Why Floss?

Posted on Apr 14, 2020 by William J. Claiborne, DDS MS

As a periodontist, I treat all stages of periodontal (gum) disease. Over the years, I’ve helped patients save natural teeth and restoring their ability to enjoy healthy, confident smiles.

When people come close to losing their teeth or find themselves in need of replacing them with something more dependable than dentures or partials, I hear nearly every one express the same regrets: “I wish I’d taken better care of my teeth when I could.”

Hindsight may be 20-20, but it’s never too late. I know patients can go from having gum disease and losing teeth because of it to having excellent oral health – and end up having a renewed commitment to their smiles.

In my dental specialty, I know it begins by helping patients to understand how the problem starts in the first place. When people know the HOW, they can implement measures to bypass the repercussions of gum disease.

I’ve found that most people actually have very little awareness of how the inside of their mouth looks. We smile with lips and front teeth that show very little (if any gums). So, it stands to reason that, if a smile looks good, it’s probably healthy.

Until dental offices began using intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for a condition that didn’t hurt. There were not obvious signs initially, so nothing is wrong – right?

Intra-oral cameras are able to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual has this firsthand view of spongy, receded gums, the decision to treat often go from IF to WHEN.

Although it helps to be able to show patients the signs of gum disease, these emerged signs are indications of long-standing periodontal disease. By the time these signs appear, the early stage of gum disease, gingivitis, is past.  This is unfortunate, since early-stage gum disease can be halted with prompt measures.

Gingivitis causes the gums to become tender and swollen in some areas. You may see blood in the sink when brushing. These signs indicate that oral bacteria has accumulated in the mouth beyond the means of your immune system’s ability to manage it.

Twice daily brushing and flossing are important steps in keeping bacteria levels in the mouth under control. Brushing sweeps away built up bacteria on the surface of teeth, which is a sticky film known as plaque. Plaque, just over the course of a couple of days, can harden on teeth where build up is allowed to remain. This cement hard mass of bacteria is tartar, or also known as calculus.

The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.

Yet, try as we might, there are simply angles in the mouth that are difficult to reach with a toothbrush, manual or electric. Say you have an area of jumbled or crooked teeth. Even as you adjust the angle of the toothbrush differently to maneuver the bristles into these areas, it is often difficult to continually keep these areas clean.

This is where flossing comes in, and important step in daily, oral hygiene.

Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.

If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a jolting view of exactly what you do NOT want crawling around and breeding in your mouth. These living and breeding organisms can be highly destructive as they amass.

As research has shown for many years, your overall health is intricately linked to your oral health. The bacteria of gum disease has been linked to a long list of serious health problems, including heart disease, stroke, arthritis, some cancers, diabetes, and preterm babies. Studies are underway to track gum disease bacteria to the path of Alzheimer’s disease.

Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.

Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits): “Only four of 10 Americans floss at least once a day, and 20 percent never floss.”

Perhaps this is one reason why over 47 percent of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.

Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued.

It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.

Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. For our patients, we help them develop an at-home care regimen to maintain a healthy mouth and fresh breath between regular dental check-ups.

Be aware of the signs and symptoms of periodontal disease. Knowing them will allow you to react quickly to minimize the extent of damage and treatment needed to rid it. They include:

• Tender or swollen gums
• Gum tissues that turn red
• Gums that are tender to the touch
• Gums that bleed easily
• Spitting out blood when brushing or flossing your teeth
• Frequent bad breath
• Pus pockets that form between teeth and gums
• Teeth that loosens or shift
• Painful chewing
• Gums that pull away from your teeth (recede), making your teeth look longer than normal

These are all warning signs that bacteria overload is occurring in your mouth. It is a disease, and will only worsen without treatment.

If you suspect you have any stage of gum disease, call 828-274-9440 to schedule a thorough periodontal examination.

 

 

What You Eat & Drink May Be Compromising Your Oral Health

Posted on Mar 05, 2020 by William J. Claiborne, DDS MS

Everyone would like to have healthy bodies and brains. We all know that the best way to enjoy a full, active life is to eat a nutritionally balanced diet, get regular exercise, have periodic screenings and checkups, and stay socially involved.

Yet, in our attempts to live as we should, things like improper movements while exercising or an overloaded social calendar can actually backfire on us, having negative results. Sometimes, it’s what we don’t know in our quest for bettering our lives that can lead to damaging consequences.

Take, for example, your diet. Do you squeeze lemon in your water? Do you relax with a glass of wine each evening? Are you a chocolate lover who has switched to dark as a healthier choice?

Although these are all good for you in some ways, when it comes to your teeth and gums, they can cause problems over time. Knowing what can occur may save you much in costly dental treatment in the future.

There are a number of foods and beverages that contribute to periodontal (gum) disease, cavities, and tooth loss. Some may even surprise you, which include:

Caffeine: Caffeinated beverages such as coffee, tea, colas, and many energy drinks can have a drying effect on oral tissues. Having “dry mouth” means there is insufficient saliva flow. This leaves the mouth without its natural ‘rinsing’ agent, which is what helps to flush out bacteria to maintain manageable levels. Without this, oral bacteria have an environment where they can rapidly breed and thrive. Since bacteria accumulation is the origin of most oral problems, this heightens the risks for your oral health.

Wine: Although wine (especially red) is believed to be a healthy drink, it is the way it is consumed that makes it a particular problem for teeth and gums. Whenever you eat or drink something, an acid attack begins in the mouth. While this is an initial part of digestion, this acid is highly potent; so much that it can soften tooth enamel for up to 30 minutes after. This makes teeth more prone to decay. Because most people drink wine in sips over time, this merely extends the acid surge period. When wine’s acidity combines with digestive acids in the mouth, you place teeth at a doubly higher risk for decay. (This also applies to any alcoholic beverage, especially drinks with sweetened mixers.)

Citrus & Acidic Foods & Beverages: The acidity in citrus (such as oranges, lemons, and grapefruit) can be tough on tooth enamel and tender gum tissues. This also includes tomatoes and tomato-based foods such as spaghetti sauce, catsup, salsa, etc. that can have a highly acidic effect.

Sugar & Carbohydrates: Globally, Americans are the leading nation for sugar consumption. We also love our carbs, which essentially break down as sugar in the mouth. Oral bacteria love these foods, too, because they supercharge their ability to reproduce. Because many sweet and carb-laden foods stick to teeth longer, their ability to cause damage is even greater.

Snacking: As mentioned earlier, eating or drinking triggers an acid attack in the mouth. This means for every sip of cola or granola bar bite, an acidic bombardment occurs in the mouth for approximately 30 minutes. When the mouth endures these frequent acid attacks, the damage to precious tooth enamel will catch up to you in the form of cavities.

Research has shown that the health of teeth and gum tissues is intricately connected to your overall health. Serious diseases have been linked to the bacteria of gum disease. These include heart disease, stroke, diabetes, arthritis, some cancers, preterm babies, impotency, and Alzheimer’s disease. These bacteria, once in the bloodstream, trigger serious reactions that are obviously harmful far beyond the mouth.

Start by reading these tips on maintaining a healthy mouth…

• When snacking, eat what you wish in a brief amount of time rather than pace eating over an extended time.
• Be conscious of what alcohol you drink. Try to limit your drinks to 1 or 2 a day and omit sweet mixers. Between each drink, take gulps of plain water and let it linger in the mouth for a few seconds before swallowing. Or, swish in the bathroom between each drink. This helps dilute oral acids and rinse them from the mouth before they can damage tooth enamel.
• Brush at least twice a day and floss daily. By removing bacteria that has accumulated in the mouth, you’ll help to decrease the risk for gum disease and cavities. Although many people feel wine is a healthy drink, remember – it is highly acidic. When this acidity mixes with oral acids, your mouth is bombarded with a potent assault strong enough to soften tooth enamel.
• Limit sugar and snacking. If you like a sweet treat during the day, choose an apple or wait until a meal and have the treat while an acid attack is already underway. This will help you avoid triggering a new one.

Having a healthy mouth will help you to smile more confidently and give your overall health a leg up by minimizing bacteria that originate in the mouth.

If you have signs of gum disease (tender, bleeding gums and frequent bad breath), you should see a periodontal specialist as soon as possible. Gum disease does not improve without treatment and is the nation’s leading cause of adult tooth loss.

Call 828-274-9440 to schedule an appointment.

 

 

Aging Adults Need Extra Measures To Prevent Gum Disease, Tooth Loss

Posted on Feb 17, 2020 by William J. Claiborne, DDS MS

Whether visiting a primary care physician, ophthalmologist (eye doctor), dermatologist, or orthopedist, adults in the over-50 category often hear the same comment from their doctor.

“You’re getting older so…”

As we age, the body begins to succumb to wear and tear. The skin sags, bones weaken, joints ache, hearing dulls, and eyesight wanes. More precautions and measures are advised to keep the body operating comfortably and efficiently as we age.

The same is true for your teeth and gums.

Although people tend to react to an odd spot on the skin or blurry vision, things like having a frequent ‘dry mouth’ or gum recession are often brushed off as temporary or just a normal part of growing older.

Yet, the hazards of ignoring the signs and symptoms associated with gum disease and tooth loss should never be taken lightly. Research shows that your OVERALL health is dependent upon a healthy mouth and proper function in biting and chewing.

Here are some typical oral challenges experienced by seniors:

• Having a dry mouth: 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.
We advise drinking plenty of filtered water throughout the day, minimizing caffeinated drinks that are drying to oral tissues (coffee, tea, colas), and using an oral rinse twice a day that is formulated to replenish oral moisture. Alcohol and smoking are especially drying to oral tissues. Be especially committed to maintaining adequate oral moisture if you smoke or drink.

• Less efficiency with at-home oral hygiene: Aging causes the fingers to be less nimble and stiffens joints. This is a particular challenge when it comes to brushing and flossing. Angling a toothbrush to reach all areas in the mouth and proper flossing maneuvers require manual dexterity that becomes less capable when the rigors of aging are involved.
We advise using an electric toothbrush 2-3 times a day. Flossing can be done using an electric water flosser. However, we still recommend manual (string) flossing where you can reach. Keep in mind that crowding of natural teeth (which tends to worsen with age) creates particular challenges for reaching nooks where bacteria hide and breed. Use extra time to ensure you are reaching those areas when you brush and floss.

• Medications that interfere with oral health: 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/). Although your health may dictate taking these drugs, it is wise to be aware that some can be detrimental to your oral health.
For example, Coumadin, a commonly prescribed blood thinner, can cause more bleeding during certain procedures. Too, many meds have the side effect of oral dryness. Some prescribed for osteoporosis, bisphosphonates (known by Fosamax, etc.) have been linked with jaw osteonecrosis. The risk for jaw necrosis, or death of the jaw bone, is highest with procedures that directly expose the jaw bone, such as tooth extractions and dental implant placement.
Some herbal supplements can also cause side effects for some dental patients. For example, Ginkgo Biloba and Vitamin E can act as blood thinners. When combined with aspirin, the combination may cause difficulties in blood clotting. Be sure to provide a complete list of ALL medications you take (including vitamins and herbal supplements) at each appointment. This enables us to tailor your treatment to your specific needs.

• Hormonal changes: Post menopausal females are at higher risk for gum disease and subsequent tooth loss due to declining estrogen levels. Thus, these women have greater risk for bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is bone loss of the jaw, it can result in tooth loss. Receding gums are a sign of this bone loss since more of the tooth surface is exposed to the causes of tooth decay.

Why are your teeth and gums so important as you age?

As a periodontist in Asheville for over 30 years, I’m still surprised by the number of people who assume that losing natural teeth is to be expected with age. Yet, I see many patients who have kept the majority of their natural teeth well into their 80’s and 90’s.

Although dental implants are excellent replacements for missing teeth, there is nothing as good as the teeth God gave you. They’re referred to as “permanent” teeth for a reason; they were intended to be just that. Regardless of the replacement method, the ability of natural teeth to support neighboring teeth and provide stimulation to the jaw bone is unsurpassed.

Having the ability to comfortably and efficiently bite and chew is vital to having a healthy body. When dentures or partials compromise the ability to eat a diet of healthy foods – and chew food properly – gastrointestinal problems are common.

Too, bacteria overgrowth in the mouth is the cause of gum disease. Periodontal disease is the nation’s leading cause of adult tooth loss. Its bacteria can also enter the bloodstream, causing inflammatory reactions far beyond the mouth.

Advanced gum disease bacteria has been linked to a number of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.

Obviously, maintaining healthy gums and keeping your natural teeth is important. If you’ve experienced tooth loss, we can replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing.

If your gum health needs improvement or there are signs of gum disease, we can structure a program that restores healthy gums and helps you maintain your oral health between visits.

Although gum disease can exist without obvious signs or symptoms, the most commonly noticed 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.

With proper measures, you can enjoy healthy gums and natural teeth throughout your lifetime. Call 828-274-9440 to schedule a periodontal examination or ask for a consultation to get to know us. New smiles are always welcome!

Obesity Increases Risk Of Gum Disease.

Posted on Nov 20, 2019 by William J. Claiborne, DDS MS

Imagine one-third of your body being made up of maple syrup.

Sounds pretty absurd, doesn’t it? Yet, for Americans who are categorically obese, this imagery is actually a good description.

Obesity is when fat makes up over thirty percent of body mass. According to the Centers For Disease Control & Prevention (CDC), adults in the U.S. who are categorized as obese is at nearly 40 percent! Another 30 percent are categorized at overweight. That’s two-thirds of adults in the U.S. who have too much fat makeup.

And it’s not just adults over the age of 20 who have this problem. Sadly, nearly 30 percent of children are overweight or obese as well.

In North Carolina, over 63 percent of adults are either overweight or obese, according to a study by the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.  (https://onlinelibrary.wiley.com/doi/full/10.1002/oby.20451)

The problems associated with being overweight and obese are many, and can be deadly. Obesity seems to trigger a predisposition to a variety of serious health conditions and diseases. These include increased risk of stroke, certain cancers, coronary artery disease, and type 2 diabetes.

In addition to the added and unnecessary load that strains the back, knees and ankles, the challenges continue. Obesity decreases lifespan, up to an estimated 20 percent of people who are severely obese. (https://www.nejm.org/doi/full/10.1056/NEJMsr043743)

As 2019 holiday indulgences (often sugary and carb-laden) are before us, many of us also follow the season with with the traditional new year’s resolution of “lose weight” at the top of the list. Along with improved health and greater confidence in overall appearance, we’d like to add another reason to reach your goal.

Chronic inflammation is a known side effect obesity. Why does this matter to a Periodontist? Obesity is also known to exacerbate other inflammatory disorders, including periodontitis (advanced gum disease).  To be clear, periodontal disease is also the nation’s leading cause of adult tooth loss.

Research has shown that obese adults have a 6 times higher potential to develop periodontal (gum) disease. As a periodontal specialist my goal is always to help patients achieve optimal oral health. Although discussing the risks of periodontal disease with obese patients can be a sensitive issue, this is without judgement of why they are overweight but rather how we can help them enjoy a healthier smile.

Most of us know – losing weight is not a process that is either easy or quick. Add to this that research has shown that factors such as sleep quality and what we eat (as much as how much we eat) can cause the brain to make the challenges of weight loss even greater.

For one, studies have shown that sugar can be addictive. Sugar consumption even activates the same regions in the brain that react to cocaine. For individuals who admit to having a “sweet tooth,” trying to stay within the recommended 6 teaspoons per day limit can be a battle when we are truly “addicted.”  (https://www.brainmdhealth.com/blog/what-do-sugar-and-cocaine-have-in-common/)

Insufficient sleep also complicates the brain’s ability to regulate hunger hormones, known as ghrelin and leptin. Ghrelin stimulates the appetite while leptin sends signals of feeling full. When the body is sleep-deprived, the level of ghrelin rises while leptin levels decrease. This leads to an increase in hunger.

The National Sleep Foundation states that “people who don’t get enough sleep eat twice as much fat and more than 300 extra calories the next day, compared with those who sleep for eight hours.” (https://www.sleepfoundation.org/sleep-topics/the-connection-between-sleep-and-overeating)

As difficult as losing weight can be, it is important to be aware of risk factors that can make you more suspectible to gum disease. Initial symptoms include gums that are tender, swollen, and may bleed when brushing. This stage, known as gingivitis, is actually reversible with prompt, thorough oral hygiene.

As gum disease worsens, however, the inflammation of oral bacteria can lead to persistent bad breath, receded gums that expose sensitive tooth roots, and gums that darken in color. If untreated, pus pockets can eventually form and the base of some teeth and tooth loosening can require removal.

Armed with this information, we want to help all patients, with overweight or obese adults especially, to take added precautions to maintain good oral health, both at home and through regular dental check-ups.

Avoiding periodontal disease is particularly important since its infectious bacteria have been linked to serious health problems. These include heart disease, diabetes, arthritis, some cancers, preterm babies, impotency, and Alzheimer’s disease.

If you are experiencing symptoms of gum disease, however, it is vital to be seen by a periodontist as soon as possible to halt further progression. A periodontist is a dental specialist who has advanced training in treating all stages of gum disease as well as in the placement of dental implants. The earlier the treatment, the less involved treatment requirements will be. Gum disease will not improve without professional care.

Call 828-274-9440 to schedule an initial examination or begin with a consultation.