Dental Pain Relief With Patient’s Well-Being In Mind

Posted on Aug 19, 2022 by William J. Claiborne, DDS MS

The body relies on a nervous system for many reasons; one reason being to alert us that something is wrong. For example, when we burn our finger on the stove, the brain quickly sends pain sensations so we can remove the finger and take action to help it repair.

As a periodontal specialist in Asheville NC, I know how sensitive the gums can be, as well as teeth. A toothache or a cut in the mouth can be miserable for days. As a periodontist, ideally my skills allow patients to avoid being in pain by keeping their mouths healthy. When an individual maintains a clean mouth that has a low level of bacteria, they can avoid developing cavities and gum disease, which can both result in a significant amount of constant pain.

Yet, caregivers in the American healthcare system are very much aware of the opioid epidemic. We don’t want to deny legitimate patients the medications they need to get them out of pain, however, neither do we want to be a catalyst or contributor to an individual who becomes dependent on these or is trying to feed an already existing habit.

The dental profession has been very careful in this regard, according to the American Journal of Preventive Medicine. In 2012, dentists in the U. S. prescribed only 6.4% of the total opioid prescriptions. For procedures such as root canals or extractions, they help patients get through the initial part of recovery when pain levels are most extreme.

As opioid abuse became such a significant problem, dentists became more sensitive to prescribing these medications. In 2016, American Dental Association (ADA) issued a Statement on the Use of Opioids in the Treatment of Dental Pain.

“Dentists should consider non-steroidal anti-inflammatory analgesics as the first-line therapy for acute pain management … [and]should recognize multimodal pain strategies for management for acute postoperative pain as a means for sparing the need for opioid analgesics.”

Non-steroidal anti-inflammatory analgesics are commonly known as NSAIDs. These are typically over-the-counter meds, such as Advil, Aleve, Motrin, etc. These are non-opioid, oral medications for temporary relief of acute dental pain.

NSAIDs work to provide effective pain relief by reducing inflammation in the bone, dental pulp, and gum tissues. The ADA encourages dentists to consider NSAIDs as the preferred go-to method for managing acute pain. When NSAIDs are taken after a dental procedure, they have been shown as effective as opioids for reducing pain intensity. For some pain levels, the dentist may prescribe a higher dose (by prescription).

Although NSAIDs are effective and less likely to cause dependency, they can also inhibit the an enzyme responsible for producing other prostaglandins that provide numerous beneficial effects. This includes those that protect the gastrointestinal mucous lining, blood flow to the kidneys, and blood clotting.

NSAIDs could also heighten the risks for serious cardiovascular issues, including heart attack and stroke. NSAIDs gave the potential to trigger issues that complicate the effects of low-dose aspirin.

Another option for managing dental pain is the use of Acetaminophen (such as Excedrin and Tylenol). Acetaminophen is an internal analgesic available in over-the-counter medicines for the temporary relief of minor aches and pains and helping to reduce fever. It can also be found in medicines that contain more than one active ingredient to treat migraines.

Acetaminophen is often used for things like headaches, muscle aches and menstrual cramps. It can also be an ingredient in other medicines.

Please know that I want no less for my patients’ comfort than I would want for myself or loved ones. Pain can be an overwhelming problem, although gum disease and cavities are highly preventable. With proper at-home oral hygiene and regular dental check-ups, an individual can keep a healthy smiles and prevent tooth loss (to a signifiant degree).

Even so, the Agency for Healthcare Research & Quality shared that there were more than 615 emergency room visits for every 100,000 people in the U.S. in 2018. The statistic is much higher for low-income and minority groups.

Let’s work together to protect our population from the impact it has endured from opioid addiction. Prior to treatment, we will discuss the potential for discomfort or pain afterward and standard treatment options to help ease you through recovery.

If you are experiencing sore, tender gums that bleed easily when brushing or a deep ache like a toothache, do not delay in seeking dental care. When something is wrong in the mouth, there are very few instances that will go away on their own. Most problems worsen over time, leading to higher levels of discomfort and more-involved treatment to resolve the problem.

In our Asheville eriodontal dental office, we offer some of the most advanced technology available in dentistry, including ConeBeam 3D imaging, laser dentistry, and computerized dental implant placement technology. Additionally, we provide oral and I.V. sedation, safely and monitored closely.

Call 828-274-9440 or tap here to arrange an appointment.

Sources:

https://www.rdhmag.com/patient-care/article/14279378/the-dental-hygienists-guide-to-dental-pain-and-pain-management

https://www.deltadentalwa.com/blog/entry/2019/09/dental-pain-management

https://hcup-us.ahrq.gov/reports/statbriefs/sb280-Dental-ED-Visits-2018.pdf

Our Asheville Periodontal Dental Office Offers Some Unique Services

Posted on Jun 13, 2022 by William J. Claiborne, DDS MS

As a Periodontist in Asheville, I’ve helped hundreds of patients overcome periodontal (gum) disease and the many repercussions that come with tooth loss. Helping to save teeth that were on the verge of requiring removal has also been a victory for the patient as well as me.

I take great pride in being a part of the transformations of patients who achieve healthy, confident smiles. This is why I’ve created an environment that affords every patient with the most advanced options available for restoring oral health and replacing lost teeth with dental implants.

Let me begin by clarifying the benefits our periodontal office brings…

• A periodontist has advanced training to properly diagnose and treat all stages of gum disease.

• We are known for never over-treating or under-treating with a commitment to provide the most successful treatment for each patient’s specific needs.

• Our periodontal office is specially equipped for the diagnosis and treatment of all stages of gum disease as well as placement of dental implants.

• Diagnosis and treatment planning is backed by an immense array of advanced technology, including:

• • LANAP (Laser-Assisted New Attachment Procedure) with PerioLase MVP 7 – 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 and has even been found to stimulate bone regrowth in damaged areas.
  • 3-D Cone Beam Imaging – 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 in a process that is quick, painless and at minimal radiation levels.
  • CareStream Cone Beam Computer Tomography Imaging – is enhanced tomography that works with 3D imaging for exceptional detail and range.
  • CS 3600 Intraoral Scanner – quickly and comfortably captures digital impressions to accurately and easily create precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances, aligners, custom abutments) without the need for bulky, goopy trays.
  • Computerized Dental Implant Placement – an advanced system for pre-surgical positioning of dental implants using a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success.

 

• A commitment to comfort including I.V. sedation (twilight sleep) as well as oral sedation for total relaxation. On our team is a Board Certified Anesthesiologist to provide sedation and anesthesia for optimal comfort and safety.

Treatment options in our specialty dental office also include reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession); diagnosis and placement of dental implants; and treatment of lesions or cysts in oral tissues.

With specialized skills, a periodontist is especially respectful to oral tissues as tender layers that significantly affect the appearance of a smile and the health of teeth. Utilizing special skills to minimize incisions while effectively treating each area in the mouth, a periodontist is your expert.

Call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.

Many Reasons To Repair Gum Recession

Posted on May 19, 2022 by William J. Claiborne, DDS MS

If you are occasionally experiencing sensitivity around one or more teeth, especially when eating ice-cream or drinking hot coffee, this is likely due to receded gums.

While using a sensitivity toothpaste can somewhat minimize these sensations (which can become painful jolts), the problem will remain. The source of sensitivity, most often, is because the highly-sensitive tooth’s root area has been exposed by the pulling away of gum tissues.

The gum tissues are designed to provide a tight seal around the base of each tooth, which blocks bacterial entry to the sensitive tooth root area. In addition to sensitivity, recession means oral bacteria can penetrate beneath the gum’s surface. Once beneath the surface, the accumulating presence of this bacteria can lead to inflammation of the gums.

Eventually, the infectious bacteria attack the structures that support natural teeth. This bacteria indicates the presence of periodontal (gum) disease. Signs and symptoms of gum disease in its first stage include:

• Gum tissues that turn red

• Gums that become tender or swollen

• Gums that bleed when brushing

• Persistent bad breath

Obviously, it’s important to ensure the gums are healthy so the grip they have around teeth is snug. It’s also important to be aware of the causes of gum recession. These are:

The aging process – As people age, their gums become drier. This causes them to shrink and be less capable of keeping a secure grip around the base of teeth.

Periodontal (gum) disease – As mentioned above, gum disease destroys oral tissues and the bone that supports natural tooth roots. A sign of periodontal disease is gum recession. Gum disease is also the nation’s leading cause of adult tooth loss.

Poor dental hygiene – When twice-daily brushing, daily flossing, and keeping the mouth moist are insufficient to rid the mouth of bacteria, their accumulation can result in the sticky film you feel on teeth. This is plaque. In just a day or so, plaque can harden on teeth into tartar. This is a cement-hard bacterial colony that cannot be removed by brushing or flossing . It can only be removed during a professional tooth cleaning. If not removed, teeth, gums and the structures below the gum line can be damaged.

Brushing too hard – Brushing teeth rigorously doesn’t mean you are doing a good job. Using a scrubbing, back-&-forth motion can wear away tooth enamel and cause the gums to recede. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.

Hormones – Females experience fluctuations in estrogen levels during puberty, menstrual periods, pregnancy and menopause. During these times, the gums can be more sensitive and vulnerable to gum recession.

Tobacco use – In addition to the many health hazards smokers risk, they are more likely to develop plaque due to the oral drying effects of smoking. This dryness can lead to gum recession (not to mention brown teeth and bad breath).

Bite misalignment – When teeth don’t come together evenly, too much force can be exerted on the gums and surrounding bone, allowing gums to recede. Bite misalignment can also lead to grinding or clenching teeth. These harsh forces on teeth can cause the gums to loosen their grip.

If you have mild sensations of sensitivity, desensitizing toothpastes can help soothe the nerves by forming a protective barrier over teeth while blocking sensitivity signals. Although this type of toothpaste can be helpful, it should be used as a temporary aid.

The goal should be to repair recession and halt the problem from recurring. To do this, we begin by determining why the gum recession is occurring. The next step is to restore the gums to their proper positions.

The corrective procedure most often performed is a “gingivectomy” performed by a periodontal specialist. In addition to treating all stages of gum disease, a periodontist specializes in contouring gum tissues. Using advanced skills, a periodontist is able to create a natural look and restore your oral health.

A gingivectomy can reposition or graft gum tissues over the area of recession to restore a healthy seal and protect the tooth structures below the surface.

Another advantage of a gingivectomy is to help save a natural tooth. When a tooth breaks near the gum line, a “crown lengthening” procedure may be advised. In this, a periodontist may be able to expose enough of the tooth structure for the placement of a crown.

A crown lengthening procedure is an ideal accompaniment to many cosmetic dentistry treatments. When there are different heights of gum tissues framing the teeth most visible in a smile. This tends to create a jumbled looking smile, when when the teeth are straight.

Crown lengthening rebalances the height of gum tissues that arch the teeth to restore a smile that is balanced. From this, the eye is drawn to the smile as a whole rather than one or two teeth with varying heights of gum tissue.

A gingivectomy is also performed for individuals who wish to correct a “gummy smile.” This is when a smile shows too much gum tissue above upper teeth when smiling fully.

Gingivectomies are performed while the patient is comfortably numbed. For some people, sedation may be a preference for enhanced relaxation. Oral sedation is available in pill form, which allows patients to ‘doze’ through procedures. I.V. sedation, also known as “twilight sleep”, is available for patients who prefer a deeper level of sedation.

Both sedations are administered by fully trained team members who use advanced safety monitoring equipment. We believe your safety is as important as your comfort.

In our Asheville periodontal dental office, we also offer a wide array of technology. This often saves the patient time in treatment, enhances comfort, and speeds healing. For example, our dental laser can seal tissues as it contours it. This eliminates or greatly minimizes bleeding.

Pain is how the body indicates that something is wrong. When the gum tissues have receded, they are not going to repair on their own. Let’s discuss your particular needs, whether for improved oral health or to enhance the appearance of your smile (or both) during a consultation appointment.

Call 828-274-9440 to schedule a time.

 

 

Optimize Your Dental Implant Experience, Results.

Posted on Jan 24, 2022 by William J. Claiborne, DDS MS

I recently had to return a small appliance at a “big box” store. I didn’t have the receipt but hoped I could at least get a store credit. When I explained this to the customer service rep, she said a receipt wasn’t necessary. She scanned the bar code and asked me if I wanted the refunded amount applied to the credit card I used to purchase it. No receipt needed, no credit card, and I was in and out of the line in no time.

With today’s technology, many processes that were once time-consuming and complicated are now simple and “painless.” Less time is required with better results. Technology has made this true, too, in dentistry.

As a periodontist, I specialize in the prevention, diagnosis, and treatment of all stages of periodontal (gum) disease. I also have advanced training and skills in the selection and placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures.

As an Asheville periodontal specialist for over 30 years, I’ve treated 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

To receive the extensive, additional 3 years of training after dental school to become a periodontist, (I believe) an individual must be passionate about the specialty. I certainly am, which is why I’m so committed to stay on top of the latest developments in the field.

This includes incorporating some of the most advanced technology available for the betterment of our Western North Carolina patients.

Our periodontal dental office features cutting edge technology, much of which is not available in other dental or periodontal offices in this region. These features help to diagnose with precision, treatment plan with superior accuracy and reduces the patient’s treatment time while optimizing comfort.

For our dental implant patients, these options have been significantly beneficial in maximizing results. Some specifically helpful in dental implant diagnosis and planning are:

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. For patients who are preparing for dental implant placement, resolving gum disease prior to treatment is mandatory. LANAP offers a non-surgical alternative for patients with moderate to severe periodontal disease with very little discomfort and a quick recovery time.

Cone Beam Imaging – These amazing 3D “x-rays’ are ideal for diagnosing and treatment planning. The highly-detailed images provide a clear view of the upper and lower jaw. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The images are captured in a quick, painless process and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging – This enhanced tomography works with 3D imaging for exceptional detail and range.

Computerized Dental Implant Placement – This system provides the futuristic ability to position dental implants before the process actually begins. Through computerized technology, the implants are selected and “ideally positioned” on a 3D model of the patient’s jaw. From this, a template is developed for optimal treatment success, even for complex cases.

CS 3600 Intraoral Scanner – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily. These are used to create precision models or appliances (dental implant crowns, bridges, or full arches). The scanner can also reach hard–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Sedation – Our Asheville periodontal practice is known for its environment of comfort and respectful care. We understand that over 70 percent of the adult population have some level of dental fear or anxiety. For optimal comfort and relaxation, 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 Medical Doctor (MD) who is a board certified Anesthesiologist.
With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

When it comes to placement of dental implants, a periodontist has a unique understanding of the tender layers of gum tissues. Using gentle and precise skills when it comes to any treatment involving oral tissues, the patient experiences less disruption and incisions. When it comes to the gums, less is definitely more. We strive to optimize comfort levels and speed the healing process.

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 required.