Don’t Let Misaligned Teeth Lead To Tooth Loss.

Posted on Feb 25, 2019 by William J. Claiborne, DDS MS

As a periodontist, I have specialized skills in treating all stages of gum disease (known as periodontal disease, or simply “perio” by some). I also have advanced training in the diagnosis and placement of dental implants.

Although my specialty does not cover the advanced training an orthodontist has in bite alignment, my dental education absolutely covered the benefits of having proper “occlusion.” It also covered the repercussions of NOT having a bite that is properly balanced.

Just as an orthodontist can spot telltale signs of gum inflammation, I (along with general dentists and most dental specialists) can see indications of teeth that are not working in unison — even at times when these teeth appear to be “straight.”

While the nation’s number one cause of adult tooth loss is gum disease, having a misaligned bite function (or “malocclusion”) can lead to tooth loss in ways you may not have realized.

For example, during chewing, the upper teeth and lower teeth are designed to work harmoniously together to grind food down for swallowing and digesting. When an upper tooth does not interact smoothly with one below it (or vice versa), a tooth can become chipped, broken or fractured.

When damage to a tooth occurs, it must be quickly repaired before oral bacteria can penetrate tooth structures. Without the protection of enamel, oral bacteria can cause tooth decay and gum disease.

A fracture in a tooth can expand over time, leading to a crack that loosens an entire segment of a tooth. These areas must also be repaired before the tooth is subjected to oral bacteria. This typically requires a crown (or “cap”) that is placed over the top portion of the tooth.

However, a crack in a tooth that extends into the gum tissues typically means the tooth must be removed. If a portion of the tooth breaks “just below” the gum tissue, the tooth can sometimes be saved by a procedure we do called a “crown lengthening.” This is often known as a gingivectomy and is performed to remove excess gum tissues.

A gingivectomy procedure exposes more of the natural tooth so a crown can be placed over the tooth to preserve its remaining structure. (For people who have a “gummy smile,” this is performed, also, to reduce the amount of gum tissue that arches over teeth most visible in a smile.)

Another hazard of bite misalignment relates to dental implants. The overall success rate of dental implants is very high, nearly 98 percent by some estimates (when properly selected, placed and maintained). However, when a newly-placed implant is subjected to the grinding forces of TMJ disorders, its risks for success are much lower.

People are often surprised to learn that they clench and/or grind their teeth at night – primarily due to bite misalignment. When a bite is “off,” the jaw joints can become strained and inflamed. During sleep, the upper and lower jaws go on a subconscious quest of sorts, searching to find a comfortable position that eliminates the strain.

The forces behind some clenching are enough to crack open a walnut. Imagine a newly placed implant that is dependent upon the jaw bones to “heal” it into this firm foundation. When the area of bone around an implant is subjected to night after night of disruption, the implant is against the odds of becoming fully embedded in supporting bone.

Here’s an example: Let’s say you use a screwdriver to firmly anchor a screw into a solid block of wood. However, every day, you use a pair of pliers to grasp the screw head and wriggle it back and forth. Obviously, it wouldn’t take long for the wood surrounding the length of the screw to wear down from the friction of the screw’s motion, even slight as it may seem. Eventually, the screw could be easily moved back and forth and would no longer serve as a dependable base of support.

It’s not unusual for more than one dental specialist to work with another to provide a patient with the combined skills needed in particular cases. I frequently work with other dental specialists and general dentists in a “team treatment” capacity in order to give patients optimal outcomes.

When we place an implant, our goal is for each patient to enjoy its benefits for the remainder of their life. Bite misalignment can jeopardize this. And, if you have all your natural teeth now, be sure to protect them by keeping your gums healthy and ensuring your bite is as well.

After all, every dental professional is on your team when it comes to enjoying confident smiles for a lifetime!

If you’ve noticed indications of gum disease (tender gums that bleed when brushing, for example) or have experienced tooth loss (or fear you are facing it), take charge of your smile now. Call 828-274-9440 to schedule a thorough examination.

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).”

http://www.dentalproductsreport.com/dental/article/study-finds-more-60-percent-people-suffer-dental-fear

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.

 

Think “E-Cigs” Are A Safe Alternative? Read On…

Posted on Jan 16, 2019 by William J. Claiborne, DDS MS

Smokeless cigarettes, or “e-cigs,” first appeared on the market in 2004. Since then, their popularity has exploded.

Unlike tobacco cigarettes, where nicotine is inhaled through smoke, e-cigarettes are electronic devices that often mimic the shape of a small cigarette. They are designed to heat a liquid and produce an aerosol, or mix of small particles in the air. The inhalation process is known as vaping.

Because these battery-operated devices deliver nicotine without some of the toxic chemicals in tobacco cigarettes, they are deemed as safer alternatives. Although both cigarettes and e-cigs are vehicles that deliver addictive nicotine, vaping wins when it comes to being the lesser of the two evils.

However, the vapor from e-cigarettes does contain toxic compounds, just at much lower levels than cigarette smoke. This is good news for people who are quitting smoking and vaping instead.

That doesn’t mean e-cigs are SAFE, however. They’re just safer than traditional cigarettes.

A particular concern is the appeal, and hence rapid growth, among teen users.

E-cig vapor, once inhaled, is absorbed by the body. For teens, it may be particularly harmful to developing brains and bodies. The vapor contains a chemical mix of nicotine, formaldehyde and other chemicals. A recent study that examined urine and saliva specimens from teen participants showed e-cig users had elevated levels of harmful compounds such as acrylonitrile, acrolein, propylene oxide, and crotonaldehyde.

For those who both smoked cigarettes and vaped, they had the highest levels of toxins and carcinogens (when compared to e-cig only users and non-smokers). (http://pediatrics.aappublications.org/content/141/4/e20173557)

Flavorings such as diacetyl, a chemical linked to lung disease, are also a concern. (https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html)

And nicotine is nothing to take lightly as far as adolescent development goes. The Centers For Disease Control & Prevention warns that nicotine can harm the developing adolescent brain, which continues to develop until about age 25. Adolescence nicotine use can also harm the parts of the brain that control attention, learning, mood, and impulse control.

Using nicotine in adolescence may also increase risk for future addiction to other drugs.

With limited scientific evidence to develop public health policies, researchers are urging priority status be given to studying the effects of e-cigs aerosol mixtures on cells, tissues and the oral cavity (interior of the mouth). The problem has become such a concern that the National Institute of Dental & Craniofacial Research is studying the biological and physiological effects of their chemical components.

Rather than focusing on the effects of nicotine (those findings are well-known), this will examine how the high concentrations of aerosol mixes affect oral tissues. They will also monitor the tissues in the mouth, airway structures and lungs that absorb the vaporized chemicals in e-cigs. Hopefully, the findings will show the true effects of long-term exposure to these chemical mixtures.

Your smile is particularly vulnerable to e-cigs, just as it is to traditional cigarettes. Since oral tissues are moist by nature, the water vapor inhaled into the mouth is absorbed readily by gum tissues. Nicotine, consumed by any method, is known to have a drying effect on oral tissues. This decreases saliva that helps wash food particles and bacteria from the mouth.

Without sufficient saliva, bacteria rapidly reproduce, increasing the potential for tooth decay and gum disease. A dry mouth also leaves you fighting bad breath on a frequent basis.

Having a dry mouth can lead to a higher risk of periodontal (gum) disease. Initially, the condition causes the gums to become swollen, tender, red, and bleed easily when brushing. If not treated promptly, this early-stage of gum disease (known as gingivitis) can progress to periodontal disease.

In addition to attacking gum tissues and the bone that support teeth, gum disease can weaken gum tissues and allow entry of infectious bacteria into the bloodstream. Once bloodborne, the bacteria can cause inflammatory reactions elsewhere in the body. Research has shown it can increase one’s risk for heart disease, stroke, diabetes, arthritis, preterm births, impotency, and some cancers.

Additionally, nicotine from any source has been shown to constrict blood vessels in the mouth so much that it compromises the ability of oral tissues to heal. This is why we caution patients to stop (or greatly decrease) smoking after an extraction or dental implant placement.

Don’t allow misconceptions of e-cigs being “a safe alternative to smoking” to put the health of your smile at risk. Smoking, in any form, places your oral – and overall – health at a disadvantage. If you do smoke, be especially committed to your regular check-ups and cleanings so we can help you maintain a healthy mouth.

If you’ve noticed signs of gum disease, please know this will not go away on its own. Gum disease will progress and can lead to tooth loss when not treated sufficiently. A periodontist is a specialist and your wisest choice in overcoming all levels of gum disease, and getting your smile back on track! Call 828-274-9440 for an examination appointment in our Asheville periodontal office.