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“Gray Tsunami” Brings New Numbers in Dementia, Alzheimer’s
Posted on Feb 11, 2023 by William J. Claiborne, DDS MS
The American Academy of Periodontology (perio.org), defines a periodontist as:
“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. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”
As an Asheville periodontal specialist for over 25 years, my advanced skills help patients with a variety of needs that involve the gum tissues. These include:- Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)
– Diagnosis and placement of dental implants
– Treatment of lesions or cysts in oral tissues
Why should you be concerned about the health of your gums?
Gum disease is an inflammatory disease that attacks gum tissues, teeth, and the structures that support them. It is the nation’s leading cause of adult tooth loss. As if that weren’t bad enough, research has shown that these potent bacteria are able to activate the development (or worsen the progress) of other diseases.
Past studies have shown oral bacteria from gum disease can be a contributing factor to heart disease, stroke, some cancers, diabetes, preterm babies, erectile dysfunction (ED), high blood pressure, and impotency. Studies have begun to closely study the links between gum disease and Alzheimer’s disease.
In the U.S., the growing prevalence of dementia and Alzheimer’s disease is an especially concerning issue as our aging population grows. If you are a “baby boomer” (born between the years 1946 – 1964), you make up a significant percentage of adults. Within 7 years, boomers” will comprise 21% of the population. By 2060, nearly 1 in 4 Americans will be 65 years and older, dubbed the “gray tsunami.” Seniors over the age of 85 will have tripled, with half a million adults having reached age 100-plus.
While the statistics of aging adults increase, these stats for ALL adults over the age of 30 should set off some alarms. Nearly half of the adult population has some level of gum disease, over 47%.
There is a misconception many have when it comes to the serious nature of gum disease. Too often, people perceive “if it doesn’t hurt, then nothing is wrong” when it comes to their oral health. Although symptoms of gum disease may include tender gums that bleed when brushing, gum disease can begin without any obvious signs.
This is true for many health problems. For instance, when cancer forms in the body, its initial presence isn’t obvious. This is why annual or periodic screenings are urged since treatment is typically minimal during early stages.
Early treatment, including that for gum disease, helps to resolve the problem without complex measures. This is why it is so important to have 6-month dental check-ups. These visits allow your dentist to catch gum disease early so treatment needs and expense can be minimal.
Yet gum disease is a hazard for your overall health as well. While gum disease forms in the mouth, that’s not necessarily where it remains without proper treatment. The bacteria of gum disease can enter the bloodstream. It has been found to trigger serious reactions elsewhere in the body. Some of these lead to the formation of cancer (oral, throat, pancreatic, lung) and some activate conditions such as diabetes and arthritis.
Obviously, the health of your mouth is an important part of supporting a healthy body, especially in disease prevention. To illustrate the extent of gum disease’s damaging impact to health, research is tracking its correlation to dementia and Alzheimer’s disease.
In a recent study that included over 8,200 adults, an increased risk for developing dementia was found in those having severe gum disease and missing teeth. Participants in the study had an average age of 63 at the study’s onset.
In a follow-up after 18 years, those who had severe gingivitis in addition to tooth loss had a 22% higher risk for developing Alzheimer’s disease or dementia. Having no natural teeth was associated with a 26% increased risk.
Broken down, 14% of individuals with healthy gums and all their teeth at the start of the study developed dementia by the end of the study. For those with mild gum disease, 18% (623 out of 3,470) developed dementia. Twenty-two percent of participants with severe gum disease developed dementia. For those who had no remaining teeth, 23% developed dementia – nearly 17 cases for every 1,000 persons.
They found the bacteria present in periodontal disease can travel through the mucous membranes of the mouth to the brain, potentially causing brain damage.
In the study, participants were carefully assessed based on age, gender, education, cholesterol, high blood pressure, coronary heart disease, smoking and body weight. (https://psychcentral.com/news/2020/07/30/gum-disease-may-be-linked-to-later-dementia/158497.html?MvBriefArticleId=25473)
Prior studies have led researchers to be more focused on tracking oral tissue related factors that may contribute to dementia and Alzheimer’s disease, which is affecting a growing percentage of American adults (as well as those globally). Currently, 10% of adults age 65 and over have Alzheimer’s disease. For people ages 85 and older, this increases to 32 percent. In the U.S., it is the 6th leading cause of death. (https://www.alzheimers.net/resources/alzheimers-statistics/)
By the year 2025, the number of people 65 and older with Alzheimer’s disease is expected to reach 7.1 million people, a 27 percent increase from the 5.6 million age 65 and older in 2019.
Let us help you minimize the risks associated with oral bacteria. If dental fear has kept you from having regular dental care, we will be happy to discuss our many comfort options in our comfortable Asheville office, including Oral and I.V. sedation (“twilight sleep”).
Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety.
Here, our Western North Carolina periodontal dental office also features some of the most advanced technology in dentistry. Many of these are not available in other dental offices elsewhere. Some of these features include LANAP (Laser-Assisted New Attachment Procedure. This is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. We also have 3-D Cone Beam Imaging, computerized Tomography imaging and one of the latest in intraoral scanners.
Now, more than ever, we know that maintaining a healthy smile is important and achievable for every adult. If you suspect you have gum disease (gums that bleed when brushing, tender or swollen gums, gums that have reddened or receded from teeth), it is important to be seen by a periodontist. A periodontal specialist is the best way to restore any level of gum disease to help you regain a healthy smile.
Be committed to having excellent oral health as and make it a priority as an important part of your overall health. For a consultation to discuss how a periodontist can help you, call 828-274-9440.
Some Internet Dental DIY Advice Can Result In Tooth Loss
Posted on Jan 30, 2023 by William J. Claiborne, DDS MS
With the internet and emergence of social media, there has been an explosion of information and “advice” now at our fingertips. Want to know how to remove a red wine stain, check the internet. Need recommendations on the most scenic route to a vacation cabin, google it.
Some of the pointers online are helpful. I was finally able to reprogram my garage door opener with help found on it. However, as a periodontal dental specialist in Asheville NC, I’ve been jolted by some of the dental “advice” I’ve come across. It has not been unusual for some of this info to result in patients who come to us with problems that were actually made WORSE!
From a dental standpoint, the most common I’ve seen over recent years are…
• Using ‘super glue’ to repair teeth:
Most of these chemical-laden glues are toxic. They are not intended to be ingested in any way in the human body. These toxins can seep into oral tissues, causing irritation and allergic reactions.
In some cases, glue sets by using an exothermic reaction, essentially a combustion reaction that generates heat. This can damage the dentin tubules housed within a tooth’s chambers. The risks to the tooth can include the need for extraction or a root canal.
Additionally, using these glues to try to re-attach a crown, broken bridge or a denture can actually make matters worse. For example, if a crown comes off, a dot of super glue may seem to be a quick fix and a way around a dental visit. Toxic risks aside, the DIY fit will most likely be inaccurate and can lead to misalignment with other teeth when chewing or speaking.
In turn, this can result in chips, fractures and breaks in neighboring teeth. Thus, when the patient proceeds to have the crown re-cemented properly by a dentist, the glue residue must first be removed. This requires resurfacing of the remaining natural tooth structure, which results in less structure to support the crown. Because of the change in tooth height, a new crown is commonly needed.
Dentists use special dental adhesives to provide the safest and most lasting option.
• Scrubbing teeth rigorously when brushing:
Brushing teeth hard in a back-&-forth motion isn’t the way to do a good job. This can wear away tooth enamel and cause the gums to recede. Gum recession exposes tender and sensitive tooth root areas. This detracts from a smile’s appearance and also leaves the tooth vulnerable to the entry of oral bacteria.
A circular motion that allows the bristle tips to sweep the teeth is preferred. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.
• Using home remedies to whiten teeth:
Natural teeth have a protective coating – enamel. Enamel is a hard, outer shell that prevents penetration of oral bacteria into the tooth. Without this protection, cavities can occur and teeth weaken, making cracks and fractures more likely. As hard as enamel is, it can be worn away. And, when it’s gone, it’s gone for good.
Although brushing too soon after eating can wear down enamel, there is nothing worse than the thoughts of a toothbrush with a peroxide-&-baking soda mixture scrubbing across precious tooth enamel. This is like sandpaper rubbing against a tooth!
For people who want to whiten their teeth, it’s typically more than surface stains that are discoloring teeth. Thus, sacrificing tooth enamel in an attempt to remove stains is going to be of little benefit. For many people with dull, brown or yellow teeth, the aging process and years of coffee, tea, smoking and red wine can require a deeper whitening process. This is why many dental offices offer whitening systems that are safe to teeth and gums.
• Assuming blood in the sink is normal:
Your gum tissues serve as a sealant covering inside the mouth. Gums that are pink and wrap snugly around the base of teeth indicate healthy gums. Gum tissues that redden and become sore, swollen or bleed are gums signals that something is wrong. Seeing blood in the sink when you spit out toothpaste during brushing is NOT a sign you are doing a good job. It is a sign that bacteria has attacked and weakened your gum tissues.
As this bacteria progresses, gum tissues become spongy and breath odor is frequently bad. When oral bacteria has accumulated to the point of causing soreness and bleeding, prompt attention can restore the gums to a healthy state. This includes a dental cleaning and thorough at-home oral hygiene regimen. Untreated, the gums will become more and more damaged by oral bacteria and develop into periodontal (gum) disease.
Beneath the gum line, gum disease bacteria attack the bone structures that support teeth. And, these infectious bacteria can enter the bloodstream through tears in weakened gums. The oral bacteria of gum disease has been shown to cause inflammatory triggers in the body. Research has linked it to heart disease, stroke, some cancers, diabetes, arthritis, preterm babies, impotency and even Alzheimer’s disease.
If you have symptoms of gum disease, please be seen by a periodontist promptly. Symptoms include tender gums that bleed easily when brushing, frequent bad breath, swollen and tender gums and gums that redden in color from a healthy pink. Gum disease will only worsen without treatment and is the nation’s leading cause of adult tooth loss.
Maintaining good at-home care of your oral health is easy and takes just minutes a day. Follow a thorough oral hygiene regimen by brushing twice a day (two minutes each time) and floss daily. Drink plenty of plain water throughout the day and limit sugar. Have dental cleanings every six months and follow your dental hygienist’s recommendations to keep oral bacteria at minimal levels between visits.
If you suspect you have gum disease or have delayed (or avoided) having regular dental care, call our Asheville periodontal dental office to schedule an examination. Or, ask to begin with a consultation appointment.
During this time, we can discuss any concerns. If dental fear is a factor, we offer several sedation options, including I.V. sedation (“twilight sleep”). Or, if there are financial constraints, we offer several payment plans that are interest-free with no down payment required. Call 828-274-9440.
Boost Immune System By Investing In Gum Health
Posted on Nov 17, 2022 by William J. Claiborne, DDS MS
There is no argument that the price of about everything has gone up and up over the past couple of years. The challenges that most individuals face at this time have been significant for some people but felt by about all.
Yet, there are still reasons to “spend less now so we’re not spending more later.” This is true with things such as auto maintenance, home repairs and taking good care of our health. A signifiant part of maintaining good overall health is having good oral health. The key, however, is to make the investment while the costs are still low, and avoid the big expenses later to pay for repairs and more extensive treatment.
I’d like to point out the need to bolster our immunity system, brought front-&-center during the pandemic, is actually supported by your oral health. Although the Covid virus continues to be a threat, the experience has made populations more aware of the benefits of vaccines and healthy habits such as hand-washing. Still, it is in our immune system that makes people more or less vulnerable.
By investing in having healthy gums, the immune system is actually supported more than is largely known. I’ll explain.
The bacteria in the mouth, or “oral cavity,” is intricately connected to your overall health; so much so that “bad” oral bacteria can disrupt the healthy balance in the digestive system. This bacteria comes from oral plaque, which is a cesspool of sorts formed from bacteria accumulation.
As a layer of biofilm, plaque coats teeth and gums. It is the sticky coating you feel in your mouth when you wake up, during which time the bacteria has had an opportunity to amass during sleep. Plaque, mot removed, becomes tartar. This hardened mass of oral bacteria continues to grow, doing damage in the mouth and far beyond.
Researchers have tracked oral bacteria as it enters the bloodstream. This occurs through weakened gum tissues, allowing the bacteria to travel throughout the body. Studies have shown that the bacteria are able to activate or worsen the development of a number of serious health problems.
These include heart disease, stroke, arthritis, diabetes, preterm babies, some cancers, erectile dysfunction and dementia. Research is currently being conducted to further the connections suspected between periodontitis to Alzheimer’s disease.
How does oral bacteria become destructive? Gingivitis is the initial stage of gum disease. Symptoms typically include gums that are tender in spots and some bleeding when you brush. These are warning signs that signal an immediate need for attention.
Periodontal (gum) disease and (often) its subsequent tooth loss are, simply put, products of bacterial overload in the mouth. The mouth is constantly being supplied with sustenance for these organisms. Bacteria are able to thrive through food that enters, especially sugars, and other bacteria-laden items put into the mouth.
The bacteria that cause cavities that feeds on sugar from the foods and drinks you consume. This weakens tooth enamel due as bacteria convert sugar into acids. As bacteria thrive, they are able to reproduce very rapidly.
When bacteria levels become more than the immune system can tackle, infection can set in. Accumulation of bacteria can evolve into gum disease, which is an inflammation that attacks teeth, oral tissues and the bone structures that support tooth roots.
Gum disease symptoms are those more prominent than gingivitis. These include sore gums that bleed when brushing, persistent bad breath, gums that pull away from the base around teeth, gums that darken in color.
As it worsens to the stage known as periodontitis, 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.
The reason that 6-month dental check-ups and dental cleanings is to remove tartar buildup before damage can occur. Your hygienist and dentist can look for signs of gum disease so measures can be taken before the disease explodes into the need for more costly treatment to resolve the problem. Since gum disease is the nation’s leading cause of adult tooth loss, the associated expenses of replacing teeth can also be avoided by maintaining good oral health.
Prevention begins at home: Begin by 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.
You can remove a tremendous amount of oral bacteria by using 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.
Drink lots 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. Oral dryness is the enemy. 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.
Oral dryness gives bacteria a favorable environment for reproduction. The chemicals in cigarette smoke are very drying to oral tissues. If you smoke, consider using an oral rinse that replenishes moisture in the mouth. Some oral rinses are specifically designed for moisture.
Lowering treatment costs begins with early care: If you have delayed or avoided regular dental care, it is recommended that you begin by having a periodontal examination. A periodontist is a dental specialist who can determine your precise level of gum disease and the most appropriate treatment to restore good oral health. We can detect all stages of gum disease and provide comfortable, thorough treatment to restore your gums to a health state.
If you have lost teeth due to periodontal disease, a periodontist also specializes in the diagnosis and placement of dental implants. This ideal method to replace teeth provides a lifetime solution, making them an excellent investment.
Call 828-274-9440 if you have questions about your gums or if you are experiencing any symptoms associated with gum disease. Also, visit our web site to learn more about our sedation options (including “twilight sleep”) and advanced technology, which often reduces treatment time while enhancing comfort.
Challenges of Aging to Oral Health
Posted on Oct 28, 2022 by William J. Claiborne, DDS MS
Hopefully, the phrase “older and wiser” is one of truth. In all honesty, many adults “of a certain age” worry about being more forgetful, being less energetic and having less stamina. True or not, the aging process forges on for us all!
Aging, of course, comes with certain health challenges. However, these may bring seniors more determination to “age gracefully.” Today’s older adult seems to be more active and health-conscious than that of our ancestors. Aging adults now have greater knowledge of contributors to poor health. Most try to eat healthier, have periodic physicals and screenings, and include physical activity in daily regimens.
Over the years, all ages have had access to the findings of research reporting on how the health of the mouth plays a significant role in overall health. For example, the bacteria of periodontal (gum) disease are shown to potentially activate or worsen the development of a number of serious health problems.
For seniors, these health problems are especially challenging since a major one affected is that of the immune system. This is of high concern for seniors since their immune systems are typically operating at less-than-peak levels (often complicated by other health problems, such as arthritis or high blood pressure).
Over 70% of our immune response comes from the cells within the gut. The “good” bacteria in the gut is crucial to efficient digestion. Yet, it can be compromised due to the presence of gum disease bacteria.
We now know that the inflammatory nature of infectious oral bacteria can interfere with the healthy bacteria in the gut. This causes the gut (and well as other systems in the body) to function less efficiently. Research has correlated gum disease bacteria to heart disease, stroke, high blood pressure, diabetes, arthritis, some cancers, erectile dysfunction and even Alzheimer’s disease.
According to the Centers of Disease Control & Prevention (CDC), over 47% of American adults over age 30 have gum disease. It is estimated that 64% of adults ages 65 and older have either moderate or severe periodontitis.
Gum disease, an inflammatory disease, which can trigger inflammation elsewhere in the body. Studies have shown that by reducing the level of these bacteria, however, can improve other inflammation-based health conditions (such as arthritis, prostatitis, and psoriasis).
For instance, diabetes has a clear relationship with periodontal disease. Studies show that treating one condition positively impacts the other. By the same token, uncontrolled inflammation levels of one can worsen inflammation levels in the other.
Therefore, treating inflammation may help manage periodontal diseases and also help manage other chronic inflammatory conditions.
For seniors, oral dryness is one of the biggest influences in developing gum disease. Like the skin and joints, the body’s moisture and lubrication wanes with age. Although poor oral hygiene is a key factor when it comes to bacteria in the mouth, a dry mouth is a common contributor to bacterial growth.
In addition to aging, dry mouth is particularly challenging for seniors because it has many causes, including:
• A side effect of many medications (including prescription and OTC)
• Radiation therapy, especially for head and neck cancer
• Mouth-breathing, which may be due to nasal congestion or snoring
• Medical conditions, such as diabetes, Alzheimer’s disease, stroke and Sjogren’s syndrome
While important for all ages, older adults should be especially committed to their oral hygiene, including twice daily brushing and daily flossing. In addition, you can support saliva flow by:
• Drinking plenty of plain water throughout the day
• Avoiding (or limiting) caffeinated beverages, such as coffee, tea and colas
• Using an oral rinse designed to replenish moisture in the mouth (available OTC)
• Being aware of medications that have an oral dryness side effect (increase your water intake and use a daily rinse to replenish oral moisture)
• Taking steps if you snore or breath through the mouth during sleep (ask your physician for suggestions)
• During a cold or sinus condition that increases mouth-breathing, be especially committed to your oral hygiene routine at home (brushing and flossing) and increase water intake
• Following each alcoholic drink (including beer and wine) with gulps of water as these are very drying to oral tissues
• Taking all steps mentioned above if you smoke cigarettes, “chew”, or vape
It is also important to know the signs and symptoms of periodontal (gum) disease. It begins with gingivitis, which causes the gums to become tender and swollen. When brushing, blood may be present in the sink when rinsing. Bad breath becomes persistent and the gums may turn red in color.
As an Asheville periodontist, I believe that the first step for adults who want to improve their oral health is by being informed patients. This generally leads to an individual who is committed to achieving and maintaining a healthy smile.
A good resource on maintaining good oral health is the web site of the American Academy of Periodontology: www.perio.org (go to Patient Resources). If you are experiencing any of the symptoms associated with gum disease as mentioned above, call our Asheville periodontal dental office at 828-274-9440. Gum disease will only worsen without treatment. (A referral is not necessary.)
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