School’s In! Does That Mean More Sugar (And Cavities)?

Posted on Aug 27, 2018 by William J. Claiborne, DDS MS

With school back in, the conversation surrounding soft drink machines in schools has been a more frequent one of late. While some schools know that easy access to these sugar-laden beverages is not wise, many of the major players in the cola industry are big-time sponsors of high school activities. It’s been a controversial trade-off for years.

While the sugar content of colas is seldom seen as healthy (the acidity is also harmful, likened to battery acid), soft drinks aren’t the only culprit when it comes to too much sugar in our diets (in both adults and adolescents).

Colas have largely been targeted because their sugar content is so high. A 20oz soft drink can contain 17 teaspoons of sugar. When it comes to the mouth, the harm is two-fold.

Sugar triggers a particularly challenging reaction in the mouth. When we consume sugar (whether granule or in the form of high fructose corn syrup), it super-charges oral bacteria. When these micro-organisms in the mouth mix with sugar, it produces acid that leads to a particularly higher risk for cavities.

Are your children getting lots of cavities? Don’t just look at their brushing routines. Look at what they’re eating and drinking.

A common pattern when it comes to soft drinks is to sip the beverage over an extended period of time. In addition to the harmful effects of sugar, here’s why this pace of consumption is so harmful to teeth…

Every time you eat or drink, an oral acid flows into the mouth to help break the contents down. This is the initial prep for digestion.

This acid is potent stuff – strong enough to soften tooth enamel. It lasts for 20-30 minutes after consumption, which means a cola sipped over the course of an hour keeps the acid attack going for an hour and 20 minutes.

If a cola is consumed only with meals, when an acid attack is already underway, the challenges wouldn’t be so severe. However, both kids and adults are prone to ‘pop a top’ and sip these drinks between meals and over long periods of time.

As the acidity of oral acids combines with the acidity of soft drinks, tooth enamel becomes much more vulnerable to the penetration of decay. So, then you add the onslaught of sugar to this, the potential for harm goes much higher.

Although sugary soft drinks can be a source for cause tooth rot and upping the risk for gum disease, they are but one source. I don’t want it to seems as if I’m ‘picking on’ colas, since sugar can have a greater presence in more of what Americans consume than is often realized.

For example, in a 2015 Washington Post article, it was reported that 25 percent of catsup is sugar. (https://www.washingtonpost.com/lifestyle/wellness/do-you-know-how-much-sugar-is-in-your-ketchup/2015/06/02/9496b77e-fe5f-11e4-833c-a2de05b6b2a4_story.html?noredirect=on&utm_term=.67cb41e9706b)

Interestingly, the article’s author (Casey Seidenberg is co-founder of Nourish Schools, a D.C.-based nutrition education company, and author of “The Super Food Cards”) shares, “A tablespoon-size serving has four grams of sugar, which is more sugar than a typical chocolate chip cookie. And how many kids actually limit their serving size to one tablespoon?”

I agree. When I dip french fries into catsup, I often sop up a tablespoon with 3 fries.

Other hidden sources of sugar lie in salad dressings, fruit juices, sports and energy drinks, many breakfast cereals, and things like canned baked beans. I was shocked to see that my favorite brand of lemon pepper even contains sugar!

While we all need to get into the habit of reading labels before we buy, my role as a periodontist is primarily to help you understand what occurs in your mouth from these sugary edibles. And, I believe once you’re more aware of the risks (and the resulting potential for costly repairs to teeth and gums), you should also know how to lessen the potential for cavities and gum disease.

Let’s start with a simple way to lower the severity of an acid attack in the mouth. If you’ve just consumed a food or beverage that contains sugar or has a high acid level, sneak off to the bathroom to swish with water several times. Easy!

If you’re sipping a can of cola and intend to drink it over an extended period, have a glass or bottle of plain water nearby and take a few large gulps every 20 or 30 minutes. Allow each gulp to wash over the teeth and gums before swallowing. This will help to dilute the existing acids and move some of the bacteria out of the mouth.

Also, delay brushing your teeth until the acid has waned. It is best to wait to brush for 30 minutes after eating or drinking since tooth enamel remains in a softened state for about this long. The abrasiveness of a toothpaste or toothbrush bristles can wear down precious tooth enamel while it is in a less-protective mode when used too soon after consumption.

Make sure your at-home care is thorough. Brush twice a day for at least 2 minutes per time. Use a soft to medium bristle toothbrush and fluoridated toothpaste. Floss daily to remove food particles caught between teeth. Brush your tongue or use a tongue scrapper. And, swish several times to send the dislodged and swept away bacteria down the drain!

Also, be aware of the signs and symptoms of gum disease. Sore, tender, bleeding, swollen or red gums are all warning signs. With prompt measures, we can greatly minimize treatment needs to rid your mouth of this dangerous bacteria that has been associated with a number of serious health problems (including stroke and some cancers).

Have regular dental check-ups and cleanings also. If you haven’t been regular at your general dentist, call 828-274-9440 our Asheville periodontal office and schedule an appointment. We can help to restore your mouth to a healthy state with the most conservative, yet effective, treatment possible.

Remember, gum disease only worsens without treatment. It is also the nation’s leading cause of adult tooth loss.

Watch what you eat and how often you eat it and your smile will thank you!

Women & Oral Health – Particular Challenges Exist At Many Ages.

Posted on Aug 20, 2018 by William J. Claiborne, DDS MS

The female body is a uniquely complex structure in its ability to produce offspring and feed their young. With this comes the integral interaction of much more than its housing, of course. Females have an intricate system of hormonal components that help to manage these systems in order to maintain their own health as well as that of their young.

As a male who spends the majority of his days surrounded by females – working with a mainly female staff during daytime hours and spending the rest of my hours with my wife – I have an appreciation for women of all ages. From the perspective of a periodontist, I also have an understanding of how our female patients can endure particular challenges as a result of hormonal fluctuations.

Unlike the skin, which may cause an obvious rash after consuming something that causes allergic response, the gum tissues don’t give obvious visual indications when oral health is effected. However, your gum tissues may be more reactive to hormone levels that you realize.

Although gum tissues tend to redden when inflamed, an oft first-noticed symptom is tenderness or swelling. These issues are usually accompanied by redness, which tends to be noticed after other symptoms emerge. And, these other symptoms may be much more attention-getting.

For example, tender gums that bleed when brushing are hard to ignore. While these are symptoms of early periodontal disease (also known as gingivitis), the color of gum tissues can be easily overlooked since they are hidden inside the mouth.

Yet, an imbalance in the body that lies far beyond the mouth can trigger oral symptoms that need prompt attention before worsening. For example, pregnancy gingivitis is not uncommon in women during pregnancy. If not treated and resolved, however, it can develop into full-blown periodontal disease, which is the nation’s leading cause of adult tooth loss.

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 also causes some women to have gum tissues that become inflamed. This occurs from heightened sensitivity to the toxins produced from the overload of bacteria that form plaque. For many women, the gums become less reactive after the first few months of starting birth control pills. Some medications, such as antibiotics, can lower the effectiveness of oral contraceptives. This is why it is important to keep your dentist updated on all medicines you take.

• Hormone Relationship to the TMJ: It has long been known that more women have TMJ disorders than men. This prompted researchers to look into a possible hormone-related connection. The temporo-mandibular joints (known as TMJ), are the jaw joints. These are located on each side of the head in front of the ears and hinge the lower jaw (the mandible) to the skull. These TMJ are designed to move harmoniously each time you speak, chew, yawn or laugh. Now, research has shown that the use of birth control pills can lead to decreased levels of producing natural estrogen. Studies have found that decreased natural estrogen with the combined effect of the joint compression from TMJ disorders can lead to increased inflammation. In some individuals, this inflammation can result in osteoarthritis in the joint.

• Pregnancy: With each trimester of pregnancy, hormonal levels can change. Pregnancy also causes an increased level of progesterone, which can increase your risk for the formation of plaque. 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. Because gingivitis is the first stage of gum disease, it is important to have it fully resolved so it does not progress further. Because studies have found that gum disease can cause a heightened risk for preterm and low birth weight babies, obstetricians are cautioning their pregnant patients to be particularly diligent in maintaining good oral health..

 • Menopause: As we age, a variety of changes can take place in our mouths, whether male or female. Saliva flow is less plentiful, the mouth is less moist, and side effects of taking medications can pose challenges to keeping the gums healthy. Dry mouth, a particular challenge, is a leading cause of gum disease. Without adequate saliva flow to keep the mouth cleansed and being efficient in neutralizing the acids from plaque, the risk for gum disease is greater for females, especially those 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.

Regardless of where you are in your lifespan, if you are a female, it is especially important to be aware of the signs and symptoms associated with these conditions. Having healthy gums is even more important now that science has shown a link between many serious health problems.

If you suspect you have some level of gum disease or have delayed having regular dental check-ups, begin with a consultation appointment. During this time, we’ll discuss your unique needs and how we may be the best fit for your oral health goals. Call 828-274-9440 to schedule.

How A Denture Can Be Ruining Your Health

Posted on Aug 13, 2018 by William J. Claiborne, DDS MS

Since 1962, the U.S. has allowed pharmaceutical companies to advertise their drugs directly to the public. New Zealand is the only other country that has legalized this, which (to me) is rather telling of its ‘benefits’ in educating the general public.

It’s legality is not the issue here. In the promotions, these ads may name some of the side effects associated with that particular medication. These can include minor problems, such as “redness at the injection site,” to greater issues such as “weight gain,” to dire concerns, such as “increased risk for leukemia.”

Sometimes, it’s what you don’t know that can be the greatest detriment when it comes to our health and well-being. As a periodontal specialist, this has always been a particular concern: Do people really know the full story when it comes to dentures?

Since full dentures are not a prescribed medication, they are widely recommended and placed to replace a full ‘arch’ of upper or lower teeth. Although a denture can replace missing teeth, it falls very short when it comes to actually ‘restoring’ teeth.

There are far more things that a denture cannot do than what it can.

For example, a denture can give you the appearance of teeth and enable you to speak properly. A properly-fitted denture can also enable you to chew food again. But, the snug fit of a denture when initially made may be very different to how it fits a year later.

It is what occurs BENEATH the gums that can trigger a detrimental chain of events.

Natural tooth roots are held by the upper and lower jaw bones. With this as their foundation, tooth roots are able to support teeth that can function dependably. For example, having the sturdy foundation of the jaw bones, teeth can bite and chew with stability.

This means your teeth can endure the rigorous action of biting into a crunchy carrot or chewing a thick pork chop without the worry of movement. Natural teeth are held firmly by a solid mass of bone.

Here’s the problem many people are unaware exists: When the roots of natural teeth are removed from the jaw bone, the bone begins to shrink. This process is known as resorption. As the bone declines in height and width, the gum-covered ‘arch’ where teeth were once held begins to flatten out.

Because a denture is first made to conform to the specific contours of this arch, this means that the denture’s foundation is declining, providing less and less of a base for the denture to wrap.

Bone resorption is the beginning of a long list of problems.

When a denture is not secured by the bone, it must rely on what it rests upon. When the arch is high and full, the denture can hold on more securely while eating, speaking, or laughing.

However, as the arch shrinks, the added help of denture adhesives or pastes are needed. Unfortunately, once the denture begins to move or slip, the underlying problem will only worsen. As bone loss becomes more severe, these denture products will be of little help.

What a “rocky” denture does to your overall health often hides in the background. But, the problems exist all the same. For example, people find that eating some foods are too challenging for a denture. They resort to eating foods that are soft and dissolve easily in the mouth.

A healthy diet includes foods that provide a balanced mix of protein, fiber, vitamins, and minerals. Plus, we want to eat foods that are flavorful and satisfying – right?!!! So, when a denture wearer switches from a kale salad to mashed potatoes, the trade-off is in nutrition along with the satisfaction that chewing provides.

There is an intricate relationship between the function of chewing and the brain’s ability to signal satiety (the perception of being full). When people are able to chew without the worry of a denture’s movement (which leads to uncomfortable rubbing on tender gum tissues), they are able to chew longer and more efficiently.

Additionally, proper chewing is a known support to the digestive process. In grade school, we all learned that the first phase of digestion begins in the mouth. As we chew, saliva automatically surges digestive acids into the mouth to help break down foods so they are ready to be processed further once swallowed.

However, not being able to chew well typically means it is done less. It is to no surprise that people who are denture wearers have more gastro-intestinal problems than people who have their own teeth. Of course, inadequate digestion causes a domino effect throughout the body.

In a 2013 article shared by the International Journal of Dentistry (through the U.S. National Library of Medicine/National Institutes of Health) edentulism (losing all of one’s natural teeth) leads to:

• Lower intake of fruits and vegetables, fiber, and carotene and increased cholesterol and saturated fats, in addition to a higher prevalence of obesity, increasing the risk of cardiovascular diseases and gastrointestinal disorders.
• higher rates of chronic inflammatory changes of the gastric lining, upper gastrointestinal and pancreatic cancer, and higher rates of peptic or duodenal ulcers.
• greater risk of noninsulin-dependent diabetes.
• greater risk of heart disease, hypertension, heart failure, and stroke.
• decreased daily function, physical activity, and resulting quality of life.
• higher risk of chronic kidney disease.
• higher risk of sleep apnea.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664508/

The periodontal specialty includes the advanced training and skills of diagnosing and placing dental implants. They are so beneficial to your oral and overall health that this specialized branch of dentistry includes them in our ability to enhance the oral wellness of patients.

Dental implants are positioned in the jaw bone. This not only restores the same, sturdy foundation that natural teeth once had, the presence of the implanted portions provide stimulation to the bone.

Dental implants provide three major benefits…

(1). An implant helps to halt the process of bone loss, preserving bone mass. This not only supports the ability to bite and chew, dental implants enable eating to occur without movement. No more slips, clicks or uncomfortable rubbing on tender gums.

(2). With implants, people are able to eat a healthy diet AND chew it properly. This support digestion, which in turn supports every part of the body.

(3). When people feel confident smiling, laughing, and eating in social settings, they tend to be more active socially. Being active with other people is a basic human need and necessary for our mental well-being. When the fear of embarrassment because of “slippery” dentures is eliminated, people have more confidence in these settings.

If you wear dentures, PLEASE learn the facts surrounding dental implants. Many people assume they are too expensive. Yet, what is needed for your specific situation may be less expensive than you realize.

Often, just 4 or 6 strategically-placed implants can support a full arch of replacement teeth.

Too, many dental offices offer payment plans so monthly fees are manageable to most budgets. Some plans are interest-fee and require no down payment.

It is important, too, that you know this: Once bone loss begins, it will continue at a more rapid pace with each passing year. This means that your bone will become thinner and thinner at a faster and faster rate each year.

If you’re missing all of your natural teeth, call 828-274-9440 soon to schedule an implant consultation. During this time, I’ll explain the implant systems best for your needs and the process involved. I’ll also answer your questions thoroughly. This will help you make decisions that are right for you.

 

Gum Disease, Dental Implants – A Periodontist Can Make A BIG Difference.

Posted on Aug 06, 2018 by William J. Claiborne, DDS MS

When it comes to our health, most of us have an internist, or a ‘primary care’ physician. This doctor oversees our general health. However, should a strange rash appear, our internist will likely refer us to a dermatologist. The same is true if we experience persistent back pain; the internist is likely to refer us to an orthopedist.

When it comes to the best way to pinpoint and tackle specific issues with our health, it makes sense to see a doctor who has received specialized training in that area. This helps to take the guesswork out of diagnosis and enhances the potential for a successful outcome in an efficient process.

As a periodontal specialist, I work with a large number of general dentists in Western North Carolina as well as other dental specialists and physicians. In many cases, we work together in “team treatment” so the patient receives specialized dental care that blends comfortably with the positive relationship each has with his or her regular dentist.

What is a periodontist?

A periodontist is a dentist who has continued in education to specialize in the diagnosis and treatment of all areas of the tissues in the mouth. In addition to treating all phases of periodontal (gum) disease, we are uniquely qualified to reshape gum tissues.

For gum disease, we are able to help patients overcome the problems caused by the infectious bacteria in the mouth. Through decades of research, this bacteria has been associated with many health problems elsewhere in the body. It has been found to trigger systemic inflammation and has been linked to a number of health problems, including heart disease, stroke, diabetes and arthritis.

We begin by accurately diagnosing the stage of gum disease present. From there, we develop a customized treatment plan based upon factors such as the patient’s current overall health, their diet, medications, whether they smoke or drink alcohol, and age.

Treatment recommendations are made based on what will effectively resolve the problem without over-treating or under-treating. By restoring the patient to good oral health, we are able to help them avoid tooth loss and rid their mouths (and thus, their bodies) from an overload of oral bacteria.

Gum tissues also play an important role in protecting teeth. When they recede, or pull away from the base of teeth, tooth roots may be exposed. These darker, sensitive areas can be re-covered through procedures that restore the protective seal around teeth as well as the level of the gum line, which plays an important role in a smile’s appearance.

A periodontist specializes in gum contouring to enhance the look of your smile. For example, when the gum tissues that arch over each tooth are a different levels, it can distract from a smile’s appearance. Through reshaping procedures (often referred to as a gingivectomy), we can correct this for a more balanced “smile line.”

The same is true for an individual who is born with a “gummy smile.” This occurs when too much gum tissue shows above top teeth in a full smile. Often, with minor reshaping or “crown lengthening” procedures, we can adjust the gums to a more esthetically-pleasing level.

Periodontists also specialize in the diagnosis and placement of dental implants. They are trained to understand all the intricate concepts involved in selecting the proper type of implant. Then, they are skilled at placing implants at proper depths and angles. As they oversee your “healing” time, periodontists are also able to optimize your comfort and outcome.

A periodontist receives 4 years of “undergraduate” training at a college or university and then goes on to earn a dental doctorate. After 4 years of dental school, they further their education for another 3-4 years before completing stringent requirements for a specialty certification in periodontics.

This 11 years of higher education is a commitment I made with enthusiasm, and I have relished staying on the cutting edge of new developments in the field throughout my career. On an ongoing basis, periodontal findings have revealed the integral connection between our oral health and our overall health.

As research continues, the understanding of good oral health as it benefits our overall health will hopefully become common knowledge to every individual. Sadly, our nation now has an adult population of nearly half that have some level of gum disease.

If you would benefits from the advanced skills of a periodontal specialist, please know that we are fully trained to attend to your specific periodontal needs in a comfortable, effective manner. Our entire team is committed to compassionate, respectful care that is appropriate for each need and our office is equipped to handle your care efficiently, effectively, and gently.

Call 828-274-9440 to learn more or to schedule a consultation.