April Is National Oral Cancer Awareness Month

Posted on Mar 25, 2021 by William J. Claiborne, DDS MS

Every person fears hearing the “C” word. A diagnosis of cancer, whether a diagnosis of oneself or of a loved one, invokes a dread of lengthy treatment, years of subsequent health concerns, or even death.

Over the years, breast, colon and skin cancers have received more publicity, which supports the importance of periodic screenings. As a periodontist, PLEASE add another screening to your annual must-do list.

The month of April is designated as national Oral Cancer Awareness month.

Oral Cancer is one of the most deadly of all cancers with one of the worst survival rates. Like pancreatic cancer, oral cancer can remain hidden, which allows it progress long before obvious symptoms emerge.

Once symptoms do appear, oral cancer can be difficult to battle. Treatment is often disfiguring. Sadly, every hour of every day, an American succumbs to oral cancer.

According to the National Cancer Institute Survey, there has been a 15 percent increase in oral cancer rates over the past three decades.

Adult males are at the highest risk for oral cancer, with black males being the most susceptible. The risk also increases with age, especially after age 50. Although the risk typically peaks between the ages of 60 – 70, males between ages 50 – 59 tend to have the highest numbers.

It is important to be aware of the warning signs of oral cancer, including:

• A sore, irritation, lump or thick patch in the mouth, lip, or throat
• White or red patch inside the mouth
• Feeling something is stuck in the throat
• Difficulty chewing or swallowing
• Difficulty moving the jaw or tongue
• Numbness in the tongue or other areas of the mouth
• Unexplained swelling of the jaw
• Pain in an ear without hearing loss

While these symptoms do not always indicate oral cancer, any that do not clear up on their own within 2 weeks should be examined without delay.

As mentioned prior, these symptoms may indicate the presence of oral cancer that is well underway. As with any cancer, periodic screenings are helpful in catching oral cancer in early stages. This is generally part of annual oral health exams conducted by your dentist.

Unfortunately, many people assume “if it doesn’t hurt, then nothing is wrong.” This, I believe, is one of the reasons our nation has such high levels of periodontal (gum) disease and subsequent adult tooth loss. And, as rising oral cancer statistics show, the casual attitude toward dental exams can lead to far worse than losing teeth.

The Centers Of Disease Control & Prevention (CDC) reports that only 62 percent of adults between the ages 18 – 64 have a dental check-up each year. This means that over one-third of adults are going unscreened. If the key component in catching oral cancer early lies in the hands of a dentist, until the patient is in the dental chair, the challenge will continue.

This dental exam is painless. Many patients, if not told, are not aware that the dentist is performing it. During this, the dentist does a visual examination of oral tissues, checking the lips and inside of the mouth (including under the tongue). The dentist will also check the roof and floor of your mouth.

If suspicious areas are noted during the exam, the dentist will order a biopsy. In this, a small sample of tissue from the area of concern is removed and examined under a microscope. This will determine whether further tests are needed.

Added to oral cancer concerns over the past couple of decades are rising numbers in younger age groups is the sexually transmitted human papillomavirus (HPV).

The CDC reports that HPV is now the most common sexually transmitted infection. HPV is so common that nearly all sexually active men and women get it at some point in their lives.

There are different types of HPV, some that cause genital warts and others that cause cancers. It is spread through vaginal, anal or oral sex with someone infected with the virus and can be passed even without signs or symptoms. And, symptoms may not appear until years after having sex with an infected person.

A periodontal specialist has extensive training in the treatment of the soft tissues in the mouth. In addition to treating all stages of gum disease, a periodontist is your first call when any unusual symptom in the mouth arise. This dental specialist is your first step in protecting your smile and adding to a healthy YOU.

If you have not seen a dentist on a regular basis or have noticed any of the symptoms associated with oral cancer, act promptly. Call our Asheville periodontal dental office for an examination appointment: 828-274-9440

Bad Breath – The “Body Odor” of the Mouth.

Posted on Mar 09, 2021 by William J. Claiborne, DDS MS

“Whoa!!!”

That may be our unspoken reaction when we encounter someone who’s breath odor reeks. And, we’ve all encountered it. It tends to leave a rather negative impression of the individual; one that ‘sticks’ with us every time we see him or her in the future.

Occasionally, I like to address the causes of bad breath since, at one time or another, it’s an issue for us all. Bad breath, like body odor, leaves an undesirable imprint.

Although some health conditions can be the source of bad breath, it most commonly occurs due to an overload of oral bacteria. Too many bacteria in the mouth create an odor — a sulfuric, putrid odor.

Bacteria are living organisms that eat, reproduce and emit waste. Their ability to reproduce is astounding, resulting in a consistently growing number of waste-producing creatures.

Poor oral hygiene is the most common cause for bad breath. Not brushing and flossing or doing so adequately allows oral bacteria to reproduce, which leads to plaque.

Plaque is the sticky film you feel on teeth when you’ve missed brushing or when you wake up. When not removed thoroughly on a daily basis, plaque turns into a cement-hard substance known as tartar. This mass is actually a solid colony of oral bacteria that attaches to teeth. In this form, it cannot be brushed or flossed away.

Tartar attacks enamel and gum tissues. As bacteria multiplies, it causes the gum tissues to become inflamed. This inflammation can quickly develop into gingivitis, an early form of gum disease. If not resolved fully, however, gingivitis can lead to full-blown periodontal (gum) disease.

Occasional bad breath is a nuisance but can generally be controlled with good oral hygiene, keeping our mouth moist and limiting sugar. Things like drinking sugary colas and a diet of high carbohydrate foods rev up bacteria reproduction even more, boosting their ability to grow and thrive.

However, frequent bad breath is not only embarrassing, it is a warning sign.

As one of the symptoms of periodontal (gum) disease, persistent bad breath may be accompanied by tender gums that bleed easily when brushing or tender, swollen areas around some teeth.

As gum disease advances, symptoms include gums that turn red in color and become sore, swollen and bleed easily when brushing. As it worsens, bad breath becomes persistent. Pus-filled pockets may develop near the base of some teeth. Eventually, teeth may loosen and require removal.

While what we consume can greatly contribute to the ability of these icky organisms’ ability to reproduce, a common one is having a dry mouth. This condition is known as xerostomia (zeer-o-STOE-me-uh).

Good saliva flow helps to keep bacteria moving out of the mouth. However, when brushing is infrequent or the mouth becomes dry, saliva is less able to manage the bacteria levels in the mouth.

A dry mouth may seem less likely to be a breeding ground for bacteria since they typically thrive in environments that are warm, moist, and dark. However, when saliva flow is unable to efficiently cleanse bacteria buildup from the mouth, they are easily able to reproduce.

Having ‘dry mouth’ is rather common today. In addition to a part of the aging process, a number of common medications (including anti-depressants, decongestants, and anti-histamines) have a side effect of oral dryness.

Too, many beverages contribute to having a dry mouth. These include colas, coffee, tea, and those containing alcohol. (Please note that colas are acidic and most contain caffeine. These are anything but ‘refreshing’, doing very little to hydrate the body. Stick to plain water to quench your thirst and add moisture to the body.)

Another way that oral bacteria can run rampant has to do with our oral hygiene routines. To be truly thorough in cleaning tooth surfaces, it is recommended to spend two minutes per brushing, twice a day (whether manual or electronic).

It is estimated that nearly a third of American adults brush their teeth for an insufficient amount of time. Even worse, about that same amount fail to brush twice a day. This means that an alarming amount of bacteria remain to grow and thrive in the mouth.

Proper brushing and flossing is necessary. Brush for at least two minutes twice daily and swish thoroughly. Use a circular motion rather than scrub teeth back and forth to avoid damaging tender gum tissues. Never use a hard bristle tooth brush or brush with harsh substances such as baking soda! These can wear down tooth enamel and wear away precious gum tissue.

You may be surprised to learn that brushing only tackles about half the amount of bacteria in the mouth, leaving a tremendous amount that continue to grow and thrive. The tongue actually harbors 58 – 65 percent of the bacteria in the ‘oral cavity’.

Oral bacteria love to take up housing in the tiny bumps and grooves of the tongue since they are not easily dislodged. Thus, it’s necessary that tongue cleaning be a part of your oral hygiene regimen at home to keep bacteria levels under control.

Some toothbrushes have a “tongue scraper” on the reverse side of the bristles that’s an effective option. Or, you can brush your tongue with the bristles after your teeth are brushed. Be sure to reach towards the back of the tongue where the majority of bacteria exist.

An advantage of achieving and maintaining a clean, healthy mouth is being confident when close to others. Plus, you’ll be contributing to the health and well-being of your entire body. Research has shown that a healthy mouth is a supportive component of a healthy you!

If you are experiencing symptoms of gum disease or concerned your breath is frequently bad, call 828-274-9440. We’ll arrange a periodontal exam in our comfortable Asheville periodontal office.

Here, we are committed to the comfort of each patient as well as those who have avoided dental care in the past due to fear. Dental fear is common, and we have a reputation for a gentle touch and respectful care. We also make oral and IV sedation (twilight sleep) available.

Let’s help you establish a healthy smile and feel confident in closeness!

Younger Age Groups Are Falling Behind On Maintaining A Healthy Smile

Posted on Feb 10, 2021 by William J. Claiborne, DDS MS

A recent survey, commissioned by the American Association of Endodontists, showed that working or studying from home is having a negative impact on the oral health of adults. It findings reveal that more than half of Americans say the pandemic has caused them to delay their regular dental exams and cleanings, which can lead to serious oral health problems.

Being stuck in one’s home has become an adjustment people across the globe have had to make. In spite of having easy access to a toothbrush and toothpaste, this has resulted in factors that are out-doing daily dental hygiene routines. Significant findings include:

31% admit to snacking more on sweets

24% report they are flossing less frequently with another 23% not flossing

1 in 4 said they delay brushing until later in the morning, while 21% aren’t brushing in the morning at all

28% didn’t schedule or forgot to schedule a dental visit

https://www.prnewswire.com/news-releases/survey-reveals-covid-19-is-a-major-factor-in-americans-failing-dental-health-301223396.html

This has become a more prevalent problem for adults in the millennial age group. These adults were born between 1981 – 1996 and are presently between the ages 24 of 39. According to several surveys, millennials are not only doing a poor job at oral hygiene upkeep, the convenience of working from home is working against them as well.

In a 2017 study, 30% of millennials polled admitted to only brushing their teeth once a day, and some millennials have gone over 2 days without a brushing at all. Because this survey was conducted prior to the pandemic constraints, keeping more adults inside 24/7, the figures are likely even worse.

At the time of the survey, 43% stated that working from home or attending virtual classes disrupted their usual oral hygiene regimens during the pandemic lockdown. Couple this with not having a set schedule to follow (thus, no daily brush-&-floss routine). Work-from-home adults (or students) also have 24/7 access to snacking.

All these factors equal future oral health problems for a large percentage of millennials. These include cavities, gum disease, and subsequent tooth loss. Is the nonchalance of oral hygiene because tooth loss is not a true worry, as with baby boomers?

Many baby boomers (now between ages 57-75) grew up with parents or grandparents who kept a glass by the bathroom sink where their dentures would “soak” during the night. This image may have helped to keep the over 55 age group more determined to maintain good oral health and keep their natural teeth.

Regular dental care is important for all ages, but especially for the aging adult. A thorough brushing and flossing routine at home is simply a greater need as older adult experience more challenges when it comes to oral health.

Older adults must deal with oral dryness, which creates an environment for more rapid bacteria growth. The cracks and fractures that natural teeth endured over the years can also give way. This leads to the need for crowns and even dental implants to replace lost teeth.

And, wallets are thinner in retirement. As people retire, there is less insurance coverages for dental expenses in addition to less income. To continue with regular, preventive dental care, an older adult must budget carefully to include these appointments.

Yet, baby boomers are also more determined to hold onto a more youthful sense. Losing natural teeth, to this age group in particular, is associated with an “old age” mindset that has been widely resisted by boomers.

Statistics from 2018  showed that nearly 50,000 more cosmetic procedures were performed on those 55 and older than in the previous year, with noticeable increases in surgical procedures like liposuction, hair transplantation and breast augmentation along with options like Botox and fillers. This age group also accounted for nearly half of all eyelid surgeries and two-thirds of facelifts.

https://www.plasticsurgery.org/news/press-releases/more-baby-boomers-seek-cosmetic-procedures-as-they-re-enter-dating-scene

However, segmenting oral health habits into age groups is not the chief concern among those of us who are dental caregivers. As a periodontal specialist, I see all ages and know every adult should be highly committed to good oral health. Now, more than ever, having a healthy mouth can be a booster to the body’s overall immune system.

Gum disease occurs from an overload of infectious bacteria that the immune system can no longer manage. It extends below the surface and can no longer be brushed or flossed away.

These destructive bacteria can enter the bloodstream through tears in diseased gum tissues. Research has linked this bacteria to serious health conditions including heart disease, stroke, high blood pressure, some cancers, preterm babies, arthritis, diabetes, impotency and even Alzheimer’s disease.

However, twice-daily brushing and daily flossing, on their own, will not shield you from developing gum disease. If you’ve been avoiding regular dental check-ups, the problems in the future can require costly repairs and even tooth replacement – problems that may have  been easily prevented.

If you have delayed dental care or have been less-than-diligent in maintaining good oral health, be aware of the signs of periodontal disease. These include seeing blood in the sink when brushing teeth, sore or swollen gums, gums that darken to a red color, persistent bad breath and sensitivity to hot or cold.

In our Asheville periodontal dental office, patients can begin with a consult in our private consultation room to discuss oral health options. A referral is not required.

Call 828-274-9440 to schedule.

Smokers CAN Lower Oral Health Risks With Proper Measures

Posted on Feb 04, 2021 by William J. Claiborne, DDS MS

If you smoke, you may be tempted to quit as one of your New Year’s resolutions. By now, you may be “over the hump” and feel success in this challenge (and breathing much easier!). Good for you!

However, if you’ve stumbled and faltered (and perhaps even thrown up your hands in defeat), you are not alone. According to the Centers for Disease Control & Prevention (CDC), over 55 percent of smokers in the U.S. had made a quit attempt in 2018, with only 7.5 percent succeeding. (https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html)

Yet, less than 7 percent of adult smokers reported (in 2015) that they had sought counseling or medications in their attempts to quit. Yet, the need for support is clear. For most people who are trying to quit, it is a long, tough journey. The CDC also reports that:

“more people in the United States are addicted to nicotine than to any other drug. Research suggests that nicotine may be as addictive as heroin, cocaine, or alcohol.”

As the need to maintain healthy immune systems has never been more urgent, smokers will hopefully reach out to every source in order to kick the habit, for good. Data assembled by a team at the University of California (San Francisco) found that smoking nearly doubles the rate of COVID progression.

The analysis took into account over 11,500 COVID patients. The findings showed by current and former smokers were twice as likely to have conditions that require hospitalization and higher death rates. (https://www.ucsf.edu/news/2020/05/417411/smoking-nearly-doubles-rate-covid-19-progression)

The authors of the study warned that both cigarettes and e-cigs were involved in this higher risk rate.

Smoking increases mucus production and inflammation, which injures the lungs’ defense system. This is why people who smoke are more likely to have serious respiratory infections and illnesses.

However, my role as an Asheville periodontist is not to lecture our patients. We believe our patients deserve to be informed about the risks to their oral health, in particular, and provide encouragement. Too, we want patients to understand the best ways to avoid developing periodontal (gum) disease and the subsequent repercussions (such as tooth loss) as a result.

So, let’s focus on your periodontal health if you smoke (including cigarette smoking or vaping).

Smokers are often unaware of what occurs in the mouth from smoking. To begin, smokers have a greater risk of periodontal (gum) disease due to its drying effect on the soft tissues in the mouth. When saliva flow is depleted, its ability to rinse away oral bacteria enables the mouth to a bacterial breeding ground.

As oral bacteria reproduce and accumulate in the mouth, gum tissues become inflamed. In the early stages of gum disease, symptoms may include frequent bad breath, tender and swollen gums, and gums that bleed easily when brushing teeth.

As gum disease progresses, the gums change in color from a healthy pink hue to red. The gums loosen their grip around the base of teeth and seem more spongy. Breath odor is consistently bad. Pus pockets may form at the base of some teeth.

Eventually, the bone and the tissue structures that support natural teeth are under attack. The infectious bacteria ramp up their onslaught of attack, tooth roots no longer have the firm support they need. Some teeth begin to loosen and may require removal.

Advanced periodontal disease, known as periodontitis, is a health risk that goes far beyond the mouth. For years, research has shown an intricate connection between the “good” bacteria in the mouth, especially beneficial in gut health. It has also been known that the “bad” and infectious bacteria of advanced gum disease can alter the roles of certain factors in the body that help to prevent the formation of disease.

For example, certain cancers can be activated or progressed through the inflammatory bacteria of gum disease. These bacteria are able to become blood borne and activate “pathogens” that create a domino effect of disease development.

When you factor in the vulnerability to the lungs from inhaling the toxic smoke of cigarettes, you have a perfect storm. Consider that the gum tissues are the first contact with these inhaled chemicals. Because oral tissues are absorbent in nature, they are at the front line of smoking’s effect.

If you do smoke, we want to help you minimize the risks it poses to your oral health. In addition to maintaining regular dental check-ups and cleanings (at least every 6 months), below are some tips for your at-home oral hygiene regimen.

• Brush twice a day (at least) for two minutes each time. Use a fluoridated toothpaste and a soft to medium bristle toothbrush.
• Floss your teeth every day and floss before your brush. You would be surprised at how many particles can be lodged between teeth that brushing won’t rid. If flossing is an awkward maneuver, try one of the water flossers, which are affordable and as effective as manual flossing.
• Brush your tongue after your teeth to unroot embedded bacteria, especially reaching the back area of the tongue (where most bacteria are embedded). This also helps to give you fresh breath.
• Use an oral rinse that replenishes moisture (and is alcohol-free) twice a day (or as directed). These are available OTC at most drug stores.
• Chew sugarless gum, preferably a brand that contains Xylitol. Xylitol looks and tastes like sugar, yet has 40 percent fewer calories.
• Drink plenty of water throughout the day. Be aware that beverages such as most coffee, tea and colas contain caffeine are drying to the mouth. Many medications also have the side effect of oral dryness – another good reason to stay hydrated.
• Limit your intake of sugar and carbohydrates. These are oral bacteria super boosters.

In our Asheville periodontal dental office, please know that we are here for you regardless of your needs or goals. Although we prefer you give up smoking, we want to give you the very best care possible so you can enjoy a healthy mouth and confident smile.

If you haven’t had regular dental exams or have any of the symptoms associated with gum disease (mentioned above), call our dental office to schedule a thorough periodontal exam at 828-274-9440.