Alzheimer’s Disease, Dementia and Periodontal Disease

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

In information posted on the web site of the Alzheimer’s Association (www.alz.org),

“A recent analysis led by National Institute on Aging (NIA) scientists suggests that the bacteria associated with periodontal disease that causes the chronic inflammation are also associated with the development of Alzheimer’s disease and related dementias, especially vascular dementia.”

https://www.alz.org/co/news/oral-health-and-alzheimers-risk#:~:text=A%20recent%20analysis%20led%20by,related%20dementias%2C%20especially%20vascular%20dementia.

Is there a more dreaded disease today than Alzheimer’s? Not only is the individual effected, entire families are devastated when dealing with a loved one’s diagnosis.

In the U.S., it is the 6th leading cause of death.

https://www.alzheimers.net/resources/alzheimers-statistics/

By the year 2025, the number of people 65 and older with Alzheimer’s disease is expected to reach 7.1 million people, a 27% increase from the 5.6 million over the age of 65 in 2019.

In 2020, it was estimated that 11.6% of North Carolina adults aged 65 and over had some level of the disease. Currently, 10% of American adults 65 and over have Alzheimer’s disease. For people ages 85 and older, this increases to 32%.
By 2060, nearly 1 in 4 Americans will be 65 years and older with seniors over age 85 having tripled.

https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf

As a periodontist in Asheville NC, I’ve been following the findings related to Alzheimer’s disease and periodontal disease. Yes, the connection between the two seems far-fetched, but research is showing there is a correlation.

First, allow me to explain periodontal (gum) disease. Gum disease is an inflammatory disease that attacks gum tissues, teeth, and the structures that support them. It is the nation’s leading cause of adult tooth loss. In addition to the problematic oral symptoms associated with gum disease, research has shown that the infectious bacteria are able to activate the development (or worsen the progress) of other diseases.

Because the bacteria of gum disease are able to enter the bloodstream through weakened oral tissues, studies have connected them to serious reactions elsewhere in the body. Some of these lead to the formation of cancer (oral, throat, pancreatic, lung) and some activate conditions such as diabetes and arthritis.

While the statistics of aging adults increase, nearly half of the adult population has some level of gum disease, over 47%. As a periodontal specialist in Western NC, I believe the high prevalence of gum disease among U.S. adults may be, in part, due to the assumption, “if it doesn’t hurt, nothing is wrong”. People also tend to brush off some symptoms as “normal,” such as seeing blood in the sink when brushing teeth.

Although symptoms of gum disease may include tender gums that bleed when brushing, gum disease can begin without any obvious signs. One study included over 8,200 adult at an average age of 63 at the study’s onset. The findings showed an increased propensity for developing dementia for participants who had severe gum disease and missing teeth.

Having no natural teeth was associated with a 26% increased risk. At the end of the study:

• 14% of individuals with healthy gums and all their teeth at the start of the study developed dementia by the end of the study
• 18% of participants with mild gum disease developed dementia
• 22% with severe gum disease (periodontitis) developed dementia
• 23% of those with no remaining teeth developed dementia

Eighteen years later, a follow-up study found those who had severe gingivitis in addition to tooth loss had a 22% higher risk for developing Alzheimer’s disease or dementia.

What researchers found is the bacteria present in periodontal disease are able to travel through the mucous membranes of the mouth to the brain. This is believed to cause potential brain damage.

https://psychcentral.com/news/2020/07/30/gum-disease-may-be-linked-to-later-dementia/158497.html?MvBriefArticleId=25473

Now, more than ever, maintaining a healthy smile is important for every adult. If you suspect you have gum disease (gums that bleed when brushing, tender or swollen gums, gums that have reddened or receded from teeth), be seen by a periodontist. This disease will only worsen without treatment.

Be committed to having excellent oral health as and make it a priority as an important part of your overall health. For a consultation to discuss how we can help you achieve optimal oral health, call 828-274-9440.

In addition to the treatment of all stages of gum disease and the reshaping of gum tissues, a periodontist is a specialist in the placement of dental implants. If you have lost teeth, dental implants are the ideal tooth replacement option.

Also, please know that our Asheville periodontal dental office offers many comfort options, including Oral and I.V. sedation. Oral sedation is a pill that helps patients relax. I.V. sedation (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety.

When Trepidation Keeps You From Going Further For The Smile You Desire

Posted on Jul 31, 2024 by William J. Claiborne, DDS MS

In my 30-plus years as a periodontist in Asheville, I’ve treated hundreds of patients who comes with a variety of needs. Some need treatment that involves the gum tissues, including:

• all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
• reshaping gum tissues for esthetic enhancement (crown lengthening, correcting ‘gummy smiles’, repairing gum recession)
• diagnosis and placement of dental implants
• treating lesions or cysts in oral tissues

Over the years, I’ve seen adults of all ages who have the ultimate desire for a healthy, confident, and even more attractive smile. While many come to our Western NC periodontal dental office through the referral of their general dentist or another dental specialist, we also see a number who are referred by someone they know (often a past patient) or those who have found us online.

We are happy to welcome all new patients, even those who come to us with trepidation. And, trepidation is something my team and I understand.

While some individuals admit to having dental anxiety or fear, others aren’t in the category of being a fearful patients. Some are holding something in that even they cannot pinpoint, although its a reservation that we can often work through. Their trepidation tends to wane once the patients become more familiar with our skills, technology, and unique features.

To begin, patient comfort is a high priority in our our Asheville periodontal practice. While we are widely known for an environment of comfort and respectful care. This is because, in part, over 70% of the adult population have some level of dental fear or anxiety. The other part is that we would want such an approach to care for ourselves and our loved ones.

For optimal comfort and relaxation, 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. It is administered 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 also have a reputation for featuring some of the most advanced technology available, much of which is not available in other dental or periodontal offices in this region. These features help to diagnose with precision, treatment plan with superior accuracy and reduces the patient’s treatment time while optimizing comfort.

Advancements in today’s dental technology are remarkable. Whether the patient’s need is the restoration of gum health or the replacement of missing teeth through dental implants, the advanced skills of a periodontist can help minimize treatment time and complexity of treatment.

In our periodontal dental office, some of the features that help enhance comfort, optimize treatment outcomes, minimize treatment, and speed healing include:

LANAP Protocol Using PerioLase MVP-7: Efficiently and effectively treats periodontitis (advanced gum disease) with laser technology. It causes very little discomfort and has a quick recovery time. This has also been found to stimulate bone regrowth in damaged areas.

Dental Radiology With 3-D Cone Beam Technology: This imaging is ideal for diagnosis and treatment planning. The imaging covers the entire dentition area with clear views of the mandible and maxilla (upper and lower jaw).

CareStream Cone Beam Computer Tomography Imaging: This computerized tomography provides imaging in exceptional detail and range.

CS 3600 intraoral scanner: Patients no longer have to endure having impressions made with bulky, gloopy trays held in their mouths! This quickly and comfortably scans the mouth’s interior for digital impressions using a small, handheld scanner. It can also reach difficult–to–access areas in the patient’s mouth with improved patient comfort.

Simplant Dental Software for Computerized Dental Implant Placement: This system helps in pre-surgical positioning of dental implants on the computer, using a 3D model of the patient’s jaw. This aids in the selection of the implant type that ensures a precision fit.

Intraoral Camera Technology: This provides outstanding quality of images within the mouth. These images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment issues.

Computer Imaging In Treatment Suites: Treatment suites are equipped with computers for convenient image sharing with patients.

Advanced Sterilization: Our custom sterilization unit adheres to (or exceeds) CDC guidelines for instrument processing protocols, particularly in the cleaning of instruments.

Fully-Equipped Surgical Suites: Relax during treatment while surrounded by beautiful mountain views of Asheville.

Once a patient who had reservations understands the amazing environment we offer for their periodontal dental needs, they tend to relax. For those who have periodontal (gum) disease, proceeding with treatment has a more urgent timetable, which has to do with their overall health.

Gum disease is the nation’s leading cause of adult tooth loss. Yet, the bacteria that destroy gums and the structures that support natural teeth don’t always remain confined to the mouth. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.

Once blood borne, the bacteria are able to activate or worsen serious conditions in the human body. Research has correlated oral bacteria to a long list of serious health problems. These include heart disease, stroke, Alzheimer’s disease, arthritis, diabetes, preterm babies, erectile dysfunction (ED), some cancers (including pancreatic), and more.

It is estimated that over 47% of American adults have some level of periodontal (gum) disease. This disease is the nation’s number one cause of adult tooth loss. However, gum health needs to be seen by the general population as a vital player in one’s overall health.

I believe that our population would be more committed to their oral wellness with a more widespread understanding of the hazards of gum disease in the U.S. This is why it is important to be familiar with the signs and symptoms, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding (pulling away from the teeth) or make the appear teeth longer than normal
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

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

There are so many connections between your oral health and your overall health that are yet to be known. Yet, the more research delves into this, the more comes to light. An illustration of this is research at Case Western Reserve University School of Dental Medicine. In this recent study, they found that humans with fewer fat cells are better able to combat periodontal (gum) disease. This is because fat cells trigger inflammation in the body.

In the study, 31 obese people who had clear indications of gum disease were monitored. Half of the group had gastric bypass surgery with fat cells removed from the abdomen. Those in the other group had not had gastric bypass surgery or fat removed.

Researchers noted that the majority of the bypass surgery group had a drop in their glucose levels following the procedure. This is a positive outcome based upon the higher risk of overweight people for diabetes and insulin-related problems.

All study participants underwent non-surgical periodontal treatments and were provided oral hygiene instructions for at-home care. While both groups showed improvement, the surgery group had better results.

https://www.sciencedaily.com/releases/2011/11/111109111540.htm

If you have oral wellness needs, want to replace teeth through dental implants, esthetic goals with the involvement of gum tissues, or have dental fear that has prevented you from receiving regular dental care, let’s sit down together and discuss ways we can help you.

If financial concerns are an issue, we offer several payment plans. These often break treatment fees into monthly payment amounts that are manageable to most budgets. Most have no down payment required and are interest-free.

Call our Asheville periodontal office at: 828-274-9440 and speak with our friendly staff. You can begin with a consultation, if desired.

The “Risk vs. Reward” of Oral Health

Posted on Jun 25, 2024 by William J. Claiborne, DDS MS

Risk versus reward.

This is a phrase that’s often associated with decision-making, such as stock market investments. While certain strategies can increase the potential for “reward,” there is still an element of “risk” in losing part or all of the investment.

As a periodontist in Asheville, I see this in how it relates to decisions in dentistry. This is the case in replacing lost teeth. As a periodontal specialist, I place many dental implants in patients who’ve lost teeth that likely could have been kept had the patient made different decisions.

I also see this is in the decision of patients to have a crown (“cap”) placed on teeth. When a dentist recommends a crown, it is typically to keep the existing tooth structure intact and protected. So, when a tooth that’s been filled and needs yet another filling, the dentist may advise crowning the tooth instead. This preserves the remaining structure by avoiding the “risk” of tooth from breaking off.

Or, when a tooth shows signs of fracture(s), crowning may prevent the tooth from the need for removal. This is because a tooth that eventually breaks below the gum line can no longer be saved. Once removed, tooth replacement brings on an entirely new set of decisions, and costs.

Your general dentist’s goal, like yours, is to help you achieve and maintain a healthy smile. He or she wants you to keep your natural teeth or, if tooth loss does occur, replace them in a way that supports your overall oral health. A periodontist can be a strong team player in this goal.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease and in the placement of dental implants. A periodontist is also a specialist in reshaping gum tissues, for reasons that may include esthetics as well as maintaining oral wellness.

I place many dental implants and am a proponent of them as a superior tooth replacement option. However, as ideal as an implant is, there is nothing as good for your oral health as natural teeth. This is why it’s so important to keep them. This may, for certain teeth, require the placement of a crown.

A periodontist may be involved in certain aspects of treatment to optimize a patient’s results and success level while minimizing discomfort. For instance, a periodontist may work with your general dentist to help save a tooth from removal when a tooth has broken close to the gum line. This is accomplished through crown lengthening procedures where gum tissues are removed to expose more of the tooth. This may be able to make sufficient tooth structure available to support a crown.

Crown lengthening is also beneficial in sealing gum tissues surrounding a tooth at its base. By securing the tissue around the tooth or crown, bacterial entry is avoided and the risk for periodontal (gum) disease decreased. This is especially beneficial in cases where gum tissues have receded, exposing sensitive tooth root sections that are easily affected by oral bacteria.

In some cases, gum tissue height can be corrected by careful removal in a procedure known as a gingivectomy. To enhance the appearance of a smile with an esthetically-pleasing smile line, combined with the placement of crowns, the tooth-to-gum ratio is rebalanced.

This is what is often referred to as a “gummy smile.” Crown lengthening is a common method that teams your general dentist with a periodontist to create a smile that looks natural and is beautifully flattering.

Another look at the risk-reward consideration, the “risk” of not caring properly for oral health can easily upend the “reward” of having a healthy smile. Regular dental check-ups and a thorough at-home oral hygiene regimen can prevent the development of cavities and periodontal disease.

When oral bacteria levels in the mouth are not managed, the teeth and gums pay the price, often through the need for costly treatment that may have been prevented. Periodontal disease is the nation’s leading cause of adult tooth loss.

Research has also found that the inflammatory bacteria of gum disease can enter the bloodstream, triggering or worsening a long list of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.

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

As a periodontist in Asheville, we want everyone to know the benefits of a healthy, confident smile. Maintaining healthy gums and keeping your natural teeth is important to every individual.

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.

For those who have already experienced tooth loss, we are happy to discuss the process to 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. Too, dental implants are designed to last a lifetime, making them an excellent investment.

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. A referral to our office is not required.

If dental fear or anxiety has kept you from receiving regular dental care, please ask us about oral or I.V. sedation (“twilight sleep”). Both are administered safely with patient comfort always a priority.

Females & Males – Oral Health Differences

Posted on Jun 05, 2024 by William J. Claiborne, DDS MS

As a periodontist, I have an intense understanding of how oral health impacts the overall health of both males and females. However, my specialized skills also allow me to understand the unique factors that affect the oral health of our female patients.

As a result of hormonal fluctuations, females can face particular challenges when it comes to oral wellness. For example, pregnancy gingivitis is not uncommon in women during pregnancy. If not treated and resolved, however, it can develop into periodontitis (advanced periodontal disease) and subsequent tooth loss.

A good illustration of how women face unique oral health challenges was noted in findings shared recently on Fox News. (https://www.foxnews.com/health/women-experience-dental-health-issues-men-experts-say-heres-what-do-about)

Using a pH meter, the pH levels in saliva were tested on multiple people over the course of many years. The researchers found the pH of women’s saliva was frequently 5.5 or 6 – a lower saliva flow rate than men.

Saliva’s ideal pH rate is between 7 and 7.4. If the pH of saliva constantly drops below 5.5, the tooth enamel gets demineralized, which means it will be more prone to tooth decay. Because the aging process causes a lower flow of saliva, a drier mouth weakens teeth due to the slower remineralization or buffering capacity.

Below are some of the different phases of life that can be accompanied by various challenges to a female’s oral health:

Puberty: Estrogen and progesterone hormones produced during puberty increase blood flow to the gums. This changes how the gums respond to plaque, the sticky film of bacteria in the mouth. With this may be gums that bleed when brushing and become red, tender, and swollen.

Menstruation: The menstrual cycle causes hormonal changes that cause some women to experience symptoms such as swollen gums that turn bright red, canker sores, or gums that bleed easily. Referred to as menstruation gingivitis, this usually occurs just prior to the onset of the period and resolves in a day or so.

Oral Contraceptives: Taking birth control pills that contain progesterone cause some women to have gum tissue inflammation. This occurs from heightened sensitivity to the toxins produced from the overload of bacteria that form plaque. While many women have less gum reactions after the first few months, some medications can lower the effectiveness of oral contraceptives. This reinforces the need to keep your dentist updated on all medicines you take.

Pregnancy: With each trimester of pregnancy, hormonal levels can change. Pregnancy also causes increased progesterone levels, which can increase the risk for plaque formation. This can lead to pregnancy gingivitis, particularly during the second to eighth month of pregnancy. This condition causes the gum tissues to become swollen and bleed easily. Gingivitis is the first stage of gum disease, which is why it is important to have gingivitis fully resolved to prevent its further progress. Because studies have found that gum disease can increase the risk for preterm and low birth weight babies, obstetricians are urging their pregnant patients to be particularly diligent in maintaining good oral health.

Menopause: With age, a variety of changes can take place in our mouths for both males and females. A particular challenge is the decrease in saliva flow, leaving the mouth is less moist. Additionally, the side effects of certain medications can pose challenges to keeping the gums healthy. Without adequate saliva flow to keep the mouth cleansed and efficient in neutralizing the acids from plaque, the risk for gum disease is greater for females in menopausal years. Declining estrogen levels also place women at 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 expose to the causes of tooth decay.

Researchers in Romania studied the gender differences in oral health. Through an online survey of 600 adults, the study assessed attitudes, behaviors, and educational understanding related to oral health and dental services.

The results show that women have more positive attitudes towards dental services with higher oral health values, better self-care behaviors, and have higher oral health literacy than men.

While the study indicated that oral care attitudes and behaviors of men had different influencing factors, women were primarily influenced by their level of oral health literacy. The study also noted that differences in oral health attitudes and values for both genders can be based upon education.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604615/

This is a good reason to stay on top of how intricately your oral health is to your overall health. Because the bacteria of periodontitis can penetrate the bloodstream through weak gum tissues, it has been correlated to a long list of serious health problems.

Research has found that periodontal bacteria can trigger the development or worsen the likelihood of heart disease, stroke, some cancers (including pancreatic and lung
cancer), preterm babies, diabetes, arthritis, erectile dysfunction, Alzheimer’s disease and more.

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

In our Asheville periodontal dental office, patients can begin with a private consultation. We are always happy to discuss oral health options with new patients. A referral is not needed.

Call 828-274-9440 to schedule.