Misconceptions Of Oral Health

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

As a periodontal dental specialist, I have advanced skills in the treatment of gum disease and dental implants. In my specialty, I see patients who have various issues related to oral health. Some of these can be resolved with minor treatment and others require more involved procedures.

In many cases, however, a factor in the severity of certain issues occur because it was assumed the problem would resolve itself. Some patients have also assumed that certain signs or symptoms were “normal”.

The health of the mouth is largely reliant on the condition of the gum tissues. This moist, soft covering of tissues is a protective blanket for the structures underneath. Gum tissues protect the structures that support natural teeth as well as their roots.

Yet, because the gums are not visible as are teeth, it is easy to “back burner” problems. Some of these problems DO resolve on their own. However, in too many cases, what is set aside eventually requires extensive treatment; treatment that may have easily been avoided with early care.

I’d like to address some of the more common issues I see that are misconceptions…

Assuming seeing blood in the sink when brushing teeth is normal: Srubbing teeth so rigorously that they bleed is not a sign of doing a good job. This action not only wears away precious tooth enamel, it wears away the gum tissues that wrap the base of teeth.

Gums that bleed when brushing are also a symptom of periodontal (gum) disease. In addition, gum disease can cause tenderness, swelling or frequent bad breath. Without treatment, gum disease will progress further. This is why it is the nation’s leading cause of adult tooth loss.

Protect tooth enamel and gum tissues by using a soft to medium bristled toothbrush and a non-abrasive toothpaste (never substances such as baking soda). Using a swirling motion (rather than going back-&-forth), avoid applying too much pressure. Make sure that the tips of the bristles are contacting the surfaces of teeth. Hint: If you notice your toothbrush’s bristles flay outward after a month or so of use, you’re pressing too hard.

Ignoring gum recession: The gums are designed to snugly wrap the base of each tooth, serving to seal out bacteria. Although the aging process and oral dryness can shrink gum tissues, a common cause of receded gums is gum disease.

Gum recession is what causes sensitivity to hot, cold or the bristles of a toothbrush. Oftentimes, a bite of ice cream can send a jolt of pain. Even without the sensitivity, recession can leave the darker tooth root areas exposed. This leaves the tooth vulnerable to damage by oral bacteria.

Ignoring frequent bad breath: Bad breath is typically a by-product of bacteria build up. Although certain medical conditions can contribute to bad breath, keeping oral bacteria levels under control will minimize the risk of having smelly breath odor.

Saliva is what controls a significant amount of oral bacteria. However, without regular brushing and flossing, bacteria can quickly exceed what saliva is able to manage.

This is why it is important to brush twice daily and floss daily. These small tasks help to control bacteria by removing the sticky buildup of plaque. If not removed, plaque hardens into what is known as tartar. Tartar is a destructive mass of bacteria that can no longer be brushed or flossed away.

Having gum depth measurements of four and over: During regular check-ups, hygienists check gum health by gently using a probe along the base of each tooth. This is done to indicate loosening of gum tissues on the front and back sides of teeth. A good check-up will have no depth measurement higher than a three.

If the depth measures a 4 or 5 (or higher), the gums are not sealing out oral bacteria sufficiently. This may be an indication of gum disease. The higher the number, the more advanced it is.

Assuming tooth loss is normal: Some people assume tooth loss is a natural part of the aging process. This is not accurate. Adults lose teeth due to accidents, decay or (most often) gum disease.

Occasionally, a tooth that needs crowning or filling is deemed a “problem” tooth. This causes some people to want the tooth removed rather than repaired. Yet, missing tooth roots in the jaw bone triggers a process of bone shrinkage. This is known as resorption.

Resorption occurs without the stimulating presence of the tooth root. As the bone declines in height and width, neighboring teeth can also be affected. Adjacent tooth roots in areas of insufficient bone structure are at a higher risk of cavities, gum disease, and tooth breaks or fractures. Statistics show that a tooth adjacent to a missing tooth is most likely the next to be lost.

When a tooth must be removed, we recommend replacing it with a dental implant. Because an implant is positioned in the bone, it helps halt bone loss and protect the well-being of neighboring teeth.

Not reacting to spots on the tongue, lips or inside the cheek: People occasionally develop canker sores inside the mouth. These can be caused by stress or having an acidic diet. Both should go away within ten days or so.

Any spot or change inside the mouth or throat that does not resolve on its own within two weeks should be seen immediately. This may be a sign of oral cancer and may appear as a red or white spot. Or, it may cause hoarseness or difficulty swallowing. If caught early, oral cancer can be successfully treated. Acting promptly is highly important as it can lead to disfiguring treatment and be even deadly.

Assuming oral health is contained in the mouth: It has been shown that having good oral health is an advantage to having good overall health. The potent bacteria of gum disease can enter the bloodstream and cause inflammatory reactions elsewhere in the body. Research has correlated a number of serious health problems with the infectious bacteria of gum disease. These include heart disease, stroke, some cancers, Alzheimer’s disease and arthritis.

As an Asheville periodontist, I believe that adults can improve their oral health by being informed patients and committed to having a healthy smile.

A good resource on maintaining good oral health is the web site of the American Academy of Periodontology: www.perio.org (go to Patient Resources). Or, call our Asheville periodontal dental office at 828-274-9440.

 

 

Why You’re Losing Teeth (and how to halt the process)

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

The inevitable. Murphy’s law. Sooner or later.

It is to no surprise that life throws us occasional curves, some being out of the blue and others being somewhat predictable. As an Asheville Periodontal Specialist, one that comes to mind is the path to losing teeth.

Losing natural teeth is a challenge to both oral and overall health. And, there’s nothing that will definitively replace natural teeth once they’re extracted (although dental implants come pretty close!). Keeping natural teeth and gums healthy is the best way to support your health as you age.

According to a 2017 article published by Dentistry Today that shared recent study findings:

“people who had lost 5 or more teeth by the age of 65 years were more likely to suffer from cardiovascular disease, diabetes, and osteoporosis, all of which could severely limit life expectancy. Many of these illnesses previously have been linked to a person’s quality of life and socioeconomic status. The study concludes that the number of teeth in aging humans can affect longevity and life expectancy.”

https://www.dentistrytoday.com/news/industrynews/item/1632-life-expectancy-linked-to-number-of-teeth

Of course, no one wants to lose a natural tooth. Yet, many people assume that tooth loss is simply a natural part of the aging process. It’s not.

Through the years, certainly, accidents, injuries, decay, gum disease and deep fractures in teeth can result in loss of teeth. Regardless of how committed some people are to their oral hygiene regimen at home and regular dental check-ups, unexpected occurrences can lead to the need for an extraction.

However, the people who are committed to their oral health are far less likely to endure the undesirable outcome of tooth removal. The measures are simple and take very little time.

• Brush your teeth at least twice a day, for a minimum of two minutes each time.

• Floss daily.

• Avoid snacking and limit sugar.

• Drink plenty of water.

• See your dentist twice a year for exams and cleanings.

• Don’t smoke.

Although smoking cessation is a tough task for most people, the other items listed above require just minutes a day and cost very little. What they help you accomplish is PREVENTION. Rather than have problems treated, many instances surrounding tooth loss could have been prevented.

It is far less costly and time consuming to be attentive to your oral health than deal with the repercussions of insufficient oral upkeep. Losing a tooth will require a lifelong commitment, regardless of how it is replaced. And, replacing teeth is absolutely necessary.

When a tooth is lost, whether it can be seen in a smile or not, it no longer supports the surrounding teeth. The tooth above (or below) can elongate. Neighboring teeth can tilt or turn since they lack the bolstering affect provided by the now-missing tooth.

These factors can lead to chipped, fractured or broken teeth. They can also be an issue in bite misalignment. A misaligned bite can cause stress or strain on the temporomandibular joints (TMJ). The results can be frequent headaches, sore jaw joints, ear ringing, dizziness, and difficulty opening the mouth fully.

Another problem lies in the absence of the missing tooth’s roots. When these roots are missing, there is a lack of stimulation and nourishment to the jaw bone in this area. Without this, the bone begins to shrink, or resorb. Bone mass decline affects the stability of the adjacent teeth. It is known that the next tooth to be lost will most likely be one bordering a missing one.

The path to tooth loss, other than accident or injury, is actually a pretty predictable one. For people who take their oral hygiene lightly, it’s not a matter of “if” but “when”. Bacteria buildup in the mouth should be removed regularly, which is why twice-daily brushing is advised. If not thoroughly removed, their growth runs rampant.

Saliva flow helps in moving some bacteria out of the oral cavity. However, as people age, saliva flow decreases. Add to that the many elements that are drying to oral tissues: caffeine (including coffee, tea and colas), many medications, snoring, and some health conditions.

Oral bacteria that accumulate in the mouth for more than 48 hours first create a sticky film that coats the teeth and gums. This is plaque. If not removed through brushing and flossing, plaque transforms into hardened masses on the base of (or between) some teeth. This is tartar, which can no longer be brushed or flossed away.

As tartar spreads, the gums become inflamed. This causes gingivitis – the first stage of gum disease. Gingivitis causes the gums to become tender, swell, and sometimes bleed when brushing. Breath odor can become frequently bad.

If not resolved quickly, gingivitis can progress into full-blown gum disease. At this stage, the gums are red, inflamed, tender, bleed easily and breath odor is bad, even shortly after brushing.

As gum disease worsens, gums loosen their strong seal around the base of teeth. This allows entry of these infectious bacteria below the gum line. The structures that support natural teeth (including bone) are attacked, which can cause some teeth to loosen.

The advanced stage of gum disease is periodontitis. This means that gum tissues are red, spongy, have pockets of pus, bleed even when eating, and breath odor is putrid. To add insult to injury, this devastation doesn’t remain only in the mouth. Through tears in diseased gum tissues, the inflammatory bacteria of gum disease can enter the bloodstream.

This bacteria has been linked to serious, even life-threatening, health problems, as severe as stroke, heart disease, some cancers and Alzheimer’s disease. It can cause inflammatory triggers that worsen diabetes and prostatitis and cause preterm births.

Obviously, it’s important to keep your teeth and gums healthy. And, if tooth loss does occur, consider replacing it/them with dental implants. As an Asheville periodontist, one of my areas of advanced skill is in dental implant diagnosis and placement.

Dental implants are the closest thing to the look, feel and function of natural teeth. They restore dependable biting and chewing, without the need to be removed for cleaning. Best of all, confidence in smiling and laughing returns.

We frequently see Western NC adults who feared they would lose teeth due to periodontal disease and/or had already lost one or more natural teeth. Through our advanced skills and computerized technology, we are often able to fully restore people to excellent oral health and halt the progression of tooth loss.

If you have avoided seeing a dentist because of fear or anxiety, please know that we provide our patients with an environment of respect and comfort. We offer I.V. sedation (‘twilight sleep’) as well as oral sedation to create a totally relaxed state throughout treatment.

If cost is a concern, we also have payment plans that can help you achieve the smile you desire while making monthly payments that fit your budget.

Why allow tooth loss to happen? It CAN and SHOULD be prevented and we can help you regardless of your current oral condition. Call 828-274-9440 to request a consultation appointment. This will take place in a private consultation room where your questions will be answered thoroughly.

 

 

Keep The Mouth Moist To Minimize Bacterial Growth

Posted on Jul 22, 2021 by William J. Claiborne, DDS MS

When you think of an environment of a warm, dark, moist space, it would seem to be a perfect breeding ground for bacteria growth. For homeowners, the worry over this is often how easily mold forms in such places.

According to FEMA (Federal Emergency Management Agency), molds are microscopic organisms that thrive anywhere there is a moist environment. Growth can start on a damp surface within 24 to 48 hours.

Molds digest organic material, eventually destroying the material they grow on, and then spread to destroy adjacent organic material. (https://www.fema.gov/pdf/rebuild/recover/fema_mold_brochure_english.pdf)

As an Asheville periodontist, I can’t help but think of the similarities to the mouth. Bacteria in the mouth, when not removed, can multiply and form the sticky film that coats teeth and gums. This is known as plaque.

Like molds, plaque must to be removed to prevent its spread and destructive nature. This is what your twice-daily brushing and flossing regimen is intended to do. When plaque remains in the mouth for roughly 48 hours, it hardens onto teeth. This is tartar and typically forms between teeth or in chunks at the base of teeth.

Essentially, tartar is a hardened mass of bacteria. Like mold, tartar continues to grow if not removed. And, like mold, tartar can cause damage to what it is growing on and spread to surrounding structures.

Arthritis? Recommit Yourself To Having Good Oral Health.

Posted on Jun 20, 2021 by William J. Claiborne, DDS MS

According to the Centers For Disease Control & Prevention (CDC), over 47 percent of American adults are living with some level of gum disease. For those age 65 and older, this figure jumps to 70 percent.

These concerning statistics are nothing to ignore. Although gum disease is so common, it increases risks that go far beyond the mouth. Over the years, research has tracked many diseases and conditions that correlate with gum disease bacteria. The inflammatory reactions triggered by these infectious bacteria have been linked to heart disease, stroke, some cancers, diabetes, preterm babies, and impotency.

Research has also shown a notably close relationship between gum disease and rheumatoid arthritis (RA). These studies have been ongoing for many years, and the findings should be concerning to all adults.

RA is a debilitating, painful disease that destroys joints. RA often emerges gradually, initially causing morning stiffness and weak, sore muscles. As inflammation from RA worsens, joints become swollen.  Joints become achy and stiff most often in the fingers, wrists, elbows, hips, knees, ankles, toes and neck. Unfortunately, there is no cure for RA.

On a positive note, studies have shown that treating RA patients who have periodontal disease helps to improve RA symptoms. It is felt that this occurs because of a lighter burden of oral inflammation to the body’s immune system.

Below are some of the findings you may want to review. First, however, it’s important to understand how gum disease begins and some signs and symptoms.

In the initial stage of periodontal (gum) disease, known as gingivitis, the gums may bleed when brushing. Bad breath is more frequent and the gums may be tender or swollen. As the disease progresses, the gums turn red and may pull away from the base of some teeth.

Bad breath becomes persistent and pus pockets may form at the base of some teeth. As the infectious bacteria attack the bone structures that support tooth roots, teeth will begin to loosen and may need removal. Gum disease is the leading cause of adult tooth loss in the U.S.

In addition to the devastating damage in the mouth, the infectious bacteria of gum disease can enter the bloodstream through diseased gum tissues, causing the inflammatory triggers that activate serious health problems, such as RA.

Years ago, researchers noticed an RA-perio trait among people with rheumatoid arthritis. While RA sufferers had gum disease more often, they observed that people with gum disease tended to have RA more often.

As researchers delved deeper into the connection, it appeared that the association is much more complicated than previously thought. Findings now suggest that oral bacteria could actually be a cause of rheumatoid arthritis.

In the past, doctors felt that periodontal disease was a result of RA itself since stiff, painful hands make it challenging to maintain good oral hygiene. They also suspected that medications prescribed to treat RA could be a factor since the drugs, which suppress the immune system, inhibited the body’s ability to fight harmful oral bacteria.

Both conditions cause chronic inflammation in tissues that connect to bone with both diseases having a similar inflammatory trigger. Even more similar is the particular species of bacteria found in periodontally-diseased tissues when compared with tissues around  arthritic joints. In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis.

In 2017, study findings were released by Johns Hopkins University Division of Rheumatology, which noted evidence that the tissues in the mouth of a periodontally-compromised individual and the tissues of the joint in RA have a number of likenesses. Research has also shown a genetic link between the two.

Above all, these findings reinforce how oral health correlates closely to our overall health. When you consider how the presence of gum disease can significantly increase your risk for serious health conditions, having good oral health should be a priority for every American.

What can you do to lower your risks for tooth loss and contributing to (or worsening) serious health problems? Recommit yourself to thorough oral hygiene at home and having twice-a-year exams and cleanings.

If you have signs of gum disease, have treatment at your earliest convenience. Gum disease will only worsen and requires more treatment time and expense as it progresses.

Call 828-274-9440 to schedule an examination, or begin with a consultation to discuss your needs.

https://www.hopkinsrheumatology.org/2017/01/gum-disease-linked-to-rheumatoid-arthritis/

https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html

https://pubmed.ncbi.nlm.nih.gov/17551378/