with both sexes at 65 years having an average of another 19.3 years to live. While men at 65 years are looking at another 18 years (on average), age 65 women have an average of an additional 20.5 years.

These figures are especially alarming since studies show a dramatic decrease in the number of dental visits before and after a dementia diagnosis. The first step, obviously, is better organization to detect these patients and ensure they attend to their dental health.

If you have an aging loved one in your care who may be showing signs of dementia, consider ways to help them keep their oral health in good condition. This applies to those who have their natural teeth as well as those who wear dentures or partials. Many people assume that not having natural teeth eliminates the risk of developing gum disease. To the contrary, dentures and partials can rub sore spots on tender gum tissues, making them more vulnerable to bacterial penetration.

Begin by having a periodontist conduct a thorough periodontal examination to determine if there is the presence of periodontal disease. If not, he or she can help establish an effective at-home program to follow and schedule more-frequent dental check-ups.

Through research, we’re learning that maintaining good overall health starts with a healthy smile. Staying healthy throughout our lifetimes is a goal we can all strive for and an easy, loving way to help our aging population.

Call 828-274-9440.

To Floss Or Not? Should It Really Be A Debate?

Posted on Aug 01, 2017 by William J. Claiborne, DDS MS

If you could see what I see.

Most of us see very little of the insides of our mouths. As a matter of fact, until the arrival of intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for certain things that didn’t hurt.

Intra-oral cameras are designed to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual can see red, receded gums or deep tooth fractures, the decision to treat often changes from IF to WHEN.

As a periodontal specialist, I treat all levels of periodontal disease. Over the years, I’ve helped patients go from nearly losing their natural teeth to saving them and having a healthy, confident smile. It’s impressive when a person goes from taking their oral health for granted to being highly committed.

Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits):

“Only four of 10 Americans floss at least once a day, and 20 percent never floss.”

Perhaps this is one reason why over 47% of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.

Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued. For example, one study followed children who were allowed to floss their own teeth.

It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.

Like the intra-oral camera, having a firsthand, enlarged view of what’s going on in a mouth is a powerful image. If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a pretty frightening impression of exactly what you DO NOT want crawling around and breeding in your mouth.

Oral bacteria are micro-organisms. In other words, they’re bugs living and reproducing in the mouth. Saliva flow is designed to help rinse these out during the day. However, brushing thoroughly twice a day is what keeps them to manageable levels.

Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.

Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.

As research shows on a continual basis, your overall health is intricately linked to your oral health. The bacteria of gum disease has shown correlations to a number of serious health problems, including everything from heart disease to preterm babies. Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.

We are happy to help our patients develop an at-home care regimen that helps them to enjoy a healthy mouth and fresh breath between regular dental check-ups. Call 828-274-9440 to schedule a thorough examination.

 

 

Could Gum Health Make You More Likely To Develop Cancer?

Posted on Jul 18, 2017 by William J. Claiborne, DDS MS

Periodontitis is commonly referred to as gum disease or periodontal disease. It begins with Gingivitis, which is an inflammation of the gums, typically due to inadequate oral hygiene. Periodontitis creates an infectious cauldron of bacteria that attacks the structures supporting your natural teeth.

According to research published by the National Institutes of Health (and the U.S. National Library of Medicine), evidence indicates that chronic infections and inflammation such as periodontal disease create an increased risk for developing some cancers. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917197/)

Along the same lines, there is considerable evidence that shows a relationship between bacterial and viral infections and cancer development. Because periodontitis is a bacterial infection, it has warranted more attention in recent decades as a source for other health problems.

For example, it has been determined that arthritis, an inflammation of the joints, and periodontal disease show similarities. When the tissues of both gum disease and RA are examined, their clinical structures are similar with the pathological processes being nearly identical.

Periodontitis creates a cycle that leads to the chronic release of inflammatory cytokines (a substance secreted by immune system cells that effect other cells), prostaglandins (designed to aid in tissue damage recovery), growth factors and enzymes. The combined reactions are closely associated with the development of cancer.

While all of this sounds very scientific and complex, it boils down to something that research has noted time and time again — the oral bacteria of gum disease can trigger harmful reactions elsewhere in the body.

The bacteria of gum disease can enter the bloodstream through weakened oral tissues. Once bloodborne, it can travel throughout the body and create systemic inflammation. Research has already found links between the inflammatory triggers of gum disease and heart disease, stroke, high blood pressure, preterm babies, diabetes, arthritis, erectile dysfunction and impotency.

There has also been research to support a correlation between periodontitis and pancreatic cancer, lung cancer and prostrate cancer. While more research is needed to pinpoint the cause-&-effect, the connection with oral bacteria and the chronic inflammation that can result is established.

Although over 47 percent of American adults have some level of periodontal disease, more education is needed so a stronger proactive stance can be taken. In addition to twice daily brushing and daily flossing, a particular caution should go out to denture and partial wearers. Why?

These appliances can become loose over time due to bone loss that occurs when tooth roots are no longer present in the jaw bone. They can rub sore spots on tender gum tissues in an attempt to chew, which increases susceptibility to gum inflammation.

One of the reasons we are strong proponents of dental implants is their ability to halt bone loss by recreating the presence of missing tooth roots. Additionally, they do not move when eating or speaking, eliminating the possibility of sore spots.

Your oral health is an important component of your overall health. Think of your mouth as the front door to your body. By keeping a healthy smile, your overall health will benefit. And the time and expense to have excellent gum health is so little! Just minutes per day and twice a year visits to your dentist should help you enjoy all the benefits of a clean, fresh smile!

If you’ve fallen behind on dental visits or suspect you have gum disease, begin with a thorough examination by a Periodontist. A Periodontist specializes in gum health and is the expert in treating all levels of gum disease.

Signs of gum disease include sore or bleeding gums (including seeing blood in the sink when brushing), swollen gums, gums that turn red in color, persistent bad breath, pus pockets on gums, gums that recede from teeth, and teeth that eventually loosen.

Remember — gum disease is the leading cause of adult tooth loss. It will only worsen without treatment. Please see a periodontal specialist promptly if you’re experiencing any of these signs. Your entire body will benefit through your commitment to having health gums!

Call 828-274-9440.

Protect Your Teeth By Limiting Acidity

Posted on May 31, 2017 by William J. Claiborne, DDS MS

It is said that we are what we eat. When it comes to your smile, your teeth are a testament of that statement. What you eat and drink can leave teeth vulnerable to decay.

Many people are unaware of just how damaging certain foods and beverages can be to teeth. Some of the worst ones are listed below. Knowing in advance that these consumables can leave teeth and gums at higher risk for problems can help you take proactive and preventive measures.

• Citrus & Highly-acidic Foods & Beverages: The acidity in citrus (such as oranges, lemons, and grapefruit) can be tough on tooth enamel and tender gum tissues. This also includes tomatoes and tomato-based foods such as spaghetti sauce, catsup, salsa, etc. that can have a highly acidic effect.

• Sugar & Carbohydrates: Americans are the top nation for consuming sugar. We also love our carbs. Oral bacteria love these foods, too, because they are their ‘super food’ that boosts their ability to reproduce. Because many sweet and carb-laden foods stick to teeth longer, their ability to cause damage is even greater.

• Alcohol & Caffeine: Alcoholic and caffeinated beverages (including coffee, tea, colas, and many energy drinks) can be very drying to oral tissues. A dry mouth means less saliva flow. This depletes saliva’s ability to effectively rinse oral bacteria from the mouth. This provides oral bacteria with an environment to more-rapidly breed and thrive. Since bacteria accumulation is the origin of the majority of oral problems, this creates an especially risky state.

• Wine: Although wine is believed to be a healthy drink, it is the way it is consumed that makes it a particular problem for teeth and gums. Whenever you eat or drink something, an acid attack begins in the mouth. While this is an initial part of digestion, this acid is potent. So much so that it can soften tooth enamel for 20-30 minutes, which leaves teeth more susceptible to decay. Most people drink wine in sips over a period of time, drawing out this surge of acid. When wine’s acidity combines with digestive acids in the mouth, you place teeth at a doubly higher risk for decay.

• Between-Meal Snacking: As mentioned above, eating or drinking triggers an acid attack in the mouth. This means for every time you take a sip of cola or take a bite of a cookie, acid flows freely for 20-30 minutes. When the mouth endures these frequent acid attacks, the damage to precious tooth enamel will catch up to you in the form of cavities.

While I would never assume that people should forgo some indulgences, you can take proactive measures to prevent costly repairs, such as:

  –  Brush twice daily, floss every day and maintain regular dental check-ups: Thorough at-home oral care and regular dental check-ups can help you avoid problems from occurring in the first place.

  –  Delay brushing after eating or drinking: Wait 20-30 minutes to allow the acid attack in your mouth to subside. Remember, this acid can soften tooth enamel. The abrasiveness of a tooth brush or tooth paste can wear away precious tooth enamel.

  –  Swish with water: Enjoy a cup of coffee or glass of wine. Just remember to rotate these beverages with a glass of water, allowing it to wash over teeth before swallowing. Or, swish with water in the bathroom.

  –  Eat sweets only with meals: Rather than forgo a sweet indulgence as a snack, enjoy them as dessert following your meal since your mouth is already enduring an acid attack. This merely prolongs an acid attack rather than trigger a new one.

As a periodontal specialist, I see many patients who have lost their natural teeth. I believe many people are not aware of what creates a vulnerable smile. Knowing what leaves teeth and gums susceptible to problems can help you avoid the treatment time and expense required for dental repairs, or even tooth loss.

To achieve and maintain a confident, healthy smile, begin with a consultation. Call 828-274-9440 to schedule.