Grow Older With A Confident Smile That Is An Asset To Your Well-Being


Posted on Jul 27, 2023 by William J. Claiborne, DDS MS

Oliver Wendell Holmes, an associate justice of the U.S. Supreme Court from 1902 – 1932, once said, “Old age is always fifteen years older than I am.” 

For people who’ve reached “a certain age,” it becomes clear that the advantages of aging (such as having more confidence and living life at a slower pace) are mixed with many challenges, mostly regarding health. 

From aching joints to loss of muscle strength to poor eyesight and hearing loss, the aging process comes with health challenges that seem to grow in number and severity with each passing year. Sadly, increased risk of tooth loss is also part of the process.

Depending on the retention of wisdom teeth, a full set of adult teeth should be 28 to 32. However, in a five-year study by the National Health & Nutrition Examination Survey, Americans ages 75 and over were missing over 22 natural teeth with over 26% having no remaining teeth (known as being edentulous).

While tooth loss is often perceived as a normal part of the aging process, it is not. Keeping one’s teeth throughout a lifetime is very possible. The health benefits of maintaining  natural teeth include, among many others, living a longer life.

Healthy teeth rely on a healthy foundation — your gums. Good oral health has been shown to reduce risks for serious health conditions (including heart disease, stroke, and some cancers) elsewhere in the body. In addition to lowering a number of health risks, keeping your natural teeth is necessary for proper biting, sufficient chewing, digestional health and nutritional intake.

It has also been shown that wearing dentures is a poor method of replacing natural teeth. Even though they recreate the appearance of teeth and restore function (to varying extents), dentures can actually contribute to long-term problems.

Natural tooth roots help to nourish and stimulate the jaw bones that are the supporting structures of teeth. Without them, the bones begin to shrink. Known as “resorption,” this process of bone mass decline can eventually lead to tooth loss. Once resorption begins,, it continues at an ever-increasing cases year after year.

Tooth loss also causes a domino effect of sorts. Statistics show that adjacent teeth beside an area of tooth loss have the highest risk of being the next to be lost.

And the problems associated with dentures continue. The gum-colored base of dentures is porous. This surface provides oral bacteria with tiny hideouts that are breeding grounds for high levels of bacteria. Denture wearers have higher incidences of respiratory problems, including susceptibility to pneumonia. Studies have shown that senior adults who also sleep in their dentures have even higher risks.

Wearing your dentures for prolonged periods of time (such as while you sleep) coupled with the aging process itself can lead to Denture Stomatitis. This condition causes redness, swelling and tenderness in the mouth. While it is most common among denture wearers, it can also occur from a broad spectrum of antibiotics.

Nearly 89% of adults ages 65 and older report they are currently taking any prescription medicine. More than half of adults 65 and older (54%) report taking four or more prescription drugs (compared to 32% of adults 50-64).

While a number of both prescribed and OTC medications include the side effect of oral dryness for any age, age-related reductions in salivary production are more severe for older adults, causing irritation to oral tissues.

Medications including antihistamines, blood pressure medications, decongestants, pain medications, diuretics and antidepressants typically cause dry mouth, which can create inflammation and higher susceptibility to infection.

The aging process causes the condition of “dry mouth.” Saliva plays an important role in maintaining good oral health. A healthy saliva flow makes it easy to talk, swallow, taste, and digest food. A reduction in saliva flow can increase plaque accumulation as well as the risk of developing periodontal disease. 

Referred to as gum disease, this bacteria accumulation can lead to tooth decay, mouth sores and oral infections. Inadequate saliva can contribute to bad breath, dry and cracked lips, cause the fit of dentures to become uncomfortable, and result in higher oral infection risk.

An emphasis on maintaining good oral health needs to be front and center for older adults along with their overall health care commitment. Fortunately, good oral health is easy to achieve. Twice-daily brushing, daily flossing and having 6-month dental exams and cleanings can help to minimize problems and address those that do occur at their earliest stages.

It is also important to keep your mouth moist. Drink plenty of water throughout the day. Limit foods and beverages that are caffeinated, which are drying to oral tissues. These include coffee, tea, colas and chocolate as well as spicy foods. If you take medications that have drying side effects, use an oral rinse designed to replenish moisture. Also, chew sugarless gum to help promote saliva flow.

Your diet is an important part of a healthy mouth. Evaluate your food intake carefully. Begin by limiting carbs and sugar. While all foods trigger an acid attack in the mouth for nearly 30 minutes after eating, sugar and carbs super-charge the reproduction of oral bacteria.

When teeth are lost, adults encounter a complicated set of issues – and costly challenges that can reach far beyond the mouth. As a Periodontist, I’ve seen how simple measures can save people greatly in treatment time and expense AND prevent problems like gum disease, cavities and tooth loss.

According to Woody Allen, “You can live to be a hundred if you give up all things that make you want to live to be a hundred.” Your smile should be one of your best assets throughout your lifetime, complementing appearance and as an advantage to your overall health. Don’t let the detrimental impact of tooth loss and risks associated with gum disease make you look and feel old.

If you have begun to lose natural teeth, let us help you halt the process! We can also discuss replacing them with dental implants with our specialized skills in the diagnosis and placement of dental implant.

Call 828-274-9440 to schedule a consultation to discuss how you can regain your oral health for a lasting, healthy smile!

Sources:

https://www.nidcr.nih.gov/research/data-statistics/tooth-loss/seniors

https://www.kff.org/health-reform/issue-brief/data-note-prescription-drugs-and-older-adults/

https://my.clevelandclinic.org/health/diseases/21702-denture-stomatitis

Six Reasons To Have Your Dental Implants Placed By A Periodontist


Posted on Jul 12, 2023 by William J. Claiborne, DDS MS

A periodontist is a dental specialist who is often in the background of various dental procedures. Yet, we are in the forefront when it comes to specialized skills that support specific treatment needs.

Most patients are referred to our Asheville periodontal dental office by general dentists and dental specialists to provide certain aspects of dental treatment, which may involve our skills in cosmetic dentistry, dental implants, and treating all stages of gum disease.

A periodontist has advanced training to properly diagnose and treat all stages of periodontal (gum) disease (including gingivitis and periodontitis) as well as placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures to repair gum-related disparities such as a “gummy smile” or varying gum arches that “jumble” a smile line.

A periodontist receives an additional 3 years of training after 4 years of undergraduate school and 4 years of dental school. This long, rigorous pursuit of the periodontal specialty requires the individual to be highly committed to the advanced care he or she will provide. It is our goal to help people achieve good oral health, a confident smile they love to share, and prevent tooth loss that can result from diseases of the gums.

Dental implants are now seen as the preferred option for tooth replacement. They come in over 40 different types designed to accommodate various challenges and preferences. But, why should you have your dental implants chosen and placed by a periodontist? After all, some dentists perform this in addition to their general dentistry services.

Below are 6 reasons our dental implant patients have particular advantages…


(1). With specialized skills, a periodontist is especially respectful to oral tissues as sensitive layers that have an important role in the appearance of a smile and the health of teeth. Utilizing these skills, a periodontist can help to minimize incisions while effectively treating each area in the mouth.


(2). Rather than be limited to just one or two dental implant systems that were taught in a “crash course” by the implant manufacturers, our speciality understands the complete spectrum of implant systems. Some may be ideal for your needs while others may not. Some provide you with a non-removable (“fixed”) option while others may involve removable teeth. Our specialized skills give you the best choices you should have.


(3). Additionally, the proper selection of your dental implants may greatly save you in treatment fees. For example, the All-On-4 dental implant system needs only 4 implants per arch, and can be placed in shallow bone. The treatment fees are less since the number of implants is low and the need for bone regeneration for severe bone loss may not be required. For these reasons, a periodontist may be able to help you achieve your tooth replacement goals within a budget you can manage.


(4). In our Western NC periodontal dental office, our advanced technology includes 3-D Cone Beam Imaging. This is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes. The imaging process is quick, painless and at minimal radiation levels.


(5). Another feature is our Computerized Dental Implant Placement system. This advanced technology is designed for pre-surgical positioning of dental implants that 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. This minimizes disruption of gum tissues and targets implant placement at ideal depths and angles. Thus, treatment success rates are higher with faster (and more comfortable) healing time.


(6). Optimal comfort for our patients has always been a priority. For many, a desired level of comfort and relaxation includes sedation options. Here, 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. IV 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 Medical Doctor (MD) who is a board certified Anesthesiologist.

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


If you are considering dental implants, you may wish to begin with a consultation appointment. During this time, we can explain the vast difference in comfort, treatment time, and success available through our specialized skills and extensive technology.

Call 828-274-9440 to schedule. New patients are always welcome and a referral is not always required.

Avoid An Aged Appearance By Keeping Facial Bone Structures Healthy


Posted on Jun 21, 2023 by William J. Claiborne, DDS MS

The aging process can, unfortunately, take quite a toll on appearance. Shoulders may slump, waistlines may widen, and hair may turn gray. As a periodontist in Western NC, I see another telltale sign of aging – resorption. This is the process of bone loss when natural tooth roots are missing from the jaw bones. Facial features affected by resorption can reveal quite a lot, and not in a flattering light.

A natural tooth is held by the upper or lower jaw bone by its roots. Around the base of each tooth, gum tissues wrap snugly to prevent entry of bacteria and protect sensitive tooth roots. These roots help to keep the tooth ‘alive’ by supplying blood and other nutrients to the bone supporting the tooth. Through the presence of these roots, the jaw bones also receive valuable stimulation, which helps the bone retain its mass. 

Losing a tooth can trigger a domino effect, of sorts. Statistics show that tooth loss is most likely to occur in an area next to that of a missing tooth. Without the stimulation of tooth roots, the bone in that area will begin to resorb, or shrink in mass. This increases risks for adjacent teeth.

The process of resorption begins slowly the first year. However, the rate of bone loss accelerates more and more each year. For people who wear a denture or partial, the pressure of wearing these appliances can speed up the rate bone loss even more. Eventually, facial features change due to the declining bone structure, changes that tend to age one’s appearance far beyond their actual age.

Initially, the changes may be subtle, such as deep wrinkles around the mouth. The corners of the mouth begin to turn downward, even when smiling. Jowls form as facial muscles detach from shrinking bone structures. As the bone declines further, the chin becomes more pointed and the mouth seems to collapse into the face. The chin moves closer to the nose, creating what’s referred to as a ‘granny look.’

Dental function also takes a hit when it comes to tooth loss. The strength of the bite becomes challenged. Jaw bone breaks are more likely. Wearing a denture or partial becomes challenging due to its declining ‘ridge’ that is relied upon for support. Dental prosthetics begin to slip while eating, or even speaking. Eventually, frequent applications of denture pastes and adhesives are needed. After a time, even relines help very little.

As a periodontal specialist, one of my advanced skills (in addition to the treatment of all stages of gum disease) is in the diagnosis and placement of dental implants. For adults who are missing one or more natural teeth, we recommend dental implants for a number of reasons. 

Why should you have your dental implants placed by a periodontist?

There are over 40 different implant systems, each designed to accommodate various needs and goals. For example, one consideration in determining the type of dental implant is in the assessment of jaw bone mass.

An implant needs a particular amount of bone structure to support it. After several years of missing tooth roots, the amount of existing bone may eliminate some types of dental implants or indicate the need for additional procedures prior to placement.


With adequate bone mass to support the implant(s), the choice of implant can be made based upon your needs and preferences. Without the necessary bone mass, we may advise a bone rebuilding process prior to implant placement. Typically, this does not require a bone graft. In many cases, we are able to apply a bone rebuilding material that regenerates ample bone mass. Or, we may advise an implant system that uses unique implant lengths and placement angles (the “All-On-4”) that can function dependably in minimal bone.

The benefits of dental implants are many. These include:


A lifetime solution – When properly selected and placed, dental implants are designed to last a lifetime. This is why a periodontist is an ideal choice for your selection and placement. 


A healthy choice for remaining teeth – Although each natural tooth seems to “stand alone”, individually, they provide support for the teeth on each side and the one above or below. This helps to keep teeth in their proper positions. However, dental implants provide stimulation to the bone to help retain bone mass. And, teeth supported by implants do not rely on the support of crowned (or ‘capped’) teeth on both sides. Thus, preserving the integrity of adjacent teeth.


Restoring biting and chewing stability – Because dental implants are anchored by the jaw bone, biting and chewing stability is restored. People who have dental implants are able to eat healthy, fibrous, and chewy foods once avoided due to ill-fitting dentures or partials. 


The feel of your “own teeth” – Rather than have clunky dental prosthetics in your mouth, dental implants act like your own teeth. You can brush them in your mouth and eat foods you love and laugh with friends. Unlike dentures or partials, no more sore spots rubbed on tender gum tissues and no more piercing seeds caught between the gums and denture base.


A wise investment – Dental implants, unlike crown-&-bridge, dentures or partials, will not break, develop a cavity, require periodic “relines,” or need a root canal. Made of titanium, an implant will last your lifetime without requiring the upkeep of other types of restorative options.


In our Asheville periodontal dental office, we offer some of the most advanced dental technology available. This allows our patients to enjoy optimal comfort with minimal treatment time. We are also committed to patient comfort through oral and I.V. sedation (“twilight sleep”). These are administered safely with continual monitoring by trained team members.

If you are considering dental implants to replace missing teeth, begin with a consultation appointment. This will take place in a private room where we can discuss your needs and concerns. Call 828-274-9440 to schedule, or tap here for contact information.

Safe Tips for Cancer Patients To Protect Oral Health During Treatment


Posted on Jun 09, 2023 by William J. Claiborne, DDS MS

Cancer has touched so many in the U.S. It is a major, if not deadly, challenge for not just the cancer patient. The each individual diagnosed, it can also impact the lives of spouses, children, family members, and friends.

The progress in improving the rates of cancer survival in America are, fortunately moving in the right direction. As of January 2022, the National Cancer Institute shares that there are an estimated 18.1 million cancer survivors in the United States, representing approximately 5.4% of the population.

By 2032, the number of cancer survivors is projected to increase by 24.4% and by 2040, it is projected to grow to 26.0 million.

As progress continues, treatment for cancer remains a daunting ordeal. The long treatment time and extreme side effects associated with cancer treatment is seen as simply awful. The oncology teams that surround these patients are amazing, however, and try to lessen the burden throughout.

As a periodontist, I am familiar with the oral side effects of chemotherapy and radiation. I am very dedicated to these patients, and strive to help them be comfortable while protecting their oral health.

What’s important is to care for oral health in a way that keeps the patient comfortable while helping them to avoid any after-effects. This is where I differ with some advice for cancer patients since not all “tips” are good for the teeth and gums. For example, cancer patients undergoing chemotherapy may be advised to suck on on peppermint or lemon drops to relieve dry mouth. Not so fast…

Caring for oral health during any health condition that lowers the immune system can actually support your immune system by lowering systemic inflammation. Research has linked many health problems, including some cancers, to the bacteria of advanced gum disease (periodontitis).

Information shared by the American Academy of Periodontology states:
“Researchers found that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.”

Oral dryness causes the tissues in the mouth to become inflamed, which places you at greater risk for infection. Insufficient saliva flow ups your risk for tooth decay and gum disease. So, it’s understandable that sucking on candy may help. However, the sugar from this candy that lingers in the mouth for long periods creates a higher risk of gum disease and the demineralization of tooth surfaces, opening the door for cavities.

One article in RDH Magazine shares these cautions for cancer patients:
• Products with drying and potentially irritating ingredients, like sodium lauryl sulfate, can increase risks for oral mucositis (the soft tissues in the mouth).
• Strong flavors can feel too sharp for tender tissue and can increase nausea.
• Inappropriate selection of toothbrush head sizes and bristles makes plaque removal more difficult and tissue trauma is more likely to occur. This may affect the patient’s ability to brush at all.
• Sugary and/or acidic products such as hard candies can increase risks for caries, erosion, and infection.
• Petroleum-based lip balms ultimately keep lips drier and create a dense barrier that can trap bacteria and impurities against the skin, which increases infection risks.

While chemotherapy is known to cause nausea, another common complaint of patients undergoing chemotherapy or radiation is having a metallic taste in the mouth. Just as certain components of oral medications can emerge in saliva, drugs administered intravenously can also emerge in the saliva, causing “metal mouth.”

However, it’s important to note that women who are menopausal or post-menopausal may experience changes in their mouths. They may experience dry mouth, pain and burning sensations in the gum tissue as well as altered taste, especially salty, peppery or sour.

In addition to chemotherapy, “dry mouth” is a common side effect of many medications, including prescriptive and over-the-counter. These include antihistamines, decongestants, painkillers, high blood pressure medications, anti-depressants, muscle relaxants, drugs for urinary incontinence and many others. Some medications, along with chemotherapy, can result in oral sores or spots of discoloration.

Because some spots and discolorations can be symptoms of oral cancer, keeping your dentist aware that you take these drugs helps he or she to monitor these areas closely and appropriately. However, other medications can cause sores in the mouth, inflammation or discoloration of gum tissues. These include those taken for blood pressure and oral contraceptives.

For some cancer patients, our dental laser is an option that can speed healing of these sores and restore comfort faster. Additionally, our Asheville periodontal dental office features advanced technology that often minimizes treatment and enhances patient comfort.

For those who take medications that help to strengthen bones, these have been associated with a rare but serious condition called osteonecrosis of the jaw, known as “death of the bone.” These medications, prescribed to help prevent or treat osteoporosis with certain versions administered by injection.

Osteonecrosis of the jaw commonly occurs after certain dental procedures such as extractions or implant placement. About 90% of those who have experienced osteonecrosis are those who took the medication in repeated high doses due to cancer or other diseases. However, 10% who experienced osteonecrosis were taking much lower doses, mostly intended to treat osteoporosis. Those who currently take these medications or have taken them within the past year should reveal this to their general dentist or dental specialist prior to any procedures – including a cleaning.

Periodontal (gum) disease, teeth with cavities or the loss of natural teeth can negatively affect physical, emotional, and financial quality of life. In addition to treating existing problems, our Western Carolina periodontal office is structured so our patients can avoid long-term damage to oral health. We are known for making patient comfort a priority – at every visit.

For an examination, call 828-274-9440. Or, ask to begin with a consultation.

Sources:

https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-other-diseases/

https://www.rdhmag.com/patient-care/article/14294608/the-importance-of-oral-care-during-cancer-treatment

 

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