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.

Why Floss?


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.

 

 

Be In-The-Know To Avoid Cavities, Gum Disease


Posted on Apr 02, 2020 by William J. Claiborne, DDS MS

During this highly unusual time, people are relying on the internet for communication (work and social), information, and entertainment. Computers, tablets and smart phones are keeping us connected as we ‘shelter in place’ until this global pandemic is under control.

A lot of Americans are using their “stuck inside” time to expand their minds. Whether it’s to enjoy an audio book, watch PBS specials, or learn how to do something on YouTube, using the time positively is helping people avoid getting mired down in worry and anxiety.

As a periodontal specialist in Asheville, NC, I hope adults will use some of their time to become more aware of the hazards of gum disease. The damage that periodontal disease (‘perio’) can have far reaching consequences, affecting the health inside and mouth and overall health, as I’ll explain.

People are often surprised to hear that they have developed gum disease since it is often without obvious symptoms in early stages. Once it’s fully underway, however, many people ignore the warning signs or assume they’ll “go away”.

In my dental specialty, I believe that by keeping Americans informed of how the progression of gum disease occurs could help to greatly reduce the extent of this disease, which plaques over 47 percent of adults.

Let’s begin by looking at the process of gum disease:

•  Oral Bacteria: The mouth is a warm, dark and moist environment — perfect for harboring bacteria. The mouth is the first point of contact for a large extent of the bacteria that enters the body. Bacteria is on food, utensils, lip gloss and even your tooth brush. All mouths have bacteria, some of it are beneficial. Although bacteria in the mouth are perfectly ‘normal’, the problem begins when too much bacteria accumulate.

•  Plaque: Without proper brushing, flossing, saliva flow and diet, oral bacteria can reproduce rapidly. For an example of just how quickly these bacteria accumulate, run your tongue over your teeth after brushing in the morning. They should feel slick and clean. Then, before brushing at bedtime, run your tongue over your teeth again. The accumulation of oral bacteria over the mere course of a day has likely formed a sticky film on teeth. This is known as plaque. This film is actually a coating of bacteria.

•  Tartar (or Calculus): In just 48 hours, unremoved plaque can harden into tartar. These ‘chunks’ are colonies of oral bacteria and typically attach to the base of teeth near the gum line. These cement-hard masses can no longer be brushed or flossed away. They must be removed by a dentist or hygienist with special tools. If allowed to remain, like plaque, tartar will continue to multiply as these bacterial colonies feed on tooth enamel and tender gum tissues.

•  Gingivitis: This is the first stage of gum disease. At this level, gum tissues are under attack and become sore. They may bleed easily when brushing and you may experience an aching sensation in some areas. Breath odor is stronger, even soon after brushing. At this point, with proper measures, you can restore your gums to a healthy state. However, the window of opportunity to combat gingivitis is brief.

•  Periodontal (Gum) Disease: At this stage, the gums are inflamed and tender. They begin to darken in color and the seal of gum tissues surrounding teeth begins to loosen. The breath is persistently bad. As this stage of gum disease worsens, it can lead to severe health risks elsewhere in the body.

•  Periodontitis: This is the advanced stage of gum disease. The gums are so tender that eating becomes difficult. Breath odor is putrid, as it reflects the rotting state in your mouth. The gum tissues are highly inflamed. Pus pockets may form on the gums near the base of teeth. Eventually, teeth will loosen as the gum tissues and bone structures that support them are destroyed. Tooth removal at this stage is not uncommon.

To no surprise, gum disease is the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.

An even more concerning aspect of gum disease is its ability to enter the bloodstream. Once bloodborne, these infectious bacteria can trigger inflammatory reactions elsewhere in the body. Gum disease bacteria has been linked to heart disease, diabetes, arthritis, stoke, memory loss, preterm babies, impotency, some cancers and even Alzheimer’s disease.

This is why we want you to be aware of the importance of having a healthy mouth. We realize there are financial obstacles for some people. However, most dental and specialty offices offer payment plans, many are interest free with no down payment required.

Some people avoid dental visits because they have anxiety or fears. Dental fear is fairly common, even in America where dental care is so advanced (in most practices). If deep fear or anxiety has prevented you from regular dental visits or having much-need treatment, finding a dentist who is experienced in caring for fearful patients is easier today.

Using advanced technology, such as laser dentistry, cone beam imaging, and other features, we are able to diagnose problems more precisely, which helps to minimize treatment. Many options enhance patient comfort and speed healing time.

For many fearful patients, we also offer oral or IV sedation (“twilight sleep”). We are fully equipped for the safety and comfort of administering sedatives for our patients for treatment in our office. Here, patients know us for our gentle touch and respectful, attentive care for each individual.

Occasionally, I hear a patient relay their impression of tooth loss being “just part of growing older.” That is far from the truth. The human body does ‘break down’ here and there but keeping your teeth for a lifetime is a reasonable expectation with proper measures.

Having healthy gums that support teeth can be achieved with an involved relationship with a dentist and a committed oral hygiene routine at home. With proper care, you can easily enjoy a smile of natural teeth all your life.

Twice daily brushing (at least two minutes per time), daily flossing, drinking ample water and limiting sweets and caffeine are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. And, those 6-month check-ups are important. At this time, any tartar that has accumulated can be removed and signs of early gum disease can be noted.

Losing teeth due to gum disease leads to expensive and lifelong upkeep with crown-&-bridge, partials, full denture or dental implants. These tooth replacement needs can be avoided.

If you are experiencing symptoms of gum disease, call 828-274-9440. If fear is an obstacle to having a healthy, confident smile, begin with a consultation to discuss your needs.

 

Use Your ‘Sheltering In’ Time To Expand Dental Knowledge


Posted on Mar 25, 2020 by William J. Claiborne, DDS MS

Whether by requirement or feeling the need to reduce susceptibility to COVID-19, many people in the U.S. are “sheltering in.” I think of how this is likened to the term “hunker down” when hurricanes or tornadoes are present. However, “sheltering in” is requiring lengthy periods of being housebound.

Although that may seem depressing, people all over the world are getting rather creative at how they’re managing. With the internet, we are able to stay connected, share jokes and encouragement, and relay tips and important info to one another.

You may have seen music being performed on the balconies of homes in Italy and by policemen in the streets of Germany. People who are close to hospitals are applauding the caregivers as they enter and leave.

There are many uplifting things occurring in the midst of this trying time. I hope you are using your time positively and keeping your mind and body active. These will help you get through this time with greater resilience and a ready-to-go attitude once our country is getting back to normal.

In the meantime, I thought I’d share some terms used in dentistry you may find helpful once dental offices are back up and operating on a normal schedule. Some include:

• Perio – This is actually a shortened version of ‘periodontal,’ which describes the pink, soft tissues in the mouth. Your periodontal health relates to your gum tissues, primarily.

• Buccal – This is dental lingo that refers to the front sides of teeth or gum tissues on the side of the cheeks.

• Lingual – This term describes the sides of teeth facing the tongue. A way to remember this is to think of the tongue “lingering” in the mouth and the sides of teeth and tissues surrounding it.

• Prophy – A prophy is actually a dental cleaning, which is meant to support the gum tissues by removing plaque and tartar that has accumulated on teeth since your last cleaning. A prophy is recommended every six months to help manage this buildup. When too much tartar (or calculus) accumulate on teeth, it can cause inflammation that goes deeper into gum tissues. Once this inflammation is active, a prophy likely won’t remove the extent of the damage nor halt its progress. When this occurs, the typical recommendation is a…

• Scaling & Root Planing – This procedure is a deep cleaning that goes beneath the surface of gum tissues and teeth. This is typically performed while the gums are numbed. Because some areas are time-consuming to clean, scaling and root planing is often performed in…

• Quadrants – A ‘quad,’ if you remember your high school math lessons, is a fourth of something. In the mouth, your quadrants are the top right side of the mouth, top left, lower right and lower left. If you use one of the newer electronic toothbrushes, you may get a ‘beep’ when it’s time to move from one quadrant to another. This allows you to give sufficient attention to each quadrant in the mouth so you’re doing a thorough job at each brushing.

• Pits and Fissures – Natural teeth may seem smooth. From a dentist’s view, each tooth has a distinct surface. This is especially true for teeth with larger “tops.” The grooves in these teeth are ideal hiding spots for bacteria since a toothbrush has a more difficult time sweeping them away. This is why some people have sealants applied, especially children who are still learning good brushing techniques.

• Bruxing – Simply, bruxing is the grinding or clenching of teeth, typically during sleep. Although tooth grinding is often blamed on stress or anxiety, it can also occur when teeth are misaligned (crooked).

Although we try not to use terminology that is unfamiliar to patients, we occasionally slip. Hopefully, you will speak up and question these so you stay fully informed as you make decisions that are best for your smile.

While your schedule may be anything but ‘normal’ during this period, we hope you’ll stay committed to your routine of twice daily brushing, flossing daily, limiting sugar and snacking, and drinking plenty of water to keep the mouth moist.

We look forward to “life as we know it” soon! Let’s pray this is short-lived and our nation is restored to a healthy, active country – with even greater appreciation for these gifts!

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