Flossing – A Valuable Step In Avoiding Gum Disease & Tooth Loss

Posted on Mar 17, 2021 by William J. Claiborne, DDS MS

Adults who wish to stay healthy and active as they age often workout daily, walk at least 30 minutes per day, try to get 7 – 8 hours of sleep each night, and brush their teeth twice a day.

Tooth brushing helps to keep oral bacteria levels in the mouth to manageable levels. With the help of saliva, which is a rinsing agent for the mouth, these bacteria are generally kept under control. By preventing rampant growth, the ‘oral cavity’ (interior of the mouth) is able to avoid a destructive onslaught caused by these icky organisms.

A study shared by Dental Dental showed that about 70 percent of American adults brush their teeth twice a day. Unfortunately, this leaves more than a fourth of adults who do not.

Daily flossing is also recommended by the American Dental Association (ADA) as a preventative way to keep cavities and gum disease at bay. Still, an estimated 30 percent are committed to daily flossing – less than a third.

This means that a whopping 70 percent do not include flossing in their daily oral hygiene regimens. Too, about a third of Americans admit to never flossing, with 39 percent of men and 27 percent of women who do not.

Yet, the devotion of twice daily brushing and daily flossing requires only about 5 minutes of time – total. It is recommended to spend two minutes brushing teeth in the morning and before bed. A practiced flosser requires about a minute to floss. (Consider that five minutes is about the amount of time for a commercial break between TV programs.)

Yet, if you could see what I see…

As a periodontist, my specialty includes advanced training in the treatment of gum disease. I know the destructive nature of infectious oral bacteria. I have a bird’s eye view of what can occur without a committed oral hygiene routine at home. When an overload of bacteria accumulate in the mouth, cavities are able to form and gum tissues become food for living and breeding bacteria.

While brushing twice a day is important, the bristles of a toothbrush are typically unable to dislodge food particles caught between teeth. Left behind, these particles begin to rot rather quickly, leaving even more sustenance for bacterial growth and reproduction.

To see just how much your toothbrush misses, brush your teeth thoroughly for the recommended two minutes at the end of the day. Rinse and spit a couple of times. Then, using a strand of floss, move gently between teeth, easing up and down to reach the sides of all teeth. Move the floss just slightly beneath the gums at the base of each tooth. After all teeth are flossed, rinse and spit again. Most people are shocked at just how much their toothbrush failed to remove.

When oral bacteria amass past the point that is manageable by the immune system, these bacteria become infectious. This causes inflammation in the gum tissues, which can lead to the formation of periodontal (gum) disease. This begins with gingivitis, which has mild symptoms. Untreated, it worsens to periodontal disease and the advanced level of periodontitis.

It begins when oral bacteria accumulation creates a sticky film in the mouth known as plaque. When not removed thoroughly and frequently, plaque can form cement-hard bacteria colonies that attach to teeth. This hardened form of bacteria is known as tartar and, once formed, can no longer be brushed or flossed away.

As a Periodontist, I often see people who have developed periodontal disease who come (or have been referred) because they have obvious symptoms, such as red, swollen gums. However, I also see patients who are surprised to learn they have developed the disease. Yet, even without obvious symptoms, gum disease may exist and be fully underway.

Nearly half of American adults have some level of gum disease (over 47 percent in recent estimates). Periodontal (gum) disease is the nation’s leading cause of adult tooth loss even though it’s one of the most preventable of all diseases with simple measures.

Losing natural teeth leaves an individual with having to make decisions for replacement – crown-&-bridge combination, partial denture, full denture or Dental Implant. These time-consuming procedures and expenses can be avoided. And, contrary to what many believe, losing teeth is not a natural part of the aging process. With proper care, you can easily enjoy a smile of natural teeth all your life.

It is often surprising to people to learn that oral health is an integral part of overall health. Inflammation in the mouth doesn’t simply remain in the mouth. Through tears in diseased gum tissues, the oral bacteria of gum disease are able to enter the bloodstream. As the bacteria travel throughout the body, their toxic nature can activate inflammatory effects elsewhere.

Infectious gum disease bacteria have been the focus of a numerous amount of research over the years. Studies have found that the bacteria of gum disease can trigger or worsen heart disease, stroke, preterm babies, arthritis, diabetes, some cancers, Alzheimer’s disease, erectile dysfunction (ED) and impotency. As research continues, even more serious (and deadly) connections are being made.

They key is to keep oral bacteria levels to a minimum, which is why brushing and flossing are an important part of your daily care routine. Neither step should be taken for granted. Yet, as a periodontal specialist, I understand how it can be difficult to get into the habit of daily flossing.

For some, the tight floss around fingers is uncomfortable. For others who have large fingers or problems with manual dexterity, the act of flossing is awkward or challenging. However, for those who floss on a daily basis, it becomes a maneuver that is as simple as brushing teeth.

For individuals who are challenged by manual flossing, there are some excellent water flossers on the market. These are affordable and can be just as effective as ‘string’ flossing when used properly – and daily.

Twice daily brushing (at least two minutes per time), daily flossing, drinking ample water and limiting sweets and caffeine are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. And, those 6-month check-ups are important. During these visits, tartar that may have formed can be removed and signs of early gum disease can be addressed.

If you are experiencing symptoms of gum disease, call 828-274-9440. In our state-of-the-art Asheville periodontal dental office, our patients are treated with respect, compassion and a gentle touch. Here, you’ll never be lectured. Our goal is to restore your smile to a healthy state and develop a program to help you keep it at its best.

New patients are always welcome. A referral is not needed to become a patient.

Missing Teeth? Know The Ends-&-Outs of Dental Implants

Posted on Jan 29, 2021 by William J. Claiborne, DDS MS

If you are one of the millions of adults who are missing one or more natural teeth, you are actually in the majority if you are over the age of 50.

According to the Centers of Disease Control & Prevention (CDC), by the age of 50, Americans have lost an average of 12 teeth. For those between the ages of 50 to 64, over 10 percent have no remaining natural teeth. Twenty-six percent – more than one-fourth – of adults between 65 – 74, have lost ALL of their natural teeth.

Replacing natural teeth may seem simple. Often, people assume that a partial or bridge will solve the problem. Yet, these dental appliances merely worsen an already precarious situation. While these dental prosthetics “mimic” the appearance of teeth, what’s occurring beneath the gum line has a significant impact on what’s to come.

To understand the rocky road in the future, consider the foundation of natural teeth – the jaw bone.

The reason biting and chewing occurs dependably and with stability with natural teeth is because they are secured by the jaw bone. When natural teeth are removed, their roots are no longer present in the jaw bone. The presence of these roots actually provides stimulation to the jaw bone, which helps to preserve the bone’s mass. Without this stimulation, the bone resorbs, a process of which bone mass “melts away”.

Resorption is to blame for dentures or partials that start to move or slip over time, even though the fit was snug when first made. Because resorption reduces bone height, the ridge the denture was contoured to fit begins to flatten. A shrinking ridge leaves the denture with an insufficient base.

The pace of bone loss speeds up a little more each year. The pressure of a denture on the ridge accelerates the rate. For people who sleep in their dentures or partials, the continual pressure ramps up the pace further.

As the ridge flattens, denture adhesives or pastes become of little help while trying to eat. This leads many denture wearers to switch to a diet of soft foods that dissolve easily in the mouth. Often, the pleasure of eating is overshadowed by trying to avoid sore spots on tender gum tissues or embarrassing slips.

Declining bone mass also leads to changes in facial appearance, contributing to an appearance that is far older than one’s actual age. As bone mass declines, jowls form as facial muscles detach from a shrinking bone mass. Deep wrinkles form around the mouth and the corners of the mouth turn downward, even in a smile. As bone loss becomes severe, the chin points and the nose moves closer to the chin, creating a ‘granny look.’

As an Asheville periodontist, my dental specialty includes the diagnosis and placement of dental implants. Dental implants are the closest thing to natural teeth, for many reasons.

Dental implants restore the ability to bite and chew comfortably and without the fear of embarrassment or uncomfortable rubbing. Because implants are placed in the jaw bone, they have the same dependable foundation as that of natural teeth.

Among the many benefits of dental implants, they also provide stimulation to the jaw bone. This helps to halt the process of bone loss. For those who have already lost a great deal of bone loss, bone rebuilding procedures can be performed to restore a healthy, more youthful face shape.

An added advantage of implants is they do not rely on the crowning of otherwise healthy, neighboring teeth for the mere purpose of supporting a bridge. While a traditional crown-&-bridge combination relies on crowned teeth for support, an implant uses the sturdy foundation of your jaw bone.

There are over 40 different types of dental implant systems, each designed to accommodate specific needs and goals. For example, some implants are designed for placement in minimal bone mass. Others can be strategically placed to support a bridge of two or more teeth or support a full arch.

When choosing Dental Implants to replace teeth, you are making a lifelong investment. Since implants are designed to last a lifetime, they provide a ‘one & done’ choice for dependable tooth replacement. There are not many things these days that give you so much value!

If you struggle with dental fear or anxiety, rest assured that patient comfort – at every appointment – is of the highest priority. Our office is structured to attend to the specific needs of each patient, gently and respectfully. Patients begin with a consultation in a comfortable, private setting rather than seated in a treatment chair.

For patients who desire a “sleep” state, we offer oral sedation as well as I.V. sedation (twilight sleep). 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 places the patient in a deeper sedative state (twilight sleep), also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety.

With both, patients are closely monitored with advanced safety equipment throughout treatment. Patients also find our entire staff to be a unified team, each bringing a sincere level of compassion and commitment to excellent care.

Rather than bypass the very best option for replacing lost teeth, consider a consultation to discuss the benefits, anticipated costs, and treatment process. Call 828-274-9440 for an appointment in our Asheville periodontal dental office.

Tooth Loss Cause of Shrinking Face, Sunken-In Mouth

Posted on Jan 14, 2021 by William J. Claiborne, DDS MS

The aging process is not an easy one. Joints begin to creak, muscles are more easily strained, skin dries out, eyesight wanes and hearing declines.

Yet, throughout the aging process, some adults seem to go through it as less of an ordeal than others. Although diseases and certain health conditions can occur regardless of how well some people manage, some people take a number of steps that can have a significant impact on aging well and “getting old.”

The basics of good health include a diet low in sugar, alcohol and unhealthy fats. NOT smoking is a big factor in maintaining a healthy body. Regular exercise, sufficient sleep and regular physicals and dental check-ups are all beneficial.

A factor that plays a bigger role in having good overall health is having natural teeth. Having the ability to comfortably bite and chew food is important to effective digestion, since the digestive process begins in the mouth. When adults struggle to eat with a denture or partial, the efficiency of this initial stage of digestion is compromised.

It’s not unusual for adults who have “rocky” or “slippery” dentures to opt for soft foods that dissolve easily in the mouth. These are often carb heavy and lack the nutritional value of a diet that combines healthy proteins, fruits and vegetables. However, missing teeth or dentures that move when eating can cause other detrimental problems.

When people sense their dentures may cause embarrassment when eating, speaking or laughing with others, social involvement can take a hit. According to a 2012 statement by the World Health Organization:

Oral health is essential to general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psycho-social well-being.

An extensive study on “The Link Between Teeth and Emotions” was published by Clinical Psychology of Oral Health (https://journals.sagepub.com/doi/full/10.1177/2158244017728319) in 2017.

In the study, the concept of quality of life was categorized in five dimensions: physical well-being, material well-being, social well-being, emotional well-being, and development and activity”.

The authors found that oral health is “an integral part of general health and well-being” and examined how oral disorders may impair at least three of the five dimensions: the physical, emotional, and social well-being.

The authors found also an association between oral health and late life depression (LLD) in older adults, who experienced “compromised social function and impaired self-maintenance skills (e.g., bathing, dressing, hygiene).” This depression can cause a loss of pleasure and interest for daily life activities, and even in the interest in personal oral hygiene.

Oral health not only has an impact on the psychological well-being of older adults, the physical changes attributed to tooth loss are of equal concern to many denture wearers.

Let’s look at your oral anatomy for a moment…

Your natural teeth are supported by your upper and lower jaw bone, known respectfully as the Maxilla and Mandible. With these strong, study bones, tooth roots are held securely. Thus, biting and chewing occurs comfortably.

The jaw bones are actually kept healthy by the presence of tooth roots. These roots provide stimulation to the bone as well as nourishment that feeds through the tooth’s interior.

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

This has a domino effect. Partials can replace the presence of teeth above the gum line, but there is nothing to benefit the jaw bones below. Thus, tooth loss continues and can go from a few missing teeth to losing all teeth (being “edentulous”).

According to the Center for Disease Control & Prevention (CDC), 69 percent of adults between the ages of 35 – 44 have lost at least one permanent tooth. By age 50, Americans are missing an average of 12 teeth. For adults between the ages of 65 – 74, 26 percent are missing all of their natural teeth. That’s over one-fourth of the adult population over age 65.

Although dentures and partials mimic the presence of teeth, the jaw bones below are shrinking away, and at a rather rapid pace. The pressure of wearing a denture or partial actually speeds this process up, known as “resorption.”

As these bones decline in mass, deep wrinkles form around the mouth. The corners of the mouth turn downward. The chin takes on a more pointed form and the mouth sinks into the face. The nose seems to get closer to the chin as the jaw bones thin. Jowls form as facial muscles detach from shrinking bone structure.

Dental implants were designed to recreate the presence of natural teeth both above and below the gum line. Because teeth attached to the implants are supported by the jaw bones, the study foundation restores the ability to bite and chew without movement or fear of embarrassing slips.

For patients who are missing a great deal of bone, we offer bone rebuilding that does not require a bone graft. We also perform sinus lifts (when the upper jaw has declined to a significant level) to restore sufficient bone distance between vital structures.

For many of our dental implant patients, their lives become more active with the restored confidence. They become more socially involved, have more self-confidence and higher self-esteem.

Although dentures and partials may seem to be a less-expensive way to replace teeth, the savings is hardly worth the detrimental repercussions associated with them. Too, the upkeep required for dentures over time is actually high, considering replacement, relines and repairs.

As a periodontal specialist serving Western NC, I take great pride in the diagnosis and placement of dental implants. Each is selected based upon the patient’s individual needs and goals. We provide oral or I.V. sedation to ensure a comfortable experience and a friendly, respectful environment.

Begin with a friendly conversation in our private consultation room. In this comfortable setting, we’ll discuss your options and I’ll answer your questions. For many people, they are able to make a decision on how they wish to proceed after this conversation, even if it’s to go forward with dentures. We are supportive of each person’s preferences.

Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office. I think you’ll feel especially confident in learning about our specialized skills and highly-advanced technology, not available in many dental offices in this area.

 

 

 

 

Ask Santa To Make The Toothbrush Under The Tree Electric!

Posted on Dec 16, 2020 by William J. Claiborne, DDS MS

Although your Christmas wish list probably doesn’t include an electric toothbrush, it should. Studies have shown that brushing teeth with an electric version promotes better gum health and slower progression of periodontal (gum) disease. Electric tooth brushing is also helpful in reducing tooth loss, by 20 percent (compared to those who brush with manual toothbrushes).

If you use an electric toothbrush, most people think of its benefits in giving fresh breath and a bright smile. As an Asheville periodontist for over three decades, I have a firsthand view of how a thorough at-home oral hygiene regimen can help significantly in preventing gum disease and tooth loss.

An electric toothbrush can be an important tool in daily oral hygiene. Findings of an 11 year study published in the Journal of Clinical Periodontology tracked the oral health of over 2800 adults. The use of electric toothbrushes was monitored to watch for periodontal disease, cavities, and the number of natural teeth.

From 2002 – 2006, participants were examined with follow ups conducted after 6 and 11 years. Eighteen percent of the participants were electric tooth brush users. At the time of their 11 year follow up, 37 percent had switched to using electric toothbrushes.

Although more adults are using them, the long-term effectiveness of electric tooth brushes has not been proven to be significant. It is suspected that this is due to the technique used rather than due to the brushing tool itself. For manual users, a significant challenge with brushing this way is in the choice of bristles. Stiff, hard bristles can be very damaging.

A hard bristled tooth brush can actually damage tooth enamel and gum tissues. To the detriment of teeth, people tend to press down too firmly as they brush, scrubbing with a ‘back & forth’ motion. They may feel this is the way to do a good job brushing. However, this action can wear down the protective coating of tooth enamel, leaving teeth more vulnerable to decay.

Another problem with a hard bristle tooth brush is its ability to damage tender gum tissues. These can thin out the protective seal that gums have around the base of each tooth. This increases the potential for bacterial entry of the sensitive tooth root area of teeth.

Hint: If the bristles on your toothbrush are fanned out after a couple of months, you are applying too much pressure when brushing.

The ideal technique for brushing teeth is to use gentle pressure with a swirling motion. By using a circular pattern over both sides of each tooth and along the tops, teeth are cleansed without wearing away gum tissues or wearing down precious tooth enamel.

This is where electric toothbrushes can help greatly. Many of the newer models include a beep when too much pressure is being applied. Most also have timers to indicate the time needed for each quadrant, which is your teeth divided into 4 sections. The timers are good aids in helping you to brush at least two minutes.

As devastating as tooth loss can be to one’s overall health, we now know that the bacteria of gum disease can enter the bloodstream. Research has shown this infectious bacteria can trigger inflammatory reactions elsewhere in the body. It has been linked to heart disease, stroke, high blood pressure, some cancers, diabetes, arthritis, impotency, preterm babies and more.

Whether using a manual or electric tooth brush, it is necessary to brush twice a day to effectively remove plaque. Plaque is the sticky film you feel on teeth when you wake up or at the end of the day.

Plaque is a buildup of oral bacteria that coats teeth and gums. If not removed daily, it forms a hardened mass of calculus (or tartar) that attaches to teeth. This is what you may feel your hygienist scraping off teeth during cleanings since it cannot be brushed or flossed away.

Another place that oral bacteria can thrive are in the grooves in the tongue. These offer a dark, warm and moist environment for bacterial reproduction. To uproot these icky organisms, use your toothbrush to brush your tongue after brushing teeth. Be sure to reach the back of the tongue where the majority of oral bacteria are embedded. Swish with water several times after.

Flossing is another way to improve gum health, lower cavity risk and prevent tooth loss. It is estimated that only 31 percent of American adults floss on a daily basis. Flossing removes trapped bits of food remain in the mouth, which feeds oral bacteria and allows them to quickly multiply. Because brushing cannot dislodge all food particles caught between teeth, daily flossing should be a part of oral hygiene routines.

Proper flossing is easy for those who are in the habit and takes only a minute each day. For those who have difficulty with manual dexterity or find the maneuver awkward, water flossers are effective alternatives and easy to use. (This is another good item to add to your wish list!)

Practice these recommended techniques  and you’ll not only do a better job at having a clean mouth, you’ll find your time at the sink requires less effort. If you feel you may be experiencing symptoms of periodontal disease, act promptly. You should be seen at your earliest convenience for treatment since this disease will only worsen over time.

Signs of gum disease include tender gums that bleed easily when brushing, gums that darken in color to red (versus a healthy pink), frequent bad breath, and gums that pull away from teeth (receded gums) and expose darker root areas of the tooth.

As a periodontal specialist, I have advanced skills in the treatment of all stages of gum disease (as well as in the placement of dental implants). Our office features some of the most advanced technology available in dentistry to optimize patient outcomes and comfort.

Here, we will help you achieve the healthy smile you want and prevent tooth loss to the greatest extent possible. If you’ve already lost teeth, we’ll discuss their replacement through dental implants. Dental implants are the closest thing to natural teeth, restoring biting and chewing strength and stability.

Call 828-274-9440 to learn more or to schedule a consultation to discuss how you can achieve excellent oral health.