How Straight Teeth Support Oral Health & Dental Implant Success
Posted on Apr 19, 2021 by William J. Claiborne, DDS MS
As a Periodontist, I often work in conjunction with other dental specialists to provide an optimal outcome at the direction of the patient’s general dentist. By combining our specific skills, we are able to create a complete-care integration of services tailored to attend to unique or complex needs.
For example, as a specialist in the treatment of gum disease and placement of dental implants, my skills are beneficial for ideal outcomes as well as in long-term success. This is especially true when I note signs of bite misalignment in a dental implant patient.
The ‘bite’ refers to how the top row of teeth fit to the bottom row. These upper and lower teeth should “rest” together harmoniously. This fit has a great deal to do with a balanced alignment that is far reaching.
For instance, when teeth are not in proper alignment, there is an interference in the
Teeth worn down from grinding, or “bruxing”
interaction of biting, chewing and even speaking. This misalignment can strain the jaw joints as well as the muscles of the face, extending out to neck and shoulder muscles.
Bite misalignment is a common cause of temporomandibular joint (or TMJ) disorder. The TMJ are located on each side of the head and hinge the lower jaw to the skull. Continual stress on these joints can lead to an inflammation that triggers a series of problems.
In most cases, bite misalignment is what triggers night-time clenching and grinding. Known as bruxing, this action can result in chipped, broken and fractured teeth. Other symptoms associated with a misaligned bite – and thus, TMJ problems – include frequent headaches and migraines, ear ringing, dizziness and difficulty opening the mouth fully.
As an Asheville periodontist, I also see how bite misalignment can cause the gums to recede. This occurs as misaligned teeth tilt or turn, which causes an unnatural pulling on the gum tissues surrounding the tooth at its base. As more vulnerable sections of the tooth are exposed, the risks for developing cavities and gum disease increases.
When it comes to dental implants, success rates can be greatly compromised with the presence of clenching and grinding. Here’s why…
A dental implant is placed in the jaw bone, serving as a replacement tooth root. During the first 3 – 6 months, the bone grows around it, securing it firmly into the bone surrounding it. This process is known as osseo-integration.
It is during this time that an implant is most vulnerable to the forces that clenching and grinding exert. When you consider that implants require up to 6 months to become fully integrated into the bone structure, the stress from grinding or clenching can disrupt this process.
According to an analysis published in Dental Implants (Oct. 2015), and using data from ten publications, bruxers experienced a 6.45 failure rate (as compared to 3.65 in non-bruxers.(https://journals.lww.com/implantdent/fulltext/2015/10000/bruxism_and_dental_implants__a_meta_analysis.5.aspx)
My involvement helps to detect what is not always apparent, yet could have a tremendous impact for a successful outcome. Working to help dental implant patients avoid problems in the future is my goal and helps to protect the patient’s investment.
Certainly, misaligned teeth that are crowded or crooked tend to bunch up together. These teeth often form tight angles, creating hard-to-reach areas that make thorough toothbrushing more difficult. As oral bacteria remain, these areas become breeding grounds for an overload of bacteria that run rampant. This can lead to the formation of cavities and the development of gum disease.
The problem of misalignment can result in a vicious cycle: (1) greater risk for gum disease; (2) higher potential for TMJ disorder; (3) increased risk for tooth loss; (4) more likelihood for dental implant failure.
Consider that periodontal (gum) disease is the nation’s leading cause of adult tooth loss. Thus, a condition such as bruxing, which can lead to gum disease, can increase the potential for tooth loss. And, in replacing teeth, bruxing can continue to compromise tooth replacement success (with dental implants or other means, such as crown-&-bridge).
If you’re considering dental implants but suspect you clench or grind your teeth, we’ll discuss ways you can achieve your smile goals and protect your investment.
Call our Asheville periodontal dental office at 828-274-9440 to schedule a consultation.
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.
Understanding Dental Implants & Their Benefits
Posted on Nov 03, 2020 by William J. Claiborne, DDS MS
When you lose a natural tooth, even one that isn’t visible when you smile, its absence causes a reaction that takes place below the gum line. Many people are unaware of what occurs – at first. When it becomes obvious, it leads to problems that are not only bothersome, they are detrimental to your overall health.
The absence of a tooth root in the upper or lower jaw bone is a loss of stimulation the bone mass where it was once positioned. These roots provide stimulation and nourishment that enables the bone to maintain a healthy mass. Without the presence of tooth roots, the bone begins to “melt away.” The term for this process is known as resorption.
Resorption begins shortly after the tooth root is removed. Once it begins, it continues at an ever-increasing pace. For example, the first year after a tooth root is missing, the loss of bone may be minimal. With each passing year, the rate of loss accelerates.
As the bone shrinks in height, the natural tooth roots adjacent to the area of missing teeth are vulnerable to movement and root damage. On average, the teeth most likely to be lost are the ones next to areas of tooth loss.
For the support of remaining natural teeth, it’s important to replace missing teeth as soon as possible so adjacent teeth can retain their proper positions. It is even more important to replace missing teeth before bone loss begins. And, it’s HOW you replace them that’s most important.
Because dental implants replace the tooth above the gum line AND the root portion below it, the bone is able to retain its mass. Dental implants are designed to restore the look, feel and chewing stability like that of natural teeth.
As the advantages of dental implants become more familiar for natural tooth replacement, there are still some misconceptions among the general population. The following will hopefully clear up some of the confusion.
First, Dental Implants are a term that describes 3 components. The “implanted” portion is placed in your jaw bone where a tooth root was once held. The “implant” is not what holds the tooth. It serves to anchor an attached tooth (or bridge of two or more teeth).
Made from titanium, this metal bonds to living bone successfully. As a matter of fact, dental implants have one of the highest success rates of any implant-in-bone procedures.
The implanted portion becomes anchored in the jaw bone through a process known as ‘osseo-integration.’ Once the implant has been secured by the bone, a post is inserted into the center of the implant. This post is known as an abutment.
The replacement tooth (or teeth) is usually made of porcelain. This is the portion that you see and looks just like a natural tooth. This is known as a restoration or crown. It is attached securely to this post.
Porcelain is commonly used to create the restorations because they provide the most durable material possible and have the look and feel of a natural tooth. Porcelain has a luminosity of natural teeth and even reflects light as a natural tooth would. Porcelain is also very resistant to staining.
When missing more than one tooth in one area, an implant is not always necessary to replace each one. As mentioned prior, one implant can often hold two or a bridge of teeth. Several strategically-placed implants may also be used support a full arch of teeth.
When people can chew properly and eat a healthy diet, their overall health is better. And, without the fear of embarrassing slips or clicks (often associated with denture wear), being socially active can continue to be a positive part of a happy life.
Dental implants restore the ability to eat with stability, chew comfortably, laugh and speak with confidence. Dental implants do not decay and will never need root canals. And, with proper care, they’ll last your lifetime.
There are many types of implants, each designed to accommodate specific needs. Many dental implants are chosen and placed by a Periodontist. This is a dental specialist who has extensive and specialized training in the diagnosis and placement of all types of dental implants. He or she can select the one that will work best for you.
Proper placement and support in caring for implants is an important part of a successful outcome. Dental Implants CAN fail. This is why a periodontal specialist can be an asset to your investment.
If infection sets in and reaches the implanted portion, the implant may need to be removed so treatment can resolve the problem. Your periodontist can assess gum health prior to placement and monitor your healing process to help minimize this risk.
There are other threats to dental implant success. Clenching or grinding teeth can also contribute to implant failure. Smoking complicates and delays the healing process and is also a known contributor to implant failure. Again, a periodontist can oversee your care to optimize your ability to enjoy a lifetime of confident smiles.
Call 828-274-9440 to arrange a consultation. During this time, we can discuss treatment that can achieve your needs and goals as well as the process and anticipated costs. If dental fear is a concern, I’ll also explain sedation options. We offer both oral sedation and IV sedation, if a “twilight sleep” state is preferred. Here, you’ll find your comfort is always a priority.
Pregnancy & Your Gum Health
Posted on Jul 09, 2020 by William J. Claiborne, DDS MS
Today’s American female has a long list of guidelines that enhance the potential to have a healthy, full-term baby. Even so, pre-term births in this country occur at a rather high rate for the advanced health care available to most.
According to data released in 2017 by the National Center for Health Statistics (NCHS), the U.S. preterm birth rate actually rose from 2015 -2016, from 9.6 percent of births to 9.8 percent.
There seems to be a rather close connection between gum disease and preterm babies, as unrelated as the two may seem. First, consider the risks cited by the Centers for Disease Control & Prevention (CDC). As far back as the year 2000, the Surgeon General warned that pregnant females who had gum disease had a far greater risk of a pre-term, low birth weight baby.
Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and low birth weight babies (less than 5.5 lbs.).
“Studies have found that expectant mothers with periodontal disease are up to seven times more likely to deliver premature, low birth weight babies.” (https://www.adha.org/resources-docs/7228_Oral_Health_Total.pdf)
One study showed the preterm birth rate for pregnant women with moderate to severe periodontal disease to be nearly 29%.
Estimates are that over half of pregnant women have some form of gingivitis (gum inflammation, an early stage of gum disease) or periodontitis (infectious, advanced gum disease). Nearly a third of pregnant females will acquire gum disease because of their higher vulnerability to inflammation.
Infections in the mother have been identified as increasing the risk for pregnancy complications. Due to varying hormone levels, nearly all females will develop gingivitis during their pregnancy.
Referred to as pregnancy gingivitis, symptoms include swollen, tender gums that bleed easily when brushing. The goal is to halt the inflammation before it progresses to a more infectious stage.
Most obstetricians now urge their pregnant patients (or those trying to conceive) to have a thorough periodontal examination. Even with no obvious signs, gum disease can still exist. It lies beneath the surface of the gum tissues and should be resolved before it worsens and is able to seep into the bloodstream.
Symptoms of gum disease include gums that bleed when brushing, swollen or tender gums, receded gums or gums that darken in color.
When periodontal disease is present, successful treatment has shown to lower the risk of preterm births. A periodontal specialist is trained to treat all levels of disease in a way that is safe for pregnant women (as well as all patients).
Pregnancy is not the sole risk factor for developing gum disease, of course. Most adults of both genders have at least one factor that heightens susceptibility to this oral infection. Among these are stress, poor diet with high sugar intake, smoking, obesity, age, and poor dental hygiene can all contribute to an increased potential for developing periodontal disease.
Other risk factors include clinching or grinding teeth, predisposition due to genetics, diseases such as diabetes or cancer, some medications, and changes in female estrogen levels (puberty, pregnancy, menopause).
Gum disease bacteria is obviously a potent threat to any individual. As the nation’s leading cause of adult tooth loss, oral bacteria of this disease have been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.
If you have symptoms associated with gum disease, schedule an appointment at your earliest convenience by calling 828-274-9440. Gum disease will only worsen without treatment.