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Asheville Periodontist
Our Asheville Periodontal Dental Office Offers Some Unique Services
Posted on Jun 13, 2022 by William J. Claiborne, DDS MS
As a Periodontist in Asheville, I’ve helped hundreds of patients overcome periodontal (gum) disease and the many repercussions that come with tooth loss. Helping to save teeth that were on the verge of requiring removal has also been a victory for the patient as well as me.
I take great pride in being a part of the transformations of patients who achieve healthy, confident smiles. This is why I’ve created an environment that affords every patient with the most advanced options available for restoring oral health and replacing lost teeth with dental implants.
Let me begin by clarifying the benefits our periodontal office brings…
• A periodontist has advanced training to properly diagnose and treat all stages of gum disease.
• We are known for never over-treating or under-treating with a commitment to provide the most successful treatment for each patient’s specific needs.
• Our periodontal office is specially equipped for the diagnosis and treatment of all stages of gum disease as well as placement of dental implants.
• Diagnosis and treatment planning is backed by an immense array of advanced technology, including:
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- LANAP (Laser-Assisted New Attachment Procedure) with PerioLase MVP 7 – an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease and has even been found to stimulate bone regrowth in damaged areas.
- 3-D Cone Beam Imaging – is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes in a process that is quick, painless and at minimal radiation levels.
- CareStream Cone Beam Computer Tomography Imaging – is enhanced tomography that works with 3D imaging for exceptional detail and range.
- CS 3600 Intraoral Scanner – quickly and comfortably captures digital impressions to accurately and easily create precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances, aligners, custom abutments) without the need for bulky, goopy trays.
- Computerized Dental Implant Placement – an advanced system for pre-surgical positioning of dental implants using a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success.
• A commitment to comfort including I.V. sedation (twilight sleep) as well as oral sedation for total relaxation. On our team is a Board Certified Anesthesiologist to provide sedation and anesthesia for optimal comfort and safety.
Treatment options in our specialty dental office also include reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession); diagnosis and placement of dental implants; and treatment of lesions or cysts in oral tissues.
With specialized skills, a periodontist is especially respectful to oral tissues as tender layers that significantly affect the appearance of a smile and the health of teeth. Utilizing special skills to minimize incisions while effectively treating each area in the mouth, a periodontist is your expert.
Call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.
How Losing Natural Teeth Can Lead To Changes In Facial Appearance
Posted on Jun 01, 2022 by William J. Claiborne, DDS MS
If you’ve worn dentures or partials for five or more years, take a moment to literally see how your facial appearance is changing.
Look in the mirror without your denture in place. Your mouth may appear sunken-in with your chin more pointed than before tooth loss.
Other signs of bone loss may include deep wrinkling around the mouth, the corners of the mouth turning downward (even when smiling), and jowls that are forming as facial muscles detach.
These are the telling signs of bone loss as the jaw bone declines in mass.
Natural tooth roots provide stimulation to the jaw bone, which preserves its ability to maintain a healthy mass. When tooth roots are no longer present, the jaw bone loses the stimulation needed to keep blood flow active. Over time, this results in ‘resorption,’ or a shrinking of bone.
Over time, the resorption process causes the gum ridge to flatten. The pressure on the gum ridge from wearing dentures actually accelerates the rate of bone loss. For those who sleep in their dentures, this 24/7 pressure speeds the rate of bone loss even more.
When a denture is first made, it is designed to conform to the unique contours of the bone ‘arch’ where tooth roots were once positioned. The reason that denture wearers commonly experience movement or slips is because the denture’s foundation is changing. Even with frequent application of adhesives or pastes, this dwindling foundation means a denture is likely to move while eating.
A new denture may fit securely for the first five years. However, as the jaw bone continues to lose height, relines may be needed. Eventually, these are more and more temporary with relines needed at more frequent intervals each time.
One year after natural teeth have been extracted, denture wearers average losing about 25 percent of this bone ridge. After three years, the average decline in bone is approximately 60 percent.
Biting becomes overshadowed by concerns of uprooting the denture’s position. Chewing is more difficult, and to no wonder. The biting force of natural teeth is about 250 lbs. while an average denture wearer is able to apply about 5 lbs. of force.
To avoid discomfort when eating, denture wearers may adjust their diets to consist of soft foods that dissolve easily in the mouth. In many cases, these diets lack the nutritional benefits of fiber, vitamins and protein necessary for a healthy body.
These problems begin to affect people on a social scale, also. Due to fear of embarrassing slips, people also begin to avoid social gatherings where food is the centerpiece. It has been shown that denture wearers are less likely to dine out and wear less makeup.
Bone resorption even leaves adjacent teeth susceptible to the effects of bone loss. As the area of bone declines in height and width, neighboring teeth are at a greater risk of cavities, gum disease, and tooth fractures. It is a fact that when a tooth is lost, the one next to the one missing is most likely the next to be lost.
It’s not just denture or partial wearers who can anticipate the hazards of bone resorption. For people who opt to replace a tooth (or teeth) with a crown-&-bridge, they can also expect bone loss. Over time, this can be detected through a gap that appears between the bridge and gums. In a smile, this gap may be visible.
It stands to reason that there is a need to replace more than the presence of teeth. This is why so many dentists and dental specialists now recommend Dental Implants. Over the years, they have proven to be a successful alternative to dentures and partial dentures.
There are many advantages to Dental Implants. From a health standpoint, I see their ability to halt bone loss as a leading benefit. Dental implants are placed in the jaw bone, recreating the stimulation of tooth roots. This helps to preserve the strength of the jaw bone while restoring biting strength and chewing stability.
I also like that Dental Implants are self-supporting since they use the jaw bone for support. They do not rely on having otherwise-healthy, natural teeth crowned for the mere purpose of supporting replacement teeth (as in crown-&-bridge combinations).
From a value perspective, Dental Implants are an excellent investment. With proper selection, placement and care, they are designed to last a lifetime. And, it’s an investment you’ll enjoy every day as you comfortably eat foods you love, smile and laugh without worry, and wake up with a smile!
There is much to know as to why keeping your natural teeth is so important. However, when tooth loss does occur, you can protect your health and well-being by replacing them with Dental Implants. With Dental Implants, you are able to avoid the long-term repercussions of bone loss.
A Periodontist specializes in the treatment of gum tissues as well as the diagnosis and placement of Dental Implants. Although the failure rate of Dental Implants is rather low, having a successful outcome can greatly depend on the Doctor who selects and places your implants.
Begin with a consultation by calling our Asheville periodontal dental office at 828-274-9440. I’ll be happy to answer your questions and discuss our many comfort options, including Oral and I.V. Sedation.
Many Reasons To Repair Gum Recession
Posted on May 19, 2022 by William J. Claiborne, DDS MS
If you are occasionally experiencing sensitivity around one or more teeth, especially when eating ice-cream or drinking hot coffee, this is likely due to receded gums.
While using a sensitivity toothpaste can somewhat minimize these sensations (which can become painful jolts), the problem will remain. The source of sensitivity, most often, is because the highly-sensitive tooth’s root area has been exposed by the pulling away of gum tissues.
The gum tissues are designed to provide a tight seal around the base of each tooth, which blocks bacterial entry to the sensitive tooth root area. In addition to sensitivity, recession means oral bacteria can penetrate beneath the gum’s surface. Once beneath the surface, the accumulating presence of this bacteria can lead to inflammation of the gums.
Eventually, the infectious bacteria attack the structures that support natural teeth. This bacteria indicates the presence of periodontal (gum) disease. Signs and symptoms of gum disease in its first stage include:
• Gum tissues that turn red
• Gums that become tender or swollen
• Gums that bleed when brushing
• Persistent bad breath
Obviously, it’s important to ensure the gums are healthy so the grip they have around teeth is snug. It’s also important to be aware of the causes of gum recession. These are:
The aging process – As people age, their gums become drier. This causes them to shrink and be less capable of keeping a secure grip around the base of teeth.
Periodontal (gum) disease – As mentioned above, gum disease destroys oral tissues and the bone that supports natural tooth roots. A sign of periodontal disease is gum recession. Gum disease is also the nation’s leading cause of adult tooth loss.
Poor dental hygiene – When twice-daily brushing, daily flossing, and keeping the mouth moist are insufficient to rid the mouth of bacteria, their accumulation can result in the sticky film you feel on teeth. This is plaque. In just a day or so, plaque can harden on teeth into tartar. This is a cement-hard bacterial colony that cannot be removed by brushing or flossing . It can only be removed during a professional tooth cleaning. If not removed, teeth, gums and the structures below the gum line can be damaged.
Brushing too hard – Brushing teeth rigorously doesn’t mean you are doing a good job. Using a scrubbing, back-&-forth motion can wear away tooth enamel and cause the gums to recede. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.
Hormones – Females experience fluctuations in estrogen levels during puberty, menstrual periods, pregnancy and menopause. During these times, the gums can be more sensitive and vulnerable to gum recession.
Tobacco use – In addition to the many health hazards smokers risk, they are more likely to develop plaque due to the oral drying effects of smoking. This dryness can lead to gum recession (not to mention brown teeth and bad breath).
Bite misalignment – When teeth don’t come together evenly, too much force can be exerted on the gums and surrounding bone, allowing gums to recede. Bite misalignment can also lead to grinding or clenching teeth. These harsh forces on teeth can cause the gums to loosen their grip.
If you have mild sensations of sensitivity, desensitizing toothpastes can help soothe the nerves by forming a protective barrier over teeth while blocking sensitivity signals. Although this type of toothpaste can be helpful, it should be used as a temporary aid.
The goal should be to repair recession and halt the problem from recurring. To do this, we begin by determining why the gum recession is occurring. The next step is to restore the gums to their proper positions.
The corrective procedure most often performed is a “gingivectomy” performed by a periodontal specialist. In addition to treating all stages of gum disease, a periodontist specializes in contouring gum tissues. Using advanced skills, a periodontist is able to create a natural look and restore your oral health.
A gingivectomy can reposition or graft gum tissues over the area of recession to restore a healthy seal and protect the tooth structures below the surface.
Another advantage of a gingivectomy is to help save a natural tooth. When a tooth breaks near the gum line, a “crown lengthening” procedure may be advised. In this, a periodontist may be able to expose enough of the tooth structure for the placement of a crown.
A crown lengthening procedure is an ideal accompaniment to many cosmetic dentistry treatments. When there are different heights of gum tissues framing the teeth most visible in a smile. This tends to create a jumbled looking smile, when when the teeth are straight.
Crown lengthening rebalances the height of gum tissues that arch the teeth to restore a smile that is balanced. From this, the eye is drawn to the smile as a whole rather than one or two teeth with varying heights of gum tissue.
A gingivectomy is also performed for individuals who wish to correct a “gummy smile.” This is when a smile shows too much gum tissue above upper teeth when smiling fully.
Gingivectomies are performed while the patient is comfortably numbed. For some people, sedation may be a preference for enhanced relaxation. Oral sedation is available in pill form, which allows patients to ‘doze’ through procedures. I.V. sedation, also known as “twilight sleep”, is available for patients who prefer a deeper level of sedation.
Both sedations are administered by fully trained team members who use advanced safety monitoring equipment. We believe your safety is as important as your comfort.
In our Asheville periodontal dental office, we also offer a wide array of technology. This often saves the patient time in treatment, enhances comfort, and speeds healing. For example, our dental laser can seal tissues as it contours it. This eliminates or greatly minimizes bleeding.
Pain is how the body indicates that something is wrong. When the gum tissues have receded, they are not going to repair on their own. Let’s discuss your particular needs, whether for improved oral health or to enhance the appearance of your smile (or both) during a consultation appointment.
Call 828-274-9440 to schedule a time.
There Are Good Reasons To Keep The Mouth Moist
Posted on May 11, 2022 by William J. Claiborne, DDS MS
Having good oral health takes a commitment. It requires us to devote time each day for oral hygiene, at least twice per day. However, it’s in-between these brushings that can impact the good that we are doing at the sink.
Nearly everything that causes problems in the mouth has to do with oral bacteria that has gone beyond manageable levels. Although the mouth is home to some very “good” bacteria, an overload of “bad” bacteria is what becomes the origin of many problems.
The reason people are advised to brush at least twice a day and floss daily is to remove accumulated oral bacteria from the mouth. When not removed on a regular basis, a sticky film of bacteria form, which coats the teeth and gums. This film is known as plaque. Without sufficient and frequent removal of plaque, it begins to harden at the base of teeth.
This is tartar (or calculus), which is actually a hardened mass of oral bacteria. Tartar cannot be brushed or flossed away; it requires removal by a dental professional who uses special tools during dental cleanings to scrap tartar from tooth surfaces.
Your periodic dental cleanings are important. If tartar is allowed to further amass, the bacteria can become inflamed, attacking gum tissues. As bacteria continue to reproduce, they create an inflammation that extends beneath the gum line. The infection they trigger can reach down into the structures that support natural teeth, including tooth roots, tissues, ligaments and bone.
Periodontal disease is the leading cause of adult tooth loss. The advanced stage of gum disease, known as periodontitis, creates a bacteria so potent that research has linked it to serious diseases elsewhere in the body. These include some cancers, heart disease, stroke, Alzheimer’s disease, diabetes, arthritis, preterm babies, and impotency.
To help control bacteria in the mouth, saliva serves as a rinse that removes food particles from the mouth. Combined with brushing and flossing, good saliva flow helps to keep bacteria levels under control.
When saliva flow is compromised, oral bacteria are able to reproduce and multiply quickly. As bacteria accumulate, a sticky film forms on teeth and gums from this buildup. As bacteria coat the interior of your mouth, bad breath begins. Then, the sequence of plaque, tartar and potential for gum disease (as mentioned above) begins.
Oral dryness is one of the biggest influences in developing gum disease. Even though poor oral hygiene is a key factor when it comes to bacteria overload, dry mouth is a common contributor because it has many causes.
A dry mouth can occur from:
• The aging process (affecting about 1 in every 5 adults)
• As 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
In addition to your twice daily brushing and flossing routines, it is important to know how you can support saliva flow and avoid the risks created by a dry mouth. These include:
• Drink plenty of plain water throughout the day. Leave off the lemon wedge, which is hard on tooth enamel.
• Avoid (or limit) caffeinated beverages, such as coffee, tea and colas. If you drink these beverages, rinse your mouth after or alternate with gulps of water.
• Consider using an oral rinse designed to replenish moisture in the mouth (available OTC).
• Be aware of medications that have a side effect of oral dryness. Some of the worst are antihistamines, depression and incontinence medications, and some that control blood pressure. If you take one of these, ask your doctor about options that may be less drying to the mouth. Or, increase your water intake and use a daily rinse to replenish oral moisture.
• If you snore or breath through the mouth during sleep, oral tissues are dry during these hours. Consider adjusting your sleeping position or adding a side pillow. Your physician may also have some suggestions, including an oral appliance.
• Certain health conditions can cause dry mouth, including acid reflux, sinus infections, diabetes and bronchitis . A bad cold can also force people to breathe more through their mouth. For these conditions, be especially committed to your oral hygiene routine at home (brushing and flossing) and up your water intake.
• Alcohol (including beer and wine) are very drying to oral tissues. Wine and mixed drinks have high levels of acidity and sugar that adds extra challenges to oral tissues. You can help to dilute the severity of these by swishing with water between drinks. Or, keep a glass of water nearby for occasional gulps that wash over teeth before swallowing.
• Smoking (cigarettes, cigars, vaping) are all laden with toxic chemicals (including e-cigs). Be aware of the added risks and be highly committed to your at-home care and drinking plenty of water to keep your mouth clean and moist.
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.
Gingivitis, at this stage, can be contained and resolved if quickly addressed. If not, the bacteria will continue to multiply. This creates inflammation in the gums. This means the inflammation has progressed to periodontal disease, which requires treatment since it is now below the gum line.
Beneath the gum line, the bacteria continue their attack on the structures that support natural teeth. This includes the bone structures surrounding tooth roots. At this point, the gums bleed easily and breath odor is persistently bad. The gums become red and swollen and may pull away from the base of some teeth (gum recession).
If the disease is not treated, it will worsen to the stage of periodontitis. This is an advanced level of gum disease that is highly infectious and destructive. Because it leaves the gum tissues in such a weakened state, the infection can easily penetrate the gums and enter the bloodstream.
Periodontitis causes the gums to turn spongy with a putrid breath odor. Pus pockets form on the gums and it may become painful to eat. Some teeth may loosen and eventually need removal.
Periodontal disease is the nation’s leading cause of adult tooth loss. Yet, it becomes even more destructive once in the bloodstream. Researchers have linked these bacteria to a wide range of serious health problems.
The bacteria of gum disease have been correlated to heart disease, stroke, some cancers, diabetes, arthritis, preterm babies, memory loss and even impotency. This is rather telling as to the potency of this harmful bacteria and the destructive nature.
As a periodontal specialist, I find that most cases of dry mouth are due to factors that can be easily controlled with simple changes. If you have delayed or avoided dental care, call 828-274-9440 to request a consultation, or begin with a thorough examination in our Asheville periodontal office.
We offer the latest techniques, technology, and skills while always making patient comfort a top priority.
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