Nothing To Fear To Accomplish Healthy Smile Here

Posted on Apr 16, 2023 by William J. Claiborne, DDS MS

As a dental specialist, I find that many people are unfamiliar with exactly what a periodontist does. Yet, when they are recommended to see me (typically by their general dentist), it is because they need specialized care that falls under our unique set of skills.

A periodontist has advanced skills to help patients with a variety of needs that involve the gum tissues. These include:
– Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)
– Diagnosis and placement of dental implants
– Treatment of lesions or cysts in oral tissues

Let’s begin with gum disease.

Because the majority of care I provide has to do with the treatment of all stages of periodontal disease, it may be helpful to understand how this develops. Although many people delay or avoid regular dental care (mistakenly thinking “if nothing hurts, then nothing must be wrong”), I have a close-up view of its destructive nature. Its formation creates cavities, periodontal (gum) disease, and leads to eventual tooth loss.

Even people who are committed to a regimen of thorough at-home oral hygiene (twice-daily brushing, daily flossing), can be doing an insufficient job of removing the daily buildup of plaque. Plaque is a sticky film of bacteria that accumulates in the mouth. When not thoroughly removed, it can harden into a mass that attaches to the base of, or in-between, teeth.

In the form of tartar, this cement-hard mass of bacteria cannot be brushed or flossed away. Once tartar forms, it can only be removed by a dentist or hygienist using special tools. Without removal, it will continue to amass and attack gum tissues, working its way beneath the gum line.

Below the gums lie the support system for natural teeth, consisting of tissues, ligaments and bone. When the bacteria reach an uncontrollable level, they become infectious. As these infectious bacteria accumulate further, symptoms of gum disease become more apparent, such as tender or swollen gums or seeing blood in the sink when brushing teeth. Breath odor may be bad on a regular basis.

As symptoms worsen, the gums become red with infectious and loosen their grip around the base of teeth. The gums may become spongy and pus pockets may form. Breath odor at this point is persistently putrid. Eventually, the structures that support teeth are compromised and teeth may loosen. Gum disease is the leading cause of adult tooth loss in the U.S.

Research has found that certain strains of oral bacteria from gum disease create reactions in the body that can trigger systemic inflammation. Thus far, research findings have shown a correlation between periodontal disease bacteria and some cancers (including pancreatic and lung), Alzheimer’s disease, pre-term babies, heart disease, stroke, diabetes, arthritis and erectile dysfunction (ED).

As if all that weren’t bad enough, one study suggests that gum disease relates to a reduction in one’s quality of life: “Periodontal disease has been linked to lower quality of life.” “Quality of life encompasses several domains, including psychological functioning and social relationships among others. Oral health-related quality of life has been shown to be reduced in patients with periodontal disease.” (https://www.hindawi.com/journals/prm/2017/5491923/)

While estimates show about 75 percent of American adults have some degree of dental fear or anxiety, over 47 percent have some level of periodontal disease. As a periodontist, both are alarming numbers. Nearly half our nation is walking around with a potentially life-threatening disease in their mouths.

Treating this may sound like it would be pretty intimidating. However, Although there are many treatments offered and at various levels, our main goal is to provide patients with comfortable and positive experiences at every visit. One way we accomplish this is through the advanced technology featured here in our Western North Carolina periodontal dental office. We feature some of the most advanced in dentistry, much of which is not available in dental offices elsewhere. Some of these features include:

LANAP With PerioLase MVP 7: Laser-Assisted New Attachment Procedure is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease. LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

3D Cone Beam Imaging: Ideal for diagnoses and treatment planning, these images provide a clear view of the upper and lower jaw, used for: intricate review of endodontics; periodontics; orthodontics; implantology: TMJ; and prosthodontics, as well as dental and maxillofacial surgery. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The process is quick, painless and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging: This enhanced tomography works with 3D imaging for exceptional detail and range.

CS 3600 Intraoral Scanner: Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily for creating precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments). The scanner can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Computerized Dental Implant Placement: This advanced system for pre-surgical positioning of dental implants uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases.

In addition, we offer a unique environment for comfort. We understand how dental fear or anxiety can cause people to delay or avoid having dental treatment, sometimes for decades. We believe that every patient deserves respect, a gentle touch and knowing they are in a “lecture free” zone. For those who have high fear levels, we offer several sedation options, including oral and IV sedation.

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 (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. In our Asheville office, 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.

I hope I’ve given you a helpful and positive picture of what a periodontist does and how he/she can help you with some challenging needs; all the while keeping you comfortable, minimizing treatment time, and shortening treatment time.

Although most of our patients are referred to us by other dentists and dental specialists, a referral is not required for accepting a new patient. Call 828-274-9440 if you feel we can make recommendations for your specific needs or provide helpful information.

Choose A Periodontist To Correct A Gummy Smile

Posted on Aug 29, 2022 by William J. Claiborne, DDS MS

About Periodontal Plastic Surgery

When Lauren Hutton, the model well-known for a space between her front teeth, began modeling, she felt she needed to camouflage the gap (or “diastema”). Yet, she soon began to feel it was a unique feature that set her apart from the others. She was right, and now at the age of 77, she’s been on more front covers than nearly any other model.

Each smile is unique. Hopefully, your smile makes you feel good every time you share it. And, the very act of smiling has been shown to release endorphins in the brain. Those are the chemicals that create a bit of a ‘natural high.’ Smiling is obviously an asset to our well-being.

If you have a “gummy” smile, you may be perfectly fine with it. After all, it is not detrimental to oral health if you care for your gums properly (which goes for everyone). And, it can be a positive part of your personality. Katie Couric has a gummy smile and shares hers openly.

However, not everyone with this trait feels comfortable with the look nor the way it makes them feel when smiling. Some people tend to suppress  a full smile. Others often conceal their smile with a hand when smiling fully or laughing. Some people smile with their lips only.

A gummy smile, in the periodontal specialty, is known as EGD, an abbreviation for excessive gingival display or a gingival smile (GS). The trait occurs more often in females than in males. (Gingival is of or relating to the gums.)

Esthetically, a balanced smile typically shows the front top 6 or 8 teeth. Arching each tooth, there is generally minimal gum tissues showing , and sometimes none. Another esthetic complement to a smile is having gum tissues that  show a slight arch over each tooth at a similar line as those that arch adjacent teeth. Gums that are lower over one or two teeth tend to create a jumbled look in a full smile.

When the height of gum tissues distract from the appearance of a smile, a periodontist is your expert. This dental specialist has specialized skills in all aspects of oral tissues. Through their advanced training, they are able to safely and beautifully reshape the tissues that surround teeth.  

For people who wish to have a gummy smile or uneven gum line re-contoured, a periodontist performs a gingivectomy. A gingivectomy is a procedure during which excess gum tissue is remove. During this, the gumline is sculpted to give your smile balance with a more even smile line.

In addition to repairing a gummy smile, a gingivectomy is involved in a procedure known as crown lengthening. Crown lengthening involves removing the excessive gum tissue to expose more of the crown of the tooth, as well as sculpting the gumline to make it higher up. After the gum tissues are shaped, a crown is typically placed to protect the tooth above the gum line and to create a more beautiful smile.

A crown lengthening may also help to save a tooth from removal. When a tooth breaks off near the gum line, a crown lengthening can be performed to expose a sufficient amount of the tooth’s base so it can support a crown.

Another procedure a periodontist  expertly performs is gum grafting. This is often to cover exposed roots, to reduce further gum recession, protect vulnerable tooth roots from decay, and improve your smile. Recession can occur as a result of periodontal disease, which causes tooth roots to become exposed and makes the teeth look long.

Gum tissues are very tender tissues with many nerves. Procedures that involve the gums must be performed with precision to minimize discomfort and speed healing time. A periodontist excels in the skills to create an optimal outcome with the most conservative treatment needed.

Our Asheville periodontal dental office provides some of the most advanced imaging and computerized technology available. This includes cone beam 3D imaging and laser dentistry. Additionally, we provide oral and IV sedation (“twilight sleep”) so patients are able to relax or snooze comfortably while being monitored by specially-trained team members who use advanced safety equipment.

Begin with a consultation with an experienced periodontist, who can answer your questions thoroughly and determine the best treatment option for your individual needs. Call 828-274-9440.

Some sources:

https://www.colgate.com/en-us/oral-health/mouth-and-teeth-anatomy/3-treatment-options-for-a-gummy-smile

https://www.researchgate.net/figure/Female-and-male-percentages-in-the-gummy-smile-sample_tbl1_340258838

Our Asheville Periodontal Dental Office Offers Some Unique Services

Posted on Jun 13, 2022 by William J. Claiborne, DDS MS

As a Periodontist in Asheville, I’ve helped hundreds of patients overcome periodontal (gum) disease and the many repercussions that come with tooth loss. Helping to save teeth that were on the verge of requiring removal has also been a victory for the patient as well as me.

I take great pride in being a part of the transformations of patients who achieve healthy, confident smiles. This is why I’ve created an environment that affords every patient with the most advanced options available for restoring oral health and replacing lost teeth with dental implants.

Let me begin by clarifying the benefits our periodontal office brings…

• A periodontist has advanced training to properly diagnose and treat all stages of gum disease.

• We are known for never over-treating or under-treating with a commitment to provide the most successful treatment for each patient’s specific needs.

• Our periodontal office is specially equipped for the diagnosis and treatment of all stages of gum disease as well as placement of dental implants.

• Diagnosis and treatment planning is backed by an immense array of advanced technology, including:

• • LANAP (Laser-Assisted New Attachment Procedure) with PerioLase MVP 7 – an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease and has even been found to stimulate bone regrowth in damaged areas.
  • 3-D Cone Beam Imaging – is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes in a process that is quick, painless and at minimal radiation levels.
  • CareStream Cone Beam Computer Tomography Imaging – is enhanced tomography that works with 3D imaging for exceptional detail and range.
  • CS 3600 Intraoral Scanner – quickly and comfortably captures digital impressions to accurately and easily create precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances, aligners, custom abutments) without the need for bulky, goopy trays.
  • Computerized Dental Implant Placement – an advanced system for pre-surgical positioning of dental implants using a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success.

 

• A commitment to comfort including I.V. sedation (twilight sleep) as well as oral sedation for total relaxation. On our team is a Board Certified Anesthesiologist to provide sedation and anesthesia for optimal comfort and safety.

Treatment options in our specialty dental office also include reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession); diagnosis and placement of dental implants; and treatment of lesions or cysts in oral tissues.

With specialized skills, a periodontist is especially respectful to oral tissues as tender layers that significantly affect the appearance of a smile and the health of teeth. Utilizing special skills to minimize incisions while effectively treating each area in the mouth, a periodontist is your expert.

Call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.

Many Reasons To Repair Gum Recession

Posted on May 19, 2022 by William J. Claiborne, DDS MS

If you are occasionally experiencing sensitivity around one or more teeth, especially when eating ice-cream or drinking hot coffee, this is likely due to receded gums.

While using a sensitivity toothpaste can somewhat minimize these sensations (which can become painful jolts), the problem will remain. The source of sensitivity, most often, is because the highly-sensitive tooth’s root area has been exposed by the pulling away of gum tissues.

The gum tissues are designed to provide a tight seal around the base of each tooth, which blocks bacterial entry to the sensitive tooth root area. In addition to sensitivity, recession means oral bacteria can penetrate beneath the gum’s surface. Once beneath the surface, the accumulating presence of this bacteria can lead to inflammation of the gums.

Eventually, the infectious bacteria attack the structures that support natural teeth. This bacteria indicates the presence of periodontal (gum) disease. Signs and symptoms of gum disease in its first stage include:

• Gum tissues that turn red

• Gums that become tender or swollen

• Gums that bleed when brushing

• Persistent bad breath

Obviously, it’s important to ensure the gums are healthy so the grip they have around teeth is snug. It’s also important to be aware of the causes of gum recession. These are:

The aging process – As people age, their gums become drier. This causes them to shrink and be less capable of keeping a secure grip around the base of teeth.

Periodontal (gum) disease – As mentioned above, gum disease destroys oral tissues and the bone that supports natural tooth roots. A sign of periodontal disease is gum recession. Gum disease is also the nation’s leading cause of adult tooth loss.

Poor dental hygiene – When twice-daily brushing, daily flossing, and keeping the mouth moist are insufficient to rid the mouth of bacteria, their accumulation can result in the sticky film you feel on teeth. This is plaque. In just a day or so, plaque can harden on teeth into tartar. This is a cement-hard bacterial colony that cannot be removed by brushing or flossing . It can only be removed during a professional tooth cleaning. If not removed, teeth, gums and the structures below the gum line can be damaged.

Brushing too hard – Brushing teeth rigorously doesn’t mean you are doing a good job. Using a scrubbing, back-&-forth motion can wear away tooth enamel and cause the gums to recede. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.

Hormones – Females experience fluctuations in estrogen levels during puberty, menstrual periods, pregnancy and menopause. During these times, the gums can be more sensitive and vulnerable to gum recession.

Tobacco use – In addition to the many health hazards smokers risk, they are more likely to develop plaque due to the oral drying effects of smoking. This dryness can lead to gum recession (not to mention brown teeth and bad breath).

Bite misalignment – When teeth don’t come together evenly, too much force can be exerted on the gums and surrounding bone, allowing gums to recede. Bite misalignment can also lead to grinding or clenching teeth. These harsh forces on teeth can cause the gums to loosen their grip.

If you have mild sensations of sensitivity, desensitizing toothpastes can help soothe the nerves by forming a protective barrier over teeth while blocking sensitivity signals. Although this type of toothpaste can be helpful, it should be used as a temporary aid.

The goal should be to repair recession and halt the problem from recurring. To do this, we begin by determining why the gum recession is occurring. The next step is to restore the gums to their proper positions.

The corrective procedure most often performed is a “gingivectomy” performed by a periodontal specialist. In addition to treating all stages of gum disease, a periodontist specializes in contouring gum tissues. Using advanced skills, a periodontist is able to create a natural look and restore your oral health.

A gingivectomy can reposition or graft gum tissues over the area of recession to restore a healthy seal and protect the tooth structures below the surface.

Another advantage of a gingivectomy is to help save a natural tooth. When a tooth breaks near the gum line, a “crown lengthening” procedure may be advised. In this, a periodontist may be able to expose enough of the tooth structure for the placement of a crown.

A crown lengthening procedure is an ideal accompaniment to many cosmetic dentistry treatments. When there are different heights of gum tissues framing the teeth most visible in a smile. This tends to create a jumbled looking smile, when when the teeth are straight.

Crown lengthening rebalances the height of gum tissues that arch the teeth to restore a smile that is balanced. From this, the eye is drawn to the smile as a whole rather than one or two teeth with varying heights of gum tissue.

A gingivectomy is also performed for individuals who wish to correct a “gummy smile.” This is when a smile shows too much gum tissue above upper teeth when smiling fully.

Gingivectomies are performed while the patient is comfortably numbed. For some people, sedation may be a preference for enhanced relaxation. Oral sedation is available in pill form, which allows patients to ‘doze’ through procedures. I.V. sedation, also known as “twilight sleep”, is available for patients who prefer a deeper level of sedation.

Both sedations are administered by fully trained team members who use advanced safety monitoring equipment. We believe your safety is as important as your comfort.

In our Asheville periodontal dental office, we also offer a wide array of technology. This often saves the patient time in treatment, enhances comfort, and speeds healing. For example, our dental laser can seal tissues as it contours it. This eliminates or greatly minimizes bleeding.

Pain is how the body indicates that something is wrong. When the gum tissues have receded, they are not going to repair on their own. Let’s discuss your particular needs, whether for improved oral health or to enhance the appearance of your smile (or both) during a consultation appointment.

Call 828-274-9440 to schedule a time.