Sores In The Mouth

Posted on Nov 03, 2016 by William J. Claiborne, DDS MS

Tis the season! Not only is it cold season, it’s a stressful time of year. This means your likelihood of getting a cold or canker sore increases.

They are often confused, however. The difference is…

Canker Sores
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.

Cold Sores
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.

However, any change to oral tissue that does not heal within 14 days should be examined without 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.

The survival rate is one of the worst of all cancers. Of those who acquire oral cancer, only 57% are estimated to be living 5 years from now. The death rate is higher than cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, thyroid cancer, or skin cancer (malignant melanoma).

The death rate for these cancers has seen a slight decrease since 1980. Unfortunately, some symptoms do not emerge until the cancer has reached an advanced stage because symptoms can mimic a bite on the inside of your cheek.

Because tissue changes in your mouth are normal, ignoring symptoms can prove deadly. The most common are:

• 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

Although new cases have been dropping over the past few decades, a recent rise has been seen in throat cancers related to HPV (human papilloma virus) in white males under age 50. The average age of most people diagnosed with these cancers is 62, but about a third occur in patients younger than 55.

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. However, you should 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 828-274-9440 immediately for an appointment.

Men & Oral Well-Being

Posted on Oct 26, 2016 by William J. Claiborne, DDS MS

As a male, I’ve accepted the fact that there are certain things men don’t do as well as women. Actually, there is probably a long list! And, while some things like being slack when it comes to vacuuming and making the bed can be chalked up to ‘guys being guys,’ I know that other things are far more important; one of these being taking care of our oral hygiene.

Studies have shown that men, in general, are not doing a very good job when it comes to taking care of their mouths. It seems that men are less regular when it comes to caring for their oral health, less likely to have regular check-ups and neglect their oral health more often. Men are also less likely to visit the dentist when a problem does occur and tend to go only to resolve pain.

Males also brush their teeth less than twice a day, according to statistics. This leaves them means more likely to develop periodontal (gum) disease. On average, men will lose more than 5 teeth by the age of 72. Those who smoke will lose an average of 12 teeth by that age.

And, for men who wear a partial denture, they can expect higher levels of oral bacterial, which leads to greater challenges when it comes to preventing further tooth loss. This is because the material of a denture or partial that mimics the gums is porous. This provides a warm, dark and moist environment that is a perfect breeding ground for oral bacteria.

While many denture and partial wearers soak their appliance overnight, this merely delays the growth of oral bacteria, not halt it. The rapid reproduction of bacteria revs back up as soon as the appliance is back in a mouth that is already bacteria-laden.

For men with exposed tooth roots, this creates a higher risk for cavities. Aging, over-zealous brushing and a misaligned bite can cause gum tissue to pull away from teeth. Over time, the darker, more sensitive portions of the tooth are exposed. This area is actually  the root section of the tooth. While this detracts from the appearance of your smile, it also exposes a portion of the tooth that is more susceptible to bacteria. This can increase the risk for cavities.

Regardless of gender, adults who are on medications that have a drying effect on the mouth are more apt to have gum disease and cavities. Saliva removes oral bacteria and helps to reduce bacteria accumulation. When salivary flow is inadequate to keep the mouth well-rinsed, the risk for cavities increases. Dry mouth also increases your potential for bad breath.

Genetics on its own can leave both men and women more susceptible to the problems associated with oral bacteria. While all people have bacteria in their bodies, two kinds (referred to as SM and LB) are especially harmful to teeth. Those who have higher levels have a naturally greater risk for tooth decay.

It is important to maintain a good oral hygiene routine, whether male or female. At home, brush with a fluoride toothpaste twice daily, floss daily and be committed to your 6-month cleanings to avoid problems and catch those that arise early.

We want to help you avoid problems, which will save you time and money and help you avoid a life in dentures. Call (828) 274-9440 to schedule a consultation to begin.

Your Smile Is What You Eat

Posted on Oct 11, 2016 by William J. Claiborne, DDS MS

We are in a smile-risky time of year. October brings Halloween and its onslaught of sugar. November is filled with sweet and carbohydrate yummies like pecan pie and stuffing with gravy. December surrounds you with candy canes, sweet gifts from the kitchen and frequent nibbling at social gatherings.

Enjoying this time of year with friends and family is a healthy part of being socially active. However, some of these indulgences can put you at a higher risk for problems they can cause your smile.

Before you pop that piece of fudge into your mouth (even if it is Aunt Betty’s secret recipe!), be aware that some foods have greater potential to damage teeth and increase your risk for gum disease. These include:

• Wine: While wine is said to be good for you, how it is consumed creates a particular problem when it comes to your smile. Anytime you eat or drink, your mouth experiences an acid attack, a normal part of the digestive process. However, this acid is so potent that it can soften tooth enamel, leaving teeth vulnerable to decay. As most people do, sipping wine over a period of time simply draws out this acid bath. Add to that the acidity of wine and your smile gets a one-two punch for a higher risk of decay.

• Citrus & acidic foods and beverages: The acidity in citrus (oranges, lemons, grapefruit, etc.) can erode tooth enamel, leaving them more susceptible to decay. And, it’s not just tart-tasting fruits that have this risk. Foods with vinegar (pickles, salad dressings, etc.) and tomatoes or tomato-based foods (red pasta sauce, catsup, etc.) have an acidic effect on tooth enamel that heightens the risk of decay.

• Sugar & Carbs: The American population over-indulges in sweets and carbohydrates to an often unhealthy extent. Just look at the obesity rate in the U.S. (nearly 36% of adults) and it’s pretty clear this isn’t occurring from eating green beans and grilled fish. The problem for your smile is how oral bacteria are super-charged by these foods, boosting their ability to reproduce. And, since many of these foods stick to teeth longer, the potential for damage is much higher.

• Caffeine: Caffeine has a drying effect on oral tissues. A dry mouth means less saliva flow, which gives oral bacteria less opportunity to be rinsed from the mouth efficiently. This provides an environment where bacteria can breed and thrive. Caffeinated beverages include coffee, tea, colas, and many energy drinks. While not caffeinated, alcoholic beverages are also drying to oral tissues. Remember, oral bacteria is the source of the majority of problems in the mouth. The next time you feel your mouth is dry and your breath is bad (common companions), it’s because oral bacteria are running rampant.

• Snacking: As mentioned above, every time you eat or drink, an acid attack begins in the mouth. This means that when you sip your soda or nibble on a cookie, an acid attack occurs. When your mouth is experiencing frequent acid attacks during the day, it’s easy to see why the damage can place such high risks to tooth enamel and gum tissues.

Of course, I would never advise you to skip a glass of wine at a fun cocktail party or deny yourself a piece of Aunt Betty’s fudge. However, now that you know the foods that are most harmful to your smile and why, let a little voice in the back of your mind remind you, “Your smile is at risk.” This may help you to alter your choices so you can avoid costly and time-consuming repairs.

As you indulge during the holiday season, here are a few ways to lessen the impact of damaging foods and beverages:

   –  Don’t rush to brush: After eating or drinking, wait 20-30 minutes before brushing. This allows the acid attack in your mouth to subside so abrasion from your tooth brush or tooth paste won’t wear down tooth enamel.

   –  Rinse with water: After a cola or glass of wine, drink some water and let it wash over teeth before swallowing. Even better, swish with water in the bathroom.

   –  Combine sweets with meals: Rather than eat caramel popcorn or a pumpkin pie slice as a snack, indulge in these as dessert following your meal. Since your meal has already created an acid attack in your mouth, these yummies only prolong it a bit rather than trigger a new one.

   –  Brush, floss and have regular dental check-ups: Daily home care coupled with regular dental cleanings and exams are your best ways to prevent problems or to catch small ones before they require major repairs.

This holiday season, use these tips to save the time and money you may have needed for dental repairs. These will help you to maintain a confident, healthy smile that follows you far beyond this special time of year.

Oil Pulling – Beneficial Or Bunk?

Posted on Oct 06, 2016 by William J. Claiborne, DDS MS

Occasionally, I am asked about the recent fad of oil pulling. The internet is full of followers of this practice who claim it pulls bacteria and toxins from the body.

Oil pulling is an ancient folk remedy that involves holding a tablespoon of coconut oil in the mouth for 5-15 minutes. It is swished around during this time and spit out at the end of the oil pulling period.

This action is supposed to draw impurities from the mouth. In most situations, coconut oil is used for this purpose but oils such as sesame, olive and palm may also be used.

Those who adhere to Ayurvedic health practices (an ancient, holistic medicine) claim this balances the body’s doshas, which are the energies that affect one’s physical, physiologic and mental state as well as their susceptibility to disease. However, most who practice oil pulling do so for its so-called oral health benefits.

Oil pulling to improve dental health is said to improve gum problems, remove plaque and whiten teeth. However, claims on the internet are not always reliable and what is in the best interest of your oral health deserves careful scrutiny.

Research has found that oil pulling has not lived up to some claims. For example, one study compared oil pulling to mouthwash as a method to reduce bad breath and oral bacteria. Findings showed that oil pulling was no more effective than mouthwashes that contain chlorhexidine, a common ingredient.

While research did not refute that there were some advantages to oil pulling, the American Dental Association (ADA) cites a “lack of science” and does not recommend oil pulling as either a supplement to oral hygiene nor as a replacement for standard oral health treatments.

The ADA is also keeping a watchful eye over claims in research being conducted, citing that some past studies have been inadequate to support claims of oil pulling. They feel that results have been based on too small samplings, not adjusting for demographic variations and failure to incorporate blind testing.

Additionally, the ADA stated, “scientific studies have not provided the necessary clinical evidence to demonstrate that oil pulling reduces the incidence of dental caries, whitens teeth or improves oral health and well-being.”

The leading concern in the dental profession is that it has prompted some people to rely on oil pulling to fully replace standard oral care practices. Twice daily brushing and daily flossing have proven to be safe and effective methods of achieving and maintaining good dental health. Substituting this routine for oil pulling is an uncertain way to prevent cavities and periodontal (gum) disease.

As a periodontal specialist, I don’t see oil pulling as detrimental when it is an addition to a proper oral hygiene regimen at home. However, I am troubled by unsubstantiated claims that inspire people to alter time-tested methods for maintaining a healthy mouth.

Some people may remember when baking soda was touted as a powerful cleaning substance for brushing teeth. Yet, those who abided by the practice worn down healthy gum tissues and wore away protective tooth enamel. This set them up for easy penetration of oral bacteria that resulted in cavities and gum disease.

While oil pulling likely won’t do harm, it is probably best done in conjunction with a thorough brush-&-floss routine.