A Periodontal Specialist Explained


Posted on Dec 13, 2019 by William J. Claiborne, DDS MS

Occasionally, I meet someone new who is unfamiliar with my specialty. Although a periodontist may seems to be a “behind the scenes” specialist, our focus actually has an upfront role in your oral health, and beyond.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school.

In addition to having advanced training in the latest techniques for diagnosing and treating periodontal disease, a periodontal specialist is also trained in performing cosmetic procedures that involve gum tissues, such as correcting a “gummy smile”.

Periodontists often treat more problematic periodontal cases, such as people with severe gum disease or have a complex medical history. A periodontist offers a wide range of treatments, such as scaling and root planing (cleaning the infected surface of the root) or root surface debridement (removing damaged gum tissue).

Periodontal specialists can also treat patients with severe gum problems using a range of surgical procedures.

In addition, periodontists are specially trained in the placement, maintenance, and repair of dental implants.

During the initial appointment in our Asheville periodontal office, we typically begin with a review of the patient’s medical and dental histories. This information is important so we are aware of medications being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.

During the examination, we check the patient’s gums to look for gum line recession. We will also assess how the teeth fit together when biting, and check for any loose teeth. An important part of this exam is in the measuring of spaces between gum tissues at the base of teeth.

Using an instrument called a probe that is gently positioned between specific points surrounding each tooth, we determine the depth of periodontal “pockets”. These measurements help us assess the health of your gums. Images (x-rays) may also be taken to revealsthe health of the bone below the gum line.

Periodontal disease, also referred to as “gum disease,” often exists without an individual being aware of its presence. In its early stage, gingivitis, some people even assume that symptoms, such as seeing blood in the sink when brushing, are normal.

Obvious symptoms, such as pain, may not appear until the disease has reached an advanced stage. This is why it is important to be familiar with the signs and symptoms, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding (pulling away from the teeth) or make the appear teeth longer than normal
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

If you notice any of these symptoms, be sure to contact your dentist or periodontist without delay. Gum disease will only worsen without treatment.

Who Should See a Periodontist?
Some patients’ periodontal needs can be managed by their general dentist. However, patients who are experiencing signs and symptoms of moderate or severe levels of gum disease or have more complex cases receive the most efficient and effective care through team treatment between a general dentist and periodontist.

Restoring your gums to a healthy state is important! As research continually shows, gum health is intricately connected to overall health. Oral bacteria of periodontal disease has been linked as a trigger for more and more chronic diseases, including heart disease, some cancers, stroke, memory loss, diabetes, and arthritis. Having prompt periodontal treatment by a trained periodontal specialist may lower the risk for more serious, and even deadly, diseases and health conditions.

If you are experiencing any of the symptoms associated with periodontal disease, a referral is not required. Call 828-274-9440 and we will be happy to assist you.

If you do not have a general dentist, we can also refer some who are near to you and we know to provide gentle, thorough and appropriate care for their patients’ needs.

Ties Between Obesity And Gum Disease


Posted on Dec 05, 2019 by William J. Claiborne, DDS MS

QUESTION: What do obesity and periodontal (gum) disease have in common?

ANSWER: They are both inflammatory diseases.

So, how could having healthy gums impact your weight?

Although the connection between obesity and gum disease may seem far-fetched, Researchers from Case Western Reserve University School of Dental Medicine followed their similar path that lead to inflammation.

Obesity in the U.S. has become a severe problem. People who are obese have a body mass index of over 30 percent. That means that nearly one-third of their overall weight is made up of fat. Over 35 percent of American adults are categorized as obese.

Obesity can lead to a long list of serious health problems, including:
• Heart disease and stroke
• Type 2 diabetes
• Certain types of cancer
• Osteoarthritis
• Digestive problems
• Sexual problems
• Sleep apnea

By the same token, gum disease is nothing to take lightly. It can have dire consequences far beyond the mouth.

Gum disease is an infection of the tissues that hold your teeth in place. It’s typically caused by poor brushing and flossing habits that allow plaque – a sticky film of bacteria – to build up on teeth and harden.

In its initial stage, Gingivitis, it causes the gums to become red, swollen, and bleed easily. In advanced stages, gum disease can destroy the bone and tissue structures that support tooth roots, causing sore, bleeding gums and the need to remove some teeth.

Periodontal disease is associated with an increased risk for:
• Heart disease and stroke
• Type 2 diabetes
• Certain types of cancer
• Arthritis
• Impotency
• Preterm, low birth weight babies

Notice the similarity between the health risks of obesity and periodontal disease?

Studies have concluded that changes in body chemistry affect metabolism, which trigger inflammation–something present in both gum disease and obesity. Because gum disease has been shown to occur in people who are more susceptible to inflammation, the same holds true for being more susceptible to obesity.

While further research on the connection is needed, it is hoped that treatment of one can positively impact the other. For example, by successfully treating periodontal disease, the path to achieving a healthy weight could be a more successful goal as well.

If your 2020 resolutions include a healthy weight goal, then start with a healthy smile. Begin with a periodontal examination by a specialist in periodontics. By reducing inflammation that originates in the mouth, the top-down effect may be the “leg up” you need to move forward for reaching your weight goals.

Call 828-274-9440 to schedule or to learn more about our Asheville periodontal dental office.

Obesity Increases Risk Of Gum Disease.


Posted on Nov 20, 2019 by William J. Claiborne, DDS MS

Imagine one-third of your body being made up of maple syrup.

Sounds pretty absurd, doesn’t it? Yet, for Americans who are categorically obese, this imagery is actually a good description.

Obesity is when fat makes up over thirty percent of body mass. According to the Centers For Disease Control & Prevention (CDC), adults in the U.S. who are categorized as obese is at nearly 40 percent! Another 30 percent are categorized at overweight. That’s two-thirds of adults in the U.S. who have too much fat makeup.

And it’s not just adults over the age of 20 who have this problem. Sadly, nearly 30 percent of children are overweight or obese as well.

In North Carolina, over 63 percent of adults are either overweight or obese, according to a study by the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.  (https://onlinelibrary.wiley.com/doi/full/10.1002/oby.20451)

The problems associated with being overweight and obese are many, and can be deadly. Obesity seems to trigger a predisposition to a variety of serious health conditions and diseases. These include increased risk of stroke, certain cancers, coronary artery disease, and type 2 diabetes.

In addition to the added and unnecessary load that strains the back, knees and ankles, the challenges continue. Obesity decreases lifespan, up to an estimated 20 percent of people who are severely obese. (https://www.nejm.org/doi/full/10.1056/NEJMsr043743)

As 2019 holiday indulgences (often sugary and carb-laden) are before us, many of us also follow the season with with the traditional new year’s resolution of “lose weight” at the top of the list. Along with improved health and greater confidence in overall appearance, we’d like to add another reason to reach your goal.

Chronic inflammation is a known side effect obesity. Why does this matter to a Periodontist? Obesity is also known to exacerbate other inflammatory disorders, including periodontitis (advanced gum disease).  To be clear, periodontal disease is also the nation’s leading cause of adult tooth loss.

Research has shown that obese adults have a 6 times higher potential to develop periodontal (gum) disease. As a periodontal specialist my goal is always to help patients achieve optimal oral health. Although discussing the risks of periodontal disease with obese patients can be a sensitive issue, this is without judgement of why they are overweight but rather how we can help them enjoy a healthier smile.

Most of us know – losing weight is not a process that is either easy or quick. Add to this that research has shown that factors such as sleep quality and what we eat (as much as how much we eat) can cause the brain to make the challenges of weight loss even greater.

For one, studies have shown that sugar can be addictive. Sugar consumption even activates the same regions in the brain that react to cocaine. For individuals who admit to having a “sweet tooth,” trying to stay within the recommended 6 teaspoons per day limit can be a battle when we are truly “addicted.”  (https://www.brainmdhealth.com/blog/what-do-sugar-and-cocaine-have-in-common/)

Insufficient sleep also complicates the brain’s ability to regulate hunger hormones, known as ghrelin and leptin. Ghrelin stimulates the appetite while leptin sends signals of feeling full. When the body is sleep-deprived, the level of ghrelin rises while leptin levels decrease. This leads to an increase in hunger.

The National Sleep Foundation states that “people who don’t get enough sleep eat twice as much fat and more than 300 extra calories the next day, compared with those who sleep for eight hours.” (https://www.sleepfoundation.org/sleep-topics/the-connection-between-sleep-and-overeating)

As difficult as losing weight can be, it is important to be aware of risk factors that can make you more suspectible to gum disease. Initial symptoms include gums that are tender, swollen, and may bleed when brushing. This stage, known as gingivitis, is actually reversible with prompt, thorough oral hygiene.

As gum disease worsens, however, the inflammation of oral bacteria can lead to persistent bad breath, receded gums that expose sensitive tooth roots, and gums that darken in color. If untreated, pus pockets can eventually form and the base of some teeth and tooth loosening can require removal.

Armed with this information, we want to help all patients, with overweight or obese adults especially, to take added precautions to maintain good oral health, both at home and through regular dental check-ups.

Avoiding periodontal disease is particularly important since its infectious bacteria have been linked to serious health problems. These include heart disease, diabetes, arthritis, some cancers, preterm babies, impotency, and Alzheimer’s disease.

If you are experiencing symptoms of gum disease, however, it is vital to be seen by a periodontist as soon as possible to halt further progression. A periodontist is a dental specialist who has advanced training in treating all stages of gum disease as well as in the placement of dental implants. The earlier the treatment, the less involved treatment requirements will be. Gum disease will not improve without professional care.

Call 828-274-9440 to schedule an initial examination or begin with a consultation.

Rheumatoid Arthritis (RA) Linked To Periodontal Disease


Posted on Oct 02, 2019 by William J. Claiborne, DDS MS

As a periodontist, I specialize in the treatment of all stages of periodontal (gum) disease. Although this particular dental specialty is not as visible as a general dentist, we are very-involved members of the medical and dental community. According to the Centers for Disease Control & Prevention (CDC), over 47 percent of American adults have some level of gum disease.

Like the formation of cancer, many individuals are unaware when periodontal disease becomes active. When early symptoms appear (such as bleeding gums when brushing, bad breath and gum tenderness), many people shrug them off as temporary.

However, gum disease only progresses once underway. Eventually, gums become red in color and pus pockets form at the base of teeth. In advanced stages, teeth loosen and may require removal. Gum disease, to no surprise, is the nation’s leading cause of adult tooth loss.

The potent bacteria of periodontal disease can enter the bloodstream through tears in weakened gum tissues. This allows it to travel throughout the body. Research has shown it is able to trigger a number of serious health problems, including heart disease, stroke, diabetes, memory loss, and impotency.

Rheumatoid arthritis (RA), a condition seemingly unrelated to gum disease, is a debilitating disease that destroys joints. It is disabling and painful. In most cases, RA emerges gradually, often beginning with morning stiffness along with weak and aching muscles. Joint pain follows, with joints feeling sore and stiff. RA is typically found in the fingers, wrists, elbows, hips, knees, ankles, toes, shoulder and neck.

As inflammation from RA increases, joints become swollen with symptoms including fever, disfiguring of hands and feet, numbness and tingling. There is no cure for RA and lifelong treatment is required. Treatment may consist of medications, physical therapy, or even surgery.

Yet, like RA, gum disease causes pain, swelling, and tenderness. As it worsens, the associated inflammation can lead to destruction of the bone that supports teeth along with surrounding tissues. And, the similarities go much deeper.

Both gum disease and RA share a genetic likeness in clinical makeup and structures. This has been particularly apparent in pathogens, which are agents in the body that lead to disease or illness. The pathological processes that occurs in both gum disease and RA are almost identical.

Too, the particular species of bacteria found in gum-diseased oral tissues and tissues that surround joints in those who suffer with RA. Equally concerning is, while both conditions clearly cause chronic inflammation in tissues connected to bone, researchers have found the two diseases share a similar inflammatory trigger.

In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis. It has also been shown that, by treating periodontal disease in RA patients, RA symptoms often improve ( likely due to the system’s reduced burden of oral inflammation).

These findings reveal just how closely our oral health correlates

A relaxing and comfy environment.

to our overall health. This information should send up alarms that the presence of gum disease can greatly increase your risk for serious health conditions. Clearly, people who have RA should be particularly diligent when it comes to their oral health.

If you are experiencing symptoms of gum disease (as mentioned above), seek treatment at your earliest convenience. You can begin with a consultation appointment in our  comfortable Asheville periodontal office. A referral is not needed.

Call 828-274-9440 to learn more.

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