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.
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
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.
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.
What Gum Disease Bacteria Does To You That May Surprise You.
Posted on Dec 15, 2023 by William J. Claiborne, DDS MS
As we round the corner of another year, making oral hygiene a priority seems a distant thought in the midst of holiday preparations and activities of the season. But, it should be at all times in our lives, for many reasons.
Over the years, research has continuously shown that the bacteria of periodontal disease can have a number of harmful effects – in the mouth AND elsewhere.
This is because these inflammatory bacteria can enter the bloodstream and travel throughout the body. Studies show that these bacteria can activate or worsen a number of serious health problems.
People easily understand that a mouthful of bacteria can cause bad breath and gums that may be tender and redden in color. This makes sense, since an area with a skin cut can redden and swell if it doesn’t heal properly. Yet, because gum tissues are concealed behind cheeks and lips, it is easier to ignore problems that may be clear that something is wrong if more exposed.
To be clear, bacteria in our bodies is not always a bad thing. For example, certain bacteria in the gut actually enhance the process of digestion and help to keep the digestive system operating efficiently.
However, some bacteria are bad. These ignite when too much bacteria invade the body, causing the immune system to become overburdened. Bacterial overload can leave the body’s natural defense response, white blood cells, unable to conquer the infection. So, when a cut becomes infected, your doctor may prescribe an antibiotic to give the immune system added reinforcements.
And, when bacteria overload occurs in the mouth, an inflammatory reaction begins. This is the beginning of gum disease.
Signs of gum disease include bleeding or sore gums, persistent bad breath, receded gums, and/or gums that are red rather than a healthy pink. These are warning signs since gum disease will only worsen without treatment.
As gum disease progresses, gums begin to pull away from the base of teeth, gums become very tender and bleed easily when brushing, pus pockets form on gums and teeth may shift or loosen.
Unfortunately, gum disease is ignored too often by adults in the U.S. The CDC estimates that over 47% of Americans have some level of gum disease, which is also the leading cause of tooth loss.
A periodontist is a specialist in the treatment of all stages of gum disease and in the placement of dental implants. He or she is the expert who can help to restore a bacteria-burdened “oral cavity” to a healthy state.
In addition to a healthy smile, the health of your gums can impact your overall health. By keeping the bacteria of advanced gum disease, known as periodontitis, you lower your risks of a long list of serious health problems that have been shown connected to gum disease bacteria. These include:
• Heart Disease & Stroke –
According to research, having advanced gum disease makes you twice as likely to develop heart disease. This is due to clot-causing proteins that occur from oral bacteria that can clog arteries, including the carotid artery that supplies the brain with blood.
• Dementia & Alzheimer’s disease
– Studies have shown that tooth loss from oral bacteria is a risk factor for memory loss and early stage Alzheimer’s disease. Apparently, oral infection cause inflammation triggers that can lead to the destruction of brain cells.
• Cancer –
Researchers found that males with gum disease are 54% more likely to develop pancreatic cancer, nearly 50% more likely to develop kidney cancer and 30% more likely to have blood cancers.
– Because people with diabetes are more susceptible to infections, with 95% of whom also have periodontal disease.
• Erectile Dysfunction –
Men with periodontal disease are 7 times more likely to have erectile dysfunction (ED).
• Premature Birth – Nearly 13% of U.S. babies are born premature, which can lead to breathing issues and infections. Infection in the mother’s body, which includes infection from periodontal disease, can create inflammatory reactions that are related to premature and low birth weight babies.
• Infertility –
Research has found that gum disease can complicate attempts for a female to become pregnant.
• Respiratory Problems –
When bloodborne bacteria from gum disease reaches the lungs, people with respiratory problems are at higher risk of pneumonia and acute bronchitis (COPD).
It has been said that the mouth is the gateway to the body. Whether it’s the holidays or vacation time or just a busy schedule, your oral health should be a commitment. It takes just minutes a day to brush your teeth thoroughly (at least 2 minutes each time), twice daily, floss daily and swish after meals.
Drink plenty of water, especially after consuming caffeinated beverages or alcohol (including wine). If you smoke, begin with a periodontal exam and ask our hygienist for at-home care instructions.
Call 828-274-9440 if you have questions about your gums or if you are experiencing any of the above mentioned symptoms of gum disease. Also, visit our website to learn more about our sedation options (including “twilight sleep”) and advanced technology, which often reduces treatment time while enhancing comfort.
Achieve Smile Goals With A Periodontist
Posted on Dec 11, 2023 by William J. Claiborne, DDS MS
If you’re like me, I’m usually looking at the end of each year feeling like there are several things I wanted to accomplish for the year, but kept putting them off until I ran out of time.
For some people, their oral health and appearance goals are on this list, with some who keep moving the goals to the next year and the next. These goals may include:
• Improving the appearance of a smile
• Having a “cleaner” mouth with fresh breath, etc.
• Replacing missing teeth
• Getting past fear or anxiety of dental visits
If you have one of these on your list, you may be surprised that a periodontal specialist can play a major role in helping you achieve your goals. And, because of the advanced skill level of a periodontist, your comfort, time in treatment and overall results can make the process easier for you.
Many general dentists and other dental specialists refer their patients to a for their specific skills. A periodontist is a dental specialist who is the expert in caring for the gum tissues in your mouth and in the placement of dental implants.
The majority of patients arrive because of periodontal (gum) disease. Common symptoms are red, swollen and tender gums. It often causes gum that bleed easily (often noticed when brushing teeth) and persistent bad breath.
Gum disease (sometimes referred to as ‘perio’ disease) only worsens without treatment. It is the leading cause of adult tooth loss. Additionally, it has been linked to the development or worsening of a long list of serious health problems elsewhere in the body.
Because the inflammatory bacteria disease can enter the bloodstream through diseased gums, their presence can activate conditions that are seemingly unrelated to oral health. Yet, the connection is severe. These health problems include stroke, heart attack, Alzheimer’s disease, dementia, preterm babies, some cancers, arthritis, diabetes, and erectile dysfunction (ED).
In our Asheville periodontal dental office, we are able to treat all stages of gum disease to restore your oral health and minimize the risk of tooth loss. For those who have developed gum disease because they’ve been afraid of dental visits, we offer oral and IV sedation (“twilight sleep”).
Sedation is administered safely by a doctor in anesthesia who uses advanced safety equipment. Our priority is always patient comfort with their safety equally so.
Too, our advanced technology is able to minimize treatment time with amazing results. For example, LANAP (Laser-Assisted New Attachment Procedure) combined with PERIOLASE MVP-7 is designed to efficiently and effectively treat periodontitis (advanced gum disease) with the advantages of a dental laser. This offers non-surgical treatment for patients with moderate to severe periodontal disease. LANAP treatment minimizes discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.
When tooth loss has occurred (whether from gum disease, an accident, or due to genetics), our NW NC dental specialty office also works with a number of dentists in the diagnosis and placement of dental implants.
With over 40 different implant systems, the one suited best for you depends on factors that an experienced dentist must take into consideration. For example, the number of implants you need and how much jaw bone mass exists.
For individuals who have lost a great deal of bone, specific implant types may be recommended. Some, like the “All On 4” implant system, uses specially designed implants which are placed at specific angles.
Bone loss can also be overcome by incorporating a bone rebuilding process into treatment. This is done prior to implant placement and does not require a bone graft. In many cases, we can apply a bone rebuilding material that restores ample bone mass.
The same is true when the sinus cavity will be too close to the proximity. This can be remedied through a “sinus lift.” We provide complete services of these procedures as well as dental implant placement – all performed with advanced skills and technology, such as our Cone Beam 3D imaging.
These images are ideal in diagnosis and treatment planning by giving a clear view of the mandible and maxilla (upper and lower jaw). Cone beam radiographs provide images in sagittal, axial, and coronal planes. This makes it possible to locate and trace the mandibular nerve canal for pre-surgical planning for an ideal implant position. Patients are exposed to only minute levels of radiation through a process that is fast and comfortable.
When the enhanced appearance of a smile is being sought, a periodontist also plays a part in helping to create a balanced smile line. In the procedure known as “crown lengthening,” the arch of gum tissues over teeth visible in a smile can be repositioned. This is done in a procedure known as a gingivectomy.
A gingivectomy is also performed to repair a “gummy smile.” This is when too much gum tissue shows above the teeth most visible in a smile. While the condition is not detrimental to oral health, some individuals seek to have it corrected by a periodontist.
Get the coming year started with your smile goals achieved! Call our Asheville periodontal dental office to schedule a consultation. Our friendly staff can help you arrange this private time together by calling 828-274-9440.
A Periodontist Can Contour Gum Tissues For A More Beautiful Smile
Posted on Nov 23, 2023 by William J. Claiborne, DDS MS
During the holidays, my wife and I attend gatherings where we occasionally meet new people. A common question, as applies to most of us, is “What do you do?” When I reply that I’m a periodontist, it is often met with a look of not knowing what a periodontist is but not wanting to appear as if that’s the case.
I’d like to explain what “we” are and, from a smile enhancement basis, what we can provide. I typically find that when I say “periodontal plastic surgery” it comes across as far more familiar than “performing gingivectomies.”
A periodontist is a dental specialist who has an advanced level of understanding when it comes to diseases of the oral tissues, reshaping of gum tissues and in the selection and placement of dental implants.
The American Academy of Periodontology defines a Periodontist as:
“A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”
To reach this specialty begins with educational requirements that are extensive. First, there is completion of 4 years of college (for an undergraduate degree) followed by another 4 years in dental school (for a doctorate). To specialize in Periodontics, he or she must further their education for another 3-4 years before completing the stringent requirements for specialty certification in periodontics.
The gums are rather under-rated when it comes to the tremendous role they play in both oral health and even your overall health.
Think of the gum tissues as a protective blanket in the mouth. The gums cover over the structures that support teeth and house the tissues and bone that are vital to our health. For instance, look at the base of each tooth. You’ll see that gum tissues snugly wrap around the base of each tooth. This protective seal is what prevents bacterial penetration beneath the gum line.
When oral bacteria amass to an extent that cannot be controlled by oral hygiene measures at home, they cause inflammation in the gums. In turn, the gums loosen their tight grip around teeth, which allows entry of the now-potent bacteria. These infectious bacteria have been linked to a number of problems related to a long list of serious health problems.
Oral bacteria has been found to trigger or worsen systemic conditions, including atherosclerotic vascular (heart) disease, pulmonary (respiratory) disease, diabetes, pregnancy-related complications (including preterm births), osteoporosis (bone loss), and kidney disease. A shared trait between gum disease and these medical conditions is that they are chronic conditions that take a long time to develop.
It is important to be familiar with the signs and symptoms of periodontal (gum) disease, which include:
• Red, swollen or tender gums
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that pull away from the teeth (recede) or make the teeth appear longer than normal
• Loose or separating teeth
• Pus pockets that form between gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way teeth fit together when biting
• A change in the fit of partial dentures
If you have any of these, you are urged to seek a thorough periodontal evaluation as soon as possible. This disease will only worsen without treatment. Gum disease is the nation’s leading cause of adult tooth loss.
Healthy gum tissues do more than serve in a protective role. The appearance of a smile can be greatly affected by the shape and amount of gum tissues exposed when smiling.
When a smile shows too much or too little gum tissue bordering the tops of teeth, it moves the “smile line” out of balance. For example, in a beautiful smile, the arches of gum tissues visible in a full smile flow at a similar height. These gum arches are in a complimentary line to teeth, rather than at varying levels over teeth. When the gum lime is not evenly balanced, it causes a smile to have a jumbled look.
Crown lengthening is performed to reposition the gum tissues to enhance the appearance of a smile. In addition to creating a more appealing look, crown lengthening is also performed to restore the tight seal of protection around teeth. While you enjoy the beauty of your new smile, crown lengthening gives your oral health a boost at the same time.
When the height of gum tissues that show above all teeth in a smile is too high, it is referred to as a “gummy smile.” A gummy smile is not detrimental to your oral health. However, having one does affect the appearance of a smile based on balance. For some people, it makes them “hold back” on a full smile.
This can be corrected with a gingivectomy. To begin, we numb the gum tissues and carefully trim the excess. As a Periodontist, I take specific measures to ensure a natural looking arch remains over the teeth while preserving the natural points that ‘dip’ between each tooth.
A gingivectomy is performed in our Asheville periodontal office with a dental laser. This provides patients with a number of advantages: (1) enhanced comfort; (2) precision lines; (3) minimal or no bleeding; and, (4) faster healing time.
In our Asheville NC periodontal office, we use the highly-advanced LANAP with PerioLase MVP 7 Laser-Assisted Attachment Procedure. This is an advanced protocol that efficiently and effectively treats advanced gum disease (periodontitis) with the added advantages of a dental laser. It is a non-surgical alternative for patients with moderate to severe periodontal disease, causes very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.
In some cases, the crown lengthening procedure can save a tooth from removal. Typically, when a tooth fractures or breaks at the gum line, it must be removed since there is not enough tooth structure to support a crown. However, a crown lengthening procedure may be able to expose more of the tooth’s structure, essentially saving the natural tooth.
For those who have avoided gum treatment due to dental fear, we offer several sedation options, including oral and IV sedation. 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 (also known as “twilight sleep”) places the patient in a deeper sleep state and erases memory of the procedure. Here, anesthesia is overseen by a medical doctor (MD) who is a board certified Anesthesiologist. With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.
We help patients understand that their fears and concerns are not unusual. The doctors and staff of our Asheville periodontal dental office respect each patient and provide gentle, compassionate care – at every appointment.
We believe you’ll find no better periodontal dental environment in western NC. Whatever your need for the treatment of gum disease, recontouring of gum tissues, or in the placement of dental implants, call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.