What Can A Periodontist Do For You?

Posted on May 13, 2024 by William J. Claiborne, DDS MS

In meeting someone for the first time, a common question is “What do you do?” Telling them that I am a periodontist often gets followed by another question: “What does a periodontist do?” The long version, according to the American Academy of Periodontology, is:

“A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”

Choosing this dental specialty is achieved by an understanding that it will require many years of education. A periodontist begins by completing 4 years of college (undergraduate training) followed by another 4 years in dental school to earn a doctorate. The periodontal specialty then requires another 3-4 years before completing the stringent requirements for a specialty certification in periodontics.

What can all of this in-depth education and advanced skill level do for you?

Let’s begin with the diagnosis and treatment of all stages of periodontal (gum) disease. According to the Centers of Disease Control & Prevention (CDC), it is estimated that over 47% of Americans have some level of gum disease, which is also the leading cause of tooth loss. That’s nearly half of our population.

In addition to a healthy smile, the health of your gums can impact your overall health. By keeping the bacteria of advanced gum disease, known as periodontitis, you lower your risks of a long list of serious health problems that have been shown connected to gum disease bacteria. These include heart disease, stroke, diabetes, arthritis, Alzheimer’s disease, some cancers, preterm babies, and erectile dysfunction (ED).

A periodontal specialist is also a leading choice in the selection and placement of dental implants. 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.

When it comes to the selection of the implant system best for you, our speciality also understands the complete spectrum of all implant types. Some implant systems offer a non-removable (“fixed”) option with others functioning with removable teeth.

Proper selection of your dental implants can also help to keep treatment fees to a minimum. This is because some implants can support more than one tooth and others are designed to support a full arch of replacement teeth. Because treatment fees are based on the number of implants required, your tooth replacement goals may be within a more manageable budget with fewer implants needed to accomplish your goals.

Reshaping gum tissues is also part of our specialized skills. The gum tissues are designed to provide a tight seal around the base of teeth and block bacterial entry to the sensitive tooth root area. When oral bacteria are able to penetrate beneath the gum line, they can cause inflammation to tender gums and attack the structures that support natural teeth.

In a procedure known as a gingivectomy, we are able to reposition or graft gum tissues over the area of recession to restore a healthy seal and protect the tooth structures below the surface.

In some cases, we are also able to save a natural tooth when the tooth breaks near the gum line. In a procedure known as  crown lengthening, a periodontist can sometimes expose enough of the tooth structure for the placement of a crown. By preventing the need for the tooth’s removal, the patient is able to avoid the extensive costs and potential upkeep of replacing it.

When it comes to a smile’s appearance, a periodontist is also the go-to. In smiles that have an uneven line of gum tissues, meaning that some teeth have more gum showing than others. This up-and-down line of gum tissue creates a jumbled look. Crown lengthening can alter the height of these tissues prior to placement of a crown (‘cap’) to provide a more flattering smile line.

Another benefit of the skills of gum recontouring  are the correction of a “gummy smile.” In this, the patient has too much gum tissue bordering the tops of teeth, making the smile line unbalanced. Using the gingivectomy procedure, a periodontist can lower the height of gum tissues, which is generally followed by placement of crowns.

Here, our Western North Carolina periodontal dental office features some of the most advanced technology in dentistry. Many of these features are not available in other dental offices elsewhere. Some of these include:

LANAP With PerioLase MVP 7 (Laser-Assisted New Attachment Procedure) – 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 has also been found to stimulate bone regrowth in damaged areas.

3-D Cone Beam Imaging – used for diagnoses and treatment planning, giving clear views of the upper and lower jaw, used for intricate review of sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement.

CareStream Cone Beam Computer Tomography Imaging – provides enhanced tomography that interacts with 3D imaging for exceptional detail and range.

CS 3600 Intraoral Scanner – This scanner quickly and comfortably captures digital impressions without the need for bulky, goopy trays! Through this process, we are able to create 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 – allows 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, even for complex cases.

Sedation Dentistry – When dental fear or anxiety causes people to delay or avoid having dental treatment, we offer oral or 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.

Through our extensive menu of treatments offered, it’s easy to see that our main goal is to provide patients with a comfortable and positive experience within our specialized skills. We believe this helps patients truly appreciate the advantages of a healthy smile and understand how our involvement can create a healthier, more confident individual.

I also feel it’s important that people are aware of the signs and symptoms of periodontal disease, which are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

If any of these are present, please know that the condition will only worsen without treatment. And, early treatment can minimize treatment needs and costs.

Call 828-274-9440 if you have questions or wish to arrange a consultation discuss your individual needs (or those of a smile you love!). Our Asheville periodontal dental office staff will be happy to help you!

https://www.perio.org/consumer/what-is-a-periodontist

Men – Take On The Challenges In Oral Health Upkeep.

Posted on May 05, 2024 by William J. Claiborne, DDS MS

If you’re a male, or have ones in your life you love, the following information will be good-to-know. This is filled with reasons why you (or they) should make oral health a priority.

Let’s begin with the hazards of gum disease. According to a survey by the Centers For Disease Control & Prevention (CDC), only 66% of males brush their teeth twice or more a day (compared with 86% of females).

Flossing stats weren’t much better, but that proved to be the case with both sexes. Only 49% in the survey said they were daily flossers with 1 out of 3 with the misconception that seeing blood in the sink when brushing is normal (it’s not).

Periodontal (gum) disease is the result of an over-accumulation of oral bacteria. It begins with Gingivitis.

Gingivitis is caused by the toxins in plaque. Plaque is the sticky layer of bacteria that coats teeth and gums. When not removed (through regular brushing and flossing), it can harden into a form known as tartar (that can no longer be brushed away).

Gingivitis is typically treated with a professional cleaning and thorough at-home care. Some cases may require root planing and deep scaling procedures to rid the gum tissue of debris pockets (pus-filled bulges on gum tissues). This procedure reaches bacteria that has penetrated beneath the gum line.

The next stage of gum disease is known as chronic periodontal disease. The most common form of gum disease, this is characterized by inflammation beneath the gum line with damage to gums and bone tissue. At this level, treatment includes scaling and root planing along with antimicrobial treatments. In some stages, surgical procedures are also necessary for pocket reduction. Some cases require tissue grafts to strengthen the bone and improve the appearance of the smile.

As gum disease worsens, it moves to periodontitis, a more aggressive stage of gum disease. Periodontitis has similar symptoms to those listed above but tends to progress at a faster pace. Because this stage of gum disease is more difficult to combat, treatment is the same treatment needed for chronic periodontal disease along with surgical intervention. A combined treatment of scaling, root planing, antimicrobial, and surgical procedures may save oral tissue and bone.

Periodontal disease is the nation’s leading cause of adult tooth loss, affecting over 47% of adults ages 30 and over. Research has found that gum disease is higher in men (over 56%) than in women (38%).

The Centers for Disease Control & Prevention (CDC) notes that men are typically less likely to sufficiently maintain their oral health. Oral health should be especially concerning for men since they have some challenging odds against them as far as health statistics go. These include:

• Men have higher rates of periodontal (gum) disease, tooth loss, and oral infections. Because statistics show that men typically have poorer dental habits than women, they tend to have more dental health problems. Men can’t blame this on biological predisposition as the statistic is based upon lifestyle choices (such as not brushing, etc).

• Men tend to have higher blood pressure, putting them at an increased risk for heart disease later in life. Medications that treat these conditions can cause dry mouth, which ups the risks to their oral health.

• Elderly men typically have fewer teeth than women of the same age, and need dentures more than women. Although research shows a correlation between tooth loss and body mass index, elderly men having few teeth is the result of poor dental habits and attention to dental health accumulated over time.

• Oral cavity and oropharyngeal (throat) cancers are twice as common in men than in women. It is suspected that this is due to men being more likely to have a history of tobacco and alcohol use.

• HPV-related oropharyngeal cancers occur more often in men. Human Papilloma Virus (HPV) is the most common sexually transmitted infection in the U. S. HPV can lead to certain types of cancer and is thought to cause 70% of oropharyngeal cancers in the U.S. The development of oropharyngeal cancer due to HPV is about three times less prominent in females than in men of the same age.

While a healthy smile is important to both genders, older adults should pay particular attention to having a good oral health. By CDC estimates, approximately 13% of adults ages 65 – 74 have no teeth. For people ages 75 and older, that number jumps to 26% (over one-fourth!).

Too, ALL ADULTS should be concerned with the overall health repercussions related to the inflammatory bacteria of gum disease. Able to enter the bloodstream through tears in diseased oral tissues, these bacteria can trigger inflammatory reactions elsewhere in the body. This has been associated with the development or worsening of heart disease, diabetes, some cancers, diabetes, arthritis, erectile dysfunction, elevated PSA levels, and respiratory diseases.

Also applicable to all adults, the Journal of Periodontology shared nine risk factors for tooth loss due to periodontal (gum) disease, including …
 • Being over age 35
 • Being male
 • Not having professional dental care
 • Not brushing teeth
 • Smoking
 • Being diabetic
 • Having high blood pressure
 • Having rheumatoid arthritis (RA)

Treating gum disease before it becomes severe can be done comfortably and affordably. In our Asheville periodontal dental office, we use cutting-edge technology that often minimizes treatment needs, lessens healing time, and optimizes comfort.

If dental fears have caused you to delay or avoid having regular dental care, consider beginning with a consultation. As a periodontist, I know many individuals like that this occurs in a comfortable, private consultation room. We can discuss the use of oral or I.V. sedation (sleep dentistry, or “twilight sleep”) during procedures. These are administered safely with patients monitored with advanced safety equipment throughout treatment.

If financial constraints are an obstacle in receiving treatment, we offer several payment plans. Most are interest-free with no down payment required (for qualified individuals).

Call 828-274-9440 to begin with a private consultation to discuss your best options. New patients are welcome and a referral is not needed.

Sources:
https://www.perio.org/consumer/gum-disease-and-men
https://www.perio.org/consumer/gender-differences
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544688/
https://pubmed.ncbi.nlm.nih.gov/20116657/
https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/risk-
https://www.colgate.com/en-us/oral-health/hiv-aids-and-stds/dental-care-hpv-and-men#

 

What You May Be Doing To Increase Potential For Gum Disease

Posted on Apr 11, 2024 by William J. Claiborne, DDS MS

There’s a saying: “We don’t know what we don’t know.”

That applies to so much in life. With all good intentions, adults go about their days feeling they are doing what is right. However, we occasionally learn that what we thought was right is to our detriment.

For example, decades ago, people felt that rigorous scrubbing of teeth with a hard toothbrush and baking soda was a good way to clean your teeth. We now know that the hard bristles and abrasive substances can wear down tooth enamel and scrub away tender gum tissues.

And, there are ways that we actually – and unconsciously – add to the risks for developing periodontal disease.

Over the years, research has continuously shown that the bacteria of periodontal disease can have a number of harmful effects – in the mouth and further. Because these inflammatory bacteria can enter the bloodstream and travel throughout the body, research has shown that they can activate or worsen a number of serious health problems. These include:
– heart disease
– stroke
– Alzheimer’s disease and dementia
– arthritis
– diabetes
– preterm babies
– erectile dysfunction (ED)
– some cancers (including lung and pancreatic)
– obesity

Signs of gum disease include bleeding or sore gums, persistent bad breath, receded gums, and/or gums that are red rather than a healthy pink. These are warning signs since gum disease will only worsen without treatment.

As gum disease progresses, gums begin to pull away from the base of teeth, gums become very tender and bleed easily when brushing, pus pockets form on gums and teeth may shift or loosen.

Unfortunately, gum disease is ignored too often by adults in the U.S. The CDC estimates that over 47% of Americans have some level of gum disease, which is also the leading cause of tooth loss.

Bacterial overload can leave the body’s natural defense response, white blood cells, unable to conquer the infection. Thus, bacteria overload in the mouth triggers an inflammatory reaction begins, which is the beginning of gum disease.

Below are things that can increase the risk for gum disease, some of which you may not realize are contributors:

Aging: Studies have indicated that the incidence of periodontal disease increases as we get older. Over 70% of adults who are aged 65 and older have some form of gum disease.

Some Existing Health Problems: People who have diseases such as cancer or heart problems already have weaker immune systems. When the bacteria of gum disease enter the bloodstream through tears in oral tissues, harmful clotting factors and proteins can occur elsewhere in the body. Research has linked gum disease bacteria with heart disease, diabetes, stroke, preterm babies, and memory loss.

Dry Mouth: Smoking, certain medications, drinking alcohol and aging all contribute to a dry mouth. The saliva in your mouth plays an important part in removing food particles and bacteria. When insufficient saliva cannot cleanse the mouth adequately, bacteria buildup results.

Stress: It has been proven that people who endure long-term stress have a greater risk for developing diseases such as cancer, hypertension and even gum disease. Stress takes a toll on the body’s entire operation, weakening its ability to fight infection.

Medications: The side effects of some drugs can dry out oral tissues and even weaken the density of bones, opening the door for gum disease. Like your physician, your dentist should have an up-to-date list of all medications you take, including herbal supplements.

Grinding Teeth: When you grind and clench your teeth during sleep, the teeth wear down and connective oral tissues are weakened. When the tissues surrounding your teeth are vulnerable, your entire jaw bone area is exposed to certain infections, which can lead to gum disease.

Genetics: Because of genetics, you can be predisposed to develop gum disease. Research indicates that 30% of the population may be genetically susceptible to gum disease.

Gender: Periodontal disease occurs more in men than women (56% vs. 38%).

Smoking: Smoking dries out the tissues in the mouth, increasing one’s susceptibility to calculus. Research shows that smokers lose more teeth than nonsmokers and typically require longer healing times after treatment with results that are less predictable.

A periodontist is a specialist in the treatment of all stages of gum disease and in the placement of dental implants. He or she is the expert who can help to restore a bacteria-burdened “oral cavity” to a healthy state.

In our Asheville periodontal dental office, we feature some of the most advanced technology in the industry. The patient benefits from these through diagnoses that are exact, more conservative treatment, and having reduced healing time. This also can mean there is less discomfort.

One of the features we provide is the LANAP Protocol Using Periolase MVP-7. LANAP (an acronym for Laser-Assisted New Attachment Procedure) is amazing technology that more efficiently and effectively treats periodontitis (advanced gum disease) with the PerioLase® MVP-7™ laser. As a minimally invasive (non-surgical) treatment for moderate to severe periodontal disease, LANAP has even been found to stimulate bone regrowth in damaged areas.

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. New patients are always welcome.

If dental fear has kept you from having regular dental care and you’re experiencing symptoms of gum disease, consider starting with a consultation. During this time, we can discuss comfort options, including oral and IV sedation (“twilight sleep”). Referrals are not required.

Avoid Dental Implant Failure

Posted on Apr 04, 2024 by William J. Claiborne, DDS MS

There are reasons to go to an expert for certain things. For example, I’d never try to do electrical work around my house on my own; I’d call an electrician.

When it comes to dental implants, there are also reasons to seek out an “expert.” In this article, I’ll explain why it’s best to have your dental implants selected and placed by a periodontist.

First, let’s look at the structure of an implant. Serving as a replacement for a missing tooth, the implanted portion is a titanium screw that is positioned into the jawbone. Over the course of 3-6 months, the jawbone grows around the implant, securing it in place. It can now support an artificial tooth or crown.

Dental implants have many benefits when it comes to restoring biting/chewing/speaking function and smiling appearance, including:

• enhancing the appearance of a smile
• improving biting and chewing function
• stabilizing surrounding teeth and jaw tissue
• halting the process of bone loss, known as resorption
• an increased quality of life for many people

Dental implants have an excellent success rate – 90-95%. However, there are instances where a dental implant can fail.

Dental implant complications can occur from infections, gum recession, and nerve and tissue damage. There is also a higher risk of implant failure for individuals who smoke or have diabetes, gum disease, have radiation therapy to the jaw area or take certain medications.

A periodontal specialist has advanced training and skills in the diagnosis and placement of all types of dental implants. This means that this dental specialist can determine which implant system will work best for your individual needs. For example, a person who has lost a great deal of bone mass may only be a candidate of certain implant types or may need a sinus lift prior to placement. A periodontist can make these determinations so your potential for implant success is higher.

One of the most common causes for implants failure is due to an infection at the implant site. Because a periodontist specializes in the care of gum tissues in the mouth, he or she can take measures to treat the infection at early stage to resolve the problem. However, in some cases, treating the infection may require implant removal in order to reach the infected bone tissue.

Using advanced skills, a periodontist can also assess your gum health prior to implant placement. He or she can pretreat any periodontal diseases so the implant has a healthy foundation. When the gum tissues around the implant are inflamed or have receded, the implant is at risk for entry of bacteria into the area where it is implanted.

After the implant is placed, it should fuse with the bone. A complication that prevents this may require the dental surgeon may remove it. Fortunately, after the implanted area is restored to a healthy state, the implant procedure can be redone.

Another benefit in using a periodontal specialist for implant placement is in their in-depth understanding of the nerves and tissues surrounding the jaw bones. There is a risk for failure when a dental implant is placed too close to a nerve. For example, there is a nerve that runs horizontally through the lower jaw. If the implant is placed in close proximity, it can cause numbness, tingling, or pain.

Nerve or tissue damages can result in:

• • numbness on the side of the implant, including the lower lip and chin
  • persistent pain or discomfort
  • tingling, tickling, or burning sensations in the gums and skin

While precision placement (depth, position and angle) is a bonus of a periodontist’s skills for implant patients, our Asheville periodontal dental patients have the benefits of advanced technology. Our Computerized Dental Implant Placement system 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.

An example of this precision placement guidance in with upper dental implants. With declined bone mass of the upper jaw (typically from years of missing tooth roots), the sinus cavities can hover too close to the position(s) where implants are to be placed. In these cases, we can perform a sinus lift.

Should the dental implant protrude into the sinus cavity, the sinuses can become inflamed, causing:

• pain, tenderness, or swelling around the cheeks, eyes or forehead
• nasal blockage, often with green or yellow mucus
• a reduced sense of smell
• headaches
• toothache
• persistent bad breath

Of course, like a natural tooth, excessive force or impact can cause a dental implant to crack or become loose. For example, for people who grind or forcefully clench their teeth (“bruxing”) during sleep may need to wear a bite guard to prevent damage to the implant as well as their natural teeth.

In some instances, it can take up to 5 years for implant-related problems or infections to become apparent to the patient. Any issues that arise around the site of the dental implant should be examined and addressed without delay.

We want your dental implant(s) to last your lifetime and bring you as much eating and laughing pleasure as they are known to give. The best way to ensure the success of a dental implant is to follow the aftercare advice your periodontist and dentist provide.

As with a person’s natural teeth, an implant and the tissues surrounding it require regular cleaning. Daily flossing in the area at least once per day is needed after the gums have healed. Some patients prefer interdental brushes to access areas that are more difficult to reach.

Regular dental check-ups and appointments for cleanings should occur at least twice a year to ensure the longterm success of your implants. Once a quarter may be advised for some individuals who have higher risks for plaque development.

Optimal comfort for our Western Carolina 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 (“twilight sleep”). These are administered safely by an anesthesiologist who uses advanced safety equipment throughout your 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.