Reshaping Gum Tissues To Protect Oral Health & Enhance Smiling Appearance

Posted on Mar 21, 2024 by William J. Claiborne, DDS MS

When people think about the appearance of their smiles, it’s typically the teeth that are the focus. Everyone wants a smile that enhances appearance, instills self-confidence and gets compliments. Yet, the appearance of a smile involves more than just teeth. The “frame” of gum tissues that arch the teeth most visible in a smile have a lot to do with how a smile looks.

As a periodontal specialist in Asheville, NC, part of my specialty involves the treatment of all stages of periodontal (gum) disease, the placement of dental implants, and the contouring of gum tissues. Gum contouring is generally done for esthetic reasons but may also be advised for oral wellness.

Gums most often pull away from the base of teeth (or “recede”), exposing darker areas of the tooth. This darker area is part of the tooth’s root and highly vulnerable to damage. Recession also causes teeth to look longer and expose darker tooth root areas of the tooth. Being sensitive to hot or cold – causing a sudden jolt of pain – is often the final warning sign that the gums are not protecting tender root segments of the tooth.

Gum recession is commonly due to:

• Gum disease, which destroys gums tissues, causing them to loosen their firm grip around the base of teeth. This enables oral bacteria to penetrate beneath the gum line, reaching vulnerable bone and tissues.

• Over-vigorous toothbrushing can wear away precious gum tissues that surround the base of teeth. When using a back-&-forth scrubbing motion, or a hard toothbrush, gum tissues can be scrubbed off. Too, using abrasive substances to brush (such as baking soda) not only wear down gum tissues, they wear away tooth enamel.

• The aging process lessens hydration in the body. Because the gum tissues are moist layers that require continual hydration (supported by saliva), oral dryness can cause the gums to draw up as they become drier. Unfortunately, this creates more challenges in maintaining healthy teeth.

While gum recession is an oral health concern, it is a cosmetic issue as well. For an attractive smile, teeth should be arched by a balanced level and shape of gum tissues. When there is too much gum tissue showing above teeth or varying heights of gums arching teeth, the height and symmetry of gum tissues can be corrected by a periodontist.

For example, in a gummy smile, too much of the gum line is visible. This makes teeth look short and draws the eye to the gums rather than the teeth. Gum tissues should complement teeth with a balanced line of gum tissues. While a gummy smile is not generally problematic for one’s oral health, many people find it makes them “hold back” on smiling fully.

The procedure to correct a gummy smile is a gingival lift, also known as a gum lift or gum contouring. This in-office procedure is performed to reduce and reshape highly visible gums.

In our Western NC periodontal dental office, we use a dental laser to perform a gingival lift. Our dental laser gives a precision line while only removing specific areas of the gums, leaving all surrounding tissue unharmed. This allows us to reshape the gums to create better balance in the smile.

A laser gingival lift also offers patients a more comfortable experience since it causes very little pain and therefore requires only topical anesthesia. In addition, laser treatments result in almost no bleeding and tissues tend to heal more quickly than after traditional surgery.

We also perform gum grafting that recovers areas where gum recession has occurred. This helps to protect the tooth roots and improves the appearance of the smile.

In gum grafting, we normally take a small area of tissue from the roof of the mouth and place it in the area of recession. When there is not sufficient tissue available, a graft may be from a donor source. The graft is attached to the natural gum tissue and gently sutured into the position where it corrects a smile’s appearance and reduces further recession and the potential for gum disease.

Several teeth may be involved in gum grafting when used to even out the gum line or reduce the risk of gum and bone collapse after a tooth has been lost. In these cases, cosmetic gum surgery is beneficial in reshaping excess gum and bone tissue. It also reduces sensitivity from exposed roots to hot or cold foods.

As a periodontist, I most commonly see gums that cover too much of the teeth as being due to genetics. When gums fail to cover sufficiently over the base of teeth, it’s typically the cause of recession, which can occur from several reasons (as listed prior). Regardless of why it has occurred, our goal is to provide the patient with the most healthy and esthetic outcome in a procedure that is comfortable, successful, and requires minimal healing time.

In our Asheville periodontal dental office, we offer some of the most advanced dental technology available. In addition to amazing imaging, such as Cone Beam 3D imaging, we provide Laser-Assisted New Attachment Procedure (or LANAP). This is a cutting-edge protocol to more efficiently and effectively treat periodontitis (advanced gum disease) with the PerioLase® MVP-7™ laser. Treatment is minimally invasive and helps to minimize both discomfort and recovery time. It has also been found to stimulate bone regrowth in damaged areas.

Additionally, our office offers both oral and I.V. sedation (“twilight sleep”) for complete relaxation during treatment. Sedation is administered safely by a doctor of anesthesia to provide optimal safety and comfort.

If finances have kept you from seeking out the care you need or the beautiful smile you desire, feel free to contact our friendly staff and arrange a consultation appointment. During this time, we can discuss the best options for you, cost estimates, and predicted treatment time.

We can also review several payment plans that make treatment affordable through extended, interest-free payment periods with no down payment required. These often help our patients enjoy their confident, new smiles while making easy monthly payments that are budget friendly.

Call 828-274-9440 to schedule.

Dental Fear Can Be Detrimental To More Than Your Smile

Posted on Feb 15, 2024 by William J. Claiborne, DDS MS

There are varying figures on the prevalence of dental fear in the U.S. However, there is no argument that it exists and affects a rather substantial number of adults.

A 2018 study shared by Dental Products Report listed the results of a study of things that keep adults from going to the dentist. Over 60% of the 18,000 polled admitted to having dental fear. Four percent shared they had never gone to a dentist as a result.

https://www.dentalproductsreport.com/view/study-finds-more-60-percent-people-suffer-dental-fear

Another study by the Cleveland Clinic stated that about 36% of people in the U.S. have a fear of dental treatment, with 12% having an extreme fear (known as “dental phobia”). 

While traumatic experiences in the past (often as a child) cause some people to be fearful of dental visits, others are not aware of why or how their fears began.

The Cleveland Clinic cites the top reasons that cause people to avoid or delay dental care are:

• Fear that the anesthetic won’t be sufficient or fear of the side effects (such as numb lips) after treatment

• Fear of bleeding during a dental procedure

• Fear gagging, choking or not being able to breathe or swallow during treatment

• Fear of dentist (often due to a bad experience in the past)

• Fear of pain

• Fear of needles

• The noise made by drills or other instruments used by the dentist or hygienist

• The smells of antiseptics or other chemicals used in a dental office

https://my.clevelandclinic.org/health/diseases/22594-dentophobia-fear-of-dentists

Having the jitters at the dental office is not all that difficult to understand. During these visits, patients are positioned on their backs on a narrow recliner with a bright light shining in their faces. Add to that having to maintain an open mouth (which is full of sensitive nerves) without really knowing what is being done. It’s not surprising that there are some uneasy feelings.

Fear or anxiety are normal reactions of the brain’s “fight or flight” response. For instance, some people have an intense fear of spiders or heights. Their reactions are automatic. Yet, in many cases of dental fear, some learn to override these reactions once they develop a sense of trust in being treated gently and respectfully.

In addition to avoiding care due to fear, some of the oral health problems we see occur from:

– Insufficient oral hygiene
– Avoiding regular dental check-ups and cleanings
– Ignoring symptoms of gum disease, such as seeing blood in the sink when brushing
– Brushing too rigorously or using abrasive substances to brush
– Age-related problems, such as oral dryness
– Oral dryness due to snoring or sinus problems
– Eating a high-carb diet or snacking frequently
– Smoking (including cigarettes, vaping, marijuana, and chew)
– Regular alcohol consumption

Certainly, some people are merely more susceptible to dental decay and bacterial buildup in the mouth. It can be due to genetics or some illnesses and diseases. Yet, the majority of reasons for having oral problems can be dealt with through proper at-home care and having regular dental exams.

When dental care is delayed or avoided due to fear, small problems that could have been prevented (or easily resolved) become big problems. Big problems require more extensive procedures, more expense and more time in treatment. When dental needs become more significant, fearful patients are actually adding to their reasons to dread the dentist.

Too, when regular dental check-ups and cleanings are avoided, the result can lead to periodontal (gum) disease, which is the nation’s leading cause of adult tooth loss. Periodontal disease occurs when an over-accumulation of oral bacteria become infectious. As it penetrates gum tissues, it also attacks the bone structures underneath the gums. This disease requires treatment that is more extensive. 

Additionally, tooth loss can create an entirely new set of procedural needs and costs.

For the individual who has high anxiety or fear associated with dental visits, how are they supposed to set aside these obstacles in order to receive the dental care they need? Obviously, problems in the mouth can easily exacerbate when the signs and symptoms of gum disease are back-burnered.

At our Asheville periodontal dental office, we believe that an informed patient is a healthier patient. Understanding what the problems are and what we are doing to attend to them often helps to keep the patient involved with their oral health. It also tends to help the patient relax. 

As a periodontist, I feel it’s important for every adult to know the signs and symptoms of gum disease:

Gums that bleed easily

Red, swollen, tender gums

Persistent bad breath

Gums that pull away from the teeth (recede)

Changes in the way teeth fit together when biting

Changes in the fit of partial dentures

Permanent teeth that loosen or separate

When any of these emerge, prompt treatment can minimize treatment time and costs. However, ignoring the warning signs merely allows the disease to progress further – requiring more time in treatment and greater expense.

In addition to the related problems of cavities, bad breath and tooth loss, the inflammatory bacteria of gum disease can impact overall health. Years of studies have found frightening correlations between oral bacteria and the worsening or development of serious diseases.

Research has found that the oral bacteria of gum disease (which affects over 47% of the nation’s adult population) can enter the bloodstream. Once bloodborne, this bacteria has been found to trigger inflammation that has been associated with a wide range of serious health problems. Research has shown links between these infectious bacteria to heart disease, stroke, diabetes, arthritis, some cancers, preterm babies, erectile dysfunction (ED) and even Alzheimer’s disease.

I am very proud of the relationship of trust my team and I have with our patients. They know our goal is to never cause them discomfort. Although we cannot always guarantee they’ll have no discomfort at all, we take extra steps to provide optimal comfort at every visit. 

In addition to this commitment, we offer oral sedation and I.V. sedation (also referred to as “twilight sleep”).

Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation places the patient in a deeper sleep state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology, overseen by Dr. Brad Stone, a Medical Doctor (MD) and a board certified Anesthesiologist & Pediatric Anesthesiologist.

https://www.biltmoreperiodontics.com/comprehensive-care-team/

With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

If fear has prevented you from a healthy smile, schedule a consultation in our Western NC periodontal dental office. During this time, we can discuss comfort options that may be best for your individual needs. Call 828-274-9440.

Do Different Age Groups Perceive the Importance of Oral Health Differently?

Posted on Feb 09, 2024 by William J. Claiborne, DDS MS

Just how important is your oral health?

Although Americans often focus on their smiles esthetically, it’s a far more important part of you than is often given due credit on a day-to-day basis. Yes, straight, white teeth help to enhance the appearance of a smile (as well as facial appearance), it’s what is typically not seen that has far greater importance.

About 50% of the world’s population over the age of 30 suffer from periodontitis. In the U.S., a developed country with excellent healthcare, a whopping 47% of adults over the age of 30 have some level of periodontal disease.

Because gum disease can begin without obvious symptoms, or be present without having pain, it is too easily ignored. This allows the disease to progress further.

The early stage, known as gingivitis, usually begins with swollen and tender gums that bleed easily when brushing teeth. As it worsens, the healthy pink hue of gums darken to more of a red color and breath odor is persistently bad. The gums begin to loosen their strong grip around the base of teeth, allowing infectious bacteria to reach bone structures that support tooth roots. In advanced stages (periodontitis), pus pockets form near the base of some teeth and gums become spongy in texture.

The bacteria of periodontal disease doesn’t just damage oral health. Through weakened oral tissues, the bacteria can enter the bloodstream and trigger inflammatory reactions. These reactions can worsen some serious health conditions and even activate others.

Research has found correlations between these bacteria and heart disease, stroke, diabetes, arthritis, some cancers (including pancreatic), preterm babies, erectile dysfunction, and Alzheimer’s disease.

In a 2020 study, individuals with gum disease who contracted COVID-19 were 9 times more likely to die. And, the study showed that COVID patients who already had advanced gum disease were 3 times more likely to end up in intensive care or on a ventilator. Evidence shows that poor oral health can increase viral infection severity, and even fatality rates.

But, does age play a part in the commitment to oral health?

A report commissioned by Delta Dental Plans Association revealed some concerning information regarding age groups and perceptions of oral health. With over 1,000 online participants, 87% listed their priority for maintaining proper oral care was to save money or avoid unexpected expenses. Two-thirds of the group listed their commitment to at-home dental hygiene as the desire to avoid tooth decay and gum disease. Yet, only 79% of adults stated they brushed their teeth twice a day with only 33% admitting to flossing daily.

In reviewing age groups, the report found that baby boomers (those born between 1946 – 1964) understand there is a strong link between their oral and overall health, but are less aware than other generations about the connection between poor dental health and chronic diseases (such as arthritis and diabetes). Those listed in the Generation Z group (born between 1997 – 2012) showed less commitment to their oral health as the “boomers,” but are more focused on eco-friendly and nontraditional oral care products. Only 76% of Generation Z agreed that oral health is closely connected to overall health.

An article in RDH Today recently shared that one-third of millennials (born between 1981 and 1996) admit to only brushing once per day, and the average millennial has gone over two days without brushing at all. Yet, 28% of young adults admit that ““The appearance of my mouth and teeth affects my ability to interview for a job.”

The study also shared that 27% of millennials are uncomfortable going to the dentist compared to 23% of respondents 55 years and older, and 56% of millennials have simply made an excuse not to go to the dentist compared to the 36% of those 55 years and older.

While fear remains a factor in a percentage of adults, this deterrent has existed for years among all ages. The American Dental Association conducted a survey on millennials, the fear issue was not the leading problem. Cost and inconvenient time and location were cited as the top excuses for avoiding regular dental care.

Excuses aside, here are some reminders about the benefits of maintaining good oral health:

• Technology – Today’s imaging technology (such as our Cone Beam technology and IntraOral scanners), allow us to treatment plan for the most conservative treatment possible. These amazing features provide amazing detail so treatment can be performed with precision for optimal outcomes.

• Comfort – In addition to the conservative treatment made possible by advanced imaging technology, we offer enhanced comfort options, including oral and I.V. sedation. Also referred to as “twilight sleep” or “sleep dentistry,” these sedatives are administered by a doctor of anesthesia who utilizes advanced safety monitoring equipment.

• Savings of Time & Money – The reason for 6-month dental check-ups and dental cleanings is to remove tartar buildup before damage can occur. Your hygienist and dentist can look for signs of gum disease so measures can be taken before the disease explodes into the need for more costly treatment to resolve the problem. Since gum disease is the nation’s leading cause of adult tooth loss, the associated expenses of replacing teeth can also be avoided by maintaining good oral health.

• Bolstering Overall Health – Although the Covid pandemic made us more aware of the benefits of vaccines and healthy habits such as hand-washing, it is our immune system that makes people more or less vulnerable. By investing in having healthy gums, the immune system is supported.

Be aware of the signs and symptoms of gum disease. These include:
Sore, swollen gums
Gums that bleed easily when brushing
Persistent bad breath
Gums that recede (pull away or loosen from the base of teeth)
Gums that turn red in color
Pus pockets that form at the base of some teeth
Teeth that loosen or shift

If you have any of these, you are urged to seek periodontal care as soon as possible. This disease will only worsen without treatment.

Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office. A referral is not required.

 

Sources:

https://onlinelibrary.wiley.com/doi/10.1111/jcpe.13435https://www.cdc.gov/nchs/fastats/dental.htm

https://www.deltadental.com/content/dam/ddpa/us/en/state-of-america%27s-oral-health-and-wellness-report/DDPA_State%20of%20Oral%20Health%20Report_2023-Release_FINAL.pdfse-you

https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/us-oral-health-well-being.pdf

https://www.todaysrdh.com/do-millennials-truly-have-worse-oral-health-than-their-parents/

https://nypost.com/2018/02/23/millennials-are-terrible-at-keeping-their-teeth-clean/

Gum Disease, Tooth Loss Warnings For Smokers

Posted on Jan 29, 2024 by William J. Claiborne, DDS MS

We’re a month in to the new year. If you made the resolution to quit smoking, you may be struggling at this point. But keep up the effort. In addition to the many problems associated with smoking, your smile is also at risk.

As a periodontist in Asheville, NC, I’ve seen how significantly the habit of cigarette smoking can have on one’s smile. It’s no secret that smoking cigarettes can stain teeth and cause bad breath. However, nicotine in any form is a hazardous force in the mouth.

In studies, smokers were 3 – 6 times more likely to have gum disease than nonsmokers. One reason is because smoking is very drying to oral tissues and decreases saliva production. Less saliva means there is less of a natural ‘rinsing’ away of bacteria in the mouth. This leads to higher concentrations of oral bacteria.

Dry tissues also slows healing in the mouth. The longer it takes for tissues to heal, the greater the potential for bacterial complications.

In one study, it was found that smokers were twice as likely as non-smokers to lose teeth in the five years after completing treatment for gum disease. Smokers are also shown to respond less favorably to oral surgery treatments due to slowed healing. For the same reason, dental implants are more likely to fail in smokers.

Researchers who have studied the effects of tobacco smoke on oral tissues say it appears to interfere with the body’s natural ability to fight disease and promote healing. Apparently, smoking affects the way gum tissue responds to all types of treatment, possibly due to tobacco chemicals that interfere with blood flow to the gums. This slows the healing process and makes treatment results less favorable.

According to a study at Temple University, pipe and cigar smokers and users of smokeless tobacco (“chew”) are just as prone to implant complications than cigarette smokers. The study showed three times the amount of moderate to severe gum disease as that of non-smokers.

The American Dental Association (ADA) also warns that smoking can cause the gums to recede from teeth, exposing vulnerable tooth root sections. This enables easier entry of oral bacteria into the structures that support tooth roots. Smoking can also delay healing following periodontal therapy, extractions or implant placement. The longer it takes oral tissues to heal, the greater the risks for infection to develop.

Additionally, smoking increases the risks of oral cancer, lesions inside the mouth, periodontal (gum) disease, enamel erosion and tooth loss. It greatly reduces saliva flow in the mouth, which is a tremendous aid in removing bacteria and food particles from the mouth, helping to control bacteria levels. The condition of “dry mouth” also causes bad breath.

According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker. (https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)

When a patient is diagnosed with advanced periodontal disease (periodontitis), they must make a commitment of time and expense to rid this inflammatory disease from their mouths. For those who ignore its presence or assume it will get better on its own, the disease will simply progress further.

Gum disease begins with sore gums that may bleed while brushing teeth. Or, it may cause no noticeable symptoms at all in early stages.

As it worsens, gum disease will cause frequent bad breath, tender gums that turn red, gum recession, and gums that bleed easily when brushing. Pus pockets may form on the gums. As it attacks the structures beneath the gum line, teeth may loosen or shift.

As the nation’s leading cause of adult tooth loss, it brings the hard decisions (and expense) for replacement. After all, you need teeth for eating and speaking. Do you go with dental implants? Or, do you take on the challenges that come with dentures and partials? As hard as the decisions of replacing teeth can be, gum disease can bring even more devastation with it.

Research has linked the bacteria of gum disease to serious health problems. These include heart disease, stroke, preterm babies, arthritis, diabetes, impotency, some cancers and even Alzheimer’s disease. These connections occur through the infectious bacteria of gum disease entering the bloodstream through tears in diseased gum tissues.According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker.

(https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)

When a patient is diagnosed with advanced periodontal disease (periodontitis), they must make a commitment of time and expense to rid this inflammatory disease from their mouths. For those who ignore its presence or assume it will get better on its own, the disease will simply progress further.

Gum disease begins with sore gums that may bleed while brushing teeth. Or, it may cause no noticeable symptoms at all in early stages.

As it worsens, gum disease will cause frequent bad breath, tender gums that turn red, gum recession, and gums that bleed easily when brushing. Pus pockets may form on the gums. As it attacks the structures beneath the gum line, teeth may loosen or shift.

As the nation’s leading cause of adult tooth loss, it brings the hard decisions (and expense) for replacement. After all, you need teeth for eating and speaking. Do you go with dental implants? Or, do you take on the challenges that come with dentures and partials? As hard as the decisions of replacing teeth can be, gum disease can bring even more devastation with it.

Research has linked the bacteria of gum disease to serious health problems. These include heart disease, stroke, preterm babies, arthritis, diabetes, impotency, some cancers and even Alzheimer’s disease. These connections occur through the infectious bacteria of gum disease entering the bloodstream through tears in diseased gum tissues.

If you feel your smile is safe by switching to vaping (use of e-cigarettes), read on.

Because of the vape’s moist presence in the mouth, the assumption with vaping over smoking cigarettes is the “benefit” of oral dryness. However, this is easily dispelled when looking at the true facts.

While there are more than 7,000 chemicals found in the smoke of tobacco products, (including nicotine, tar, carbon monoxide, acetaldehyde and N-nitrosamines),  nicotine is the primary addicting component. A study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, as well as potentially toxic metal particles from the device itself.

The e-liquids delivered by these devices typically contain nicotine, propylene or polyethylene glycol, glycerin, and additives.

In addition to the treatment of all stages of periodontal disease, a periodontist is highly skilled in dental implant placement. Dental implants have become a leading choice in tooth replacement for many reasons, including:

• Dental implants restore one’s natural ability to bite and chew comfortably.
• Dental implants allow people to eat a healthy diet of foods, chewing thoroughly to support good digestion.
• Dental implants enhance confidence when speaking, laughing and dining in social gatherings.
• Dental implants recreate stimulation to the jaw bone like that of natural tooth roots, which helps to halt bone loss.
• Through the prevention of further bone loss, dental implants contribute to the well-big of neighboring teeth
• Dental implants slow the aging changes to facial appearance by preserving jaw bone mass.
• Dental implants, with properly maintenance, are designed to last a lifetime.

One of the most appealing aspects is the longevity of dental implants. Today’s implants are designed to last a lifetime with up to a 98 percent success rate. This is one of the highest success rates for any implant-in-bone procedure.

However, like anything that’s not a natural part of the body, there is a potential for failure. For smokers, the habit is a significant contributor to implant failure.

Studies have shown that people who smoke have more calculus (also known as tartar) than nonsmokers. Calculus is the cement-like buildup on teeth, which is a concentrated mass of oral bacteria. When gums are weakened by an over-accumulation of bacteria, successful integration of dental implants is compromised.

Having a successful outcome with dental implant treatment is worth the efforts to quit smoking. Within two weeks of quitting, gum health improves. (https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet)

In our Western NC periodontal dental office, we intend for every dental implant we place to provide a successful outcome. However, patients who smoke must understand they have higher risks for complications, and even failure of dental implants. The first step is a thorough evaluation of your gums and the existing bone to support dental implants.

At your initial visit, I’ll answer your questions about the process, anticipated costs, and even sedation options. Call 586-739-2155 for an exam appointment or consultation or tap here to begin.