Rheumatoid Arthritis (RA) Linked To Periodontal Disease


Posted on Oct 02, 2019 by William J. Claiborne, DDS MS

As a periodontist, I specialize in the treatment of all stages of periodontal (gum) disease. Although this particular dental specialty is not as visible as a general dentist, we are very-involved members of the medical and dental community. According to the Centers for Disease Control & Prevention (CDC), over 47 percent of American adults have some level of gum disease.

Like the formation of cancer, many individuals are unaware when periodontal disease becomes active. When early symptoms appear (such as bleeding gums when brushing, bad breath and gum tenderness), many people shrug them off as temporary.

However, gum disease only progresses once underway. Eventually, gums become red in color and pus pockets form at the base of teeth. In advanced stages, teeth loosen and may require removal. Gum disease, to no surprise, is the nation’s leading cause of adult tooth loss.

The potent bacteria of periodontal disease can enter the bloodstream through tears in weakened gum tissues. This allows it to travel throughout the body. Research has shown it is able to trigger a number of serious health problems, including heart disease, stroke, diabetes, memory loss, and impotency.

Rheumatoid arthritis (RA), a condition seemingly unrelated to gum disease, is a debilitating disease that destroys joints. It is disabling and painful. In most cases, RA emerges gradually, often beginning with morning stiffness along with weak and aching muscles. Joint pain follows, with joints feeling sore and stiff. RA is typically found in the fingers, wrists, elbows, hips, knees, ankles, toes, shoulder and neck.

As inflammation from RA increases, joints become swollen with symptoms including fever, disfiguring of hands and feet, numbness and tingling. There is no cure for RA and lifelong treatment is required. Treatment may consist of medications, physical therapy, or even surgery.

Yet, like RA, gum disease causes pain, swelling, and tenderness. As it worsens, the associated inflammation can lead to destruction of the bone that supports teeth along with surrounding tissues. And, the similarities go much deeper.

Both gum disease and RA share a genetic likeness in clinical makeup and structures. This has been particularly apparent in pathogens, which are agents in the body that lead to disease or illness. The pathological processes that occurs in both gum disease and RA are almost identical.

Too, the particular species of bacteria found in gum-diseased oral tissues and tissues that surround joints in those who suffer with RA. Equally concerning is, while both conditions clearly cause chronic inflammation in tissues connected to bone, researchers have found the two diseases share a similar inflammatory trigger.

In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis. It has also been shown that, by treating periodontal disease in RA patients, RA symptoms often improve ( likely due to the system’s reduced burden of oral inflammation).

These findings reveal just how closely our oral health correlates

A relaxing and comfy environment.

to our overall health. This information should send up alarms that the presence of gum disease can greatly increase your risk for serious health conditions. Clearly, people who have RA should be particularly diligent when it comes to their oral health.

If you are experiencing symptoms of gum disease (as mentioned above), seek treatment at your earliest convenience. You can begin with a consultation appointment in our  comfortable Asheville periodontal office. A referral is not needed.

Call 828-274-9440 to learn more.

Protect Your Heart. Start With Your Smile!


Posted on Jul 17, 2019 by William J. Claiborne, DDS MS

According to a report on the health of Americans (published by the Centers for Disease Control & Prevention, or ‘CDC’), it is estimated that over 47 percent have some form of gum disease. Although we all aspire to have a smile that is appealing, it is what lies beneath the teeth and gums that can reek havoc on one’s overall health.

Signs of gum disease

Over time, inadequate daily oral hygiene enables an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even more susceptible to this bacterial buildup.

This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to ‘wash away’ bacteria at sufficient levels, the accumulation runs rampant.

Oral bacteria are living, eating, and reproducing organisms. They thrive on rotting food particles caught between teeth. They attack gum tissues and tooth enamel. Eventually, they can work their way down tooth roots and attack the bones and tendons that support teeth.

What’s even scarier is the fact that these infectious critters can enter the bloodstream. This potent bacteria are now associated with a number of serious health conditions due to their ability to trigger systemic inflammation.

When the gum tissues can no longer combat the onslaught of bacteria, there can be very few signs of periodontal (gum) disease initially. Signs that emerge are typically frequent bad breath along with swollen, tender and beefy red gums that bleed when you brush. As they grow in number, the gum tissues become weaker and they can penetrate the bloodstream.

According to the American Academy of Periodontology (www.perio.org),
“Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.
“Scientists believe that inflammation caused by periodontal disease may be responsible for the association.
“Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.”

For this reason, cardiologists are more often advising their patients to be evaluated by a periodontist prior to heart surgery. As mentioned above, gums that bleed are a sign of gum disease. These oral bacteria, given an opportunity to enter the bloodstream, are able to travel anywhere, including the heart. They can reach the heart muscle and cause a severe infection.

For decades, researchers have probed the link between gum disease and cardiovascular health. People with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke or other serious cardiovascular event.

Acting as a contributing factor to heart disease is highly serious. Yet, the risks associated with gum disease don’t stop there. Research has shown this potent oral bacteria can set a path of destruction into motion. It has been linked to some cancers, stroke, diabetes, arthritis, preterm babies, impotency, and even Alzheimer’s.

Twice-daily brushing and daily flossing takes mere minutes and is inexpensive to do. Seeing a dentist every 6 months for oral exams and cleanings saves an individual far more by preventing problems than they cost. Yet, too many adults fail to devote the investment to this necessary part of a healthy lifestyle.

An estimated 65 percent of adults ages 18 – 64 see a dentist only once a year. Approximately 55 percent of adults brush their teeth twice a day, which is too little. (https://www.reference.com/health/many-times-day-people-brush-teeth-34d1104798029b7a) I believe it would be jolting to most adults to view dental floss under a microscope after their teeth have been flossed.

As an Asheville periodontal specialist, I have an up-close view of the damaging affects of insufficient oral hygiene. It often results in tooth loss, which is not a natural part of the aging process, as some people believe. Having your natural teeth for a lifetime is more than achievable and has even been shown to add to one’s lifespan (by up to ten years).

If you’ve failed to be fully committed to your oral health, there is no better time to begin than the present. Start with a thorough periodontal examination. Call 828-274-9440.

If dental fears have prevented you from having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. This will be a friendly, informative conversation and you will not be asked to sit in a treatment chair during this visit.

Let’s protect you, top to bottom, beginning with your smile!

A Dry Mouth Can Have Many Causes And Lead To A Number Of Oral Health Problems


Posted on Jun 21, 2019 by William J. Claiborne, DDS MS

Our lips and teeth – our smile – is a stage curtain to what is actually going on inside the mouth. As an Asheville periodontist, I have a daily view of  the hazards that exist beyond the veil.

Oral bacteria is the root source of most problems that occur in the mouth. Their presence is normal, of course. The mouth (or “oral cavity”) is designed to be able to manage a certain level of oral bacteria. It is the over-accumulation of this bacteria that is the origination source of many problems.

Although certain foods, such as a garlicky shrimp or onion-laden hot dogs, can create “stand-offish” bad breath, this breath odor is temporary. The bad breath that is truly offensive and occurs on a more consistent basis comes from an overload of oral bacteria.

The reason we’re advised to brush at least twice a day and floss our teeth daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, the bacteria form a sticky film that coats the teeth and gums. This film is known as plaque.

Keep in mind that bacteria are living, eating, and reproducing organisms. Because they eat, they also create waste – in our mouths! Although that in itself should be reason enough to be committed to brushing and flossing, without pain, people assume that all is well.

Yet, an over-accumulation of oral bacteria can lead to far worse than bad breath. Because oral bacteria critters eat, they look to the gum tissues. As they amass, they can create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth.

Periodontal disease is the leading cause of adult tooth loss. The advanced stage of gum disease, known as periodontitis, creates a bacteria so potent that it has been linked to a wide array of conditions and diseases elsewhere in the body.

The oral bacteria of advanced-stage gum disease has been associated with some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency. As research continues, more and more health problems are being correlated to this bacteria.

The saliva in the mouth is designed to move bacteria out. Twice daily brushing and flossing help. However, certain contributing factors complicate the ability to keep oral bacteria levels to manageable levels. These include:

• Colas/Sodas: Not only is the acidity level in these drinks harmful to tooth enamel, it can make oral tissue to dry out. Downing these beverages because you feel you are replenishing moisture is the last thing they do; refreshing they are not. Drink plain, filtered water instead. It’s much better for your mouth and hydrating to the entire body.

• Coffee/Tea: Like colas, these drinks contain acid added to caffeine. Even green tea often contains caffeine. Caffeine has a drying effect on oral tissues and therefore depletes the helpful rinsing benefits or saliva.

• Alcohol (including beer and wine): Mixed drinks, “shots,” wine and even beer are all drying to oral tissues. Add the acidity and sugar levels that exist in wine or mixers and these drinks pack a double-whammy to oral tissues. If you imbibe, alter your drink with a glass of water in-between to neutralize acids and wash sugars from the mouth.

• Smoking (cigarettes, cigars, vaping, cannabis): People who have smoked for years often have dry skin that has an aged appearance far beyond their actual years. The same is occurring inside the mouth. The smoke of cigarettes and cigars is laden with toxic chemicals; true for e-cigs as well. Vaping doesn’t keep your mouth much safer than cigarettes. Even marijuana has been found to have a negative impact on oral tissues.

• Aging: Through aging, our skin, cartilage, and tissues are less supple. Our bodies simply dry out more and more with each decade. Although there’s nothing we can do to halt the aging process, we can take measures to minimize the damage to our oral health. We recommend drinking plenty of water throughout the day, using an oral rinse designed to replenish moisture in the mouth, and limit sugar and caffeine.

As a periodontist, I also urge people to be familiar with the signs and symptoms of periodontal disease, which begins with gingivitis. In this early-stage of gum disease, the gums may feel tender and swollen in one area. You may notice some bleeding when brushing your teeth. Your breath may feel less-than-fresh more often. However, some people experience no symptoms at all at this early stage.

If not treated, gingivitis can progress to periodontal disease, where symptoms are more obvious. The gum tissues are sore and bleed easily when brushing. Your breath will be bad more frequently. The gum tissues may swell in some areas and turn red.

As gum disease advances, the gums can begin to pull away from their tight grip around the base of some teeth, exposing darker, more sensitive areas of the tooth’s root. The gums will ache often and pus pockets may form at the base of some teeth. The breath is foul, even after brushing. And, tooth brushing is very uncomfortable with blood in the sink each time.

Eventually, the disease will have penetrated the supportive bone and ligaments that support teeth. In advanced cases, the teeth will begin to move and some may require removal.

All of this devastation to the mouth can be avoided, however. When people respond to early signs of gum disease by seeing a periodontal specialist, they can avoid the time and expense required. In addition to preventing the loss of natural teeth,

Enjoy beautiful, relaxing views from our surgical suite.

research now shows that serious health problems far beyond the body can be avoided as well.

If you have delayed or avoided dental care, begin with a consultation to learn about your options to have a healthy smile that is worry-free. Regardless of your love of coffee, your smoking habit, or your age, we can develop a program that allows you to have good oral health.

Begin by calling 828-274-9440 to request a consultation, or begin with a thorough examination in our Asheville periodontal office. We offer the latest techniques, technology, and skills while always putting patient comfort at the top of the list!

 

How You Develop Gum Disease, And How To Avoid It.


Posted on May 29, 2019 by William J. Claiborne, DDS MS

Other than a canker sore or bite on the cheek, almost no problem in the mouth will clear up on its own. This is often because the symptoms of most oral problems don’t emerge until they are well-developed.

For example, a cavity typically doesn’t become obvious until it begins to ache. Once it causes discomfort, it is a well-established problem. It won’t repair itself, and will eventually worsen (and become even more painful) to the extent where removal becomes necessary.

As a Periodontist, I often see people who have developed periodontal disease who come (or have been referred) because they are enduring obvious problems. However, I also see patients who are surprised to learn they have developed the disease. Yet, even without obvious symptoms, gum disease may exist and be fully underway.

Signs of gum disease

For some people, warning signs are ignored. Some simply don’t associate bad breath or bleeding gums with a disease of the mouth. As a matter of fact, I see may people who first arrive and proudly claim they do such a good job brushing their teeth, they spit blood in the sink.

Let’s use this time together to understand how gum disease forms and the symptoms associated with it. The typical process of how gum disease begins and progresses is:

1. Accumulation Of Oral Bacteria – We all have bacteria in our mouths. This warm, moist environment takes in an enormous amount of bacteria-laden items. Bacteria is on our food, utensils, the glass we drink from and the pencil we hold between our teeth. Of course, bacteria cannot be prevented altogether. However, the problem begins when too much bacteria accumulate.

2. Plaque Forms – Without proper brushing, flossing, saliva flow and diet, oral bacteria can reproduce rapidly. Their accumulation over the course of a day forms a sticky film you feel on teeth. This is known as plaque.

3. Development of Calculus – In just 48 hours, unremoved calculus, also known as tartar, can harden onto teeth. This is actually a cement-hard colony of oral bacteria. Like plaque, calculus will continually reproduce and grow as the bacteria feed on tooth enamel and tender gum tissues.

4. Initial Stage Gingivitis – This is actually 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. Your breath will no longer feel fresh. At this point, with proper measures, you can restore your gums to a healthy state. However, there is a fine line between being able to undo gingivitis and its progression to gum disease.

5. Periodontal (Gum) Disease – At this level, the gums are inflamed and tender. You may notice them darken in color and begin to pull away from the base of some teeth. You’ll have persistent bad breath.

6. Advanced Gum Disease – When gum disease progresses to periodontitis, your breath odor is persistently offensive. Bacteria-filled pus pockets may form on gum tissues near the base of some teeth. Chewing becomes painful and teeth can loosen, eventually requiring removal.

There are various stages of periodontitis. The Mayo Clinic does an excellent job explaining these advanced-stage levels (https://www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473):

  • Chronic periodontitis is the most common type, affecting mostly adults, though children can be affected, too. This type is caused by plaque buildup and involves slow deterioration that may improve and get worse over time but causes destruction in the gums and bone and loss of teeth if not treated.
  • Aggressive periodontitis usually begins in childhood or early adulthood and affects only a small number of people. It tends to affect families and causes rapid progression of bone and tooth loss if untreated.
  • Necrotizing periodontal disease is characterized by the death of gum tissue, tooth ligaments and supporting bone caused by lack of blood supply (necrosis), resulting in severe infection. This type generally occurs in people with a suppressed immune system — such as from HIV infection, cancer treatment or other causes — and malnutrition.

Nearly half of American adults have some level of gum disease. Sadly, it is the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.

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.

Imagine losing your teeth and having to decide on a crown-&-bridge combination, partial, full denture or Dental Implants. These procedures and expenses can be avoided. And, contrary to what many believe, losing teeth is not a natural part of the aging process. With proper care, you can easily enjoy a smile of natural teeth all your life.

If you are experiencing symptoms of gum disease, call 828-274-9440. We’ll restore your oral wellness and develop a program to help you keep it at its best.

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