Why You May Have A Metallic Taste In Your Mouth.

Posted on Sep 12, 2018 by William J. Claiborne, DDS MS

Occasionally, a patient will mention that they have been having a metallic taste in their mouth. After several questions, I’m usually able to determine that the condition is related to a prescription they’re taking. As a matter of fact, the majority of people who notice a metallic taste experience this due to a medication’s side effect.

The most common medications to cause a metallic taste in the mouth are antibiotics, antihistamines, some OTC supplements, and medications that treat blood pressure, neurologic and cardiac conditions.

Pharmacy Times states that “more than 300 drugs are associated with metallic taste” and that “as many as 11 percent of elderly patients who take multiple medications experience taste problems.” (https://www.pharmacytimes.com/publications/issue/2015/july2015/drug-induced-metallic-taste-no-irony)

This occurs when the body ingests and absorbs medications with iron, chromium, calcium, and zinc, which all cause a metallic taste in the mouth. The body absorbs these substances, which are released and excreted in the saliva, often resulting in a metallic taste. In addition to causing this taste, another common medication side effect is dry mouth, which can also cause a foul or metallic taste.

Dysgeusia is the medical term used to describe an abnormal or impaired sense of taste.

An excess of zinc in the body – or even lack of – can also cause taste changes. Malnutrition can lead to a zinc deficiency, slowing cell renewal that alters taste. Taking too much zinc (typically through supplements) can trigger dysgeusia that causes a metallic taste.

Another common source for a metallic taste are respiratory infections, including colds, sinus infections, and middle-ear infections. Anything that causes congestion and mucus may lead to having a foul or metallic taste in the mouth.

Pregnancy can also alter your sense of taste due to hormonal changes. Tasting metal in the mouth is not unusual. This usually occurs in the first trimester and subsides in the second.

Some people are surprised to learn that poor oral hygiene can cause a metallic taste in the mouth. When oral bacteria accumulate to the point of causing inflammation, a metallic taste may be detected in the mouth. This is why it is important to have dental check-ups every six months and be committed to a thorough, daily oral hygiene routine at home.

While chemotherapy is known to cause nausea, another common complaint of patients undergoing chemotherapy is having a metallic taste in the mouth. Just as certain components of oral medications can emerge in saliva, drugs administered intravenously can also emerge in the saliva, causing “metal mouth.”

Allergic reactions that trigger sinus reactions can lead to a metallic taste as well. Allergens most often associated with causing a metallic taste include tree pollen, tree nuts, and shellfish, according to Medical News Today. (https://www.medicalnewstoday.com/articles/313744.php) Some people may have a metallic taste in their mouths for up to 2 days after eating pine nuts, which are commonly used in salads and pesto.

Too, a side effect of mercury poisoning is a metallic taste in the mouth. Although the neurological issues associated with mercury poisoning are more concerning, tasting metal in the mouth may serve as an early warning sign. By recognizing this as one of the indications of mercury toxicity, it may hopefully motivate people to seek medical evaluation.

Finally, liver or kidney disease can cause a metallic taste in the mouth. These conditions create a buildup of chemicals in the body, which are released into the saliva. For patients with severe kidney disease, the excess production of ammonia shows up in the saliva, causing a metallic taste in the mouth.

It’s amazing at how intricately and integrally connected each part of the body is to all other parts. Just as a skin rash may indicate an allergic reaction to something eaten, the mouth can be an indication point of things off-kilter in other areas.

If you suspect that your “metal mouth” is the result of a medication, it may subside (or lessen) after a few weeks. If not, it may be wise to have other areas checked. Your zinc levels, hormones, oral health, and other items may need to be evaluated to ensure all parts of your body are in proper balance.

Women & Oral Health – Particular Challenges Exist At Many Ages.

Posted on Aug 20, 2018 by William J. Claiborne, DDS MS

The female body is a uniquely complex structure in its ability to produce offspring and feed their young. With this comes the integral interaction of much more than its housing, of course. Females have an intricate system of hormonal components that help to manage these systems in order to maintain their own health as well as that of their young.

As a male who spends the majority of his days surrounded by females – working with a mainly female staff during daytime hours and spending the rest of my hours with my wife – I have an appreciation for women of all ages. From the perspective of a periodontist, I also have an understanding of how our female patients can endure particular challenges as a result of hormonal fluctuations.

Unlike the skin, which may cause an obvious rash after consuming something that causes allergic response, the gum tissues don’t give obvious visual indications when oral health is effected. However, your gum tissues may be more reactive to hormone levels that you realize.

Although gum tissues tend to redden when inflamed, an oft first-noticed symptom is tenderness or swelling. These issues are usually accompanied by redness, which tends to be noticed after other symptoms emerge. And, these other symptoms may be much more attention-getting.

For example, tender gums that bleed when brushing are hard to ignore. While these are symptoms of early periodontal disease (also known as gingivitis), the color of gum tissues can be easily overlooked since they are hidden inside the mouth.

Yet, an imbalance in the body that lies far beyond the mouth can trigger oral symptoms that need prompt attention before worsening. For example, pregnancy gingivitis is not uncommon in women during pregnancy. If not treated and resolved, however, it can develop into full-blown periodontal disease, which is the nation’s leading cause of adult tooth loss.

Below are some of the different phases of life that can be accompanied by various challenges to a female’s oral health:

• Puberty: Estrogen and progesterone hormones produced during puberty increase blood flow to the gums. This changes how the gums respond to plaque, the sticky film of bacteria in the mouth. With this may be gums that bleed when brushing and become red, tender, and swollen.

• Menstruation: The menstrual cycle causes hormonal changes that cause some women to experience symptoms such as swollen gums that turn bright red, canker sores, or gums that bleed easily. Referred to as menstruation gingivitis, this usually occurs just prior to the onset of the period and resolves in a day or so.

• Oral Contraceptives: Taking birth control pills that contain progesterone also causes some women to have gum tissues that become inflamed. This occurs from heightened sensitivity to the toxins produced from the overload of bacteria that form plaque. For many women, the gums become less reactive after the first few months of starting birth control pills. Some medications, such as antibiotics, can lower the effectiveness of oral contraceptives. This is why it is important to keep your dentist updated on all medicines you take.

• Hormone Relationship to the TMJ: It has long been known that more women have TMJ disorders than men. This prompted researchers to look into a possible hormone-related connection. The temporo-mandibular joints (known as TMJ), are the jaw joints. These are located on each side of the head in front of the ears and hinge the lower jaw (the mandible) to the skull. These TMJ are designed to move harmoniously each time you speak, chew, yawn or laugh. Now, research has shown that the use of birth control pills can lead to decreased levels of producing natural estrogen. Studies have found that decreased natural estrogen with the combined effect of the joint compression from TMJ disorders can lead to increased inflammation. In some individuals, this inflammation can result in osteoarthritis in the joint.

• Pregnancy: With each trimester of pregnancy, hormonal levels can change. Pregnancy also causes an increased level of progesterone, which can increase your risk for the formation of plaque. This can lead to pregnancy gingivitis, particularly during the second to eighth month of pregnancy. This condition causes the gum tissues to become swollen and bleed easily. Because gingivitis is the first stage of gum disease, it is important to have it fully resolved so it does not progress further. Because studies have found that gum disease can cause a heightened risk for preterm and low birth weight babies, obstetricians are cautioning their pregnant patients to be particularly diligent in maintaining good oral health..

 • Menopause: As we age, a variety of changes can take place in our mouths, whether male or female. Saliva flow is less plentiful, the mouth is less moist, and side effects of taking medications can pose challenges to keeping the gums healthy. Dry mouth, a particular challenge, is a leading cause of gum disease. Without adequate saliva flow to keep the mouth cleansed and being efficient in neutralizing the acids from plaque, the risk for gum disease is greater for females, especially those in menopausal years. Declining estrogen levels also place women at greater risk for bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is bone loss of the jaw, it can result in tooth loss. Receding gums are a sign of this bone loss since more of the tooth surface is expose to the causes of tooth decay.

Regardless of where you are in your lifespan, if you are a female, it is especially important to be aware of the signs and symptoms associated with these conditions. Having healthy gums is even more important now that science has shown a link between many serious health problems.

If you suspect you have some level of gum disease or have delayed having regular dental check-ups, begin with a consultation appointment. During this time, we’ll discuss your unique needs and how we may be the best fit for your oral health goals. Call 828-274-9440 to schedule.

Ways To Have A Successful Outcome With Dental Implants

Posted on Jul 16, 2018 by William J. Claiborne, DDS MS

For many individuals who wish to replace one or more missing teeth, dental implants have become the leading preference. Dental implants restore the look, feel, and function like that of natural teeth. They also help to prevent bone shrinkage that occurs when tooth roots are no longer present in the jaw bone.

A periodontist has advanced training in the diagnosis and placement of dental implants. He or she can help you enjoy a higher potential for dental implant treatment that lasts your lifetime. There are a number of reasons you should strongly consider having a periodontal specialist involved in your treatment.

SELECTION OF IMPLANTS – Dental implants come in a wide array of shapes and sizes. Each system is designed to accommodate certain needs and preferences. For example, some implants are designed to support a full arch of teeth while others can be placed in areas where a great deal of bone loss has occurred. The selection of the implant type that is appropriate for your needs and goals requires a unique understanding of all implant types. That is, a periodontist can select the type that will work best for you rather than go with the one or two in which they have received training.

PLACEMENT OF IMPLANTS – In addition to selecting the best type for your needs, proper placement of implants has a great deal to do with having a successful outcome. When an implant that is too long, for instance, is placed in bone that is too shallow, it can have future repercussions that may require its removal. This could occur when a lower implant is placed too close to a nerve that runs horizontal through the jaw bone (mandible). Or, when an upper implant is placed in shallow bone, it can work its way into the sinus cavity. A periodontal specialist considers intricate factors that can effect your potential for success.

STRUCTURAL ISSUES – In addition to the factors involved with bone loss, other issues can ‘make or break’ having a successful treatment outcome with dental implants. For example, for people who have bite misalignment or TMJ disorders, they may be grinding or clenching their teeth during sleep – often unknowingly. Telltale signs of ‘bruxing’ including remaining, natural teeth that are chipped or worn. These forces have been measured to that enough to crack a walnut! When dental implants endure these forces, especially during their ‘healing’ phase, there is greater risk for implant failure. A periodontist considers these issues prior to your treatment, helping you to bypass problems that can result in eventual removal.

INDIVIDUALIZED TREATMENT CONSIDERATIONS – Our goal is to help you get the most from your dental implants. When there are individual habits or preferences that can complicate success, we work with each patient to help them enjoy their dental implants for a lifetime. For smokers, we advise ways to support saliva flow and minimize oral bacteria levels. For people who take certain medications that can interfere with oral moisture, we recommend methods to keep the mouth properly hydrated. And so on. We want to make sure your care is individualized so your potential for implant success is high!

Unfortunately, I have seen a number of patients over the years who have had implants that were improperly placed or chosen. It is a significant loss for the patient when they have to have these implants removed and start all over. Like any procedure, you want your treatment time and investment to be successful and a pleasant experience. We do, too!

If you’ve considered dental implants to replace missing teeth, let’s discuss how a periodontal dental office can enhance your potential to enjoy confident smiles and chewing comfort for your lifetime! Call 828-274-9440 to schedule an appointment.

Don’t Let Hot Weather Drinks Dry You Out!

Posted on May 29, 2018 by William J. Claiborne, DDS MS

Summer is right around the corner! The coming months are typically those that move us to outdoor activities for “fun in the sun!”

Before you stock a cooler to tote along meant to quench your thirst, consider it’s contents — for your smile! While the intention with these drinks is to re-hydrate, many of these beverages can actually dry you out, including the oral tissues.

Let me explain the hazards behind having a dry mouth. First, think about how your mouth feels when you first wake up. Because the mouth is dry upon awakening, it causes a sticky buildup. This occurs when saliva flow is at minimum levels during sleep.

Without sufficient saliva flow, bacteria in the mouth are not being cleansed efficiently. Their accumulation leads to a sticky film that forms over teeth and gums. When we wake up, this is why our breath is less-than-fresh.

This film of bacteria is known as plaque. Bacteria are tiny organisms that eat, reproduce, and create waste. When the film they form becomes acidic, it can lead to the demineralization of teeth – a fancy term for cavities. Bacteria capable of eating into tooth enamel should be taken seriously!

Obviously, the goal is to keep oral bacteria levels to a minimum not only for fresh breath, but to avoid cavities and periodontal (gum) disease. When oral bacteria becomes too much for healthy gums tissues to handle, they become inflamed.

This inflammation destroys gum tissues, which become feeding and breeding grounds for oral bacteria. Once inflamed to a certain extent, the gums (the foundation of healthy teeth and the bones that support them) are destroyed.

As oral bacteria amass further, diseased gum tissues will release their firm grip around teeth, allowing these potent bacteria to attack structures below the gum line. They can also enter the bloodstream.

Research has shown that the oral bacteria of gum disease can create inflammatory triggers in the body. This inflammation has been linked to a number of serious health problems, including heart disease and stroke.

The goal is to keep oral bacteria levels manageable. This is why it’s so important to brush thoroughly twice daily, floss each day, and to keep the mouth moist. Through these simple steps, you greatly reduce your risk for cavities, gum disease, bad breath, and the penetration of oral bacteria into the bloodstream.

Saliva is your body’s natural oral cleanser. However, a number of things can deplete the amount of moisture in the mouth. Summer beverages tend to fool people since it is assumed that something cold and wet replenishes moisture. Beware the following:

• Colas – A cooler full of colas may seem like a good way to cool down, but most of these beverages pack a double whammy. The majority of colas are caffeinated AND contain sugar. Even those that are “sugar-free” and/or caffeine-free are bad for you. Why? Colas are highly acidic. This acid mixes with digestive acids that flow into the mouth each time you eat or drink. Sugar ramps up the acid content even more. When you combine a drink that has caffeine and sugar with these acids, you create a challenging ordeal for teeth and gums.
As if all that weren’t bad enough, think of the nature of how we drink colas. Most of us sip these drinks over a period of time. So, with each sip, oral acids are flowing into the mouth, wreaking havoc on teeth and gums. Because it takes 20-30 minutes for an acid attack to subside after the last bite or sip, drinking a cola over an extended period of time merely lengthens the period of overly-high acid levels.

• Alcohol – Ahhh… savoring a cold beer by the lake or a poolside daiquiri sounds refreshing, doesn’t it? Although these beverages are cooling to the mouth, alcohol is a drying agent to oral tissues. Even wine or alcoholic drinks with sugarless mixes (such as club soda or tonic) can trigger drying reactions in the mouth.

• Iced Coffees & Teas – Remember the problems created by the acid in colas? Iced coffee and iced tea are acidic as well. They are also caffeinated, which is drying to oral tissues. Add in sweeteners and you have a challenging concoction for the mouth.

• Ice-Cream – Everyone’s favorite summertime dessert, ice-cream, is laden with sugar and fat. Although ice-cream can be a source of calcium, the sugar content can easily deplete its benefits to teeth. Hint: Opt for chocolate ice cream (and sugar-free versions, if available). Chocolate contains anti-oxidants and dissolves quickly in the mouth, reducing sugar’s contact time on teeth.

• Antihistamines – Summer’s blooms (and even grass) cause a number of people to deal with allergic reactions, including itchy eyes and sniffling noses. To lessen the symptoms, a number of antihistamines are available over-the-counter. Keep in mind that these medications typically have a side effect of oral dryness. When the mouth is dry due to these meds, it can last for hours. (By the way, these drying side effects are common in many other medications as well).

For all of these oral dryness challenges, there is an easy solution – water! Drinking lots of plain, filtered water throughout the day not only replenishes moisture in our mouths, it hydrates the body. Keeping adequate hydration levels allows the body (including the mouth) to function more efficiently. In the mouth, especially, water helps to keep saliva flowing at proper levels. Thus, oral bacteria are less likely to reproduce and accumulate.

While we would never suggest that you deny yourself a cold cola with your just-grilled burger or a Marguerita with friends, remind yourself to enjoy a glass of water after each drink or bowl of Rocky Road. We want your summer outings to be relished while you keep your teeth and gums in great shape at the same time!

With simple measures, you will hopefully avoid the time and expense required to treat cavities and gum disease. Plus, you’ll share summer smiles with fresher breath and brighter teeth!

How better to begin your summer than with a healthy smile! For a thorough periodontal check, call 828-274-9440.