Ways To Have A Successful Outcome With Dental Implants

Posted on Jul 16, 2018 by William J. Claiborne, DDS MS

For many individuals who wish to replace one or more missing teeth, dental implants have become the leading preference. Dental implants restore the look, feel, and function like that of natural teeth. They also help to prevent bone shrinkage that occurs when tooth roots are no longer present in the jaw bone.

A periodontist has advanced training in the diagnosis and placement of dental implants. He or she can help you enjoy a higher potential for dental implant treatment that lasts your lifetime. There are a number of reasons you should strongly consider having a periodontal specialist involved in your treatment.

SELECTION OF IMPLANTS – Dental implants come in a wide array of shapes and sizes. Each system is designed to accommodate certain needs and preferences. For example, some implants are designed to support a full arch of teeth while others can be placed in areas where a great deal of bone loss has occurred. The selection of the implant type that is appropriate for your needs and goals requires a unique understanding of all implant types. That is, a periodontist can select the type that will work best for you rather than go with the one or two in which they have received training.

PLACEMENT OF IMPLANTS – In addition to selecting the best type for your needs, proper placement of implants has a great deal to do with having a successful outcome. When an implant that is too long, for instance, is placed in bone that is too shallow, it can have future repercussions that may require its removal. This could occur when a lower implant is placed too close to a nerve that runs horizontal through the jaw bone (mandible). Or, when an upper implant is placed in shallow bone, it can work its way into the sinus cavity. A periodontal specialist considers intricate factors that can effect your potential for success.

STRUCTURAL ISSUES – In addition to the factors involved with bone loss, other issues can ‘make or break’ having a successful treatment outcome with dental implants. For example, for people who have bite misalignment or TMJ disorders, they may be grinding or clenching their teeth during sleep – often unknowingly. Telltale signs of ‘bruxing’ including remaining, natural teeth that are chipped or worn. These forces have been measured to that enough to crack a walnut! When dental implants endure these forces, especially during their ‘healing’ phase, there is greater risk for implant failure. A periodontist considers these issues prior to your treatment, helping you to bypass problems that can result in eventual removal.

INDIVIDUALIZED TREATMENT CONSIDERATIONS – Our goal is to help you get the most from your dental implants. When there are individual habits or preferences that can complicate success, we work with each patient to help them enjoy their dental implants for a lifetime. For smokers, we advise ways to support saliva flow and minimize oral bacteria levels. For people who take certain medications that can interfere with oral moisture, we recommend methods to keep the mouth properly hydrated. And so on. We want to make sure your care is individualized so your potential for implant success is high!

Unfortunately, I have seen a number of patients over the years who have had implants that were improperly placed or chosen. It is a significant loss for the patient when they have to have these implants removed and start all over. Like any procedure, you want your treatment time and investment to be successful and a pleasant experience. We do, too!

If you’ve considered dental implants to replace missing teeth, let’s discuss how a periodontal dental office can enhance your potential to enjoy confident smiles and chewing comfort for your lifetime! Call 828-274-9440 to schedule an appointment.

How Gum Disease Begins, And How To Prevent It!

Posted on Jun 27, 2018 by William J. Claiborne, DDS MS

When we wake up in the morning, we all have a bit of a coating in our mouths that makes us feel ‘not-so-fresh.’ Morning breath occurs because, during the night, oral bacteria accumulate and form a film that coats the teeth, tongue and gum tissues.

For people who are diligent about twice-daily brushing and flossing before bedtime, this helps to minimize the amount of bacteria that accumulate throughout the night. However, during sleep, saliva flow is at a minimum.

Saliva helps to move bacteria out of the mouth on a continual basis. This means that the rinsing action you get from saliva during the day is less helpful during sleep. Thus, oral bacteria build up over the course of 8 or so hours.

For those who do not have a thorough brushing and flossing routine, oral bacteria amass at a much faster rate, of course. The level of bacteria vary tremendously from an individual who has a thorough oral hygiene regimen versus someone who is less frequent and/or less thorough.

Keep in mind that oral bacteria are living organisms. Bacteria thrive in an environment that is warm, moist and dark. In the mouth, they subsist on gum tissues and food particles (the reason why you should floss to dislodge that bit of pork chop caught between teeth). And, bacteria breed – in your mouth. The more there are, the faster they reproduce in number.

As oral bacteria grow, they form a film that coats the teeth and gums, known as plaque. Plaque forms quickly, so quickly it can be felt just by running your tongue over teeth at the end of the day before brushing.

If plaque is not removed on a daily basis, it can harden into a substance known as tartar, or calculus. This cement-hard mass of bacteria attaches to teeth. It can no longer be brushed or flossed away and is only removable by dental caregivers using special tools.

Once tartar is attached to teeth, bacterial growth continues, attacking tooth enamel and gum tissues. When the bacteria levels accumulate to more than the immune system can manage, the gum tissues become tender and swollen. This is gingivitis, the beginning of gum disease.

As a normal part of the digestive process, an acid attack begins in the mouth, which helps to break foods down as we chew. This occurs every time you eat or drink. For those who snack often or consume food and beverages slowly (such as sipping a cola or sucking on a piece of hard candy over an extended period of time), these acids are a continual bombardment of acid to tooth enamel. You may be surprised to learn that these acids are so potent they can actually soften tooth enamel.

As the growth of bacteria penetrate beneath the gum line, they are able to attack the structures that support teeth. As bacterial growth continues, the inflammation spreads and the gums become sore and bleed easily when brushing teeth.

As it progresses, bad breath becomes a frequent problem with inflamed gums and the gums will turn red. At this point, the infection in your gums can no longer be overcome with at home care.

As the infectious bacteria spread further, it can cause pus pockets to form. The damage to gum tissues and bone structures that support teeth will cause some teeth to loosen, requiring eventual removal.

Decades ago, it was found that this potent bacteria is able to penetrate gum tissues and enter the bloodstream. Once bloodborne, oral bacteria are able to travel throughout the body and trigger inflammatory reactions far beyond the mouth. This is known as systemic inflammation and is now known to cause a number of health problems.

Research has shown links between oral bacteria and heart disease, stroke, diabetes, arthritis, preterm babies, some cancers, high blood pressure, impotency and even Alzheimer’s disease. As a matter of fact, the make-up of tissues from oral bacteria and that of affected arthritis joints are nearly identical — both being inflammatory diseases.

Yet, this destructive process can be easily avoided. By devoting 2-3 minutes twice a day to proper brushing (at least two minutes each time) and daily flossing (which requires a minute, typically), you can prevent this barrage of inflammatory bacteria growth, risk of tooth loss, and risk for serious health problems.

Gum disease is the nation’s number one cause of adult tooth loss even though it is one of the most preventable of all diseases. Even so, nearly half of American adults have some level of gum disease. Are you one of them?

Make a commitment to take charge of your smile and your overall health through a thorough oral hygiene regimen of brushing, flossing, and having 6-month dental checkups. Know the signs and symptoms of gum disease and react quickly to have treatment.

If you’re behind on dental checkups and are experiencing any of the symptoms of gum disease mentioned earlier, don’t wait until “something hurts” to schedule a periodontal exam. A periodontist is a dental specialist who has advanced training in treating all stages of gum disease and in the placement of dental implants. He or she is your surest way to a healthy, confident smile.

We’ll begin by restoring your mouth to a healthy state so it’s easy to maintain. Call 828-274-9440 to schedule an initial exam.

 

 

 

Your Gums – An Important Part Of Your Smile’s Appearance

Posted on Jun 20, 2018 by William J. Claiborne, DDS MS

The word “smile” actually sums up the combination of several components. What creates a smile is the lips, teeth, and gum tissues. Certainly, the teeth are an important part of what “makes or breaks” a flattering smile. However, as a Periodontist, I know how significantly the shape of the gums can as well.

A periodontal specialist is uniquely trained in the diagnosis and treatment of all phases of periodontal disease and other problems associated with gum tissues. He or she also has advanced skills in the diagnosis and placement of dental implants. To the general public, however, an often unknown skill of the Periodontist is in the “esthetic” contouring of gum tissues.

To understand the intricate involvement a periodontal specialist has in smile enhancement, just look in the mirror and get a close-up view of your smile.

You’ll notice that each tooth is arched by gum tissue. You’ll also see a slight dip of this tissue that seems to separate each individual tooth. What you may not have noticed before is how the gum tissues that border each tooth are in a fairly even line. This is your “smile line.”

In seeing photos of people who have what is deemed as beautiful smiles, the teeth are nicely shaped and the gums are evenly contoured over each. In a smile that has an uneven smile line, it tends to create a jumbled look, even though the teeth may be properly shaped and aligned.

In some situations, people have experienced gum recession. This is when the gums pull away from the base of teeth, which exposes darker, tooth root portions. This not only detracts from a smile’s appearance, it leave the tooth vulnerable to decay. It also causes sensitivity, especially to hot or cold foods and beverages.

In this instance, we often perform a gum graft. This uses a small portion of the patient’s own gum tissue to cover the area of recession. This restores appearance and helps to protect the health of the tooth.

For other people, too much gum tissue may arch the teeth most visible in a smile. This is known as a “gummy smile.” Katie Couric, when she smiles fully, is an example of this. Essentially, a gummy smile is a genetic trait and does not pose a risk to one’s oral health. However, for some people, it causes them to feel self-conscious about their smile’s appearance.

It takes a precision hand and special skills to be able to reshape the gum tissues in order to preserve a natural contour. For example, that “dip” in-between each tooth is an important part of the smile line, as small as it is. This dip is known as a pointed papilla.

One of the reasons we urge people to have an implant placed at the time of tooth removal is to protect the natural contour of the gums, including this slight dip. It takes only days for this small point to begin to flatten. For teeth that are visible in a smile, the lack of this point can detract from the natural appearance in a smile.

In periodontology, we reshape gums through a procedure known as a gingivectomy (gin-geh-vect-om-ee). In this, excess gum tissue is removed. For mild cases, we may be able to reshape the gums without the need for crowning the tooth. In many cases, however, a crown is placed in addition to gum re-contouring. This is known as crown lengthening.

The crown not only enhances the appearance of the tooth involved in treatment, it helps to protect it’s root. If too much gum tissue is removed, sensitive root portions of the tooth can be exposed. This can allow entry of oral bacteria, compromising the health of the tooth and surrounding gum tissues (which can lead to gum disease).

In our office, crown lengthening or gingivectomies are performed with a high level of comfort. Although gum tissues are laden with nerves, we take special measures to minimize anything that would add to one’s discomfort or the amount of time needed for healing. As a specialist in this area, I am trained to help each patient achieve optimal results with treatment that they remember as “no big deal!”

Healthy gums are an important part of your overall health and the foundation for your teeth. The appearance of your gums, however, are an important part of your smile, too. The self-confidence in knowing a smile looks attractive tends to cause people to smile more often. That’s a good reason to ensure your teeth AND gums are in good shape!

If you’ve noticed your smile is less-than-its-best because of uneven or excess gum tissue, call us at 828-274-9440. We will be happy to schedule a consultation appointment. During this time, we’ll make recommendations and I’ll explain the procedure. From there, you can make the decision that is best for your needs and goals.

Advantages Of Dental Implants In The Hands Of A Periodontal Specialist

Posted on Jun 14, 2018 by William J. Claiborne, DDS MS

The American Academy of Periodontology defines a Periodontist as: “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.”

(https://www.perio.org/consumer/what-is-a-periodontist)

For people who are considering dental implants to replace missing teeth, a Periodontist brings a number of advantages to the table, many of which you may not be aware. For those who pursue the requirements for the periodontology specialty, most devote over 11 years to educational, clinical and specialty training once they’ve graduated from high school.

A Periodontist must first complete the requirements to become a dentist by attaining a bachelor’s degree before entering dental school, which typically requires 4 years of college. He or she then continues with further education and training to advance their skills in the prevention, diagnosis and treatment of problems related to the structures that support and surround the teeth. This is typically an additional 4 years.

With a dental degree in hand, the periodontist candidate begins a graduate program after successfully completing a rigorous National Board Exam.

Periodontal training is typically an additional 3 year period. The advanced training of a periodontist focuses on the development of gum and bone diseases as well as how they relate to other systemic diseases. They must participate in clinical trials of new therapies while learning intricate aspects of dental implants and other oral surgical techniques.

Once the educational phase is completed, licensing is required. The U.S. requires all those in the dental profession to pass written and hands-on examinations before they can begin in professional practice.

Once in practice, many Periodontists tackle the added requirements to become Board Certified by the American Board of Periodontology. A Board Certified Periodontist is “one who has made significant achievements beyond the mandatory educational requirements of the specialty and who is certified by the American Board of Periodontology.”  (https://abperio.org/)

Board Certification requires: (1) Passing oral and written exams on all phases of periodontal disease and its treatment, including dental implants. (2) Presentation of detailed reports on a broad range of actual treatment. Once certified, Periodontists are required to take significant hours of continuing education on an annual basis and must be re-certified every 3 years to maintain Board Certification.

While some general dentists perform dental implant diagnosis and placement procedures in their practice, putting your care in the hands of a specially-trained periodontist can help you enjoy an optimal outcome with a lower risk of implant failure. And, implants can fail!

For a successful result, a periodontist uses specialized training and understanding to carefully assess the best type of implant system for you. He or she will treatment plan the most ideal positioning of the implant selected with a particular respect for the surrounding gum tissues.

It may be tempting to consider a “cheap” dental implant offer or a “one-stop clinic” for the treatment. However, your overall comfort and long-term success should be the guiding force in making your decisions in tooth replacement.

Begin with a consultation appointment. Call 828-274-9440. I’ll be happy to discuss the dental implant type that may work best for you and the process involved. We can also discuss anticipated fees and payment options, if desired.

Dental implants, when properly chosen, placed, and cared for, are designed to last your lifetime. In the proper hands, your new smile will be an everyday joy, every day of your life!