Smokers Add Challenges To Dental Implant Success

Posted on Aug 09, 2016 by William J. Claiborne, DDS MS

Not only does smoking complicate the body’s natural ability to heal, it is a particular challenge to oral tissues. The chemicals in cigarette smoke have a drying effect on the gum and decreases blood oxygen levels. This results in slower healing and can lead to a greater risk of bacterial build-up.

In implant placement, both gum tissue and bone are involved in the process. Through gum tissues, I position each implant in the upper or lower jaw bone at a precise depth and angle.

Once the implant is placed, it requires a healing period as the bone grows around it, securing it in place. This process is known as ‘osseo-integration.’ Proper healing requires normal blood circulation and sufficient oxygen levels. Implant failures occur most often during this phase when the bone is growing around the implant.

In addition to smoking’s effects on the rate of tissue and bone recovery, smoking patients can develop a condition known as peri–implantitis. Peri-implantitis leads to inflammation around the implant site and pockets of pus that form in gum tissues. Although the potential to develop peri–implantitis exists for any dental implant patient, smokers have a substantially higher risk.

When smokers develop infections after implant surgery, medications used to combat the infection have a reduced effect. This is because the potency of antibiotics does not work as well on smokers. When infection is not eliminated before it can work its way into the implant area, the risk for losing the implant is significant.

Keep in mind that an implant that must be removed due to the healing complications of smoking is not refundable. This means that the investment you made has gone up in smoke – cigarette smoke.

So many negative effects from smoking make it highly advisable to stop smoking prior to implant placement. If you don’t stop, you can increase your potential for success somewhat by reducing your smoking by half at least one week prior to your placement procedure and throughout the healing period.

Having dental implants allows you to eat the foods you love again and restores eating comfort and smiling confidence. The many benefits you’ll reap with dental implants are well worth kicking the habit. Call 828-274-9440 to schedule a consultation to discuss your potential for a successful outcome.

Problems Experienced When Jaw Bone Shrinks

Posted on Jul 05, 2016 by William J. Claiborne, DDS MS

When natural teeth are lost, there are a number of ways to restore the appearance of your smile. However, there is only one way to maintain dependable, secure biting and chewing – Dental Implants. Here’s why…

Natural tooth roots provide stimulation to the jaw bone, which preserves its ability to maintain a healthy mass. When tooth roots are missing, the jaw bone loses the stimulation needed to keep blood flow active. Over time, this results in ‘resorption,’ or a decline in bone mass.

The resorption process causes the gum ridge to flatten. The pressure on the gum ridge from wearing dentures actually accelerates the rate of bone loss. For those who sleep in their dentures, this 24/7 pressure speeds the rate of bone loss even more.

When a denture is first made, it is designed to conform to the unique contours of the bone ‘arch’ where tooth roots were once positioned. The reason that denture wearers commonly experience movement or slips is because the denture’s foundation is shrinking. Even with the help of adhesives or pastes, this dwindling foundation means a denture is likely to move while eating.

A new denture may fit securely for the first five years. However, as the jaw bone continues to lose height, relines may help on a temporary basis. As bone loss continues, relines to your denture or partial will need to be done at more frequent intervals each time.

One year after natural teeth have been extracted, denture wearers average losing about 25 percent of this bone ridge. After three years, the average decline in bone is approximately 60 percent. Biting becomes risky. Chewing is more difficult. The biting force of natural teeth is about 250 lbs. while an average denture wearer is able to apply about 5 lbs. of force.

Want to see the extent of resorption you’ve experienced? Begin by looking in the mirror without your denture in place. Your mouth may appear sunken-in with your chin more pointed than before tooth loss. Other signs of bone loss include deep wrinkling around the mouth, the corners of the mouth turning downward (even when smiling), and jowls from the detachment of facial muscles.

There is a solution to the ongoing challenges of bone loss. Today’s implant dentistry offers excellent options to replace missing teeth and overcome the problems associated with bone loss (even when bone loss is severe). Implant systems such as All-On-4 can be positioned in minimal bone using just four implants. Placed at specific angles, All-On-4 can support a full, non-removable denture in minimal bone.

There are many reasons so many adults are now choosing Dental Implants for tooth replacement.  They halt the process of bone loss while restoring chewing comfort and confidence when speaking or laughing.

A Periodontist specializes in the treatment of gum tissues as well as the diagnosis and placement of Dental Implants. Although the failure rate of Dental Implants is rather low, having a successful outcome can greatly depend on the Doctor who selects and places your implants.

Begin with a consultation by calling 828-274-9440. I’ll be happy to answer your questions and discuss our many comfort options, including Oral and I.V. Sedation.

Losing Teeth In Old Age Is NOT To Be Expected

Posted on Jun 27, 2016 by William J. Claiborne, DDS MS

With proper care, your natural teeth are designed to last your lifetime. And it is important that you do everything possible to keep your natural teeth.

It has been shown that denture wearers take more medications and have more gastrointestinal problems than those with their natural teeth. It should also be noted that denture wearers die ten years sooner, on average, than those who have their natural teeth.

The discomfort, inconvenience, and embarrassment experienced by most denture or partial wearers is due to a shrinking bone foundation. When natural tooth roots no longer exist in the jaw bone, the bone begins to shrink in depth and height. While denture adhesives may lessen the amount of movement for brief periods, difficulty when eating forces many people to resort to a diet of soft foods that dissolve easily in the mouth.

Bone loss also causes changes in one’s facial appearance, including deep wrinkling and a sunken-in appearance of the mouth. The corners of the mouth turn downward, even in a smile. Jowls form when facial muscles detach from the declining mass of jaw bone. This causes denture wearers to look far older than their actual age.

Because Dental Implants are held by the jaw, just as natural tooth roots, they halt the bone loss that dentures and partials actually accelerate. Another benefit is that Dental Implants are ‘self-supporting’ so it is not necessary to crown otherwise healthy, adjacent teeth to serve as a support for a bridge.

With proper selection and placement by an experienced Doctor, Dental Implants will provide as much pleasure and satisfaction as natural teeth. To discuss replacing a denture or partial, call 828-274-9440 to arrange a consultation appointment.

Dealing With Pain The OTC Way!

Posted on Jun 20, 2016 by William J. Claiborne, DDS MS

As a periodontist, a priority with each patient is to make every appointment as comfortable as possible. For patients with problems that have become painful, my goal is to get them out of pain as quickly as possible.

While I’d like to think that everything we do is painless, the periodontal specialty often involves procedures that require penetrating tender gum tissues.

We offer sedation options and use technology and techniques designed to speed healing and minimize discomfort. However, once the patient leaves our office, post-surgical or post-treatment discomfort may occur as the tissues heal.

For example, when we place Dental Implants, we sedate patients so they will be relaxed and comfortable throughout the process. Once the patient returns home and the numbness wears off, they may experience some swelling and tenderness for a day or so.

During the healing period, we make prescription strength medications available to our patients for pain relief. Most tell us they did not need them and only took over-the-counter (OTC) medications (if any).

Although we make recommendations as to which OTC medications will be most effective for pain relief and swelling, I thought it would be helpful to explain the variations between the long list of drug store pain relief.

Once upon a time, if you had pain, you took aspirin. Drug options have greatly expanded. For most mild to moderate pain, over-the-counter pain relievers (analgesics), like non-steroidal anti-inflammatory drugs (non-steroidal anti-inflammatory drugs – commonly known as NSAIDs) or acetaminophen are the first choice.

When medications do not require a prescription, we typically assume they are safe. Yet, analgesics can have side effects and interact with other medicines, dietary supplements, and alcohol. Too, they contain the same ingredients found in many prescription drugs. This means if you’re taking several medications, you could be getting more of a particular pain reliever than you realize.

NSAIDs (aspirin, ibuprofen (Advil, Motrin, others), naproxen sodium (Aleve, Naprosyn, others), and ketoprofen (Orudis, others) are non-steroidal anti-inflammatory drugs. They reduce pain, inflammation, and fever by inhibiting production of the prostaglandins (hormone-like substances) that cause them. The down side is that they also block other prostaglandins that protect the stomach lining, regulate blood flow to the kidneys, and initiate blood clotting.
Stomach inflammation, peptic ulcers, and intestinal bleeding are major hazards for NSAID users. People who take high doses for an extended time are at greater risk, older adults especially. NSAIDs also slightly increase the risk for hemorrhagic stroke (bleeding in the brain).

Acetaminophen (Tylenol, Anacin-3, others) relieves pain and fever by affecting the parts of the brain that receive pain signals. Although acetaminophen reduces pain and fever, it has no effect on inflammation, but neither does it cause the bleeding and clotting problems associated with NSAIDs.
Acetaminophen is metabolized by enzymes in the liver. Taking too much can lead to liver damage in susceptible people, such as those who drink alcohol regularly. Taking two or more acetaminophen-containing products at the same time, or taking doses too close together, can cause overdose.
Closely read the labels of all medications to ensure you’re not exceeding the maximum recommended dose of acetaminophen — 4,000 mg per day, for people with no liver problems.

If you don’t fall into a specific risk group, taking nonprescription pain relievers as directed is generally safe. The potential for trouble emerges when you add the following:
• Some NSAID and acetaminophen products, as well as cold, sinus, and allergy remedies, contain a combination of pain relievers. Regular and long-term use of painkillers that combine analgesics can damage the kidneys.
    • Many prescription painkillers contain acetaminophen (Darvocet, Vicodin, others) or NSAIDS (Celebrex, Percodan, others). Do not take both prescription and over-the-counter painkillers without checking first with your doctor. A chart of prescription drugs containing acetaminophen and NSAIDs is available on the American Academy of Family Physicians’ website: www.familydoctor.org/otc/knowmeds.html.
    • NSAIDs can interact with many drugs, including ACE inhibitors, anticoagulants, beta blockers, lithium, and methotrexate. Aspirin interacts with anticonvulsants, corticosteroids, insulin, and sulfa antibiotics. If you take any of these prescription medicines, check before using NSAIDs.
    • Herbal supplements such as garlic, ginger, feverfew, ginkgo, and ginseng can thin blood and should be avoided when taking an NSAID.
    • NSAIDs can interfere with absorption of folic acid. If taking NSAIDs regularly, take a multivitamin daily.

It is important that your treatment and recovery result in a positive outcome without undue complications or discomfort. By understanding the advantages as well as potential adverse reactions of NSAIDs and acetaminophen, you can minimize the amount needed while gaining the most comfort from your chosen brand.