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Arthritis? Recommit Yourself To Having Good Oral Health.


Posted on Jun 20, 2021 by William J. Claiborne, DDS MS

According to the Centers For Disease Control & Prevention (CDC), over 47 percent of American adults are living with some level of gum disease. For those age 65 and older, this figure jumps to 70 percent.

These concerning statistics are nothing to ignore. Although gum disease is so common, it increases risks that go far beyond the mouth. Over the years, research has tracked many diseases and conditions that correlate with gum disease bacteria. The inflammatory reactions triggered by these infectious bacteria have been linked to heart disease, stroke, some cancers, diabetes, preterm babies, and impotency.

Research has also shown a notably close relationship between gum disease and rheumatoid arthritis (RA). These studies have been ongoing for many years, and the findings should be concerning to all adults.

RA is a debilitating, painful disease that destroys joints. RA often emerges gradually, initially causing morning stiffness and weak, sore muscles. As inflammation from RA worsens, joints become swollen.  Joints become achy and stiff most often in the fingers, wrists, elbows, hips, knees, ankles, toes and neck. Unfortunately, there is no cure for RA.

On a positive note, studies have shown that treating RA patients who have periodontal disease helps to improve RA symptoms. It is felt that this occurs because of a lighter burden of oral inflammation to the body’s immune system.

Below are some of the findings you may want to review. First, however, it’s important to understand how gum disease begins and some signs and symptoms.

In the initial stage of periodontal (gum) disease, known as gingivitis, the gums may bleed when brushing. Bad breath is more frequent and the gums may be tender or swollen. As the disease progresses, the gums turn red and may pull away from the base of some teeth.

Bad breath becomes persistent and pus pockets may form at the base of some teeth. As the infectious bacteria attack the bone structures that support tooth roots, teeth will begin to loosen and may need removal. Gum disease is the leading cause of adult tooth loss in the U.S.

In addition to the devastating damage in the mouth, the infectious bacteria of gum disease can enter the bloodstream through diseased gum tissues, causing the inflammatory triggers that activate serious health problems, such as RA.

Years ago, researchers noticed an RA-perio trait among people with rheumatoid arthritis. While RA sufferers had gum disease more often, they observed that people with gum disease tended to have RA more often.

As researchers delved deeper into the connection, it appeared that the association is much more complicated than previously thought. Findings now suggest that oral bacteria could actually be a cause of rheumatoid arthritis.

In the past, doctors felt that periodontal disease was a result of RA itself since stiff, painful hands make it challenging to maintain good oral hygiene. They also suspected that medications prescribed to treat RA could be a factor since the drugs, which suppress the immune system, inhibited the body’s ability to fight harmful oral bacteria.

Both conditions cause chronic inflammation in tissues that connect to bone with both diseases having a similar inflammatory trigger. Even more similar is the particular species of bacteria found in periodontally-diseased tissues when compared with tissues around  arthritic joints. In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis.

In 2017, study findings were released by Johns Hopkins University Division of Rheumatology, which noted evidence that the tissues in the mouth of a periodontally-compromised individual and the tissues of the joint in RA have a number of likenesses. Research has also shown a genetic link between the two.

Above all, these findings reinforce how oral health correlates closely to our overall health. When you consider how the presence of gum disease can significantly increase your risk for serious health conditions, having good oral health should be a priority for every American.

What can you do to lower your risks for tooth loss and contributing to (or worsening) serious health problems? Recommit yourself to thorough oral hygiene at home and having twice-a-year exams and cleanings.

If you have signs of gum disease, have treatment at your earliest convenience. Gum disease will only worsen and requires more treatment time and expense as it progresses.

Call 828-274-9440 to schedule an examination, or begin with a consultation to discuss your needs.

https://www.hopkinsrheumatology.org/2017/01/gum-disease-linked-to-rheumatoid-arthritis/

https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html

https://pubmed.ncbi.nlm.nih.gov/17551378/

 

 

 

Oral Bacteria Can Put An Immune System At A Disadvantage


Posted on May 20, 2021 by William J. Claiborne, DDS MS

Long before the COVID pandemic, it was widely known in the medical/dental and scientific communities that the bacteria in the mouth was intricately connected to the body’s overall health.

The oral cavity (interior of the mouth) contains some of the most varied and vast flora in the human body. It is the entryway for two systems vital to human function and physiology, the gastrointestinal and respiratory systems. Therefore, specific infections in the oral cavity may contribute to infection that can affect systemic health.

Systemic health refers to issues that affect the entire body, rather than a single organ or body part. An example of a systemic disorder is high blood pressure, which affects the body as a whole.

Research demonstrates that inflammation is a likely trigger for the systemic connection. For this reason, researchers have studied inflammation in the oral tissues caused by periodontal (gum) disease as a contributing factor of continual inflammation in the body.

Hundreds of diseases and medications impact the oral cavity. Although the precise point of activation remains to be determined with some health problems, there is a more obvious association between oral bacteria and certain conditions.

For instance, diabetes has a clear relationship with periodontal disease. Strong evidence shows 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 not only help manage periodontal diseases but may also help manage other chronic inflammatory conditions.

Oral bacteria has been found to trigger or worsen other systemic conditions, including atherosclerotic vascular (heart) disease, pulmonary (respiratory) disease, diabetes, pregnancy-related complications, osteoporosis (bone loss), and kidney disease. A shared trait between gum disease and these medical conditions is that they are chronic conditions that take a long time to develop.

https://www.agd.org/docs/default-source/self-instruction-(gendent)/gendent_nd17_aafp_kane.pdf

According to the Centers of Disease Control & Prevention (CDC), nearly half of American adults ages 30 and over have gum disease – a whopping 47 percent. In a recent study, they found that about 9 percent have mild levels of gum disease, 30 percent have moderate levels and 8.5 percent have severe gum disease (periodontitis).

Researchers of a recent study found that 64 percent of adults ages 65 and older had either moderate or severe periodontitis. Gum disease rates were highest in males, Mexican Americans, adults with less than a high school education, adults below the poverty line and current smokers.

Although the initial stages of gum disease may be concealed behind the lips and cheeks, the interior of the mouth can signal the presence of periodontal disease at nearly every stage. For example, sore and swollen areas can indicate gingivitis, an early form of gum disease.

Worsening levels of gum disease can cause redness, tenderness, bad breath, bleeding when brushing, and receding gums. Progressive gum disease can lead to persistent bad breath, pus pockets forming around teeth, loosening teeth and painful chewing.

In your regular dental check-ups, your dental hygienist uses a “probe” to measure “pockets” along the base of teeth. During the exam, he or she measures the gum depth along each tooth – front, back and in-between. These depth measurements indicate areas where gum tissues have loosened from the base of teeth, and to what extent. The higher the number, the deeper the pocket.

For example, healthy gums will measure 1 or 2. In some areas that are harder to reach when brushing or flossing, a 3 may be measured. However, a 4 or higher number indicates the gums are loosening their protective grip from the tooth. This leaves the tooth at risk for bacterial penetration below the gums.

Healthy gums wrap snugly around the base of each tooth. This prevents the entry of bacteria, which can cause damage to the tissues and bone structures supporting tooth roots. Gum disease, to no surprise, is the nation’s leading cause of adult tooth loss.

However, infectious bacteria of gum disease don’t necessarily remain confined to the mouth. Through tears in diseased gum tissues, the bacteria are able to enter the bloodstream. Traveling through the body, these potent organisms can trigger reactions that activate or worsen serious health conditions.

For example, studies have indicated a relationship between periodontal disease and stroke. In one study focused on oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia showed a higher likelihood for having an oral infection than those who had healthy gums. (https://www.perio.org/consumer/gum-disease-and-heart-disease)

Along similar lines, men with gum disease have been found to be 49 percent more likely to develop kidney cancer, 54 percent more likely to develop pancreatic cancer, and 30 percent more likely to develop blood cancers.

Having healthy gums is actually easy – and rather inexpensive. Adults should brush thoroughly (at least 2 minutes) twice a day and floss daily. Snacking and sugar should be limited. The mouth should be kept moist throughout the day by drinking plenty of water (coffee, colas and tea doesn’t count). Moisture can also be replenished by the use of specially formulated oral rinses (available over-the-counter at many drug stores). By all means, drink alcohol moderately and avoid smoking.

Additionally, adults should maintain their 6-month dental check-ups and cleanings. These appointments help to remove any build-up of plaque or tartar on teeth so they are easier to maintain between visits. Too, your hygienist can point out areas of risk so you can concentrate appropriately during your at-home oral hygiene regimen.

If you’ve delayed (or avoided) regular dental care, your likelihood of having some level of gum disease is pretty high, even though you may not have obvious symptoms in early stages. Gum disease, once underway, does not go away on its own. It will gradually worsen and become a source of infectious bacteria that strains your immune system and increases your risks for serious health problems.

Begin with an examination appointment by calling our beautiful Asheville periodontal dental office at 828-274-9440. Here, we treat our patients with compassion, respect and with comfort a priority at all times. And, we provide patients with decades of experience and advanced skills — along with exceptional dental technology – so your treatment is successful and performed efficiently and effectively in minimal time.

While your smile is greatly important to your appearance, it’s what you can’t see that may harbor a rather ugly presence. Let’s get your smile in great shape!

 

Advanced Skills & Technology Enhance Comfort, Speed Healing


Posted on Apr 27, 2021 by William J. Claiborne, DDS MS

If you’ve ever watched a cabinet maker, his skill and attention to detail is impressive. He knows the various wood types, understands the details of joints and angles, and respects the individual components as interacting pieces that will work harmoniously as a whole.

Because he has the tools and skills specific to his craft, the coming-together of this typically provides a ‘forever’ result.

In the periodontal specialty, our specific skills create a number of advantages for patients who have different needs. Some of these skills are not always obvious, yet they allow for a higher level of success, greater comfort, and less time required for healing.

A periodontist, as defined by the American Academy of Periodontology (perio.org), is:

“A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”

As an Asheville periodontal specialist for over 25 years, I’ve utilized my advanced skills to help patients with a variety of needs that involve the gum tissues. These include:

– Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)

– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)

– Diagnosis and placement of dental implants

– Treatment of lesions or cysts in oral tissues

Although there are other treatments offered, our main goal is to provide the patient with a comfortable and positive experience within our specialized skills. We believe that patients will come to appreciate the advantages of having a healthy smile and understand how our involvement can create a healthier, more confident individual.

Here, our Western North Carolina periodontal dental office features some of the most advanced technology in dentistry. Many of these are not available in other dental offices elsewhere. Some of these features include:

LANAP With PerioLase MVP 7 – Laser-Assisted New Attachment Procedure is 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. LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

3-D Cone Beam Imaging
 – Ideal for diagnoses and treatment planning, these images provide a clear view of the upper and lower jaw, used for: intricate review of endodontics; periodontics; orthodontics; implantology: TMJ; and prosthodontics, as well as dental and maxillofacial surgery. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The process is quick, painless and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging
 – This enhanced tomography works with 3D imaging for exceptional detail and range.

CS 3600 Intraoral Scanner
 – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily for creating precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments). The scanner can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Computerized Dental Implant Placement
 – This advanced system for pre-surgical positioning of dental implants uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases.

In addition, we offer a unique environment for comfort. We understand how dental fear or anxiety can cause people to delay or avoid having dental treatment, sometimes for decades. Too, when regular dental cleanings and check-ups are not maintained, the results often culminate into more complex problems (and necessary repairs) in the future.

We help patients understand that these fears and concerns are not unusual. Our doctors and staff respect each patient and provide gentle, compassionate care – at every appointment.

For those who have high fear levels, we offer several sedation options, including oral and IV sedation. 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 (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our Asheville office, anesthesia is overseen by a Medical Doctor (MD) who is a board certified Anesthesiologist.

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

How I would describe the difference between a periodontist and other dental specialists is in how gentle and respectful we are to the tissues in the mouth. These are tender layers that significantly affect the appearance of a smile and the health of teeth. By understanding the techniques to minimize incisions while effectively treating each area in the mouth, a periodontist is your expert.

We feel you’ll find no better periodontal dental environment. Call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.

 

Bad Breath – The “Body Odor” of the Mouth.


Posted on Mar 09, 2021 by William J. Claiborne, DDS MS

“Whoa!!!”

That may be our unspoken reaction when we encounter someone who’s breath odor reeks. And, we’ve all encountered it. It tends to leave a rather negative impression of the individual; one that ‘sticks’ with us every time we see him or her in the future.

Occasionally, I like to address the causes of bad breath since, at one time or another, it’s an issue for us all. Bad breath, like body odor, leaves an undesirable imprint.

Although some health conditions can be the source of bad breath, it most commonly occurs due to an overload of oral bacteria. Too many bacteria in the mouth create an odor — a sulfuric, putrid odor.

Bacteria are living organisms that eat, reproduce and emit waste. Their ability to reproduce is astounding, resulting in a consistently growing number of waste-producing creatures.

Poor oral hygiene is the most common cause for bad breath. Not brushing and flossing or doing so adequately allows oral bacteria to reproduce, which leads to plaque.

Plaque is the sticky film you feel on teeth when you’ve missed brushing or when you wake up. When not removed thoroughly on a daily basis, plaque turns into a cement-hard substance known as tartar. This mass is actually a solid colony of oral bacteria that attaches to teeth. In this form, it cannot be brushed or flossed away.

Tartar attacks enamel and gum tissues. As bacteria multiplies, it causes the gum tissues to become inflamed. This inflammation can quickly develop into gingivitis, an early form of gum disease. If not resolved fully, however, gingivitis can lead to full-blown periodontal (gum) disease.

Occasional bad breath is a nuisance but can generally be controlled with good oral hygiene, keeping our mouth moist and limiting sugar. Things like drinking sugary colas and a diet of high carbohydrate foods rev up bacteria reproduction even more, boosting their ability to grow and thrive.

However, frequent bad breath is not only embarrassing, it is a warning sign.

As one of the symptoms of periodontal (gum) disease, persistent bad breath may be accompanied by tender gums that bleed easily when brushing or tender, swollen areas around some teeth.

As gum disease advances, symptoms include gums that turn red in color and become sore, swollen and bleed easily when brushing. As it worsens, bad breath becomes persistent. Pus-filled pockets may develop near the base of some teeth. Eventually, teeth may loosen and require removal.

While what we consume can greatly contribute to the ability of these icky organisms’ ability to reproduce, a common one is having a dry mouth. This condition is known as xerostomia (zeer-o-STOE-me-uh).

Good saliva flow helps to keep bacteria moving out of the mouth. However, when brushing is infrequent or the mouth becomes dry, saliva is less able to manage the bacteria levels in the mouth.

A dry mouth may seem less likely to be a breeding ground for bacteria since they typically thrive in environments that are warm, moist, and dark. However, when saliva flow is unable to efficiently cleanse bacteria buildup from the mouth, they are easily able to reproduce.

Having ‘dry mouth’ is rather common today. In addition to a part of the aging process, a number of common medications (including anti-depressants, decongestants, and anti-histamines) have a side effect of oral dryness.

Too, many beverages contribute to having a dry mouth. These include colas, coffee, tea, and those containing alcohol. (Please note that colas are acidic and most contain caffeine. These are anything but ‘refreshing’, doing very little to hydrate the body. Stick to plain water to quench your thirst and add moisture to the body.)

Another way that oral bacteria can run rampant has to do with our oral hygiene routines. To be truly thorough in cleaning tooth surfaces, it is recommended to spend two minutes per brushing, twice a day (whether manual or electronic).

It is estimated that nearly a third of American adults brush their teeth for an insufficient amount of time. Even worse, about that same amount fail to brush twice a day. This means that an alarming amount of bacteria remain to grow and thrive in the mouth.

Proper brushing and flossing is necessary. Brush for at least two minutes twice daily and swish thoroughly. Use a circular motion rather than scrub teeth back and forth to avoid damaging tender gum tissues. Never use a hard bristle tooth brush or brush with harsh substances such as baking soda! These can wear down tooth enamel and wear away precious gum tissue.

You may be surprised to learn that brushing only tackles about half the amount of bacteria in the mouth, leaving a tremendous amount that continue to grow and thrive. The tongue actually harbors 58 – 65 percent of the bacteria in the ‘oral cavity’.

Oral bacteria love to take up housing in the tiny bumps and grooves of the tongue since they are not easily dislodged. Thus, it’s necessary that tongue cleaning be a part of your oral hygiene regimen at home to keep bacteria levels under control.

Some toothbrushes have a “tongue scraper” on the reverse side of the bristles that’s an effective option. Or, you can brush your tongue with the bristles after your teeth are brushed. Be sure to reach towards the back of the tongue where the majority of bacteria exist.

An advantage of achieving and maintaining a clean, healthy mouth is being confident when close to others. Plus, you’ll be contributing to the health and well-being of your entire body. Research has shown that a healthy mouth is a supportive component of a healthy you!

If you are experiencing symptoms of gum disease or concerned your breath is frequently bad, call 828-274-9440. We’ll arrange a periodontal exam in our comfortable Asheville periodontal office.

Here, we are committed to the comfort of each patient as well as those who have avoided dental care in the past due to fear. Dental fear is common, and we have a reputation for a gentle touch and respectful care. We also make oral and IV sedation (twilight sleep) available.

Let’s help you establish a healthy smile and feel confident in closeness!

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