Taking Prescriptions? Some Supplements Can Cause Problems.

Posted on Sep 27, 2016 by William J. Claiborne, DDS MS

As baby boomers age, a growing number are turning to alternatives to prescription medications. Thus, there has been a growing demand for natural supplements. It is estimated that over 15 million Americans are using vitamins and herbal supplements along with prescription medications.

Surveys estimates show that herbal supplements are used by 12 – 24% of the American adult population with usage of those aged 65 and older doubling from 1999 to 2002.

Since supplements are available over the counter (OTC), many adults don’t see them as medications. So, when a new patient is completing their medical history form, these are not always listed. They should be.

Both medical and dental health care providers need this information to determine how these supplements will effect your body’s ability to clot properly during procedures that cause bleeding. Too, excessive bleeding can occur when these supplements are not acknowledged prior to procedures.

A number of aging adults take prescription medications to prevent arterial or venous thrombosis and stroke. When completing your medical history form, most patients readily acknowledge their use of these medications and understand that some drugs increase bleeding during certain procedures or hamper their ability to clot when bleeding. Knowing the patient is on these medications enables the medical or dental caregiver to monitor bleeding and clotting before complications arise.

However, patients are less informed that the use of OTC medications can impact bleeding in conjunction with their prescription medications. Yet, according to the Natural Medicines Comprehensive Database, approximately 180 dietary supplements have the potential to interact with warfarin and more than 120 may interact with aspirin, such as clopidogrel (Plavix) and dipyridamole (Aggrenox).

The National Institutes of Health (NIH) identified these supplements as having the potential to cause adverse bleeding interactions:
• Anise
• Dong Quai
• Omega-3 fatty acids in fish oil
• Ajoene in Garlic
• Ginger
• Ginkgo
• Vitamin E
• Fucus
• Danshen
• St. John’s Wort
• American Ginseng

The Centers for Disease Control and Prevention (CDC) shows the supplements having the highest sales include ginseng, ginkgo blob, garlic, St John’s wort and ginger. It is not unusual for a patient to take up to seven dietary supplements at the same time with some taken inconsistently.

In addition, the following herbs may affect blood clotting:
• High doses of Vitamin E
• Alfalfa
• Coenzyme Q10

While more studies are needed to determine precisely how these supplements alter bleeding or interact with prescription medications, it is important for medical and dental professionals to have consumption information in order to properly plan for procedures.

Warfarin (Coumadin®, Jantoven™), an oral anticoagulant, is used prevent and treatment VTE (venous thrombo-embolism), PE (pulmonary embolism), and atrial fibrillation (A-Fib) patients who are at risk of embolism. Warfarin is highly affected by medication use. In fact, more food and drug interactions have been reported for warfarin than with any other prescription medication.

A study in England noted a high number of patients were taking herbal supplements along with warfarin. In a survey of nearly 1400 patients, it was found that nearly 9% regularly took one or more of garlic,  ginseng,  ginkgo biloba, feverfew, ginger, and St. John’s
wort. Yet, nearly all admitted to failing to share this information with any of their health care professionals.

In addition to many herbal supplements, alcohol has been found to increase bleeding in warfarin users along with Vitamin C and Cranberry juice. However, the herbal supplements that tend to complicate clotting ability the most during bleeding include:
• Bromelain
• Cat’s claw
• Dong quai
• Evening primrose
• Feverfew
• Garlic
• Green tea
• Ginseng
• Ginkgo
• Horse chestnut
• Red clover

In addition to Aspirin’s ability to reduce mild to moderate pain, inflammation, and fever, it is also used in the prevention of myocardial infarction (MI) and cardiovascular problems, such as stroke. Aspirin may also be advised as added therapy during procedures like coronary bypass. While many users of Aspirin realize it “thins the blood,” many regular users fail to notify their dental professional.

As a periodontist, I perform a number of procedures that cause bleeding to tissues in the mouth. It is important for your safety and a successful outcome of your procedure to have this information prior to treatment planning.

While filling out those often-lengthy medical history forms seem daunting, the information they provide is necessary. It is also necessary that it be complete. Herbal and vitamin supplements taken regularly should always be listed.

If you have questions, please call 828-274-9440.

Sedation Can Help Relax Dental Patients

Posted on Jun 10, 2016 by William J. Claiborne, DDS MS

In our office, many procedures involve incisions into tender gum tissues. As a Periodontal practice, it is necessary to penetrate periodontal tissue in order to treat some levels of gum disease. It is also necessary to open up gum tissues to place dental implants. And, in repairing gum recession, performing gum grafts or recontouring gum tissues, incisions may be part of the process.

We pride ourselves on providing optimal comfort to all patients – for any procedure. However, we are aware that many people have developed gum disease or lost natural teeth as a result of dental fear. Being afraid of dental visits prevents a great many adults from having regular dental care. As a matter of fact, it is estimated that nearly 70% of American adults have some level of dental fear.

Just as a general dentist does prior to a filling or extraction, we use novocaine to numb the areas in the mouth being treated. However, we also offer I.V. sedation to help patients be totally relaxed throughout their procedure.

For fearful patients, I.V. sedation (also known as ‘twilight sleep’) places them in a sleep state prior to and throughout their procedure. Although the patient may be able to respond to my request to things like, “Turn your head a little towards me,” they are essentially sedated to the point of snoozing. This removes the anxiety of anticipating things such as sounds or smells that may evoke thoughts of pain.

Another benefit of I.V. sedation is its ability to erase most or all memory of the procedure afterwards. While a few patients may remember hearing my voice a time or two, the time is generally erased from their memory. All most remember is a peaceful sleep.

I.V. stands for intra-venous, which is translated as “in the vein.” The sedation is administered by a drip into a vein, typically in the arm. Patients are in a sleep-like state very quickly thereafter. Throughout your time, you will be closely monitored by a trained staff member who uses advanced safety equipment.

Once your treatment is completed, the I.V. is removed and you will be monitored for a recovery period in our office. Your companion will then return you home where you will relax or even nap for a brief time until you feel back to normal. We do advise that I.V. sedated patients avoid driving or using machinery for 24 hours.

Some patients who have no dental fears prefer the relaxation effects of I.V. sedation. Certain procedures that require lengthy appointments can be tiring and I.V. sedation is an advantage to the patient in being comfortable while in a dental chair in one position for long treatments.

Our ultimate goal is to restore our patients to a healthy, confident smile. We believe this can be accomplished with gentle hands and a respectful environment. In many situations, sedation can be advantageous to providing a positive experience and successful outcome.

If you have dental fears or wish to discuss comfort options related to periodontal or dental implant procedures, feel free to call us at 828-274-9440.

 

Feel Good When You Smile, From The Inside Out!

Posted on Jun 01, 2016 by William J. Claiborne, DDS MS

What makes you smile? REALLY smile?

You may find yourself smiling joyfully when a child or grandbaby smiles at you. A favorite comic or a funny movie may cause you to open up and smile or laugh. Isn’t it great to smile? Smiling just seems to make us feel great!

However, certain reasons leave many adults feeling self-conscious about smiling, causing them to conceal their smile or ‘hold back’ rather than reveal a full smile.

An attractive smile looks good and creates an impression of an upbeat, happy individual. Healthy teeth and gums also project good health standards. And, people who feel good about their smile tend to smile more often.

The benefits of an attractive smile actually go much deeper than enhancing one’s facial appearance. Research has shown that smiling activates endorphins, which are the ‘feel good’ chemicals in the brain. Studies also show that faking a smile when you don’t feel like smiling tricks the brain into releasing endorphins.

Smiling can also add years to one’s life. Some studies indicate that people who smile more often can add ten years to their lifespans, on average. People who frown more often live an average of three years less!

There are a number of reasons that can make individuals feel less apt to smile openly. Cosmetic flaws, such as teeth that are stained or crooked, can detract from the appearance of a smile. As a Periodontist, I see people who have severe gum disease, missing teeth or a gummy smile.

If you are not smiling as often or as openly as you’d like, let’s start with the foundation of your smile — your gums. The health of your periodontal (gum) tissues provides the foundation for your teeth. If you are experiencing symptoms of gum disease, you may have gum recession. This is when the gums pull away from the teeth, exposing darker sections of tooth roots.

Gum disease also causes frequent bad breath and tender gums that turn red in color versus the pink tint of healthy gums. The disease can cause gums to bleed when brushing and eventually leads to loose teeth. In some cases, teeth have to be removed. As a matter of fact, gum disease is the nation’s leading cause of adult tooth loss. And, studies have shown that nearly half (47.2%) of American adults suffer with some level of gum disease. (https://www.perio.org/consumer/cdc-study.htm)

When teeth are lost, many people worry about wearing dentures or partials. Typical concerns are teeth that don’t look (or feel) natural, embarrassing slips, difficulty eating certain foods and chewing discomfort. These common problems have motivated many adults to opt for Dental Implants.

Dental Implants are positioned in the jaw bone, restoring the same, stable foundation as that of natural tooth roots. This restores your ability to bite and chew the foods you love comfortably and confidently. And, since the teeth attached to the implants are custom-designed for each individual, creating an improved smile appearance is incorporated into the process.

If a gummy smile prevents you from smiling widely, repairing it can be done in a single visit, in most cases. This repositions the gum tissue that arches the teeth most visible in a smile. For many who have a gummy smile, the procedure enables them to finally open up and smile without feeling awkward.

Crown lengthening can also add beautifully to the appearance of a smile. This recontours the gums so the smile line (the gums over teeth) is more even.

Healthy teeth and gums can make a dramatic improvement in one’s appearance, self-esteem, confidence level. Let this year be the year of your best smile! Begin with a consultation to discuss a confident smile that you’ll share openly and often! Call 828-274-9440 for an appointment.

Healthy Body Begins With A Healthy Mouth

Posted on May 23, 2016 by William J. Claiborne, DDS MS

As a dental specialist, I diagnose and treat a number of problems in the mouth. A Periodontist has advanced training in treating all levels of gum disease and other problems associated with gum tissues. We are also the experts in dental implant placement and recontouring gum tissues (such as repairing gummy smiles or gum recession).

In my specialty, I see the origins that can destroy a smile as well as complicate one’s quality of life. What happens in the mouth can create a downward spiral for the entire body. For example, periodontal (gum) disease can lead to tooth loss. Tooth loss can lead to eating a less healthy diet. Consuming a poor diet can lead to a decline in overall health and more gastrointestinal problems. And so on.

While tooth loss can be overcome with Dental Implants, the cycle of destruction that is possible from an overload of oral bacteria is a far deeper problem. As damaging as oral bacteria can be in the oral cavity (the mouth), the bacteria of gum disease can become bloodborne and cause severe reactions elsewhere in the body.

Here is how the problem begins: First, gum disease bacteria eats away at gum tissues in the mouth. This weakens the tissues, which are easily torn and bleed. Oral bacteria are then able to enter the bloodstream by penetrating these tears.

As the infectious bacteria travel through the body via bloodflow, they can trigger inflammatory reactions elsewhere in the body. This inflammation has shown correlation to some serious health problems, including heart disease, stroke, high blood pressure, arthritis, diabetes, pre-term babies, impotency (ED) and more.

Although the destruction of oral bacteria can be severe, and even deadly, it is also rather easy to prevent. The bacteria of gum disease occurs when there is an accumulation of oral bacteria in the mouth, typically as a result of poor oral hygiene at home. The age-old urging from the family dentist to brush twice daily, floss each day, and limit snacking on sugary treats stands true today.

When bacteria in the mouth are not removed thoroughly each day, they band together to form a sticky film, known as plaque. As this film remains, it takes just days to harden into a cement-like substance that attaches to teeth. This is calculus (or tartar), which is actually a massive colony of oral bacteria that is so destructive it can eat into tooth enamel.

As the oral bacteria reproduce and thrive, they subsist on gum tissues as sustenance. Gums become weak and bleed easily when brushing. Gums become tender and darken in color. Persistent bad breath sets in and pus pockets form at the base of some teeth. If not treated, gum disease will eventually lead to teeth loosening, requiring removal.

How many times in our lives have we wanted to turn back the hands of time and take proactive measures to prevent costly and time-consuming problems? It makes perfect sense to us that a car needs regular maintenance, sufficient oil levels and proper tire tread. Yet, having 6-month check-ups and cleanings seem less necessary since “nothing hurts.”

The mouth has been described as the window to the body. As research continues to find links between gum disease bacteria and serious health problems, this is becoming a more profound statement. It can also be said that the mouth is the moat to the castle. It can either serve to protect the structure (your body) or pollute it.

Just as you are committed to maintaining good overall health, remember that your oral health is a key component in that goal. Take the proper steps to avoid the pitfalls of gum disease, for your smile and your whole-health. If you are experiencing signs of gum disease, call 828-274-9440 for an exam. Gum disease will only worsen without treatment.

The Mayo Clinic has excellent explanations of periodontal disease. Visit the site at: http://www.mayoclinic.org/diseases-conditions/periodontitis/multimedia/periodontitis/img-20008444