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.

Dental Implants Gaining Ground In Tooth Replacement Preferences

Posted on Jun 20, 2024 by William J. Claiborne, DDS MS

For adults who have lost natural teeth, I have good news and bad news. Let’s get the bad news out of the way first…

Missing natural teeth, whether replaced by a full denture, partial denture, bridge, or not being replaced at all, can lead to problems that impact your oral health, even the lifespan of remaining natural teeth. I’ll address those problems further on, but let’s move on to some good news.

According to the National Institutes of Health & Nutrition Examination, by 2026 nearly 23% of adults are estimated to opt for dental implants as their choice to replace teeth.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6854267/

This is great news for our rapidly aging population. Dental implants come with a number of advantages that effect overall health. These include:

• The ability to bite and chew food thoroughly, aiding digestion. It has been found that people who wear dentures take more medications and have more gastro-intestinal problems.

• Eating comfort so a diet of fibrous and healthy food choices can provide sufficient vitamins, minerals and protein.

• Confidence in social situations, which (according to an article by the Mayo Clinic News Report): “Socializing not only staves off feelings of loneliness, but also it helps sharpen memory and cognitive skills, increases your sense of happiness and well-being, and may even help you live longer.”

https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-the-benefits-of-being-socially-connected/

• Helping to support remaining natural teeth by preserving jaw bone mass. When a tooth root is removed from the jaw bone where it was once supported, a process known as resorption begins. Once underway, it continues at an ever-increasing pace, accelerating with each passing year. As the bone shrinks, adjacent teeth are subject to movement and root damage. On average, the next teeth you’ll most likely lose are those bordering areas of missing teeth.

Since the mid to late-60’s, dental implants have been fine-tuned and perfected. Today, there are nearly 40 different types of dental implants. These systems are designed to accommodate specific needs and goals.

For instance, using just 4 or 6 implants placed at unique angles, the All on 4 Dental Implant system is able to evenly distribute the forces of biting and chewing in minimal bone. This is ideal for people who have experienced severe bone loss, helping them avoid the need for bone rebuilding procedures.

With all the great reasons to replace missing teeth with dental implants, an important decision in having a successful outcome is in who places your implants.

Although some generalists take courses in dental implant placement, many of these are offered by the manufacturers of particular implant systems. Thus, these courses primarily focus on the implant available through this one company, which may not be the most ideal choice for your specific needs.

This is why many dentists refer the placement portion of implants to a periodontal specialist. A periodontist has advanced training and skills in the diagnosis and placement of all types of dental implants. This means that this dental specialist can determine which implant system will work best for your individual needs.

Another benefit of a periodontist’s skills for implant patients is in their ability to conduct additional procedures, such as a sinus lift, needed in treatment. This ensures the patient’s implant(s) are positioned in the proper bone mass at a healthy depth so it does not pose risks to surrounding structures.

As a specialist in treating all stages of gum disease, a periodontist is also able to help optimize your gum health prior to implant placement. By pretreating any periodontal inflammation, the implant has a healthy foundation from the very beginning.

In our Western NC periodontal dental office, we incorporate the advantages of some of the most advanced technology in dentistry; many of these options which are not readily available in other dental offices in our region. These computerized marvels offer advantages to patients in helping to minimize treatment needs, speed healing, and optimize comfort.

These include laser dentistry, Cone Beam imaging, Cone Beam computerized tomography imaging, intraoral scanning, and computerized dental implant placement.

Additionally, in our Asheville periodontal dental office, we offer oral and IV sedation (“twilight sleep”) for optimal comfort. Both have an amnesiac effect, leaving most with little or no memory of treatment afterward. Here, anesthesia is overseen 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.

If you’ve considered dental implants, take the first step to a new you today! Begin by calling our Asheville periodontal dental office to speak with a friendly staff member at: 828-274-9440.

If the cost of dental implants has prevented you from choosing this optimal tooth replacement option, most of our payment plans require no down payment, are interest-free, and have no prepayment penalty. Feel free to ask about those during a consultation.

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.