AI in Dentistry – A Good Thing.

Posted on Jul 05, 2023 by William J. Claiborne, DDS MS

I remember when microwave ovens first appeared on the market. My mom wouldn’t even go near one in operation. Now, we know how to use them and the good things that come from their use.

Shoot forward 50 years and, like it or not, AI (artificial intelligence) is here. Self driving cars and round vacuums that move along floors are no longer Jetson-like imaginings. They’re blending into our lives in ways that are beneficial and non-threatening.

Like the microwave oven easing its way into day-to-day living, it’s logical that some people fear AI as a bad thing. After all, movies made decades ago prompted a vision of robots meandering among the human race as a new, threatening species.

As an Asheville periodontist, I’ve already seen – and incorporated in use – the positive aspects of breakthrough technology. Understanding its detection capabilities and accuracy, I’m particularly excited about the potential AI brings to the medical and dental fields.

You may be surprised to know that dentists are already beginning to turn to AI technology to quickly and accurately detect and prevent periodontitis, decay, bone loss and other gum health issues.

For example, a medical technology company in Boston has developed an AI platform that can assess X-ray images to an extent of over 50 times what can be detected by dentists through visual reviews. This allows dentists to give more effective treatment recommendations for patients while supporting the potential to avoid (or minimize) existing problems from developing or worsening.

For patients, AI assessments can also be reassuring. For those who anticipate particular treatment needs – a root canal, for instance – these assessments can zero in on exact issues so treatment planning is as conservative and as minimal possible, while being fully effective for the particular need.

Not just in medical and dental offices, but we’ll likely see AI used mainstream in many sectors. It can optimize accuracy in organizational materials, financial and budget projections, construction, farming, etc. For those of us in the periodontal dental field, AI has a vast potential to greatly improve the oral – and overall – health of our population.

Gum disease affects over 47% of American adults. With the help of AI, we can identify a higher percentage of cavities in earliest development stages while cutting the rate of misdiagnosis in half (thus curtailing over-treatment, in some cases). AI analysis will also aid in early detection of abscesses, lesions and oral diseases. It can prove to be a remarkable asset in catching oral cancer, helping to increase its poor survival rate or minimize the severity of treatment.

Through decades of research and extensive studies, keeping good oral health has been shown to be a supporting factor in good overall health. By keeping the “bad” bacteria in the mouth to manageable levels, the immune system operates more efficiently. Too, risk of medical complications from diabetes, heart disease and other illnesses can be significantly decreased.

It is suspected that many people are unaware that they even have periodontal (gum) disease, mainly because gum disease often begins with no obvious symptoms of its presence. Then, once symptoms appear (such as seeing blood in the sink when brushing), people may shrug this off as normal, or merely a sign they are being thorough in their brushing technique.

Gum disease is a particular problem for our aging population. The normal aging process dries out our hair, skin, and yes, the mouth. When the mouth is dry and saliva flow is insufficient, bacteria accumulation is more likely. This, in turn, provides a more welcoming environment for bacteria growth.

Too, many medications on the market – both prescription and OTC – have a side effect or oral dryness. This is double trouble for seniors, who already have “dry mouth” to combat. However, for people who smoke and/or are consumers of caffeine, they fall into this risk group as well.

Caffeine is present in coffee, tea, most colas, and (darn!) even chocolate. It can be in high concentrations in things like energy drinks and “power” bars. Caffeine-fortified foods can surprisingly include marshmallows, some cereals (and breakfast bars), jelly beans, gummy bears and frozen waffles.

Although AI will be an added perk to diagnosing oral health problems, it is the dentist and the patient together who have much more important roles. While regular dental check-ups help to remove existing buildup on teeth (known as plaque, which can harden into tartar), at-home care is what helps to prevent problems between visits.

It is first important to know the signs and symptoms of the various stages of gum disease. Warning signs include:

• Red, swollen, or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or eating hard food
• Gums that recede or pull away from the base of teeth
• Loose or separating teeth
• Pockets of pus between gums and teeth
• Sores in the mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

The dentist-patient relationship can never be replaced by AI. Once you find a dental office where you feel respected, comfortable, and have total confidence, technology itself is merely an add-on.

If you have not had regular dental care or feel you have symptoms of gum disease (as listed above), it is recommended that you renew your commitment to your smile and your overall health with a complete periodontal dental examination.

During this time, your periodontist will note any areas that are diseased or at risk of developing such. He or she will explain recommended treatment and discuss a comfortable pace for your individual needs. Payment plans can also be discussed after determining the type of treatment most appropriate for your care.

If dental fear or anxiety has kept you from regular dental care, our NW Carolina periodontal dental office has a reputation for helping adults overcome the obstacles it can pose. Please share your concerns prior to or during your examination appointment. We offer several comfort options (in addition to our reputation for a gentle touch) and can explain what may be best for your care. We offer oral and IV sedation (twilight sleep), which are administered safely and with advanced monitoring equipment.

Too, our vast array of advanced technology often helps to minimize treatment while optimizing comfort. Please learn more about these features at: BiltmorePerio-Technology

We can’t stop progress, nor should we resist it. While most anything can be used with ill-will, I see AI in dentistry as a positive part of providing exceptional oral health to our patients – and our adult population!

But first, we must get you into the office. And that’s your decision. We don’t have technology to coax you in and hope you will take that step on your own before problems force you into a dental chair (which is often the case, unfortunately).

Call 828-274-9440 for an appointment or to have your initial questions answered.

Sources:

https://www.perio.org/for-patients/gum-disease-information/

https://www.foxnews.com/health/ai-helps-dentists-catch-cavities-gum-disease-unbiased-gives-more-accurate-diagnoses

 

Safe Tips for Cancer Patients To Protect Oral Health During Treatment

Posted on Jun 09, 2023 by William J. Claiborne, DDS MS

Cancer has touched so many in the U.S. It is a major, if not deadly, challenge for not just the cancer patient. The each individual diagnosed, it can also impact the lives of spouses, children, family members, and friends.

The progress in improving the rates of cancer survival in America are, fortunately moving in the right direction. As of January 2022, the National Cancer Institute shares that there are an estimated 18.1 million cancer survivors in the United States, representing approximately 5.4% of the population.

By 2032, the number of cancer survivors is projected to increase by 24.4% and by 2040, it is projected to grow to 26.0 million.

As progress continues, treatment for cancer remains a daunting ordeal. The long treatment time and extreme side effects associated with cancer treatment is seen as simply awful. The oncology teams that surround these patients are amazing, however, and try to lessen the burden throughout.

As a periodontist, I am familiar with the oral side effects of chemotherapy and radiation. I am very dedicated to these patients, and strive to help them be comfortable while protecting their oral health.

What’s important is to care for oral health in a way that keeps the patient comfortable while helping them to avoid any after-effects. This is where I differ with some advice for cancer patients since not all “tips” are good for the teeth and gums. For example, cancer patients undergoing chemotherapy may be advised to suck on on peppermint or lemon drops to relieve dry mouth. Not so fast…

Caring for oral health during any health condition that lowers the immune system can actually support your immune system by lowering systemic inflammation. Research has linked many health problems, including some cancers, to the bacteria of advanced gum disease (periodontitis).

Information shared by the American Academy of Periodontology states:
“Researchers found that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.”

Oral dryness causes the tissues in the mouth to become inflamed, which places you at greater risk for infection. Insufficient saliva flow ups your risk for tooth decay and gum disease. So, it’s understandable that sucking on candy may help. However, the sugar from this candy that lingers in the mouth for long periods creates a higher risk of gum disease and the demineralization of tooth surfaces, opening the door for cavities.

One article in RDH Magazine shares these cautions for cancer patients:
• Products with drying and potentially irritating ingredients, like sodium lauryl sulfate, can increase risks for oral mucositis (the soft tissues in the mouth).
• Strong flavors can feel too sharp for tender tissue and can increase nausea.
• Inappropriate selection of toothbrush head sizes and bristles makes plaque removal more difficult and tissue trauma is more likely to occur. This may affect the patient’s ability to brush at all.
• Sugary and/or acidic products such as hard candies can increase risks for caries, erosion, and infection.
• Petroleum-based lip balms ultimately keep lips drier and create a dense barrier that can trap bacteria and impurities against the skin, which increases infection risks.

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

However, it’s important to note that women who are menopausal or post-menopausal may experience changes in their mouths. They may experience dry mouth, pain and burning sensations in the gum tissue as well as altered taste, especially salty, peppery or sour.

In addition to chemotherapy, “dry mouth” is a common side effect of many medications, including prescriptive and over-the-counter. These include antihistamines, decongestants, painkillers, high blood pressure medications, anti-depressants, muscle relaxants, drugs for urinary incontinence and many others. Some medications, along with chemotherapy, can result in oral sores or spots of discoloration.

Because some spots and discolorations can be symptoms of oral cancer, keeping your dentist aware that you take these drugs helps he or she to monitor these areas closely and appropriately. However, other medications can cause sores in the mouth, inflammation or discoloration of gum tissues. These include those taken for blood pressure and oral contraceptives.

For some cancer patients, our dental laser is an option that can speed healing of these sores and restore comfort faster. Additionally, our Asheville periodontal dental office features advanced technology that often minimizes treatment and enhances patient comfort.

For those who take medications that help to strengthen bones, these have been associated with a rare but serious condition called osteonecrosis of the jaw, known as “death of the bone.” These medications, prescribed to help prevent or treat osteoporosis with certain versions administered by injection.

Osteonecrosis of the jaw commonly occurs after certain dental procedures such as extractions or implant placement. About 90% of those who have experienced osteonecrosis are those who took the medication in repeated high doses due to cancer or other diseases. However, 10% who experienced osteonecrosis were taking much lower doses, mostly intended to treat osteoporosis. Those who currently take these medications or have taken them within the past year should reveal this to their general dentist or dental specialist prior to any procedures – including a cleaning.

Periodontal (gum) disease, teeth with cavities or the loss of natural teeth can negatively affect physical, emotional, and financial quality of life. In addition to treating existing problems, our Western Carolina periodontal office is structured so our patients can avoid long-term damage to oral health. We are known for making patient comfort a priority – at every visit.

For an examination, call 828-274-9440. Or, ask to begin with a consultation.

Sources:

https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-other-diseases/

https://www.rdhmag.com/patient-care/article/14294608/the-importance-of-oral-care-during-cancer-treatment

 

Older Adults (80’s, 90’s, 100’s) Benefit By Dental Implants

Posted on Apr 25, 2023 by William J. Claiborne, DDS MS

Someone once told me, “Old age is always ten years older than the age you are at the time.” I get it. While a teenager may think of anyone over the age of 55 as “old,” aging in the U.S. today has taken a positive position within America’s population.

Proof of this is in how more and more people are living to be 100. Many of them are still sharp and spry. Although reaching the 100 age pinnacle was once a rare feat, it’s a growing trend. Today, there are nearly twice as many 100+ year olds in the U.S. than there were 20 years ago (nearly 90,000 now).

Reaching these elevated ages, of course, depends on factors like location, gender, lifestyle and genetics. Living a long life has evolved from lifestyle changes rather different than what was taken for granted in the 1950’s, for example.

Between 1900 and 2020, life expectancy in the U.S. rose by more than 30 years. Much of this can be credited to life choices, such as things like not smoking. Smoking, a leading contributor to heart disease, can decrease life expectancy by 10 years.

In 1965, 45% of Americans smoked. Now, knowing the health hazards to smoking, the number has declined to only 12.5% as of 2020.

Of course, Americans can also credit medical advances for the centenarian growth in population. The survivability of things like heart attacks and cancer has greatly increased, giving adults a longer lifespan.

As Americans realize their lifespan may well reach age 90, 100 or beyond, the resistance to having dental implants due to “old age” is becoming less of a factor.

Dental implants are the ideal tooth replacement system. Unlike dentures or ‘partials,’ dental implants are supported by the jaw bone, just as natural teeth. While dentures sit on top of the gums, dental implants restore biting strength and stability, giving back the look, feel and function of the teeth you once had.

Two decades ago, some “older” adults would deny themselves the benefits of dental implants, saying things like, “I’m too old to spend that amount of money on myself.” Yet, for my dental implant patients in their 80’s and 90’s, I never had one who didn’t feel it was one of the wisest investments they’d ever made.

Here’s why…

 – Dental implants are designed to last your lifetime. They do not decay, need root canals or compromise neighboring teeth or bone structure.

 – Because dental implants are positioned in the jaw, they recreate stimulation to the bone. This helps to preserve the bone’s mass, halting the pace of jaw bone shrinkage (known as resorption).

 – Resorption is what causes changes in one’s facial appearance, aging one’s appearance far older than their actual age.

 – Dental implants do not move or slip when eating, speaking or laughing. A denture is designed to fit the contours of one’s gum ridge; contours that exist at the time the denture is made. However, as resorption reduces bone height, the ridge that holds the denture flattens out over time. This is why a denture becomes ‘wobbly’ or ‘slippery.’

 – Dental implant treatment is largely determined by the number of implants placed. In most cases, one implant can support more than one tooth. A full arch (all upper or lower) of teeth are typically supported by several strategically-placed implants.

 – Unlike a crown-&-bridge, dental implants so not need the support of adjacent teeth. Therefore, it is not necessary to have teeth shaved down for crowning simply to serve as supports for a bridge.

When it comes to dental implants, there are many decisions and choices that can become confusing without the guidance of a dental specialist. For example, there are over 40 different implant systems.

Dental Implants are designed in a variety of shapes and sizes to accommodate various needs. For those who are missing all upper or lower teeth, for instance, some implant types can support a full arch of removable teeth while others support non-removable (or ‘fixed’) teeth.

As a periodontist for over 3 decades, our patients receive advanced skills in dental implant diagnosis and placement. Additionally, our Asheville periodontal dental office features some of the most advanced technology in the industry today. This includes computerized imaging that can lessen treatment needs, optimize comfort and speed healing.

If you feel you are too old to make this wise investment, check out some of the health benefits that dental implants provide:

• As the ‘arch’ (or ridge) flattens, the appliance is more apt to move while chewing. As the denture rubs against tender gum tissues when eating, sore spots form, which are difficult and slow to heal. And, when small seeds or nut particles become trapped between the appliance and gums, it can cause a piercing, painful sensation.

This discomfort and concern often prompts people to adjust their diets. The chewy, crunchy foods they once enjoyed tend to be bypassed for those that dissolve quickly with minimal chewing required. Unfortunately, these foods are typically lacking in the fiber, vitamins and protein necessary for a healthy diet.

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• The gum-colored base of dentures or partials that hold the replacement teeth is made of a porous material. This means there are tiny holes in the base. In the mouth, a denture sits in a warm, dark, moist environment – perfect for bacterial growth. These holes become living spaces to oral bacteria, which thrive and breed at a rapid rate. Bad breath and increased risk of pneumonia are actually some of the lesser problems that can occur.

Additionally, oral bacteria can create havoc throughout the body. It is a known contributor to a long list of serious health diseases and conditions. These include some cancers, stroke, heart disease, diabetes, arthritis, Alzheimer’s disease, pre-term babies and many more.

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• The insecurity of a denture that may move when eating causes some people to avoid social gatherings. The fear of embarrassment can be a deterrent to involvement with friends and family. This places the individual at a disadvantage, as research shows that socially active seniors age more slowly than those who avoid social interactions.

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If dental fear has prevented you from looking further into dental implants, please know that we have a reputation for respect, a gentle touch, and compassionate care. Additionally, we offer Oral sedation as well as I.V. sedation (also known as ‘twilight sleep’). These are administered safely by a doctor of anesthesia who monitors patients with advanced safety equipment.

Also, financing can be easy through monthly payment plans. Most are interest-free with no down payment required.

To schedule a consultation appointment, call 828-274-9440. Also, get to know more about dental implants at: DrClaiborneDentalImplants

Sources:

https://www.sciencedaily.com/releases/2014/10/141007144514.htm

https://greatergood.berkeley.edu/article/item/how_social_connections_keep_seniors_healthy

https://thehill.com/changing-america/well-being/longevity/3847532-more-people-are-living-to-be-100-heres-why/#:~:text=But%20the%20nation’s%20population%20is,Division%20of%20the%20United%20Nations

 

Heightened Oral Cancer Risk From HPV Virus

Posted on Apr 10, 2023 by William J. Claiborne, DDS MS

April is National Oral Cancer Awareness Month. There is good reason that an entire month has been devoted to this dire health problem. With the growing statistics surrounding HPV and its ties to Oral Cancer, especially amongst adolescents, the need for education and clear, straight-forward discussions are needed.

First, know that the human papilloma virus (HPV) is the nation’s most common sexually transmitted virus. At least 50% of sexually active people will have genital HPV at some time in their lives. While awareness of HPV risk is gaining ground, it is not commonly known that the virus can spread through oral sex and linked to diseases in the mouth.

An estimated 20 million Americans are infected with the human papilloma virus. HPVs, which are a group of more than 200 viruses with 40 types, can easily spread through direct sexual contact, including vaginal, anal, and oral sex.

Virtually all cases of cervical cancer are caused by HPV. In the 1980’s, HPV was attributed to around 16% of mouth and throat tumors. Within two decades, that figure had increased to nearly 75%. According to the World Health Organization (WHO):

“Almost all cervical cancer cases (99%) are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact.”

A particular type of HPV, the high risk HPV 16, is found in cancer of the tonsils, vocal cords, base of the tongue, and oesophagus. A low risk HPV that causes genital warts may also be found in some cases of cancer of the vocal cords.

Oropharyngeal cancers include malignancies of the tonsils, soft palate, base of the tongue and throat. HPV is commonly transferred through genital contact but HPV spread through oral sex is what increases the risk of mouth and throat cancers.

Another fact that is not widely known is the higher risks for males. Oral cavity and oropharyngeal (throat) cancers are twice as common in men than in women. HPV-related oropharyngeal cancers occur more often in men. The development of oropharyngeal cancer due to HPV is about three times less prominent in females than in men of the same age.

About 10% of men and 3.6% of women have Oral HPV, which is transmitted through sexual or skin-to-skin contact. Oral HPV can spread through deep tongue kissing and oral sex. In men, symptoms may appear in the form of warts, growths, lumps, or sores on the penis, scrotum, anus, mouth, or throat.

Other factors that can heighten the risk that HPV will develop into cancer include:
• Smoking or chewing tobacco (increases oropharyngeal cancer risk)
• Weakened immune system
• Having many children (increases cervical cancer risk)
• Long-term oral contraceptive use (increases cervical cancer risk)
• Poor oral hygiene (increases oropharyngeal cancer risk)
• Chronic inflammation

The spread of HPV is said to be at an epidemic level. Thus, the Centers For Disease Control & Prevention (CDC)  which has prompted the recommendation for HPV vaccinations for ages 11 – 12 year olds. Being vaccinated before becoming sexually active can lower one’s risk of being infected by HPV types and several types of cancers associated with HPV.

Regardless of age, vaccines are available, which many doctors encourage for sexually active patients who have multiple partners. For those who are not vaccinated against HPV, condoms can lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer.

However, HPV can infect areas that are not covered by a condom. Therefore, the risk remains high for many even with the use of condoms. Condoms do not give complete protection against HPV transmission, which can mean potential infection of areas not covered.

When it comes to oral cancer, alert us immediately if you experience any of the following symptoms that do not clear up within two weeks:
• Have difficulty swallowing
• Have lumps in the neck
• Experience pain in the mouth or ear
• Notice unusual spots inside the mouth (including the tongue) or on the lips

A periodontist is a specialist in the treatment of oral gum tissues and in the placement of dental implants. This dental specialist understands the unique health and risks to gum tissues.

In our Asheville periodontal dental office, we also offer some of the industry’s most advanced digital technology available. These features often minimize the extent of treatment needed, speed healing, and enhance comfort.

We also offer oral and IV sedation for many procedures. These sedatives are safely administered by professionals who are specifically trained in the administration of anesthesia. Here, patient safety and comfort are always priorities.

If you have ANY symptoms that may indicate oral cancer, do NOT wait until your next check-up to have these evaluated. Call 828-274-9440 for an immediate appointment.

Sources:

https://www.who.int/health-topics/cervical-cancer#tab=tab_1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544688/

https://pubmed.ncbi.nlm.nih.gov/20116657/

https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/risk-factors.html#:~:text=Oral%20cavity%20and%20oropharyngeal%20cancers%20are%20twice%20as%20common%20in,seen%20more%20often%20in%20men

https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet

https://www.colgate.com/en-us/oral-health/hiv-aids-and-stds/dental-care-hpv-and-men#