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.
Could Poor Gum Health Increase Stroke Risk?
Posted on Mar 12, 2020 by William J. Claiborne, DDS MS
The human body is a complex structure on the inside and out. Each body is built for movement and action, its parts governed by a central control system – the brain.
Like any complex machine with its many intricate parts, there is a delicate balance. Working together, the body stays interconnected and functioning properly.
When any part malfunctions, the problem seldom stays within its own realm. Other areas are typically affected, which is what research is finding when it comes to the health inside your mouth, or your oral health.
For decades, it has been shown that the bacteria of periodontal (gum) disease can enter the bloodstream through tears in weakened gum tissues. Research has found that this bacteria can trigger harmful reactions.
For example, the bacteria can trigger inflammation that sets into motion risks factors connected to arthritis and diabetes. Some cancers have also been correlated to this bacteria. Heart disease and high blood pressure been as well.
Stroke, too, is among the long list of serious health problems associated with the potent bacteria of gum disease. While there is no clear pathway to verify gum disease bacteria are the “cause” of these serious conditions, research has continually shown they are linked, which can greatly increase one’s potential for having these problems develop (or worsen).
Say the word “stroke” and people immediately think of a deadly or debilitating, disfiguring episode that may never be recoverable. Strokes are the third leading cause of death in the United States.
There are several types of strokes. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. These cause death in about 50 percent of cases.
However, most strokes are Ischemic strokes, caused by an abrupt blockage of arteries leading to the brain. These occur when the brain’s blood vessels become narrowed or blocked, severely reducing blood flow.
Blocked or narrowed blood vessels are caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through your bloodstream and lodge in the blood vessels in your brain.
In one study, 265 patients who experienced a stroke between 2015 and 2017 were followed. Researchers noted that large artery strokes – those located inside the brain – were twice as common in patients with gum disease as in those without gum disease.
What connection could gum disease bacteria have with arteries in the brain?
Let’s step back and look at the makeup of bacteria found within gum disease.
It all begins when plaque, the sticky film that builds up around teeth, is allowed to remain and multiply. In the meantime, the plaque found in blood can accumulate inside arteries. Known as atherosclerosis, this fatty plaque is the hallmark of coronary artery disease.
People with gum disease have 2 – 3 times the risk of having a heart attack, stroke, or other cardiovascular event. Still, finding a direct connection has yet to be determined. Although researchers have taken into consideration factors like smoking or a poor diet, there is an emerging concern that gum disease may be a factor – on its own – when it comes to heart disease.
Gum disease is an inflammatory disease that starts as gingivitis, the initial stage of periodontal disease. This causes gum tissues to turn red, swell and bleed sometimes when brushing. Untreated, gingivitis will progress to periodontitis, advanced gum disease.
The inflammation of periodontitis can destroy tissue and bone in the mouth, causing gums to separate from the teeth. This separation allows bacteria to infect the gums, and, over time, can lead to tooth loss.
Although we recommend that people react promptly to signs of gum disease, we also felt it beneficial to provide the signs and symptoms of stroke (for you or someone else). These include:
• Trouble speaking and understanding what others are saying. This may include confusion, slurring or having difficulty understanding speech.
• Paralysis or numbness of the face, arm or leg, typically on one side of the body.
• Vision problems in one or both eyes. This may cause blurred or blackened vision in one or both eyes, or seeing double.
• Headache, which may be sudden and severe. This may cause vomiting and/or dizziness.
• Trouble walking, sudden dizziness or loss of coordination.
Some studies indicate that treating gum disease (with other stroke risk factors) could reduce your risk for stroke.
While the direct path of gum disease to stroke may not be known at this time, research has clearly shown that the bacteria of periodontitis is harmful far beyond the mouth.
If you would like a periodontal evaluation, call our Asheville periodontal dental office at 828-274-9440. As a periodontist, my specialty is the treatment of all stages of gum disease. Through our advanced skills and technology, we can restore your smile to a healthy state and give your overall health a leg up!
Aging Adults Need Extra Measures To Prevent Gum Disease, Tooth Loss
Posted on Feb 17, 2020 by William J. Claiborne, DDS MS
Whether visiting a primary care physician, ophthalmologist (eye doctor), dermatologist, or orthopedist, adults in the over-50 category often hear the same comment from their doctor.
“You’re getting older so…”
As we age, the body begins to succumb to wear and tear. The skin sags, bones weaken, joints ache, hearing dulls, and eyesight wanes. More precautions and measures are advised to keep the body operating comfortably and efficiently as we age.
The same is true for your teeth and gums.
Although people tend to react to an odd spot on the skin or blurry vision, things like having a frequent ‘dry mouth’ or gum recession are often brushed off as temporary or just a normal part of growing older.
Yet, the hazards of ignoring the signs and symptoms associated with gum disease and tooth loss should never be taken lightly. Research shows that your OVERALL health is dependent upon a healthy mouth and proper function in biting and chewing.
Here are some typical oral challenges experienced by seniors:
• Having a dry mouth: The tissues inside the mouth need to be kept moist. Saliva flow is designed to do this. However, with age, the flow of saliva is less plentiful. Just as the skin and hair get drier with age, the mouth endures this same consequence. When saliva flow is less efficient at rinsing bacteria from the oral cavity (inside of the mouth), bacteria grow at a more rapid rate. This means bacteria accumulation occurs more frequently than twice-a-day brushing can control.
We advise drinking plenty of filtered water throughout the day, minimizing caffeinated drinks that are drying to oral tissues (coffee, tea, colas), and using an oral rinse twice a day that is formulated to replenish oral moisture. Alcohol and smoking are especially drying to oral tissues. Be especially committed to maintaining adequate oral moisture if you smoke or drink.
• Less efficiency with 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 becomes less capable when the rigors of aging are involved.
We advise using an electric toothbrush 2-3 times a day. Flossing can be done using an electric water flosser. However, we still recommend manual (string) flossing where you can reach. Keep in mind that crowding of natural teeth (which tends to worsen with age) creates particular challenges for reaching nooks where bacteria hide and breed. Use extra time to ensure you are reaching those areas when you brush and floss.
• Medications that interfere with oral health: The average 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 your health may dictate taking these drugs, it is wise to be aware that some can be detrimental to your oral health.
For example, Coumadin, a commonly prescribed blood thinner, can cause more bleeding during certain procedures. Too, many meds have the side effect of oral dryness. Some prescribed for osteoporosis, bisphosphonates (known by Fosamax, etc.) have been linked with jaw osteonecrosis. The risk for jaw necrosis, or death of the jaw bone, is highest with procedures that directly expose the jaw bone, such as tooth extractions and dental implant placement.
Some herbal supplements can also cause side effects for some dental patients. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting. Be sure to provide a complete list of ALL medications you take (including vitamins and herbal supplements) at each appointment. This enables us to tailor your treatment to your specific needs.
• Hormonal changes: Post menopausal females are at higher risk for gum disease and subsequent tooth loss due to declining estrogen levels. Thus, these women have greater risk for bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is bone loss of the jaw, it can result in tooth loss. Receding gums are a sign of this bone loss since more of the tooth surface is exposed to the causes of tooth decay.
Why are your teeth and gums so important as you age?
As a periodontist in Asheville for over 30 years, I’m still surprised by the number of people who assume that losing natural teeth is to be expected with age. Yet, I see many patients who have kept the majority of their natural teeth well into their 80’s and 90’s.
Although dental implants are excellent replacements for missing teeth, there is nothing as good as the teeth God gave you. They’re referred to as “permanent” teeth for a reason; they were intended to be just that. Regardless of the replacement method, the ability of 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.
Too, 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.
If your gum health needs improvement or there are signs of gum disease, we can structure a program that restores healthy gums and helps you maintain your oral health between visits.
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
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.
With proper measures, you can enjoy healthy gums and natural teeth throughout your lifetime. Call 828-274-9440 to schedule a periodontal examination or ask for a consultation to get to know us. New smiles are always welcome!
Tissue Regeneration In Dentistry Is Here & Now!
Posted on Jan 31, 2020 by William J. Claiborne, DDS MS
It may sound far-fetched to think of repairing the urethra by regenerating tissues from the mouth. Yet, it’s being done – with the help of advanced technology.
Stricture of the urethra (the duct that carries urine out of the bladder) affects about 1 percent of the male population. For the one percent who suffer with it, urethral stricture contributes to a severely diminished quality of life.
The condition causes patients to be chronically ill, have low urine flow, pain, urinary infections, urinary stones and can lead to failure of the urinary system. Untreated, life-threatening urinary retention can occur.
Recently, a breakthrough in the surgical treatment of male urethral stricture was reported when over 81 percent of patients with urethral strictures were successfully treated with MukoCell.
MukoCell is a method for tissue-engineered oral mucosa transplantation. It takes a small area of oral mucosa (the secreting tissues in the mouth) that is easily accessible in any patient. (https://www.healtheuropa.eu/treatment-of-mens-disease-with-regenerative-medicine/96925/)
In the past, the most successful treatment for urethral reconstruction was through an oral mucosa graft. However this process requires harvesting a large area of oral tissues. The repercussions can leave patients with persistent pain, bleeding, swelling, sensory loss and oral numbness.
Removing large segments of tissues in the mouth can also cause impaired ability to drink, eat and speak. It can lead to periodontal (gum) disease,tooth loss and dental implant failure along with an increased risk of oral cancer.
MukoCell is a method for a tissue-engineered oral mucosa transplant with even better success rates that the standard grafting procedure. Like our LANAP technology, MukoCell can regenerate tissues, although MukoCell regeneration is through a tissue factory that uses a small piece of the patient’s oral mucosa.
In our Asheville Periodontal dental office, tissue regeneration can be successfully performed in the patient’s mouth. Through our LANAP technology (Laser-Assisted New Attachment Procedure) this highly-advanced method efficiently and effectively treats periodontitis (advanced gum disease).
When it comes to oral structure loss, our LANAP technology is able to stimulate bone regrowth in damaged areas. It can regrow periodontal ligament, alveolar bone (the bony ridge that supports the upper teeth), and regrow the bony film that adheres teeth to the jaw.
LANAP includes a minimally invasive (essentially ‘non-surgical’) PerioLase laser that treats patients with moderate to severe periodontal disease – in as little as one session. It is safe for people with conditions such as diabetes, heart disease, and hemophilia.
LANAP’s laser also eliminates the need for cutting into gum tissues with a scalpel. There are no stitches and patients have minimal discomfort following the procedure.
The advanced technology of LANAP offers a simple yet successful way to rid the infectious bacteria of advanced gum disease. By combating this inflammatory disease, the body is at less risk for systemic inflammation that has been shown to contribute to serious and even deadly health problems.
Overcoming gum disease can help patients to save natural teeth. This means the trauma of tooth loss and decisions for replacement can be avoided.
While we applaud astounding developments in tissue regeneration, MukoCell’s progress reinforces the importance of having a healthy ‘oral cavity’. This is why we committed to include the LANAP protocol into our periodontal dental office, making this cutting edge technology accessible to people all across Western North Carolina.
Although people often think of their smile as ‘teeth,’ the tissues in the mouth are a vital part of your smile, your oral health, and your overall health. They are your blanket of protection that shields vulnerable structures beneath from bacterial destruction. When this covering of gum tissues becomes damaged, LANAP offers an efficient and effective method to restore the healthy state of what was lost.
If you suffer with symptoms of gum disease (tender gums that bleed when brushing, persistent bad breath, or gums that have turned red in color), call our office promptly at 828-274-9440. The condition will only worsen without treatment and could result in tooth loss as well as the release of potent bacteria into the bloodstream.