Challenges of Aging to Oral Health

Posted on Oct 28, 2022 by William J. Claiborne, DDS MS

Hopefully, the phrase “older and wiser” is one of truth. In all honesty, many adults “of a certain age” worry about being more forgetful, being less energetic and having less stamina. True or not, the aging process forges on for us all!

Aging, of course, comes with certain health challenges. However, these may bring seniors more determination to “age gracefully.” Today’s older adult seems to be more active and health-conscious than that of our ancestors. Aging adults now have greater knowledge of contributors to poor health. Most try to eat healthier, have periodic physicals and screenings, and include physical activity in daily regimens.

Over the years, all ages have had access to the findings of research reporting on how the health of the mouth plays a significant role in overall health. For example, the bacteria of periodontal (gum) disease are shown to potentially activate or worsen the development of a number of serious health problems.

For seniors, these health problems are especially challenging since a major one affected is that of the immune system. This is of high concern for seniors since their immune systems are typically operating at less-than-peak levels (often complicated by other health problems, such as arthritis or high blood pressure).

Over 70% of our immune response comes from the cells within the gut. The “good” bacteria in the gut is crucial to efficient digestion. Yet, it can be compromised due to the presence of gum disease bacteria.

We now know that the inflammatory nature of infectious oral bacteria can interfere with the healthy bacteria in the gut. This causes the gut (and well as other systems in the body) to function less efficiently. Research has correlated gum disease bacteria to heart disease, stroke, high blood pressure, diabetes, arthritis, some cancers, erectile dysfunction and even Alzheimer’s disease.

According to the Centers of Disease Control & Prevention (CDC), over 47% of American adults over age 30 have gum disease. It is estimated that 64% of adults ages 65 and older have either moderate or severe periodontitis.

Gum disease, an inflammatory disease, which can trigger inflammation elsewhere in the body. Studies have shown that by reducing the level of these bacteria, however, can improve other inflammation-based health conditions (such as arthritis, prostatitis, and psoriasis).

For instance, diabetes has a clear relationship with periodontal disease. Studies show that treating one condition positively impacts the other. By the same token, uncontrolled inflammation levels of one can worsen inflammation levels in the other.

Therefore, treating inflammation may help manage periodontal diseases and also help manage other chronic inflammatory conditions.

For seniors, oral dryness is one of the biggest influences in developing gum disease. Like the skin and joints, the body’s moisture and lubrication wanes with age. Although poor oral hygiene is a key factor when it comes to bacteria in the mouth, a dry mouth is a common contributor to bacterial growth.

In addition to aging, dry mouth is particularly challenging for seniors because it has many causes, including:

• A side effect of many medications (including prescription and OTC)
• Radiation therapy, especially for head and neck cancer
• Mouth-breathing, which may be due to nasal congestion or snoring
• Medical conditions, such as diabetes, Alzheimer’s disease, stroke and Sjogren’s syndrome

While important for all ages, older adults should be especially committed to their oral hygiene, including twice daily brushing and daily flossing. In addition, you can support saliva flow by:

• Drinking plenty of plain water throughout the day
• Avoiding (or limiting) caffeinated beverages, such as coffee, tea and colas
• Using an oral rinse designed to replenish moisture in the mouth (available OTC)
• Being aware of medications that have an oral dryness side effect (increase your water intake and use a daily rinse to replenish oral moisture)
• Taking steps if you snore or breath through the mouth during sleep (ask your physician for suggestions)
• During a cold or sinus condition that increases mouth-breathing, be especially committed to your oral hygiene routine at home (brushing and flossing) and increase water intake
• Following each alcoholic drink (including beer and wine) with gulps of water as these are very drying to oral tissues
• Taking all steps mentioned above if you smoke cigarettes, “chew”, or vape

It is also important to know the signs and symptoms of periodontal (gum) disease. It begins with gingivitis, which causes the gums to become tender and swollen. When brushing, blood may be present in the sink when rinsing. Bad breath becomes persistent and the gums may turn red in color.

As an Asheville periodontist, I believe that the first step for adults who want to improve their oral health is by being informed patients. This generally leads to an individual who is committed to achieving and maintaining a healthy smile.

A good resource on maintaining good oral health is the web site of the American Academy of Periodontology: www.perio.org (go to Patient Resources). If you are experiencing any of the symptoms associated with gum disease as mentioned above, call our Asheville periodontal dental office at 828-274-9440. Gum disease will only worsen without treatment. (A referral is not necessary.)

Some Surprising Repercussions of Dental Fear

Posted on Mar 24, 2022 by William J. Claiborne, DDS MS

Dental fear has been ranked fifth among the most common of all fears, affecting nearly 50 million people in the U.S. Although a traumatic dental experience during childhood is often assumed to be the leading cause of dental fear, some findings show this is the case for about half of these adults.

For decades, dental fear has been to blame for many adults failing to have adequate oral health. Although cost, access, and awareness of need can be factors, nearly half of American adults avoid dentistry due to having some level of associated fear.

There are a number of false perceptions that don’t help lower this statistic. For example, a parent who tells a child “It won’t hurt much” before a dental visit simply sets the anticipation of pain into place. Hearing things like “That’ll be worse than a root canal,” and “nothing is wrong because nothing hurts,” add to the misconceptions when it comes to the reasons for avoiding regular, preventive dental care.

By some estimates, an adult with dental fear will endure pain for over two weeks to avoid seeing a dentist. They will self-medicate, use ice packs or try ‘home remedies’ found online, all to no avail. Some people end up in an emergency room because they could not force themselves to see a dentist.

Another factor may have to do with genetic makeup. In research conducted at the National Institute of Dental & Craniofacial Oral Health Research Center in Appalachia, “a gene variant was found that may contribute to heightened pain sensitivity and thus dental anxiety.”

https://www.proquest.com/openview/7df1b384b0fb8a79f854e9f304c524c1/1?pq-origsite=gscholar&cbl=30166

https://www.wiley.com/en-gb/Behavioral+Dentistry%2C+2nd+Edition-p-9781118272060

If you’ve ever heard the term, “you don’t know what you don’t know,” this is especially true for oral health. Although people are generally aware that insufficient oral hygiene can lead to bad breath and cavities, too many are unaware of some far worse consequences. Poor oral hygiene at home and lack of regular dental check-ups and cleanings form a straight line to developing periodontal (gum) disease.

While gum disease is the nation’s leading cause of adult tooth loss, it can also contribute to devastating health problems far beyond the mouth. The bacteria of gum disease are inflammatory. These infectious bacteria can enter the bloodstream through tears in weakened gum tissues, triggering a number of serious reactions.

To name a few, gum disease bacteria has been associated with the development or worsening of:
• Heart disease
• Stroke
• Alzheimer’s disease
• Pre-term babies
• Arthritis
• Diabetes
• High blood pressure
• Some cancers

Obviously, these bacteria are highly potent. Although being committed to a thorough, twice daily oral hygiene regimen at home is an important part of having good oral health, regular dental care is also necessary. These visits help to catch early signs of gum disease (which can begin without obvious symptoms). Early treatment can help to reduce treatment costs and time. And, the care can be essentially ‘painless’ when administered by the advanced skills of a periodontal specialist.

As a periodontist in Asheville NC, I want to be encouraging to adults about the risks associated with lack of dental care. I can cite the hazards of non-compliance of regular check-ups over and over. But, for people who have deep-seated fears when it comes to dental visits, far more support is needed to help an individual go from being fearful to relaxed.

A periodontal specialist has advanced training and skills in the diagnosis and placement of all types of dental implants. In our beautiful Asheville periodontal dental office, patient comfort is a priority at every visit. Our office is designed to pamper patients from the moment they enter. For certain procedures or patients who prefer the addition of sedatives, we offer oral sedation as well as I.V. sedation (twilight sleep).

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 places the patient in a deeper sleep state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our office, this is overseen by a board certified Anesthesiologist.

With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

When patients realize our goal is to provide exceptional care in comfort, they relax. Over time, many patients feel they no longer need a sedative and are able to have regular dental care without worry.

Another way we enhance comfort for our patients is through our immense array of dental technology. In many cases, this advanced technology shortens both treatment time and speeds healing. For example, our LANAP (Laser-Assisted New Attachment Procedure) provides an advanced protocol to efficiently and effectively treat periodontitis (advanced gum disease).

Essentially non-surgical, LANAP treatment provides an alternative for patients with moderate to severe periodontal disease with a quick recovery time.

Regardless of numerous features to optimize patient comfort, it’s still difficult for many to feel ‘ready’ for dental care. We can reassure people on the phone, yet, some simply cannot make an appointment and actually arrive. This is why we often begin with a consultation in our comfortable, private consultation room. This room is removed from the clinical side of the office.

To learn more, call 828-274-9440 to begin with a consultation appointment. New patients are always welcome and a referral is not required.

ED Risks Higher With Presence of Gum Disease

Posted on Feb 25, 2022 by William J. Claiborne, DDS MS

For over two decades, medical researchers have closely focused on inflammation in the body and its power to activate health problems, heart and cardiovascular diseases in particular.

It has been determined that inflammation anywhere in the body can set off a series of biochemical changes in the bloodstream; those that are designed to help the body repair inflamed tissues. However, when inflammation becomes chronic, blood chemistry never returns to normal, and trouble ensues. Researchers have noted this significantly in its increased risk of heart attack and stroke.

Think of chronic inflammation as a pan of water that is boiling on the stove. When the body is in proper control, the boiling process ceases when the stove is turned to “off.” In chronic inflammation, however, the water continues to boil even after the pan is removed from the stove top.

Chronic inflammation can exist in the mouth, set at a constant “boiling point” due to advanced gum disease (known as periodontitis). Common symptoms are puffy gums that turn red in color; inflamed, swollen, or bleeding gums; gums that loosen from the base of teeth; persistent bad breath; gums that become spongy and bleed easily; and, pus pockets that form on the gums at the base of teeth.

In addition to creating higher risks of heart disease and stroke, advanced gum disease has been shown to increase the risks for diabetes, arthritis, preterm babies, some cancers, Alzheimer’s disease, high blood pressure and erectile dysfunction (ED). Yes, even ED.

Below are findings of several recent studies showing that periodontitis to be a significant risk factor for erectile dysfunction. Rather telling is as gum disease worsens, so does erection impairment.

• Turkish investigators studied 162 men, age 30 to 40. Eighty-two of the participants had normal erection function and 80 who complained of ED. Some men in both groups had chronic periodontitis, but the condition was more than twice as prevalent in the ED group. Men with periodontitis who also presented with decayed or missing teeth showed the greatest level of ED.

• Chinese scientists examined data of several studies involving a total of 213,076 men. Compared with those who had good erection function, those with ED had three times the risk of periodontal disease.

• The University of Granada School of Dentistry found that men with severe gum disease are more than twice as likely to suffer from erectile dysfunction. This was true even after careful adjustments were made for other health issues that could distort the findings, including socioeconomic data. In the study, 80 men with clear indications of erectile dysfunction were given a periodontal examination. According to the researchers, 74 percent of the participants with ED also presented with chronic periodontitis. The researchers concluded that patients with chronic periodontitis were more likely to have erectile dysfunction independent of other confounders.

• Israeli researchers surveyed the erection function of 305 men, average age 40, and then examined their gums. Those with chronic periodontitis had the greatest risk of ED.

The connection is actually logical. Periodontal disease has emerged as an independent risk factor for cardiovascular disease, and cardiovascular disease raises risk for ED. These studies show that everything that raises the risk for cardiovascular disease (such as smoking, obesity, chronic stress, high cholesterol, high blood pressure, and chronic sleep apnea) also raises the risk of ED.

This finding also makes biochemical sense. During sexual arousal, the body releases nitric oxide, which plays a key role in enabling erection. Chronic inflammations, including periodontal disease, impairs release of nitric oxide and contributes to ED.

Health risks such as our propensity for cancer or a decline in eyesight can occur regardless of lifestyle choices. However, it makes perfect sense to eliminate or greatly minimize risk factors, including periodontal disease. Research findings on ED’s association with infectious oral bacteria of gum disease will hopefully spurn more men to devote a higher level of commitment to care for their gums.

It takes mere minutes a day to maintain a healthy mouth and reduce the risks for developing gum disease.

These include brushing teeth for at least two minutes twice a day. Daily flossing will remove bacteria in the gums that may elude brushing. And, keeping the mouth moist will support saliva flow, the mouth’s natural rinsing agent.

If you feel your erections are worth the effort, then these measures will become higher priorities in your daily hygiene upkeep. It is also important to see a dentist regularly. If you don’t feel anything is wrong because “nothing hurts,” you are only cheating yourself.

Gum disease can exist without obvious symptoms. Catching it early and before it begins to “boil” will help you avoid costly and time-consuming treatment later. And, these steps may keep your sex life active.

If you are experiencing any of the signs of gum disease (as mentioned prior), please know that gum disease will only worsen without treatment. It is also the leading cause of adult tooth loss.

A periodontist is a dental specialist who treats all stages of gum disease. If it is found to exist, this periodontal specialist can help to resolve the problem and restore your smile to a healthy state in the most conservative way possible. He or she can then help you maintain good oral health, which will support your overall health.

For an examination, or to begin with a consultation, call 828-274-9440.

https://www.psychologytoday.com/us/blog/all-about-sex/202006/the-connection-between-erections-and-gum-disease

https://onlinelibrary.wiley.com/doi/abs/10.1111/jcpe.12909?af=R

Dental Fear Can Lead To Gum Disease, Tooth Loss

Posted on Nov 23, 2021 by William J. Claiborne, DDS MS

Fear is a natural reaction to things that may harm us; it’s a safety mechanism activated by the brain. Take snakes, for instance. Even harmless snakes tend to provoke an initial reaction that warns of impending danger.

Some fears are learned, however. Some people are afraid of dogs, usually stemming from a frightful encounter as children. The incident triggers something in the brain that reminds the individual, even into adulthood, that dogs are to be feared.

When it comes to the fear of dentistry, it often exists because of a traumatic incident in the patient’s past. Or, in some cases, it exists for unknown reasons. Too, certain smells, sounds or sights can trigger the “panicky” reaction some people have to dental visits.

As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss.

Typically, adults who avoid dental visits feel they are doing an adequate job maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass recommended 6-month dental check-ups and cleanings.

Yet, even the best of at-home dental hygiene can be insufficient to the buildup of tartar.

Tartar is the hardened form of plaque, which is a sticky film of bacteria that accumulates in the mouth. In the form of tartar, this cement-hard mass of bacteria cannot be brushed or flossed away. It can only be removed by a dentist or hygienist using special tools.

While plaque can cause bad breath and a “furry” feeling mouth, tartar eats away at tender gum tissues and bores into tooth enamel. As it grows, it works its way below the gum line, creating inflammation in the gum tissues.

Early symptoms of gum disease, known as gingivitis, are tender or swollen gums. You may see blood in the sink when brushing teeth. Breath odor may be bad on a regular basis.

At this point, proper measures may be able to reverse the progression of these rapidly-reproducing bacteria. This requires thorough brushing (twice a day, at the very least), daily flossing, drinking lots of plain water, and using an oral rinse to control bacteria levels.

However, if tartar exists, it’s not going to go away. It will continue to amass and attack the gums and work its way into the tissues below. When the bacteria reach an uncontrollable level, they become infectious.

Think of gum disease bacteria as you would water in a pan on the stove. The heat will eventually cause bubbles to form on the bottom of the pan. This can be likened to gingivitis.

However, as the water heats more, bubbles start to move to the surface. This can symbolize the development of gum disease. The symptoms of gum disease include gums that turn red and bleed easily and persistent bad breath.

When advanced stage periodontal disease develops (periodontitis), imagine the water at full boil. Unfortunately, once aboil, the roil continues even after you remove the pan from the heat. This is known as systemic inflammation.

Gum disease is the nation’s leading cause of adult tooth loss. Yet, the bacteria that destroy gums and the structures that support natural teeth don’t remain confined to the mouth. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.

Research has correlated oral bacteria to a long list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. These include heart disease, stroke, Alzheimer’s disease, arthritis, diabetes, preterm babies, erectile dysfunction (ED), some cancers (including pancreatic), and more.

Obviously, these bacteria are potent and a threat to overall health. For those who avoid dental care due to anxiety or fear, knowing all this is not necessarily going to change their resistance. We understand that it’s still difficult to overcome the challenges even knowing there are risks.

There are options, however, for even high fear dental patients.

In our office, we offer I.V. sedation (“twilight sleep”) as well as oral sedation. Oral sedation is in pill form and creates a totally relaxed feeling. It enables patients to recover quickly and offers an amnesiac effect.

I.V. sedation is a deeper level of sedative. This places patients in a sleep state and erases most or all memory of the procedure after. With both sedations, however, we apply numbing medications to the area being treated to create optimal comfort for patients. We want patients to be in total comfort throughout their treatment, regardless of the addition of sedation.

We also have a reputation for treating our patients with respect and a gentle touch. We are just as committed to comfort for patients who do not want to be sedated as we are for those who are. Our goal is to help each person achieve a healthy, confident smile.

One of the most satisfying parts of my specialty is helping a once-fearful patient achieve a healthy, confident smile and see dental care as a welcomed part of their health care commitment.

If you are ready to get past your dental fears so you can have the smile you desire, begin by calling our Asheville periodontal office at: 828-274-9440 and speaking with our friendly staff. You can begin with a consultation, if desired.