Missing Teeth? HOW You Replace Them Will Make the Biggest Difference.

Posted on Oct 23, 2023 by William J. Claiborne, DDS MS

I remember a time when people assumed they would lose their natural teeth as they aged. Wearing full dentures in one’s senior years was almost an expectation. However, today’s adults are less accepting of “false teeth.”

Over time, adults have learned that the removal of a natural tooth has lasting repercussions. Although the tooth may have been removed because of decay or a break, the long list of problems and associated expenses are generally far greater than what was anticipated. I’ll explain.

When a natural tooth is removed, its absence causes a reaction that begins below the gum line. Without the presence of tooth roots, the bone begins to “melt.” This process is known as resorption.

The absence of a tooth root in the upper or lower jaw bone removes stimulation to the bone mass where it was once positioned. Along with the stimulation, natural tooth roots channel nourishment needed for maintaining a healthy mass.

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. For people who sleep with their dentures, the 24/7 pressure on the gum ridge speeds up the pace even more.

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. Yet, merely replacing the presence of a tooth above the gum line leaves the underlying risk factors in place. Over time, problems arise for most individuals.

There are many reasons we recommend dental implants for tooth replacement, whether for one, several or a full mouth of missing teeth. 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 able to restore a natural biting strength with dependable stability. Having the ability to bite and chew efficiently and enjoy a diet of foods you love enhances eating pleasure and proper digestion. It’s no surprise that people who wear dentures have more gastrointestinal problems than those who have their natural teeth.

Another advantage to dental implants is their 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 to properly diagnose and place the most appropriate dental implant system for your needs and goals. As an Asheville periodontist with over 30 years of experience in dental implants, I have a reputation for treatment that provides the most successful outcome based on each patient’s unique needs – and by the most conservative means possible. Thus, the patient avoids having more time and expense involved than is necessary.

We are also known for providing a high level of patient comfort through the administration of IV sedation (twilight sleep) with our on-site Board Certified Anesthesiologist. Additionally, diagnosis and treatment planning is backed by images from our on-site 3D Cone Beam imaging.

Our Western NC periodontal office is fully prepared for the placement of dental implants. We tend to our patients in an efficient and effective manner so treatment occurs in minimal time and to an exceptional level of comfort.

We receive many patients who have been referred by their physician, dentist, and past/present patients, often because of our advanced skills and the respectful environment we provide. Here, each patient is treated with the same respect, compassion and gentle hands that we would want for ourselves and our loved ones. We take great pride in knowing our patients experience the finest periodontal and implant care in the Southeastern U.S.

A periodontist is a dental specialist who is trained to understand the intricate concepts involved in selecting the proper type of implant and skilled at placing implants at proper depths and angles. A periodontist is also able to optimize patient comfort during treatment and throughout the healing phase.

In addition to this advanced training, our office offers some of the most advanced technology available. This aids in the diagnosis and treatment planning of dental implants, providing patients with optimized comfort and outcomes. This technology, combined with our advanced skill level, creates a comfortable, efficient experience that helps you enjoy a lifetime of confident smiles.

Dental implants are also designed to last a lifetime. I can think of very few things that provide this kind of value. With proper selection and maintenance, they will never need replacing or repair, making them an excellent investment.

If you are considering dental implants, increase your potential for a successful outcome by asking a Periodontist to join your dentist in team treatment. Most general dentists have close relationships with periodontal specialists for implant placement, gum reshaping and in the treatment of gum disease.

If you have lost natural teeth or are facing the potential of tooth removal, call 828-274-9440 to schedule a consultation. This will occur in a private, comfortable consultation room conveniently located in our Asheville periodontal dental office. During this time, we’ll discuss the implant systems that may work best for your needs and preferences. I’ll explain the treatment involved, sedation options and estimated fees.

A “Lecture-Free” Look At Cigarettes & Your Smile

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

In this article, I’m going to address cigarette smoking as it affects oral health. This is not intended to lecture or chastise an adult for making a choice to smoke or those caught up in the addictive grip of nicotine. My goal is to relay factual information regarding oral health for smokers so they can better protect their smiles.

Because I’m a native North Carolinian, I’ll begin by sharing some information on our State, as provided by 2018 stats from the CDC (Centers for Disease Control & Prevention).

In 2018, the percentage of adults in North Carolina who smoked was reported as 17.4% (of every 100 adults). The CDC shared findings of all states, with smoking ranged from nearly 9 of every 100 adults in Utah (9.0%) to 25 of every 100 adults in West Virginia (25.2%).

They also shared that cigarette smoking was lowest among those with a graduate degree (3.2%) and highest for those who had only achieved a GED certificate (30.7%). Those with a high school diploma showed a lower percentage of nearly half of the GED level adults at 17.1%.

As an Asheville periodontal dental specialist, smoking is a particular concern since many people are unaware of the oral health risks. While many smokers are familiar with the risks smoking poses related to cancer and other diseases, smoking is also terribly harmful to your smile.

For instance, smokers have a greater risk of periodontal (gum) disease. The drying effect that smoking has on the soft tissues in the mouth offers an ideal breeding ground for oral bacteria. This enables easier entry of oral bacteria into the structures that support tooth roots.

According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared to that of a nonsmoker.

As oral bacteria thrive and reproduce in the mouth, gum tissues become tender and inflamed. These are signs of gingivitis, the beginning stage of gum disease.

Gum disease at this stage can cause persistent bad breath, swollen gums and gums that bleed easily when brushing. As it progresses, gum tissues turn red or purple from inflammation. Pus pockets may form at the base of some teeth. This advanced stage is known as periodontitis.

Eventually, the infectious bacteria penetrate below the gum line and attack supporting bone and the tissues surrounding tooth roots. This can cause teeth to loosen and eventually require removal. Gum disease is the nation’s leading cause of adult tooth loss.

Losing teeth is detrimental to your overall health and not a normal part of the aging process. Studies have shown that people who wear dentures die an average of ten years earlier than those who keep their natural teeth.

Denture wearers also have higher incidences of pneumonia, and worse. A 2015 report by NBC News shared findings surrounding dentures and MRSA biofilm. The report included a dental specialist’s warning that, “Concern about biofilms on dentures is growing as researchers continue to identify links between oral bacteria and heart disease, chronic obstructive pulmonary disease or COPD, and respiratory diseases, including aspiration pneumonia.”

Many smokers are aware that they have stained teeth and more-frequent bad breath than non-smokers. They also have slower healing periods after procedures such as extractions, gum treatment and oral surgery.

Although a hygienist may go slowly and gently, dental cleanings are typically less comfortable for smokers. This is because smoking causes a greater buildup of plaque. With gum tissues already tender from the bacterial irritation of plaque, removing buildup from between and around the base of teeth adds to the discomfort of inflamed tissues.

According to the American Dental Association (ADA), smoking increases the risks of oral cancer, lesions inside the mouth, enamel erosion and tooth loss in addition to periodontal (gum) disease.

If you vape, remember that nicotine in any form is a hazardous force in the mouth. And the vapor itself is not safe for oral health.

Vaping (using e-cigarettes) delivers nicotine through an inhaled mist. Although the vapor is generally not labeled as “dangerous,” one study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, including, propylene or polyethylene glycol, glycerin, and additives. And, its nicotine is no less harmful to the user as that delivered via cigarette smoke.

Unfortunately, many cigarette users switch to vaping based on the perception that “e-cigs” are a safer alternative. For those hoping to wean themselves off cigarettes through this switch, very few achieve that goal as a result.

A 2018 report by the National Academy of Sciences, Engineering, and Medicine concluded there was “evidence that e-cigarette use increases the frequency and intensity of cigarette smoking in the future.”

Although the focus in this article is meant to be on oral health, allow me to reiterate some of the benefits of “kicking the habit” …

• Smokers have a decreased life expectancy of an average of 10–15 years compared to non-smokers.


• Smoking is linked to nearly a third of all cancer diseases and deaths.


• Pregnant women who smoke have a higher risk for first-trimester spontaneous abortion, preterm births, low birth weight babies and sudden infant death syndrome (SIDS).


• Women who smoke are at risk for early menopause while men who smoke are more at risk for impotency.


• People who breathe in your “second hand” smoke (what you exhale) are subjected to over 50 known carcinogens and other harmful chemicals.

For those who are able to give up smoking, the effort is well worth it. The positive effects can be felt almost immediately. In about 48 hours, damaged nerve endings begin to restore. The sense of smell and taste begin to return to normal.

“Quitters” also notice their breathing is easier in about 3 days and they have fuller air intake. Oral health improves within 2 weeks as blood circulation in the gums and teeth returns to nearly that of non-smokers. Heart attack risk also declines with blood flow greatly improving. Activities are easier and the constant smokers cough is gone.

In our Asheville periodontal office, our goal – for every patient – is to help each achieve optimal oral health and a smile he or she is proud to share. For those who smoke, we make individualized recommendations so the potential for achieving this is favorable.

If tooth loss has already occurred, we are specialists in the treatment of all stages of gum disease and in the diagnosis and placement of dental implants. We will be happy to discuss the dental implant system that may be best for your needs.

Or, if dental fear or anxiety have kept you from receiving regular dental care, ask us about oral or IV sedation (“twilight sleep”). These sedatives are delivered by an MD of anesthesia for your optimal safety and comfort. And, in all procedures, we make patient comfort a high priority.

Call 828-274-9440 to schedule an examination.

Sources:

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm#:~:text=This%20means%20an%20estimated%2028.3,with%20a%20smoking%2Drelated%20disease.&text=Current%20smoking%20has%20declined%20from,every%20100%20adults)%20in%202021.

https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html

https://www.sciencedaily.com/releases/2016/11/161116101821.htm

https://www.nbcnews.com/healthmain/dirty-dentures-dangerous-mrsa-may-be-lurking-dentists-say-662637

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm

Common Contributors to Tooth Loss

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

Our natural teeth seem hard and solid, able to endure much over the span of a lifetime. However, as we all know, teeth can be knocked out due to accidents or injury and lost due to becoming overly decayed, fractured, infected and – the leading cause – periodontal (gum) disease.

Your gum tissues serve as protection for the tooth structures you cannot see – the tooth roots and bone and tissues supporting the roots. And, teeth need these bone structures to stay healthy and vice versa; the bone structures beneath the gums need the presence of the roots to stay healthy.

The jaw bones are kept healthy by tooth roots that provide stimulation to the bone as well as nourishment that runs through the tooth’s interior.

When a tooth is removed, so is the stimulation and nourishment to that area of the jaw bone. Without it, the bone begins to shrink. As it declines in height, 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.

According to the Center for Disease Control & Prevention (CDC), 69% of adults between ages 35 – 44 have lost at least one permanent tooth. By age 50, Americans are missing an average of 12 teeth. For adults between the ages of 65 – 74, 26% are missing all of their natural teeth. That’s over one-fourth of the adult population over age 65.

Because of the strength and seemingly rock-solid presence of teeth, it may be assumed they’ll last for a lifetime. And, they can. Natural teeth can and should last a lifetime with proper maintenance and care. However, certain things can contribute to tooth loss; some of these may not be well known.

These include:

GUM DISEASE – Signs and symptoms of gum disease are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

When these indications exist, it is important to seek periodontal treatment as soon as possible. Gum disease only worsens without treatment, requiring more time and expense to rid this serious, even deadly, inflammatory disease.

NOT FLOSSING – While tooth brushing helps to keep oral bacteria levels in the mouth to manageable levels, daily flossing is also recommended as a preventative way to keep cavities and gum disease at bay. Still, 70% of the American adult population do not floss daily. Even worse, about a third of Americans admit to never flossing (39% of men and 27% of women who do not).

SMOKING – According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker. (https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)

AGING – With age, the body becomes less efficient in maintaining itself. Due to hormone changes and being less hydrated, joints wear down, skin loses subtlety and muscle mass and strength declines. The same is true with teeth, especially as gum tissues dry out. This means their tight, protective grip around the base of teeth loosens and pockets can easily for between teeth. All these factors contributor to higher risks of gum disease and tooth loss.

ORAL DRYNESS – The tissues inside the mouth need to be kept moist. Saliva flow is designed to do this. However, with age, the flow of saliva is less plentiful. Just as the skin and hair get drier with age, the mouth endures this same consequence. When saliva flow is less efficient at rinsing bacteria from the oral cavity (inside of the mouth), bacteria grow at a more rapid rate. This means bacteria accumulation occurs more frequently than twice-a-day brushing can control.

MEDICATIONS – The average adult in the 65-79 age group has over 27 prescriptions filled each year. (https://www.statista.com/statistics/315476/prescriptions-in-us-per-capita-by-age-group/). Many meds have the side effect of oral dryness or increased bleeding, including some herbal supplements. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting.

To halt the potential for tooth loss if you are already missing teeth, dental implants are recommended. They actually protect the health of neighboring teeth. In addition to helping the supportive bone structures retain bone mass, teeth supported by implants do not rely on the support of crowned (or ‘capped’) teeth on both sides. This means the integrity of adjacent teeth is preserved.

Dental implants come in over 40 different types designed to accommodate various challenges and preferences. This is one reason (of many) that a periodontist is an ideal choice for the diagnosis and placement of your implants. Our speciality understands the complete spectrum of implant systems. While some implant systems may be ideal for your needs, others may not. And, the choice of which will achieve your goals is not limited to just those types a non-specialist knows how to place.

For example, some dental implants provide you with a non-removable (“fixed”) option while others may involve removable teeth. Additionally, the proper selection of your dental implants may greatly save you in treatment fees.

For example, the All-On-4 dental implant system needs only 4 implants per arch, and can be placed in shallow bone. The treatment fees are less since the number of implants is low and the need for bone regeneration for severe bone loss may not be required. For these reasons, a periodontist may be able to help you achieve your tooth replacement goals within a budget you can manage.

Our Western NC periodontal dental office features some of the industry’s most advanced technology, which helps to optimize success rates, shorten treatment time, and enhance comfort. This includes 3-D Cone Beam imaging, which is ideal for diagnoses and treatment planning. These amazing images provide a clear view of the upper and lower jaw (including nerve canals) in a process that is quick, painless and at minimal radiation levels.

We also have a computerized Dental Implant Placement system for pre-surgical positioning of dental implants. Using a 3D model of the patient’s jaw, a template is developed for the most conservative treatment process needed, even for complex cases. This minimizes disruption of gum tissues and targets implant placement at ideal depths and angles.

Because we make patient comfort one of our highest priorities, 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.

If you have lost teeth (or struggle with a denture or partial) and are considering dental implants, begin with a consultation appointment. Call 828-274-9440. New patients are always welcome.

How the “Bad” Bacteria in the Mouth Can Lead To Serious Health Problems

Posted on Aug 08, 2023 by William J. Claiborne, DDS MS

The human body is a fascinating structure. It seems every year there are new findings that show just how complex and amazing it is.

Recently, one of the biggest areas of interest has been the study of microbiome in the body. Once thought to be icky little cesspools, these colonies of microorganisms are now seen as having an important role in our health. For example, the microbiome in the gut has been shown to aid in digestion and it’s now seen that skin microbiome may potentially help people overcome conditions like acne and eczema.

As a periodontist, I’ve followed research in how microbiome is being recognized for having a positive role in oral health. While bacteria that convert sugar to acid are the driving force behind tooth decay, this means that those critters in our mouths are not always bad guys.

There are about 700 different species of bacteria in your mouth. Some can be “bad,” yet the good bacteria are able to give our overall health a “leg up” in certain regards.

Certainly, having a clean, healthy mouth helps to prevent cavities and periodontal (gum) disease. However, read on to learn how the health of your mouth can contribute to your overall health to a rather significant extent.

Over the years, numerous studies have been able to pinpoint how diseases – such as heart disease, diabetes, arthritis, and more – might be triggered. The “trigger” seems to consistently link back to internal inflammation.

Inflammation in the body has been shown to set actions into play that cause the onset or worsening of a wide variety of health problems. Periodontal (gum) disease is a chronic inflammatory disease. This means the bacteria attacking gum tissues are in a consistently active state.

When the bacteria of gum disease enter the bloodstream (through tears in weakened gum tissues), it can create inflammatory triggers far beyond the mouth. This bloodborne inflammation, in turn, results in higher risks for heart disease, stroke, diabetes, preterm babies, arthritis, respiratory diseases and even impotency.

How can this occur?

In chronic inflammation, the body’s defense mechanism becomes stuck in the ‘on’ position. This sets off a chain of reactions that alter the helpful response of the immune to a harmful one. When an area in the body stays in an inflammatory setting, damaging reactions can occur.

Once in the bloodstream, several species of harmful gum disease bacteria can add to existing inflammation, including that in the arteries, where it can lead to heart attack and stroke.

In one study of 265 stroke patients, researchers found that patients with gum disease had twice as many strokes (due to thickening and hardening of brain arteries) as patients without. Additionally, patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.

In a separate study of over 1,100 patients who had not experienced a stroke, researchers noted that 10% had severely blocked brain arteries. They also found that patients with gum inflammation were twice as likely to have moderately severe narrowing of brain arteries.

Another example is in the similarities between tissues of gum disease and those taken from arthritic joints. Studies show that gum disease is not only a risk factor for arthritis (both are inflammatory diseases), one can contribute to the other. Thus, gum disease is a risk factor for developing RA and arthritic patients have a greater risk for gum disease.

Additionally, people with diabetes are more likely to have periodontal disease than people without it, likely because they’re more susceptible to contracting infections overall, according to the American Academy of Periodontology.

Studies also show that pregnant women with periodontal disease have a greater risk of having pre-term and low birth weight babies. These indications have been found in amniotic fluid and in fetal cord blood samples of infants.

Findings show, too, that the bacteria of periodontal disease may contribute to a higher risk of pancreatic cancer. For years, researchers at the National Cancer Institute and the American Cancer Society have conducted cancer prevention and screening studies.

By studying oral samples, notably higher levels of two types of oral bacteria were measured in study participants with pancreatic cancer. One oral bacteria was found to create a 50% increased risk for pancreatic cancer and the second oral bacteria led to a 59% greater likelihood.

Chronic inflammation, in any area of the body, is a health risk that poses severe health challenges now highly recognized in the medical field. Not surprisingly, we occasionally see patients who have been advised by their surgeons to have their gum health checked prior to surgery. This proactive measure is to reduce risk factors that could complicate surgical outcome.

Your body’s natural defenses along with good oral hygiene — such as daily brushing and flossing — helps to keep bacteria under control. Also, people should readily recognize the signs and symptoms of periodontal disease.

Healthy gums fit snugly around the base of teeth and be a light pink color. Although the initial stage of gum disease (gingivitis) may exist without obvious symptoms, common signs of gum disease include:

• Swollen or puffy gums
• Bright red or purplish gums
• Gums that feel tender or bleed easily
• Spitting out blood when brushing or flossing
• Frequent or persistent bad breath
• Pus pockets between some teeth and gums
• Loose teeth or a change in the way teeth fit
• Painful chewing
• Gums that pull away from teeth or are sensitive to heat and/or cold

Maintaining good at-home oral hygiene is easy and takes just minutes a day. Brush 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 and I’ll answer your questions. Call 828-274-9440.

Let’s help you achieve a healthy, confident smile that adds to the well-being of your overall health!

Sources:

https://www.jnj.com/innovation/4-things-scientists-know-about-the-bacteria-in-your-mouth

https://www.nih.gov/news-events/nih-research-matters/identifying-new-contributor-tooth-decay

https://pubmed.ncbi.nlm.nih.gov/26474422/

https://www.reuters.com/article/us-health-periodontitis-erectile-dysfunc/chronic-gum-disease-tied-to-risk-of-erectile-dysfunction-idUSKBN13K1UP

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

https://www.cancer.org/research/cancer-facts-statistics.html