Smoking, Vaping Lead To Gum Disease, Tooth Loss.


Posted on Sep 15, 2020 by William J. Claiborne, DDS MS

With all good intentions, adults occasionally trade one bad habit for another. For instance, a commitment to exercise more often for weight loss can easily backfire when justifying a thick smoothie as a daily reward.

This is what worries me about Vaping. Vaping, the use of e-cigarettes, hit the market around 2007. It is designed to deliver nicotine through a vapor. Although the vapor is generally not labeled as harmful (it’s not “safe”, either), its nicotine is no less harmful to the user as that delivered via cigarette smoke.

Unfortunately, many cigarette users switched to vaping based on the perception that “e-cigs” were a safer alternative. For those who wanted to wean themselves off of cigarettes through this switch, very few achieve that goal as a result.

A 2018 report by the National Academy of Sciences, Engineering, and Medicine concluded there was “evidence that e-cigarette use increases the frequency and intensity of cigarette smoking in the future.”

Teens have been most susceptible to the hazards of vaping. It is the most commonly used tobacco product among U.S. youth. E-cigarette use among middle and high school students increased 900 percent during 2011-2015. According to the Surgeon General, 1 in 5 high school students and 1 in 20 middle school students were using e-cigarettes in 2018.

Unfortunately, nicotine exposure can harm the brain as it develops, until about age 25. During adolescence, nicotine use can affect learning, memory and attention span as well as increase their risk for future drug addictions. (https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf)

As a periodontist in Asheville, NC, my concern when it comes to oral health is what many cigarette smokers and vapers don’t realize when it comes to high risks to their smiles.

In our periodontal dental office, I’ve seen how significantly the habit of cigarette smoking can have on one’s smile. It’s no secret that smoking cigarettes can stain teeth and cause bad breath. However, nicotine in any form is a hazardous force in the mouth.

According to the American Dental Association (ADA), smoking can cause the gums to recede from teeth, exposing vulnerable tooth root sections. This enables easier entry of oral bacteria into the structures that support tooth roots. Smoking can also delay healing following periodontal therapy, extractions or implant placement. The longer it takes oral tissues to heal, the greater the risks for infection to develop.

Additionally, smoking increases the risks of oral cancer, lesions inside the mouth, periodontal (gum) disease, enamel erosion and tooth loss. It greatly reduces saliva flow in the mouth, which is a tremendous aid in removing bacteria and food particles from the mouth, helping to control bacteria levels. The condition of “dry mouth” also causes bad breath.

Because of the vape’s moist presence in the mouth, the assumption with vaping over smoking cigarettes is the “benefit” of oral dryness. However, this is easily dispelled when looking at the true facts.

While there are more than 7,000 chemicals found in the smoke of tobacco products, (including nicotine, tar, carbon monoxide, acetaldehyde and N-nitrosamines),  nicotine is the primary addicting component. A study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, as well as potentially toxic metal particles from the device itself.

The e-liquids delivered by these devices typically contain nicotine, propylene or polyethylene glycol, glycerin, and additives. Sound safe? Not at all.

According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker. (https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)

When a patient is diagnosed with advanced periodontal disease (periodontitis), they must make a commitment of time and expense to rid this inflammatory disease from their mouths. For those who ignore its presence or assume it will get better on its own, the disease will simply progress further.

Gum disease begins with sore gums that may bleed while brushing teeth. Or, it may cause no noticeable symptoms at all in early stages.

As it worsens, gum disease will cause frequent bad breath, tender gums that turn red, gum recession, and gums that bleed easily when brushing. Pus pockets may form on the gums. As it attacks the structures beneath the gum line, teeth may loosen or shift.

As the nation’s leading cause of adult tooth loss, it brings the hard decisions (and expense) for replacement. After all, you need teeth for eating and speaking. Do you go with dental implants? Or, do you take on the challenges that come with dentures and partials? As hard as the decisions of replacing teeth can be, gum disease can bring even more devastation with it.

Research has linked the bacteria of gum disease to serious health problems. These include heart disease, stroke, preterm babies, arthritis, diabetes, impotency, some cancers and even Alzheimer’s disease. These connections occur through the infectious bacteria of gum disease entering the bloodstream through tears in diseased gum tissues.

Once in the bloodstream, the bacteria can travel throughout the body and create inflammatory reactions. This “systemic inflammation” is able to trigger the onset of some diseases and conditions or even further the development of others.

Certainly, we all have the right to determine what is in our best interest as far as our own health goes. However, I believe that many individuals end up in our office with serious gum problems and facing tooth loss because of what they did not know. Having factual information allows us to make wise decisions for our health and well-being.

As a periodontist, I have advanced skills in the treatment of all stages of periodontal (gum) disease. My dental specialty also includes the diagnosis and placement of dental implants. Here, our patients can relax under Oral or IV sedation (“twilight sleep”) while having their smiles restored. We also create a customized care program that allows each person to maintain good oral health once their treatment is complete.

If you smoke or vape, don’t assume “that won’t happen to me.” The reason we wear seat belts in cars is because there are great risks when we do not. The risks for losing your teeth and having potent bacteria running rampant through your system is something you can take easy measures to prevent.

Experiencing symptoms associated with gum disease? We urge you to schedule an examination appointment as soon as possible. Call our beautiful, comfortable Asheville office at 828-274-9440. A referral is not necessary.

 

 

 

How To Avoid Thinning Jaw Bones That Cause “Granny Look”


Posted on Sep 10, 2020 by William J. Claiborne, DDS MS

Imagine your mouth begins to sink into your face. Deep wrinkles form around your mouth and the corners of the mouth begin to turn downward, even when you smile. Jowls form, allowing skin to seem to loosen and hang on both sides of the face. The chin becomes more pointed and the nose and chin get closer and closer.

This sounds pretty awful. It is like a disfigurement of the face. It’s not a horror movie, though. This is real, caused by one of the most preventable of all diseases afflicting American adults. It’s a disease that affects over 47 percent of all adults over the age of 30. For adults over the age of 65, the figure rises to over 70 percent. (https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html)

Amazingly, this highly prevalent disease is simply periodontal disease. Often referred to as gum disease, some people also refer to it as “perio.” These are fairly familiar terms when it comes to what adults endure. Yet, it seems to be easily ignored, which merely allows it to progress further.

Before we get into the causes (and easy prevention measures) of gum disease, let’s examine how the dreaded changes in facial appearance are related to it.

Gum disease is the nation’s leading cause of adult tooth loss. Assumed to be a normal part of the aging process, it is anything but. Yes, older adults are more prone to acquiring gum disease due to a reduction in saliva and perhaps being less efficient at oral hygiene. But losing teeth can be prevented, and should be.

The problem with losing natural teeth has to do with their roots. It is the roots of a tooth that serve a much greater purpose than most people realize. While the appearance and function of dentures and partials (albeit reduced) can be replaced, they do nothing to replace what is lost beneath the gum line.

Simply put, the lack of tooth roots is the beginning of a “melting face.” This leads to bone loss and is known as resorption. Resorption is the shrinking of the bone structures that support teeth. As tooth roots are absent, the loss of bone mass can create a number of problems – both related to oral health and in facial appearance.

Tooth roots are a living part of your skeletal structure. Tooth roots are what provide nourishment and stimulation to the jaw bones. This helps the jaws to maintain a healthy mass. When tooth roots are removed, the bones slowly begin to shrink. Although most people don’t notice anything different for a while, bone loss begins almost immediately.

As described at the beginning of this article, there is a ‘look’ of bone loss, which causes changes in facial structures. This is because the bone mass is shrinking. As it shrinks, muscles detach and facial skin hangs looser.

Initially, you may only notice more wrinkles around the mouth. As it worsens, you may realize your chin seems to be more pointed. The extreme visual change of bone resorption is referred to as a ‘granny look.’ This causes people to appear far older than their actual age.

For those who wear a denture or partial, losing jaw bone mass also causes a change in the way the denture or partial fits. For example, a denture may fit fine the first year after teeth are removed and a denture is fitted. However, you’ll eventually notice slips when biting or chewing. This is because the bone under the “arch” that supports the denture or partial is declining in height.

The changing foundation for the denture allows it to “slip” or become “wobbly.” As bone loss continues, you may experience uncomfortable rubbing on tender gum tissues while eating. You may start to bypass foods that require rigorous chewing, opting for softer foods that dissolve quickly in the mouth. Outings with friends and family seem to be overshadowed by the fear of embarrassing slips.

Eventually, even frequent applications of denture pastes or adhesives are of little help. A reline may be recommended by your dentist to reshape your denture or partial to fit the reduced contours of the gum ridge (or “arch”). Continued bone loss will require yet another reline as the ridge flattens further.

Denture wearers are typically unaware that the pressure on the gums from wearing a denture accelerates the rate of bone loss. For those who sleep in their dentures, this means that pace of bone loss occurs 24/7.

Sleeping in a denture can also add to higher risks for the flu and pneumonia. A 3-year study of more than 500 adults was published by the Journal of International Oral Health. Of the 186 (of 453 denture wearers) who did not remove their dentures for sleeping, they had over twice the risk for pneumonia than those who did. Sleeping in dentures also led to higher levels of tongue and denture plaque, gun inflammation and other oral issues.

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295446/)

When it comes to replacing natural teeth, there are many reasons we recommend dental implants, a major advantage being their ability to halt bone loss. Because dental implants act as replacement tooth roots, they are able to restore stimulation to the jaw bones.

Additionally, dental implants use the same, sturdy foundation as natural teeth once had. This means you can bite and chew the foods you love (including that thick steak) without fearing embarrassment or uncomfortable rubbing against tender gum tissues.

Dental implants are also designed to last a lifetime, making them a wise investment.

A particular skill of the periodontal specialty is the advanced training in the diagnosis and placement of dental implants. This training allows the specialist to determine the best dental implant type for your needs. A periodontist can also enhance your outcome through proper placement.

If you are missing natural teeth or have become frustrated with a denture or partial, call 828-274-9440 for a consultation in our Asheville periodontal dental office. During this time, we can discuss the implant system that may be most appropriate for your needs. I’ll also be happy to explain the procedural process, comfort options, and easy payment plans.

For a smile that looks beautiful and functions to support good health, don’t let the detrimental effects of dentures lead to a “granny look”. Dental implants can help you enjoy a confident, worry-free smile through your lifetime.

 

 

Gum Disease Connected To Dementia, Alzheimer’s Disease


Posted on Aug 11, 2020 by William J. Claiborne, DDS MS

The statistics of periodontal (gum) disease are alarming. In the U.S., nearly half of the adult population has some level of gum disease.

There is a misconception among the general population 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. That’s far from the case. Although symptoms of gum disease may include tender gums that bleed when brushing, gum disease can begin without any obvious signs.

This shouldn’t be surprising. When cancer forms in the body, its initial presence isn’t obvious. The reason for screenings such as mammograms or colonoscopies are to catch mutant formations at their earliest stages.

Early treatment helps to resolve the problem with hopefully positive outcomes. 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.

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 percent higher risk for developing Alzheimer’s disease or dementia. Having no natural teeth was associated with a 26 percent increased risk.

Broken down, 14 percent 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 percent (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 percent 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. Psych Central.com (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 continue 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 percent 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.

Maintaining a healthy smile – good gum health and healthy teeth – 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. This dental specialist can restore your gums to a healthy state.

A periodontist is also a specialist in the diagnosis and placement of all types of dental implants. For adults who are missing natural teeth, dental implants are the closest thing to providing the look, feel and function of ‘real’ teeth. They restore the ability to bite and chew comfortably and dependably. Dental implants are also designed to last a lifetime, making them a wise investment.

Take charge of your health by overseeing your oral health as carefully as you do to other needs. For a consultation to discuss how a periodontist can help you, call 828-274-9440.

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”).

Afraid Of The Dentist? Let’s Help You Get Past That For A Healthy Smile!


Posted on Jul 22, 2020 by William J. Claiborne, DDS MS

By some estimates, having a fear of dental visits affects over 70 percent of American adults. When people are afraid of going to the dentist, many often do not receive the regular care necessary to maintain a healthy smile.

As an Asheville Periodontist, I find that the origin of many who develop periodontal (gum) disease is from fear associated with dental visits. It is not unusual for a fearful dental patient to avoid going to the dentist for years, only ‘giving in’ when something becomes so painful they can no longer delay treatment.

We know that when it comes to dental fear, different people have different levels. Some patients are very relaxed in our office from the moment they walk in and throughout treatment. Others are fine until they are seated in the treatment chair. Still, others are anxious throughout their visit.

A study published by the Dental Research Journal revealed nearly 59 percent of 473 adult participants had dental fears. The study included males and females of varying ages and education levels. Although females presented a higher likelihood for dental fear, there was very little difference elsewhere. What did stand out, however, was how many had experienced traumatic dental episodes.

Unfortunately, a traumatic experience in a dental chair with a too-rough dentist tends to remain in the subconscious forever. Many fears are the result of a frightful experience as a child, feeling helpless and afraid. Such an experience tends to make an indelible mark on the subconscious and resurface whenever a dentist or dental office comes to mind.

If you experience these feelings associated with dental visits, there is nothing ‘wrong’ with you. However, delays in care can allow small problems to become more complex, requiring more involved treatment.

Many high-fear patients only force themselves into a dental chair when they are in such pain that they have no choice. It is far easier for adults to find a way to have regular exams and cleanings to prevent emergency needs. This begins by finding the right dental office.

Until then, regular dental check-ups are something that can’t be duplicated at home. Even a thorough, daily brushing and flossing routine misses bacteria on occasion. Within the course of just 48 hours, oral bacteria can form a cement-hard colony attached to tooth surfaces. This accumulation of bacteria eats away at tooth enamel and gum tissues.

As oral bacteria consume gum tissues, inflammation begins. This is gingivitis, the initial stage of gum disease. In this, the gums are tender and occasionally bleed when brushing. As gingivitis progresses to periodontal disease, symptoms include persistent bad breath and gums that turn red versus a healthy pink color. Gum tissues may begin to recede, exposing sensitive areas of tooth roots.

Eventually, the infectious bacteria will attack further beneath the gum line. This inflammation leads to damage to the bone structures that support tooth roots. Pus pockets may form on gums and teeth may loosen. To no surprise, periodontal disease is the nation’s leading cause of adult tooth loss.

This infectious bacteria doesn’t just remain in the mouth. Through tears in weakened gum tissues, it can enter the bloodstream. It’s presence can trigger inflammatory reactions that have been linked to heart disease, stroke, some cancers, preterm babies, arthritis, diabetes, erectile dysfunction (ED), and impotency. Some studies are showing a correlation to Alzheimer’s disease.

What we often find with high-fear patients is their assumption that good at-home care can take the place of their regular care visits. However, even a diligent home-care routine leaves them susceptible to oral bacteria. A number of factors heighten vulnerability to bacterial accumulation, including dry mouth and diet.

Dry mouth occurs due to a wide range of factors. Some medications have a drying affect on the mouth. Certain foods and beverages contribute to dry mouth, especially those containing caffeine and alcohol. Smoking is very drying to oral tissues. And, the aging process leaves us with drier mouths.

Eating sugary foods and many carbohydrates are just as detrimental to oral health. Many Americans snack during the day, often on chips, crackers and candy bars – which are then washed down with sugary sodas. All this converts into a sugar based super-food in the mouth that provides oral bacteria with sustenance that super charges their reproduction.

How does a fearful adult overcome the problem so they can have the dental care they need?

In our office, patient comfort is a priority at every visit. We have even designed our reception area to pamper you from the moment you enter. Patients in this area can enjoy a selection of gourmet coffees, cable television and WIFI connection. The seating is comfortable and our front office staff are attentive to your needs.

We offer a private consultation room for patients as well. In this room, we can discuss treatment and answer questions in a comfortable setting. This allows patients to become better informed about their treatment needs and options versus communicating while they are seated in a treatment chair.

Our surgical suite offers a rather unique setting for a periodontal office. A large window provides beautiful mountain views, very soothing to our patients. In addition, we offer oral sedation as well as I.V. sedation (twilight sleep) for most procedures, if desired.

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 places the patient in a deeper sedative state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are monitored with advanced safety equipment throughout treatment.

Our patients also find our entire staff is a unified team who reflect sincere compassion and commitment to exceptional, comfortable care. While the doctors involved in your care are all top-notch, I must admit that our staff are the pros at making our patients feel truly pampered.

When patients realize that our goal is to provide exceptional care and comfort, most relax. This creates a sense of trust that causes many to no longer perceive dental care as dreaded, frightening events. Once the obstacle of fear is replaced with feelings of trust, the process to achieve a healthy, confident smile becomes a much easier one.

If you or someone you know has fear that has prevented dental care, the possibility of gum disease is pretty high. We suggest beginning with a consultation appointment, which occurs in our private consultation room. This is removed from the clinical area and provides a relaxed setting where patients can share their unique needs and concerns.

Call 828-274-9440 to schedule or learn more. I’m sure you’ll find our friendly telephone staff is welcoming and reassuring from the very first conversation.

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