Bad Breath? That May Be The Least Of Your Problems!

Posted on May 23, 2019 by William J. Claiborne, DDS MS

We’ve all run into people who have bad breath. Although a tuna salad lunch or onion-laden hot dog can cause folks to pull back from close-up conversations, these forms of bad breath are temporary.

The smelly breath odor that is more concerning is that which comes from the sticky film of bacteria that coats the mouth and emits sulfuric odors (likened to rotten eggs). This film, known as plaque, coats the teeth and gums when allowed to build up.

For example, the reason you wake up with not-so-fresh breath in the morning is the result of the mouth being closed all night while bacteria reproduces and accumulates. Without brushing and due to declined saliva flow (your mouth’s natural rinsing agent) during sleep, oral bacteria amass. Thus, you wake up with the sticky film and the breath that goes with it.

For those who are mouth-breathers during sleep or who snore, dry oral tissues allow for even more bacterial growth.

Once you brush and rinse thoroughly, however, you can expect your breath to become more pleasant. Persistent bad breath, however, may be the a side effect of medication, an illness, or periodontal (gum) disease.

As a periodontal specialist, I’m very much aware of the distinct odor produced by gum disease. Although it varies slightly from person to person, it has an offensive scent than that of typical bad breath.

The best way to determine gum disease as the true source is through a periodontal exam. In addition to persistent bad breath, periodontal disease symptoms include gum tenderness, gums that bleed when brushing, and gums that are red in color rather than a healthy pink. Early stage gum disease (gingivitis) may not cause any obvious symptoms, however.

Regardless of the source of unpleasant breath odor, it is imperative to have and maintain good oral health – for reasons that can impact your overall health. Through decades of research and studies, the bacteria of gum disease has been linked to serious health problems, including heart disease, stroke, arthritis, diabetes, impotency and some cancers.

For example, rheumatoid arthritis (RA) and pneumonia are just two diseases that have a connection to gum disease. Researchers have found that RA sufferers have a higher incidence of periodontal (gum) disease compared to individuals with a healthy oral condition.

Studies have also shown that RA patients are nearly 8 times more likely to have gum disease. Although insufficient oral hygiene can certainly be a determining factor in acquiring gum disease, other parameters point to a deeper association between RA and gum disease.

Because both RA and gum disease both cause internal inflammation, a connection between the two are most prevalent when examining the joints and oral tissues. Oral tissues with the presence of periodontitis compared to tissues of RA-affected joints show a number of similarities. Research has also discovered a genetic link between the two.

And the health threats go further. One study published by Science Daily found that the bacteria present in the mouth can release toxins that can make their way into the brain. (https://www.sciencedaily.com/releases/2019/01/190123165002.htm)

Once there, they may contribute to Alzheimer’s disease. While studies on this connection continue, other studies have found a clear path of triggers traced to the inflammatory reactions caused by the bacteria of gum disease.

Once periodontal disease is established in the mouth, its pathological byproducts can enter the bloodstream, lymph fluid, and bone structures. This can lead to the spread of infection and inflammation to all areas of the body. In this way, periodontal disease has been shown to be a cause of systemic disease.

While fresh breath and a gleaming smile are important, it’s clear that oral wellness plays a leading role in helping you avoid serious, and even deadly, health conditions.

If you’re experiencing any of the symptoms of gum disease mentioned above or are past due for a dental exam, call our Asheville periodontal office at 828-274-7440. If desired, you can begin with a private consultation, where we will discuss your symptoms and health history. During this time, I’ll answer your questions, explain treatment options and discuss comfort methods.

How To Make Flossing An Easy Part Of Your Oral Care Routine

Posted on Mar 06, 2019 by William J. Claiborne, DDS MS

You can imagine that dental offices hear just about every excuse known to man as to why people “forget” to brush or don’t floss or don’t go to the dentist or don’t proceed with recommended treatment or don’t ….. It’s endless.

While many patients know their excuses are not really justified reasons, we adults can rationalize just about anything when it comes down to it. We know what may seem unjustified can be true reality for others.

We learn – starting from childhood – how to rationalize certain viewpoints. Some of us justify grabbing something sweet rather than healthy for a “quick pick-me-up.” Some don’t make the bed in the morning because it’s just going to get messed up at night. Some don’t go to the dentist until something hurts because they feel that’s the first sign that something is wrong.

OK, we all know, deep down, that there are things we shouldn’t avoid. No one WANTS to go to a dentist twice a year but also know it’s part of the process for a confident smile and way to avoid cavities and periodontal (gum) disease.

It’s clear that it’s not just these 6-month check-ups and cleanings alone that lower our risks of needing dental repairs and treatment, things that occur that were essentially preventable with daily care. What I’d like to address is the daily care you give to your oral health, and flossing, in particular.

In our Asheville periodontal dental office, we pride ourselves on not “lecturing” our patients. Our goal is to provide sufficient information to each individual, helping him or her understand the HOW & WHY of recommendations.

For instance, here is HOW to brush thoroughly and effectively twice a day. Here is WHY it can save you time and money by preventing or minimizing dental procedures that may be needed in the future.

Brushing one’s teeth effectively and regularly is easily instructed. We advise at least twice a day, using a soft to medium bristle tooth brush and fluoride tooth paste. Using a swirling motion, each individual should spend at least two minutes per brushing, going over all sides and tops of teeth.

And then there’s flossing. This is where the patient starts to twitch and squirm in the discussion. Flossing is a complicated, difficult maneuver in the minds of some people. Yet, for those who floss on a daily basis, it’s a simple technique that takes less than a minute.

The action of flossing helps to dislodge food particles that become trapped between teeth. For older adults who have shrinking gum tissues (a normal part of the aging process), food bits can also become wedged in the tight openings beneath the area where teeth meet one another.

Flossing is a particular need for people who have crowded, crooked teeth. These jumbled angles and nooks offer ideal havens for oral bacteria accumulation. Too, people in orthodontic treatment (braces) are particularly vulnerable to oral bacteria buildup because of the food trapping potential of wires and brackets.

Food that is not removed from the mouth after several hours begins to rot. Rotting particles are sustenance for oral bacteria. This gives them sustenance that helps them reproduce and thrive. As oral bacteria accumulate in the mouth, they begin attacking tooth enamel and gum tissues.

A tooth brush is often unable to dislodge food caught between teeth. This is why the use of floss is beneficial. However, manual floss can be a challenge to some individuals. Some people don’t like the tight feel around their fingers. Some people have large hands and find it difficult to reach certain areas in the mouth. Others have dexterity issues that leave them unable to floss.

Our goal is to create an ideal program for each patient that is customized to their needs and goals. For example, people with large or arthritic hands can STILL floss, simply by using a water flosser.

A water flosser pulsates a stream of water between teeth that is forceful enough to dislodge trapped food bits but without harming teeth or gums. Water flossers are affordable, easy to purchase online or in most stores, and easy to use.

Best of all, most water flossers have been shown to be just as effective as manual flossing. And, because they typically sit out in clear view of the sink where tooth brushing occurs, water flossers help to remind the individual that it’s a part of their at-home oral hygiene routine.

There is always an excuse to avoid doing something we know, deep down, we should be doing. I don’t like taking the trash out at night but know it’s simply part of keeping our home clean and pleasant. Yet, certain tasks are well worth the small steps we take each day to keep things in good shape.

A healthy, confident smile is worth the daily upkeep of regular brushing and flossing. You can also enhance your potential for a healthy mouth by drinking plenty of water throughout the day, limiting sugar and caffeine (which is drying to oral tissues), and avoiding snacking (or select what you snack on wisely).

For patients who have lost natural teeth or have developed periodontal disease due to insufficient oral hygiene care, their regret is a powerful warning to others. We frequently hear, “If I could go back, I’d have taken better care of my teeth.” Let us help you to avoid ever having to say that.

Begin with an examination. We’ll assess the health of your gums and the condition of your teeth. If you have signs of gum disease, we have advanced training and skills to treat all stages of gum disease. We also utilize state-of-the-art technology designed to enhance treatment outcomes and optimize patient comfort.

For individuals who have lost teeth, a periodontist also specializes in the diagnosis and placement of all types of dental implants. Dental implants recreate the strength and stability of natural teeth. Additionally, implants help to halt bone loss to the jaw bone. This enhances your ability to keep neighboring natural teeth, versus a crown-&-bridge or partial denture.

And please remember, research has shown numerous links to the oral bacteria of gum disease and serious health problems. These potent bacteria have been found to activate systemic inflammation in the body, contributing to higher risks of heart disease, stroke, diabetes, arthritis, some cancers, preterm babies, and impotency.

For an appointment, call 828-274-9440. We’ll also be happy to answer your questions.

 

 

 

Older Adults Should Make Oral Health VERY High Priority.

Posted on Feb 17, 2019 by William J. Claiborne, DDS MS

Whoever said, “Growing old is not for sissies!” surely knew what he or she was talking about. That statement seems to describe the process pretty accurately, for those who endure it!

While the visual signs of growing old – hair thinning (or loss), wrinkles, sagging skin, age spots, and shifting fat – is apparent, those are minor in comparison to the aches, pains, and challenges that persist ‘below the surface.’

From aching joints to loss of muscle strength to poor eyesight to memory decline (and a long list in-between), the aging process adds health challenges that seem to grow in number and severity with each passing year. Sadly, increased risk of tooth loss seems to be part of the process.

A five-year study by the National Health & Nutrition Examination Survey showed that Americans ages 65 and over have lost an average 19 natural teeth with over 27 percent having no remaining teeth (known as being edentulous).

While tooth loss is often perceived as a normal part of the aging process, it is not. Keeping one’s teeth throughout a lifetime is very possible. And, maintaining one’s natural teeth have been associated with living a longer life.

Healthy teeth begin with a health foundation — your gums. Good oral health has been shown to reduce risks for serious health conditions (including heart disease, stroke, and some cancers) elsewhere in the body. In addition to being able to keep your teeth, natural teeth are a bonus to biting, proper chewing, and nutritional intake.

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

Without natural tooth roots, which help to nourish and stimulate the jaw, supporting bone structures begin to shrink. Known as “resorption,” this process of bone mass decline can eventually lead to tooth loss. Once resorption begins, unfortunately, it continues. Statistics show that adjacent teeth beside an area of tooth loss have the highest risk for being the next to be lost.

The ‘gum-colored’ base of dentures is also porous. This surface provides oral bacteria with tiny ‘homes’ that become breeding grounds for high levels of bacteria. Denture wearers have higher incidences of repiratory problems, including susceptibility to pneumonia.

RDH (registered dental hygiene) Magazine (https://www.rdhmag.com/articles/print/volume-34/issue-12/columns/infection-control/dentures-and-aspiration-pneumonia.html) shares one study of senior adults and the higher risks for those who also sleep in their dentures.

Too, with the aging process also comes the condition of ‘dry mouth.’ Saliva plays an important role in maintaining good oral health. A healthy saliva flow makes it easy to talk, swallow, taste, and digest food.

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

Almost half of Americans take at least one prescription daily. For adults over the age of 65, nearly 90 percent take one or more. While a number of both prescribed and OTC medications include the side effect of oral dryness for any age, age-related reductions in salivary production causes irritation to oral tissues.

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

Older adults obviously need to make their oral health one of their highest priorities. Fortunately, good oral health is easy to achieve. Daily brushing and flossing and regular 6-month exams and cleanings can help to minimize problems and address those that do occur at their earliest stages.

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

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

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

If you have started to lose natural teeth already, let us help you halt the process! Call 828-274-9440 to schedule a consultation so we can discuss how you can regain your oral health for a lasting, healthy smile!

Think “E-Cigs” Are A Safe Alternative? Read On…

Posted on Jan 16, 2019 by William J. Claiborne, DDS MS

Smokeless cigarettes, or “e-cigs,” first appeared on the market in 2004. Since then, their popularity has exploded.

Unlike tobacco cigarettes, where nicotine is inhaled through smoke, e-cigarettes are electronic devices that often mimic the shape of a small cigarette. They are designed to heat a liquid and produce an aerosol, or mix of small particles in the air. The inhalation process is known as vaping.

Because these battery-operated devices deliver nicotine without some of the toxic chemicals in tobacco cigarettes, they are deemed as safer alternatives. Although both cigarettes and e-cigs are vehicles that deliver addictive nicotine, vaping wins when it comes to being the lesser of the two evils.

However, the vapor from e-cigarettes does contain toxic compounds, just at much lower levels than cigarette smoke. This is good news for people who are quitting smoking and vaping instead.

That doesn’t mean e-cigs are SAFE, however. They’re just safer than traditional cigarettes.

A particular concern is the appeal, and hence rapid growth, among teen users.

E-cig vapor, once inhaled, is absorbed by the body. For teens, it may be particularly harmful to developing brains and bodies. The vapor contains a chemical mix of nicotine, formaldehyde and other chemicals. A recent study that examined urine and saliva specimens from teen participants showed e-cig users had elevated levels of harmful compounds such as acrylonitrile, acrolein, propylene oxide, and crotonaldehyde.

For those who both smoked cigarettes and vaped, they had the highest levels of toxins and carcinogens (when compared to e-cig only users and non-smokers). (http://pediatrics.aappublications.org/content/141/4/e20173557)

Flavorings such as diacetyl, a chemical linked to lung disease, are also a concern. (https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html)

And nicotine is nothing to take lightly as far as adolescent development goes. The Centers For Disease Control & Prevention warns that nicotine can harm the developing adolescent brain, which continues to develop until about age 25. Adolescence nicotine use can also harm the parts of the brain that control attention, learning, mood, and impulse control.

Using nicotine in adolescence may also increase risk for future addiction to other drugs.

With limited scientific evidence to develop public health policies, researchers are urging priority status be given to studying the effects of e-cigs aerosol mixtures on cells, tissues and the oral cavity (interior of the mouth). The problem has become such a concern that the National Institute of Dental & Craniofacial Research is studying the biological and physiological effects of their chemical components.

Rather than focusing on the effects of nicotine (those findings are well-known), this will examine how the high concentrations of aerosol mixes affect oral tissues. They will also monitor the tissues in the mouth, airway structures and lungs that absorb the vaporized chemicals in e-cigs. Hopefully, the findings will show the true effects of long-term exposure to these chemical mixtures.

Your smile is particularly vulnerable to e-cigs, just as it is to traditional cigarettes. Since oral tissues are moist by nature, the water vapor inhaled into the mouth is absorbed readily by gum tissues. Nicotine, consumed by any method, is known to have a drying effect on oral tissues. This decreases saliva that helps wash food particles and bacteria from the mouth.

Without sufficient saliva, bacteria rapidly reproduce, increasing the potential for tooth decay and gum disease. A dry mouth also leaves you fighting bad breath on a frequent basis.

Having a dry mouth can lead to a higher risk of periodontal (gum) disease. Initially, the condition causes the gums to become swollen, tender, red, and bleed easily when brushing. If not treated promptly, this early-stage of gum disease (known as gingivitis) can progress to periodontal disease.

In addition to attacking gum tissues and the bone that support teeth, gum disease can weaken gum tissues and allow entry of infectious bacteria into the bloodstream. Once bloodborne, the bacteria can cause inflammatory reactions elsewhere in the body. Research has shown it can increase one’s risk for heart disease, stroke, diabetes, arthritis, preterm births, impotency, and some cancers.

Additionally, nicotine from any source has been shown to constrict blood vessels in the mouth so much that it compromises the ability of oral tissues to heal. This is why we caution patients to stop (or greatly decrease) smoking after an extraction or dental implant placement.

Don’t allow misconceptions of e-cigs being “a safe alternative to smoking” to put the health of your smile at risk. Smoking, in any form, places your oral – and overall – health at a disadvantage. If you do smoke, be especially committed to your regular check-ups and cleanings so we can help you maintain a healthy mouth.

If you’ve noticed signs of gum disease, please know this will not go away on its own. Gum disease will progress and can lead to tooth loss when not treated sufficiently. A periodontist is a specialist and your wisest choice in overcoming all levels of gum disease, and getting your smile back on track! Call 828-274-9440 for an examination appointment in our Asheville periodontal office.