Are YOU One Who Is More Likely To Have Gum Disease?


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

As a periodontist, I have a pretty unique view of the inside of a mouth.

In my specialty, we are particularly focused on the condition of the gum tissues in the mouth, or “periodontal” tissues. We are specially trained to treat all stages of gum disease and in the diagnosis and placement of dental implants.

A periodontal specialist is also trained in performing esthetic procedures that involve gum tissues, such as crown lengthening and correcting a “gummy smile”.

To clarify, a periodontist is a dentist who extends his or her education and skills further (typically 3 years past completing dental school) to specialize in the prevention, diagnosis, and treatment of periodontal disease and other gum conditions.

1). THE NATURAL AGING PROCESS

Although we treat patients of all ages, there are certain segments of the population we see more often. For instance, a large segment of our patients are age 50 and older. In addition to having more susceptibility to have gum disease, many in this age group have lost teeth.

In a recent report by the Centers for Disease Control & Prevention (CDC) on data related to prevalence of periodontitis in the U.S.: over 47% of adults ages 30 years and older have some form of periodontal disease. For adults 65 years and older, that number rises to over 70%.

This is because the aging process causes the body begins to succumb to wear and tear. The skin sags, bones weaken, joints ache, hearing dulls, and eyesight wanes. This means that more precautions and measures are needed to keep the teeth and gum tissues in good shape.

In addition to healthy gums, it’s important to keep your natural teeth as you age. Natural teeth to support neighboring teeth and provide stimulation to the jaw bone is unsurpassed.

Having the ability to comfortably and efficiently bite and chew is vital to having a healthy body. When dentures or partials compromise the ability to eat a diet of healthy foods – and chew food properly – gastrointestinal problems are common.

Although dental implants are excellent replacements for missing teeth, there is nothing as perfect as your “permanent” teeth.

There are a number of reasons why seniors face more oral challenges, including:

• A dry mouth: The tissues inside the mouth need to be kept moist. Saliva is designed to do this. However, with age, the flow of saliva becomes less plentiful. Just as the skin and hair get drier with age, the mouth undergoes this as well. When saliva flow is less efficient at rinsing bacteria from the oral cavity, bacteria grow at a more rapid rate. This allows bacteria accumulation to occur more frequently than twice-a-day brushing can control.
• Reduced ability to maintain at-home oral hygiene: Aging causes the fingers to be less nimble and stiffens joints. This is a particular challenge when it comes to brushing and flossing. Angling a toothbrush to reach all areas in the mouth and proper flossing maneuvers require manual dexterity that are more difficult due to the natural aging process.
• Medication side effects: The average American adult in the 65-79 age group has over 27 prescriptions filled each year. (https://www.statista.com/statistics/315476/prescriptions-in-us-per-capita-by-age-group/). Although you may need these medications, keep in mind that some can be detrimental to your oral health. This is why it’s important to provide a complete list of all medications you take (including vitamins and herbal supplements) at every dental appointment so your dentist can adjust care to your specific needs.
• Hormonal changes: Due to declining estrogen levels, post menopausal females have a higher risk for gum disease and subsequent tooth loss. This causes an increased risk of bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is a decline in jaw bone mass, it can result in tooth loss.

Bacteria overgrowth in the mouth is the cause of gum disease. Periodontal disease is the nation’s leading cause of adult tooth loss. Its bacteria can also enter the bloodstream, causing inflammatory reactions far beyond the mouth.

Advanced gum disease bacteria has been linked to a number of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.

Obviously, maintaining healthy gums and keeping your natural teeth is important. If you’ve experienced tooth loss, we can replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing.

At any age, the goal is to keep bacteria levels in the mouth to the lowest level possible. When oral bacteria are allowed to accumulate, it can lead to Gingivitis. This is an early stage of gum disease. As it progresses, periodontal disease continually worsens. Eventually, it becomes periodontitis, which is an advanced level of gum disease.

Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:

• Red, swollen or tender gums


• Seeing blood in the sink when brushing 


• Receded gums
• Loose or separating teeth


• Pus pockets on gum tissues


• Sores in the mouth


• Persistent bad breath

2). ADULTS WITH DENTAL FEAR

Another large segment of our patients are those who have avoided dental care for years, often due to having dental fear.

One study, published by StudyFinds.org, shares recent findings of 2,000 adults in the U.S. regarding dental visits. Results show a whopping 62% of those surveyed stating they were too afraid to even visit a dentist’s office. (https://www.studyfinds.org/adults-too-scared-visit-dentist-teeth/)

If dental fears or anxiety have kept you from regular dental checkups for a year or more, it would be rare to NOT have some level of gum disease. Quite frankly, some people with high fear levels avoid seeing a dentist for decades. Those visits are vital in one’s ability to have healthy gums.

While twice daily brushing and daily flossing are necessary components for having good oral health, the routine alone isn’t enough to combat a number of additional factors that make one vulnerable to the disease.

For example, a study by Delta Dental revealed, only 7 out of 10 adults are brushing twice a day. This means that 30% aren’t brushing enough. (https://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits)

3). PREGNANCY

We also see a number of moms-to-be. For decades, the Surgeon General has 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.

When these indications exist, it is important to seek periodontal treatment as soon as possible. Gum disease only worsens without treatment, requiring more time and expense to rid this serious, even deadly, inflammatory disease.

4). ALL ADULTS

Regardless of age or health status, oral wellness has always been important to overall health. Without good gum health, there is a greater drain on the body’s immune system. This is now even more important than ever, due to COVID and the flu season upon us.

Remember, even a twice-daily brusher and daily flosser does not mean you will avoid gum disease. Avoiding regular dental check-ups is a sure recipe for needing treatment down the road that may have easily been prevented.

In our Asheville periodontal dental office, patients can begin with a consult in our private consultation room that’s removed from the clinical side of the practice. We are always happy to discuss oral health options with new patients. A referral is not needed.

Call 828-274-9440 to schedule.

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.

Pregnant? Make Oral Health A Particular Priority!


Posted on Apr 23, 2019 by William J. Claiborne, DDS MS

With pregnancy, there seems to be a long list of do’s and don’ts for the mom-to-be. For instance, pregnant women are advised to avoid most drugs, alcohol, certain foods, and all smoking! Proper exercise, a balanced diet, and plenty of sleep help to keep both mother and baby healthy when it comes time for delivery.

Now, obstetricians are urging their pregnant patients (or those trying to become pregnant) to add a very important item to this list. They are advising particular devotion to achieving and maintaining good oral health.

The reason to keep a healthy mouth is based on decades of research and findings related to how infectious bacteria of periodontal (gum) disease can penetrate the bloodstream. Once bloodborne, the bacteria are able to activate inflammatory triggers elsewhere in the body.

A mother-to-be is especially vulnerable to gum disease due to hormonal changes during her pregnancy. Almost 50 percent develop pregnancy gingivitis, a mild form of gum disease that causes gums to become swollen, tender and bleed easily when brushing.

However, because of their susceptibility, the risk for full-blown gum disease is higher for pregnant females with nearly a third developing gum disease.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and babies of low birth weight (less than 5.5 lbs.). One study showed the preterm birth rate for females without gum disease to be approximately 11 percent compared to nearly 29 percent for pregnant women with moderate to severe periodontal disease.

It has also been shown that gum disease increases the likelihood for late-term miscarriage and pre-eclampsia. When oral bacteria reach placental membranes via the bloodstream, inflammatory reactions were found to trigger pre-eclampsia or early labor.

One study showed that pregnant women with higher blood levels of antibodies to oral bacteria also had higher incidences of preterm birth and babies of low birth weight. These elevated antibodies have been found in amniotic fluid and fetal cord blood samples of infants who were preterm or of low birth weight at birth.

When periodontal disease is present, however, successful treatment has shown to lower the risk of preterm births.

For all individuals, however, the bacteria of gum disease is coming to light as a major contributor to a number of serious health problems. It is the nation’s’ leading cause of adult tooth loss and has been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

Once the infectious bacteria of gum disease enter the bloodstream (typically through tears in weakened gum tissues), it can trigger inflammatory reactions, many serious and some that can have deadly consequences.

It is important to know the signs and symptoms of gum disease. These include gums that bleed when brushing, frequent bad breath, swollen or tender gums, gums that pull away from the base of teeth, or gums that darken in color.

While any of these should prompt an individual to seek out periodontal treatment, pregnant women have a particular need to seek care. A periodontist has specialized training in the diagnosis and treatment of all levels of gum disease – in a way that is safe for pregnant women (as well as all patients).

If you have any of the symptoms mentioned above (whether pregnant or not), you are urged to schedule an appointment at your earliest convenience. Call 828-274-9440 to arrange an examination to begin.

Why You May Have A Metallic Taste In Your Mouth.


Posted on Sep 12, 2018 by William J. Claiborne, DDS MS

Occasionally, a patient will mention that they have been having a metallic taste in their mouth. After several questions, I’m usually able to determine that the condition is related to a prescription they’re taking. As a matter of fact, the majority of people who notice a metallic taste experience this due to a medication’s side effect.

The most common medications to cause a metallic taste in the mouth are antibiotics, antihistamines, some OTC supplements, and medications that treat blood pressure, neurologic and cardiac conditions.

Pharmacy Times states that “more than 300 drugs are associated with metallic taste” and that “as many as 11 percent of elderly patients who take multiple medications experience taste problems.” (https://www.pharmacytimes.com/publications/issue/2015/july2015/drug-induced-metallic-taste-no-irony)

This occurs when the body ingests and absorbs medications with iron, chromium, calcium, and zinc, which all cause a metallic taste in the mouth. The body absorbs these substances, which are released and excreted in the saliva, often resulting in a metallic taste. In addition to causing this taste, another common medication side effect is dry mouth, which can also cause a foul or metallic taste.

Dysgeusia is the medical term used to describe an abnormal or impaired sense of taste.

An excess of zinc in the body – or even lack of – can also cause taste changes. Malnutrition can lead to a zinc deficiency, slowing cell renewal that alters taste. Taking too much zinc (typically through supplements) can trigger dysgeusia that causes a metallic taste.

Another common source for a metallic taste are respiratory infections, including colds, sinus infections, and middle-ear infections. Anything that causes congestion and mucus may lead to having a foul or metallic taste in the mouth.

Pregnancy can also alter your sense of taste due to hormonal changes. Tasting metal in the mouth is not unusual. This usually occurs in the first trimester and subsides in the second.

Some people are surprised to learn that poor oral hygiene can cause a metallic taste in the mouth. When oral bacteria accumulate to the point of causing inflammation, a metallic taste may be detected in the mouth. This is why it is important to have dental check-ups every six months and be committed to a thorough, daily oral hygiene routine at home.

While chemotherapy is known to cause nausea, another common complaint of patients undergoing chemotherapy is having a metallic taste in the mouth. Just as certain components of oral medications can emerge in saliva, drugs administered intravenously can also emerge in the saliva, causing “metal mouth.”

Allergic reactions that trigger sinus reactions can lead to a metallic taste as well. Allergens most often associated with causing a metallic taste include tree pollen, tree nuts, and shellfish, according to Medical News Today. (https://www.medicalnewstoday.com/articles/313744.php) Some people may have a metallic taste in their mouths for up to 2 days after eating pine nuts, which are commonly used in salads and pesto.

Too, a side effect of mercury poisoning is a metallic taste in the mouth. Although the neurological issues associated with mercury poisoning are more concerning, tasting metal in the mouth may serve as an early warning sign. By recognizing this as one of the indications of mercury toxicity, it may hopefully motivate people to seek medical evaluation.

Finally, liver or kidney disease can cause a metallic taste in the mouth. These conditions create a buildup of chemicals in the body, which are released into the saliva. For patients with severe kidney disease, the excess production of ammonia shows up in the saliva, causing a metallic taste in the mouth.

It’s amazing at how intricately and integrally connected each part of the body is to all other parts. Just as a skin rash may indicate an allergic reaction to something eaten, the mouth can be an indication point of things off-kilter in other areas.

If you suspect that your “metal mouth” is the result of a medication, it may subside (or lessen) after a few weeks. If not, it may be wise to have other areas checked. Your zinc levels, hormones, oral health, and other items may need to be evaluated to ensure all parts of your body are in proper balance.

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