Nothing To Fear To Accomplish Healthy Smile Here

Posted on Apr 16, 2023 by William J. Claiborne, DDS MS

As a dental specialist, I find that many people are unfamiliar with exactly what a periodontist does. Yet, when they are recommended to see me (typically by their general dentist), it is because they need specialized care that falls under our unique set of skills.

A periodontist has 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

Let’s begin with gum disease.

Because the majority of care I provide has to do with the treatment of all stages of periodontal disease, it may be helpful to understand how this develops. Although many people delay or avoid regular dental care (mistakenly thinking “if nothing hurts, then nothing must be wrong”), I have a close-up view of its destructive nature. Its formation creates cavities, periodontal (gum) disease, and leads to eventual tooth loss.

Even people who are committed to a regimen of thorough at-home oral hygiene (twice-daily brushing, daily flossing), can be doing an insufficient job of removing the daily buildup of plaque. Plaque is a sticky film of bacteria that accumulates in the mouth. When not thoroughly removed, it can harden into a mass that attaches to the base of, or in-between, teeth.

In the form of tartar, this cement-hard mass of bacteria cannot be brushed or flossed away. Once tartar forms, it can only be removed by a dentist or hygienist using special tools. Without removal, it will continue to amass and attack gum tissues, working its way beneath the gum line.

Below the gums lie the support system for natural teeth, consisting of tissues, ligaments and bone. When the bacteria reach an uncontrollable level, they become infectious. As these infectious bacteria accumulate further, symptoms of gum disease become more apparent, such as tender or swollen gums or seeing blood in the sink when brushing teeth. Breath odor may be bad on a regular basis.

As symptoms worsen, the gums become red with infectious and loosen their grip around the base of teeth. The gums may become spongy and pus pockets may form. Breath odor at this point is persistently putrid. Eventually, the structures that support teeth are compromised and teeth may loosen. Gum disease is the leading cause of adult tooth loss in the U.S.

Research has found that certain strains of oral bacteria from gum disease create reactions in the body that can trigger systemic inflammation. Thus far, research findings have shown a correlation between periodontal disease bacteria and some cancers (including pancreatic and lung), Alzheimer’s disease, pre-term babies, heart disease, stroke, diabetes, arthritis and erectile dysfunction (ED).

As if all that weren’t bad enough, one study suggests that gum disease relates to a reduction in one’s quality of life: “Periodontal disease has been linked to lower quality of life.” “Quality of life encompasses several domains, including psychological functioning and social relationships among others. Oral health-related quality of life has been shown to be reduced in patients with periodontal disease.” (https://www.hindawi.com/journals/prm/2017/5491923/)

While estimates show about 75 percent of American adults have some degree of dental fear or anxiety, over 47 percent have some level of periodontal disease. As a periodontist, both are alarming numbers. Nearly half our nation is walking around with a potentially life-threatening disease in their mouths.

Treating this may sound like it would be pretty intimidating. However, Although there are many treatments offered and at various levels, our main goal is to provide patients with comfortable and positive experiences at every visit. One way we accomplish this is through the advanced technology featured here in our Western North Carolina periodontal dental office. We feature some of the most advanced in dentistry, much of which is not available in 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.

3D 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. We believe that every patient deserves respect, a gentle touch and knowing they are in a “lecture free” zone. 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.

I hope I’ve given you a helpful and positive picture of what a periodontist does and how he/she can help you with some challenging needs; all the while keeping you comfortable, minimizing treatment time, and shortening treatment time.

Although most of our patients are referred to us by other dentists and dental specialists, a referral is not required for accepting a new patient. Call 828-274-9440 if you feel we can make recommendations for your specific needs or provide helpful information.

When Dentures Are “Slippery,” “Wobbly, or “Rocky”…

Posted on Mar 11, 2023 by William J. Claiborne, DDS MS

A periodontal specialist has advanced training in the selection and placement of all dental implant types. Also a specialist in the treatment of all stages of periodontal (gum) disease and the contouring of gum tissues (such as to correct a “gummy smile”), many patients who come to us have lost teeth due to gum disease.

Gum disease is the nation’s leading cause of adult tooth loss. Sadly, over 47% of Americans over the age of 30 have some level of gum disease. Many do not realize they have developed gum disease since it can begin without obvious symptoms.

Periodontitis is the advanced stage of gum disease. Its symptoms are hard to ignore. Breath odor is putrid. The gums bleed easily, at times even when eating. The gums are a dark red and may have a spongy texture. Some teeth may loosen or shift. Pus pockets form around the base of some teeth.

In this advanced stage, some (or all) natural teeth may require removal. For those who choose to replace teeth with a denture or partial (versus dental implants), something occurs below the gums that cannot be seen. However, over time, the repercussions can be quite severe.

What I’m referring to is “resorption.” This is the term used for a shrinking jaw bone.

Resorption occurs when natural tooth roots are no longer present in the jaw bone. These tooth roots actually help to provide stimulation to the bone. Tooth roots also nourish the bone mass through connective tissues that extend down through a tooth’s interior.

When a tooth is removed, the stimulation and nourishment to that area of the jaw bone is taken away. Without it, the bone begins to shrink. As it declines in height, the adjacent teeth are more vulnerable to loss. Statistics show that teeth neighboring areas where natural teeth are missing will be the most likely to be lost next.

Although a denture or partial can mimic the presence of teeth above the gum line, there is nothing to keep the jaw bones healthy beneath, which is the sturdy foundation for biting and chewing strength. As tooth loss continues, one can go from losing a few teeth to losing all teeth (being “edentulous”).

Many people are unaware that the pressure of wearing dentures or partials accelerates the pace of resorption. For people who sleep in their dental prosthetic, the 24/7 pressure applied to the jaw bones speeds up the rate of bone decline even more.

Sleeping in a denture can also add to higher risks for the flu and pneumonia. A 3-year study of more than 500 adults was published by the Journal of International Oral Health. Of the 186 (of 453 denture wearers) who did not remove their dentures for sleeping, they had over twice the risk for pneumonia than those who did. Sleeping in dentures also led to higher levels of tongue and denture plaque, gum inflammation and other oral issues.

For those who wear a denture or partial, losing jaw bone mass also causes a change in the way the denture or partial fits. For example, a denture may fit fine the first year after teeth are removed and a denture is custom-fitted. However, people eventually notice slips when biting or chewing. This is because the bone under the “arch” that supports the denture or partial is declining in height.

The changing foundation for the denture (also known as a ridge) allows it to “slip” or become “wobbly.” As bone loss continues, it causes uncomfortable rubbing on tender gums while eating.

As a result, people often adjust their diet to avoid foods that require rigorous chewing, opting for softer foods that require less chewing. Outings with friends and family become overshadowed by the fear of embarrassing slips.

Eventually, even frequent applications of denture pastes or adhesives are of little help. A reline may be recommended by your dentist to reshape the contours of the denture or partial to the slowly declining arch. Unfortunately, this process will continue as bone loss requires periodic relines as the arch flattens further.

The solution?

For most individuals who are missing one or more natural teeth, we advise replacing teeth with dental implants. A dental implant recreates the presence of a natural tooth. It provides stimulation to the bone, halting the process of bone loss.

Dental implants do not rely on neighboring teeth for support, as in a crown-&-bridge combination. The crowning of bordering natural teeth to support a bridge is not needed. Thus, the integrity of surrounding teeth is protected.

Because dental implants are supported by the jaw bone, sturdy and dependable biting and chewing strength is restored. Eating a healthy diet of the foods you love is again possible.

And, dental implants also have an exceptional success rate, higher than any implant-in-bone option. They are designed to last a lifetime, making them an excellent investment.

If you are considering dental implants to replace missing teeth, we invite you to 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 more contact information.

 

Mental Health Can Adversely Affect Oral Health

Posted on Mar 06, 2023 by William J. Claiborne, DDS MS

It seems almost every week that I read findings of recent studies that correlate oral health to overall health. It is not surprising that research newly shared reveals connections of how mental health can affect oral health, and vice versa.

It shows that people with mental conditions can be a contributing factor to poor oral hygiene. These conditions include depression, mood disorders, anxiety, OCD (obsessive-compulsive disorders), mood disorders, and eating disorders. These individuals are 2.7 times more likely to experience tooth loss early.

One factor is anxiety and panic, which are often associated with dental treatment.

According to the National Institute of Mental Health, mental illnesses in the U.S. Nearly 1 in 5 adults have with a mental illness (52.9 million in 2020). These numbers have increased post-pandemic.

The Mayo Clinic shared:
“Surveys show a major increase in the number of U.S. adults who report symptoms of stress, anxiety, depression and insomnia during the pandemic, compared with surveys before the pandemic. Some people have increased their use of alcohol or drugs, thinking that can help them cope with their fears about the pandemic. In reality, using these substances can worsen anxiety and depression.”

Poor dental health can be seen in depressed people by a dentist. For example, over 46% of depressed people report tooth pain without apparent cause, known as atypical odontalgia. Too, burning mouth syndrome is an oral condition more common with adults suffering from depression.

Additionally, mental conditions have been linked to oral conditions, such as:
Gum inflammation
Periodontal disease
Cavities
Dry mouth
Chronic jaw and facial pain
Oral ulcers

The relationship between the two – oral health and mental health – seems to lie in cortisol levels. Cortisol is a stress hormone. Stress and anxiety cortisol levels that are too high adversely affect the immune system. This increases the risk of gum disease, oral sores, and infections.

Seeking professional help at the right time is essential to manage an excellent oral and mental state and overall health.

There is also a domino effect once depression or anxiety trigger an imbalance in cortisol. When one’s smile is in poor condition (cavities, stained teeth, missing teeth, bad breath), it can lead to low self-esteem and social isolation. This contributes to a lower quality of life and, in turn, disrupted mental health.

Mental health status has been shown to activate, aggravate or worsen oral problems. These include…

•Gum health and periodontitis (advanced gum disease)
When stress and periodontal disease negatively impact the body’s immune system, inflammation often worsens gum disease. Too, people who endure ongoing stress are more likely to smoke, drink alcohol, or take drugs. These can cause people to neglect maintaining good oral hygiene and be less committed to having regular dental checkups.

•Dry mouth
Eating disorders (such as anorexia nervosa and bulimia) can reduce the amount of saliva – the mouth’s bacteria-rinsing agent. A dry mouth enables the growth of bacteria. Add to this is how many antidepressant medications have a side effect of causing oral dryness.

•Pain in jaw joints
Chronic stress and anxiety are frequent contributors to facial and jaw pain. Teeth grinding and clenching are not uncommon among people with mental conditions. These actions can cause broken, worn or chipped teeth in addition to the painful conditions associated with TMJ disorders.

•Oral ulcers
Lip, tongue, and ulcers inside the mouth can occur more often in people under frequent or chronic stress.

•Developing Cavities
Individuals with mental illnesses are more likely to have dental decay due to a rise in cavity-causing bacterium with a reduced saliva flow – a recipe for developing cavities.

•Tooth erosion
Bulimia is an eating disorder in which vomiting is used to lose weight. Over a third of bulimia patients with eating disorders suffer from tooth erosion due to regurgitated stomach acids that cause tooth erosion.

•Oral cancer
When dental health neglect is coupled with heavy consumptions of alcohol and smoking, the risk of oral cancers increases. Persons who are heavy smokers and drinkers are 50 times more likely to get oral cancer compared to those who never smoke or drink heavily.

Obviously, mental health is closely connected to your oral health. Begin by speaking with a therapist or mental health specialist. Taking care of your mental health is vital to overcome related dental issues.

If you are noticing any of the signs of oral health problems, you should see a periodontal specialist as soon as possible. These signs and symptoms include:
– Bleeding gums when brushing
– Frequent bad breath
– Red, swollen gums
– Gums that are tender or sore
– Gums that pull away from the base of teeth
– Loose teeth

A periodontist is a dental specialist who can help you restore your oral health and enjoy a confident smile. If you’ve experience tooth loss, a periodontist also specializes in the placement of dental implants.

Our Asheville periodontal office also provides sedation options. These include oral and I.V. sedation (“twilight sleep”). These are administered safely by a doctor of anesthesiology who uses advanced safety equipment to monitor you throughout your procedure.

Call 828-274-9440 to schedule an exam or an initial consultation to get to know us better.

Sources include:

https://healthnews.com/family-health/dental-and-oral-health/how-mental-illness-affects-your-oral-health/

https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/mental-health-covid-19/art-20482731

https://health.uconn.edu/sbirtacademy/wp-content/uploads/sites/101/2016/08/Dental-brochure.pdf

How Good Oral Health Protects Your Heart

Posted on Feb 16, 2023 by William J. Claiborne, DDS MS

Having just celebrated Valentine’s Day, hearts were everywhere. The heart was mentioned in poems, cards, gifts and even in the shape of boxes that contained candy.

Your heart (the one in your chest) and your oral health are actually very much related. You may not realize how connected your mouth is to your heart.

Bacteria in our bodies is not always a bad thing. For example, certain bacteria in the gut actually enhance the process of digestion and help to keep the digestive system operating efficiently.

However, certain bacteria are bad. When too much bacteria invade the body, the immune system becomes overburdened. In bacteria overload, the body’s natural defense response, white blood cells, aren’t always able to conquer infection. This is when your doctor may prescribe an antibiotic – to give the immune system added reinforcements.

According to a report on the health of Americans (published by the Centers for Disease Control & Prevention), it is estimated that over 47% have some form of gum disease. Although we all aspire to have a smile that is appealing, it is what lies beneath the teeth and gums that can wreak havoc on one’s overall health.

Over time, inadequate daily oral hygiene enables an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even more susceptible to this bacterial buildup.

This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to ‘wash away’ bacteria at sufficient levels, the accumulation runs rampant.

Oral bacteria are living, eating, and reproducing organisms. They thrive on rotting food particles caught between teeth. They attack gum tissues and tooth enamel. Eventually, they can work their way down tooth roots and attack the bones and tendons that support teeth.

Through tears in diseased gum tissues, this infectious bacteria can enter the bloodstream. This potent bacteria are now associated with a number of serious health conditions due to their ability to trigger systemic inflammation.

When the gum tissues can no longer combat the onslaught of bacteria, there can be very few signs of periodontal (gum) disease initially. Signs that emerge are typically frequent bad breath along with swollen, tender and beefy red gums that bleed when you brush. As they grow in number, the gum tissues become weaker and they can penetrate the bloodstream.

According to the American Academy of Periodontology (www.perio.org),

“Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.

“Scientists believe that inflammation caused by periodontal disease may be responsible for the association.

“Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.”

For this reason, cardiologists are more often advising their patients to be evaluated by a periodontist prior to heart surgery. As mentioned above, gums that bleed are a sign of gum disease. These oral bacteria, given an opportunity to enter the bloodstream, are able to travel anywhere, including the heart. They can reach the heart muscle and cause a severe infection.

As an Asheville periodontal specialist, I have an up-close view of the damaging affects of insufficient oral hygiene. If you are experiencing any of the following symptoms of gum disease, please know that it will only worsen without treatment.

Common signs are:
• Gums that bleed easily when brushing
• Tender or swollen gums
• Gum recession
• Frequent bad breath
• Gums that darken in color from a healthy pink to red
• Gus pockets that form near the base of some teeth

Gum disease is also the nation’s leading cause of adult tooth loss. And, studies have shown that the loss of natural teeth compromises the digestive process, social confidence and one’s lifespan.

If you’ve failed to be fully committed to your oral health, there is no better time to begin than the present. Start with a thorough periodontal examination. Call 828-274-9440.

If dental fears have prevented you from having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. Let’s protect you, top to bottom, beginning with your smile!