When Dentures Are “Slippery,” “Wobbly, or “Rocky”…

Posted on Mar 11, 2023 by William J. Claiborne, DDS MS

A periodontal specialist has advanced training in the selection and placement of all dental implant types. Also a specialist in the treatment of all stages of periodontal (gum) disease and the contouring of gum tissues (such as to correct a “gummy smile”), many patients who come to us have lost teeth due to gum disease.

Gum disease is the nation’s leading cause of adult tooth loss. Sadly, over 47% of Americans over the age of 30 have some level of gum disease. Many do not realize they have developed gum disease since it can begin without obvious symptoms.

Periodontitis is the advanced stage of gum disease. Its symptoms are hard to ignore. Breath odor is putrid. The gums bleed easily, at times even when eating. The gums are a dark red and may have a spongy texture. Some teeth may loosen or shift. Pus pockets form around the base of some teeth.

In this advanced stage, some (or all) natural teeth may require removal. For those who choose to replace teeth with a denture or partial (versus dental implants), something occurs below the gums that cannot be seen. However, over time, the repercussions can be quite severe.

What I’m referring to is “resorption.” This is the term used for a shrinking jaw bone.

Resorption occurs when natural tooth roots are no longer present in the jaw bone. These tooth roots actually help to provide stimulation to the bone. Tooth roots also nourish the bone mass through connective tissues that extend down through a tooth’s interior.

When a tooth is removed, the stimulation and nourishment to that area of the jaw bone is taken away. Without it, the bone begins to shrink. As it declines in height, the adjacent teeth are more vulnerable to loss. Statistics show that teeth neighboring areas where natural teeth are missing will be the most likely to be lost next.

Although a denture or partial can mimic the presence of teeth above the gum line, there is nothing to keep the jaw bones healthy beneath, which is the sturdy foundation for biting and chewing strength. As tooth loss continues, one can go from losing a few teeth to losing all teeth (being “edentulous”).

Many people are unaware that the pressure of wearing dentures or partials accelerates the pace of resorption. For people who sleep in their dental prosthetic, the 24/7 pressure applied to the jaw bones speeds up the rate of bone decline even more.

Sleeping in a denture can also add to higher risks for the flu and pneumonia. A 3-year study of more than 500 adults was published by the Journal of International Oral Health. Of the 186 (of 453 denture wearers) who did not remove their dentures for sleeping, they had over twice the risk for pneumonia than those who did. Sleeping in dentures also led to higher levels of tongue and denture plaque, gum inflammation and other oral issues.

For those who wear a denture or partial, losing jaw bone mass also causes a change in the way the denture or partial fits. For example, a denture may fit fine the first year after teeth are removed and a denture is custom-fitted. However, people eventually notice slips when biting or chewing. This is because the bone under the “arch” that supports the denture or partial is declining in height.

The changing foundation for the denture (also known as a ridge) allows it to “slip” or become “wobbly.” As bone loss continues, it causes uncomfortable rubbing on tender gums while eating.

As a result, people often adjust their diet to avoid foods that require rigorous chewing, opting for softer foods that require less chewing. Outings with friends and family become overshadowed by the fear of embarrassing slips.

Eventually, even frequent applications of denture pastes or adhesives are of little help. A reline may be recommended by your dentist to reshape the contours of the denture or partial to the slowly declining arch. Unfortunately, this process will continue as bone loss requires periodic relines as the arch flattens further.

The solution?

For most individuals who are missing one or more natural teeth, we advise replacing teeth with dental implants. A dental implant recreates the presence of a natural tooth. It provides stimulation to the bone, halting the process of bone loss.

Dental implants do not rely on neighboring teeth for support, as in a crown-&-bridge combination. The crowning of bordering natural teeth to support a bridge is not needed. Thus, the integrity of surrounding teeth is protected.

Because dental implants are supported by the jaw bone, sturdy and dependable biting and chewing strength is restored. Eating a healthy diet of the foods you love is again possible.

And, dental implants also have an exceptional success rate, higher than any implant-in-bone option. They are designed to last a lifetime, making them an excellent investment.

If you are considering dental implants to replace missing teeth, we invite you to begin with a consultation appointment. This will take place in a private room where we can discuss your needs and concerns. Call 828-274-9440 to schedule, or tap here for more contact information.

 

Some Internet Dental DIY Advice Can Result In Tooth Loss

Posted on Jan 30, 2023 by William J. Claiborne, DDS MS

With the internet and emergence of social media, there has been an explosion of information and “advice” now at our fingertips. Want to know how to remove a red wine stain, check the internet. Need recommendations on the most scenic route to a vacation cabin, google it.

Some of the pointers online are helpful. I was finally able to reprogram my garage door opener with help found on it. However, as a periodontal dental specialist in Asheville NC, I’ve been jolted by some of the dental “advice” I’ve come across. It has not been unusual for some of this info to result in patients who come to us with problems that were actually made WORSE!

From a dental standpoint, the most common I’ve seen over recent years are…

 

• Using ‘super glue’ to repair teeth:
Most of these chemical-laden glues are toxic. They are not intended to be ingested in any way in the human body. These toxins can seep into oral tissues, causing irritation and allergic reactions.

In some cases, glue sets by using an exothermic reaction, essentially a combustion reaction that generates heat. This can damage the dentin tubules housed within a tooth’s chambers. The risks to the tooth can include the need for extraction or a root canal.

Additionally, using these glues to try to re-attach a crown, broken bridge or a denture can actually make matters worse. For example, if a crown comes off, a dot of super glue may seem to be a quick fix and a way around a dental visit. Toxic risks aside, the DIY fit will most likely be inaccurate and can lead to misalignment with other teeth when chewing or speaking.

In turn, this can result in chips, fractures and breaks in neighboring teeth. Thus, when the patient proceeds to have the crown re-cemented properly by a dentist, the glue residue must first be removed. This requires resurfacing of the remaining natural tooth structure, which results in less structure to support the crown. Because of the change in tooth height, a new crown is commonly needed.

Dentists use special dental adhesives to provide the safest and most lasting option.

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• Scrubbing teeth rigorously when brushing:

Brushing teeth hard in a back-&-forth motion isn’t the way to do a good job. This can wear away tooth enamel and cause the gums to recede. Gum recession exposes tender and sensitive tooth root areas. This detracts from a smile’s appearance and also leaves the tooth vulnerable to the entry of oral bacteria.

A circular motion that allows the bristle tips to sweep the teeth is preferred. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.

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• Using home remedies to whiten teeth:
Natural teeth have a protective coating – enamel. Enamel is a hard, outer shell that prevents penetration of oral bacteria into the tooth. Without this protection, cavities can occur and teeth weaken, making cracks and fractures more likely. As hard as enamel is, it can be worn away. And, when it’s gone, it’s gone for good.

Although brushing too soon after eating can wear down enamel, there is nothing worse than the thoughts of a toothbrush with a peroxide-&-baking soda mixture scrubbing across precious tooth enamel. This is like sandpaper rubbing against a tooth!

For people who want to whiten their teeth, it’s typically more than surface stains that are discoloring teeth. Thus, sacrificing tooth enamel in an attempt to remove stains is going to be of little benefit. For many people with dull, brown or yellow teeth, the aging process and years of coffee, tea, smoking and red wine can require a deeper whitening process. This is why many dental offices offer whitening systems that are safe to teeth and gums.

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• Assuming blood in the sink is normal:
Your gum tissues serve as a sealant covering inside the mouth. Gums that are pink and wrap snugly around the base of teeth indicate healthy gums. Gum tissues that redden and become sore, swollen or bleed are gums signals that something is wrong. Seeing blood in the sink when you spit out toothpaste during brushing is NOT a sign you are doing a good job. It is a sign that bacteria has attacked and weakened your gum tissues.

As this bacteria progresses, gum tissues become spongy and breath odor is frequently bad. When oral bacteria has accumulated to the point of causing soreness and bleeding, prompt attention can restore the gums to a healthy state. This includes a dental cleaning and thorough at-home oral hygiene regimen. Untreated, the gums will become more and more damaged by oral bacteria and develop into periodontal (gum) disease.

Beneath the gum line, gum disease bacteria attack the bone structures that support teeth. And, these infectious bacteria can enter the bloodstream through tears in weakened gums. The oral bacteria of gum disease has been shown to cause inflammatory triggers in the body. Research has linked it to heart disease, stroke, some cancers, diabetes, arthritis, preterm babies, impotency and even Alzheimer’s disease.

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If you have symptoms of gum disease, please be seen by a periodontist promptly. Symptoms include tender gums that bleed easily when brushing, frequent bad breath, swollen and tender gums and gums that redden in color from a healthy pink. Gum disease will only worsen without treatment and is the nation’s leading cause of adult tooth loss.

Maintaining good at-home care of your oral health is easy and takes just minutes a day. Follow a thorough oral hygiene regimen by brushing twice a day (two minutes each time) and floss daily. Drink plenty of plain water throughout the day and limit sugar. Have dental cleanings every six months and follow your dental hygienist’s recommendations to keep oral bacteria at minimal levels between visits.

If you suspect you have gum disease or have delayed (or avoided) having regular dental care, call our Asheville periodontal dental office to schedule an examination. Or, ask to begin with a consultation appointment.

During this time, we can discuss any concerns. If dental fear is a factor, we offer several sedation options, including I.V. sedation (“twilight sleep”). Or, if there are financial constraints, we offer several payment plans that are interest-free with no down payment required. Call 828-274-9440.

Simple Ways To Keep A Healthy Smile Throughout The Coming Year

Posted on Dec 27, 2022 by William J. Claiborne, DDS MS

With a new year just ahead, I wanted to remind the smiles in our beautiful Western NC area about ways to have and keep a healthy one!

Nearly every problem that begins in the mouth is due to bacterial overload. Our mouths are constantly being supplied with sustenance for these organisms. Bacteria are able to thrive through the food that enters, especially sugars, and other bacteria-laden items put into the mouth. As bacteria thrive, they are able to reproduce very rapidly.

Insufficient care can lead to a build-up of bacteria, known as plaque. Plaque is a sticky film that forms on teeth when oral bacteria are not removed on a regular basis. In just 48 hours, plaque can harden into a mass that attaches to the base of teeth.

This hardened form of bacteria is known as tartar or calculus. Unlike plaque, tartar cannot be brushed or flossed away. And, once formed, it will continue to amass further.

As oral bacteria reproduce and accumulate, tooth enamel is attacked. The tight seal of gum tissues that surround the base of teeth become inflamed and loosen. This allows for the penetration of running-wild bacteria beneath the gum line. Once this infectious bacteria reaches this point, dental treatment (often ‘planing and root scaling’) is necessary to halt its continued development and restore healthy gums.

If untreated, the stages of gum disease worsen. Eventually, the infectious bacteria of gum disease are able to enter the bloodstream through weakened oral tissues.

Periodontal (gum) disease symptoms include sore gums that bleed when brushing, frequent bad breath, gums that pull away from the base around teeth, and gums that darken in color. As it worsens, pus pockets may form on the gums at the base of some teeth. In advanced stages, gum disease causes teeth to loosen and eventually require removal.

Gum disease often progresses because people are unaware that bleeding or receding gums is actually a symptom. Insufficient brushing, failing to floss and not having regular dental cleanings form a path that begin the process.

Gum disease is an inflammation that attacks teeth, oral tissues and the bone structures that support tooth roots. As the gums pull away from the teeth, darker portions of the tooth are exposed. These are tooth roots sections, now exposed without the protective layer of gum tissue over these areas, leaving teeth vulnerable to bacterial attack.

While the darkersegments of teeth detract from the appearance of a smile, they are also highly sensitive. Drinking hot coffee, eating ice cream or brushing across these areas can send a quick jolt of pain. In addition to periodontal disease, common causes for gum recession can include:

• Rigorous tooth brushing: Using a tooth brush with hard bristles or being too zealous when brushing can wear down enamel as well as gum tissue. Also, abrasive substances such as baking soda are too gritty for teeth and can wear down gum tissues.
• Smoking: A dry mouth is when saliva flow is insufficient to effectively wash bacteria from the mouth. The chemicals in tobacco are terribly drying to oral tissues, which creates an ideal environment for the formation of plaque. Plaque is a build up of oral bacteria that destroys gum tissue and contributes to recession.
• Grinding & clenching teeth: When you clench or grind your teeth during sleep, the force that is placed on teeth can be so strong that they begin to tilt out of  position. As this continues, the gums eventually pull away from teeth.
• Hormonal changes: Pregnancy, menopause and puberty can cause changes in hormone levels. These hormonal fluctuations can cause gums to feel tender and be more vulnerable to recession.
• Misaligned teeth: When not properly aligned, teeth endure added force to bite and chew. This can also place added strain to the TMJ (jaw joints), gums and bone that supports tooth roots. This can lead to gum recession.

To avoid the expense and treatment time of gum disease, commit now to thorough oral hygiene and regular dental check-ups and cleanings. Your at-home oral hygiene regimen should include:
– Twice daily brushing with a soft bristle tooth brush and use a fluoridated tooth paste. Brush for at least two minutes each time. Floss daily. Be sure not to pop the floss between teeth to avoid damaging tender gums. Move the floss in a back-&-forth motion between teeth to ease it down so you can scrape the sides of each tooth.
– Use a tongue scrapper daily or brush your tongue with your tooth brush at the end of each brushing. This helps to dislodge bacteria that is embedded in the grooves of the tongue.
– Keep the mouth moist by drinking plenty of water during the day. This will help keep saliva flow at ample levels. Saliva is designed to move oral bacteria from the mouth on a consistent basis. Avoid foods and beverages that are drying to oral tissues such as caffeine, alcohol, and spicy foods. Also, try to minimize the amount of sugar and carbohydrates you consume. These foods amplify the reproduction of oral bacteria.
– Smokers should consider using an oral rinse that replenishes moisture in the mouth. The chemicals in cigarette smoke are very drying to oral tissues. Some oral rinses are specifically designed to replenish oral moisture.

A periodontist is a dentist who has specialized skills in the diagnosis and treatment of all levels of periodontal disease. This specialist can also recontour the shape of gums and place dental implants for optimal results.

In our Asheville periodontal dental office, we feature some of the most advanced technology in dentistry, much of which is not available in other dental offices elsewhere in the Western Carolina region. These features are designed to help maximize comfort, shorten treatment time, speed healing and pinpoint areas of need for the most conservative treatment possible.

If you have not seen a dentist on a regular basis, you may be experiencing symptoms that indicate gum disease. As you would respond to a warning sign with your overall health, so should you with your oral health.

Begin with a thorough periodontal examination to determine what your needs are and the best way to achieve and maintain good oral health. You’ll be supporting your overall health in addition to having a confident smile.

If dental fear or anxiety have prevented you from regular dental care, ask about sedation options. We offer both oral sedation and IV sedation (twilight sleep). Both are safely administered and you are closely monitored by medical personnel who use advanced safety equipment throughout treatment.

Call 828-274-9440 for more information or to schedule an exam appointment.
 

The “Why” & “How” of Dental Implants

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

According to the Centers for Disease Control & Prevention (CDC), over one-fourth (26%) of American adults ages 65 and older have 8 or less natural teeth. The CDC equates this number (having 8 or fewer teeth) as “severe tooth loss” since it impacts an individual’s ability to thoroughly eat a healthy diet.

An even worse statistic shared by the CDC is 1 in 6 (17%) adults ages 65 and older have lost all of their teeth.

When it comes to losing natural teeth, they also share that the most vulnerable older adults are those who are poor, have less than a high school education, or are cigarette smokers.

Being totally edentulous (having lost all teeth) amongst the 65 or older age group has fortunately declined over the years. The CDC shared that the figure dropped by more than 30% from 1999–2004 (when it was 27%) to 17% in 2011–2016. At least American adults are moving in the right direction.

https://www.cdc.gov/oralhealth/fast-facts/tooth-loss/index.html

Tooth loss is a bigger deal than is assumed by a large segment of the population. When a natural tooth is removed, its absence causes a reaction that begins below the gum line. What occurs initially is typically not obvious. Yet, the repercussions of “resorption” can become quite the dilemma.

The absence of a tooth root in the upper or lower jaw bone is a loss of stimulation to the bone mass where it was once positioned. These roots provide both stimulation and nourishment that enables the bone to maintain a healthy mass. Without the presence of tooth roots, the bone begins to “melt away.” This process is known as resorption.

Think of the stimulation that tooth roots provide to how you might muscle atrophy. We all know that muscles, not used, will shrink in mass. When the jaw bones are lacking stimulation by the tooth roots they’re designed to hold, bone mass begins to shrink.

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

As the bone shrinks in height, the natural tooth roots adjacent to the area of missing teeth are subject to movement and root damage. On average, the next teeth you’re most likely to lose are the ones bordering areas of missing teeth.

Obviously, it is important to replace lost teeth before bone loss begins. For the support of remaining natural teeth, it’s also important to replace missing teeth as soon as possible so adjacent teeth can retain their proper positions. And, it’s HOW you replace them that’s most important.

Because dental implants replace the tooth above the gum line AND the root portion below it, the bone is able to retain its mass. Through the sturdy foundation of the jaw bone, dental implants are able to restore the look, feel and chewing stability like that of natural teeth.

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.

Our Western NC periodontal dental office features some of the most advanced technology available. This cutting edge technology is beneficial in a number of ways, with much specifically helpful in optimal dental implant diagnosis and planning. This includes:

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. 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 (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.

Ideal diagnosis is important, and 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 support a full arch of teeth.

Dental implants restore the ability to eat with stability, chew comfortably, laugh and speak with confidence. Dental implants do not decay and will never need root canals. They 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.

Dental implants come in many sizes and shapes, each system designed to accommodate various needs and preferences. This means your implant can be chosen to suit your long-term goals.

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.