Smokers CAN Lower Oral Health Risks With Proper Measures


Posted on Feb 04, 2021 by William J. Claiborne, DDS MS

If you smoke, you may be tempted to quit as one of your New Year’s resolutions. By now, you may be “over the hump” and feel success in this challenge (and breathing much easier!). Good for you!

However, if you’ve stumbled and faltered (and perhaps even thrown up your hands in defeat), you are not alone. According to the Centers for Disease Control & Prevention (CDC), over 55 percent of smokers in the U.S. had made a quit attempt in 2018, with only 7.5 percent succeeding. (https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html)

Yet, less than 7 percent of adult smokers reported (in 2015) that they had sought counseling or medications in their attempts to quit. Yet, the need for support is clear. For most people who are trying to quit, it is a long, tough journey. The CDC also reports that:

“more people in the United States are addicted to nicotine than to any other drug. Research suggests that nicotine may be as addictive as heroin, cocaine, or alcohol.”

As the need to maintain healthy immune systems has never been more urgent, smokers will hopefully reach out to every source in order to kick the habit, for good. Data assembled by a team at the University of California (San Francisco) found that smoking nearly doubles the rate of COVID progression.

The analysis took into account over 11,500 COVID patients. The findings showed by current and former smokers were twice as likely to have conditions that require hospitalization and higher death rates. (https://www.ucsf.edu/news/2020/05/417411/smoking-nearly-doubles-rate-covid-19-progression)

The authors of the study warned that both cigarettes and e-cigs were involved in this higher risk rate.

Smoking increases mucus production and inflammation, which injures the lungs’ defense system. This is why people who smoke are more likely to have serious respiratory infections and illnesses.

However, my role as an Asheville periodontist is not to lecture our patients. We believe our patients deserve to be informed about the risks to their oral health, in particular, and provide encouragement. Too, we want patients to understand the best ways to avoid developing periodontal (gum) disease and the subsequent repercussions (such as tooth loss) as a result.

So, let’s focus on your periodontal health if you smoke (including cigarette smoking or vaping).

Smokers are often unaware of what occurs in the mouth from smoking. To begin, smokers have a greater risk of periodontal (gum) disease due to its drying effect on the soft tissues in the mouth. When saliva flow is depleted, its ability to rinse away oral bacteria enables the mouth to a bacterial breeding ground.

As oral bacteria reproduce and accumulate in the mouth, gum tissues become inflamed. In the early stages of gum disease, symptoms may include frequent bad breath, tender and swollen gums, and gums that bleed easily when brushing teeth.

As gum disease progresses, the gums change in color from a healthy pink hue to red. The gums loosen their grip around the base of teeth and seem more spongy. Breath odor is consistently bad. Pus pockets may form at the base of some teeth.

Eventually, the bone and the tissue structures that support natural teeth are under attack. The infectious bacteria ramp up their onslaught of attack, tooth roots no longer have the firm support they need. Some teeth begin to loosen and may require removal.

Advanced periodontal disease, known as periodontitis, is a health risk that goes far beyond the mouth. For years, research has shown an intricate connection between the “good” bacteria in the mouth, especially beneficial in gut health. It has also been known that the “bad” and infectious bacteria of advanced gum disease can alter the roles of certain factors in the body that help to prevent the formation of disease.

For example, certain cancers can be activated or progressed through the inflammatory bacteria of gum disease. These bacteria are able to become blood borne and activate “pathogens” that create a domino effect of disease development.

When you factor in the vulnerability to the lungs from inhaling the toxic smoke of cigarettes, you have a perfect storm. Consider that the gum tissues are the first contact with these inhaled chemicals. Because oral tissues are absorbent in nature, they are at the front line of smoking’s effect.

If you do smoke, we want to help you minimize the risks it poses to your oral health. In addition to maintaining regular dental check-ups and cleanings (at least every 6 months), below are some tips for your at-home oral hygiene regimen.

Brush twice a day (at least) for two minutes each time. Use a fluoridated toothpaste and a soft to medium bristle toothbrush.
Floss your teeth every day and floss before your brush. You would be surprised at how many particles can be lodged between teeth that brushing won’t rid. If flossing is an awkward maneuver, try one of the water flossers, which are affordable and as effective as manual flossing.
Brush your tongue after your teeth to unroot embedded bacteria, especially reaching the back area of the tongue (where most bacteria are embedded). This also helps to give you fresh breath.
• Use an oral rinse that replenishes moisture (and is alcohol-free) twice a day (or as directed). These are available OTC at most drug stores.
• Chew sugarless gum, preferably a brand that contains Xylitol. Xylitol looks and tastes like sugar, yet has 40 percent fewer calories.
• Drink plenty of water throughout the day. Be aware that beverages such as most coffee, tea and colas contain caffeine are drying to the mouth. Many medications also have the side effect of oral dryness – another good reason to stay hydrated.
• Limit your intake of sugar and carbohydrates. These are oral bacteria super boosters.

In our Asheville periodontal dental office, please know that we are here for you regardless of your needs or goals. Although we prefer you give up smoking, we want to give you the very best care possible so you can enjoy a healthy mouth and confident smile.

If you haven’t had regular dental exams or have any of the symptoms associated with gum disease (mentioned above), call our dental office to schedule a thorough periodontal exam at 828-274-9440.

 

Erectile Dysfunction (ED) Risks Increase With Presence of Gum Disease


Posted on Jan 07, 2021 by William J. Claiborne, DDS MS

Men have a long way to go when it comes to taking good care of their teeth and gums, according to several surveys.

One from the Academy of General Dentistry stated that men in the U.S. are less likely to have regular dental check-ups and cleanings than women. Another survey shared by the Journal of Periodontology said men are less likely to brush regularly, and more likely to lose teeth as they age as well as develop oral cancer and gum disease.

According to the Centers for Disease Control & Prevention, over 56 percent of men have gum disease, compared to just over 38 percent of women. Men, in particular, should be aware of the increased health risks associated with periodontal (gum) disease.

Researchers have given closer assessment to recent studies and found that erectile dysfunction (ED) is more common in men with gum disease.

In addition to higher ED risks, research has found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums – 49 percent more likely to develop kidney cancer, 59 percent more likely to develop pancreatic cancer and 30 percent more likely to develop a blood cancer.

If concerns about heart disease and cancers aren’t enough to get men thinking more seriously about their oral health, ED may be a condition that does.

Gum disease has emerged as an independent risk factor for cardiovascular disease, and cardiovascular disease raises the risk for ED. For men, there are a number of factors that contribute to an increased risk of cardiovascular disease. These include smoking, obesity, chronic stress, high cholesterol, high blood pressure, and chronic sleep apnea.

One study published in the Journal of Sexual Medicine revealed that men in their thirties with severe gum disease are 3 times more likely to have erection problems. As cardiovascular health issues develop, erection ability suffers, and as health problems increase in number and severity, so does the severity of ED.

The association between periodontal disease, heart disease, and erectile dysfunction relates to inflammation brought on by gum disease bacteria. This process actually comes down to a biochemical reaction. During sexual arousal, the body releases nitric oxide, which plays a key role in enabling erection. Chronic inflammations, including periodontal disease, impairs release of nitric oxide and contributes to ED.

In the U.S., an estimated 18 percent of males have erectile dysfunction. Although men who are over age 70 are more likely to have ED, males most affected by ED are getting younger. One outpatient clinic showed that 1 in 4 men who sought help for erectile dysfunction were under the age of 40.

Could maintaining a healthy mouth lower the risk of ED? In a 2013 study, it was found that treating periodontal disease improves ED symptoms. Thus, a growing number of physicians are advising male patients who have both ED and periodontitis to seek periodontal treatment as a way to reduce its risk.

In data analyzed from five studies published between 2009 – 2014 (which included 213,000 male participants between ages 20 – 80), men who had chronic periodontitis (advanced gum disease) were more likely to have erectile dysfunction.

In another study, nearly half of the men with ED also had diabetes, another chronic inflammatory disease with links to periodontal disease. Chronic inflammation in the body can be lowered when gum health is kept in good condition.

Men can help to protect their overall health by keeping their oral health at an excellent level. It is especially important to watch for signs of gum disease. Symptoms include: puffy, red gums; inflamed, swollen, or bleeding gums; gums that recede from the base of teeth; and persistent bad breath.

If you are experiencing any of these symptoms, call our Asheville periodontal dental office for an examination as soon as possible. Gum disease does not improve without treatment.

Although many serious health problems are linked to the potent bacteria of gum disease, it is one of the most preventable of all diseases. Twice daily brushing, daily flossing, a diet limited in sugar and carbohydrates and drinking plenty of water are simple guidelines to follow.

Even with these easy steps that take mere minutes per day, it is estimated that over 47 percent of American adults have some level of gum disease.

For the good of your overall health and well-being, renew your commitment to a healthy smile for the new year. Begin with a thorough examination. (A referral is not required.) We’ll discuss how to get your oral health in good shape and ways to maintain it between dental check-ups.

Call 828-274-9440 to schedule or ask to begin with a consultation. If dental anxiety or fear has kept you from regular dental care, mention this during your appointment. This is a common problem for both men and women. If desired, we offer a number of comfort options, including Oral Sedation or I.V. Sedation (twilight sleep).

If Your Mouth Is Frequently Dry, You Have Higher Risk For Gum Disease


Posted on Dec 02, 2020 by William J. Claiborne, DDS MS

Our bodies are home to trillions of micro-organisms. This includes micro ‘ponds’ of viruses, fungi, and bacteria. As we’ve learned over the years, some of this bacteria is highly beneficial to how our systems operate.

Although the thoughts of bacteria often conjure up images of infectious organisms, the mouth is home to some very “good” bacteria. For bacteria that are present under normal circumstances, they do not cause disease and actually have a purpose. It’s the “bad” bacteria I want to focus on for now.

Oral bacteria is the source of nearly every problem that develops in the mouth. The oral cavity (mouth) is structured to manage a certain level of bacteria. As the entry point of most of the bacteria we add to our bodies, it can process a “normal” amount on a day-to-day basis. It is the overload of bacteria that becomes the origination source of problems.

The reason people are advised to brush at least twice a day and floss daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, a sticky film of bacteria form that coats the teeth and gums. This film is known as plaque. Without sufficient and frequent removal of plaque, it begins to harden at the base of teeth.

This is tartar (or calculus), which is actually a cement-hard mass of oral bacteria. Tartar cannot be brushed or flossed away; it requires removal by a dental professional. During your dental cleanings, you probably notice when your hygienist is scraping away at teeth. It is tartar that she is trying to remove.

Your periodic dental cleanings are important. If tartar is allowed to further amass, the bacteria can become inflamed, attacking gum tissues. As bacteria continue to reproduce, they create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth, including tooth roots, tissues, ligaments and bone.

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 research has linked it to serious diseases elsewhere in the body. These include some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency.

Saliva is the mouth’s natural rinse that helps cleanse oral bacteria from the mouth. This keeps bacteria levels to a minimum and lowers their ability to cause problems. When saliva flow is depleted, however, bacteria remain in the mouth longer – and multiply rapidly.

Saliva helps to continually cleanse your mouth, removing particles that can rot and cause bad odors. A condition called “dry mouth” (known as Xerostomia) is when production of saliva is decreased.

When the “dry mouth” condition is continual, the problem may be due to low salivary gland production or some diseases. Dry mouth naturally occurs during sleep and in people who breathe through their mouth. However, as a periodontal specialist, I find that most cases are due to factors that can be easily controlled with simple changes.

To support saliva flow and reduce “bad” bacteria in the mouth, twice daily brushing and flossing help. However, knowing contributors to a dry mouth can help you better manage or control oral bacteria levels. These include:

The aging process – Aging causes the skin, cartilage, and tissues to become less supple, drier. We can’t stop the aging process but can help protect our oral health by drinking plenty of water throughout the day. Coffee, tea and colas don’t count. Also, consider using an oral rinse designed to replenish moisture in the mouth.

Medications – Many over-the-counter and prescribed medications today have a side effect of oral dryness. Some of the worst culprits are antihistamines, depression and incontinence medications, and some that control blood pressure. If you take one of these, ask your doctor about options that may be less drying to the mouth. Or, increase your water intake and use a daily rinse to replenish oral moisture.

Sleep habits – To dry something out, a flow of air is just the thing. This also applies to the mouth. Snoring or breathing through the mouth during sleep create added dryness to oral tissues. Talk to your doctor about ways to resolve these problems. It may be as easy as adjusting your sleeping position or adding a side pillow.

Medical conditions – Having acid reflux, sinus infections, diabetes and bronchitis can cause dry mouth. A bad cold can also force people to breathe more through their mouth. For these conditions, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.

Caffeinated beverages – Caffeine has a drying effect on oral tissues and therefore depletes the helpful rinsing benefits of saliva. Most colas contain caffeine, which is drying to oral tissues. Add to that the high acidity level in colas (also harmful to tooth enamel). Also drying are coffee and tea. Like colas, these drinks contain acid added to caffeine. If you drink these beverages, be sure to rinse your mouth after or alternate with gulps of water.

Alcohol (including beer and wine) – Mixed drinks, wine and 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. Again, swish with water between drinks or have a glass of water nearby to dilute the impact of these.

Smoking (cigarettes, cigars, vaping) – People who have smoked for years often have dry skin that ages their appearance far beyond their actual years. The same is occurring inside the mouth. Cigarette and cigar smoke is laden with toxic chemicals, which is true for e-cigs as well. Just be aware at your added risk and the drying effects and take added measures to keep your mouth clean and moist.

If you have delayed or avoided dental care, call 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 making patient comfort a top priority.

 

How To Avoid Gum Disease & Cavities From Sugar This Holiday


Posted on Nov 12, 2020 by William J. Claiborne, DDS MS

Regardless of size and distancing limitations on 2020 holiday gatherings, you can bet that Americans will still consume the yummy indulgences associated with the season. After all, we all need comfort food these days. The holidays simply give us “justification” for eating the sugary, rich treats we’ve waited all year to enjoy. We release the guilt and know we’ll pay for it through our new year’s resolutions.

I’m the last person on earth who would preach abstinence when it comes to things like thick egg nog, sugar cookies and pecan pie. Like you, I wait all year to savor things like this. However, I’m also a periodontist and have a unique look at what this added sugar can do to teeth and gums.

Keep in mind that all food (as well as beverages other than plain water) cause an acidic surge into the mouth. This is sent in via saliva and is the first stage of the digestive process. This acid is so strong it can actually soften tooth enamel for 20-30 minutes, leaving you with a higher risk for tooth decay.

Sugar also super-charges oral bacteria, which are living, eating and breeding organisms. They thrive in colonies as they subsist on gum tissues. As bacteria levels grow, the gums become inflamed. This is the first stage of periodontal (gum) disease.

As gum disease worsens, the inflammation caused by these bacteria can lead to persistent bad breath, receded gums that expose sensitive tooth roots, and gums that darken in color. If untreated, pus pockets can eventually form at the base of some teeth and attack the tooth supporting structures beneath the gums.

Eventually, teeth will loosen and can require removal. Also known as periodontal disease, this is the nation’s leading cause of adult tooth loss.

Even without the holidays, Americans are the biggest sugar consumers on earth. Although the World Health Organization (WHO) recommends no more than 5% of daily sugar intake, or less than 25 grams, Americans consume 82 grams each day, on average. That translates into over 19 teaspoons of sugar per day and 66 pounds each year, per person.

When researchers from the University College London & London School of Hygiene studied public health records from around the world, they found that 92% of American adults have cavities. Compare this to Nigeria, a country with a diet very low in sugar, where only 2% of the population have had tooth decay. Also concerning were their findings that nearly 90% of America’s school age children have experienced tooth decay.

Childhood obesity is also out of control. The Centers For Disease Control & Prevention (CDC) reports that the U.S. percentage of children with obesity “has more than tripled since the 1970s. Today, about one in five school-aged children (ages 6–19) has obesity.”  That’s nearly one-third of children who are overweight or obese. https://www.cdc.gov/healthyschools/obesity/facts.htm Obesity is when fat content of the body is over thirty percent of its overall mass.

According to the Centers For Disease Control & Prevention (CDC), adults in the U.S. who are categorized as obese is at nearly 40 percent. Another 30 percent are categorized at overweight.

While sugar is not the only culprit, Americans have been lured into a lifestyle surrounded by sugary snacks and beverages. (After all, ads tell us that we need to grab a Snickers bar, not an apple, as an afternoon pick-me-up.)

You may be surprised to know that studies show that sugar is even addictive. It activates the same regions in the brain that react to cocaine.  (https://www.brainmdhealth.com/blog/what-do-sugar-and-cocaine-have-in-common/)

How does this apply to your smile? Research has shown that obese adults have a 6 times higher potential to develop periodontal (gum) disease. As a periodontal specialist, my goal is always to help patients achieve optimal oral health. In our Asheville periodontal dental office, we address the risks of periodontal disease with our patients without judgement of their weight, but rather how we can help them enjoy a healthier smile.

As difficult as losing weight can be, it is important to be aware of risk factors that can make you more susceptible to gum disease. Initial symptoms include gums that are tender, swollen, and may bleed when brushing. This stage, known as gingivitis, is actually reversible with prompt, thorough oral hygiene.

This holiday, try to reduce your intake of sugar and carbohydrates. This will help to lower your potential for damage by oral bacteria, reducing your risk for cavities and gum disease. Additionally, be committed to a thorough at-home routine of daily flossing, twice a day brushing and drinking plenty of water.

If you are experiencing symptoms of gum disease, however, it is important to be seen by a periodontist as soon as possible to halt further progression. A periodontist is a dental specialist who has advanced training in treating all stages of gum disease as well as in the placement of dental implants. The earlier the treatment, the less involved treatment requirements will be. Gum disease will not improve without professional care.

Call 828-274-9440 to schedule an initial examination or begin with a consultation.

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