Simple Ways To Keep A Healthy Smile Throughout The Coming Year


Posted on Dec 27, 2022 by William J. Claiborne, DDS MS

With a new year just ahead, I wanted to remind the smiles in our beautiful Western NC area about ways to have and keep a healthy one!

Nearly every problem that begins in the mouth is due to bacterial overload. Our mouths are constantly being supplied with sustenance for these organisms. Bacteria are able to thrive through the food that enters, especially sugars, and other bacteria-laden items put into the mouth. As bacteria thrive, they are able to reproduce very rapidly.

Insufficient care can lead to a build-up of bacteria, known as plaque. Plaque is a sticky film that forms on teeth when oral bacteria are not removed on a regular basis. In just 48 hours, plaque can harden into a mass that attaches to the base of teeth.

This hardened form of bacteria is known as tartar or calculus. Unlike plaque, tartar cannot be brushed or flossed away. And, once formed, it will continue to amass further.

As oral bacteria reproduce and accumulate, tooth enamel is attacked. The tight seal of gum tissues that surround the base of teeth become inflamed and loosen. This allows for the penetration of running-wild bacteria beneath the gum line. Once this infectious bacteria reaches this point, dental treatment (often ‘planing and root scaling’) is necessary to halt its continued development and restore healthy gums.

If untreated, the stages of gum disease worsen. Eventually, the infectious bacteria of gum disease are able to enter the bloodstream through weakened oral tissues.

Periodontal (gum) disease symptoms include sore gums that bleed when brushing, frequent bad breath, gums that pull away from the base around teeth, and gums that darken in color. As it worsens, pus pockets may form on the gums at the base of some teeth. In advanced stages, gum disease causes teeth to loosen and eventually require removal.

Gum disease often progresses because people are unaware that bleeding or receding gums is actually a symptom. Insufficient brushing, failing to floss and not having regular dental cleanings form a path that begin the process.

Gum disease is an inflammation that attacks teeth, oral tissues and the bone structures that support tooth roots. As the gums pull away from the teeth, darker portions of the tooth are exposed. These are tooth roots sections, now exposed without the protective layer of gum tissue over these areas, leaving teeth vulnerable to bacterial attack.

While the darkersegments of teeth detract from the appearance of a smile, they are also highly sensitive. Drinking hot coffee, eating ice cream or brushing across these areas can send a quick jolt of pain. In addition to periodontal disease, common causes for gum recession can include:

• Rigorous tooth brushing: Using a tooth brush with hard bristles or being too zealous when brushing can wear down enamel as well as gum tissue. Also, abrasive substances such as baking soda are too gritty for teeth and can wear down gum tissues.
• Smoking: A dry mouth is when saliva flow is insufficient to effectively wash bacteria from the mouth. The chemicals in tobacco are terribly drying to oral tissues, which creates an ideal environment for the formation of plaque. Plaque is a build up of oral bacteria that destroys gum tissue and contributes to recession.
• Grinding & clenching teeth: When you clench or grind your teeth during sleep, the force that is placed on teeth can be so strong that they begin to tilt out of  position. As this continues, the gums eventually pull away from teeth.
• Hormonal changes: Pregnancy, menopause and puberty can cause changes in hormone levels. These hormonal fluctuations can cause gums to feel tender and be more vulnerable to recession.
• Misaligned teeth: When not properly aligned, teeth endure added force to bite and chew. This can also place added strain to the TMJ (jaw joints), gums and bone that supports tooth roots. This can lead to gum recession.

To avoid the expense and treatment time of gum disease, commit now to thorough oral hygiene and regular dental check-ups and cleanings. Your at-home oral hygiene regimen should include:
– Twice daily brushing with a soft bristle tooth brush and use a fluoridated tooth paste. Brush for at least two minutes each time. Floss daily. Be sure not to pop the floss between teeth to avoid damaging tender gums. Move the floss in a back-&-forth motion between teeth to ease it down so you can scrape the sides of each tooth.
– Use a tongue scrapper daily or brush your tongue with your tooth brush at the end of each brushing. This helps to dislodge bacteria that is embedded in the grooves of the tongue.
– Keep the mouth moist by drinking plenty of water during the day. This will help keep saliva flow at ample levels. Saliva is designed to move oral bacteria from the mouth on a consistent basis. Avoid foods and beverages that are drying to oral tissues such as caffeine, alcohol, and spicy foods. Also, try to minimize the amount of sugar and carbohydrates you consume. These foods amplify the reproduction of oral bacteria.
– Smokers should consider using an oral rinse that replenishes moisture in the mouth. The chemicals in cigarette smoke are very drying to oral tissues. Some oral rinses are specifically designed to replenish oral moisture.

A periodontist is a dentist who has specialized skills in the diagnosis and treatment of all levels of periodontal disease. This specialist can also recontour the shape of gums and place dental implants for optimal results.

In our Asheville periodontal dental office, we feature some of the most advanced technology in dentistry, much of which is not available in other dental offices elsewhere in the Western Carolina region. These features are designed to help maximize comfort, shorten treatment time, speed healing and pinpoint areas of need for the most conservative treatment possible.

If you have not seen a dentist on a regular basis, you may be experiencing symptoms that indicate gum disease. As you would respond to a warning sign with your overall health, so should you with your oral health.

Begin with a thorough periodontal examination to determine what your needs are and the best way to achieve and maintain good oral health. You’ll be supporting your overall health in addition to having a confident smile.

If dental fear or anxiety have prevented you from regular dental care, ask about sedation options. We offer both oral sedation and IV sedation (twilight sleep). Both are safely administered and you are closely monitored by medical personnel who use advanced safety equipment throughout treatment.

Call 828-274-9440 for more information or to schedule an exam appointment.
 

Dental Implants – Lower Risks Of Failure With These Tips


Posted on Apr 21, 2022 by William J. Claiborne, DDS MS

In our Asheville periodontal dental office, we believe our patients appreciate being fully informed about their oral health status and understanding their options for treatment. For those who have lost natural teeth, our specialty dental services include the diagnosis and placement of dental implants.

The specialized skills of a periodontist provides implant patients with a high level of success in treatment outcome. It also offers patients a wider variety of choices when it comes to implant systems.

This is why many general dentists who offer dental implants refer the placement portion to a periodontal specialist. For their patient, this can mean a higher level of success, especially for complex needs.

For example, a patient who is missing a lot of bone mass (often due to missing natural teeth for many years) benefits from the specialized skills of our Asheville periodontal office. Another example is a patient who has lost teeth due to periodontal (gum) disease. Because a periodontist combines advanced skills in treating gum disease as well as in dental implants, these patients are given a ‘leg up’ when it comes to treatment success.

In making your decision to opt for dental implants vs. crown-&-bridge, dentures or partials, it is important to understand the basics of how dental implants work. Although there are different types of implant systems, all work in in a similar fashion.

An implant is similar to a screw-like cylinder that is hollowed out in the center. This segment is what is placed into the bone to serve as a tooth root replacement.

Selecting the most appropriate type of implant and how many are needed is based on specific needs and goals. Our Western NC periodontal office plans for your placement procedure using computerized technology to determine the precise angles and depths for each implant before the placement procedure begins. This minimizes disruption to the gum tissues and bone structures, which in turn reduces healing time and optimizes comfort.

Once placed, each implant is covered over with gum tissue. For several months after, the implant goes through a process known as “osseo-integration.” During this phase, the bone grows around the implant, securing it into the bone. This recreates the foundation of natural tooth roots to give biting and chewing stability. Throughout this time, you can wear a denture or temporary so you are never without teeth.

Once healing is complete, a post is secured inside the hollow core of the implant. This post (or “abutment”) will support your final replacement tooth or teeth.

An important aspect of implant success also relies on the proper assessment of bone mass. When the upper or lower jaw has insufficient bone to support the implant being placed, there is a risk of failure.

Again, an implant requires careful selection and placement to be able to support the replacement teeth being attached. In some cases, as few as 4 – 6 implants can support a complete arch of teeth. This decision is best left in the hands of a periodontal specialist.

Severe bone loss can require bone rebuilding procedures prior to implant placement. This can be done by bone grafting or the application of a bone-rebuilding material. In some cases, dental implant systems designed with unique angles (such as the “All On 4”) can support a fulll arch of upper or lower teeth using minimal bone depth with no bone rebuilding necessary.

Another perk of the All On 4 is the forces of chewing and biting require only 4 implants on the upper and/or lower. Because implant costs are largely based on the number of implants placed, this can be a great savings for people who are candidates.

Why does successful placement rely so greatly on assessing bone mass? An implant must be placed in adequate bone that does not risk interfering with adjacent structures.

Without proper placement in sufficient bone, an implant risks coming in contact with a nerve that extends horizontally through the lower jaw. Upper implants placed too close to the sinus cavity can, over time, penetrate that area. Removing an implant in either of these situations, of course, is no simple task.

The ability to select the proper implant type for available bone depth is equally important.

Dental implant diagnosis and placement skills can vary greatly from one dentist to another. While some have taken extensive courses in implant dentistry, others may have taken a weekend course here and there. These are typically ‘hosted’ by a particular manufacturer who provides ‘training’ in a limited selection of implant types. In turn, this can limit the patient’s choices when relying on appropriate recommendations for his or her unique needs.

Obviously, a qualified doctor can enhance your potential for a successful outcome, which is where a periodontal specialist is a wise choice. A Periodontist has particular expertise in the diagnosis and placement of all types of Dental Implants. As a matter of fact, many general dentists prefer to have a Periodontist place implants in their patients. The patient then returns to their dentist for the attachment of teeth to the implants.

Rest assured – in our office, comfort is always a priority. For our patients, we offer oral or I.V sedation to accompany many procedures. While both are beneficial to calm anxiety, tension, stress or even intense feelings of fear, each has its advantages as well as limitations.

Oral sedation is in pill form and provides a fully relaxed state. It often erases most memory of the procedure after and has a quick recovery.

While oral sedation provides a very relaxed state, I.V. sedation puts you in a complete sleep state. This is sometimes referred to as “twilight sleep.”  I.V. sedation is ideal for people with dental fear or phobia. This sedation is delivered through an I.V. drip, or intravenously. It takes effect rather quickly and patients nod off within minutes. This sedative erases memory of treatment afterward.

Whether given oral or I.V. sedation, comfort and safety are important to us at all times. And, while sedation is helpful when fear or anxiety exist, some people who have no fears at all request sedation for its ability to relax them during lengthy appointments.

While the doctor involved in your treatment is important, much of the potential for a successful result falls into the patient’s hands after the placement process. As a patient, having a successful outcome begins as soon as your implants are placed.

First, closely follow your post-placement instructions. For a few days following placement, most patients are advised to eat only cool, soft foods. This helps to minimize swelling and bleeding, which helps gum tissues to more quickly seal incision sites. This can lower your risk for infection.

Once home, other factors can also place your implants at risk. For example, smokers have a higher risk for implant failure. Because the chemicals in cigarette smoke are very drying to oral tissues, the healing process takes longer. Delayed healing creates a greater risk for infection to occur.

An element of risk that may surprise you is grinding or clenching teeth during sleep, which is typically a symptom of a misaligned bite. Some clenching is so intense the force can be likened to that used to crack a walnut. A sign of night-time clenching or grinding may be worn, chipped or broken teeth. However, even without signs, if you suspect you grind or clench, mention this to your implant dentist prior to treatment. This way, proactive measures can be taken to resolve the problem before complications result.

Most important of all is the patient’s commitment to maintaining good oral hygiene. Although Dental Implants themselves do not experience decay, the gum tissues and bone supporting the implants are as susceptible to oral bacteria as before. When oral bacteria infection (gum disease) penetrates to the implant site positions, the only way to treat the infection may require removing the implant.

In addition to being highly committed to your oral hygiene at home, your dental check-ups may be scheduled for every four months rather than twice a year. During these visits, a hygienist will remove accumulated oral bacteria to reduce risk to your Dental Implants. The condition of your gums will also be assessed.

Dental implants are designed to last a lifetime and are the closest thing to the natural teeth you once had. Too, the restored ability to bite, chew, speak and laugh without worry can be a tremendous boost to one’s self-esteem and self-confidence.

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.

 

 

 

 

Cracked & Broken Teeth A ‘Sign of the Times’


Posted on Jan 06, 2022 by William J. Claiborne, DDS MS

As a periodontist in Asheville NC for over 25 years, I’ve seen my fair share of teeth that have been removed or need removal. Most of these teeth, based on national statistics, are lost due to damage caused by periodontal (gum) disease.

Yet, in more recent years, I’m seeing people lose teeth due to broken or fractured teeth.

In my dental specialty, I have advanced skills in the treatment of gum disease as well as in the diagnosis and placement of dental implants. As the ideal option in tooth replacement, dental implants restore the stability and dependability of natural teeth.

So, it stands to reason that a lost tooth is best replaced by a dental implant. But, why are more and more individuals losing teeth due to fractured, cracked or split teeth?

It’s becoming more common to hear that dentists are treating more cracked teeth since the beginning of the pandemic. A recent survey shared by the American Dental Association (ADA) reported that over 70 percent of dentists surveyed (nearly 2300) saw an increase in patients who had experienced night-time clenching and grinding of teeth, or ‘bruxing’. These problems have typically been the result of bite misalignment, which interferes with the harmonious congruity of upper and lower teeth while eating or speaking.

https://www.ada.org/about/press-releases/2021-archives/new-survey-finds-stress-related-dental-conditions-continue-to-increase

When a tooth breaks or fractures below the gum line, it requires removal (in most cases) since the above-the-gum structure is generally insufficient to support a crown. As a periodontist, another area of the periodontal specialty is crown lengthening.

This procedure is often performed prior to the placement of crowns to correct the height of the gum arch that borders teeth. This is especially common for patients who have a ‘gummy smile,’ or too much gum area visible above upper teeth when in a full smile.

However, in cases where a tooth breaks, crown lengthening is sometimes performed to alter the surrounding gum tissues and expose enough tooth structure to support a crown. The benefit of this is the patient is able to avoid having the tooth removed and endure the many decisions (and costs) involved to replace it.

Pandemic stress, quarantine fatigue, mask burnout, a succession of variants, less social involvement, and general stress overload has become a global problem. Although stress is experienced by different people in different ways, it is not uncommon for it to be revealed through dental issues.

Many people hold stress and tension in their jaw muscles and jaw joints. This is why, during relaxation phases in a yoga class, it’s common for the instructor to encourage participants to relax their jaw muscles. Since the onset of the COVID-19 pandemic, stress is causing an unusually higher rate of oral health problems.

Based on the ADA survey, about 60 percent of responding dentists shared an increase in patients who clearly cite stress as the culprit for tooth damage. Thus, dentists have seen significant increases (up 63 percent) in chipped teeth, and about the same percentage of increases for cracked teeth and temporomandibular joint (TMJ) disorder symptoms, which includes headaches and jaw pain.

If you are experiencing problems regarding stress held in the jaw joints, here are a few tips that may help lessen the load:

• Walk away from the computer an hour before bedtime.
• Relax with a warm shower or play soothing music.
• Relax your jaw joints by putting your lips together, teeth apart, and resting your tongue behind front teeth or the roof of the mouth.
• Ask your dentist about a custom-designed night guard to protect your teeth from night-time clenching or grinding.

If the worst has occurred – losing a natural tooth – the best way to replace it is with a dental implant.

Dental implants recreate stimulation to the jaw bone, thereby halting the pace of bone loss. When bone mass is maintained, neighboring teeth have a reduced risk for being lost as well. Because dental implants are held in the jaw bone, they are also able to restore a natural biting strength with dependable stability.

There are many advantages to having dental implants, including the longevity. When dental implants are properly selected, placed and maintained, they should last your lifetime. This is why it’s so important to have your implant treatment through a Periodontist.

A periodontal specialist has advanced training and skills in the diagnosis and placement of all types of dental implants. He or she can enhance your ability to enjoy this superior tooth replacement option for a lifetime of confident, healthy smiles.

In our beautiful Asheville periodontal dental office, we offer the most advanced technology in dentistry. Additionally, oral and IV sedation (‘twilight sleep’) are also available for optimal patient comfort.

To learn more, call 828-274-9440. If preferred, you can begin with a consultation appointment. New patients are always welcome and a referral is not needed.

 

Mouth Sores – What Is Harmless & What To Watch Closely


Posted on Nov 04, 2021 by William J. Claiborne, DDS MS

As the holiday season approaches, our risk for illness goes up. Our chances for picking up colds or the flu increases, which is worrisome on its own. Add that to already-high concerns surrounding exposure to COVID, and we’re all taking added precautions to protect our health.

As in any year, colder months mean we’re more confined to the indoors and in closer proximity to others. With heightened potential for illness, the holidays simply create more stress to our lives. Stress is a contributor to our health as it compromises the immune system. This, in turn, lowers our resistance to fight off illness.

After the holiday mingling constraints endured in 2020, people are trying to take added precautions in 2021 so our “togetherness” is not overshadowed with worries about exposure to illness. To bolster our resistance, many people have had their Covid booster and flu vaccines, practice frequent hand washing, take vitamin supplements such as C, and are trying to stay active physically inside and out-of-doors.

Certainly, we applaud the health safety efforts taken by our Northwest NC population. As an Asheville periodontist, just a added tip for your overall health and well-being: Don’t forget to monitor the inside of your mouth while being committed to the other health measures you’re taking. You may be surprised at what your mouth reveals.

In busy times of year like the holiday season, we see a greater number of individuals who develop canker and cold sores.  As stress goes up, your likelihood of getting a cold or canker sore increases as well.

The difference between Canker and Cold sores is:

Canker Sores
These are small ulcers that typically have a white or gray base and red border. Unlike cold sores, canker sores appear inside the mouth and are not contagious. The exact cause of canker sores is uncertain but fatigue, stress or allergies can increase the likelihood of a canker sore. Some experts suspect immune system problems, bacteria or viruses can also spurn eruption. A cut caused by biting the tongue or inside of the cheek as well as hot foods or beverages may contribute to canker sore development. Canker sores usually heal on their own in a week or two. Over-the-counter topical anesthetics, steroid preparations,  and antimicrobial mouth rinses can provide temporary relief. As a holistic method, you may try swishing with plain, sugar-free yogurt for a minute or so. This helps to restore a healthy bacteria balance in the mouth while soothing discomfort.

Cold Sores
These are also referred to as fever blisters or Herpes simplex and are located around the lips, under the nose or on the chin. Caused by herpes virus type 1, cold sores are very contagious. These are clusters of fluid-filled blisters that often erupt since are they are most commonly found around the edge of the lips. Cold sores are Herpes lesions that may follow a fever, sunburn, skin abrasions or emotional upset. Because cold sore blisters are on the outside of the mouth, they can be embarrassing and uncomfortable. Although they usually heal in a week, over-the-counter topical anesthetics may speed the process while providing some relief. In our office, we can use a dental laser to hasten healing, often within a couple of days. If occurrences are frequent, ask about prescription drugs that can help reduce the duration of these viral infections.

Other issues your mouth’s interior can reveal include:

White Coating On Tongue
The tiny, bumpy protrusions on the tongue’s surface are papillae. Papillae are our source for taste and touch, allowing for feeling food’s form and texture. Saliva and food residue can become embedded in the grooves between the papillae, especially on the back portion of the tongue. This can create areas for rapid bacterial growth. As bacteria accumulate, a whitish film coats the tongue, which leads to bad breath. Let your white tongue be a warning sign of too much bacteria and take measures to manage it before cavities and gum disease develop. It’s important to keep the mouth moist since a dry mouth provides a breeding ground for bacteria reproduction. Drying sources, in addition to age, include smoking, alcohol consumption, caffeinated foods and beverages, and many prescription and OTC medications. Uproot bacteria in the tongue daily by brushing the tongue with your toothbrush after brushing teeth. Some toothbrushes have a tongue scraper on the back side of the bristles or you may want to purchase a tongue scraper. These are flexible strips you use to scrape over the tongue’s surface in a back to front motion.

Cheek Biting
Cheek biting can occur from a minor accident, such as during a fall. It can also occur from careless chewing or talking while eating. Cheek bites can occur more frequently due to a bite that is misaligned. A disparity in the bite can disrupt the harmonious congruency of upper and lower teeth while chewing and speaking. Cheek biting can be a symptom of bite misalignment. Other signs may indicate temporomandibular joint (or TMJ) disorders, which often result from a misaligned bite. Thus, cheek biting can be related. Too, TMJ disorders can cause night-time clenching or grinding of teeth. During these actions, you may be unknowingly biting the inside of your cheek while asleep. Cheek biting can cause inflammation at the location of the bite and can also result in canker sores. Chronic cheek biting can result in redness, painful sores, and tears in the mouth’s inner lining. Repeated bites can cause the oral tissues to become thick, scarred, and paler in the affected area. This surface can prompt the individual to continue biting in an attempt to create a smooth surface. If cheek biting has become habitual, there may be an emotional cause, such as  stress, anxiety, depression, or even genetics. This should be discussed with your primary care physician.

Oral Cancer
It is important to pay close attention to any change to oral tissue that does not heal within 10-14 days. When oral tissue does not repair on its own in a week or so, it should be examined by your dentist or periodontist without delay. Some of these spots can be a symptom of oral cancer.
Oral cancer has one of the worst survival rates of all cancers. Because symptoms can mimic a bite on the inside of your cheek, more obvious symptoms often do not emerge until the cancer has reached advanced stages. Of those who acquire oral cancer, only 57% are estimated to still be alive 5 years later. Know the signs of oral cancer, which include:

• white or red patch of tissue
• unusual lesion in the mouth
• difficulty or discomfort when swallowing
• persistent sore throat or feeling something is stuck in the throat
• a lump or mass inside the mouth or neck
• wart-like mass
• numbness in the mouth or face

Lesions or discolorations that are early warning signs are not always visible, particularly in the back portion of the mouth. Because symptoms emerge slowly, the delay in early diagnosis and treatment can have deadly consequences. This reinforces the need to maintain regular oral hygiene exams and cleanings every six months. During these times, unusual changes in the mouth can be noted and, if concerning, further steps can be taken. Remember, never wait until your next dental check-up appointment to have anything unusual examined.

Bleeding Gums
Contrary to what some people believe, having gums bleed at any time is not normal. Seeing blood in the sink when you brush is not a sign you’re doing a good job. It’s a sign that the gum tissues are either being scrubbed too harshly or the gum tissues are infected by accumulated oral bacteria. If you notice bleeding – at all – take extra measures to maintain excellent oral hygiene at home. This includes twice daily brushing, daily flossing, using an oral rinse, keeping the mouth moist (ideally by drinking plain water), and limiting sugar. If bleeding continues for more than a couple of days, make a dental appointment. You may have developed Gingivitis, which is an early stage of gum disease. Halting this in its tracks early can save you greatly in treatment time and expenses.

The interior of your mouth can be a great indicator of your health in other areas. Just be sure to look inside and stay proactive on steps needed to keep the interior “in the pink”. Again, if an unusual spot or sore is still present after two weeks, call 828-274-9440 immediately for an appointment.

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