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Asheville Periodontist
Older Adults Should Make Oral Health VERY High Priority.
Posted on Feb 17, 2019 by William J. Claiborne, DDS MS
Whoever said, “Growing old is not for sissies!” surely knew what he or she was talking about. That statement seems to describe the process pretty accurately, for those who endure it!
While the visual signs of growing old – hair thinning (or loss), wrinkles, sagging skin, age spots, and shifting fat – is apparent, those are minor in comparison to the aches, pains, and challenges that persist ‘below the surface.’
From aching joints to loss of muscle strength to poor eyesight to memory decline (and a long list in-between), the aging process adds health challenges that seem to grow in number and severity with each passing year. Sadly, increased risk of tooth loss seems to be part of the process.
A five-year study by the National Health & Nutrition Examination Survey showed that Americans ages 65 and over have lost an average 19 natural teeth with over 27 percent having no remaining teeth (known as being edentulous).
While tooth loss is often perceived as a normal part of the aging process, it is not. Keeping one’s teeth throughout a lifetime is very possible. And, maintaining one’s natural teeth have been associated with living a longer life.
Healthy teeth begin with a health foundation — your gums. Good oral health has been shown to reduce risks for serious health conditions (including heart disease, stroke, and some cancers) elsewhere in the body. In addition to being able to keep your teeth, natural teeth are a bonus to biting, proper chewing, and nutritional intake.
It has also been shown that wearing dentures is a poor method of ‘replacing’ them. Even though they recreate the appearance of teeth and restore function (to varying extents), they can actually contribute to long-term problems.
Without natural tooth roots, which help to nourish and stimulate the jaw, supporting bone structures begin to shrink. Known as “resorption,” this process of bone mass decline can eventually lead to tooth loss. Once resorption begins, unfortunately, it continues. Statistics show that adjacent teeth beside an area of tooth loss have the highest risk for being the next to be lost.
The ‘gum-colored’ base of dentures is also porous. This surface provides oral bacteria with tiny ‘homes’ that become breeding grounds for high levels of bacteria. Denture wearers have higher incidences of repiratory problems, including susceptibility to pneumonia.
RDH (registered dental hygiene) Magazine (https://www.rdhmag.com/articles/print/volume-34/issue-12/columns/infection-control/dentures-and-aspiration-pneumonia.html) shares one study of senior adults and the higher risks for those who also sleep in their dentures.
Too, with the aging process also comes the condition of ‘dry mouth.’ Saliva plays an important role in maintaining good oral health. A healthy saliva flow makes it easy to talk, swallow, taste, and digest food.
A reduction in saliva flow can increase plaque accumulation as well as the risk of developing periodontal disease. Referred to as gum disease, this can lead to tooth decay, mouth sores ,and oral infections. Inadequate saliva can contribute to bad breath, dry and cracked lips, cause the fit of dentures to become uncomfortable, and result in higher oral infection risk.
Almost half of Americans take at least one prescription daily. For adults over the age of 65, nearly 90 percent take one or more. While a number of both prescribed and OTC medications include the side effect of oral dryness for any age, age-related reductions in salivary production causes irritation to oral tissues.
Medications including antihistamines, blood pressure medications, decongestants, pain medications, diuretics and antidepressants typically cause dry mouth, which can create inflammation and higher susceptibility to infection.
Older adults obviously need to make their oral health one of their highest priorities. Fortunately, good oral health is easy to achieve. Daily brushing and flossing and regular 6-month exams and cleanings can help to minimize problems and address those that do occur at their earliest stages.
It is also important to keep your mouth moist. Drink plenty of water throughout the day. Limit foods and beverages that are caffeinated, which are drying to oral tissues. These include coffee, tea, colas and chocolate as well as spicy foods. If you take medications that have drying side effects, use an oral rinse designed to replenish moisture. Also, chew sugarless gum to help promote saliva flow.
Your diet is an important part of a healthy mouth. Evaluate your food intake carefully. Begin by limiting carbs and sugar. While all foods trigger an acid attack in the mouth for nearly 30 minutes after eating, sugar and carbs super-charge the reproduction of oral bacteria.
When teeth are lost, adults encounter a complicated set of issues – and costly challenges that can reach far beyond the mouth. As a Periodontal specialist, I’ve seen how simple measures can save people greatly in treatment time and expense AND prevent problems like gum disease, cavities and tooth loss.
If you have started to lose natural teeth already, let us help you halt the process! Call 828-274-9440 to schedule a consultation so we can discuss how you can regain your oral health for a lasting, healthy smile!
Cancer Risk And Gum Health
Posted on Feb 05, 2019 by William J. Claiborne, DDS MS
I know of no one who hasn’t lost someone dear to them – family member or close friend – to cancer. The disease, although now more survivable than ever thanks to advancements in early detection and treatment – remains a dreaded diagnosis.
Still, a cancer diagnosis often drags entire families through the battle. Treatment can be lengthy and time-consuming as well as financially and emotionally draining. Some diagnoses are considered ‘death sentences,’ with terribly low survival rates. For instance, pancreatic cancer’s 5-year survival rate, depending on the type, ranges between 3 – 9 percent. (https://www.pancan.org/facing-pancreatic-cancer/about-pancreatic-cancer/survival-rate/)
Decades of research has resulted in improved measures, and many cancers once thought dooming are now very treatable. Success rates are improving with most survivors going on to live normal, healthy, active lives.
Preventing cancer isn’t a simple matter. We know that a healthy lifestyle can help but isn’t a guarantee for avoiding it. Cancer can result from a number of triggers. For example, smoking is a known contributor to oral and lung cancer. The toxic chemicals delivered through cigarette smoke are proven activators in some cancer development.
As research has been able to go deeper into the cause-&-effect of various cancers, the health of periodontal tissues are coming to light as having an intricate role in your overall health, including your risk for developing some cancers.
Periodontal disease, often referred to as gum disease, runs rampant in the U.S. According to the Centers for Disease Control & Prevention (CDC), over 47 percent of adults over the age of 30 have some level of gum disease. For adults over the age of 65, this figure increases to 70 percent.
This is a frightening statistic considering the devastation that infectious bacteria of periodontal disease can cause. While it is the nation’s leading cause of adult tooth loss, research has also revealed links to increased risk of heart disease, stroke, arthritis, diabetes, preterm babies, high blood pressure, and erectile dysfunction (ED).
Yet, much progress is being made in tracking down activators of cancer in the body. For instance, research shared in a January 2018 article in Medical News Today revealed exciting progress along these lines. (https://www.medicalnewstoday.com/articles/320634.php)
Researchers found that some gastrointestinal cancers, such as pancreatic cancer, share an enzyme. This enzyme, typically found in the mouth, serves as the “boosting” agent in the development of gum disease. They noted that the enzyme was also present in certain cancerous tumors.
In additional research shared by the AACR (American Association For Cancer Research), cited that previous research has revealed gum disease as a risk factor for breast, oral, and esophageal cancers. (https://www.aacrfoundation.org/Science/Pages/assessing-gum-disease-cancer-risk.aspx). The warn that women, especially, should be urged to maintain good periodontal disease to lower their risk of additional types of cancer.
One study showed that post-menopausal females were more susceptible to several cancers.
Between 1999 – 2003, researchers monitored cancer outcomes of female participants ages 54 to 86 through self-reported questionnaires onn periodontal disease. The study showed that: “a history of gum disease was associated with a 14 percent higher risk of developing any cancer”.
The greatest association was for cancer of the esophagus, which was more than 3 times more likely in women with periodontal disease than women who did not list having periodontal disease. Lung cancer, gallbladder cancer, melanoma, and breast cancer were also associated with higher risk.
Although women who smoked had higher risks for breast cancer, lung cancer, and gallbladder cancer, non-smokers with gum disease also had increased risks of these cancers.
Still not fully understood, it is suspected that gum disease bacteria are able to enter the bloodstream through diseased gum tissues. This allows them to reach other body sites and contribute to “carcinogenesis”, the process where normal cells are transformed into cancer cells, leading to the formation of cancer.
Because the study consisted of self-reported data, the study’s authors suspect the prevalence of periodontal disease may have been under-reported. This would make the percentages even higher. While further research is needed through more precise assessments of periodontal disease, these statistics are helpful in confirming the link between periodontal disease and cancer.
This study also reinforces previous findings that show our oral health is more closely related to our overall health than most are aware. As a periodontal specialist, I urge you to be aware of the signs and symptoms associated with all stages of gum disease. These include tender gums that bleed easily when brushing, gums that turn red in color, frequent bad breath, and gums that loosen their grip around teeth.
For more, you may find it helpful to visit the web site of the American Academy of Periodontology: www.perio.org.
A periodontist is a dental specialist with advanced training in the diagnosis and treatment of all stages of gum disease. This advanced care is your wisest choice for tackling gum disease and having good oral health at any age. For more information or to schedule an appointment, call 828-274-9440 or tap here to begin.
Dental Implants Overcome The Problems Of Missing Teeth.
Posted on Jan 28, 2019 by William J. Claiborne, DDS MS
Advanced periodontal (gum) disease is the number one cause of adult tooth loss in the U.S., affecting nearly 48 percent of American adults. Although teeth play an important role in our overall health, there is a misconception with some adults that tooth loss is a natural part of the aging process.
Hopefully, this is changing.
In 1957-58, it was estimated that over 55 percent of adults over the age of 65 were totally edentulous (having no natural teeth). In 1971, a survey by the National Center For Health Statistics found that the percentage had dropped to 45. By the year 2024, it is estimated that only 10 percent of Americans between ages 65 – 74 will be without teeth.
Teeth are more than just what you use to smile, bite, and chew. They play an important role below the gumline as well.
Tooth roots provide nourishment and stimulation to the upper or lower jaw bone. This helps the bone to maintain its mass. Without tooth roots, the jaw bone begins to shrink in a process known as resorption. Dentures wearers often notice first signs of this when their once-snug ‘appliance’ begins to move or slip when chewing.
Here’s why that is occurring…
A denture, when first made, is designed to conform to the unique contours of an existing ‘ridge.’ This is the gum-covered arches in your mouth where natural teeth were once held. Without the stimulation of tooth roots to the bone, resorption causes the ridge to gradually flatten. As it loses height, the denture becomes “slippery” or “wobbly,” as patients often describe.
When dentures slip and rub sore spots on tender gums, denture wearers quickly learn which foods are too challenging for their unstable denture. They may use denture pastes or adhesives more frequently. Eventually, many switch to a diet of soft foods that dissolve easily in the mouth.
When a diet is deficient in the fiber and nutritional components of a healthy makeup, overall health suffers. Because the act of chewing and acids in saliva flow are the first stage of digestion, denture wearers are known to take more medications and have more gastro-intestinal problems than those who still have natural teeth.
Also at risk is social involvement, now shown to be an important part of being healthy. Because of fear of embarrassment, it’s fairly common for longtime denture wearers to avoid these gatherings, especially those centered around food. (And, try to think of many social activities that don’t – at some point – include food!)
One survey of over 20,000 dentists (by the Academy of General Dentistry) showed that having a tooth removed causes many patients to feel socially embarrassed and less likely to participate in functions that are psychologically beneficial.
Psychological issues related to tooth loss are also associated with feelings of depression and being less goal-oriented in the workplace.
The decline of bone mass can even be seen, contributing to changes in facial appearance. As bone height declines, deep wrinkles form around the mouth. Even when smiling, the corners of the mouth turn downward. Jowls form as facial muscles detach. The chin becomes pointed and the mouth appears to be collapsed into the face (often described as a ‘granny look’).
To see the extent of bone loss, a denture wearer should look in the mirror without the denture in place. Because a denture ‘plumps up’ the face, it can be deceiving as to just how much bone loss has been experienced.
For those who have already experienced tooth loss, I highly recommend dental implants for replacement. There are many types of implant systems, each designed to accommodate specific needs. A Periodontist, a dental specialist, has advanced training in the diagnosis and placement of all types of implants. The type that is best for you depends on many factors that a periodontal specialist takes into consideration.
There are even implant types that can be successful for people who have already experienced a great deal of resorption. In many cases, bone rebuilding procedures can restore the height of the jaw bone with a bone graft not needed,.
Dental implants restore the look, feel and function of natural teeth while boosting one’s ability to feel confident and eat comfortably. Another bonus? Dental implants do not rely on adjacent teeth for support as with partial dentures or crown-&-bridge combinations.
The implanted portion is held by the jaw bone, just as the natural tooth roots you once had. This helps to halt the process of bone loss. Dental implants are also designed to last a lifetime, making them a wise investment.
For those who feel they are “too old” for dental implants, I remind them that many of our implant patients are well into their 80’s or 90’s. Keep in mind that today’s adults are staying in the workplace longer, staying active in senior years, and living longer.
Since 1950, Americans added over 11 years to average life expectancy, to over age 79, according to 2013 statistics. Although females were once living an average of seven years longer than males, that gap has now narrowed to less than five.
When an adult, at any age, expresses frustration with feeling they are caught in a dental office’s revolving door, an examination typically reveals that they have some level of periodontal (gum) disease. Like most diseases that form in our bodies, gum disease begins silently. When symptoms do emerge, they include tender gums that bleed when brushing, persistent bad breath, and gums that pull away from teeth (known as gum recession).
Amazingly, so many adults have gum disease even though it is completely avoidable. Proper brushing and flossing, minimizing sugar intake, avoiding smoking, and having regular dental checkups can help curtail the cycle of dental problems.
First, you must establish a healthy foundation, which begins with healthy gums. The first step is to have a periodontal exam to determine your current gum condition. If signs of gum disease exists, we will explain the process needed to restore your gums to a healthy state. We will also make home care recommendations to help you maintain good gum health between dental checkups.
While adults are getting better at keeping their natural teeth, we still have a long way to go. I believe many adults would be more determined to keep their natural teeth if they had a better understanding of their value. Hopefully, this has helped your appreciation of what supports those pearly whites!
For more information, contact us at 828-274-9440 or tap here to being.
http://www.cdc.gov/nchs/products/databriefs/db197.htm
How Our Asheville Periodontal Dental Office Makes Your Care Comfortable, Easy.
Posted on Jan 20, 2019 by William J. Claiborne, DDS MS
When people understand what a periodontist does, they realize the advantages of having this specialized treatment when it comes to the health and appearance of a smile.
A Periodontist has advanced training and skills in all stages of periodontal (gum) disease as well as in the re-contouring gum tissues. Additionally, they offer unique skills in the diagnosis and placement of all types of dental implants. (Learn more at the web site of the American Academy of Periodontology: http://perio.org/consumer/what-is-a-periodontist)
However, in any dental office, whether specialty or general, there must be a commitment to the individual needs of each patient.
In our Asheville office, this is where people who have periodontal (gum) disease properly diagnosed and successfully treated. This begins with early-stage gingivitis and through the advanced level of periodontitis. And, our advanced technology optimizes diagnosis and treatment, enhancing comfort and saving treatment time.
Research has shown that your oral health is a vital component of overall health. Studies continually uncover intricate interactions that oral bacteria of advanced periodontal disease has with other processes in the body.
For example, that the health of your gums and number of teeth directly correspond to a healthier you. Don’t delay care that you need, even if fear has prevented this in the past. For example, an article published by Johns Hopkins Medicine stated, “Diabetes that is not properly controlled can lead to periodontal (gum) diseases in both young and old people.”
There is a flip side of this. They go on to share, “… if diabetes is poorly controlled, higher glucose levels in the mouth fluids will encourage the growth of bacteria that can cause gum disease.” (https://www.hopkinsmedicine.org/healthlibrary/conditions/diabetes/diabetes_and_periodontal_gum_disease_85,P00349)
An unfortunate obstacle for many to receive regular dental care, however, has been fear or anxiety associated with dental visits.
According to findings of a study that included over 18,000 people (reported in Dental Products Report), “61 percent of the respondents said they’re suffering from dental fear, and almost 4 percent of them said they’ve never been to a dentist. The biggest percentage of people (39 percent) are afraid of the pain, followed by the smell of chemicals (24 percent) and the sound of the drill (21 percent).”
This is why adults often end up with gum disease and tooth loss. As a matter of fact, the Centers For Disease Control & Prevention (CDC) estimates that over 47 percent of American adults have some level of gum disease, which is the leading cause of adult tooth loss.
To help anxious or fearful patients relax, we make sure we are communicating thoroughly. Our belief is that patients who are fully informed of their needs and the procedures required are more confident in proceeding with treatment. This, in turn, creates a patient who is able to relax and let fears go.
Some patients are unable to relax, however. This is why our office provides Oral or I.V. Sedation. Oral sedation is a pill form of relaxation. Although most patients have little or no memory of the procedure afterwards, this provides deep relaxation with a quick recovery.
I.V. sedation (also known as ‘twilight sleep’) for a deeper level of relaxation. This medication is administered via a drip. Patients comfortably doze throughout their procedures are accomplished and generally have no memory of treatment afterwards. Although recovery time is longer with IV sedation, most are able to resume normally within 24 hours.
Regardless of the sedation chosen, patients are closely monitored by trained staff and advanced safety equipment. Your safety is as important to us as your comfort, so we ensure all measures are taken to provide both to optimal levels.
Sedation can be used for procedures involving gum reshaping, treatment of gum disease, or placement of dental implants. For any procedure, however, we carefully assess each patient’s current gum health, age, medical and dental history, medications, and number of remaining teeth.
Please know that your procedure, comfort option, and individual needs are important to every member on our team. Here, you’ll be respected, given exceptional care, and never over-treated or under-treated.
To begin, call 828-274-9440 to begin with a consultation appointment. During this time, we can discuss the options that may work best for your needs. I’ll explain comfort options and we can have our financial coordinator review payment options with you, if desired.
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