Challenges of Aging to Oral Health

Posted on Oct 28, 2022 by William J. Claiborne, DDS MS

Hopefully, the phrase “older and wiser” is one of truth. In all honesty, many adults “of a certain age” worry about being more forgetful, being less energetic and having less stamina. True or not, the aging process forges on for us all!

Aging, of course, comes with certain health challenges. However, these may bring seniors more determination to “age gracefully.” Today’s older adult seems to be more active and health-conscious than that of our ancestors. Aging adults now have greater knowledge of contributors to poor health. Most try to eat healthier, have periodic physicals and screenings, and include physical activity in daily regimens.

Over the years, all ages have had access to the findings of research reporting on how the health of the mouth plays a significant role in overall health. For example, the bacteria of periodontal (gum) disease are shown to potentially activate or worsen the development of a number of serious health problems.

For seniors, these health problems are especially challenging since a major one affected is that of the immune system. This is of high concern for seniors since their immune systems are typically operating at less-than-peak levels (often complicated by other health problems, such as arthritis or high blood pressure).

Over 70% of our immune response comes from the cells within the gut. The “good” bacteria in the gut is crucial to efficient digestion. Yet, it can be compromised due to the presence of gum disease bacteria.

We now know that the inflammatory nature of infectious oral bacteria can interfere with the healthy bacteria in the gut. This causes the gut (and well as other systems in the body) to function less efficiently. Research has correlated gum disease bacteria to heart disease, stroke, high blood pressure, diabetes, arthritis, some cancers, erectile dysfunction and even Alzheimer’s disease.

According to the Centers of Disease Control & Prevention (CDC), over 47% of American adults over age 30 have gum disease. It is estimated that 64% of adults ages 65 and older have either moderate or severe periodontitis.

Gum disease, an inflammatory disease, which can trigger inflammation elsewhere in the body. Studies have shown that by reducing the level of these bacteria, however, can improve other inflammation-based health conditions (such as arthritis, prostatitis, and psoriasis).

For instance, diabetes has a clear relationship with periodontal disease. Studies show that treating one condition positively impacts the other. By the same token, uncontrolled inflammation levels of one can worsen inflammation levels in the other.

Therefore, treating inflammation may help manage periodontal diseases and also help manage other chronic inflammatory conditions.

For seniors, oral dryness is one of the biggest influences in developing gum disease. Like the skin and joints, the body’s moisture and lubrication wanes with age. Although poor oral hygiene is a key factor when it comes to bacteria in the mouth, a dry mouth is a common contributor to bacterial growth.

In addition to aging, dry mouth is particularly challenging for seniors because it has many causes, including:

• A side effect of many medications (including prescription and OTC)
• Radiation therapy, especially for head and neck cancer
• Mouth-breathing, which may be due to nasal congestion or snoring
• Medical conditions, such as diabetes, Alzheimer’s disease, stroke and Sjogren’s syndrome

While important for all ages, older adults should be especially committed to their oral hygiene, including twice daily brushing and daily flossing. In addition, you can support saliva flow by:

• Drinking plenty of plain water throughout the day
• Avoiding (or limiting) caffeinated beverages, such as coffee, tea and colas
• Using an oral rinse designed to replenish moisture in the mouth (available OTC)
• Being aware of medications that have an oral dryness side effect (increase your water intake and use a daily rinse to replenish oral moisture)
• Taking steps if you snore or breath through the mouth during sleep (ask your physician for suggestions)
• During a cold or sinus condition that increases mouth-breathing, be especially committed to your oral hygiene routine at home (brushing and flossing) and increase water intake
• Following each alcoholic drink (including beer and wine) with gulps of water as these are very drying to oral tissues
• Taking all steps mentioned above if you smoke cigarettes, “chew”, or vape

It is also important to know the signs and symptoms of periodontal (gum) disease. It begins with gingivitis, which causes the gums to become tender and swollen. When brushing, blood may be present in the sink when rinsing. Bad breath becomes persistent and the gums may turn red in color.

As an Asheville periodontist, I believe that the first step for adults who want to improve their oral health is by being informed patients. This generally leads to an individual who is committed to achieving and maintaining a healthy smile.

A good resource on maintaining good oral health is the web site of the American Academy of Periodontology: www.perio.org (go to Patient Resources). If you are experiencing any of the symptoms associated with gum disease as mentioned above, call our Asheville periodontal dental office at 828-274-9440. Gum disease will only worsen without treatment. (A referral is not necessary.)

Men Have Unique Challenges When Oral Health Is Poor

Posted on Oct 18, 2022 by William J. Claiborne, DDS MS

In almost any fitness center, you’ll see guys lift weights, sweat buckets on the stair climber, and use the rowing machine like mad. Men can be pretty appearance-conscious when it comes to their physique. Yet, when it comes to their smiles, their track record is not so impressive.

According to the National Institute of Health, a gender-based study of college students concluded that women were far better at brushing than men. Another study’s findings (published in the Journal of Periodontology) showed that men were less likely to brush regularly, schedule regular dental checkups, and follow through with recommended dental treatment.

While women are doing a better job, it is necessary due to their own challenges. A female’s fluctuating hormone levels as they go through different stages of life affect gum health and lead to inflammation.

Men should understand that a healthy smile may be far more appealing than they realize. A survey by dental insurer Delta reported that good oral health was one of the top “sexiest qualities” that women saw in men. Poor hygiene topped the list of turn-offs for women with 70% of females claiming they would not kiss someone believed to have poor oral health.

According to the Centers for Disease Control and Prevention (CDC), men are less likely to sufficiently maintain their oral health. This should be especially concerning for men since they have some pretty challenging odds against them as far as health statistics go. These include:

• Men have higher rates of periodontal (gum) disease, tooth loss, and oral infections. Because statistics show that men typically have poorer dental habits than women, they tend to have more dental health problems. Men can’t blame this on biological predisposition as the statistic is based upon lifestyle choices (such as not brushing, etc).

• Men tend to have higher blood pressure, putting them at an increased risk for heart disease later in life. Medications that treat these conditions can cause dry mouth, which ups the risks to their oral health.

• Elderly men typically have fewer teeth than women of the same age, and need dentures more frequently than women do. Although research shows a correlation between tooth loss and body mass index, in the case of elderly men, having few teeth boils down to poor dental habits/health accumulated over time. 

• Oral cavity and oropharyngeal (throat) cancers are twice as common in men than in women. This is suspected (somewhat) to be because men have been more likely to use tobacco and alcohol in the past.

• HPV-related oropharyngeal cancers occur more often in men. Human Papilloma Virus (HPV) is the most common sexually transmitted infection in the United States. HPV can lead to certain types of cancer and thought to cause 70% of oropharyngeal cancers in the U.S. 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.

While a healthy smile is important to both genders, older adults should pay particular attention to having a healthy smile. By CDC estimates, approximately 13% of adults age 65 – 74 have no teeth. For people ages 75 and older, that number jumps to 26%.

Keeping a healthy smile that looks “kissable” isn’t that difficult. By following simple guidelines of at-home care and 6-month dental check-ups, men (and women) can avoid the time and expense of cavities and gum disease (the nation’s leading cause of adult tooth loss). And, you’ll enjoy fresher breath by reducing bacterial levels in the mouth.

In addition to twice-daily brushing and daily flossing, here are some tips to help you:

– Drink lots of water! It’s good for you and helps in the production of saliva, which cleanses the mouth.

– Swish with water after drinking or eating.

– An acid attack occurs every time you eat or drink so limit between meal treats. If you want a cola, for example, have it with a meal since an acid attack will already be underway.

– Snack wisely and read the labels on sauces, dressings, etc. Sugar in high content appears in some surprising ways.

– Brush twice daily, however, don’t brush immediately after eating. Wait 30 minutes for the acid attack in your mouth to subside to keep abrasion on enamel.

A periodontal specialist has advanced training and skills in treating all stages of gum disease as well as in the diagnosis and placement of dental implants. In our beautiful Asheville periodontal dental office, patient comfort is a priority at every visit.

Dental fear and anxiety are common amongst men and women. If dental fear has kept you from having regular dental care, we offer oral sedation as well as I.V. sedation (twilight sleep) in addition to a gentle touch and respectful team.

Call 828-274-9440 to begin with a private, no obligation consultation to discuss your best options. New patients are welcome and a referral is not needed.

Sources:

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

 

April is National Oral Cancer Awareness Month

Posted on Apr 12, 2022 by William J. Claiborne, DDS MS

April is recognized as National Oral Cancer Month. It provides an annual opportunity for the medical and dental communities to remind the American population of the dire consequences that can be brought on by this cancer.

Oral cavity and oropharyngeal (which includes the base of the tongue and soft palate) cancers occur most often in the tongue, gums, floor of the mouth, tonsils, and other parts of the mouth and oropharynx. These cancers also occur in the lips and salivary glands (typically those in the roof of the mouth).

According to the American Cancer Society’s, recent statistics of oral and oropharyngeal (throat) cancers include:

• In 2022, an estimated 54,000 new cases will occur with about 11,230 deaths.

• The average age of people diagnosed with these cancers is 63, but over 20% (1 in 5) of cases occur in patients under the age of 55.

• These cancers are more than twice as common in men as in women and slightly more common in white people than black people. Overall, the lifetime risk of developing oral cavity and oropharyngeal cancer is about 1 in 60 for men and 1 in 140 for women.

Although the death rate and new cases of oral cavity has risen only slightly over the past 20 years, there has been an increase specifically in oropharyngeal cancers associated with an human papillomavirus (HPV) infection in both men and women. These HPV-positive cancers tend to act differently than HPV-negative cancers.

A number of other factors can affect your risk for developing mouth and throat cancer. These include:

Tobacco and alcohol use – Tobacco use is one of the strongest risk factors for head and neck cancers, including oral cavity and oropharyngeal cancer. The risk for these cancers is much higher in people who smoke than in people who don’t. Most people with these cancers have a history of smoking or other tobacco exposure, like chewing tobacco. The more you smoke, the greater your risk. Smoke from cigarettes, pipes, and cigars all increase your risk of getting these cancers. Some studies indicate that long-term exposure to secondhand smoke might increase the risk of these cancers.

Oral tobacco products (snuff, dip, spit, chew, or dissolvable tobacco) are linked with cancers of the cheek, gums, and inner surface of the lips. Using oral tobacco products for a long time is linked to a very high risk. These products also cause gum disease, destruction of the bone sockets around teeth, and tooth loss.

For people who continue to smoke and use oral tobacco products after cancer treatment, their risk of developing a second cancer in the mouth, throat, larynx (voice box), lung and other organs greatly increases.

Drinking alcohol increases the risk of developing oral cavity and oropharyngeal cancers. Heavy drinkers have a higher risk than light drinkers. Smoking and drinking alcohol together multiplies the risk of these cancers. The risk of these cancers in people who drink and smoke heavily is about 30 times higher than the risk in people who don’t smoke or drink.

Human papillomavirus (HPV) infection – HPV is a group of more than 150 types of viruses called papillomaviruses. Some of these viruses cause a type of growth commonly called a papilloma or wart.

Infection with certain types of HPV can cause some forms of cancer, including cancers of the penis, cervix, vulva, vagina, anus, mouth, and throat. HPV type 16 (HPV16) is the type most often linked to cancer of the oropharynx, especially those in the tonsil and base of tongue.

The number of oropharyngeal cancers linked to HPV has risen greatly over the past few decades due to becoming more common in younger people who have a history of multiple sex partners (including oral sex). This is true for even those with no history of alcohol abuse or tobacco use.

Gender – Oral cavity and oropharyngeal cancers are twice as common in men than in women. HPV-related oropharyngeal cancers are also seen more often in men.

Poor nutrition – Studies have found that a diet low in fruits and vegetables is linked with an increased risk of cancers of the oral cavity and oropharynx.

Being obese or overweight – Too much body weight appears to increase the risk of these cancers.  It is advised that eating more plant-based foods, such as non-starchy vegetables and whole fruit, may help people lose weight as well as reduce their risk of oropharyngeal and laryngeal cancer.

Age – Because oral and oropharynx cancers can take many years to develop, they’re not common in young people. Most patients with these cancers are older than 55 when the cancers are first detected. HPV-linked cancers tend to be diagnosed in people younger than 50.

Sunlight – Cancers of the lip are more common in people who have outdoor jobs where they are exposed to sunlight for long periods of time.

Genetics – People with certain genes have a higher risk of mouth and middle throat cancer.

Signs and symptoms of mouth cancer may include:
• A lip or mouth sore that doesn’t heal within two weeks
• White or reddish patch on the inside of the mouth
• Loose teeth
• A growth or lump inside the mouth
• Mouth pain
• Ear pain
• Difficult or painful swallowing

Although oral cancer may first make itself known by a spot on the lips, inside of cheeks or on (or under) the tongue, oropharyngeal cancer can exist without symptoms. When symptoms do arise, they may be:
   Mass felt in the neck or in the back of the throat
   Difficulty or pain with swallowing
   Muffled voice
   Ear pain
   Throat pain or sore throat

https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/risk-factors.html

A periodontist is a dental specialist who has advanced skills in treatment involving the gums, including gum disease, gum reshaping and in the placement of dental implants. This specialist can also detect suspicious areas that may be early warning signs of oral or oropharyngeal cancer. Through a painless process, the examination can determine is a biopsy is needed for a thorough testing process. The earlier the treatment, the less involved the process will be. Too, early treatment helps to increase survival rates.

As an Asheville NC periodontal specialist, please react promptly to any signs or symptoms associated with these cancers. And, with this knowledge, make it your goal to share this information with a smile you love.

Some Surprising Repercussions of Dental Fear

Posted on Mar 24, 2022 by William J. Claiborne, DDS MS

Dental fear has been ranked fifth among the most common of all fears, affecting nearly 50 million people in the U.S. Although a traumatic dental experience during childhood is often assumed to be the leading cause of dental fear, some findings show this is the case for about half of these adults.

For decades, dental fear has been to blame for many adults failing to have adequate oral health. Although cost, access, and awareness of need can be factors, nearly half of American adults avoid dentistry due to having some level of associated fear.

There are a number of false perceptions that don’t help lower this statistic. For example, a parent who tells a child “It won’t hurt much” before a dental visit simply sets the anticipation of pain into place. Hearing things like “That’ll be worse than a root canal,” and “nothing is wrong because nothing hurts,” add to the misconceptions when it comes to the reasons for avoiding regular, preventive dental care.

By some estimates, an adult with dental fear will endure pain for over two weeks to avoid seeing a dentist. They will self-medicate, use ice packs or try ‘home remedies’ found online, all to no avail. Some people end up in an emergency room because they could not force themselves to see a dentist.

Another factor may have to do with genetic makeup. In research conducted at the National Institute of Dental & Craniofacial Oral Health Research Center in Appalachia, “a gene variant was found that may contribute to heightened pain sensitivity and thus dental anxiety.”

https://www.proquest.com/openview/7df1b384b0fb8a79f854e9f304c524c1/1?pq-origsite=gscholar&cbl=30166

https://www.wiley.com/en-gb/Behavioral+Dentistry%2C+2nd+Edition-p-9781118272060

If you’ve ever heard the term, “you don’t know what you don’t know,” this is especially true for oral health. Although people are generally aware that insufficient oral hygiene can lead to bad breath and cavities, too many are unaware of some far worse consequences. Poor oral hygiene at home and lack of regular dental check-ups and cleanings form a straight line to developing periodontal (gum) disease.

While gum disease is the nation’s leading cause of adult tooth loss, it can also contribute to devastating health problems far beyond the mouth. The bacteria of gum disease are inflammatory. These infectious bacteria can enter the bloodstream through tears in weakened gum tissues, triggering a number of serious reactions.

To name a few, gum disease bacteria has been associated with the development or worsening of:
• Heart disease
• Stroke
• Alzheimer’s disease
• Pre-term babies
• Arthritis
• Diabetes
• High blood pressure
• Some cancers

Obviously, these bacteria are highly potent. Although being committed to a thorough, twice daily oral hygiene regimen at home is an important part of having good oral health, regular dental care is also necessary. These visits help to catch early signs of gum disease (which can begin without obvious symptoms). Early treatment can help to reduce treatment costs and time. And, the care can be essentially ‘painless’ when administered by the advanced skills of a periodontal specialist.

As a periodontist in Asheville NC, I want to be encouraging to adults about the risks associated with lack of dental care. I can cite the hazards of non-compliance of regular check-ups over and over. But, for people who have deep-seated fears when it comes to dental visits, far more support is needed to help an individual go from being fearful to relaxed.

A periodontal specialist has advanced training and skills in the diagnosis and placement of all types of dental implants. In our beautiful Asheville periodontal dental office, patient comfort is a priority at every visit. Our office is designed to pamper patients from the moment they enter. For certain procedures or 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 for optimal comfort and safety. In our office, this is overseen by a board certified Anesthesiologist.

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

When patients realize our goal is to provide exceptional care in comfort, they relax. Over time, many patients feel they no longer need a sedative and are able to have regular dental care without worry.

Another way we enhance comfort for our patients is through our immense array of dental technology. In many cases, this advanced technology shortens both treatment time and speeds healing. For example, our LANAP (Laser-Assisted New Attachment Procedure) provides an advanced protocol to efficiently and effectively treat periodontitis (advanced gum disease).

Essentially non-surgical, LANAP treatment provides an alternative for patients with moderate to severe periodontal disease with a quick recovery time.

Regardless of numerous features to optimize patient comfort, it’s still difficult for many to feel ‘ready’ for dental care. We can reassure people on the phone, yet, some simply cannot make an appointment and actually arrive. This is why we often begin with a consultation in our comfortable, private consultation room. This room is removed from the clinical side of the office.

To learn more, call 828-274-9440 to begin with a consultation appointment. New patients are always welcome and a referral is not required.