A Periodontal Specialist Explained

Posted on Dec 13, 2019 by William J. Claiborne, DDS MS

Occasionally, I meet someone new who is unfamiliar with my specialty. Although a periodontist may seems to be a “behind the scenes” specialist, our focus actually has an upfront role in your oral health, and beyond.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school.

In addition to having advanced training in the latest techniques for diagnosing and treating periodontal disease, a periodontal specialist is also trained in performing cosmetic procedures that involve gum tissues, such as correcting a “gummy smile”.

Periodontists often treat more problematic periodontal cases, such as people with severe gum disease or have a complex medical history. A periodontist offers a wide range of treatments, such as scaling and root planing (cleaning the infected surface of the root) or root surface debridement (removing damaged gum tissue).

Periodontal specialists can also treat patients with severe gum problems using a range of surgical procedures.

In addition, periodontists are specially trained in the placement, maintenance, and repair of dental implants.

During the initial appointment in our Asheville periodontal office, we typically begin with a review of the patient’s medical and dental histories. This information is important so we are aware of medications being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.

During the examination, we check the patient’s gums to look for gum line recession. We will also assess how the teeth fit together when biting, and check for any loose teeth. An important part of this exam is in the measuring of spaces between gum tissues at the base of teeth.

Using an instrument called a probe that is gently positioned between specific points surrounding each tooth, we determine the depth of periodontal “pockets”. These measurements help us assess the health of your gums. Images (x-rays) may also be taken to revealsthe health of the bone below the gum line.

Periodontal disease, also referred to as “gum disease,” often exists without an individual being aware of its presence. In its early stage, gingivitis, some people even assume that symptoms, such as seeing blood in the sink when brushing, are normal.

Obvious symptoms, such as pain, may not appear until the disease has reached an advanced stage. This is why it is important to be familiar with the signs and symptoms, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding (pulling away from the teeth) or make the appear teeth longer than normal
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

If you notice any of these symptoms, be sure to contact your dentist or periodontist without delay. Gum disease will only worsen without treatment.

Who Should See a Periodontist?
Some patients’ periodontal needs can be managed by their general dentist. However, patients who are experiencing signs and symptoms of moderate or severe levels of gum disease or have more complex cases receive the most efficient and effective care through team treatment between a general dentist and periodontist.

Restoring your gums to a healthy state is important! As research continually shows, gum health is intricately connected to overall health. Oral bacteria of periodontal disease has been linked as a trigger for more and more chronic diseases, including heart disease, some cancers, stroke, memory loss, diabetes, and arthritis. Having prompt periodontal treatment by a trained periodontal specialist may lower the risk for more serious, and even deadly, diseases and health conditions.

If you are experiencing any of the symptoms associated with periodontal disease, a referral is not required. Call 828-274-9440 and we will be happy to assist you.

If you do not have a general dentist, we can also refer some who are near to you and we know to provide gentle, thorough and appropriate care for their patients’ needs.

Asheville Periodontic Specialty Office Offers Latest To Enhance Treatment Outcomes, Comfort.

Posted on May 13, 2019 by William J. Claiborne, DDS MS

As an Asheville NC periodontist, I know it is more than my specialized skills that keep us busy. Many dentists and other dental specialists refer patients to our office because they know each patient receives optimal care with a gentle, respectful touch.

Another thing we are known for is the state-of-the-art technology we use to save patients time while they achieve the very best results in minimal treatment time. Some of our advanced features available include:

LANAP Protocol Using PerioLase MVP-7 – An acronym for Laser-Assisted New Attachment Procedure, LANAP provides an advanced protocol to more efficiently and effectively treat periodontitis (advanced gum disease) with the PerioLase® MVP-7™ laser. This offers a minimally invasive (non-surgical) treatment alternative for patients with moderate to severe periodontal disease.LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

Dental Radiology With 3-D Cone Beam Technology
 – We rely on 3D imaging in diagnostic and treatment planning. This latest level of 3D imaging covers the whole dentition area, giving a clear view of the mandible and maxilla (upper and lower jaw) for intricate review for the diagnostic requirements of endodontics, periodontics, orthodontics, implantology, TMJ and prosthodontics as well as dental and maxillofacial surgery.

In addition to imaging, cone beam radiographs provide images in sagittal, axial, and coronal planes. This makes it possible to locate and trace the mandibular nerve canal for pre-surgical planning for an ideal implant position.

We also like that our patients are exposed to only minute levels of radiation through a process that is fast and comfortable.

CareStream Cone Beam Computer Tomography Imaging
 – Our office features the Carestream 9300. This Cone Beam Computer Tomography provides dual modality panoramic and 3D imaging with exceptional detail and range. The CS 9300 can deliver 3D imaging at a significantly lower dose than 2D panoramic imaging. In fact, in a recent study, the CS 9300 and CS 9300 had up to an 85% lower radiation dose than traditional panoramic imaging.

CS 3600 intraoral scanner
 – No longer do our patients have impressions made with bulky, goopy trays held in their mouths!

The CS 3600 Scanner is designed to quickly and comfortably scan areas inside our patient’s mouth. It acquires digital impressions accurately and easily, scanning a full or dual arch for the fabrication of digital models or appliances.

The CS 3600 provides a highly accurate digital impression using a small, handheld scanner. It can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Just some of the superior features of the CS 3600 Scanner include:

• Acquires digital impressions to design crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments and RPD;
• Has an Intelligent Matching System that prevents missing data in any area. Plus, it even sends a warning to indicate areas of the scan that lack detail;
• Has adaptive hole filling that automatically identifies holes and selects the appropriate anatomical color for optimal aesthetic outcomes;
• Enhances outcomes for restorations, orthodontics and implants; and,
• Displays precise, accurate HD 3D color images with vivid color and details for improved case review, analysis and communication between doctors, referrals and labs.

Simplant Dental Software for Computerized Dental Implant Placement
 – This advanced software system allows for pre-surgical positioning of dental implants on the computer using a 3D model of the patient’s jaw. Once the implant type is selected, a surgical template is developed that ensures a precision fit. Simplant creates optimal implant treatment success, even for complex cases. It also simplifies the team treatment process so intricate aspects of the surgical process can be discussed prior to placement.

Intraoral Camera Technology – 
This self-contained intraoral camera features full motion video with outstanding image quality from an internal camera that captures ideal angles and images with the click of a button. The images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment issues.

Computer Imaging In Treatment Suites
 – Treatment suites are equipped with computers for convenient image sharing with patients. This allows patients to have a more complete understanding of their individual needs through images that can be pulled up by our dental team, with the ability to enlarge certain areas to show specific details. Through this, patients have greater involvement in treatment decisions.

Advanced Sterilization – Our custom sterilization unit is designed to adhere to or exceed established Centers For Disease Control & Prevention (CDC) guidelines for instrument processing protocols. Intuitive colored lighting identifies the receiving and cleaning of instruments.

Fully-Equipped Surgical Suites – Relax during treatment (under sedation, if desired) while you are surrounded with the serene views surrounding our Asheville periodontal office.

So you see, we are committed to providing each patient with advanced skills, experience, comfort, and technology that provides the very best in periodontal and dental implant treatment available.

If you have experienced periodontal (gum) disease or are considering gum recontouring or tooth replacement with dental implants, being referred is not always needed. Call our friendly staff to discuss your needs: 828-274-9440.

Don’t Let Misaligned Teeth Lead To Tooth Loss.

Posted on Feb 25, 2019 by William J. Claiborne, DDS MS

As a periodontist, I have specialized skills in treating all stages of gum disease (known as periodontal disease, or simply “perio” by some). I also have advanced training in the diagnosis and placement of dental implants.

Although my specialty does not cover the advanced training an orthodontist has in bite alignment, my dental education absolutely covered the benefits of having proper “occlusion.” It also covered the repercussions of NOT having a bite that is properly balanced.

Just as an orthodontist can spot telltale signs of gum inflammation, I (along with general dentists and most dental specialists) can see indications of teeth that are not working in unison — even at times when these teeth appear to be “straight.”

While the nation’s number one cause of adult tooth loss is gum disease, having a misaligned bite function (or “malocclusion”) can lead to tooth loss in ways you may not have realized.

For example, during chewing, the upper teeth and lower teeth are designed to work harmoniously together to grind food down for swallowing and digesting. When an upper tooth does not interact smoothly with one below it (or vice versa), a tooth can become chipped, broken or fractured.

When damage to a tooth occurs, it must be quickly repaired before oral bacteria can penetrate tooth structures. Without the protection of enamel, oral bacteria can cause tooth decay and gum disease.

A fracture in a tooth can expand over time, leading to a crack that loosens an entire segment of a tooth. These areas must also be repaired before the tooth is subjected to oral bacteria. This typically requires a crown (or “cap”) that is placed over the top portion of the tooth.

However, a crack in a tooth that extends into the gum tissues typically means the tooth must be removed. If a portion of the tooth breaks “just below” the gum tissue, the tooth can sometimes be saved by a procedure we do called a “crown lengthening.” This is often known as a gingivectomy and is performed to remove excess gum tissues.

A gingivectomy procedure exposes more of the natural tooth so a crown can be placed over the tooth to preserve its remaining structure. (For people who have a “gummy smile,” this is performed, also, to reduce the amount of gum tissue that arches over teeth most visible in a smile.)

Another hazard of bite misalignment relates to dental implants. The overall success rate of dental implants is very high, nearly 98 percent by some estimates (when properly selected, placed and maintained). However, when a newly-placed implant is subjected to the grinding forces of TMJ disorders, its risks for success are much lower.

People are often surprised to learn that they clench and/or grind their teeth at night – primarily due to bite misalignment. When a bite is “off,” the jaw joints can become strained and inflamed. During sleep, the upper and lower jaws go on a subconscious quest of sorts, searching to find a comfortable position that eliminates the strain.

The forces behind some clenching are enough to crack open a walnut. Imagine a newly placed implant that is dependent upon the jaw bones to “heal” it into this firm foundation. When the area of bone around an implant is subjected to night after night of disruption, the implant is against the odds of becoming fully embedded in supporting bone.

Here’s an example: Let’s say you use a screwdriver to firmly anchor a screw into a solid block of wood. However, every day, you use a pair of pliers to grasp the screw head and wriggle it back and forth. Obviously, it wouldn’t take long for the wood surrounding the length of the screw to wear down from the friction of the screw’s motion, even slight as it may seem. Eventually, the screw could be easily moved back and forth and would no longer serve as a dependable base of support.

It’s not unusual for more than one dental specialist to work with another to provide a patient with the combined skills needed in particular cases. I frequently work with other dental specialists and general dentists in a “team treatment” capacity in order to give patients optimal outcomes.

When we place an implant, our goal is for each patient to enjoy its benefits for the remainder of their life. Bite misalignment can jeopardize this. And, if you have all your natural teeth now, be sure to protect them by keeping your gums healthy and ensuring your bite is as well.

After all, every dental professional is on your team when it comes to enjoying confident smiles for a lifetime!

If you’ve noticed indications of gum disease (tender gums that bleed when brushing, for example) or have experienced tooth loss (or fear you are facing it), take charge of your smile now. Call 828-274-9440 to schedule a thorough examination.

Reshaping Gums Can Protect & Beautify Your Smile.

Posted on Jan 08, 2019 by William J. Claiborne, DDS MS

As a periodontal specialist, I spend a great deal of my time treating patients who have periodontal (gum) disease and placing dental implants. My specialty has given me advanced training in both areas; both being important for the preservation of your smile and protection of your health.

One aspect of the periodontal specialty that is not always familiar to the general public, however, is our ability to recontour gum tissues. While this can be done to enhance the appearance of a smile, reshaping the gum tissues is also performed to protect and even save natural teeth. I’ll explain.

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 can be exposed. This not only causes discomfort, these areas are more susceptible to bacteria. And, because of allowing 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, gum re-contouring 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 can also be performed to enhance the appearance of 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.

This procedure is known as a Gingivectomy. This repositions or removes excess gum tissues so the smile line is more balanced to teeth. The procedure is performed while the patient is fully comfortable and the healing time is greatly reduced with our advanced technology.

Another procedure that greatly enhances the look of a smile is crown lengthening. This is recommended when the gum tissues that arch one or several teeth is at a different level than surrounding teeth. With this uneven alignment of gum tissue, it can create a jumbled look in spite of having attractive, healthy teeth.

A crown lengthening procedure typically combines the repositioning of gum tissues along with placement of a crown. This recreates a smile that has proper balance amongst teeth and gum tissues.

It’s not uncommon for new patients to arrive with misconceptions about the procedures. With advanced technology and techniques, along with specialized skills, our patients enjoy optimal comfort, minimal treatment time, and exceptional outcomes for every periodontal need.

Too, many patients feel these procedures are out of reach financially. For many treatments, we offer payment options that are manageable to most budgets. This way, you can make payments while enjoying the benefits of a healthy, beautiful smile.

Now that you know how a periodontist can enhance the health and appearance of your smile, consider scheduling a consultation and exam. Call 828-274-9440 or tap here to begin.