Don’t Let Tooth Loss Make You LOOK or FEEL Old.

Posted on Aug 26, 2024 by William J. Claiborne, DDS MS

I have never imagined how old I could look until the first timerI saw my image on FaceTime. It reminded me of a time I unexpectedly passed by a mirror and saw an old man looking at me, which of course was my reflection.

Aging is tough enough without looking or feeling old. While adults have gotten better at staying more active and eating better diets than some previous generations, having an aged appearance beyond one’s actual years is a downer.

Something people often do not factor into the telltale signs of aging is bone loss. Generally, people acknowledge that they’ll lose some height with age as the skeleton submits to typical bone loss. However, bone loss due to missing natural teeth isn’t typically perceived as part of the process.

Yet, losing bone mass in the jaws can greatly affect one’s appearance, regardless of their actual years. This is due to the lack of stimulation provided to the jaws that natural tooth roots once provided.

Your natural teeth are supported by your upper and lower jaw bone, known respectfully as the maxilla and mandible. These strong, study bones support tooth roots securely.

When a natural tooth is removed, its absence causes a reaction below the gum line. This is through a process known as “resorption.” Without tooth roots present in the bone, the stimulation and nourishment needed for the bone to maintain a healthy mass is removed. Thus, the bone begins to decline.

As it shrinks in height, the adjacent teeth are more vulnerable to loss. Statistics show that teeth adjacent to areas where natural teeth are missing will be the most likely to be lost next.

Resorption begins shortly after the tooth root is removed. Once it starts, it continues at an ever-increasing rate year after year. For example, the first year after a tooth root is absent, the loss of bone may be minimal, probably unnoticeable. With each passing year, however, the pace of loss accelerates.

Over time, resorption’s effects become visible. As the bones decline in mass, deep wrinkles form around the mouth. The corners of the mouth turn downward. The chin takes on a more pointed shape and the mouth sinks into the face. The nose seems to get closer to the chin as the jaw bones thin. Jowls form as facial muscles detach from shrinking bone structure.

For people who wear a denture or partial, the pressure of wearing these appliances can speed up the rate of bone loss. For those who sleep in their denture, the 24/7 pressure speeds this pace even further. Even people who have a “bridge” may start to notice a space between the bridge and the gums, one that was probably not obvious before.

As a periodontist, I specialize in the prevention, diagnosis, and treatment of all stages of periodontal (gum) disease. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures. I also have advanced training and skills in the selection and placement of dental implants.

When it comes to replacing natural teeth, dental implants are the ideal for many reasons. When it comes to halting bone loss, they are able to restore stimulation to the jaw bone. Additionally, dental implants restore the ability to eat with stability, chew comfortably, and laugh and speak with confidence. Dental implants do not decay and will never need root canals.

There are over 40 different implant systems, each designed to accommodate various needs and goals. Obviously, a strong consideration in determining which type of dental implant is recommended is in the amount of jaw bone mass present.

An implant needs a particular amount of bone structure to support it.  Depending on the amount of bone present to support the implant(s), the choice of which implant system to recommend can be made.

For some, we may recommend a bone rebuilding process prior to implant placement. Or, we may advise an implant that uses unique implant lengths and placement angles (the “All-On-4”) that can overcome the challenges of bone loss.

While there are also many considerations in selecting the right type of dental implant, the final choice, of course, is the patient’s preference. Does he or she want an implant that is non-removable (“fixed”)? Is cost the determining factor? Does the patient need just one implant or several? Can one implant dependably support a “bridge” of teeth in one area?

All in all, however, dental implants are an excellent choice for replacing teeth. Implants have an extremely high success rate, higher than any implant-in-bone option. And, dental implants are designed to last a lifetime. With proper selection and maintenance, they will never need replacing or repair.

Our Asheville periodontal practice is known for its priority on comfort and providing respectful care. With over 70% of the adult population having some level of dental fear or anxiety, we have a long-standing reputation for compassion and understanding.

For optimal comfort and relaxation, we offer several sedation options, including oral and IV sedation. With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

• Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward.

• I.V. sedation (“twilight sleep“) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a Medical Doctor (MD) who is a board certified Anesthesiologist.

Ideal diagnosis is another important aspect of care here, which can save the patient much in overall treatment costs. For example, when missing more than one tooth in one area, one implant can often hold two or a bridge of teeth. Several strategically placed implants may also be used to support a full arch of teeth.

To support diagnostics in our Western NC periodontal dental office, we feature some of the region’s most advanced technology in the industry, including Cone Beam 3D imaging and laser dentistry. Our dental implant patients also have the advantages of technology that can minimize treatment speed healing and enhance comfort, thanks to Simplant.

With the support of Simplant computerized dental implant placement, we can actually position the implants on the computer using a 3D model of the patient’s jaw pre-surgically. This aids in the selection of the implant type that ensures a precision fit.

For individuals who have lost a great deal of bone and need bone rebuilding procedures prior to placement, we are highly skilled in the procedures of bone grafting. However, in many cases, we are able to apply bone generation material to the area that is less involved than the grafting process.

We believe that proper placement and support in caring for implants is an important part of a successful outcome. However, dental implants can fail. This is why a periodontal specialist can be an asset to your investment. When dental implants are chosen and placed by a periodontist, he or she can select the one that will work best for you now and throughout your lifetime.

In our Asheville periodontal dental office, we combine technology with our advanced skills and compassionate approach to care so you can enjoy a comfortable, efficient experience that allows you to have optimal success.

Call 828-274-9440 to arrange a consultation. During this time, we can discuss treatment that can achieve your needs and goals as well as the process and anticipated costs. If interested, we will also explain payment plans, some that are interest free and require no down payment.

 

Alzheimer’s Disease, Dementia and Periodontal Disease

Posted on Aug 15, 2024 by William J. Claiborne, DDS MS

In information posted on the web site of the Alzheimer’s Association (www.alz.org),

“A recent analysis led by National Institute on Aging (NIA) scientists suggests that the bacteria associated with periodontal disease that causes the chronic inflammation are also associated with the development of Alzheimer’s disease and related dementias, especially vascular dementia.”

https://www.alz.org/co/news/oral-health-and-alzheimers-risk#:~:text=A%20recent%20analysis%20led%20by,related%20dementias%2C%20especially%20vascular%20dementia.

Is there a more dreaded disease today than Alzheimer’s? Not only is the individual effected, entire families are devastated when dealing with a loved one’s diagnosis.

In the U.S., it is the 6th leading cause of death.

https://www.alzheimers.net/resources/alzheimers-statistics/

By the year 2025, the number of people 65 and older with Alzheimer’s disease is expected to reach 7.1 million people, a 27% increase from the 5.6 million over the age of 65 in 2019.

In 2020, it was estimated that 11.6% of North Carolina adults aged 65 and over had some level of the disease. Currently, 10% of American adults 65 and over have Alzheimer’s disease. For people ages 85 and older, this increases to 32%.
By 2060, nearly 1 in 4 Americans will be 65 years and older with seniors over age 85 having tripled.

https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf

As a periodontist in Asheville NC, I’ve been following the findings related to Alzheimer’s disease and periodontal disease. Yes, the connection between the two seems far-fetched, but research is showing there is a correlation.

First, allow me to explain periodontal (gum) disease. Gum disease is an inflammatory disease that attacks gum tissues, teeth, and the structures that support them. It is the nation’s leading cause of adult tooth loss. In addition to the problematic oral symptoms associated with gum disease, research has shown that the infectious bacteria are able to activate the development (or worsen the progress) of other diseases.

Because the bacteria of gum disease are able to enter the bloodstream through weakened oral tissues, studies have connected them to serious reactions elsewhere in the body. Some of these lead to the formation of cancer (oral, throat, pancreatic, lung) and some activate conditions such as diabetes and arthritis.

While the statistics of aging adults increase, nearly half of the adult population has some level of gum disease, over 47%. As a periodontal specialist in Western NC, I believe the high prevalence of gum disease among U.S. adults may be, in part, due to the assumption, “if it doesn’t hurt, nothing is wrong”. People also tend to brush off some symptoms as “normal,” such as seeing blood in the sink when brushing teeth.

Although symptoms of gum disease may include tender gums that bleed when brushing, gum disease can begin without any obvious signs. One study included over 8,200 adult at an average age of 63 at the study’s onset. The findings showed an increased propensity for developing dementia for participants who had severe gum disease and missing teeth.

Having no natural teeth was associated with a 26% increased risk. At the end of the study:

• 14% of individuals with healthy gums and all their teeth at the start of the study developed dementia by the end of the study
• 18% of participants with mild gum disease developed dementia
• 22% with severe gum disease (periodontitis) developed dementia
• 23% of those with no remaining teeth developed dementia

Eighteen years later, a follow-up study found those who had severe gingivitis in addition to tooth loss had a 22% higher risk for developing Alzheimer’s disease or dementia.

What researchers found is the bacteria present in periodontal disease are able to travel through the mucous membranes of the mouth to the brain. This is believed to cause potential brain damage.

https://psychcentral.com/news/2020/07/30/gum-disease-may-be-linked-to-later-dementia/158497.html?MvBriefArticleId=25473

Now, more than ever, maintaining a healthy smile is important for every adult. If you suspect you have gum disease (gums that bleed when brushing, tender or swollen gums, gums that have reddened or receded from teeth), be seen by a periodontist. This disease will only worsen without treatment.

Be committed to having excellent oral health as and make it a priority as an important part of your overall health. For a consultation to discuss how we can help you achieve optimal oral health, call 828-274-9440.

In addition to the treatment of all stages of gum disease and the reshaping of gum tissues, a periodontist is a specialist in the placement of dental implants. If you have lost teeth, dental implants are the ideal tooth replacement option.

Also, please know that our Asheville periodontal dental office offers many comfort options, including Oral and I.V. sedation. Oral sedation is a pill that helps patients relax. I.V. sedation (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety.

Connections of Oral Wellness and Overall Health

Posted on Aug 08, 2024 by William J. Claiborne, DDS MS

Over the past few decades, an increased number of studies have pursued the many connections of periodontal (gum) disease and our overall health. With the findings, research has become more focused with links found between infectious oral bacteria and a growing list of serious health problems.

Periodontitis is the most severe form of periodontal disease. It is a severe form of gum infection that damages soft tissues and destroys the bone that supports teeth. This occurs when toxins produced by the bacteria in plaque irritate the gums.

These toxins activate a chronic inflammatory response in which the body, which turns on itself. This systemic inflammation leads to break down and destruction of tissues and bone that support the teeth.

The potent bacteria of gum disease are able to enter the bloodstream through tears in weakened tissues. It is now known that it can trigger inflammatory reactions that are related to the development of the conditions mentioned above. While it can activate the development of serious health problems far beyond the mouth, it can also worsen others already underway.

The initial stage of periodontal disease is gingivitis. This may have mild symptoms or even some deemed “normal.” These include areas where the gums are tender or seeing blood in the sink when brushing teeth. However, gingivitis, if not halted, can soon progress to periodontal disease.

Gum disease symptoms include:

• Gums that loosen from teeth (or “recede”)
• Red or swollen gums
• Gums that bleed when flossing or brushing
• Persistent bad breath 

• Teeth that may loosen or drift

Without treatment, gum disease worsens. Many people are unaware of the severity of damage capable by these infectious bacteria. Below are some of the correlations that may surprise you.

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Using findings from previous research, studies have closely scrutinized two types of oral bacteria pathogens. Researchers found that one pathogen was far more prevalent in the saliva of participants who developed pancreatic cancer with a 59% increased risk of developing the deadly cancer. Just as alarming was that the second pathogen was shown to increase this risk by 50%.

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The connections between periodontal disease and other diseases in the body also include a link between oral health and psoriasis. Psoriasis is a chronic disease that affects the skin. Its cause isn’t fully understood but seems to relate to the immune system turning on itself.

This condition causes the life cycle of skin cells to accelerate beyond normal. Cells build up rapidly on the skin’s surface, forming scales and red patches that are often itchy and sometimes painful.

In one study, researchers found that while “people with psoriatic arthritis had about the same rate of gum disease as those without joint inflammation, people with psoriatic arthritis were more likely to have severe gum problems.”

https://www.psoriasis.org/advance/prevention-tips-for-uveitis-stroke-and-gum-disease

Other studies have shown that people with periodontitis (advanced gum disease) are nearly 1.5 times more likely to develop psoriasis than people with healthy gums. Could one trigger the other, and vice versa?

Another study showed that 36% of people with psoriasis had one or more sites of bone loss measuring at least 3 millimeters (over a tenth of an inch). This was compared to 13% of people without psoriasis.

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For people who have rheumatoid arthritis (RA), many are learning that research is noting close connections with arthritis and gum disease, too.

RA is a debilitating, painful disease that destroys joints. RA often emerges gradually, initially causing morning stiffness and weak, sore muscles. As inflammation from RA worsens, joints become swollen.  Joints become achy and stiff most often in the fingers, wrists, elbows, hips, knees, ankles, toes, and neck. Unfortunately, there is no cure for RA.

Apparently, gum disease and RA share a genetic similarity. The clinical makeup shows similar structures, primarily in pathogens that spark disease or illness. Research has found that the pathological process that occurs in both gum disease and RA are nearly identical.

Both conditions cause chronic inflammation in tissues that connect to bone with both diseases having a similar inflammatory trigger. Even more similar is the particular species of bacteria found in periodontally-diseased tissues when compared with tissues around arthritic joints. In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis.

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Another example of damage possible by the infectious bacteria of periodontal disease is coronary artery disease. The heart disease connection, as explained by Harvard Medical School’s newsletter, states:

“In people with periodontitis (erosion of tissue and bone that support the teeth), chewing and toothbrushing release bacteria into the bloodstream. Several species of bacteria that cause periodontitis have been found in the atherosclerotic plaque in arteries in the heart and elsewhere. This plaque can lead to heart attack.

“Oral bacteria could also harm blood vessels or cause blood clots by releasing toxins that resemble proteins found in artery walls or the bloodstream. The immune system’s response to these toxins could harm vessel walls or make blood clot more easily. It is also possible that inflammation in the mouth revs up inflammation throughout the body, including in the arteries, where it can lead to heart attack and stroke.”

http://www.health.harvard.edu/press_releases/heart-disease-oral-health

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And the list goes on, even including connections between periodontal disease and erectile dysfunction (ED). For men in the 40 – 70 age group, ED affects over 40% with nearly 70% of men at age 70 affected.

https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/erectile-dysfunction/

One study of 162 males ages 30 to 40 by Turkish researchers, 82 of the participants had normal erection function while 80 who complained of ED, nearly half. Some men in both groups had chronic periodontitis, but the condition was more than twice as prevalent in the ED group.

In another study, 80 male participants who had severe gum disease were more than twice as likely to suffer from erectile dysfunction. This was true even after adjustments were made for other issues that could distort the findings.

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Gum disease affects nearly 47% of American adults. It will worsen without treatment and, to no surprise, is the nation’s leading cause of adult tooth loss. As an Asheville periodontal specialist, I have an up-close view of the damaging effects of gum disease.

If you are experiencing signs of gum disease, start with a thorough periodontal examination. Call 828-274-9440 or ask our friendly staff about beginning with a consultation.

If dental fears have caused you to delay or avoid having regular dental care, many treatments can include oral or I.V. sedation (sleep dentistry, or “twilight sleep”).

And, if financial constraints are an obstacle in receiving treatment, we offer several payment plans. Most are interest-free with no down payment required (for qualified individuals). Feel free to ask about these during your consultation.