Tissue Regeneration In Dentistry Is Here & Now!

Posted on Jan 31, 2020 by William J. Claiborne, DDS MS

It may sound far-fetched to think of repairing the urethra by regenerating tissues from the mouth. Yet, it’s being done – with the help of advanced technology.

Stricture of the urethra (the duct that carries urine out of the bladder) affects about 1 percent of the male population. For the one percent who suffer with it, urethral stricture contributes to a severely diminished quality of life.

The condition causes patients to be chronically ill, have low urine flow, pain, urinary infections, urinary stones and can lead to failure of the urinary system. Untreated, life-threatening urinary retention can occur.

Recently, a breakthrough in the surgical treatment of male urethral stricture was reported when over 81 percent of patients with urethral strictures were successfully treated with MukoCell.

MukoCell is a method for tissue-engineered oral mucosa transplantation. It takes a small area of oral mucosa (the secreting tissues in the mouth) that is easily accessible in any patient. (https://www.healtheuropa.eu/treatment-of-mens-disease-with-regenerative-medicine/96925/)

In the past, the most successful treatment for urethral reconstruction was through an oral mucosa graft. However this process requires harvesting a large area of oral tissues. The repercussions can leave patients with persistent pain, bleeding, swelling, sensory loss and oral numbness.

Removing large segments of tissues in the mouth can also cause impaired ability to drink, eat and speak. It can lead to periodontal (gum) disease,tooth loss and dental implant failure along with an increased risk of oral cancer.

MukoCell is a method for a tissue-engineered oral mucosa transplant with even better success rates that the standard grafting procedure. Like our LANAP technology, MukoCell can regenerate tissues, although MukoCell regeneration is through a tissue factory that uses a small piece of the patient’s oral mucosa.

In our Asheville Periodontal dental office, tissue regeneration can be successfully performed in the patient’s mouth. Through our LANAP technology (Laser-Assisted New Attachment Procedure) this highly-advanced method efficiently and effectively treats periodontitis (advanced gum disease).

When it comes to oral structure loss, our LANAP technology is able to stimulate bone regrowth in damaged areas. It can regrow periodontal ligament, alveolar bone (the bony ridge that supports the upper teeth), and regrow the bony film that adheres teeth to the jaw.

LANAP includes a minimally invasive (essentially ‘non-surgical’) PerioLase laser that treats patients with moderate to severe periodontal disease – in as little as one session. It is safe for people with conditions such as diabetes, heart disease, and hemophilia.

LANAP’s laser also eliminates the need for cutting into gum tissues with a scalpel. There are no stitches and patients have minimal discomfort following the procedure.

The advanced technology of LANAP offers a simple yet successful way to rid the infectious bacteria of advanced gum disease. By combating this inflammatory disease, the body is at less risk for systemic inflammation that has been shown to contribute to serious and even deadly health problems.

Overcoming gum disease can help patients to save natural teeth. This means the trauma of tooth loss and decisions for replacement can be avoided.

While we applaud astounding developments in tissue regeneration, MukoCell’s progress reinforces the importance of having a healthy ‘oral cavity’. This is why we committed to include the LANAP protocol into our periodontal dental office, making this cutting edge technology accessible to people all across Western North Carolina.

Although people often think of their smile as ‘teeth,’ the tissues in the mouth are a vital part of your smile, your oral health, and your overall health. They are your blanket of protection that shields vulnerable structures beneath from bacterial destruction. When this covering of gum tissues becomes damaged, LANAP offers an efficient and effective method to restore the healthy state of what was lost.

If you suffer with symptoms of gum disease (tender gums that bleed when brushing, persistent bad breath, or gums that have turned red in color), call our office promptly at 828-274-9440. The condition will only worsen without treatment and could result in tooth loss as well as the release of potent bacteria into the bloodstream.

Osteoporosis Meds May Cause Permanent Damage To Jaw Bone

Posted on Jan 18, 2020 by William J. Claiborne, DDS MS

Many physicians who prescribe bisphosphonates for osteoporosis have relied on the drug makers’ stance of low risk for side effects. This has often left patients unfamiliar with the risks when they are scheduled for dental procedures.

Bisphosphonates include Fosamax, Actonel, Boniva, Reclast, Binosto, Prolia, Zometa and Xgeva. The most prescribed is Fosomax and ranks as one of the top 25 most prescribed drugs on the market.

The complication with bisphosphonates is a risk for jaw osteonecrosis. In simple terms, this is death of the jaw bone.

Jaw osteonecrosis occurs when the bone fails to heal after a surgery, even a minor procedure such as a tooth extraction. It results from obstruction of blood supply, which is caused by the drug’s potential interference with the bone’s ability to repair itself.

Common symptoms of jaw osteonecrosis are pain, swelling or infection of the gums and jaw, gums that don’t heal, and loose teeth. However, its onset can also occur without obvious symptoms.

In addition to treating osteoporosis, bisphosphonates are used to treat cancer that has spread to the bone. In these cases, bisphosphonates are given intravenously and in higher doses. This creates an even greater risk of osteonecrosis of the jaw than for individuals on oral doses.

Jaw osteonecrosis risk seems to increase with the amount of time biphosphonates are taken. However, researchers have determined that bisphosphonates can create a risk for necrosis with even short-term use of the oral medications for osteoporosis.

The most commonly prescribed bisphosphonate, Fosamax, was approved by the FDA in 1995. By 2003, reports began surfacing that linked bisphosphonates with jaw osteonecrosis.

In a study of over 200 participants who took Fosamax for varying durations, 4 percent acquired osteonecrosis. This finding was in contrast to the drug makers’ claims that bisphosphonate use only posed a noticeable risk for those who took the medication intravenously, such as cancer patients.

Not only did the study show that short-term usage can place the patient at risk, the drug can maintain a 10-year half-life in bone tissue. The risk for jaw necrosis is highest with procedures that directly expose the jaw bone, such as tooth extractions and dental implant placement.

Many people are often surprised by the wide range of medications that affect their oral health. For example, Coumadin, a commonly prescribed blood thinner, can cause more bleeding during certain procedures.

Antidepressants and high blood pressure medications can cause elevated levels of plaque and signs of gingivitis. Too, gingival enlargement, a condition that causes the gums to swell and grow over teeth, can lead to severe periodontal infection. Calcium channel blockers used to control high blood pressure can also contribute to this gum tissue overgrowth.

Many cough drops, medications in syrup form and antacids contain sugars that often leave a sticky residue on teeth, making them more susceptible to decay. Certain antibiotics and ibuprofen can cause lesions or ulcers in the mouth.

Oral contraceptives and blood pressure medications have been linked to mouth sores and inflammation. Tetracycline, typically used for treating acne, can discolor teeth as well as supporting bone.

While you may assume that herbal supplements don’t apply, they can actually have serious side effects for some dental patients. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting. For patients undergoing surgical procedures, this can be a serious problem.

Taking high dosages of vitamins before undergoing anesthesia can also put you at risk. For instance, high doses of Vitamin C can weaken the efficiency of anesthesia. On the flip side, supplements such as Kava Kava or St. John’s Wort can accentuate anesthesia’s effectiveness.

This is why it is important to make us aware of all the drugs you take, including over-the-counter supplements. The goal is to provide a successful outcome for each periodontal procedure or dental implant placement. Being familiar with your overall health enhances the potential for positive oral health.

If you have questions regarding the medications you are taking in regard to oral risks, call our Asheville periodontal office at 828-274-9440 prior to your appointment. And, at each visit, keep us updated on your medications.

The Value Of Dental Implants Goes On & On.

Posted on Jan 08, 2020 by William J. Claiborne, DDS MS

Many people have a list of favorite holiday movies. One that stand out for me is “Christmas Vacation,” where Clark Griswold attempts to create the perfect Christmas for a hoard of family members who have descended upon his home.

In the movie, Clark learns that, instead of his company’s annual Christmas bonus, he’s received a certificate for “Jelly of the Month” club. Cousin Eddie famously comments, “It’s the gift that keeps on giving.”

Laughs aside, this always reminds me of how much we spend, all year long, on things that really add very little to our lives. People invest in new cars, clothes, jewelry, and fancy electronics – many purchases based on ads indicating these items will bring us great pleasure.

Yet, year after year, Americans struggle to pay January credit card bills laden with holiday purchases. And, we begin a new year not as fulfilled as we thought. I’d like to make a suggestion: your smile!

Is there anything that would give you as much pleasure as a healthy, confident smile?

Life’s best moments are things like laughing with close friends, dining out in our favorite restaurant, close conversations with loved ones, and the bite of a red apple picked right off the tree.

As a Periodontist, I see how difficult life can be for patients with dentures and partial dentures. To witness the transformation of an individual who has replaced “slippery” dentures with dental implants has been a particular joy throughout my career.

Over the past three decades, there have been remarkable advancements in implant dentistry. It has easily become the preferred replacement for missing, natural teeth. Today, there are implant types that offer exceptional choices to fulfill nearly any need when it comes to replacing teeth with dependable stability and a natural look and feel.

While I share the excitement of our implant patients when they “see” their appealing, confident smiles after treatment completion, as a periodontist, I know it is the foundation beneath the gums that is the true benefit of dental implants.

Like natural teeth, implants are held by the upper or lower jaws. The jaw bones actually thrive on the presence of tooth roots for stimulation to keep the bone healthy. Without tooth roots, the bone goes through a process known as resorption. Resorption causes bones to lose height and width, almost like they are melting.

Dental implants are able to mimic the stimulation they need to prevent the process of resorption.

Bone loss contributes to a number of problems. Once resorption sets in, the teeth adjacent to the area of bone loss are affected. Bone loss that neighbors areas of resorption weakens tooth root stability. When a natural tooth is lost, statistics show the next to be lost will most likely be an adjacent tooth.

Bone loss can even be seen in some people. It causes the appearance of  a collapsed mouth (referred to as a “granny look”) where the nose is unusually close to the chin. It is also the reason that dentures and partials begin to move or “slip.” This can cause uncomfortable rubbing on gum tissues.

When a denture is first made, it is shaped to fit the unique contours of your gum ridge (the gum-covered arch that once held your natural tooth roots). As bone loss continues, the once-secure fit loosens and cause sore spots on tender gum tissues while chewing. Denture pastes or adhesives can help, but eventually even relines are of little help.

For many, another appealing advantage of dental implants is that they are a lifelong investment. Dental implants, properly selected and placed, are designed to last a lifetime with proper maintenance.

Adults are also seeing dental implants as a wiser option than crown-&-bridge combinations. Unlike dental implants, crowns and bridges can require repairs or replacements over time. Too, crowning natural teeth for the sole purpose of supporting a bridge forever compromises the health of otherwise natural teeth.

Dental implants do not rely on adjacent teeth for support since they are anchored in the jaw bone. This restores the same, sturdy foundation as natural tooth roots. An added bonus is how the implanted portion recreates the presence of a tooth root, halting the process of resorption.

If you are missing natural teeth, consider the advanced skills of a periodontist to consult with on dental implants. For a private, no obligation consultation to discuss your specific goals or concerns, call 828-274-9440 for an appointment.

If fear of dentistry is an obstacle for you, we can also discuss our sedation options. Our office is known for providing respectful, gentle care and oral and IV sedation are available as needed, administered safely and to the highest standards. Feel free to mention your concerns during your consultation.