Smokers CAN Lower Oral Health Risks With Proper Measures
Posted on Feb 04, 2021 by William J. Claiborne, DDS MS
If you smoke, you may be tempted to quit as one of your New Year’s resolutions. By now, you may be “over the hump” and feel success in this challenge (and breathing much easier!). Good for you!
However, if you’ve stumbled and faltered (and perhaps even thrown up your hands in defeat), you are not alone. According to the Centers for Disease Control & Prevention (CDC), over 55 percent of smokers in the U.S. had made a quit attempt in 2018, with only 7.5 percent succeeding. (https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html)
Yet, less than 7 percent of adult smokers reported (in 2015) that they had sought counseling or medications in their attempts to quit. Yet, the need for support is clear. For most people who are trying to quit, it is a long, tough journey. The CDC also reports that:
“more people in the United States are addicted to nicotine than to any other drug. Research suggests that nicotine may be as addictive as heroin, cocaine, or alcohol.”
As the need to maintain healthy immune systems has never been more urgent, smokers will hopefully reach out to every source in order to kick the habit, for good. Data assembled by a team at the University of California (San Francisco) found that smoking nearly doubles the rate of COVID progression.
The analysis took into account over 11,500 COVID patients. The findings showed by current and former smokers were twice as likely to have conditions that require hospitalization and higher death rates. (https://www.ucsf.edu/news/2020/05/417411/smoking-nearly-doubles-rate-covid-19-progression)
The authors of the study warned that both cigarettes and e-cigs were involved in this higher risk rate.
Smoking increases mucus production and inflammation, which injures the lungs’ defense system. This is why people who smoke are more likely to have serious respiratory infections and illnesses.
However, my role as an Asheville periodontist is not to lecture our patients. We believe our patients deserve to be informed about the risks to their oral health, in particular, and provide encouragement. Too, we want patients to understand the best ways to avoid developing periodontal (gum) disease and the subsequent repercussions (such as tooth loss) as a result.
So, let’s focus on your periodontal health if you smoke (including cigarette smoking or vaping).
Smokers are often unaware of what occurs in the mouth from smoking. To begin, smokers have a greater risk of periodontal (gum) disease due to its drying effect on the soft tissues in the mouth. When saliva flow is depleted, its ability to rinse away oral bacteria enables the mouth to a bacterial breeding ground.
As oral bacteria reproduce and accumulate in the mouth, gum tissues become inflamed. In the early stages of gum disease, symptoms may include frequent bad breath, tender and swollen gums, and gums that bleed easily when brushing teeth.
As gum disease progresses, the gums change in color from a healthy pink hue to red. The gums loosen their grip around the base of teeth and seem more spongy. Breath odor is consistently bad. Pus pockets may form at the base of some teeth.
Eventually, the bone and the tissue structures that support natural teeth are under attack. The infectious bacteria ramp up their onslaught of attack, tooth roots no longer have the firm support they need. Some teeth begin to loosen and may require removal.
Advanced periodontal disease, known as periodontitis, is a health risk that goes far beyond the mouth. For years, research has shown an intricate connection between the “good” bacteria in the mouth, especially beneficial in gut health. It has also been known that the “bad” and infectious bacteria of advanced gum disease can alter the roles of certain factors in the body that help to prevent the formation of disease.
For example, certain cancers can be activated or progressed through the inflammatory bacteria of gum disease. These bacteria are able to become blood borne and activate “pathogens” that create a domino effect of disease development.
When you factor in the vulnerability to the lungs from inhaling the toxic smoke of cigarettes, you have a perfect storm. Consider that the gum tissues are the first contact with these inhaled chemicals. Because oral tissues are absorbent in nature, they are at the front line of smoking’s effect.
If you do smoke, we want to help you minimize the risks it poses to your oral health. In addition to maintaining regular dental check-ups and cleanings (at least every 6 months), below are some tips for your at-home oral hygiene regimen.
• Brush twice a day (at least) for two minutes each time. Use a fluoridated toothpaste and a soft to medium bristle toothbrush.
• Floss your teeth every day and floss before your brush. You would be surprised at how many particles can be lodged between teeth that brushing won’t rid. If flossing is an awkward maneuver, try one of the water flossers, which are affordable and as effective as manual flossing.
• Brush your tongue after your teeth to unroot embedded bacteria, especially reaching the back area of the tongue (where most bacteria are embedded). This also helps to give you fresh breath.
• Use an oral rinse that replenishes moisture (and is alcohol-free) twice a day (or as directed). These are available OTC at most drug stores.
• Chew sugarless gum, preferably a brand that contains Xylitol. Xylitol looks and tastes like sugar, yet has 40 percent fewer calories.
• Drink plenty of water throughout the day. Be aware that beverages such as most coffee, tea and colas contain caffeine are drying to the mouth. Many medications also have the side effect of oral dryness – another good reason to stay hydrated.
• Limit your intake of sugar and carbohydrates. These are oral bacteria super boosters.
In our Asheville periodontal dental office, please know that we are here for you regardless of your needs or goals. Although we prefer you give up smoking, we want to give you the very best care possible so you can enjoy a healthy mouth and confident smile.
If you haven’t had regular dental exams or have any of the symptoms associated with gum disease (mentioned above), call our dental office to schedule a thorough periodontal exam at 828-274-9440.
Erectile Dysfunction (ED) Risks Increase With Presence of Gum Disease
Posted on Jan 07, 2021 by William J. Claiborne, DDS MS
Men have a long way to go when it comes to taking good care of their teeth and gums, according to several surveys.
One from the Academy of General Dentistry stated that men in the U.S. are less likely to have regular dental check-ups and cleanings than women. Another survey shared by the Journal of Periodontology said men are less likely to brush regularly, and more likely to lose teeth as they age as well as develop oral cancer and gum disease.
According to the Centers for Disease Control & Prevention, over 56 percent of men have gum disease, compared to just over 38 percent of women. Men, in particular, should be aware of the increased health risks associated with periodontal (gum) disease.
Researchers have given closer assessment to recent studies and found that erectile dysfunction (ED) is more common in men with gum disease.
In addition to higher ED risks, research has found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums – 49 percent more likely to develop kidney cancer, 59 percent more likely to develop pancreatic cancer and 30 percent more likely to develop a blood cancer.
If concerns about heart disease and cancers aren’t enough to get men thinking more seriously about their oral health, ED may be a condition that does.
Gum disease has emerged as an independent risk factor for cardiovascular disease, and cardiovascular disease raises the risk for ED. For men, there are a number of factors that contribute to an increased risk of cardiovascular disease. These include smoking, obesity, chronic stress, high cholesterol, high blood pressure, and chronic sleep apnea.
One study published in the Journal of Sexual Medicine revealed that men in their thirties with severe gum disease are 3 times more likely to have erection problems. As cardiovascular health issues develop, erection ability suffers, and as health problems increase in number and severity, so does the severity of ED.
The association between periodontal disease, heart disease, and erectile dysfunction relates to inflammation brought on by gum disease bacteria. This process actually comes down to a biochemical reaction. During sexual arousal, the body releases nitric oxide, which plays a key role in enabling erection. Chronic inflammations, including periodontal disease, impairs release of nitric oxide and contributes to ED.
In the U.S., an estimated 18 percent of males have erectile dysfunction. Although men who are over age 70 are more likely to have ED, males most affected by ED are getting younger. One outpatient clinic showed that 1 in 4 men who sought help for erectile dysfunction were under the age of 40.
Could maintaining a healthy mouth lower the risk of ED? In a 2013 study, it was found that treating periodontal disease improves ED symptoms. Thus, a growing number of physicians are advising male patients who have both ED and periodontitis to seek periodontal treatment as a way to reduce its risk.
In data analyzed from five studies published between 2009 – 2014 (which included 213,000 male participants between ages 20 – 80), men who had chronic periodontitis (advanced gum disease) were more likely to have erectile dysfunction.
In another study, nearly half of the men with ED also had diabetes, another chronic inflammatory disease with links to periodontal disease. Chronic inflammation in the body can be lowered when gum health is kept in good condition.
Men can help to protect their overall health by keeping their oral health at an excellent level. It is especially important to watch for signs of gum disease. Symptoms include: puffy, red gums; inflamed, swollen, or bleeding gums; gums that recede from the base of teeth; and persistent bad breath.
If you are experiencing any of these symptoms, call our Asheville periodontal dental office for an examination as soon as possible. Gum disease does not improve without treatment.
Although many serious health problems are linked to the potent bacteria of gum disease, it is one of the most preventable of all diseases. Twice daily brushing, daily flossing, a diet limited in sugar and carbohydrates and drinking plenty of water are simple guidelines to follow.
Even with these easy steps that take mere minutes per day, it is estimated that over 47 percent of American adults have some level of gum disease.
For the good of your overall health and well-being, renew your commitment to a healthy smile for the new year. Begin with a thorough examination. (A referral is not required.) We’ll discuss how to get your oral health in good shape and ways to maintain it between dental check-ups.
Call 828-274-9440 to schedule or ask to begin with a consultation. If dental anxiety or fear has kept you from regular dental care, mention this during your appointment. This is a common problem for both men and women. If desired, we offer a number of comfort options, including Oral Sedation or I.V. Sedation (twilight sleep).
Ask Santa To Make The Toothbrush Under The Tree Electric!
Posted on Dec 16, 2020 by William J. Claiborne, DDS MS
Although your Christmas wish list probably doesn’t include an electric toothbrush, it should. Studies have shown that brushing teeth with an electric version promotes better gum health and slower progression of periodontal (gum) disease. Electric tooth brushing is also helpful in reducing tooth loss, by 20 percent (compared to those who brush with manual toothbrushes).
If you use an electric toothbrush, most people think of its benefits in giving fresh breath and a bright smile. As an Asheville periodontist for over three decades, I have a firsthand view of how a thorough at-home oral hygiene regimen can help significantly in preventing gum disease and tooth loss.
An electric toothbrush can be an important tool in daily oral hygiene. Findings of an 11 year study published in the Journal of Clinical Periodontology tracked the oral health of over 2800 adults. The use of electric toothbrushes was monitored to watch for periodontal disease, cavities, and the number of natural teeth.
From 2002 – 2006, participants were examined with follow ups conducted after 6 and 11 years. Eighteen percent of the participants were electric tooth brush users. At the time of their 11 year follow up, 37 percent had switched to using electric toothbrushes.
Although more adults are using them, the long-term effectiveness of electric tooth brushes has not been proven to be significant. It is suspected that this is due to the technique used rather than due to the brushing tool itself. For manual users, a significant challenge with brushing this way is in the choice of bristles. Stiff, hard bristles can be very damaging.
A hard bristled tooth brush can actually damage tooth enamel and gum tissues. To the detriment of teeth, people tend to press down too firmly as they brush, scrubbing with a ‘back & forth’ motion. They may feel this is the way to do a good job brushing. However, this action can wear down the protective coating of tooth enamel, leaving teeth more vulnerable to decay.
Another problem with a hard bristle tooth brush is its ability to damage tender gum tissues. These can thin out the protective seal that gums have around the base of each tooth. This increases the potential for bacterial entry of the sensitive tooth root area of teeth.
Hint: If the bristles on your toothbrush are fanned out after a couple of months, you are applying too much pressure when brushing.
The ideal technique for brushing teeth is to use gentle pressure with a swirling motion. By using a circular pattern over both sides of each tooth and along the tops, teeth are cleansed without wearing away gum tissues or wearing down precious tooth enamel.
This is where electric toothbrushes can help greatly. Many of the newer models include a beep when too much pressure is being applied. Most also have timers to indicate the time needed for each quadrant, which is your teeth divided into 4 sections. The timers are good aids in helping you to brush at least two minutes.
As devastating as tooth loss can be to one’s overall health, we now know that the bacteria of gum disease can enter the bloodstream. Research has shown this infectious bacteria can trigger inflammatory reactions elsewhere in the body. It has been linked to heart disease, stroke, high blood pressure, some cancers, diabetes, arthritis, impotency, preterm babies and more.
Whether using a manual or electric tooth brush, it is necessary to brush twice a day to effectively remove plaque. Plaque is the sticky film you feel on teeth when you wake up or at the end of the day.
Plaque is a buildup of oral bacteria that coats teeth and gums. If not removed daily, it forms a hardened mass of calculus (or tartar) that attaches to teeth. This is what you may feel your hygienist scraping off teeth during cleanings since it cannot be brushed or flossed away.
Another place that oral bacteria can thrive are in the grooves in the tongue. These offer a dark, warm and moist environment for bacterial reproduction. To uproot these icky organisms, use your toothbrush to brush your tongue after brushing teeth. Be sure to reach the back of the tongue where the majority of oral bacteria are embedded. Swish with water several times after.
Flossing is another way to improve gum health, lower cavity risk and prevent tooth loss. It is estimated that only 31 percent of American adults floss on a daily basis. Flossing removes trapped bits of food remain in the mouth, which feeds oral bacteria and allows them to quickly multiply. Because brushing cannot dislodge all food particles caught between teeth, daily flossing should be a part of oral hygiene routines.
Proper flossing is easy for those who are in the habit and takes only a minute each day. For those who have difficulty with manual dexterity or find the maneuver awkward, water flossers are effective alternatives and easy to use. (This is another good item to add to your wish list!)
Practice these recommended techniques and you’ll not only do a better job at having a clean mouth, you’ll find your time at the sink requires less effort. If you feel you may be experiencing symptoms of periodontal disease, act promptly. You should be seen at your earliest convenience for treatment since this disease will only worsen over time.
Signs of gum disease include tender gums that bleed easily when brushing, gums that darken in color to red (versus a healthy pink), frequent bad breath, and gums that pull away from teeth (receded gums) and expose darker root areas of the tooth.
As a periodontal specialist, I have advanced skills in the treatment of all stages of gum disease (as well as in the placement of dental implants). Our office features some of the most advanced technology available in dentistry to optimize patient outcomes and comfort.
Here, we will help you achieve the healthy smile you want and prevent tooth loss to the greatest extent possible. If you’ve already lost teeth, we’ll discuss their replacement through dental implants. Dental implants are the closest thing to natural teeth, restoring biting and chewing strength and stability.
Call 828-274-9440 to learn more or to schedule a consultation to discuss how you can achieve excellent oral health.
Are YOU One Who Is More Likely To Have Gum Disease?
Posted on Dec 10, 2020 by William J. Claiborne, DDS MS
As a periodontist, I have a pretty unique view of the inside of a mouth.
In my specialty, we are particularly focused on the condition of the gum tissues in the mouth, or “periodontal” tissues. We are specially trained to treat all stages of gum disease and in the diagnosis and placement of dental implants.
A periodontal specialist is also trained in performing esthetic procedures that involve gum tissues, such as crown lengthening and correcting a “gummy smile”.
To clarify, a periodontist is a dentist who extends his or her education and skills further (typically 3 years past completing dental school) to specialize in the prevention, diagnosis, and treatment of periodontal disease and other gum conditions.
1). THE NATURAL AGING PROCESS
Although we treat patients of all ages, there are certain segments of the population we see more often. For instance, a large segment of our patients are age 50 and older. In addition to having more susceptibility to have gum disease, many in this age group have lost teeth.
In a recent report by the Centers for Disease Control & Prevention (CDC) on data related to prevalence of periodontitis in the U.S.: over 47% of adults ages 30 years and older have some form of periodontal disease. For adults 65 years and older, that number rises to over 70%.
This is because the aging process causes the body begins to succumb to wear and tear. The skin sags, bones weaken, joints ache, hearing dulls, and eyesight wanes. This means that more precautions and measures are needed to keep the teeth and gum tissues in good shape.
In addition to healthy gums, it’s important to keep your natural teeth as you age. Natural teeth to support neighboring teeth and provide stimulation to the jaw bone is unsurpassed.
Having the ability to comfortably and efficiently bite and chew is vital to having a healthy body. When dentures or partials compromise the ability to eat a diet of healthy foods – and chew food properly – gastrointestinal problems are common.
Although dental implants are excellent replacements for missing teeth, there is nothing as perfect as your “permanent” teeth.
There are a number of reasons why seniors face more oral challenges, including:
• A dry mouth: The tissues inside the mouth need to be kept moist. Saliva is designed to do this. However, with age, the flow of saliva becomes less plentiful. Just as the skin and hair get drier with age, the mouth undergoes this as well. When saliva flow is less efficient at rinsing bacteria from the oral cavity, bacteria grow at a more rapid rate. This allows bacteria accumulation to occur more frequently than twice-a-day brushing can control.
• Reduced ability to maintain at-home oral hygiene: Aging causes the fingers to be less nimble and stiffens joints. This is a particular challenge when it comes to brushing and flossing. Angling a toothbrush to reach all areas in the mouth and proper flossing maneuvers require manual dexterity that are more difficult due to the natural aging process.
• Medication side effects: The average American adult in the 65-79 age group has over 27 prescriptions filled each year. (https://www.statista.com/statistics/315476/prescriptions-in-us-per-capita-by-age-group/). Although you may need these medications, keep in mind that some can be detrimental to your oral health. This is why it’s important to provide a complete list of all medications you take (including vitamins and herbal supplements) at every dental appointment so your dentist can adjust care to your specific needs.
• Hormonal changes: Due to declining estrogen levels, post menopausal females have a higher risk for gum disease and subsequent tooth loss. This causes an increased risk of bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is a decline in jaw bone mass, it can result in tooth loss.
Bacteria overgrowth in the mouth is the cause of gum disease. Periodontal disease is the nation’s leading cause of adult tooth loss. Its bacteria can also enter the bloodstream, causing inflammatory reactions far beyond the mouth.
Advanced gum disease bacteria has been linked to a number of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.
Obviously, maintaining healthy gums and keeping your natural teeth is important. If you’ve experienced tooth loss, we can replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing.
At any age, the goal is to keep bacteria levels in the mouth to the lowest level possible. When oral bacteria are allowed to accumulate, it can lead to Gingivitis. This is an early stage of gum disease. As it progresses, periodontal disease continually worsens. Eventually, it becomes periodontitis, which is an advanced level of gum disease.
Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:
• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath
2). ADULTS WITH DENTAL FEAR
Another large segment of our patients are those who have avoided dental care for years, often due to having dental fear.
One study, published by StudyFinds.org, shares recent findings of 2,000 adults in the U.S. regarding dental visits. Results show a whopping 62% of those surveyed stating they were too afraid to even visit a dentist’s office. (https://www.studyfinds.org/adults-too-scared-visit-dentist-teeth/)
If dental fears or anxiety have kept you from regular dental checkups for a year or more, it would be rare to NOT have some level of gum disease. Quite frankly, some people with high fear levels avoid seeing a dentist for decades. Those visits are vital in one’s ability to have healthy gums.
While twice daily brushing and daily flossing are necessary components for having good oral health, the routine alone isn’t enough to combat a number of additional factors that make one vulnerable to the disease.
For example, a study by Delta Dental revealed, only 7 out of 10 adults are brushing twice a day. This means that 30% aren’t brushing enough. (https://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits)
We also see a number of moms-to-be. For decades, the Surgeon General has 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.
When these indications exist, it is important to seek periodontal treatment as soon as possible. Gum disease only worsens without treatment, requiring more time and expense to rid this serious, even deadly, inflammatory disease.
4). ALL ADULTS
Regardless of age or health status, oral wellness has always been important to overall health. Without good gum health, there is a greater drain on the body’s immune system. This is now even more important than ever, due to COVID and the flu season upon us.
Remember, even a twice-daily brusher and daily flosser does not mean you will avoid gum disease. Avoiding regular dental check-ups is a sure recipe for needing treatment down the road that may have easily been prevented.
In our Asheville periodontal dental office, patients can begin with a consult in our private consultation room that’s removed from the clinical side of the practice. We are always happy to discuss oral health options with new patients. A referral is not needed.
Call 828-274-9440 to schedule.