It’s Flu Season – Why You Should Keep Your Oral Health In Tip-Top Shape.

Posted on Oct 16, 2023 by William J. Claiborne, DDS MS

It’s cold and flu season. Now having weathered the worst pandemic Americans have ever experienced, a new emphasis has taken hold for the need to have flu vaccines and the latest Covid booster.

Vaccines, of course, do not fully eliminate the potential to acquire these health conditions. While they lower the chances of their development, the immune system still relies on our own actions. This includes taking measures to avoid their development in the first place, such as frequent handwashing, eating a healthy diet, mask-wearing in crowds for vulnerable populations, etc.

We learned much about the immune system during the Covid pandemic. And, the need for keeping oral health in good condition became more clear than ever.

During the worst of the outbreak, a 2020 study found that individuals with gum disease who contracted COVID-19 were 9 times more likely to die. And, the study showed that COVID patients who already had periodontitis (the advanced form of gum disease) were 3 times more likely to end up in intensive care or on a ventilator.

Evidence shows, too, that avoiding dental care may actually increase the potential to contract the virus. And, poor oral health can increase its severity, and even fatality rates.
https://onlinelibrary.wiley.com/doi/10.1111/jcpe.13435

This is not only a concern for U.S. citizens, it’s a worldwide wake-up call. About 50% of the world’s population over the age of 30 suffer from periodontitis. Americans aren’t in much better shape – with over 47% having some form of gum disease.

Because gum disease can begin without obvious symptoms, or be present without having pain, it can be easily ignored. This allows the disease to progress further.

This is why dental care is deemed by Congress as “essential healthcare,” as it supports the need for preventive measures for gum disease and tooth loss. As a periodontist, I believe it is also important that Americans understand the signs and symptoms of gum disease as well as the overall health risks it brings.

Although gum disease can exist without obvious indication (typically in the early stage known as gingivitis), warning signs of gum disease usually begin with swollen and tender gums that bleed easily when brushing teeth.

As it worsens, the healthy pink hue of gums darkens to more of a red or purple color and breath odor is persistently bad. The gums begin to loosen their strong grip around the base of teeth, allowing infectious bacteria to reach bone structures that support tooth roots. In advanced stages, pus pockets form near the base of some teeth and gum tissues become spongy in texture.

The bacteria of periodontal disease don’t just damage oral health. This is where there is so much concern throughout the healthcare fields.

Through weakened oral tissues, the bacteria can enter the bloodstream and trigger inflammatory reactions. These reactions can worsen some serious health conditions and even activate others. Research has found correlations between these bacteria and heart disease, stroke, diabetes, arthritis, some cancers (including pancreatic), preterm babies, erectile dysfunction, and Alzheimer’s disease.

With such serious correlations, it should be common knowledge that oral wellness is a necessary part of maintaining good overall health. However, this isn’t necessarily the case. A report commissioned by Delta Dental Plans Association recently revealed concerning information regarding age groups and perceptions of oral health.

With over 1,000 online participants, 87% listed their priority for maintaining proper oral care was to save money or avoid unexpected expenses. Two-thirds of the group listed their commitment to at-home dental hygiene being to avoid tooth decay and gum disease. Yet, only 79% of adults stated they brushed their teeth twice a day with only 33% claiming to floss daily.

In reviewing age groups, the report found that baby boomers (those born between 1946 – 1964) understand there is a strong link between their oral and overall health but are less aware than other generations about the connection between poor dental health and chronic diseases (such as arthritis and diabetes).

Those listed in the Generation Z group (born between 1997 – 2012) showed less commitment to their oral health as the “boomers,” but were more focused on eco-friendly and nontraditional oral care products. Only 76% of Generation Z agreed that oral health is closely connected to overall health.

https://www.deltadental.com/content/dam/ddpa/us/en/state-of-america%27s-oral-health-and-wellness-report/DDPA_State%20of%20Oral%20Health%20Report_2023-Release_FINAL.pdfse-you

If you wear dentures or partials, keeping them clean is an important measure to take to avoid getting sick. Why?

One study (published in the Journal of The American Dental Association) assessed bacteria levels of the porous material that make up the gum base of dentures and partials. In the mouth, it becomes coated with a sticky bacteria known as biofilm.

One study found that wearing dentures while sleeping doubles the risk of pneumonia in elderly adults. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541085/)

It has also been found that this biofilm can harbor MRSA or bacteria that is resistant to antibiotics. It was also found that the bacteria in the biofilm doesn’t just stay in the mouth. It can be inhaled into the lungs where infections become much more difficult to treat. (https://www.nbcnews.com/healthmain/dirty-dentures-dangerous-mrsa-may-be-lurking-dentists-say-662637)

Regardless of age, Americans must maintain a healthy smile in order to support their immune systems. Research shows that oral bacteria are also connected to gut health, so keeping bacteria levels in the mouth in check can go a long way in healthy benefits far beyond the mouth.

For those who have avoided regular dental care due to dental fear or anxiety, we offer several comfort options, including oral and IV sedation.

Oral sedation is a pill that helps patients relax.  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 doctor of anesthesiology for optimal comfort and safety with patients closely monitored with advanced safety equipment throughout treatment.

Call 828-274-9440 to arrange an examination appointment or to learn more about our Asheville periodontal dental office.

 

A “Lecture-Free” Look At Cigarettes & Your Smile

Posted on Oct 11, 2023 by William J. Claiborne, DDS MS

In this article, I’m going to address cigarette smoking as it affects oral health. This is not intended to lecture or chastise an adult for making a choice to smoke or those caught up in the addictive grip of nicotine. My goal is to relay factual information regarding oral health for smokers so they can better protect their smiles.

Because I’m a native North Carolinian, I’ll begin by sharing some information on our State, as provided by 2018 stats from the CDC (Centers for Disease Control & Prevention).

In 2018, the percentage of adults in North Carolina who smoked was reported as 17.4% (of every 100 adults). The CDC shared findings of all states, with smoking ranged from nearly 9 of every 100 adults in Utah (9.0%) to 25 of every 100 adults in West Virginia (25.2%).

They also shared that cigarette smoking was lowest among those with a graduate degree (3.2%) and highest for those who had only achieved a GED certificate (30.7%). Those with a high school diploma showed a lower percentage of nearly half of the GED level adults at 17.1%.

As an Asheville periodontal dental specialist, smoking is a particular concern since many people are unaware of the oral health risks. While many smokers are familiar with the risks smoking poses related to cancer and other diseases, smoking is also terribly harmful to your smile.

For instance, smokers have a greater risk of periodontal (gum) disease. The drying effect that smoking has on the soft tissues in the mouth offers an ideal breeding ground for oral bacteria. This enables easier entry of oral bacteria into the structures that support tooth roots.

According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared to that of a nonsmoker.

As oral bacteria thrive and reproduce in the mouth, gum tissues become tender and inflamed. These are signs of gingivitis, the beginning stage of gum disease.

Gum disease at this stage can cause persistent bad breath, swollen gums and gums that bleed easily when brushing. As it progresses, gum tissues turn red or purple from inflammation. Pus pockets may form at the base of some teeth. This advanced stage is known as periodontitis.

Eventually, the infectious bacteria penetrate below the gum line and attack supporting bone and the tissues surrounding tooth roots. This can cause teeth to loosen and eventually require removal. Gum disease is the nation’s leading cause of adult tooth loss.

Losing teeth is detrimental to your overall health and not a normal part of the aging process. Studies have shown that people who wear dentures die an average of ten years earlier than those who keep their natural teeth.

Denture wearers also have higher incidences of pneumonia, and worse. A 2015 report by NBC News shared findings surrounding dentures and MRSA biofilm. The report included a dental specialist’s warning that, “Concern about biofilms on dentures is growing as researchers continue to identify links between oral bacteria and heart disease, chronic obstructive pulmonary disease or COPD, and respiratory diseases, including aspiration pneumonia.”

Many smokers are aware that they have stained teeth and more-frequent bad breath than non-smokers. They also have slower healing periods after procedures such as extractions, gum treatment and oral surgery.

Although a hygienist may go slowly and gently, dental cleanings are typically less comfortable for smokers. This is because smoking causes a greater buildup of plaque. With gum tissues already tender from the bacterial irritation of plaque, removing buildup from between and around the base of teeth adds to the discomfort of inflamed tissues.

According to the American Dental Association (ADA), smoking increases the risks of oral cancer, lesions inside the mouth, enamel erosion and tooth loss in addition to periodontal (gum) disease.

If you vape, remember that nicotine in any form is a hazardous force in the mouth. And the vapor itself is not safe for oral health.

Vaping (using e-cigarettes) delivers nicotine through an inhaled mist. Although the vapor is generally not labeled as “dangerous,” one study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, including, propylene or polyethylene glycol, glycerin, and additives. And, its nicotine is no less harmful to the user as that delivered via cigarette smoke.

Unfortunately, many cigarette users switch to vaping based on the perception that “e-cigs” are a safer alternative. For those hoping to wean themselves off cigarettes through this switch, very few achieve that goal as a result.

A 2018 report by the National Academy of Sciences, Engineering, and Medicine concluded there was “evidence that e-cigarette use increases the frequency and intensity of cigarette smoking in the future.”

Although the focus in this article is meant to be on oral health, allow me to reiterate some of the benefits of “kicking the habit” …

• Smokers have a decreased life expectancy of an average of 10–15 years compared to non-smokers.


• Smoking is linked to nearly a third of all cancer diseases and deaths.


• Pregnant women who smoke have a higher risk for first-trimester spontaneous abortion, preterm births, low birth weight babies and sudden infant death syndrome (SIDS).


• Women who smoke are at risk for early menopause while men who smoke are more at risk for impotency.


• People who breathe in your “second hand” smoke (what you exhale) are subjected to over 50 known carcinogens and other harmful chemicals.

For those who are able to give up smoking, the effort is well worth it. The positive effects can be felt almost immediately. In about 48 hours, damaged nerve endings begin to restore. The sense of smell and taste begin to return to normal.

“Quitters” also notice their breathing is easier in about 3 days and they have fuller air intake. Oral health improves within 2 weeks as blood circulation in the gums and teeth returns to nearly that of non-smokers. Heart attack risk also declines with blood flow greatly improving. Activities are easier and the constant smokers cough is gone.

In our Asheville periodontal office, our goal – for every patient – is to help each achieve optimal oral health and a smile he or she is proud to share. For those who smoke, we make individualized recommendations so the potential for achieving this is favorable.

If tooth loss has already occurred, we are specialists in the treatment of all stages of gum disease and in the diagnosis and placement of dental implants. We will be happy to discuss the dental implant system that may be best for your needs.

Or, if dental fear or anxiety have kept you from receiving regular dental care, ask us about oral or IV sedation (“twilight sleep”). These sedatives are delivered by an MD of anesthesia for your optimal safety and comfort. And, in all procedures, we make patient comfort a high priority.

Call 828-274-9440 to schedule an examination.

Sources:

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm#:~:text=This%20means%20an%20estimated%2028.3,with%20a%20smoking%2Drelated%20disease.&text=Current%20smoking%20has%20declined%20from,every%20100%20adults)%20in%202021.

https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html

https://www.sciencedaily.com/releases/2016/11/161116101821.htm

https://www.nbcnews.com/healthmain/dirty-dentures-dangerous-mrsa-may-be-lurking-dentists-say-662637

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm

Oral Health & Tooth Loss Within America’s Aging Population

Posted on Sep 18, 2023 by William J. Claiborne, DDS MS

There are currently 54.1 million U.S. adults ages 65 and over; a number that is expected to grow to 95 million by 2060.

In 1900, the percentage of American adults over the age of 65 was just 4.1%. Today, that number has grown to nearly 16%. By 2040, the elderly adult population is estimated to be more than double the senior population of the year 2000.

https://www.aplaceformom.com/caregiver-resources/articles/elderly-nursing-home-population

Many baby boomers (Americans born between 1946 – 1964) will keep their teeth longer than any generation before, yet they continue to experience a preventable decline in oral health.

Common risk factors such as smoking, poor diet, a reduced capacity to care for one’s teeth and obtain professional dental care, and biological mechanisms – such as low salivary flow caused by medications – may contribute to tooth decay and tooth loss.

Periodontitis (advanced gum disease) is a prevalent oral disease in older adults. It is typically marked by inflammation of the gums and supporting structures of the teeth, resulting in sore and bleeding gums as well as painful chewing problems. Loss of the supporting structures of the teeth (including supportive bone) results from an imbalance of bacteria that exist in the space between the teeth and the gums. This leads to an inflammatory response that develops into periodontal disease.

As teeth lose support from their diseased foundation, mobility and tooth drifting can occur in addition to abscesses, which can ultimately result in tooth loss. As the disease intensifies, bone loss around affected teeth can advance with a worsening infection that can lead to serious health problems far beyond the mouth.

Periodontal disease is associated with chronic diseases such as cardiovascular disease, diabetes, respiratory disease, and dementia. Along with other challenges to maintaining good health, the prevalence of any periodontitis among older adults is high. Three in five older adults are affected, with prevalence higher in men and persons with low incomes. Four in five older adults who smoke cigarettes have some form of periodontitis.

The loss of all natural teeth, known as edentulism, reduces quality of life because it interferes with the ability to eat, speak, and feel comfortable among other people. Tooth loss also affects a person’s ability to consume nutritious food and can impact social involvement with others while consuming food.

Overall, 17% of adults 65 and older are edentulous. Fortunately, edentulism has declined over the years among older adults aged 65 to 74, from about 50% in the 1960s to 13% today.

https://www.cdc.gov/oralhealth/pdfs_and_other_files/Oral-Health-Surveillance-Report-2019-h.pdf

Prevalence of total tooth loss among adults ages 65 and over is higher in both North and South Carolina than many other states, which is in the 16.6 – 26.3 percentage range. This compares to states like Illinois, Wisconsin and Utah, which are some states in the 6.2 – 11.3 percent range.

https://www.ncbi.nlm.nih.gov/books/NBK578296/figure/ch6.fig6/?report=objectonly

Having fewer than nine teeth is considered severe tooth loss and can cause major difficulties in eating a healthy diet of fresh and nutritious fruits, protein-rich meats and sufficient fiber. Without chewing comfort, strength and stability, food choices can result in either weight loss or obesity. Extensive tooth loss also detracts from physical appearance and impedes speech, another challenge to social contact and job prospects. This can also inhibit intimacy, lower self-esteem, and impact overall quality of life.

https://www.nidcr.nih.gov/sites/default/files/2017-10/hck1ocv.%40www.surgeon.fullrpt.pdf

Another challenge for older adults is orofacial pain. Orofacial pain in older adults can originate inside the mouth from tooth-related or gum infections. It may also originate outside the mouth, such as pain in the jaw joint area, or face and cheeks. Orofacial pain often results from ill-fitting dentures or a microbial infection causing an inflammatory reaction known as denture stomatitis (an oral yeast or fungus condition)

Older adults also struggle with “dry mouth.” Dry mouth is surprisingly common – an estimated 35 million U.S. adults may have this condition, known as xerostomia. Common causes include medications, autoimmune disease, systemic diseases, and as a result of head and neck irradiation.

Drugs are by far the most common risk factors for chronic dry mouth. Nearly 9 in 10 (89%) adults aged 65 and older take prescription medicine. More than half (54%) report taking four or more prescription drugs. The drugs most consistently implicated in “dry mouth” are antidepressants, diuretics, beta blockers, bronchodilators, and antihistamines.

High-risk behaviors are generally less common among older adults than in younger age groups. About 9% of those 65 years and older reported that they were current smokers, and 8% reported excessive alcohol consumption (having five or more drinks in one day at least once in the past year). Cannabis use also is on the rise among seniors although it remains less than 5%.

The problems associated with poor oral health and tooth loss extend greatly to other areas of the body. Oral bacteria and their toxins can spread into the bloodstream through ulcerated or inflamed tissues during chewing, routine oral hygiene, and dental procedures. In weakened gum tissues, even the act of tooth brushing can open up entry points for bacteria plaque and gingival inflammation in the bloodstream.

In addition, the presence of oral bacteria or their toxins may induce inflammatory responses, which can prompt insulin resistance. Oral bacteria can reach tissues in the lung, heart, gut, placenta, joints, and even the brain. They have been associated with infective endocarditis, and chronic inflammation may contribute to systemic conditions such as cardiovascular disease and diabetes.

Obviously, there are many causes for oral health challenges, all having a detrimental effect on quality of life to some extent. We want to help the residents of Western North Carolina enjoy their retirement years with a healthy, confident smile and oral health that supports good overall health.

First, know the signs and symptoms of periodontal (gum) disease, which include:

• Swollen or puffy gums
• Gums that turn red, dark red or dark purple gums
• Gums that are tender or bleed easily
• Seeing blood when brushing or flossing
• Persistent bad breath
• Pus pockets that form between teeth and gums

When periodontal disease exists, it is important to know that this will not go away without treatment. Once this infection is underway, it will only worsen, leading to more painful symptoms and even eventual tooth loss.

If you have signs of gum disease, see a periodontal specialist as soon as possible. In addition to lowering the risk of tooth loss, a periodontist can help you lower the risks of gum disease’s infectious bacteria in the bloodstream, which research has linked to serious (and even deadly) health problems.

Call our Asheville periodontal dental office to schedule a consultation. If fear or anxiety has prevented you from regular dental visits, we can discuss several options (including oral or IV sedation) to provide comfortable, relaxed appointments. Call 828-274-9440.

 

 

Don’t Allow Dental Fear or Anxiety To Ruin Your Smile

Posted on Aug 23, 2023 by William J. Claiborne, DDS MS

It’s a proven fact that your oral health – the wellness of your teeth and gum tissues – is an influencing contributor to your overall health. For decades, researchers have studied the concerning risks, and alarming connections, between oral health and a number of serious diseases in the body.

The leading culprit in this scenario are the bacteria of advanced gum disease, known as periodontitis. Gum disease breeds bacteria that are inflammatory in makeup. Once they enter the bloodstream (through tears in disease oral tissues), studies have found these potent bacteria can trigger the onset of serious diseases, such as:

• Heart disease
• Stroke
• Alzheimer’s disease & Dementia
• Some cancers (including lung and pancreatic)
• Pre-term babies
• Diabetes
• Arthritis
• High blood pressure
• Erectile Dysfunction (ED)

As research continues, more and more findings are bringing to light just how connected the mouth is to the efficient operation of the immune system. During the Covid pandemic, it was well publicized that those most vulnerable to the virus were those who were immune compromised.

One study, conducted between February and July 2020, analyzed two groups of 568 total patients with severe COVID-19 complications (death, ICU admissions or assisted ventilation). Periodontal conditions in the two groups were analyzed. Of the patients studied, those with periodontitis were three times more likely to experience COVID‐19 complications including death, ICU admission, and the need for assisted ventilation.

https://www.perio.org/press-release/new-study-links-periodontitis-and-covid%e2%80%9019-complications/

For years, the cost of dentistry has been credited for preventing millions of American adults from having regular dental care. This was recently studied in a nationally representative survey of 5,682 adults. In this, researchers looked at knowledge, attitudes, experiences, and behaviors related to oral health.

Results from the survey show that lack of insurance is a leading reason for avoiding dental care or delaying recommended care (often until something becomes so painful that the individual is forced into a dentist’s chair seeking relief).

The study showed that 16% of adults without dental insurance admitted that they had not seen a dentist in more than five years compared to just 5% of adults with dental insurance. Forty percent of adults without dental insurance reported cost was the reason they hadn’t visited the dentist in the past two years, compared to 14% of adults with dental insurance.

https://www.dentaleconomics.com/macro-op-ed/article/14284116/new-data-show-that-americans-are-still-not-getting-the-dental-care-they-need

Yet, excruciating pain from a dental problem can be the impetus for setting aside the cost. The same is true for people who have fear or anxiety associated with dental care.

About 36% of people in the U.S. have a fear of dental treatment, with 12% having an intense fear, known as dentophobia. Dental phobics are people who avoid going to the dentist at all. Dental fear is more common in females than males, with an estimated 3% of men and almost 5% of women having dentophobia.

Reasons for these fears include:

– Fear the anesthetic will not work or be sufficient to fully numb the pain
– Blood makes some people feel afraid or panicky about bleeding during a dental procedure.
– People may fear choking or gagging and not being able to breathe or swallow.
– For individuals who have had a poor experience with a dentist in the past, they may associate negative feelings with their dentist.
– Feeling pain from the procedure or recovery
– Some people are highly fearful of needles.
– The noise from drills and dental instruments used by a dentist or dental hygienist can create high levels of anxiety for some people.
– The same is true when it comes to certain smells that arise during dental treatment.

New Study Links Periodontitis and COVID‐19 Complications

At our Asheville NC periodontal dental office, we take patient comfort very seriously, and that goes for all patients at every appointment. We find that many patients have developed severe gum disease or had tooth loss because they were afraid of going to a dentist. This prevents people from having regular dental care, which allows small problems to become worse ones.

Many with dental fear or dentophobia avoid going to the dentist for years. And, these feelings may be more common than you know. When dental anxiety, dental fear and dentophobia are combined, it affects an estimated 70% of American adults. This unfortunate statistic is a likely reason for the high percentage of adults who suffer with some level of periodontal (gum) disease – over 47%.

As a Periodontist, my staff and I work diligently to pamper patients from the moment they enter. For certain procedures as well as for patients who prefer the addition of sedatives, we offer oral sedation as well as I.V. sedation (twilight sleep).

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 places the patient in a deeper sleep state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology, overseen by Dr. Brad Stone, a Medical Doctor (MD) and a board certified Anesthesiologist & Pediatric Anesthesiologist.

https://www.biltmoreperiodontics.com/comprehensive-care-team/

With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

If fear has caused you or someone you know to avoid dental visits, please arrange a consultation with us. In our Western NC periodontal dental office, you’ll find a warm, respectful atmosphere where your concerns are understood. During this time, we can discuss comfort options that may be best for your individual needs along with estimated costs.

Call 828-274-9440.