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.

Use Your ‘Sheltering In’ Time To Expand Dental Knowledge


Posted on Mar 25, 2020 by William J. Claiborne, DDS MS

Whether by requirement or feeling the need to reduce susceptibility to COVID-19, many people in the U.S. are “sheltering in.” I think of how this is likened to the term “hunker down” when hurricanes or tornadoes are present. However, “sheltering in” is requiring lengthy periods of being housebound.

Although that may seem depressing, people all over the world are getting rather creative at how they’re managing. With the internet, we are able to stay connected, share jokes and encouragement, and relay tips and important info to one another.

You may have seen music being performed on the balconies of homes in Italy and by policemen in the streets of Germany. People who are close to hospitals are applauding the caregivers as they enter and leave.

There are many uplifting things occurring in the midst of this trying time. I hope you are using your time positively and keeping your mind and body active. These will help you get through this time with greater resilience and a ready-to-go attitude once our country is getting back to normal.

In the meantime, I thought I’d share some terms used in dentistry you may find helpful once dental offices are back up and operating on a normal schedule. Some include:

• Perio – This is actually a shortened version of ‘periodontal,’ which describes the pink, soft tissues in the mouth. Your periodontal health relates to your gum tissues, primarily.

• Buccal – This is dental lingo that refers to the front sides of teeth or gum tissues on the side of the cheeks.

• Lingual – This term describes the sides of teeth facing the tongue. A way to remember this is to think of the tongue “lingering” in the mouth and the sides of teeth and tissues surrounding it.

• Prophy – A prophy is actually a dental cleaning, which is meant to support the gum tissues by removing plaque and tartar that has accumulated on teeth since your last cleaning. A prophy is recommended every six months to help manage this buildup. When too much tartar (or calculus) accumulate on teeth, it can cause inflammation that goes deeper into gum tissues. Once this inflammation is active, a prophy likely won’t remove the extent of the damage nor halt its progress. When this occurs, the typical recommendation is a…

• Scaling & Root Planing – This procedure is a deep cleaning that goes beneath the surface of gum tissues and teeth. This is typically performed while the gums are numbed. Because some areas are time-consuming to clean, scaling and root planing is often performed in…

• Quadrants – A ‘quad,’ if you remember your high school math lessons, is a fourth of something. In the mouth, your quadrants are the top right side of the mouth, top left, lower right and lower left. If you use one of the newer electronic toothbrushes, you may get a ‘beep’ when it’s time to move from one quadrant to another. This allows you to give sufficient attention to each quadrant in the mouth so you’re doing a thorough job at each brushing.

• Pits and Fissures – Natural teeth may seem smooth. From a dentist’s view, each tooth has a distinct surface. This is especially true for teeth with larger “tops.” The grooves in these teeth are ideal hiding spots for bacteria since a toothbrush has a more difficult time sweeping them away. This is why some people have sealants applied, especially children who are still learning good brushing techniques.

• Bruxing – Simply, bruxing is the grinding or clenching of teeth, typically during sleep. Although tooth grinding is often blamed on stress or anxiety, it can also occur when teeth are misaligned (crooked).

Although we try not to use terminology that is unfamiliar to patients, we occasionally slip. Hopefully, you will speak up and question these so you stay fully informed as you make decisions that are best for your smile.

While your schedule may be anything but ‘normal’ during this period, we hope you’ll stay committed to your routine of twice daily brushing, flossing daily, limiting sugar and snacking, and drinking plenty of water to keep the mouth moist.

We look forward to “life as we know it” soon! Let’s pray this is short-lived and our nation is restored to a healthy, active country – with even greater appreciation for these gifts!

Don’t Let Misaligned Teeth Lead To Tooth Loss.


Posted on Feb 25, 2019 by William J. Claiborne, DDS MS

As a periodontist, I have specialized skills in treating all stages of gum disease (known as periodontal disease, or simply “perio” by some). I also have advanced training in the diagnosis and placement of dental implants.

Although my specialty does not cover the advanced training an orthodontist has in bite alignment, my dental education absolutely covered the benefits of having proper “occlusion.” It also covered the repercussions of NOT having a bite that is properly balanced.

Just as an orthodontist can spot telltale signs of gum inflammation, I (along with general dentists and most dental specialists) can see indications of teeth that are not working in unison — even at times when these teeth appear to be “straight.”

While the nation’s number one cause of adult tooth loss is gum disease, having a misaligned bite function (or “malocclusion”) can lead to tooth loss in ways you may not have realized.

For example, during chewing, the upper teeth and lower teeth are designed to work harmoniously together to grind food down for swallowing and digesting. When an upper tooth does not interact smoothly with one below it (or vice versa), a tooth can become chipped, broken or fractured.

When damage to a tooth occurs, it must be quickly repaired before oral bacteria can penetrate tooth structures. Without the protection of enamel, oral bacteria can cause tooth decay and gum disease.

A fracture in a tooth can expand over time, leading to a crack that loosens an entire segment of a tooth. These areas must also be repaired before the tooth is subjected to oral bacteria. This typically requires a crown (or “cap”) that is placed over the top portion of the tooth.

However, a crack in a tooth that extends into the gum tissues typically means the tooth must be removed. If a portion of the tooth breaks “just below” the gum tissue, the tooth can sometimes be saved by a procedure we do called a “crown lengthening.” This is often known as a gingivectomy and is performed to remove excess gum tissues.

A gingivectomy procedure exposes more of the natural tooth so a crown can be placed over the tooth to preserve its remaining structure. (For people who have a “gummy smile,” this is performed, also, to reduce the amount of gum tissue that arches over teeth most visible in a smile.)

Another hazard of bite misalignment relates to dental implants. The overall success rate of dental implants is very high, nearly 98 percent by some estimates (when properly selected, placed and maintained). However, when a newly-placed implant is subjected to the grinding forces of TMJ disorders, its risks for success are much lower.

People are often surprised to learn that they clench and/or grind their teeth at night – primarily due to bite misalignment. When a bite is “off,” the jaw joints can become strained and inflamed. During sleep, the upper and lower jaws go on a subconscious quest of sorts, searching to find a comfortable position that eliminates the strain.

The forces behind some clenching are enough to crack open a walnut. Imagine a newly placed implant that is dependent upon the jaw bones to “heal” it into this firm foundation. When the area of bone around an implant is subjected to night after night of disruption, the implant is against the odds of becoming fully embedded in supporting bone.

Here’s an example: Let’s say you use a screwdriver to firmly anchor a screw into a solid block of wood. However, every day, you use a pair of pliers to grasp the screw head and wriggle it back and forth. Obviously, it wouldn’t take long for the wood surrounding the length of the screw to wear down from the friction of the screw’s motion, even slight as it may seem. Eventually, the screw could be easily moved back and forth and would no longer serve as a dependable base of support.

It’s not unusual for more than one dental specialist to work with another to provide a patient with the combined skills needed in particular cases. I frequently work with other dental specialists and general dentists in a “team treatment” capacity in order to give patients optimal outcomes.

When we place an implant, our goal is for each patient to enjoy its benefits for the remainder of their life. Bite misalignment can jeopardize this. And, if you have all your natural teeth now, be sure to protect them by keeping your gums healthy and ensuring your bite is as well.

After all, every dental professional is on your team when it comes to enjoying confident smiles for a lifetime!

If you’ve noticed indications of gum disease (tender gums that bleed when brushing, for example) or have experienced tooth loss (or fear you are facing it), take charge of your smile now. Call 828-274-9440 to schedule a thorough examination.

Ways To Have A Successful Outcome With Dental Implants


Posted on Jul 16, 2018 by William J. Claiborne, DDS MS

For many individuals who wish to replace one or more missing teeth, dental implants have become the leading preference. Dental implants restore the look, feel, and function like that of natural teeth. They also help to prevent bone shrinkage that occurs when tooth roots are no longer present in the jaw bone.

A periodontist has advanced training in the diagnosis and placement of dental implants. He or she can help you enjoy a higher potential for dental implant treatment that lasts your lifetime. There are a number of reasons you should strongly consider having a periodontal specialist involved in your treatment.

SELECTION OF IMPLANTS – Dental implants come in a wide array of shapes and sizes. Each system is designed to accommodate certain needs and preferences. For example, some implants are designed to support a full arch of teeth while others can be placed in areas where a great deal of bone loss has occurred. The selection of the implant type that is appropriate for your needs and goals requires a unique understanding of all implant types. That is, a periodontist can select the type that will work best for you rather than go with the one or two in which they have received training.

PLACEMENT OF IMPLANTS – In addition to selecting the best type for your needs, proper placement of implants has a great deal to do with having a successful outcome. When an implant that is too long, for instance, is placed in bone that is too shallow, it can have future repercussions that may require its removal. This could occur when a lower implant is placed too close to a nerve that runs horizontal through the jaw bone (mandible). Or, when an upper implant is placed in shallow bone, it can work its way into the sinus cavity. A periodontal specialist considers intricate factors that can effect your potential for success.

STRUCTURAL ISSUES – In addition to the factors involved with bone loss, other issues can ‘make or break’ having a successful treatment outcome with dental implants. For example, for people who have bite misalignment or TMJ disorders, they may be grinding or clenching their teeth during sleep – often unknowingly. Telltale signs of ‘bruxing’ including remaining, natural teeth that are chipped or worn. These forces have been measured to that enough to crack a walnut! When dental implants endure these forces, especially during their ‘healing’ phase, there is greater risk for implant failure. A periodontist considers these issues prior to your treatment, helping you to bypass problems that can result in eventual removal.

INDIVIDUALIZED TREATMENT CONSIDERATIONS – Our goal is to help you get the most from your dental implants. When there are individual habits or preferences that can complicate success, we work with each patient to help them enjoy their dental implants for a lifetime. For smokers, we advise ways to support saliva flow and minimize oral bacteria levels. For people who take certain medications that can interfere with oral moisture, we recommend methods to keep the mouth properly hydrated. And so on. We want to make sure your care is individualized so your potential for implant success is high!

Unfortunately, I have seen a number of patients over the years who have had implants that were improperly placed or chosen. It is a significant loss for the patient when they have to have these implants removed and start all over. Like any procedure, you want your treatment time and investment to be successful and a pleasant experience. We do, too!

If you’ve considered dental implants to replace missing teeth, let’s discuss how a periodontal dental office can enhance your potential to enjoy confident smiles and chewing comfort for your lifetime! Call 828-274-9440 to schedule an appointment.

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