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Crown Lengthening
Optimize Your Dental Implant Experience, Results.
Posted on Jan 24, 2022 by William J. Claiborne, DDS MS
I recently had to return a small appliance at a “big box” store. I didn’t have the receipt but hoped I could at least get a store credit. When I explained this to the customer service rep, she said a receipt wasn’t necessary. She scanned the bar code and asked me if I wanted the refunded amount applied to the credit card I used to purchase it. No receipt needed, no credit card, and I was in and out of the line in no time.
With today’s technology, many processes that were once time-consuming and complicated are now simple and “painless.” Less time is required with better results. Technology has made this true, too, in dentistry.
As a periodontist, I specialize in the prevention, diagnosis, and treatment of all stages of periodontal (gum) disease. I also have advanced training and skills in the selection and placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures.
As an Asheville periodontal specialist for over 30 years, I’ve treated 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
To receive the extensive, additional 3 years of training after dental school to become a periodontist, (I believe) an individual must be passionate about the specialty. I certainly am, which is why I’m so committed to stay on top of the latest developments in the field.
This includes incorporating some of the most advanced technology available for the betterment of our Western North Carolina patients.
Our periodontal dental office features cutting edge technology, much of which is not available in other dental or periodontal offices in this region. These features help to diagnose with precision, treatment plan with superior accuracy and reduces the patient’s treatment time while optimizing comfort.
For our dental implant patients, these options have been significantly beneficial in maximizing results. Some specifically helpful in dental implant diagnosis and planning are:
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. For patients who are preparing for dental implant placement, resolving gum disease prior to treatment is mandatory. LANAP offers a non-surgical alternative for patients with moderate to severe periodontal disease with very little discomfort and a quick recovery time.
Cone Beam Imaging – These amazing 3D “x-rays’ are ideal for diagnosing and treatment planning. The highly-detailed images provide a clear view of the upper and lower jaw. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The images are captured in a quick, painless process and at minimal levels of radiation.
CareStream Cone Beam Computer Tomography Imaging – This enhanced tomography works with 3D imaging for exceptional detail and range.
Computerized Dental Implant Placement – This system provides the futuristic ability to position dental implants before the process actually begins. Through computerized technology, the implants are selected and “ideally positioned” on a 3D model of the patient’s jaw. From this, a template is developed for optimal treatment success, even for complex cases.
CS 3600 Intraoral Scanner – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily. These are used to create precision models or appliances (dental implant crowns, bridges, or full arches). The scanner can also reach hard–to–access areas in the patient’s mouth for superior results with improved patient comfort.
Sedation – Our Asheville periodontal practice is known for its environment of comfort and respectful care. We understand that over 70 percent of the adult population have some level of dental fear or anxiety. For optimal comfort and relaxation, 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 Medical Doctor (MD) who is a board certified Anesthesiologist.
With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.
When it comes to placement of dental implants, a periodontist has a unique understanding of the tender layers of gum tissues. Using gentle and precise skills when it comes to any treatment involving oral tissues, the patient experiences less disruption and incisions. When it comes to the gums, less is definitely more. We strive to optimize comfort levels and speed the healing process.
If you are considering dental implants, you may wish to begin with a consultation appointment. During this time, we can explain the vast difference in comfort, treatment time, and success available through our specialized skills and extensive technology.
Call 828-274-9440 to schedule. New patients are always welcome and a referral is not required.
Cracked & Broken Teeth A ‘Sign of the Times’
Posted on Jan 06, 2022 by William J. Claiborne, DDS MS
As a periodontist in Asheville NC for over 25 years, I’ve seen my fair share of teeth that have been removed or need removal. Most of these teeth, based on national statistics, are lost due to damage caused by periodontal (gum) disease.
Yet, in more recent years, I’m seeing people lose teeth due to broken or fractured teeth.
In my dental specialty, I have advanced skills in the treatment of gum disease as well as in the diagnosis and placement of dental implants. As the ideal option in tooth replacement, dental implants restore the stability and dependability of natural teeth.
So, it stands to reason that a lost tooth is best replaced by a dental implant. But, why are more and more individuals losing teeth due to fractured, cracked or split teeth?
It’s becoming more common to hear that dentists are treating more cracked teeth since the beginning of the pandemic. A recent survey shared by the American Dental Association (ADA) reported that over 70 percent of dentists surveyed (nearly 2300) saw an increase in patients who had experienced night-time clenching and grinding of teeth, or ‘bruxing’. These problems have typically been the result of bite misalignment, which interferes with the harmonious congruity of upper and lower teeth while eating or speaking.
When a tooth breaks or fractures below the gum line, it requires removal (in most cases) since the above-the-gum structure is generally insufficient to support a crown. As a periodontist, another area of the periodontal specialty is crown lengthening.
This procedure is often performed prior to the placement of crowns to correct the height of the gum arch that borders teeth. This is especially common for patients who have a ‘gummy smile,’ or too much gum area visible above upper teeth when in a full smile.
However, in cases where a tooth breaks, crown lengthening is sometimes performed to alter the surrounding gum tissues and expose enough tooth structure to support a crown. The benefit of this is the patient is able to avoid having the tooth removed and endure the many decisions (and costs) involved to replace it.
Pandemic stress, quarantine fatigue, mask burnout, a succession of variants, less social involvement, and general stress overload has become a global problem. Although stress is experienced by different people in different ways, it is not uncommon for it to be revealed through dental issues.
Many people hold stress and tension in their jaw muscles and jaw joints. This is why, during relaxation phases in a yoga class, it’s common for the instructor to encourage participants to relax their jaw muscles. Since the onset of the COVID-19 pandemic, stress is causing an unusually higher rate of oral health problems.
Based on the ADA survey, about 60 percent of responding dentists shared an increase in patients who clearly cite stress as the culprit for tooth damage. Thus, dentists have seen significant increases (up 63 percent) in chipped teeth, and about the same percentage of increases for cracked teeth and temporomandibular joint (TMJ) disorder symptoms, which includes headaches and jaw pain.
If you are experiencing problems regarding stress held in the jaw joints, here are a few tips that may help lessen the load:
• Walk away from the computer an hour before bedtime.
• Relax with a warm shower or play soothing music.
• Relax your jaw joints by putting your lips together, teeth apart, and resting your tongue behind front teeth or the roof of the mouth.
• Ask your dentist about a custom-designed night guard to protect your teeth from night-time clenching or grinding.
If the worst has occurred – losing a natural tooth – the best way to replace it is with a dental implant.
Dental implants recreate stimulation to the jaw bone, thereby halting the pace of bone loss. When bone mass is maintained, neighboring teeth have a reduced risk for being lost as well. Because dental implants are held in the jaw bone, they are also able to restore a natural biting strength with dependable stability.
There are many advantages to having dental implants, including the longevity. When dental implants are properly selected, placed and maintained, they should last your lifetime. This is why it’s so important to have your implant treatment through a Periodontist.
A periodontal specialist has advanced training and skills in the diagnosis and placement of all types of dental implants. He or she can enhance your ability to enjoy this superior tooth replacement option for a lifetime of confident, healthy smiles.
In our beautiful Asheville periodontal dental office, we offer the most advanced technology in dentistry. Additionally, oral and IV sedation (‘twilight sleep’) are also available for optimal patient comfort.
To learn more, call 828-274-9440. If preferred, you can begin with a consultation appointment. New patients are always welcome and a referral is not needed.
Contour of Gum Tissues Is Important To A Smile’s Appearance
Posted on Oct 28, 2021 by William J. Claiborne, DDS MS
When people think of their smile, they tend to think primarily of their teeth. Certainly, having white, straight teeth are a major part of a smile’s appearance. In today’s cosmetic dentistry, porcelain veneers and crowns give an exceptionally natural appearance with excellent longevity and durability. However, the gum line that borders teeth can greatly affect a smile’s appearance, perhaps more than you’ve considered.
People with unflattering smile traits tend to “hold back” when smiling. They may smile with lips only or hold a hand in front of their mouths. Some men even admit to growing a mustache that extends down over the top lip to hide the teeth visible in a smile.
In addition to placing dental implants and treating all stages of gum disease, a Periodontist specializes in the treatment of the soft tissues of the mouth. As an expert in oral tissues, my advanced training enables me to contour gum tissues to provide a natural appearance and healthy seals around the base of teeth.
For several reasons, gum tissues can pull away from the base of teeth. This can occur from gum tissues becoming drier with age or over-zealous tooth brushing. Gums can also loosen their grip around teeth when teeth tilt out of their proper positions.
When the tight seal around the base of teeth is compromised, the tooth becomes more vulnerable to oral bacteria. Darker, sensitive tooth root segments may be exposed. This not only causes sensitivity, these areas become susceptible to bacterial penetration. As an entry point for oral bacteria, the tooth roots and bones that support teeth are more vulnerable to damage as well.
In cases when a tooth breaks near the gum line, a procedure known as crown lengthening may be able to expose enough of the tooth structure so a crown can be placed. This means the natural tooth can be saved rather than require removal. Once a natural tooth is removed, it brings with it a long list of decisions and associated costs.
Although protecting and saving teeth is the priority, gum contouring procedures, such as crown lengthening are also performed to enhance the appearance of a smile. Gum re-contouring is typically referred to as a “gingivectomy”. It is performed to remove the excess gum tissue that arches over the teeth most visible in a smile.
For example, for people who have a “gummy smile,” too much gum tissue is visible above upper teeth in a full smile. A periodontist can use his or her specialized skills to reshape the tissues to provide a more balanced smile line.
In this, crowns are typically placed in addition to having the gum height adjusted. The result? A smile is greatly improved when the gum line is contoured to blend attractively with gum tissue bordering neighboring teeth.
To begin, we numb the gum tissues and carefully trim the excess. As a Periodontist, I take specific measures to ensure a natural looking arch remains over the teeth while preserving the natural points that ‘dip’ between each tooth.
A gingivectomy performed with a dental laser provides our Asheville periodontal office patients with a number of advantages: (1) enhanced comfort; (2) precision lines; (3) minimal or no bleeding; and, (4) faster healing time.
It’s normal to experience some tenderness or swelling after the procedure. However, most patients do fine by applying an ice pack off and on for the first day. In most cases, over-the-counter pain medications are sufficient, however, we make prescription strength options available to ensure comfort during the healing process. Many patients tell us they needed no medication at all.
Healing time depends on each individual and can vary from a few days to a few weeks. The dental laser we use helps to reduce the amount of time needed for healing. For patients who smoke, healing times are longer due to smoking’s drying effect on gum tissues.
Most gingivectomies are followed by porcelain veneers or crowns to give a beautiful, even smile line.
For those who have avoided gum recontouring due to dental fear, 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.
IV 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. We help patients understand that their fears and concerns are not unusual. Our doctors and staff respect each patient and provide gentle, compassionate care – at every appointment.
Treatment fees depend on the extent of the condition and whether crowns or veneers will be applied following treatment. In either case, beautiful results can occur, helping the individual who once ‘held back’ on smiling confidently.
A healthy smile is a benefit to our overall health. An attractive, confident smile is also an asset when it comes to self-image, helping us to feel good from the inside out! Call 828-274-9440 for a consultation to discuss a gingivectomy and what may be recommended for your specific needs.
How The Contours of Your Gums Can Enhance Smile’s Appearance
Posted on Aug 10, 2021 by William J. Claiborne, DDS MS
I remember the home of a beloved Great Aunt, whom I visited often growing up. One of the things that made her home so “homey” were the displays of bric-a-brac. As a youngster, I didn’t term her arrangements of china tea sets and Hummel figurines as bric-a-brac (they were “knick knacks,” to me). However, I found myself being drawn to her displays on shelves, in curios, and on tables moreso as I grew older.
To me, what was impressive about these groupings was how balanced they were. The china tea pots were centered, surrounded by carefully spaced cups and saucers. Hummel children were in playful arrays to appear as a happenstance assembly of friends.
As a Periodontist, I am now far more appreciative of how my Aunt kept such proper balance to these displays. Everything seemed so coordinated, harmonized.
As a specialist in the treatment of all stages of periodontal (gum) disease and the placement of dental implants, I am also the expert when it comes to the contours of gum tissues surrounding teeth. The gums are important to the health of your teeth as well as the appearance of a smile.
When it comes to protecting teeth, think of the gum tissues as a protective blanket. The gums cover over the under-structures of the mouth’s interior (oral cavity). If you’ll look at the base of each tooth, you’ll see that the gum tissues snugly wrap the base of each tooth. This protective seal is what prevents bacterial penetration below the gum line.
When gum tissues loosen their grip around teeth, the leading cause is gum disease. Gum disease weakens oral tissues and causes them to become inflamed. As the gums loosen, bacteria is able to work their way into the structures that support natural teeth (including bone).
When bacteria reach this level of oral structures, ridding it involves a more involved procedure than what a mere dental cleaning can combat. As it progresses, the gums become spongy and pus pockets form. Teeth loosen and may need removal. Gum disease is the leading cause of adult tooth loss.
Yet, gum tissues not only serve as a protective element of your mouth. The appearance of a smile can be greatly affected by the shape and amount of gum tissues exposed when smiling.
Balance is an element of beauty, according to studies. We are drawn to it. According to Penn State’s “Science in Our World: Certainty and Controversy”,
“Studies show that symmetrical faces are preferred and more attractive to others than people who have asymmetrical faces. Similarly shaped eyes and eyebrows, sides of the nose mouth can all fall into the symmetrical category.”
They shared findings of one study, performed over the course of two decades, that had men and women rank the attractiveness of people in photos. The study revealed:
“Men and women both overwhelmingly chose the most symmetric face. This test was an observational study, so it was only as clear and truthful as the participants of the study were. There wouldn’t really be a way to make this sort of study an experimental test, so as far as attraction goes, studies must rely on the opinions of the participants. However, the majority of the participants chose the most symmetrical faces as the most attractive ones, so it is easily said that it is true, symmetry equals attractiveness.”
http://www.livescience.com/7023-rules-attraction-game-love.html
Although “beauty is in the eye of the beholder,” symmetry seems to be a component of what humans define as beautiful and what we’re drawn to (although inner beauty is an important factor in what keeps us connected to an individual).
When a smile shows too much or too little gum tissue bordering the tops of teeth, it moves the smile line out of balance. For example, in a “beautiful” smile, the arches of gum tissues visible in a full smile are at a similar level. The amount of gum arches are in a complimentary line to teeth, rather than an amount that draws the eye. Too much gum tissue showing is referred to as a “gummy smile.”
A gummy smile is not an unattractive feature. Having one does, however, alter the appearance of a smile based on balance. For example, a diastema is a wide space between the two front teeth. It is often a hereditary trait. Although it is not unattractive feature, the eye seems drawn to that one spot rather than seeing the smile, as a whole, as a complement to other facial features. The individual may have beautiful lips or eyes, but the gap between the teeth is what is noticed as being “off.”
Quite frankly, some people are perfectly comfortable with having a gummy smile or a diastema. For them, it’s part of their personality or signature look. After all, what would Lauren Hutton, the famous model of the 70’s, have been without her diastema?
For other people, these features cause shyness, insecurity or a feeling of awkwardness. Some people try to smile with lips only. Others try to conceal a full smile with a hand. “Holding back” on a smile is a shame, especially since smiling is a proven asset to our frame of mind.
The act of smiling causes the brain to release chemicals known as endorphins. These trigger somewhat of a natural high, creating a happier mood. This has been shown to be true even when faking a smile.
Additionally, people who smile often are deemed happier, more confident and even younger. In smiling, the facial muscles pull upward and smooth out the skin to give the face a bit of a lift. Free of charge!
Another distortion in a balanced smile can be an uneven line of gum tissues, where there is more gum showing on some teeth than others. This up-and-down line of gum tissues creates a jumbled look. Again, the appeal of balance is disrupted.
In these cases, a “crown lengthening“ procedure is often advised. This is a simple procedure that alters the height of the gum tissues prior to placement of a crown (‘cap’). Not only does this provide a more flattering smile line, it protects the teeth involved while enhancing the tooth’s shape.
Another issue that impacts both appearance and the health of a tooth is gum recession. When the gums recede from the base of teeth, more sensitive and vulnerable areas of the tooth’s root are exposed. Exposure can lead to sensitivity and higher risk for bacterial penetration.
The procedure for most gum recontouring is known as a Gingivectomy. In this, our Asheville Periodontal dental office uses a dental laser. Gingivectomy is the most common procedure performed with a laser, which is used to precisely contour gingiva (gum tissue) for restorative, cosmetic, and periodontal needs.
The laser promotes rapid healing and reduces discomfort post-operatively with periodontal packing or sutures rarely needed. In the hands of a skilled periodontal specialist, laser technology also minimizes penetration depths. For minor procedures, lasers can sometimes require little or no anesthetic.
For more involved gum contouring, our Asheville periodontal office offers both oral and I.V. 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 places the patient in a deeper sleep state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our office, this is overseen by Dr. Brad Stone, a Medical Doctor (MD) who is a board certified Anesthesiologist & Pediatric Anesthesiologist.
With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.
The health and appearance of your smile are important. It is proven that good oral health is a supportive component to your overall health. It is also shown that the appearance of a smile can add positively to an individual’s perception of “self”.
If you’re interested in improvements in the health and appearance of your smile, let’s discuss the possibilities during a consultation appointment. Call 828-274-9440. A referral is not always needed.
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