Don’t Smoke? Living Or Working With A Smoker Creates Higher Risks Than Once Thought.


Posted on May 14, 2021 by William J. Claiborne, DDS MS

I doubt there is anyone in the U.S. who smokes tobacco who is unaware of the fact that it’s an unhealthy habit. Although the heart and lungs are more widely associated with the health risks of smoking, many people miss the fact that it is also damaging to the tissues in the mouth.

Consider the devastating statistics of COVID-19 related deaths in the U.S., nearing the 600,000 mark. Yet, when it comes to your oral health, cigarette smoking is responsible for more than 480,000 deaths per year in the United States. For people who don’t smoke but live or work with a smoker, secondhand smoke exposure accounts for over 41,000 of these.

For nonsmokers who are victims of secondhand smoke, that’s a tough statistic to accept.

Just how harmful is secondhand smoke? British researchers recently released some interesting findings along these lines. Their studies included several major countries and tracked nearly 7,000 adults, with nearly half being exposed to secondhand smoke. The findings showed that breathing in the smoke of another person’s cigarette can increase the risk of oral cancer by more than 50 percent. These cancers include lip, mouth and throat cancers.

On average, smokers die 10 years earlier than nonsmokers. For every person who dies because of smoking, at least 30 people live with a serious illness related to smoking. Smoking leads to disease and disability and harms nearly every organ of the body.

When considering the mouth, smoking can create costly problems in addition to a higher risk of tooth loss.

Twenty years of research shows that cigarette smoking is a risk factor for periodontitis. A smoker is 2 – 3 times as likely to develop periodontitis, which is an advanced stage of gum disease. In addition to increased prevalence, smokers also experience greater severity of gum disease.

Nicotine (in any form) has been shown to reduce blood flow in the gum tissues in the mouth. Pipe smoking can be worse than cigarettes due to the higher temperatures generated in the upper jaw. When it comes to dental implants, smoking is a risk factor for failure. It is also detrimental for conventional bridgework.

Cigarette smoking has long been associated with serious oral conditions, including periodontal (gum) disease, bone loss, tissue loss, and tooth loss. For smokers who opt for dental implants to replace missing teeth, they have a higher risk of peri-implantitis, which is inflammation of the soft and hard gum tissues surrounding a dental implant. To no surprise, smokers have a higher incidence of dental implant failure.

In an article published by the Journal of International’s Society of Preventive & Community Dentistry as far back as 2012, it warned that smoking can impact the rate of dental implant success, accounting for up to 20 percent of failures.

“Clinical trials of endosseous implants consistently rate smoking as a primary patient-centered risk factor for implant loss.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894084/

It is common knowledge that the nicotine in cigarettes, e-cigs and ‘chew’ is an addictive drug. Some concerning quotes shared by the Oral Cancer Foundation are:

“Scientists have found that nicotine is as addictive as heroin, cocaine or amphetamines, and for most people, more addictive than alcohol,” states the article “Nicotine, Harder to Kick than Heroin,” published in the New York Times Magazine.

“Nicotine is similar in all critical measures to prototypic drugs of abuse such as cocaine, morphine and heroin.”

“Nicotine is a poison used as an insecticide.”

https://oralcancerfoundation.org/understanding/tobacco/tobacco-and-addiction/

Now, knowing the effects of secondhand smoke are likened to the non-smoking “victim” as inhaling half as many cigarettes as the user they live or work with, smokers should consider their habit in a different light.

While our Asheville periodontal dental office does not lecture or “guilt” our patients in any way, we feel they deserve to know the hazards of any risk factor related to the well being of their oral health. Without a doubt, smoking (whether cigarettes or vaping) is harmful to oral tissues and the potential to keep natural teeth.

In a report shared by Delta Dental, smokers are about twice as likely to lose their teeth than non-smokers, according to two 30-year studies at Tufts University in Boston. Their findings showed that men who smoke lose about 3 teeth for every 10 years of smoking, with women losing an average of 1.5 teeth per decade.

https://www.deltadentalins.com/oral_health/teethinpack.html

Every year, about half of smokers make some attempt at kicking the habit. Yet, only 6 or so percent are fully successful. All the while, the tobacco industry spends BILLIONS of dollars each year on cigarette and smokeless tobacco advertising and promotions.

According to the Centers for Disease Control & Prevention (CDC), in 2018 “$9.06 billion was spent on advertising and promotion of cigarettes and smokeless tobacco combined—about $25 million every day.” That’s more than $1 million dollars spent every hour of every day.

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm

While nicotine addiction means big money to the tobacco industry, it is enormously costly to our population. Now, knowing that secondhand smoke is so harmful to others, I hope our smoker patients will welcome our respectful support in their efforts to quit as we help them to maintain good oral health and keep their teeth (or dental implants) healthy for a lifetime of confident smiles.

If you’ve considered dental implants to replace missing teeth and smoke, please consult with us to discuss ways we can help you minimize the potential for dental implant failure. We want you to reap the benefits of a smile you’ll want to share proudly.

Call 828-274-9440 to schedule.

 

Your Tongue Is A Multi-Tasker!


Posted on May 05, 2021 by William J. Claiborne, DDS MS

With the tongue occupying such a large area inside the mouth (or ‘oral cavity’), you’d think its anatomy would be common knowledge. Because this muscle functions continually without tiring, it tends to be taken for granted. It’s importance to your overall health, however, is unbounded.

To correct a common misconception about the tongue, it is not the strongest muscle in the body. Although it ranks in the top 5 or so, the muscles surrounding the eyes actually have that supremacy. The heart, deemed the hardest working muscle in the body, and the masseter (jaw muscle) are also among those that are the body’s stand-outs.

The tongue does many things. It provides our sense of taste, is vital in pronunciation, moves food around as we chew, and aids in swallowing while helping to prevent certain things from being swallowed.

Not one muscle but a combination of 8, the tongue is coated with papillae. These are the tiny, bumpy protrusions on its surface. They help in various ways but are mostly credited for our sense of taste.

Different areas of the tongue are more sensitive to certain tastes. For example, the tip of the tongue detects sweet to the greatest extent while the sides detect sour.

Papillae also sense touch so that we can feel the form and texture of food.

Saliva helps to keep the tongue moist so it can move around the oral cavity freely. Saliva is also helpful to the tongue by moving bacteria from its surface. However, saliva cannot keep the tongue bacteria-free.

Saliva and food residue can get stuck in the grooves between the papillae, especially on the last third of the tongue. This can create areas for bacterial growth. These bacteria thrive on remains of protein-rich food like fish, cheese or milk.

Here is where, as an Asheville periodontist, I have a particular interest in the tongue. As bacteria accumulate, a whitish film covers the tongue, which also causes bad breath. Keeping bacteria in the mouth to manageable levels is greatly supported by saliva flow.

The tongue’s underside covers two salivary glands of the lower jaw (submandibular glands). These ducts are located where the tongue meets the floor of the mouth.

If you’ve read some of my previous articles, you’ll recall that I’m constantly reminding readers of the hazards of having a dry mouth. Smoking, consumption of alcohol and caffeine, and many medications are all obstacles to the salivary glands being able to function efficiently.

A dry mouth provides a breeding ground for bacteria reproduction. When you consider the amount of bacteria embedded in the tongue’s surface, oral bacteria levels in the mouth can run rampant.

Because the tongue’s surface color can indicate too much oral bacteria, it should be looked at during at-home oral hygiene regimens. It is advised that, after brushing teeth, using the toothbrush to brush the tongue. This can dislodge an enormous amount of bacteria.

Although brushing the tongue tends to be done on the front area, it’s helpful to brush towards the back of the tongue where most bacteria exist (hence, the whiter color and smoother surface). Gagging will stop you from going too far so use that as a guide.

Some toothbrushes have a tongue scraper surface on the back side of the bristles. There are also tongue scrapers available for purchase. These are flexible strips that should be used to scrape from back to front 3 or more times after brushing. Rinsing the scraper is advised after each pass.

To provide even more support in helping the oral cavity control bacteria, an oral rinse can be very helpful. After brushing (for a minimum of 2 minutes) and flossing, swish for 30 or more seconds with an alcohol-free mouthwash. While the intensity of the mouthwash may be greater with initial use, most people notice its easier to swish around the mouth within a week or so.

Low bacteria levels in the mouth make for fresh breath and reduced risk of developing cavities and gum disease. Periodontal disease begins with gingivitis, which causes gum tissues to be tender and bleed when brushing.

Periodontitis, an advanced stage of gum disease, causes red, sore, spongy gums. Other symptoms are persistent bad breath, bleeding easily, gums that loosen from the base of teeth, and teeth that loosen.

Periodontitis can also cause health risks far beyond the mouth. Because these infectious bacteria can enter the bloodstream through tears in the gum tissues, it has been shown to trigger or worsen the development of serious health problems. Some of these are stroke, heart disease, arthritis, Alzheimer’s disease, some cancers, and diabetes.

When it comes to the tongue, remember its important role to your oral and overall health. Keep the mouth moist and its surface clean and your reward will be sweet (without the calories!).

If you are experiencing any signs of gum disease, call 828-274-9440 for an appointment. Gum disease does not go away on its own and will progressive worsen without treatment. Remember – it is the number one cause of adult tooth loss in the U.S.

 

Bad Breath – The “Body Odor” of the Mouth.


Posted on Mar 09, 2021 by William J. Claiborne, DDS MS

“Whoa!!!”

That may be our unspoken reaction when we encounter someone who’s breath odor reeks. And, we’ve all encountered it. It tends to leave a rather negative impression of the individual; one that ‘sticks’ with us every time we see him or her in the future.

Occasionally, I like to address the causes of bad breath since, at one time or another, it’s an issue for us all. Bad breath, like body odor, leaves an undesirable imprint.

Although some health conditions can be the source of bad breath, it most commonly occurs due to an overload of oral bacteria. Too many bacteria in the mouth create an odor — a sulfuric, putrid odor.

Bacteria are living organisms that eat, reproduce and emit waste. Their ability to reproduce is astounding, resulting in a consistently growing number of waste-producing creatures.

Poor oral hygiene is the most common cause for bad breath. Not brushing and flossing or doing so adequately allows oral bacteria to reproduce, which leads to plaque.

Plaque is the sticky film you feel on teeth when you’ve missed brushing or when you wake up. When not removed thoroughly on a daily basis, plaque turns into a cement-hard substance known as tartar. This mass is actually a solid colony of oral bacteria that attaches to teeth. In this form, it cannot be brushed or flossed away.

Tartar attacks enamel and gum tissues. As bacteria multiplies, it causes the gum tissues to become inflamed. This inflammation can quickly develop into gingivitis, an early form of gum disease. If not resolved fully, however, gingivitis can lead to full-blown periodontal (gum) disease.

Occasional bad breath is a nuisance but can generally be controlled with good oral hygiene, keeping our mouth moist and limiting sugar. Things like drinking sugary colas and a diet of high carbohydrate foods rev up bacteria reproduction even more, boosting their ability to grow and thrive.

However, frequent bad breath is not only embarrassing, it is a warning sign.

As one of the symptoms of periodontal (gum) disease, persistent bad breath may be accompanied by tender gums that bleed easily when brushing or tender, swollen areas around some teeth.

As gum disease advances, symptoms include gums that turn red in color and become sore, swollen and bleed easily when brushing. As it worsens, bad breath becomes persistent. Pus-filled pockets may develop near the base of some teeth. Eventually, teeth may loosen and require removal.

While what we consume can greatly contribute to the ability of these icky organisms’ ability to reproduce, a common one is having a dry mouth. This condition is known as xerostomia (zeer-o-STOE-me-uh).

Good saliva flow helps to keep bacteria moving out of the mouth. However, when brushing is infrequent or the mouth becomes dry, saliva is less able to manage the bacteria levels in the mouth.

A dry mouth may seem less likely to be a breeding ground for bacteria since they typically thrive in environments that are warm, moist, and dark. However, when saliva flow is unable to efficiently cleanse bacteria buildup from the mouth, they are easily able to reproduce.

Having ‘dry mouth’ is rather common today. In addition to a part of the aging process, a number of common medications (including anti-depressants, decongestants, and anti-histamines) have a side effect of oral dryness.

Too, many beverages contribute to having a dry mouth. These include colas, coffee, tea, and those containing alcohol. (Please note that colas are acidic and most contain caffeine. These are anything but ‘refreshing’, doing very little to hydrate the body. Stick to plain water to quench your thirst and add moisture to the body.)

Another way that oral bacteria can run rampant has to do with our oral hygiene routines. To be truly thorough in cleaning tooth surfaces, it is recommended to spend two minutes per brushing, twice a day (whether manual or electronic).

It is estimated that nearly a third of American adults brush their teeth for an insufficient amount of time. Even worse, about that same amount fail to brush twice a day. This means that an alarming amount of bacteria remain to grow and thrive in the mouth.

Proper brushing and flossing is necessary. Brush for at least two minutes twice daily and swish thoroughly. Use a circular motion rather than scrub teeth back and forth to avoid damaging tender gum tissues. Never use a hard bristle tooth brush or brush with harsh substances such as baking soda! These can wear down tooth enamel and wear away precious gum tissue.

You may be surprised to learn that brushing only tackles about half the amount of bacteria in the mouth, leaving a tremendous amount that continue to grow and thrive. The tongue actually harbors 58 – 65 percent of the bacteria in the ‘oral cavity’.

Oral bacteria love to take up housing in the tiny bumps and grooves of the tongue since they are not easily dislodged. Thus, it’s necessary that tongue cleaning be a part of your oral hygiene regimen at home to keep bacteria levels under control.

Some toothbrushes have a “tongue scraper” on the reverse side of the bristles that’s an effective option. Or, you can brush your tongue with the bristles after your teeth are brushed. Be sure to reach towards the back of the tongue where the majority of bacteria exist.

An advantage of achieving and maintaining a clean, healthy mouth is being confident when close to others. Plus, you’ll be contributing to the health and well-being of your entire body. Research has shown that a healthy mouth is a supportive component of a healthy you!

If you are experiencing symptoms of gum disease or concerned your breath is frequently bad, call 828-274-9440. We’ll arrange a periodontal exam in our comfortable Asheville periodontal office.

Here, we are committed to the comfort of each patient as well as those who have avoided dental care in the past due to fear. Dental fear is common, and we have a reputation for a gentle touch and respectful care. We also make oral and IV sedation (twilight sleep) available.

Let’s help you establish a healthy smile and feel confident in closeness!

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.

 

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