Understanding Terms Associated With Gum Disease

Posted on Jan 23, 2017 by William J. Claiborne, DDS MS

Occasionally, I catch myself using dental terminology during patient conversations. As a Periodontist, ‘perio-talk’ is second nature to me. Deep down, however, I know it isn’t always clear to my patients.

I believe that patients are better participants in their oral health when they understand specifics of their individual needs. When I say ‘perio’ instead of ‘gum tissue,’ the patient doesn’t always ask for a better explanation, even though they may not be sure of the term’s meaning. This leaves us both at a loss – the patient doesn’t fully grasp their needs and recommended solution and I have a patient who is unsure of the ‘why’ and ‘how.’

Although dental implant placement and gum recontouring are regular treatments we provide, periodontal (gum) disease is the most frequent problem we treat. Gum disease affects over 47% of American adults and is the nation’s leading cause of tooth loss. It has been linked to heart disease, high blood pressure, stroke, memory loss, arthritis, diabetes, preterm babies and impotency.

Because gum disease begins without obvious symptoms, people often ignore the warning signs. This tends to allow the disease to progress further. As a basic explanation of how gum disease forms, I’ve listed the progression below — with dental terminology omitted!

• Oral bacteria – Bacteria in our mouths is normal. However, an overload of bacteria is how the problem begins. When oral bacteria are not removed on a daily basis, they amass and form plaque.

• Plaque – This is a sticky film that coats teeth and covers the gums and tongue. It can be felt by running the tongue over teeth at the end of the day before you brush. Plaque forms quickly, from the time you brush in the morning to the time of your evening brushing. The presence of plaque signals that your mouth is harboring more bacteria than saliva flow can rinse away. When plaque is not removed on a daily basis, oral bacteria thrive, reproduce, and harden into calculus.

• Calculus – Also known as tartar, calculus is a cement-hard mass of bacteria that develops from plaque. This colony of bacteria attaches to tooth enamel and can only be removed with special instruments used by dental professionals. This is why your 6-month check-ups and cleanings are so important. By preventing the formation of calculus or having it scraped off on a regular basis, you can avoid damage to gums and enamel.

• Gingivitis – This is the first stage of gum disease. Here, oral bacteria reproduce at a rapid rate while attacking gum tissues and tooth enamel. Signs of gingivitis are gums that bleed easily when brushing, sore gums, and frequent bad breath. When tended to promptly, gingivitis can be halted and reversed. Treatment requires twice daily brushing (at least two minutes) with a soft to medium bristle tooth brush and flouride toothpaste. Daily flossing is also needed to remove food particles and bacteria between teeth. Tongue scraping is advised to remove oral bacteria embedded in the grooves of the tongue. An alternative to a tongue scraper is to brush the tongue with your tooth brush. Be sure to get to the back of the tongue where the greatest concentration of bacteria are embedded. Drink lots of water and swish daily with an oral rinse that kills bacteria. Limit sugar-laden foods and beverages as well as caffeine (which is drying to oral tissues).

• Periodontal (Gum) Disease – When gingivitis progresses, the next stage is periodontal disease. This is when oral bacteria are at a deeper level, eating gum tissues and tooth enamel while creating inflammation. Typical symptoms are red and swollen gums, gums that recede and expose sensitive tooth root areas, and persistent bad breath.

• Periodontitis – This advanced stage of gum disease includes infectious bacteria that cause the gums to be red and tender all the time. In addition to the symptoms of previous stages of gum disease, pus pockets form at the base of some teeth. Some teeth will loosen as bacteria attack the structures that support tooth roots. Eventually, teeth will require removal. Even worse, this potent bacteria can enter the bloodstream through tears in diseased gum tissues. This has been found to trigger internal inflammation that has been found to contribute to the severe health problems mentioned prior (heart disease, arthritis, etc.).

I believe if the general population were more aware of the sequence that leads to full-blown gum disease, we’d have healthier adults, far less people who wear dentures or partials, and people who are enjoying confident smiles. If you are experiencing symptoms of gum disease, please remember that these will only worsen when treatment is delayed.

I hope I’ve provided a helpful explanation of how oral bacteria progresses and how it effects your oral and overall health. For an examination to assess the health of your gums along with recommended treatment options, call 828-274-9440 to arrange a consultation appointment. We will discuss your current situation and potential treatment options.

Reshaping Gums For Dramatic Improvements To Smile’s Appearance

Posted on Nov 07, 2016 by William J. Claiborne, DDS MS

When a Periodontist is mentioned, many people think the treatment we provide is dental implant placement and treating periodontal (gum) disease. However, another part of the periodontal specialty is reshaping gum tissues, known as periodontal plastic surgery.

In addition to the shape, shade and length of teeth, the gum tissue that surrounds teeth has a significant effect on the appearance of a smile. Think about a print you wish to hang on a wall. The matting and frame can have a tremendous role in how the print is displayed. Along the same lines, your teeth also rely on a balanced, properly-aligned amount of gum tissue, which is the frame around each tooth.

With unique expertise in the re-contouring of oral tissues, a periodontist offers several ways to improve a smile’s appearance.

Gum reshaping is often performed when certain teeth are bordered by more gum tissue than that bordering surrounding teeth. Crown lengthening is the procedure most commonly performed to correct this. This is usually done in conjunction with crown placement but may be possible in mild cases of excess gum tissue.

Crown lengthening creates an appealing, balanced smile line that frames each tooth with an arch that is balanced to that over adjoining teeth. This procedure typically requires only one visit with minimal healing time.

Another way that Periodontal Plastic Surgery can enhance the appearance of a smile is grafting to repair gum recession. Receded gums are the result of gum tissue that pulls away from the base of the tooth, exposing darker, more sensitive tooth root sections. Receded gums are often the result of age, bite misalignment, gum disease and too-rigorous tooth brushing.

Also referred to as Gingival Grafting, this procedure uses a small section of tissue from the roof of your mouth, which heals quickly. The section is placed over the receded area and allowed to heal (normally requiring only a week or two). The results restore the look of a healthy tooth with a natural gum arch.

Another example is repositioning gum tissues for those who are born with a Gummy Smile, or a gingivectomy. This creates a balance of gums to teeth for a more beautiful smile.

In a gummy smile, too much gum tissue is exposed above the teeth most visible in a smile. This causes many people to ‘hold back’ from smiling fully. Some with this trait smile with their lips only or conceal their smile with a hand.

The procedure to correct a gummy smile can be done in one visit. Excess gum tissue is removed and the remaining gums are arched over each tooth for a natural appearance. In most cases, porcelain crowns or veneers are placed to accentuate the natural look and feel of the teeth involved. The result is a fabulous smile that can be shared fully and joyfully!

The bonus of using a Periodontist to create an optimal outcome is the skill level needed to minimize disruption to the gums involved. Tender gum tissues heal faster and more predictably when the precision skills of a periodontal specialist incorporates their ability to tend gently and adeptly to each patient’s individual needs.

When it comes to your smile, your gum tissues are truly a significant part of its appearance. To improve the health and appearance of your smile, call 828-274-9440 for a consultation. During this time, I’ll gladly make recommendations and discuss specifics of each part of the process.

Men & Oral Well-Being

Posted on Oct 26, 2016 by William J. Claiborne, DDS MS

As a male, I’ve accepted the fact that there are certain things men don’t do as well as women. Actually, there is probably a long list! And, while some things like being slack when it comes to vacuuming and making the bed can be chalked up to ‘guys being guys,’ I know that other things are far more important; one of these being taking care of our oral hygiene.

Studies have shown that men, in general, are not doing a very good job when it comes to taking care of their mouths. It seems that men are less regular when it comes to caring for their oral health, less likely to have regular check-ups and neglect their oral health more often. Men are also less likely to visit the dentist when a problem does occur and tend to go only to resolve pain.

Males also brush their teeth less than twice a day, according to statistics. This leaves them means more likely to develop periodontal (gum) disease. On average, men will lose more than 5 teeth by the age of 72. Those who smoke will lose an average of 12 teeth by that age.

And, for men who wear a partial denture, they can expect higher levels of oral bacterial, which leads to greater challenges when it comes to preventing further tooth loss. This is because the material of a denture or partial that mimics the gums is porous. This provides a warm, dark and moist environment that is a perfect breeding ground for oral bacteria.

While many denture and partial wearers soak their appliance overnight, this merely delays the growth of oral bacteria, not halt it. The rapid reproduction of bacteria revs back up as soon as the appliance is back in a mouth that is already bacteria-laden.

For men with exposed tooth roots, this creates a higher risk for cavities. Aging, over-zealous brushing and a misaligned bite can cause gum tissue to pull away from teeth. Over time, the darker, more sensitive portions of the tooth are exposed. This area is actually  the root section of the tooth. While this detracts from the appearance of your smile, it also exposes a portion of the tooth that is more susceptible to bacteria. This can increase the risk for cavities.

Regardless of gender, adults who are on medications that have a drying effect on the mouth are more apt to have gum disease and cavities. Saliva removes oral bacteria and helps to reduce bacteria accumulation. When salivary flow is inadequate to keep the mouth well-rinsed, the risk for cavities increases. Dry mouth also increases your potential for bad breath.

Genetics on its own can leave both men and women more susceptible to the problems associated with oral bacteria. While all people have bacteria in their bodies, two kinds (referred to as SM and LB) are especially harmful to teeth. Those who have higher levels have a naturally greater risk for tooth decay.

It is important to maintain a good oral hygiene routine, whether male or female. At home, brush with a fluoride toothpaste twice daily, floss daily and be committed to your 6-month cleanings to avoid problems and catch those that arise early.

We want to help you avoid problems, which will save you time and money and help you avoid a life in dentures. Call (828) 274-9440 to schedule a consultation to begin.

Oil Pulling – Beneficial Or Bunk?

Posted on Oct 06, 2016 by William J. Claiborne, DDS MS

Occasionally, I am asked about the recent fad of oil pulling. The internet is full of followers of this practice who claim it pulls bacteria and toxins from the body.

Oil pulling is an ancient folk remedy that involves holding a tablespoon of coconut oil in the mouth for 5-15 minutes. It is swished around during this time and spit out at the end of the oil pulling period.

This action is supposed to draw impurities from the mouth. In most situations, coconut oil is used for this purpose but oils such as sesame, olive and palm may also be used.

Those who adhere to Ayurvedic health practices (an ancient, holistic medicine) claim this balances the body’s doshas, which are the energies that affect one’s physical, physiologic and mental state as well as their susceptibility to disease. However, most who practice oil pulling do so for its so-called oral health benefits.

Oil pulling to improve dental health is said to improve gum problems, remove plaque and whiten teeth. However, claims on the internet are not always reliable and what is in the best interest of your oral health deserves careful scrutiny.

Research has found that oil pulling has not lived up to some claims. For example, one study compared oil pulling to mouthwash as a method to reduce bad breath and oral bacteria. Findings showed that oil pulling was no more effective than mouthwashes that contain chlorhexidine, a common ingredient.

While research did not refute that there were some advantages to oil pulling, the American Dental Association (ADA) cites a “lack of science” and does not recommend oil pulling as either a supplement to oral hygiene nor as a replacement for standard oral health treatments.

The ADA is also keeping a watchful eye over claims in research being conducted, citing that some past studies have been inadequate to support claims of oil pulling. They feel that results have been based on too small samplings, not adjusting for demographic variations and failure to incorporate blind testing.

Additionally, the ADA stated, “scientific studies have not provided the necessary clinical evidence to demonstrate that oil pulling reduces the incidence of dental caries, whitens teeth or improves oral health and well-being.”

The leading concern in the dental profession is that it has prompted some people to rely on oil pulling to fully replace standard oral care practices. Twice daily brushing and daily flossing have proven to be safe and effective methods of achieving and maintaining good dental health. Substituting this routine for oil pulling is an uncertain way to prevent cavities and periodontal (gum) disease.

As a periodontal specialist, I don’t see oil pulling as detrimental when it is an addition to a proper oral hygiene regimen at home. However, I am troubled by unsubstantiated claims that inspire people to alter time-tested methods for maintaining a healthy mouth.

Some people may remember when baking soda was touted as a powerful cleaning substance for brushing teeth. Yet, those who abided by the practice worn down healthy gum tissues and wore away protective tooth enamel. This set them up for easy penetration of oral bacteria that resulted in cavities and gum disease.

While oil pulling likely won’t do harm, it is probably best done in conjunction with a thorough brush-&-floss routine.