ED Risks Higher With Presence of Gum Disease

Posted on Feb 25, 2022 by William J. Claiborne, DDS MS

For over two decades, medical researchers have closely focused on inflammation in the body and its power to activate health problems, heart and cardiovascular diseases in particular.

It has been determined that inflammation anywhere in the body can set off a series of biochemical changes in the bloodstream; those that are designed to help the body repair inflamed tissues. However, when inflammation becomes chronic, blood chemistry never returns to normal, and trouble ensues. Researchers have noted this significantly in its increased risk of heart attack and stroke.

Think of chronic inflammation as a pan of water that is boiling on the stove. When the body is in proper control, the boiling process ceases when the stove is turned to “off.” In chronic inflammation, however, the water continues to boil even after the pan is removed from the stove top.

Chronic inflammation can exist in the mouth, set at a constant “boiling point” due to advanced gum disease (known as periodontitis). Common symptoms are puffy gums that turn red in color; inflamed, swollen, or bleeding gums; gums that loosen from the base of teeth; persistent bad breath; gums that become spongy and bleed easily; and, pus pockets that form on the gums at the base of teeth.

In addition to creating higher risks of heart disease and stroke, advanced gum disease has been shown to increase the risks for diabetes, arthritis, preterm babies, some cancers, Alzheimer’s disease, high blood pressure and erectile dysfunction (ED). Yes, even ED.

Below are findings of several recent studies showing that periodontitis to be a significant risk factor for erectile dysfunction. Rather telling is as gum disease worsens, so does erection impairment.

• Turkish investigators studied 162 men, age 30 to 40. Eighty-two of the participants had normal erection function and 80 who complained of ED. Some men in both groups had chronic periodontitis, but the condition was more than twice as prevalent in the ED group. Men with periodontitis who also presented with decayed or missing teeth showed the greatest level of ED.

• Chinese scientists examined data of several studies involving a total of 213,076 men. Compared with those who had good erection function, those with ED had three times the risk of periodontal disease.

• The University of Granada School of Dentistry found that men with severe gum disease are more than twice as likely to suffer from erectile dysfunction. This was true even after careful adjustments were made for other health issues that could distort the findings, including socioeconomic data. In the study, 80 men with clear indications of erectile dysfunction were given a periodontal examination. According to the researchers, 74 percent of the participants with ED also presented with chronic periodontitis. The researchers concluded that patients with chronic periodontitis were more likely to have erectile dysfunction independent of other confounders.

• Israeli researchers surveyed the erection function of 305 men, average age 40, and then examined their gums. Those with chronic periodontitis had the greatest risk of ED.

The connection is actually logical. Periodontal disease has emerged as an independent risk factor for cardiovascular disease, and cardiovascular disease raises risk for ED. These studies show that everything that raises the risk for cardiovascular disease (such as smoking, obesity, chronic stress, high cholesterol, high blood pressure, and chronic sleep apnea) also raises the risk of ED.

This finding also makes biochemical sense. 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.

Health risks such as our propensity for cancer or a decline in eyesight can occur regardless of lifestyle choices. However, it makes perfect sense to eliminate or greatly minimize risk factors, including periodontal disease. Research findings on ED’s association with infectious oral bacteria of gum disease will hopefully spurn more men to devote a higher level of commitment to care for their gums.

It takes mere minutes a day to maintain a healthy mouth and reduce the risks for developing gum disease.

These include brushing teeth for at least two minutes twice a day. Daily flossing will remove bacteria in the gums that may elude brushing. And, keeping the mouth moist will support saliva flow, the mouth’s natural rinsing agent.

If you feel your erections are worth the effort, then these measures will become higher priorities in your daily hygiene upkeep. It is also important to see a dentist regularly. If you don’t feel anything is wrong because “nothing hurts,” you are only cheating yourself.

Gum disease can exist without obvious symptoms. Catching it early and before it begins to “boil” will help you avoid costly and time-consuming treatment later. And, these steps may keep your sex life active.

If you are experiencing any of the signs of gum disease (as mentioned prior), please know that gum disease will only worsen without treatment. It is also the leading cause of adult tooth loss.

A periodontist is a dental specialist who treats all stages of gum disease. If it is found to exist, this periodontal specialist can help to resolve the problem and restore your smile to a healthy state in the most conservative way possible. He or she can then help you maintain good oral health, which will support your overall health.

For an examination, or to begin with a consultation, call 828-274-9440.

https://www.psychologytoday.com/us/blog/all-about-sex/202006/the-connection-between-erections-and-gum-disease

https://onlinelibrary.wiley.com/doi/abs/10.1111/jcpe.12909?af=R

HPV – How The Virus Relates To Oral & Throat Cancers

Posted on Feb 17, 2022 by William J. Claiborne, DDS MS

Every April, a number of oral health and cancer organizations come together to recognize Oral Cancer Awareness Month on a national basis. This is meant to expand awareness of this cancer, which takes a victim every hour of every day. Of those individuals, 43 percent will not survive longer than five years. Those who do survive may suffer from problems, such as severe facial disfigurement or difficulties with eating and speaking.

Oral cancer includes cancer of the mouth and upper throat, known as oropharyngeal cancer. The death rate associated with oral and oropharyngeal cancers is particularly high largely because detection typically occurs late in its development. However, when oral cancer is detected and treated early, treatment-related problems are reduced and with improved survival rates.

Annual oral cancer examinations during regular dental check-ups are the best method for detecting oral cancer in its early stages. It is also important to respond immediately to signs and symptoms of oral cancer, which include:

• A sore or ulceration that does not heal within 14 days;
• A red, white, or black discoloration of the soft tissues of the mouth;
• An abnormality that bleeds easily;
• A lump or hard spot in the tissue, usually border of the tongue;
• Raised tissue or a newly emerged growth;
• A sore beneath a denture or partial that does not heal;
• A lump or thickening that develops in the mouth; and
• A painless, firm, fixated lump on the outside of the neck that does not go away within two weeks.

Historically, factors that can contribute to having a higher risk of oral and oropharyngeal cancers have been heavy drinkers and smokers older than age 50. However, in recent years the cancer is occurring more often in nonsmoking people due to HPV 16, the virus most commonly associated with cervical cancer.

The human papilloma virus 16 (HPV) is sexually transmitted, although it is a different virus than HIV or (HSV) herpes. HPV is now the most common sexually transmitted infection (STI) in the United States.

Exposure can occur by having vaginal, anal, or oral sex with someone who has the virus. It most commonly spreads during anal or vaginal sex. It can also spread through close skin-to-skin touching during sex. HPV can spread even when a person with the infection has no signs or symptoms.

There are many different types of HPV; most do not cause any health problems. Most individuals who get HPV never have symptoms and the virus goes away by itself. But, if HPV does not go away, it can cause genital warts or certain kinds of cancer. Symptoms can appear years after having sex with someone who has the infection.

Approximately 99 percent of people who develop HPV will clear the virus on their own. In approximately 1 percent of individuals, the immune system will not clear the virus and it can lay dormant for decades before potentially causing a cancer.

HPV itself isn’t a cancer but it can cause changes in the body that lead to cancer. Because of the growing rate of HPV, the increasing incidence of oropharyngeal cancer have been particularly concerning for younger age groups. Within the age range of 15 to 59, 40 percent will have HPV. This is an alarming rate for people with no other risk factors.

HPV-related oral cancer most commonly involves lymphoid tissue in the tonsils or the base of the tongue. Signs and symptoms of HPV-caused oropharyngeal cancer may include one or more of the following:

• Hoarseness or sore throat that does not resolve within a few weeks;
• A swollen tonsil on one side (usually painless);
• A painless, firm, fixated lump felt on the outside of the neck, which has been present for two weeks or more;
• A persistent cough that does not resolve after many days;
• Difficulty swallowing or feeling something is caught in your throat; and/or
• An earache on one side that persists for more than a few days.

https://oralcancerfoundation.org/april-is-oral-cancer-awareness-month-2021/

https://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm

Cervical cancer is the most common HPV-associated cancer among women (48 percent), and oropharyngeal cancers (82 percent) are the most common among men. The diagnosis may not be until years, or even decades, after a person gets HPV. Currently, there is no way to know who will get cancer after getting HPV.

https://www.cdc.gov/cancer/uscs/about/data-briefs/no26-hpv-assoc-cancers-UnitedStates-2014-2018.htm

HPV vaccines can prevent some of the health effects HPV causes. Once acquired, however, there is no specific treatment for HPV although there are treatments for health problems that develop from HPV, such as genital warts. Your healthcare provider can treat genital warts with prescription medication.

Because cancers from HPV are more treatable when found and treated early, it is important for those who acquire the virus to be especially diligent in having oral cancer screenings and promptly responding to any signs or symptoms (as mentioned above).

The HPV vaccine is safe and shown to be effective at preventing the virus. Like any vaccine, side effects can occur, which are typically short-lived and mild, such as headache, fatigue, fever or nausea. Most people have no side effects at all.

You are also urged to be committed to your 6-month dental exams. This provides your dentist an opportunity to note any suspicious areas in the mouth or on the lips. If you have not had regular dental check-ups, you may need to begin by seeing a periodontal specialist.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease (a chronic inflammatory disease that affects the gums and bone supporting the teeth also known as gum disease), and in the placement of dental implants. Periodontists receive extensive training in both of these areas and more, including three additional years of education beyond dental school.

As a periodontal specialist in Asheville for over 25 years, I take great pride in making our patients feel comfortable and understanding of their particular oral health status. If oral problems exist, we are able to resolve many with conservative treatment measures. Our Western NC periodontal dental office features some of the most advanced technology available to minimize treatment needs, treatment time, and speed healing with comfort always a priority. Oral and IV sedation are available.

To schedule an appointment, call 828-274-9440. New patients are always welcome and a referral is not required.

Ages 65 & Over: Stay More Socially Involved With A Healthy Smile.

Posted on Feb 09, 2022 by William J. Claiborne, DDS MS

Science has shown that the act of smiling gives a boost to our mood. Even a “fake” smile triggers endorphins (feel-good chemicals) in the brain to release, providing a bit of a “natural high.”

There are many things that make us smile. Time spent with friends, family, and social activity are helpful in keeping an individual active and involved, and hopefully smiling. Unfortunately, older adults are more prone to social isolation. This has proven to be unhealthy, mentally, physically and yes, even for the health of a smile.

Older adults are already at a disadvantage when it comes to having a healthy, full smile. Some estimates show that over one-quarter (26 percent) of adults ages 65 and older have 8 or less remaining natural teeth. About 17 percent in this same age category are missing all of their teeth.

On a positive note, total tooth loss (being “fully edentulous”) in the 65 or older category is decreasing. When comparing the 5-year periods of 1999–2004 to 2011–2016, it dropped by nearly 30 percent.

However, tooth loss comes with many frustrations, and even embarrassment. Many adults who wear dentures or partial dentures to replace missing teeth have similar complaints: sore spots on tender gum tissues, difficulty biting or chewing, slips while speaking or laughing, discomfort and the fear of embarrassment.

These frustrations often lead to (1) a change in diet; and (2) less social involvement. When certain foods become too difficult to chew properly, adults often alter their diet, opting for softer foods that dissolve easily in the mouth. Unfortunately, these foods typically lack in protein and fiber needed for good health.

Too, improper chewing is challenging to the digestive system. It is no wonder that denture wearers have more gastrointestinal problems and take more medications than people who still have their natural teeth.

Social isolation and loneliness have been linked to numerous measures of health and well-being. One interesting study focused specifically on the effects of social isolation and loneliness in relationship to oral health.

The Chinese Longitudinal Healthy Longevity Survey was conducted in three time segments: 2011-12, 2014 and 2018. The purpose of the study was to asssess the effects of social isolation and loneliness on the rate of tooth loss.

Data of the survey was evaluated, with nearly 4300 adults 65 and older who were participants in at least two of the time segments. The findings showed that, as tooth loss increased, so did social isolation. This study provided strong evidence that social isolation was associated with fewer remaining teeth and even accelerated the pace of tooth loss.

This problem is not just one of our current 65+ age group. According to the U.S. Census, the number of American adults aged 65 years or older is expected to reach 98 million by 2060, making up nearly one-quarter of the overall population. This means that a 30-year-old today will be well within this age group in less than 40 years.

Currently, the poorest oral health in Americans 65 and over are those who are economically disadvantaged, have no insurance, smoke, and in racial and ethnic minorities. Additional factors are being disabled, homebound, or who live in nursing homes. After retirement, some adults lose insurance benefits and find that Medicare does not cover routine dental care.

A high percentage of older adults also have periodontal (gum) disease, the nation’s leading cause of adult tooth loss. Nearly 68 percent of adults aged 65 years or older have some level of gum disease. While nearly 1 in 5 older adults have lost all of their teeth, total tooth loss is twice as prevalent for adults ages 75 and older compared with the 65-74 age group.

Aging also increases the likelihood of developing oral cancer. Oral and pharyngeal cancers are primarily diagnosed in older adults at a median age of 62 years. Gum disease also increases risks of chronic diseases including arthritis, diabetes, heart disease, and stroke.

All of these challenges are why a periodontist can be instrumental in the health and well-being of adults, especially those in the “older” age groups.

A periodontist is a dental specialist who receives 4 years of undergraduate training at a college or university and 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.

A periodontist begins by accurately diagnosing the stage of gum disease present, or if it does exist. Many people are surprised by its presence since it can exist without obvious signs or symptoms.

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 their age. We also discuss sedation options if dental fear is a concern.

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

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. Additionally, they are skilled at placing implants at proper depths and angles. As they oversee your “healing” time, periodontists are able to optimize your comfort and outcome.

When tooth loss begins, replacing that tooth with a dental implant is highly advised. Dental implants are designed to last a lifetime and restore biting and chewing comfort and stability. Additionally, the stimulation they provide to the jaw bone helps to halt bone loss.

This is because the implanted portion, held by the jaw bone, recreates the presence of the natural tooth roots you once had. While a denture or partial is positioned on top of the gum tissues, dental implants have the advantage of the jaw bone as their foundation, just as natural teeth.

For those who feel they are “too old” for dental implants, many of our implant patients are well into their 80’s or 90’s.  Keep in mind that today’s adults are staying in the workplace longer, staying active in senior years, and living longer. Since 1950, Americans added over 11 years to average life expectancy, to age 79, according to 2019 statistics.

At every age, your smile reflects you, and should be a positive reflection throughout your lifetime. If you are experiencing tooth loss, let’s discuss halting the process during a consultation appointment in our comfortable Asheville periodontal dental office.

Call 828-274-9440 to schedule an appointment.

https://www.cdc.gov/oralhealth/basics/adult-oral-health/adult_older.htm

https://onlinelibrary.wiley.com/doi/abs/10.1111/cdoe.12727