Your Smile Is What You Eat

Posted on Oct 11, 2016 by William J. Claiborne, DDS MS

We are in a smile-risky time of year. October brings Halloween and its onslaught of sugar. November is filled with sweet and carbohydrate yummies like pecan pie and stuffing with gravy. December surrounds you with candy canes, sweet gifts from the kitchen and frequent nibbling at social gatherings.

Enjoying this time of year with friends and family is a healthy part of being socially active. However, some of these indulgences can put you at a higher risk for problems they can cause your smile.

Before you pop that piece of fudge into your mouth (even if it is Aunt Betty’s secret recipe!), be aware that some foods have greater potential to damage teeth and increase your risk for gum disease. These include:

• Wine: While wine is said to be good for you, how it is consumed creates a particular problem when it comes to your smile. Anytime you eat or drink, your mouth experiences an acid attack, a normal part of the digestive process. However, this acid is so potent that it can soften tooth enamel, leaving teeth vulnerable to decay. As most people do, sipping wine over a period of time simply draws out this acid bath. Add to that the acidity of wine and your smile gets a one-two punch for a higher risk of decay.

• Citrus & acidic foods and beverages: The acidity in citrus (oranges, lemons, grapefruit, etc.) can erode tooth enamel, leaving them more susceptible to decay. And, it’s not just tart-tasting fruits that have this risk. Foods with vinegar (pickles, salad dressings, etc.) and tomatoes or tomato-based foods (red pasta sauce, catsup, etc.) have an acidic effect on tooth enamel that heightens the risk of decay.

• Sugar & Carbs: The American population over-indulges in sweets and carbohydrates to an often unhealthy extent. Just look at the obesity rate in the U.S. (nearly 36% of adults) and it’s pretty clear this isn’t occurring from eating green beans and grilled fish. The problem for your smile is how oral bacteria are super-charged by these foods, boosting their ability to reproduce. And, since many of these foods stick to teeth longer, the potential for damage is much higher.

• Caffeine: Caffeine has a drying effect on oral tissues. A dry mouth means less saliva flow, which gives oral bacteria less opportunity to be rinsed from the mouth efficiently. This provides an environment where bacteria can breed and thrive. Caffeinated beverages include coffee, tea, colas, and many energy drinks. While not caffeinated, alcoholic beverages are also drying to oral tissues. Remember, oral bacteria is the source of the majority of problems in the mouth. The next time you feel your mouth is dry and your breath is bad (common companions), it’s because oral bacteria are running rampant.

• Snacking: As mentioned above, every time you eat or drink, an acid attack begins in the mouth. This means that when you sip your soda or nibble on a cookie, an acid attack occurs. When your mouth is experiencing frequent acid attacks during the day, it’s easy to see why the damage can place such high risks to tooth enamel and gum tissues.

Of course, I would never advise you to skip a glass of wine at a fun cocktail party or deny yourself a piece of Aunt Betty’s fudge. However, now that you know the foods that are most harmful to your smile and why, let a little voice in the back of your mind remind you, “Your smile is at risk.” This may help you to alter your choices so you can avoid costly and time-consuming repairs.

As you indulge during the holiday season, here are a few ways to lessen the impact of damaging foods and beverages:

   –  Don’t rush to brush: After eating or drinking, wait 20-30 minutes before brushing. This allows the acid attack in your mouth to subside so abrasion from your tooth brush or tooth paste won’t wear down tooth enamel.

   –  Rinse with water: After a cola or glass of wine, drink some water and let it wash over teeth before swallowing. Even better, swish with water in the bathroom.

   –  Combine sweets with meals: Rather than eat caramel popcorn or a pumpkin pie slice as a snack, indulge in these as dessert following your meal. Since your meal has already created an acid attack in your mouth, these yummies only prolong it a bit rather than trigger a new one.

   –  Brush, floss and have regular dental check-ups: Daily home care coupled with regular dental cleanings and exams are your best ways to prevent problems or to catch small ones before they require major repairs.

This holiday season, use these tips to save the time and money you may have needed for dental repairs. These will help you to maintain a confident, healthy smile that follows you far beyond this special time of year.

Oil Pulling – Beneficial Or Bunk?

Posted on Oct 06, 2016 by William J. Claiborne, DDS MS

Occasionally, I am asked about the recent fad of oil pulling. The internet is full of followers of this practice who claim it pulls bacteria and toxins from the body.

Oil pulling is an ancient folk remedy that involves holding a tablespoon of coconut oil in the mouth for 5-15 minutes. It is swished around during this time and spit out at the end of the oil pulling period.

This action is supposed to draw impurities from the mouth. In most situations, coconut oil is used for this purpose but oils such as sesame, olive and palm may also be used.

Those who adhere to Ayurvedic health practices (an ancient, holistic medicine) claim this balances the body’s doshas, which are the energies that affect one’s physical, physiologic and mental state as well as their susceptibility to disease. However, most who practice oil pulling do so for its so-called oral health benefits.

Oil pulling to improve dental health is said to improve gum problems, remove plaque and whiten teeth. However, claims on the internet are not always reliable and what is in the best interest of your oral health deserves careful scrutiny.

Research has found that oil pulling has not lived up to some claims. For example, one study compared oil pulling to mouthwash as a method to reduce bad breath and oral bacteria. Findings showed that oil pulling was no more effective than mouthwashes that contain chlorhexidine, a common ingredient.

While research did not refute that there were some advantages to oil pulling, the American Dental Association (ADA) cites a “lack of science” and does not recommend oil pulling as either a supplement to oral hygiene nor as a replacement for standard oral health treatments.

The ADA is also keeping a watchful eye over claims in research being conducted, citing that some past studies have been inadequate to support claims of oil pulling. They feel that results have been based on too small samplings, not adjusting for demographic variations and failure to incorporate blind testing.

Additionally, the ADA stated, “scientific studies have not provided the necessary clinical evidence to demonstrate that oil pulling reduces the incidence of dental caries, whitens teeth or improves oral health and well-being.”

The leading concern in the dental profession is that it has prompted some people to rely on oil pulling to fully replace standard oral care practices. Twice daily brushing and daily flossing have proven to be safe and effective methods of achieving and maintaining good dental health. Substituting this routine for oil pulling is an uncertain way to prevent cavities and periodontal (gum) disease.

As a periodontal specialist, I don’t see oil pulling as detrimental when it is an addition to a proper oral hygiene regimen at home. However, I am troubled by unsubstantiated claims that inspire people to alter time-tested methods for maintaining a healthy mouth.

Some people may remember when baking soda was touted as a powerful cleaning substance for brushing teeth. Yet, those who abided by the practice worn down healthy gum tissues and wore away protective tooth enamel. This set them up for easy penetration of oral bacteria that resulted in cavities and gum disease.

While oil pulling likely won’t do harm, it is probably best done in conjunction with a thorough brush-&-floss routine.

Five Easy Steps To Save Time & Money At The Dentist

Posted on Oct 03, 2016 by William J. Claiborne, DDS MS

The reason we change the filters in our home’s air vents is to keep our HVAC system operating efficiently and to avoid expensive repairs.

The reason we have our car’s oil changed on a regular basis is to ensure proper operation and to avoid major problems.

The reason we clean and bandage a cut is to prevent an infection from occurring, which could require the involvement of a doctor and prescription medications.

So, doesn’t it make perfect sense to spend just minutes each day to prevent dental problems from occurring that can be costly and time-consuming to repair?

Your oral health goes far beyond a confident smile. Over the years, extensive research has linked the bacteria of periodontal (gum) disease to heart attacks, stroke, high blood pressure, arthritis, diabetes, preterm babies and impotency.

Symptoms of periodontal disease include seeing blood while brushing, frequent bad breath, tender gums, gums that pull away from teeth and gum tissue that darkens from a healthy pink to red.

Oral bacteria can cause major destruction to teeth and gums, including tooth roots beneath the gum line. Once gum disease begins, it will only worsen without treatment. However, avoiding cavities and gum disease is nothing complicated. Quite frankly, it’s easy with a commitment to a thorough at-home regimen and regular dental check-ups.

Steps to help you avoid dental expenses include:

1). Brush twice a day for a minimum of two minutes using a soft bristle tooth brush and tooth paste with fluoride. At the end of brushing, brush your tongue to dislodge oral bacteria that are embedded there.

2).  Flossing can have a tremendous effect on controlling oral bacteria. Our hygienist can help you with your technique or you may wish to purchase an electronic flosser.

3). Drink plenty of water during the day and minimize colas, tea, coffee and energy drinks. These beverages contain high levels of caffeine, which has a drying affect on oral tissues. Also drying is smoking, which contains a lengthy list of toxic chemicals that are readily absorbed by moist gum tissues.

4). When eating citrus or acidic foods (including tomatoes, orange juice, wine and foods with vinegar), remember that these highly-acidic foods will mix with a digestive acid that’s produced in the mouth. This double-whammy of acid can soften tooth enamel for 20 – 30 minutes. Because brushing your teeth right after consuming these foods can wear down tooth enamel, wait 30 minutes after eating to brush. Rather, swish with water or chew sugarless gum during this time.

5). Sugar and carbohydrates give a super-boost to the reproduction of oral bacteria. Try to limit these foods and sugar-laden drinks to protect your smile and your waistline!

In addition to a thorough at-home routine, be committed to your 6-month exams and cleanings. These visits rid your smile of build-up that has occurred since your last appointment and catches problems while they are easy to treat.

Keep your money in your pocket by avoiding cavity repair and treatment for gum disease. Your smile AND your wallet will thank you!

Call 828-274-9440 for an appointment if you are experiencing any of the symptoms mentioned above.

Taking Prescriptions? Some Supplements Can Cause Problems.

Posted on Sep 27, 2016 by William J. Claiborne, DDS MS

As baby boomers age, a growing number are turning to alternatives to prescription medications. Thus, there has been a growing demand for natural supplements. It is estimated that over 15 million Americans are using vitamins and herbal supplements along with prescription medications.

Surveys estimates show that herbal supplements are used by 12 – 24% of the American adult population with usage of those aged 65 and older doubling from 1999 to 2002.

Since supplements are available over the counter (OTC), many adults don’t see them as medications. So, when a new patient is completing their medical history form, these are not always listed. They should be.

Both medical and dental health care providers need this information to determine how these supplements will effect your body’s ability to clot properly during procedures that cause bleeding. Too, excessive bleeding can occur when these supplements are not acknowledged prior to procedures.

A number of aging adults take prescription medications to prevent arterial or venous thrombosis and stroke. When completing your medical history form, most patients readily acknowledge their use of these medications and understand that some drugs increase bleeding during certain procedures or hamper their ability to clot when bleeding. Knowing the patient is on these medications enables the medical or dental caregiver to monitor bleeding and clotting before complications arise.

However, patients are less informed that the use of OTC medications can impact bleeding in conjunction with their prescription medications. Yet, according to the Natural Medicines Comprehensive Database, approximately 180 dietary supplements have the potential to interact with warfarin and more than 120 may interact with aspirin, such as clopidogrel (Plavix) and dipyridamole (Aggrenox).

The National Institutes of Health (NIH) identified these supplements as having the potential to cause adverse bleeding interactions:
• Anise
• Dong Quai
• Omega-3 fatty acids in fish oil
• Ajoene in Garlic
• Ginger
• Ginkgo
• Vitamin E
• Fucus
• Danshen
• St. John’s Wort
• American Ginseng

The Centers for Disease Control and Prevention (CDC) shows the supplements having the highest sales include ginseng, ginkgo blob, garlic, St John’s wort and ginger. It is not unusual for a patient to take up to seven dietary supplements at the same time with some taken inconsistently.

In addition, the following herbs may affect blood clotting:
• High doses of Vitamin E
• Alfalfa
• Coenzyme Q10

While more studies are needed to determine precisely how these supplements alter bleeding or interact with prescription medications, it is important for medical and dental professionals to have consumption information in order to properly plan for procedures.

Warfarin (Coumadin®, Jantoven™), an oral anticoagulant, is used prevent and treatment VTE (venous thrombo-embolism), PE (pulmonary embolism), and atrial fibrillation (A-Fib) patients who are at risk of embolism. Warfarin is highly affected by medication use. In fact, more food and drug interactions have been reported for warfarin than with any other prescription medication.

A study in England noted a high number of patients were taking herbal supplements along with warfarin. In a survey of nearly 1400 patients, it was found that nearly 9% regularly took one or more of garlic,  ginseng,  ginkgo biloba, feverfew, ginger, and St. John’s
wort. Yet, nearly all admitted to failing to share this information with any of their health care professionals.

In addition to many herbal supplements, alcohol has been found to increase bleeding in warfarin users along with Vitamin C and Cranberry juice. However, the herbal supplements that tend to complicate clotting ability the most during bleeding include:
• Bromelain
• Cat’s claw
• Dong quai
• Evening primrose
• Feverfew
• Garlic
• Green tea
• Ginseng
• Ginkgo
• Horse chestnut
• Red clover

In addition to Aspirin’s ability to reduce mild to moderate pain, inflammation, and fever, it is also used in the prevention of myocardial infarction (MI) and cardiovascular problems, such as stroke. Aspirin may also be advised as added therapy during procedures like coronary bypass. While many users of Aspirin realize it “thins the blood,” many regular users fail to notify their dental professional.

As a periodontist, I perform a number of procedures that cause bleeding to tissues in the mouth. It is important for your safety and a successful outcome of your procedure to have this information prior to treatment planning.

While filling out those often-lengthy medical history forms seem daunting, the information they provide is necessary. It is also necessary that it be complete. Herbal and vitamin supplements taken regularly should always be listed.

If you have questions, please call 828-274-9440.