Pregnancy & Your Gum Health
Posted on Jul 09, 2020 by William J. Claiborne, DDS MS
Today’s American female has a long list of guidelines that enhance the potential to have a healthy, full-term baby. Even so, pre-term births in this country occur at a rather high rate for the advanced health care available to most.
According to data released in 2017 by the National Center for Health Statistics (NCHS), the U.S. preterm birth rate actually rose from 2015 -2016, from 9.6 percent of births to 9.8 percent.
There seems to be a rather close connection between gum disease and preterm babies, as unrelated as the two may seem. First, consider the risks cited by the Centers for Disease Control & Prevention (CDC). As far back as the year 2000, the Surgeon General 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.
Infections in the mother have been identified as increasing the risk for pregnancy complications. Due to varying hormone levels, nearly all females will develop gingivitis during their pregnancy.
Referred to as pregnancy gingivitis, symptoms include swollen, tender gums that bleed easily when brushing. The goal is to halt the inflammation before it progresses to a more infectious stage.
Most obstetricians now urge their pregnant patients (or those trying to conceive) to have a thorough periodontal examination. Even with no obvious signs, gum disease can still exist. It lies beneath the surface of the gum tissues and should be resolved before it worsens and is able to seep into the bloodstream.
Symptoms of gum disease include gums that bleed when brushing, swollen or tender gums, receded gums or gums that darken in color.
When periodontal disease is present, successful treatment has shown to lower the risk of preterm births. A periodontal specialist is trained to treat all levels of disease in a way that is safe for pregnant women (as well as all patients).
Pregnancy is not the sole risk factor for developing gum disease, of course. Most adults of both genders have at least one factor that heightens susceptibility to this oral infection. Among these are stress, poor diet with high sugar intake, smoking, obesity, age, and poor dental hygiene can all contribute to an increased potential for developing periodontal disease.
Other risk factors include clinching or grinding teeth, predisposition due to genetics, diseases such as diabetes or cancer, some medications, and changes in female estrogen levels (puberty, pregnancy, menopause).
Gum disease bacteria is obviously a potent threat to any individual. As the nation’s leading cause of adult tooth loss, oral bacteria of this disease have been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.
If you have symptoms associated with gum disease, schedule an appointment at your earliest convenience by calling 828-274-9440. Gum disease will only worsen without treatment.
We Are Seeing Patients Again With New Appointment Protocols
Posted on May 20, 2020 by William J. Claiborne, DDS MS
Lately, when people see a hospital worker on television news, healthcare workers have on layers of garb that we’re unaccustomed to seeing. Hopefully, in time, all this protective layering won’t be needed. For now, it’s in line with proper precautions for the safety of both patients and staff.
We are seeing patients again!
As established periodontists in Asheville, it has been a pleasure for Dr. Boyland and I to be able to open our doors again for patient care. And, our schedule is full! Patients in need of treatment have been patiently (but anxiously) waiting to resume periodontal therapy and dental implant placement.
However, our reopening brings some new protocols in addition to our already-stringent infection-control measures. Some new steps that patients may notice now in the flow of the appointment, from the check-in process to check-out. Too, patients will see us attired in more layers than before.
As a heads up, our doctors and staff are wearing protective equipment (N95 masks, gowns, face shields, etc.). This protective gear does not interfere with patient communication nor the exceptional care we have always provided.
Other than our “new look,” however, patients will also go through a few new steps, which include:
- Once patients arrive for scheduled appointments, they are asked to call our main number (828-274-9440) from their vehicles. Our receptionist will provide the patient with a pre-appointment questionnaire.
- After we retrieve the completed form, a staff member will escort the patient into the office. (For now, only appointed patients are allowed unless accompanying a child or disabled patient.)
- Once inside, patients will have their temperature taken and a staff member will escort them to a treatment suite.
- After care is completed, a staff member will walk the patient to our check-out desk.
In addition, patients can have the peace of mind that our Asheville periodontal office has always adhered to the highest standards of infection control in dentistry. Typical steps that have always been in place include are the sterilization process used on the instruments used in patient care (such as probes).
These pieces are heat sterilized at high temperatures for up to 40 minutes, killing bacteria, viruses and infectious micro-organisms. Once sterile, the instruments are carefully packaged until ready to unwrap for use in the treatment room.
Even the water used (for rinsing or as a spray to manage air particles) comes through water lines that undergo a special “flushing” process. This cleansing process dislodges and eliminates biofilm that can occur when minuscule particles attach to the interior of these lines. Thus, the water sprayed in your mouth during certain procedures is delivered so bacteria levels are at such a low point they are virtually non-existent.
After each patient is seen, treatment chairs, lighting, and any equipment the patient or staff come in contact with are thoroughly wiped down.
These steps have always been done to ensure the safety and well-being of our patients as well as our doctors and staff. Yet, now more than ever, we have a unique mindset in everything we do.
While the vast majority of patients seen feel very comfortable in our office and infection control steps being taken, we encourage questions or concerns so we can explain, reassure or even reschedule those who are still uneasy about close contact. Just call us at 828-274-9440. Our friendly front staff will be happy to assist you.
What’s most important is that you stay safe while keeping your oral health at its best. The progression from poor oral hygiene to gingivitis to full-blown periodontal disease is faster than many people realize.
Be sure to brush at least twice a day for at least minutes per brushing. Brush your tongue with your toothbrush once a day (especially towards the back where most bacteria hide out) and floss daily. Keep your mouth moist and limit sugar. Use an oral rinse that contains no alcohol as an added measure to minimize oral bacterial buildup.
Let’s all emerge from this odd time in our history with smiles that are healthy, accompanied by hugs!
Avoid Snacking As You ‘Shelter-In-Place’ For Your Waistline AND Your Smile!
Posted on May 07, 2020 by William J. Claiborne, DDS MS
Americans love their great outdoors. Our country is so blessed to have beautiful parks, patios, backyards, and trails that enable us to get much needed exercise, sunshine and fresh air.
While these wide-open spaces are good for us, our lives have been turned upside down since March. Stay-at-home mandates have left us struggling in this area and now our indoor time has increased greatly.
Fortunately, social interactions have been possible through tele-conferencing for work, church services online and visiting with family and friends through Zoom or Skype. However, what many people are finding is too-easy access to the pantry and refrigerator!
Lately, many of us are a little surprised when we step on the bathroom scales. If we really stop to think about it, though, it’s no wonder the needle is moving upwards.
Since the ‘shut down’ began, the only “essential” establishments that have been dependably open are grocery stores or places that sell food. Combine that with our open time that has us experimenting with new recipes and Ta-Da!, you have more time to cook, eat, and repeat.
Having three healthy meals a day is not the problem, when it comes down to it. It’s what we eat and how often we eat that becomes the issue, and not just to the detriment of our weight.
Every time you eat or drink something (other than plain water), an acid flows into the mouth through saliva. This acid begins the first stage of digestion and is designed to break foods down so they can continue on the journey once you swallow, giving more efficiency to the body’s ability to utilize what is consumed for its own good. (This is also why your Mom always said to chew your food well. It gives these acids more time to do their job.)
While this acid is beneficial to digestion, it is not good for teeth. As a matter of fact, this acid is so potent that it can soften tooth enamel for a period of about 20 – 30 minutes. And, that’s for every bite.
So, once you pop that first pretzel in your mouth, the acid attack begins and will continue for a half an hour after the last sip of cola you’re washing those pretzels down with. Yes, an acid attack is triggered by beverages as well.
This is why colas are so harmful to teeth, and wine, and coffee — anything that is sipped over extended periods of time. For example, people tend to drink a glass of wine slowly, perhaps over the course of 30 or so minutes. So, from the initial sip to 30 minutes after the last sip, your teeth have endured an acid onslaught for a full hour!
When tooth enamel is softened, it is more vulnerable to wearing away or bacterial penetration. Enamel is the protective coating for the interior structure of teeth. Once it is worn down, your teeth are forever at risk.
As far as wine, caffeinated colas, tea and coffee, these beverages are also very drying to oral tissues. This makes saliva less efficient and less capable of rinsing bacteria out of the mouth as you swallow. Add sugar to the mix, and you have quite the ‘cocktail’ of challenges for your smile.
Sugar changes the Ph balance in the mouth, which adds an even greater burden by ramping up the reproductive pace of oral bacteria. Think of sugar as creating oral bacteria on steroids. When bacteria are super-charged for reproduction, saliva can only manage a certain portion and the rest are left to riot their way through the mouth.
Rampant bacteria levels are the reason for periodontal disease. Referred to as gum disease (and sometimes ‘perio’), this is an inflammatory disease that destroys gum tissues and the bone structures that support teeth. Now, that’s serious bacteria!
Gum disease is from an overload of bacteria that the immune system cannot manage. It is infectious and gets “into” the gums, going below the surface. It can no longer be brushed or flossed away nor treated with a basic dental cleaning.
And, this harmful bacteria doesn’t necessarily remain in the area of the mouth. Through tears in diseased gum tissues, the bacteria can enter the bloodstream and travel throughout the body, continuing on its path of destruction.
Research has found links of this bacteria to a long list of serious health conditions. Heart disease, stroke, high blood pressure, some cancers, preterm babies, arthritis, diabetes, and impotency are just some. Studies are being conducted to track down its connections to Alzheimer’s disease, psoriasis, and more.
Body weight aside, all this should give you reason to relook at what you’re eating and the frequency for the well-being of your smile. Hopefully, this knowledge will start a new way of thinking for simple rules and guidelines that support your overall AND oral health.
Begin by being aware of the signs and symptoms of gum disease:
Red, swollen or tender gums
Bleeding while brushing, flossing, or when chewing rigorously
Sores in your mouth
Persistent bad breath
Receded gums that reveal darker areas of teeth or that cause teeth to look longer
Loose or separating teeth
Pus between your gums and teeth
A change in your bite when teeth are together
A change in how partial dentures fit
Keep in mind that some people are also more susceptible to oral bacteria. However, all individuals can maintain healthy teeth and gums by limiting snacking and caffeine, avoiding sugar, brushing at least twice a day, flossing daily, and drinking plenty of water to keep the mouth moist.
Just one last pointer: Comfort food is great during times of stress. After all, a large serving of Grandma’s rich and gooey Mac ‘N Cheese seems to satisfies both body and soul sometimes. But, keep in mind that carbohydrates (typically a big part of comfort foods) actually break down as sugar in the mouth. They just don’t come with the sweet taste.
As our nation gets back to normal and your dental visits resume on schedule, take pride in knowing that you are in control of what can impact the well-being of your smile. This knowledge will hopefully save you time and money in the future by helping you avoid the need for dental repairs.
If you are experiencing gum disease symptoms, our Asheville periodontal office will be happy to discuss your needs or concerns. Call us at 828-274-9440.
Posted on Apr 14, 2020 by William J. Claiborne, DDS MS
As a periodontist, I treat all stages of periodontal (gum) disease. Over the years, I’ve helped patients save natural teeth and restoring their ability to enjoy healthy, confident smiles.
When people come close to losing their teeth or find themselves in need of replacing them with something more dependable than dentures or partials, I hear nearly every one express the same regrets: “I wish I’d taken better care of my teeth when I could.”
Signs of gum disease
Hindsight may be 20-20, but it’s never too late. I know patients can go from having gum disease and losing teeth because of it to having excellent oral health – and end up having a renewed commitment to their smiles.
In my dental specialty, I know it begins by helping patients to understand how the problem starts in the first place. When people know the HOW, they can implement measures to bypass the repercussions of gum disease.
I’ve found that most people actually have very little awareness of how the inside of their mouth looks. We smile with lips and front teeth that show very little (if any gums). So, it stands to reason that, if a smile looks good, it’s probably healthy.
Until dental offices began using intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for a condition that didn’t hurt. There were not obvious signs initially, so nothing is wrong – right?
Intra-oral cameras are able to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual has this firsthand view of spongy, receded gums, the decision to treat often go from IF to WHEN.
Although it helps to be able to show patients the signs of gum disease, these emerged signs are indications of long-standing periodontal disease. By the time these signs appear, the early stage of gum disease, gingivitis, is past. This is unfortunate, since early-stage gum disease can be halted with prompt measures.
Gingivitis causes the gums to become tender and swollen in some areas. You may see blood in the sink when brushing. These signs indicate that oral bacteria has accumulated in the mouth beyond the means of your immune system’s ability to manage it.
Twice daily brushing and flossing are important steps in keeping bacteria levels in the mouth under control. Brushing sweeps away built up bacteria on the surface of teeth, which is a sticky film known as plaque. Plaque, just over the course of a couple of days, can harden on teeth where build up is allowed to remain. This cement hard mass of bacteria is tartar, or also known as calculus.
The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.
Yet, try as we might, there are simply angles in the mouth that are difficult to reach with a toothbrush, manual or electric. Say you have an area of jumbled or crooked teeth. Even as you adjust the angle of the toothbrush differently to maneuver the bristles into these areas, it is often difficult to continually keep these areas clean.
This is where flossing comes in, and important step in daily, oral hygiene.
Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.
If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a jolting view of exactly what you do NOT want crawling around and breeding in your mouth. These living and breeding organisms can be highly destructive as they amass.
As research has shown for many years, your overall health is intricately linked to your oral health. The bacteria of gum disease has been linked to a long list of serious health problems, including heart disease, stroke, arthritis, some cancers, diabetes, and preterm babies. Studies are underway to track gum disease bacteria to the path of Alzheimer’s disease.
Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.
Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits): “Only four of 10 Americans floss at least once a day, and 20 percent never floss.”
Perhaps this is one reason why over 47 percent of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.
Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued.
It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.
Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. For our patients, we help them develop an at-home care regimen to maintain a healthy mouth and fresh breath between regular dental check-ups.
Be aware of the signs and symptoms of periodontal disease. Knowing them will allow you to react quickly to minimize the extent of damage and treatment needed to rid it. They include:
- Tender or swollen gums
- Gum tissues that turn red
- Gums that are tender to the touch
- Gums that bleed easily
- Spitting out blood when brushing or flossing your teeth
- Frequent bad breath
- Pus pockets that form between teeth and gums
- Teeth that loosens or shift
- Painful chewing
- Gums that pull away from your teeth (recede), making your teeth look longer than normal
These are all warning signs that bacteria overload is occurring in your mouth. It is a disease, and will only worsen without treatment.
If you suspect you have any stage of gum disease, call 828-274-9440 to schedule a thorough periodontal examination.