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How Good Oral Health Protects Your Heart


Posted on Feb 16, 2023 by William J. Claiborne, DDS MS

Having just celebrated Valentine’s Day, hearts were everywhere. The heart was mentioned in poems, cards, gifts and even in the shape of boxes that contained candy.

Your heart (the one in your chest) and your oral health are actually very much related. You may not realize how connected your mouth is to your heart.

Bacteria in our bodies is not always a bad thing. For example, certain bacteria in the gut actually enhance the process of digestion and help to keep the digestive system operating efficiently.

However, certain bacteria are bad. When too much bacteria invade the body, the immune system becomes overburdened. In bacteria overload, the body’s natural defense response, white blood cells, aren’t always able to conquer infection. This is when your doctor may prescribe an antibiotic – to give the immune system added reinforcements.

According to a report on the health of Americans (published by the Centers for Disease Control & Prevention), it is estimated that over 47% have some form of gum disease. Although we all aspire to have a smile that is appealing, it is what lies beneath the teeth and gums that can wreak havoc on one’s overall health.

Over time, inadequate daily oral hygiene enables an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even more susceptible to this bacterial buildup.

This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to ‘wash away’ bacteria at sufficient levels, the accumulation runs rampant.

Oral bacteria are living, eating, and reproducing organisms. They thrive on rotting food particles caught between teeth. They attack gum tissues and tooth enamel. Eventually, they can work their way down tooth roots and attack the bones and tendons that support teeth.

Through tears in diseased gum tissues, this infectious bacteria can enter the bloodstream. This potent bacteria are now associated with a number of serious health conditions due to their ability to trigger systemic inflammation.

When the gum tissues can no longer combat the onslaught of bacteria, there can be very few signs of periodontal (gum) disease initially. Signs that emerge are typically frequent bad breath along with swollen, tender and beefy red gums that bleed when you brush. As they grow in number, the gum tissues become weaker and they can penetrate the bloodstream.

According to the American Academy of Periodontology (www.perio.org),

“Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.

“Scientists believe that inflammation caused by periodontal disease may be responsible for the association.

“Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.”

For this reason, cardiologists are more often advising their patients to be evaluated by a periodontist prior to heart surgery. As mentioned above, gums that bleed are a sign of gum disease. These oral bacteria, given an opportunity to enter the bloodstream, are able to travel anywhere, including the heart. They can reach the heart muscle and cause a severe infection.

As an Asheville periodontal specialist, I have an up-close view of the damaging affects of insufficient oral hygiene. If you are experiencing any of the following symptoms of gum disease, please know that it will only worsen without treatment.

Common signs are:
• Gums that bleed easily when brushing
• Tender or swollen gums
• Gum recession
• Frequent bad breath
• Gums that darken in color from a healthy pink to red
• Gus pockets that form near the base of some teeth

Gum disease is also the nation’s leading cause of adult tooth loss. And, studies have shown that the loss of natural teeth compromises the digestive process, social confidence and one’s lifespan.

If you’ve failed to be fully committed to your oral health, there is no better time to begin than the present. Start with a thorough periodontal examination. Call 828-274-9440.

If dental fears have prevented you from having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. Let’s protect you, top to bottom, beginning with your smile!

Some Internet Dental DIY Advice Can Result In Tooth Loss


Posted on Jan 30, 2023 by William J. Claiborne, DDS MS

With the internet and emergence of social media, there has been an explosion of information and “advice” now at our fingertips. Want to know how to remove a red wine stain, check the internet. Need recommendations on the most scenic route to a vacation cabin, google it.

Some of the pointers online are helpful. I was finally able to reprogram my garage door opener with help found on it. However, as a periodontal dental specialist in Asheville NC, I’ve been jolted by some of the dental “advice” I’ve come across. It has not been unusual for some of this info to result in patients who come to us with problems that were actually made WORSE!

From a dental standpoint, the most common I’ve seen over recent years are…

 

• Using ‘super glue’ to repair teeth:
Most of these chemical-laden glues are toxic. They are not intended to be ingested in any way in the human body. These toxins can seep into oral tissues, causing irritation and allergic reactions.

In some cases, glue sets by using an exothermic reaction, essentially a combustion reaction that generates heat. This can damage the dentin tubules housed within a tooth’s chambers. The risks to the tooth can include the need for extraction or a root canal.

Additionally, using these glues to try to re-attach a crown, broken bridge or a denture can actually make matters worse. For example, if a crown comes off, a dot of super glue may seem to be a quick fix and a way around a dental visit. Toxic risks aside, the DIY fit will most likely be inaccurate and can lead to misalignment with other teeth when chewing or speaking.

In turn, this can result in chips, fractures and breaks in neighboring teeth. Thus, when the patient proceeds to have the crown re-cemented properly by a dentist, the glue residue must first be removed. This requires resurfacing of the remaining natural tooth structure, which results in less structure to support the crown. Because of the change in tooth height, a new crown is commonly needed.

Dentists use special dental adhesives to provide the safest and most lasting option.

• Scrubbing teeth rigorously when brushing:

Brushing teeth hard in a back-&-forth motion isn’t the way to do a good job. This can wear away tooth enamel and cause the gums to recede. Gum recession exposes tender and sensitive tooth root areas. This detracts from a smile’s appearance and also leaves the tooth vulnerable to the entry of oral bacteria.

A circular motion that allows the bristle tips to sweep the teeth is preferred. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.

• Using home remedies to whiten teeth:
Natural teeth have a protective coating – enamel. Enamel is a hard, outer shell that prevents penetration of oral bacteria into the tooth. Without this protection, cavities can occur and teeth weaken, making cracks and fractures more likely. As hard as enamel is, it can be worn away. And, when it’s gone, it’s gone for good.

Although brushing too soon after eating can wear down enamel, there is nothing worse than the thoughts of a toothbrush with a peroxide-&-baking soda mixture scrubbing across precious tooth enamel. This is like sandpaper rubbing against a tooth!

For people who want to whiten their teeth, it’s typically more than surface stains that are discoloring teeth. Thus, sacrificing tooth enamel in an attempt to remove stains is going to be of little benefit. For many people with dull, brown or yellow teeth, the aging process and years of coffee, tea, smoking and red wine can require a deeper whitening process. This is why many dental offices offer whitening systems that are safe to teeth and gums.

• Assuming blood in the sink is normal:
Your gum tissues serve as a sealant covering inside the mouth. Gums that are pink and wrap snugly around the base of teeth indicate healthy gums. Gum tissues that redden and become sore, swollen or bleed are gums signals that something is wrong. Seeing blood in the sink when you spit out toothpaste during brushing is NOT a sign you are doing a good job. It is a sign that bacteria has attacked and weakened your gum tissues.

As this bacteria progresses, gum tissues become spongy and breath odor is frequently bad. When oral bacteria has accumulated to the point of causing soreness and bleeding, prompt attention can restore the gums to a healthy state. This includes a dental cleaning and thorough at-home oral hygiene regimen. Untreated, the gums will become more and more damaged by oral bacteria and develop into periodontal (gum) disease.

Beneath the gum line, gum disease bacteria attack the bone structures that support teeth. And, these infectious bacteria can enter the bloodstream through tears in weakened gums. The oral bacteria of gum disease has been shown to cause inflammatory triggers in the body. Research has linked it to heart disease, stroke, some cancers, diabetes, arthritis, preterm babies, impotency and even Alzheimer’s disease.

If you have symptoms of gum disease, please be seen by a periodontist promptly. Symptoms include tender gums that bleed easily when brushing, frequent bad breath, swollen and tender gums and gums that redden in color from a healthy pink. Gum disease will only worsen without treatment and is the nation’s leading cause of adult tooth loss.

Maintaining good at-home care of your oral health is easy and takes just minutes a day. Follow a thorough oral hygiene regimen by brushing twice a day (two minutes each time) and floss daily. Drink plenty of plain water throughout the day and limit sugar. Have dental cleanings every six months and follow your dental hygienist’s recommendations to keep oral bacteria at minimal levels between visits.

If you suspect you have gum disease or have delayed (or avoided) having regular dental care, call our Asheville periodontal dental office to schedule an examination. Or, ask to begin with a consultation appointment.

During this time, we can discuss any concerns. If dental fear is a factor, we offer several sedation options, including I.V. sedation (“twilight sleep”). Or, if there are financial constraints, we offer several payment plans that are interest-free with no down payment required. Call 828-274-9440.

Get Dental Fear Out Of The Way and Enjoy A Healthy Confident Smile


Posted on Jan 18, 2023 by William J. Claiborne, DDS MS

It’s a new year. Hopefully, this new beginning has given you renewed determination to conquer challenges that have held you back from living the life you want.

While some people want to lose weight and others wish to learn something new, I tend to see many people at the first of each year who wish to achieve a healthy, confident smile. A large number of these people have been less-than-successful in the past because of having dental fear.

Dental fear and high anxiety associated with dental visits is not uncommon. These fears are often borne from 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 reactions that evoke fear at even mere thoughts of dental visits.

Oral health is an integral part of your overall health. For decades, studies have proven a direct contact between poor oral health and disease related to other organs. By neglecting dental hygiene, people are at greater risk of developing (or the worsening of) serious diseases and conditions. To avoid these risks, good dental care at home and having regular dental check-ups help empower adults in improving oral health and wellness.

As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Certainly, avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss. However, the repercussions of poor oral health can wreak havoc on one’s overall health.

It’s not uncommon for adults who avoid dental visits to feel they are doing a “good enough job” at maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass regular dental cleanings and exams. Yet, even the best of at-home dental hygiene can be insufficient.

Even people who feel they are dong a good job at the sink can easily miss areas of bacteria accumulation. Grooves in the tops of teeth and the tight nooks formed by crooked teeth become ideal hiding spots for bacteria growth.

Oral bacteria reproduce rapidly and, when at a certain point, can trigger inflammatory reactions. In addition to being the origin of cavities and periodontal (gum) disease, these reactions can extend far beyond the mouth (some of which are listed below).

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

Research has correlated oral bacteria to an extensive list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. For those who avoid dental care due to anxiety or fear, knowing this is not necessarily going to quell their anxiety. However, allowing dental fear to prevent you from achieving a healthy smile can increase health risks you may not realize.

Just how bad are the risks?

Dementia & Alzheimer’s disease: Gum disease occurs when infection of the oral tissues develops. It causes bleeding gums, putrid breath odor, loose teeth, and tooth loss. Oral bacteria and the inflammatory molecules that develop can enter the bloodstream, making their way to the brain. Previous lab studies have suggested that this is a potential risk factor in the sequence of events that lead to dementia.
https://www.nia.nih.gov/news/large-study-links-gum-disease-dementia

Alzheimer’s disease is the most common form of dementia that destroys memory, shrinks the brain, and affects the brain cells to die. It degenerates the functioning of mental health, which leads to memory loss and confusion. During Alzheimer’s, loss of appetite may worsen, eventually giving rise to oral health problems. The bacterium P. gingivalis appears to migrate from the mouth to the brain of some individuals as they age with a significant proportion of subjects developing Alzheimer’s disease.

Cardiovascular disease: A potential association exists between atherosclerosis (i.e. plaque deposition in blood vessels) and periodontal pathogens. There is a broad base of common genetic variants which increase both the risk of cardiovascular disease and the risk of periodontitis.

Endocarditis: Bacteremia (defined as the entry of bacteria into the blood stream) is a precondition for endocarditis. The vast majority of bacteremia do not cause endocarditis, even in patients at high risk. However, in high-risk patients, the more frequently and the more intensely bacteremia occurs, the greater the likelihood of endocarditis. Periodontal therapy has been shown to have a protective effect in people at risk of endocarditis.

Erectile Dysfunction: In the U.S., an estimated 18% of males have erectile dysfunction (ED). Men over the age of 70 are more likely to have ED compared to 5% between ages 20 – 40. Studies have shown an association between gum disease and pancreatic cancer. From analyzed data of five studies between 2009 – 2014, studies followed 213,000 participants aged 20 – 80.

Each study found erectile dysfunction was more common among men with chronic periodontitis, particularly for those younger than 40 and older than 59. After accounting for other health factors, erectile dysfunction was found to be 2.28 times more common for men who had advanced gum disease than for men without it.
https://www.reuters.com/article/us-health-periodontitis-erectile-dysfunc/chronic-gum-disease-tied-to-risk-of-erectile-dysfunction-idUSKBN13K1UP

Stroke: In one study of 265 stroke patients, researchers found that patients with gum disease had twice as many strokes due to thickening and hardening of brain arteries as patients without. Additionally, patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.

In a separate study of over 1,100 patients who had not experienced a stroke, researchers noted that 10% had severely blocked brain arteries. They also found that patients with gum inflammation were twice as likely to have moderately severe narrowing of brain arteries.

Arthritis: For decades, it was perceived that RA (rheumatoid arthritis) patients had such a high risk of gum disease due to poor oral hygiene because of dexterity problems with using a toothbrush. However, more recent studies now show that gum disease is actually a risk factor for arthritis.

While genetic factors certainly contribute to greater RA susceptibility, the true source has been determined to be inflammatory reactions. This inflammation is triggered primarily by bacterial infections, with oral bacteria being a significant contributor to inflammatory arthritis.

Researchers found that people with severe periodontal disease also had severe rheumatoid arthritis. Patients with the most plaque, bleeding and gum tissue breakdown had worse RA by all measures, including disease activity and inflammatory markers. Other studies have found that even with treatment, RA patients with periodontitis continue to have worse arthritis symptoms and are 50% less likely to be in remission.

The relationship between gum disease and arthritis isn’t just seen in adults. Kids with juvenile idiopathic arthritis (JIA) have inflammatory mouth bacteria not found in their healthy peers.  Different types of bacteria seem to correspond to specific aspects of JIA.

Some are associated with higher disease activity and others with a greater number of affected joints.
https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/mouth-bacteria

Diabetes: It has been known that acute inflammation may lead to poor glycemic control. This is due to the fact that infections reduce the uptake of glucose into cells, and endotoxins and inflammatory mediators reduce the efficiency of insulin. Due to these pathways, periodontitis (advanced gum disease) has long been regarded as a risk factor for poor blood glucose control in diabetes patients.

Pre-Term Babies: The elevated hormone levels during pregnancy create a higher vulnerability to gum disease; the reason about half of pregnant females experience swollen, red and tender gums that bleed while brushing. Known as Pregnancy Gingivitis, the gums are more susceptible to inflammation, thus more sensitive to the bacteria of gum disease.

Studies have shown that gum disease increases the risk for preterm delivery (before 37 weeks) and low birth weight babies. Gum disease also increases the risk for poor obstetrical outcomes, late miscarriage and pre-eclampsia. For example, the preterm birth rate for women without periodontal disease is approximately 11% compared to nearly 29% for females with moderate to severe gum disease.

Through tears in gum tissues, oral bacteria can enter the bloodstream. Once this bacteria reaches placental membranes, it can trigger inflammation that can cause preeclampsia or labor.

While these health concerns are all reasons to renew your commitment to achieving and maintaining a healthy smile, the image of having a terrific smile you want to share often is an added perk of having good oral health. As a periodontist, I have advanced skills in the treatment of all stages of gum disease as well as the placement of all types of dental implants.

If dental fear is holding you back, let us help your 2023 be the year you take your smile back! Begin by understanding that having discomfort or pain is NOT a part of today’s dentistry. In our Asheville periodontal dental office, we have advanced skills and technology that enhance comfort and minimize treatment time.

Here, we make patient comfort a priority at every visit. We have even designed our reception area to pamper you from the moment you enter.

We offer a private consultation room for patients as well. In this room, we can discuss your treatment and answer your questions in a comfortable setting. This allows patients to become better informed about their treatment needs and options versus communicating while they are seated in a treatment chair.

Our surgical suite offers a rather unique setting for a periodontal office. A large window provides beautiful mountain views, very soothing to our patients. In addition, we offer oral sedation as well as I.V. sedation (twilight sleep) for most procedures, if desired.

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 sedative state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are monitored with advanced safety equipment throughout treatment.

Our entire staff provide a unified team, each bringing a sincere level of compassion and commitment to excellent care. While the doctors involved in your care are top-notch, I must admit that our staff are the pros at making our patients feel truly pampered.

When patients realize that our goal is to provide exceptional care in TOTAL comfort, they relax. When they experience this, they relax even more. When they experience this more than once, a sense of trust is born. When patients trust us, they feel they no longer need to avoid dental care. Like everyone, fearful patients desire a healthy, confident smile. Once the obstacle of fear is removed, their ability to achieve that is greatly heightened.

If you or someone you know has fear that has prevented needed or desired dental care, schedule a consultation appointment. This will take place in our private consultation room. Here, we can discuss your needs and concerns and have your questions answered thoroughly. From there, you can determine what pace is best for you.

Call 828-274-9440 to learn more. Our friendly phone staff will make you feel good from the very beginning!

Good Oral Health Could Protect Your Heart (Especially for Men!)


Posted on Dec 06, 2022 by William J. Claiborne, DDS MS

According to a report by the Centers for Disease Control & Prevention (CDC) on the health of Americans, it is estimated that over 47% of adults have some form of gum disease. Although we all aspire to have a smile that is appealing, it is what lies beneath the teeth and gums that can wreak havoc on one’s overall health. Yes, OVERALL health.

Although the nation’s leading cause of adult tooth loss is periodontal (gum) disease, the infectious bacteria of periodontitis (advanced gum disease) is associated with a wide range of serious (and even deadly) health problems.

For instance, the American Academy of Periodontology (www.perio.org) has cited studies that show that gum disease is associated with heart disease. Due to its ability to trigger inflammation beyond the mouth, periodontal disease may exacerbate existing heart conditions.

For this reason, cardiologists are often advising their patients to be evaluated by a periodontist prior to heart surgery.

For decades, researchers have probed the link between gum disease and cardiovascular health. People with gum disease have two to three times the risk of having a heart attack, stroke or other serious cardiovascular event.

For patients at risk for infective endocarditis, we often work with their cardiologist when antibiotics are required prior to dental procedures. Your cardiologist will determine if your heart condition requires use of antibiotics prior to dental treatment.

Acting as a contributing factor to heart disease is highly serious. Yet, the risks associated with gum disease don’t stop there. Research has shown this potent oral bacteria can set a path of destruction into motion. It has been linked to some cancers, stroke, diabetes, arthritis, preterm babies, impotency, and even Alzheimer’s.

Men, especially, need to know that they should be committed to having healthy teeth and gums. Research has found that periodontal disease is higher in men (56.4%) than in women (38.4%) – an 18% difference. https://www.perio.org/consumer/gum-disease-and-men

And the unfavorable statistics for men don’t stop with gum health. For men, research reveals a connection with gum disease and impotence.

Men with gum disease showed a higher risk of developing impotence due to inflammation associated with periodontal disease. This inflammation has been known to damage to blood vessels, which can lead to impotency. Men younger than 30 or older than 70 are especially at risk.

A separate study found that men with a history of gum disease are 14% more likely at risk for cancer than men with healthy gums. Specifically, men with periodontal disease are 49% more likely than women to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.

Regardless of gender, over time an inadequate daily oral hygiene leads to an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even greater.

This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to rinse away bacteria at sufficient levels, the accumulation runs rampant.

Oral bacteria are living, eating, and reproducing organisms. They thrive on rotting food particles caught between teeth. They attack gum tissues and tooth enamel. Eventually, they can work their way down tooth roots and attack the bones and tendons that support teeth.

Initially, there can be very few signs of periodontal (gum) disease. Signs that emerge are typically frequent bad breath along with swollen, tender and red gums that bleed when you brush.

Once present, gum disease does not resolve on its own; it will worsen without specific treatment. As the bacteria grow in number, the gum tissues become weaker and are able to penetrate the bloodstream. This is how the inflammatory reactions are possible, able to trigger or worsen health problems far beyond the mouth.

Twice-daily brushing and daily flossing takes mere minutes and is inexpensive to do. Seeing a dentist every 6 months for oral exams and cleanings saves an individual far more by preventing problems than they cost. Still, too many adults fail to devote the investment to this necessary part of a healthy lifestyle.

An estimated 65% of adults ages 18 – 64 see a dentist only once a year. Approximately 55% of adults brush their teeth twice a day, which is too little. https://www.reference.com/health/many-times-day-people-brush-teeth-34d1104798029b7a

As an Asheville periodontal specialist, I have an up-close view of the damaging affects of insufficient oral hygiene. It often results in tooth loss, which is (contrary to many perceptions) NOT a natural part of the aging process. Having natural teeth for a lifetime is more than achievable and has even been shown to add to one’s lifespan (by up to ten years).

If you haven’t been fully committed to your oral health, there is no better time to begin than the present. Start the new year with a thorough periodontal examination. Call 828-274-9440.

If dental fears have caused you to delay or avoid having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. Too, many treatments can include oral or I.V. sedation (sleep dentistry, or “twilight sleep”).

And, if financial constraints are an obstacle in receiving treatment, we offer several payment plans. Most are interest-free with no down payment required (for qualified individuals). Feel free to ask about these during your consultation.

As a periodontist for over 30 years, the smiles of Western North Carolina residents are very special to me. Let’s make 2023 the year your smile is an asset to a healthy YOU!

 

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