Dealing With Pain The OTC Way!

Posted on Jun 20, 2016 by William J. Claiborne, DDS MS

As a periodontist, a priority with each patient is to make every appointment as comfortable as possible. For patients with problems that have become painful, my goal is to get them out of pain as quickly as possible.

While I’d like to think that everything we do is painless, the periodontal specialty often involves procedures that require penetrating tender gum tissues.

We offer sedation options and use technology and techniques designed to speed healing and minimize discomfort. However, once the patient leaves our office, post-surgical or post-treatment discomfort may occur as the tissues heal.

For example, when we place Dental Implants, we sedate patients so they will be relaxed and comfortable throughout the process. Once the patient returns home and the numbness wears off, they may experience some swelling and tenderness for a day or so.

During the healing period, we make prescription strength medications available to our patients for pain relief. Most tell us they did not need them and only took over-the-counter (OTC) medications (if any).

Although we make recommendations as to which OTC medications will be most effective for pain relief and swelling, I thought it would be helpful to explain the variations between the long list of drug store pain relief.

Once upon a time, if you had pain, you took aspirin. Drug options have greatly expanded. For most mild to moderate pain, over-the-counter pain relievers (analgesics), like non-steroidal anti-inflammatory drugs (non-steroidal anti-inflammatory drugs – commonly known as NSAIDs) or acetaminophen are the first choice.

When medications do not require a prescription, we typically assume they are safe. Yet, analgesics can have side effects and interact with other medicines, dietary supplements, and alcohol. Too, they contain the same ingredients found in many prescription drugs. This means if you’re taking several medications, you could be getting more of a particular pain reliever than you realize.

NSAIDs (aspirin, ibuprofen (Advil, Motrin, others), naproxen sodium (Aleve, Naprosyn, others), and ketoprofen (Orudis, others) are non-steroidal anti-inflammatory drugs. They reduce pain, inflammation, and fever by inhibiting production of the prostaglandins (hormone-like substances) that cause them. The down side is that they also block other prostaglandins that protect the stomach lining, regulate blood flow to the kidneys, and initiate blood clotting.
Stomach inflammation, peptic ulcers, and intestinal bleeding are major hazards for NSAID users. People who take high doses for an extended time are at greater risk, older adults especially. NSAIDs also slightly increase the risk for hemorrhagic stroke (bleeding in the brain).

Acetaminophen (Tylenol, Anacin-3, others) relieves pain and fever by affecting the parts of the brain that receive pain signals. Although acetaminophen reduces pain and fever, it has no effect on inflammation, but neither does it cause the bleeding and clotting problems associated with NSAIDs.
Acetaminophen is metabolized by enzymes in the liver. Taking too much can lead to liver damage in susceptible people, such as those who drink alcohol regularly. Taking two or more acetaminophen-containing products at the same time, or taking doses too close together, can cause overdose.
Closely read the labels of all medications to ensure you’re not exceeding the maximum recommended dose of acetaminophen — 4,000 mg per day, for people with no liver problems.

If you don’t fall into a specific risk group, taking nonprescription pain relievers as directed is generally safe. The potential for trouble emerges when you add the following:
• Some NSAID and acetaminophen products, as well as cold, sinus, and allergy remedies, contain a combination of pain relievers. Regular and long-term use of painkillers that combine analgesics can damage the kidneys.
    • Many prescription painkillers contain acetaminophen (Darvocet, Vicodin, others) or NSAIDS (Celebrex, Percodan, others). Do not take both prescription and over-the-counter painkillers without checking first with your doctor. A chart of prescription drugs containing acetaminophen and NSAIDs is available on the American Academy of Family Physicians’ website: www.familydoctor.org/otc/knowmeds.html.
    • NSAIDs can interact with many drugs, including ACE inhibitors, anticoagulants, beta blockers, lithium, and methotrexate. Aspirin interacts with anticonvulsants, corticosteroids, insulin, and sulfa antibiotics. If you take any of these prescription medicines, check before using NSAIDs.
    • Herbal supplements such as garlic, ginger, feverfew, ginkgo, and ginseng can thin blood and should be avoided when taking an NSAID.
    • NSAIDs can interfere with absorption of folic acid. If taking NSAIDs regularly, take a multivitamin daily.

It is important that your treatment and recovery result in a positive outcome without undue complications or discomfort. By understanding the advantages as well as potential adverse reactions of NSAIDs and acetaminophen, you can minimize the amount needed while gaining the most comfort from your chosen brand.

Want To A Healthy Body? Begin With A Healthy Mouth.

Posted on Jun 15, 2016 by William J. Claiborne, DDS MS

I love being in this profession. Being a Periodontist, I’ve witnessed a number of advancements in dental technology, techniques and materials. I have also followed scientific research that has made enormous strides in connecting oral health with our overall health.

Time and again, studies keep showing how closely related the health of your gums is to the prevention and reduced risk for some serious health problems. Research has found links between the oral bacteria of periodontal (gum) disease to heart disease, stroke, memory loss, high blood pressure, diabetes, arthritis, some cancers, impotency, preterm babies and more.

The culprit is apparently in the ability of oral bacteria to trigger inflammation elsewhere in the body. When gum disease has weakened the tissues in the mouth, the bacteria is able to enter the bloodstream. As it travels through the body, it can set a series of negative reactions into motion.

Knowing this potential, it’s no surprise that a growing number of surgeons are now advising patients to have their gums checked prior to surgery. Additionally, Ob-Gyns have started recommending pregnant patients to be especially diligent in having and keeping their gum health in good shape.

Some recent research findings has shown a predisposition to the deadly pancreatic cancer. Over several years, researchers at the National Cancer Institute and the American Cancer Society collected oral samples as part of a cancer prevention and screening study. They noted elevated levels of two oral bacteria in pancreatic cancer patients. One oral bacteria was found to create a 59% higher risk of developing pancreatic cancer with another creating a 50% greater likelihood of developing this deadly disease.

The mouth can also reveal indications of some diseases, even before it is diagnosed. For example, Celiac Disease (an autoimmune disease that causes damage the small intestine) can create defects in tooth enamel. These may appear as yellow, white or brown spots on teeth or cause pits or band-like grooves to form.

Knowing this, it simply makes good sense to take VERY good care of your oral health. Yet, only half of American adults brush twice a day and nearly 80% don’t floss. These actions take just minutes a day and can make an enormous difference in your oral health, and apparently, your overall health as well.

Reconsider your oral health commitment, knowing that you’re doing a favor to your smile AND your body! And, be watchful for signs of gum disease, which include tender gums that bleed when brushing, swollen areas, gum recession or gums that darken from a healthy pink color to red.

Call (828) 274-9440 if you suspect you may have gum disease or have not seen a dentist on a regular basis.

A Missing Tooth Disrupts Positions Of Other Teeth

Posted on Jun 13, 2016 by William J. Claiborne, DDS MS

Being in a periodontal specialty, a particular part of my expertise involves the diagnosis and placement of Dental Implants. While periodontal (gum) disease is the nation’s leading cause of adult tooth loss, there is another contributing factor that many people are unaware.

The position of each tooth has unique importance to neighboring tooth. Primarily, one tooth helps to hold adjacent teeth in place. This means that when one tooth is lost and not replaced, the teeth on both sides are also left without a bolstering neighbor. This gap enables neighboring teeth to move out of their proper positions.

Because an open space allows a tooth above or below to grow longer or the teeth on each side to tilt, a long list of problems are set into motion. The teeth that grow longer or tilt typically cause chips, cracks or fractures to other teeth since the bite is now out of alignment. When a tooth fractures below the gum line, it will require removal. This results in a whole net set of expenses and problems.

When a tooth is missing, it also leads to the potential shifting of other teeth. This shifting can result in crowded, crooked teeth that are more difficult to keep clean. Imagine how much more challenging it is to sweep and mop the floor in corners than it is along straight surfaces. Your tooth brush has far more challenges trying to get into tight angles.

Bite misalignment can even lead to worn teeth since it can lead to night-time clenching and grinding. This is typically due to strain on the TMJ (jaw joints) from the now-misaligned bite. Clenching or grinding during sleep can contribute to frequent headaches, migraines, sore jaw joints, facial and neck muscle pain, ear ringing and dizziness.

The open space from the missing tooth leads to yet another ordeal. Without natural tooth roots in the jaw, the bone that once held the root begins to shrink. As the bone in this area declines in mass, bordering tooth roots are now vulnerable to a shrinking foundation of bone. It is a fact that a missing tooth leaves an adjacent tooth most likely to be lost next.

When you consider all these issues, it’s no surprise that the result is a number of dental repairs and costs. The easiest way to avoid problems and associated expenses when a tooth is lost is to replace the tooth with a Dental Implant.

Dental Implants recreate the presence of tooth roots in the jaw bone. This helps to prevent bone loss from a declining jaw that occurs when tooth roots are no longer present. The replaced tooth also helps surrounding teeth to hold their proper positions, greatly reducing the potential for chips, cracks and the barrage of problems associated with bite misalignment.

Although Dental Implants are initially more expensive than most other tooth replacement options, the investment is a one-time expense. Dental Implants do not decay and are designed to last your lifetime. They also have one of the highest success rates of all implant-in-bone treatments.

And, unlike crown-&-bridge combinations, an implant will halt further bone loss. It will never need adjacent natural teeth to be crowned to support replacement teeth. Dental Implants are held in the jaw bone, just as natural tooth roots, and do not need other teeth for support. Overall, they are an ideal investment for replacing one tooth, several teeth or a full arch.

If you are missing one or more natural teeth, call us at 828-274-9440. We will explain the process and advantages of Dental Implants so you can make the decision that is right for you.

Healthy Body Begins With A Healthy Mouth

Posted on May 23, 2016 by William J. Claiborne, DDS MS

As a dental specialist, I diagnose and treat a number of problems in the mouth. A Periodontist has advanced training in treating all levels of gum disease and other problems associated with gum tissues. We are also the experts in dental implant placement and recontouring gum tissues (such as repairing gummy smiles or gum recession).

In my specialty, I see the origins that can destroy a smile as well as complicate one’s quality of life. What happens in the mouth can create a downward spiral for the entire body. For example, periodontal (gum) disease can lead to tooth loss. Tooth loss can lead to eating a less healthy diet. Consuming a poor diet can lead to a decline in overall health and more gastrointestinal problems. And so on.

While tooth loss can be overcome with Dental Implants, the cycle of destruction that is possible from an overload of oral bacteria is a far deeper problem. As damaging as oral bacteria can be in the oral cavity (the mouth), the bacteria of gum disease can become bloodborne and cause severe reactions elsewhere in the body.

Here is how the problem begins: First, gum disease bacteria eats away at gum tissues in the mouth. This weakens the tissues, which are easily torn and bleed. Oral bacteria are then able to enter the bloodstream by penetrating these tears.

As the infectious bacteria travel through the body via bloodflow, they can trigger inflammatory reactions elsewhere in the body. This inflammation has shown correlation to some serious health problems, including heart disease, stroke, high blood pressure, arthritis, diabetes, pre-term babies, impotency (ED) and more.

Although the destruction of oral bacteria can be severe, and even deadly, it is also rather easy to prevent. The bacteria of gum disease occurs when there is an accumulation of oral bacteria in the mouth, typically as a result of poor oral hygiene at home. The age-old urging from the family dentist to brush twice daily, floss each day, and limit snacking on sugary treats stands true today.

When bacteria in the mouth are not removed thoroughly each day, they band together to form a sticky film, known as plaque. As this film remains, it takes just days to harden into a cement-like substance that attaches to teeth. This is calculus (or tartar), which is actually a massive colony of oral bacteria that is so destructive it can eat into tooth enamel.

As the oral bacteria reproduce and thrive, they subsist on gum tissues as sustenance. Gums become weak and bleed easily when brushing. Gums become tender and darken in color. Persistent bad breath sets in and pus pockets form at the base of some teeth. If not treated, gum disease will eventually lead to teeth loosening, requiring removal.

How many times in our lives have we wanted to turn back the hands of time and take proactive measures to prevent costly and time-consuming problems? It makes perfect sense to us that a car needs regular maintenance, sufficient oil levels and proper tire tread. Yet, having 6-month check-ups and cleanings seem less necessary since “nothing hurts.”

The mouth has been described as the window to the body. As research continues to find links between gum disease bacteria and serious health problems, this is becoming a more profound statement. It can also be said that the mouth is the moat to the castle. It can either serve to protect the structure (your body) or pollute it.

Just as you are committed to maintaining good overall health, remember that your oral health is a key component in that goal. Take the proper steps to avoid the pitfalls of gum disease, for your smile and your whole-health. If you are experiencing signs of gum disease, call 828-274-9440 for an exam. Gum disease will only worsen without treatment.

The Mayo Clinic has excellent explanations of periodontal disease. Visit the site at: http://www.mayoclinic.org/diseases-conditions/periodontitis/multimedia/periodontitis/img-20008444