Gum Disease Connected To Dementia, Alzheimer’s Disease

Posted on Aug 11, 2020 by William J. Claiborne, DDS MS

The statistics of periodontal (gum) disease are alarming. In the U.S., nearly half of the adult population has some level of gum disease.

There is a misconception among the general population when it comes to the serious nature of gum disease. Too often, people perceive “if it doesn’t hurt, then nothing is wrong” when it comes to their oral health. That’s far from the case. Although symptoms of gum disease may include tender gums that bleed when brushing, gum disease can begin without any obvious signs.

This shouldn’t be surprising. When cancer forms in the body, its initial presence isn’t obvious. The reason for screenings such as mammograms or colonoscopies are to catch mutant formations at their earliest stages.

Early treatment helps to resolve the problem with hopefully positive outcomes. This is why it is so important to have 6-month dental check-ups. These visits allow your dentist to catch gum disease early so treatment needs and expense can be minimal.

While gum disease forms in the mouth, that’s not necessarily where it remains without proper treatment. The bacteria of gum disease can enter the bloodstream. It has been found to trigger serious reactions elsewhere in the body. Some of these lead to the formation of cancer (oral, throat, pancreatic, lung) and some activate conditions such as diabetes and arthritis.

Obviously, the health of your mouth is an important part of supporting a healthy body, especially in disease prevention. To illustrate the extent of gum disease’s damaging impact to health, research is tracking its correlation to dementia and Alzheimer’s disease.

In a recent study that included over 8,200 adults, an increased risk for developing dementia was found in those having severe gum disease and missing teeth. Participants in the study had an average age of 63 at the study’s onset.

In a follow-up after 18 years, those who had severe gingivitis in addition to tooth loss had a 22 percent higher risk for developing Alzheimer’s disease or dementia. Having no natural teeth was associated with a 26 percent increased risk.

Broken down, 14 percent of individuals with healthy gums and all their teeth at the start of the study developed dementia by the end of the study. For those with mild gum disease, 18 percent (623 out of 3,470) developed dementia. Twenty-two percent of participants with severe gum disease developed dementia. For those who had no remaining teeth, 23 percent developed dementia – nearly 17 cases for every 1,000 persons.

They found the bacteria present in periodontal disease can travel through the mucous membranes of the mouth to the brain, potentially causing brain damage.

In the study, participants were carefully assessed based on age, gender, education, cholesterol, high blood pressure, coronary heart disease, smoking and body weight. Psych Central.com (https://psychcentral.com/news/2020/07/30/gum-disease-may-be-linked-to-later-dementia/158497.html?MvBriefArticleId=25473)

Prior studies have led researchers to continue tracking oral tissue related factors that may contribute to dementia and Alzheimer’s disease, which is affecting a growing percentage of American adults (as well as those globally). Currently, 10 percent of adults age 65 and over have Alzheimer’s disease. For people ages 85 and older, this increases to 32 percent.

In the U.S., it is the 6th leading cause of death. (https://www.alzheimers.net/resources/alzheimers-statistics/) By the year 2025, the number of people 65 and older with Alzheimer’s disease is expected to reach 7.1 million people, a 27 percent increase from the 5.6 million age 65 and older in 2019.

Maintaining a healthy smile – good gum health and healthy teeth – is important and achievable for every adult. If you suspect you have gum disease (gums that bleed when brushing, tender or swollen gums, gums that have reddened or receded from teeth), it is important to be seen by a periodontist. This dental specialist can restore your gums to a healthy state.

A periodontist is also a specialist in the diagnosis and placement of all types of dental implants. For adults who are missing natural teeth, dental implants are the closest thing to providing the look, feel and function of ‘real’ teeth. They restore the ability to bite and chew comfortably and dependably. Dental implants are also designed to last a lifetime, making them a wise investment.

Take charge of your health by overseeing your oral health as carefully as you do to other needs. For a consultation to discuss how a periodontist can help you, call 828-274-9440.

If dental fear has kept you from having regular dental care, we will be happy to discuss our many comfort options in our comfortable Asheville office, including Oral and I.V. sedation (“twilight sleep”).

“Futuristic” Technology Surrounds Patient Care

Posted on Jul 30, 2020 by William J. Claiborne, DDS MS

Many adults are unfamiliar with the specialized skills of a periodontist – until they need one.

At Biltmore Periodontics in Asheville, most patients are referred by their general dentist or other dental specialist. However, a professional referral is not required. We accept patients from the recommendations of other patients as well as those who find us through internet searches, etc.

To clarify what we are and what we offer, a periodontist is a dentist who extends his or her education and skills further (typically 3 years past completing dental school) to specialize in the prevention, diagnosis, and treatment of periodontal disease and other gum conditions.

Additionally, a periodontal specialist has advanced skills in the diagnosis and placement of dental implants. A periodontal specialist is also trained in performing esthetic procedures that involve gum tissues, such as crown lengthening and correcting a “gummy smile”.

A periodontist’s office may have a similar look and feel of your general dentist’s office. However, the advanced skills and techniques are typically supported by advanced technology. Some offices, as ours (serving Western North Carolina) provide a rather “futuristic” array of technology to enhance treatment outcomes, save the patient time in treatment, speed healing time, and optimize comfort throughout care.

Periodontists are able treat complex periodontal cases of severe gum disease or caring for patients who have complex medical histories or health issues. They offer a wide range of treatments using a range of surgical or non-surgical procedures.

A periodontal office is also attuned to caring for high-fear patients. Periodontists understand that many people who develop periodontal (gum) disease do so because they were too afraid of dental treatment to see a dentist on a regular basis. Without a solid combination of thorough at-home oral hygiene and regular dental check-ups and cleanings, the potential to develop gum disease greatly increases.

In a recent report by the Centers for Disease Control & Prevention (CDC) on data related to prevalence of periodontitis in the U.S.: 47.2 percent of adults 30 years and older have some form of periodontal disease. Periodontal disease rates increase with age, affecting 70.1 percent for adults 65 years and older.

One study, published by StudyFinds.org, shares recent findings of 2,000 adults in the U.S. regarding dental visits. Results show a whopping 62 percent of those surveyed stating they were too afraid to even visit a dentist’s office. (https://www.studyfinds.org/adults-too-scared-visit-dentist-teeth/)

Surprisingly, the age group most likely to avoid dental care because of fear were millennials (currently ages 22 – 38). With past decades of advancements in comfort and greater sensitivity surrounding anxiety and fear in the dental office (versus what older generations often experienced), their higher levels of avoidance due to fear was unexpected, but clearly significant.

In our Asheville periodontal dental office, we provide special measures to ensure the safety and comfort of all patients – for every appointment. For many patients, Dr. Claiborne and Dr. Boyland offer Oral and I.V. Sedation. Sometimes referred to as “twilight sleep,” I.V. Sedation allows patients to be totally relaxed before, during and after treatment with little or no memory of the procedure.

Our periodontists also offer Oral Sedation in pill form to give a high level of relaxation, which typically has an amnesiac effect on patients. Throughout any type of sedation, patients are closely monitored by trained professionals and advanced safety equipment.

When it comes to technology, however, Biltmore Periodontics prides itself on some of the most advanced features available in the Southeast. These include:

• LANAP Protocol Using PerioLase MVP-7 – An acronym for Laser-Assisted New Attachment Procedure, LANAP provides an advanced protocol to more efficiently and effectively treat periodontitis (advanced gum disease) with a laser. This offers a minimally invasive (non-surgical) treatment alternative for patients with moderate to severe periodontal disease in as little as one session. It is safe for people with conditions such as diabetes, heart disease, and hemophilia. LANAP treatment leaves very little discomfort and has a quick recovery time.

LANAP technology is also able to stimulate bone regrowth in damaged areas. It can regrow periodontal ligament, alveolar bone (the bony ridge that supports the upper teeth), and regrow the bony film that adheres teeth to the jaw.

• Dental Radiology With 3-D Cone Beam Technology
 – Using 3D imaging for diagnostic and treatment planning,  the entire dentition area provides clear, detailed views of the mandible and maxilla (upper and lower jaw) for precision diagnosis in endodontics (tooth roots), periodontics, orthodontics, dental implants, temporomandibular joints (TMJ) and prosthodontics as well as dental and maxillofacial surgery.

In addition, cone beam images can locate and trace the mandibular nerve canal, which optimizes pre-surgical planning of dental implant positioning.

Radiation levels are at minute levels and the imaging process is quick and comfortable.

• CareStream Cone Beam Computer Tomography Imaging
 – This technology provides panoramic and 3D imaging with exceptional detail and range at significantly lower radiation – up to an 85 percent lower dose than traditional panoramic imaging.

• CS 3600 intraoral scanner
 – Unlike impressions made with bulky, goopy trays held in a patient’s mouth, this modern scanner quickly and comfortably scans the mouth’s interior to provide digital impressions accurately. The device is a small, handheld scanner and ideal for impressions to design crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments and RPD. Its accurate HD 3D color images give precision details for improved case review, analysis and communication between doctors, referrals and labs.

• Simplant Dental Software for Computerized Dental Implant Placement 
- This advanced software system allows for pre-surgical positioning of dental implants on the computer using a 3D model of the patient’s jaw. Once the implant type is selected, a surgical template is developed that ensures a precision fit. Simplant creates optimal implant treatment success, even for complex cases. It also simplifies the team treatment process so intricate aspects of the surgical process can be discussed prior to placement.

• Intraoral Camera Technology – 
This self-contained intraoral camera features full motion video with outstanding image quality from an internal camera that captures ideal angles and images with the click of a button. The images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment issues.

• Computer Imaging In Treatment Suites
 – Treatment suites are equipped with computers for convenient image sharing with patients. This allows patients to have a more complete understanding of their individual needs through images that can be pulled up by our dental team, with the ability to enlarge certain areas to show specific details. Through this, patients have greater involvement in treatment decisions.

This extensive array of technology is in keeping with our commitment to provide each patient with advanced skills, experience and comfort to provide the very best in periodontal and dental implant treatment. Added to this is the truly talented, committed staff who tend to our patients in a warm, compassionate and respectful manner.

Overcoming gum disease can help patients to save natural teeth. This means the trauma of tooth loss and decisions for replacement can be avoided.

If you suffer with symptoms of gum disease (tender gums that bleed when brushing, persistent bad breath, or gums that have turned red in color), the condition will only worsen without treatment. Call our friendly staff to discuss your needs: 828-274-9440.

 

Afraid Of The Dentist? Let’s Help You Get Past That For A Healthy Smile!

Posted on Jul 22, 2020 by William J. Claiborne, DDS MS

By some estimates, having a fear of dental visits affects over 70 percent of American adults. When people are afraid of going to the dentist, many often do not receive the regular care necessary to maintain a healthy smile.

As an Asheville Periodontist, I find that the origin of many who develop periodontal (gum) disease is from fear associated with dental visits. It is not unusual for a fearful dental patient to avoid going to the dentist for years, only ‘giving in’ when something becomes so painful they can no longer delay treatment.

We know that when it comes to dental fear, different people have different levels. Some patients are very relaxed in our office from the moment they walk in and throughout treatment. Others are fine until they are seated in the treatment chair. Still, others are anxious throughout their visit.

A study published by the Dental Research Journal revealed nearly 59 percent of 473 adult participants had dental fears. The study included males and females of varying ages and education levels. Although females presented a higher likelihood for dental fear, there was very little difference elsewhere. What did stand out, however, was how many had experienced traumatic dental episodes.

Unfortunately, a traumatic experience in a dental chair with a too-rough dentist tends to remain in the subconscious forever. Many fears are the result of a frightful experience as a child, feeling helpless and afraid. Such an experience tends to make an indelible mark on the subconscious and resurface whenever a dentist or dental office comes to mind.

If you experience these feelings associated with dental visits, there is nothing ‘wrong’ with you. However, delays in care can allow small problems to become more complex, requiring more involved treatment.

Many high-fear patients only force themselves into a dental chair when they are in such pain that they have no choice. It is far easier for adults to find a way to have regular exams and cleanings to prevent emergency needs. This begins by finding the right dental office.

Until then, regular dental check-ups are something that can’t be duplicated at home. Even a thorough, daily brushing and flossing routine misses bacteria on occasion. Within the course of just 48 hours, oral bacteria can form a cement-hard colony attached to tooth surfaces. This accumulation of bacteria eats away at tooth enamel and gum tissues.

As oral bacteria consume gum tissues, inflammation begins. This is gingivitis, the initial stage of gum disease. In this, the gums are tender and occasionally bleed when brushing. As gingivitis progresses to periodontal disease, symptoms include persistent bad breath and gums that turn red versus a healthy pink color. Gum tissues may begin to recede, exposing sensitive areas of tooth roots.

Eventually, the infectious bacteria will attack further beneath the gum line. This inflammation leads to damage to the bone structures that support tooth roots. Pus pockets may form on gums and teeth may loosen. To no surprise, periodontal disease is the nation’s leading cause of adult tooth loss.

This infectious bacteria doesn’t just remain in the mouth. Through tears in weakened gum tissues, it can enter the bloodstream. It’s presence can trigger inflammatory reactions that have been linked to heart disease, stroke, some cancers, preterm babies, arthritis, diabetes, erectile dysfunction (ED), and impotency. Some studies are showing a correlation to Alzheimer’s disease.

What we often find with high-fear patients is their assumption that good at-home care can take the place of their regular care visits. However, even a diligent home-care routine leaves them susceptible to oral bacteria. A number of factors heighten vulnerability to bacterial accumulation, including dry mouth and diet.

Dry mouth occurs due to a wide range of factors. Some medications have a drying affect on the mouth. Certain foods and beverages contribute to dry mouth, especially those containing caffeine and alcohol. Smoking is very drying to oral tissues. And, the aging process leaves us with drier mouths.

Eating sugary foods and many carbohydrates are just as detrimental to oral health. Many Americans snack during the day, often on chips, crackers and candy bars – which are then washed down with sugary sodas. All this converts into a sugar based super-food in the mouth that provides oral bacteria with sustenance that super charges their reproduction.

How does a fearful adult overcome the problem so they can have the dental care they need?

In our office, patient comfort is a priority at every visit. We have even designed our reception area to pamper you from the moment you enter. Patients in this area can enjoy a selection of gourmet coffees, cable television and WIFI connection. The seating is comfortable and our front office staff are attentive to your needs.

We offer a private consultation room for patients as well. In this room, we can discuss treatment and answer questions in a comfortable setting. This allows patients to become better informed about their treatment needs and options versus communicating while they are seated in a treatment chair.

Our surgical suite offers a rather unique setting for a periodontal office. A large window provides beautiful mountain views, very soothing to our patients. In addition, we offer oral sedation as well as I.V. sedation (twilight sleep) for most procedures, if desired.

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 sedative state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are monitored with advanced safety equipment throughout treatment.

Our patients also find our entire staff is a unified team who reflect sincere compassion and commitment to exceptional, comfortable care. While the doctors involved in your care are all top-notch, I must admit that our staff are the pros at making our patients feel truly pampered.

When patients realize that our goal is to provide exceptional care and comfort, most relax. This creates a sense of trust that causes many to no longer perceive dental care as dreaded, frightening events. Once the obstacle of fear is replaced with feelings of trust, the process to achieve a healthy, confident smile becomes a much easier one.

If you or someone you know has fear that has prevented dental care, the possibility of gum disease is pretty high. We suggest beginning with a consultation appointment, which occurs in our private consultation room. This is removed from the clinical area and provides a relaxed setting where patients can share their unique needs and concerns.

Call 828-274-9440 to schedule or learn more. I’m sure you’ll find our friendly telephone staff is welcoming and reassuring from the very first conversation.

We Are Seeing Patients Again With New Appointment Protocols

Posted on May 20, 2020 by William J. Claiborne, DDS MS

Lately, when people see a hospital worker on television news, healthcare workers have on layers of garb that we’re unaccustomed to seeing. Hopefully, in time, all this protective layering won’t be needed. For now, it’s in line with proper precautions for the safety of both patients and staff.

As established periodontists in Asheville, it has been a pleasure for Dr. Boyland and I to be able to open our doors again for patient care. And, our schedule is full! Patients in need of treatment have been patiently (but anxiously) waiting to resume periodontal therapy and dental implant placement.

However, our reopening brings some new protocols in addition to our already-stringent infection-control measures. Some new steps that patients may notice now in the flow of the appointment, from the check-in process to check-out. Too, patients will see us attired in more layers than before.

As a heads up, our doctors and staff are wearing protective equipment (N95 masks, gowns, face shields, etc.). This protective gear does not interfere with patient communication nor the exceptional care we have always provided.

Other than our “new look,” however, patients will also go through a few new steps, which include:

• Once patients arrive for scheduled appointments, they are asked to call our main number (828-274-9440) from their vehicles. Our receptionist will provide the patient with a pre-appointment questionnaire.
• After we retrieve the completed form, a staff member will escort the patient into the office. (For now, only appointed patients are allowed unless accompanying a child or disabled patient.)
• Once inside, patients will have their temperature taken and a staff member will escort them to a treatment suite.
• After care is completed, a staff member will walk the patient to our check-out desk.

In addition, patients can have the peace of mind that our Asheville periodontal office has always adhered to the highest standards of infection control in dentistry. Typical steps that have always been in place include are the sterilization process used on the instruments used in patient care (such as probes).

These pieces are heat sterilized at high temperatures for up to 40 minutes, killing bacteria, viruses and infectious micro-organisms. Once sterile, the instruments are carefully packaged until ready to unwrap for use in the treatment room.

Even the water used (for rinsing or as a spray to manage air particles) comes through water lines that undergo a special “flushing” process. This cleansing process dislodges and eliminates biofilm that can occur when minuscule particles attach to the interior of these lines. Thus, the water sprayed in your mouth during certain procedures is delivered so bacteria levels are at such a low point they are virtually non-existent.

After each patient is seen, treatment chairs, lighting, and any equipment the patient or staff come in contact with are thoroughly wiped down.

These steps have always been done to ensure the safety and well-being of our patients as well as our doctors and staff. Yet, now more than ever, we have a unique mindset in everything we do.

While the vast majority of patients seen feel very comfortable in our office and infection control steps being taken, we encourage questions or concerns so we can explain, reassure or even reschedule those who are still uneasy about close contact. Just call us at 828-274-9440. Our friendly front staff will be happy to assist you.

What’s most important is that you stay safe while keeping your oral health at its best. The progression from poor oral hygiene to gingivitis to full-blown periodontal disease is faster than many people realize.

Be sure to brush at least twice a day for at least minutes per brushing. Brush your tongue with your toothbrush once a day (especially towards the back where most bacteria hide out) and floss daily. Keep your mouth moist and limit sugar. Use an oral rinse that contains no alcohol as an added measure to minimize oral bacterial buildup.

Let’s all emerge from this odd time in our history with smiles that are healthy, accompanied by hugs!