Nothing To Fear To Accomplish Healthy Smile Here

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

As a dental specialist, I find that many people are unfamiliar with exactly what a periodontist does. Yet, when they are recommended to see me (typically by their general dentist), it is because they need specialized care that falls under our unique set of skills.

A periodontist has advanced skills to help patients with a variety of needs that involve the gum tissues. These include:
– Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)
– Diagnosis and placement of dental implants
– Treatment of lesions or cysts in oral tissues

Let’s begin with gum disease.

Because the majority of care I provide has to do with the treatment of all stages of periodontal disease, it may be helpful to understand how this develops. Although many people delay or avoid regular dental care (mistakenly thinking “if nothing hurts, then nothing must be wrong”), I have a close-up view of its destructive nature. Its formation creates cavities, periodontal (gum) disease, and leads to eventual tooth loss.

Even people who are committed to a regimen of thorough at-home oral hygiene (twice-daily brushing, daily flossing), can be doing an insufficient job of removing the daily buildup of plaque. Plaque is a sticky film of bacteria that accumulates in the mouth. When not thoroughly removed, it can harden into a mass that attaches to the base of, or in-between, teeth.

In the form of tartar, this cement-hard mass of bacteria cannot be brushed or flossed away. Once tartar forms, it can only be removed by a dentist or hygienist using special tools. Without removal, it will continue to amass and attack gum tissues, working its way beneath the gum line.

Below the gums lie the support system for natural teeth, consisting of tissues, ligaments and bone. When the bacteria reach an uncontrollable level, they become infectious. As these infectious bacteria accumulate further, symptoms of gum disease become more apparent, such as tender or swollen gums or seeing blood in the sink when brushing teeth. Breath odor may be bad on a regular basis.

As symptoms worsen, the gums become red with infectious and loosen their grip around the base of teeth. The gums may become spongy and pus pockets may form. Breath odor at this point is persistently putrid. Eventually, the structures that support teeth are compromised and teeth may loosen. Gum disease is the leading cause of adult tooth loss in the U.S.

Research has found that certain strains of oral bacteria from gum disease create reactions in the body that can trigger systemic inflammation. Thus far, research findings have shown a correlation between periodontal disease bacteria and some cancers (including pancreatic and lung), Alzheimer’s disease, pre-term babies, heart disease, stroke, diabetes, arthritis and erectile dysfunction (ED).

As if all that weren’t bad enough, one study suggests that gum disease relates to a reduction in one’s quality of life: “Periodontal disease has been linked to lower quality of life.” “Quality of life encompasses several domains, including psychological functioning and social relationships among others. Oral health-related quality of life has been shown to be reduced in patients with periodontal disease.” (https://www.hindawi.com/journals/prm/2017/5491923/)

While estimates show about 75 percent of American adults have some degree of dental fear or anxiety, over 47 percent have some level of periodontal disease. As a periodontist, both are alarming numbers. Nearly half our nation is walking around with a potentially life-threatening disease in their mouths.

Treating this may sound like it would be pretty intimidating. However, Although there are many treatments offered and at various levels, our main goal is to provide patients with comfortable and positive experiences at every visit. One way we accomplish this is through the advanced technology featured here in our Western North Carolina periodontal dental office. We feature some of the most advanced in dentistry, much of which is not available in dental offices elsewhere. Some of these features include:

LANAP With PerioLase MVP 7: Laser-Assisted New Attachment Procedure is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease. LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.

3D Cone Beam Imaging: Ideal for diagnoses and treatment planning, these images provide a clear view of the upper and lower jaw, used for: intricate review of endodontics; periodontics; orthodontics; implantology: TMJ; and prosthodontics, as well as dental and maxillofacial surgery. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The process is quick, painless and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging: This enhanced tomography works with 3D imaging for exceptional detail and range.

CS 3600 Intraoral Scanner: Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily for creating precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments). The scanner can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Computerized Dental Implant Placement: This advanced system for pre-surgical positioning of dental implants uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases.

In addition, we offer a unique environment for comfort. We understand how dental fear or anxiety can cause people to delay or avoid having dental treatment, sometimes for decades. We believe that every patient deserves respect, a gentle touch and knowing they are in a “lecture free” zone. For those who have high fear levels, we offer several sedation options, including oral and IV sedation.

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 (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our Asheville office, anesthesia is overseen by a Medical Doctor (MD) who is a board certified Anesthesiologist.

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

I hope I’ve given you a helpful and positive picture of what a periodontist does and how he/she can help you with some challenging needs; all the while keeping you comfortable, minimizing treatment time, and shortening treatment time.

Although most of our patients are referred to us by other dentists and dental specialists, a referral is not required for accepting a new patient. Call 828-274-9440 if you feel we can make recommendations for your specific needs or provide helpful information.

Absorbent Gums Are On Front Line of “Hidden” Toxin Intake

Posted on Mar 15, 2023 by William J. Claiborne, DDS MS

When you hear someone mention the “gums,” the word often includes the pink, moist area inside the mouth. Not just the area inside the cheeks and under teeth, your oral tissue (“gingiva”) goes beyond what covers the upper and lower jaws and that which surrounds the base of the teeth. This includes …
• the lips
• inner lining of the lips and cheeks
• hard and soft palate
• gums that surround the base of teeth
• floor of the mouth under the tongue
• area behind wisdom teeth
• front two-thirds of the tongue

By design, these moist areas within the “oral cavity” are highly absorbent, so much so that these tissues absorb from anything put inside the mouth, including that which is quickly swallowed.

To help you understand just how important it is to maintain GOOD oral health, I thought it would be beneficial to share some of the BAD that the gum tissues endure. Because the mouth is the entry point for our bodies, you may be interested in seeing what foods and beverages contain some pretty scary ingredients.

According to the Environmental Working Group (www.ewg.org), these items include:

Nitrates and nitrites – are preservatives used in cured meats and linked to stomach cancer, esophageal cancer, and possibly brain and thyroid cancers.

Artificial sweeteners – can affect the hormones that regulate metabolism and have a negative effect on weight control.

Potassium Benzoate – A main ingredient in fireworks and rockets, this chemical preservative is found in many foods and beverages. It is commonly found in fruit juice, sparkling waters, soft drinks, jams, syrups and more.

Titanium dioxide – is a color additive used mostly in candy, which can damage DNA.

PFAS (polyfluoroalkyl “forever chemicals”) are used in food packaging and known to leach into the food itself. They increase the risk of cancer and damage the immune and reproductive systems, among many other health harms.

BVO (Brominated vegetable oil) – is used to stabilize citrus flavors in sodas and fruity drinks. It can cause neurological harm.

BHA (Butylated hydroxyanisole) – is a preservative used in cured meats and other foods. Multiple sources have identified it as a possible human carcinogen.

BHT (Butylated hydroxytoluene) – is a preservative found in cereals and other foods. This chemical cousin of BHA is a possible human carcinogen.

TBHQ (Tert-butylhydroquinone) – is a preservative used in Pop-Tarts and other processed foods. It may harm the immune system and weaken the effectiveness of vaccines.

Propyl paraben – is a preservative used in pastries and some tortillas. It causes developmental and reproductive harm.

That’s quite the long list. However, an even greater challenge to the gums comes from smoking. While everyone who smokes knows it’s “not good” for their health, it is less known the harm doesn’t come from the nicotine alone.

The American Lung Association lists the chemical culprits as:

Acetone—found in nail polish remover
Acetic acid—an ingredient in hair dye
Ammonia—a common household cleaner
Arsenic—used in rat poison
Benzene—found in rubber cement and gasoline
Butane—used in lighter fluid
Cadmium—active component in battery acid
Carbon monoxide—released in car exhaust fumes
Formaldehyde—embalming fluid
Hexamine—found in barbecue lighter fluid
Lead—used in batteries
Naphthalene—an ingredient in mothballs
Methanol—a main component in rocket fuel
Nicotine—used as an insecticide
Tar—material for paving roads
Toluene—used to manufacture paint

Puffing on E-cigs as a “safer” alternative?  That doesn’t preclude your oral health from the bombardment of chemicals in the vapor. Although the Food & Drug Administration (FDA) has not begun its review of any e-cigarette or its ingredients. Unfortunately, this means they have yet to issue standards on these products or submit specific warnings of their composition and effects.

The “e-juice” that fills the cartridges of e-cigs usually contain nicotine (which is extracted from tobacco and highly addictive), propylene glycol, flavorings and other chemicals. Studies have found that even e-cigarettes claiming to be nicotine-free contain trace amounts of nicotine. Additionally, when the e-liquid heats up, more toxic chemicals are formed.

Whether your e-cigarette contains nicotine or not, you may be surprised at the toxic toxic vapors contents below …

• Nicotine – a highly addictive substance that negatively affects adolescent brain development
• Propylene glycol – a common additive in food; also used to make things like antifreeze, paint solvent, and artificial smoke in fog machines
• Carcinogens- chemicals known to cause cancer, including acetaldehyde and formaldehyde
• Acrolein – a herbicide primarily used to kill weeds, known to cause irreversible lung damage
• Diacetyl – a chemical linked to a lung disease called bronchiolitis obliterans, or “popcorn lung”
• Diethylene glycol – a toxic chemical used in antifreeze that is linked to lung disease
• Heavy metals such as nickel, tin, lead
• Cadmium – a toxic metal found in traditional cigarettes that causes breathing problems and disease
• Benzene – a volatile organic compound (VOC) found in car exhaust
• Ultrafine particles that can be inhaled deep into the lungs

What does all this mean?  As an Asheville periodontist, it shows that the gums – on the front line of intake – take the first brunt of these chemicals and toxins, often when we don’t even realize we’re providing willing intake. It also shows how important it is to keep the mouth healthy.

The periodontal dental specialty is especially attuned to how the gums are more than the pink covering in the mouth. Healthy gums are known to support your overall well-being. In addition to being consumer-aware of what your mouth encounters, it is necessary to maintain a thorough oral hygiene routine at home and an involved relationship with your general dentist.

However, if you see signs of gum disease (bleeding or sore gums, persistent bad breath, receded gums, and/or gums that are red rather than a healthy pink), it is important to see a periodontal specialist as soon as possible. Gum disease will only worsen without treatment. It can also allow infectious bacteria to enter the bloodstream, which research has linked to serious (and even deadly) health problems.

Call our Asheville periodontal dental office to schedule a consultation. If fear or anxiety has prevented you from regular dental visits, we can discuss several options (including oral or IV sedation) to provide comfortable, relaxed appointments. Our friendly staff can help you arrange this private time together by calling 828-274-9440.

Sources:
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/gums
https://www.lung.org/quit-smoking/smoking-facts/whats-in-a-cigarette
https://www.ewg.org/consumer-guides/ewgs-dirty-dozen-guide-food-chemicals-top-12-avoid

Mental Health Can Adversely Affect Oral Health

Posted on Mar 06, 2023 by William J. Claiborne, DDS MS

It seems almost every week that I read findings of recent studies that correlate oral health to overall health. It is not surprising that research newly shared reveals connections of how mental health can affect oral health, and vice versa.

It shows that people with mental conditions can be a contributing factor to poor oral hygiene. These conditions include depression, mood disorders, anxiety, OCD (obsessive-compulsive disorders), mood disorders, and eating disorders. These individuals are 2.7 times more likely to experience tooth loss early.

One factor is anxiety and panic, which are often associated with dental treatment.

According to the National Institute of Mental Health, mental illnesses in the U.S. Nearly 1 in 5 adults have with a mental illness (52.9 million in 2020). These numbers have increased post-pandemic.

The Mayo Clinic shared:
“Surveys show a major increase in the number of U.S. adults who report symptoms of stress, anxiety, depression and insomnia during the pandemic, compared with surveys before the pandemic. Some people have increased their use of alcohol or drugs, thinking that can help them cope with their fears about the pandemic. In reality, using these substances can worsen anxiety and depression.”

Poor dental health can be seen in depressed people by a dentist. For example, over 46% of depressed people report tooth pain without apparent cause, known as atypical odontalgia. Too, burning mouth syndrome is an oral condition more common with adults suffering from depression.

Additionally, mental conditions have been linked to oral conditions, such as:
Gum inflammation
Periodontal disease
Cavities
Dry mouth
Chronic jaw and facial pain
Oral ulcers

The relationship between the two – oral health and mental health – seems to lie in cortisol levels. Cortisol is a stress hormone. Stress and anxiety cortisol levels that are too high adversely affect the immune system. This increases the risk of gum disease, oral sores, and infections.

Seeking professional help at the right time is essential to manage an excellent oral and mental state and overall health.

There is also a domino effect once depression or anxiety trigger an imbalance in cortisol. When one’s smile is in poor condition (cavities, stained teeth, missing teeth, bad breath), it can lead to low self-esteem and social isolation. This contributes to a lower quality of life and, in turn, disrupted mental health.

Mental health status has been shown to activate, aggravate or worsen oral problems. These include…

•Gum health and periodontitis (advanced gum disease)
When stress and periodontal disease negatively impact the body’s immune system, inflammation often worsens gum disease. Too, people who endure ongoing stress are more likely to smoke, drink alcohol, or take drugs. These can cause people to neglect maintaining good oral hygiene and be less committed to having regular dental checkups.

•Dry mouth
Eating disorders (such as anorexia nervosa and bulimia) can reduce the amount of saliva – the mouth’s bacteria-rinsing agent. A dry mouth enables the growth of bacteria. Add to this is how many antidepressant medications have a side effect of causing oral dryness.

•Pain in jaw joints
Chronic stress and anxiety are frequent contributors to facial and jaw pain. Teeth grinding and clenching are not uncommon among people with mental conditions. These actions can cause broken, worn or chipped teeth in addition to the painful conditions associated with TMJ disorders.

•Oral ulcers
Lip, tongue, and ulcers inside the mouth can occur more often in people under frequent or chronic stress.

•Developing Cavities
Individuals with mental illnesses are more likely to have dental decay due to a rise in cavity-causing bacterium with a reduced saliva flow – a recipe for developing cavities.

•Tooth erosion
Bulimia is an eating disorder in which vomiting is used to lose weight. Over a third of bulimia patients with eating disorders suffer from tooth erosion due to regurgitated stomach acids that cause tooth erosion.

•Oral cancer
When dental health neglect is coupled with heavy consumptions of alcohol and smoking, the risk of oral cancers increases. Persons who are heavy smokers and drinkers are 50 times more likely to get oral cancer compared to those who never smoke or drink heavily.

Obviously, mental health is closely connected to your oral health. Begin by speaking with a therapist or mental health specialist. Taking care of your mental health is vital to overcome related dental issues.

If you are noticing any of the signs of oral health problems, you should see a periodontal specialist as soon as possible. These signs and symptoms include:
– Bleeding gums when brushing
– Frequent bad breath
– Red, swollen gums
– Gums that are tender or sore
– Gums that pull away from the base of teeth
– Loose teeth

A periodontist is a dental specialist who can help you restore your oral health and enjoy a confident smile. If you’ve experience tooth loss, a periodontist also specializes in the placement of dental implants.

Our Asheville periodontal office also provides sedation options. These include oral and I.V. sedation (“twilight sleep”). These are administered safely by a doctor of anesthesiology who uses advanced safety equipment to monitor you throughout your procedure.

Call 828-274-9440 to schedule an exam or an initial consultation to get to know us better.

Sources include:

https://healthnews.com/family-health/dental-and-oral-health/how-mental-illness-affects-your-oral-health/

https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/mental-health-covid-19/art-20482731

https://health.uconn.edu/sbirtacademy/wp-content/uploads/sites/101/2016/08/Dental-brochure.pdf

“Gray Tsunami” Brings New Numbers in Dementia, Alzheimer’s

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

The American Academy of Periodontology (perio.org), defines a periodontist as:
“A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”

As an Asheville periodontal specialist for over 25 years, my advanced skills help patients with a variety of needs that involve the gum tissues. These include:- Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)
– Diagnosis and placement of dental implants
– Treatment of lesions or cysts in oral tissues

Why should you be concerned about the health of your gums?

Gum disease is an inflammatory disease that attacks gum tissues, teeth, and the structures that support them. It is the nation’s leading cause of adult tooth loss. As if that weren’t bad enough, research has shown that these potent bacteria are able to activate the development (or worsen the progress) of other diseases.

Past studies have shown oral bacteria from gum disease can be a contributing factor to heart disease, stroke, some cancers, diabetes, preterm babies, erectile dysfunction (ED), high blood pressure, and impotency. Studies have begun to closely study the links between gum disease and Alzheimer’s disease.

In the U.S., the growing prevalence of dementia and Alzheimer’s disease is an especially concerning issue as our aging population grows. If you are a “baby boomer” (born between the years 1946 – 1964), you make up a significant percentage of adults. Within 7 years, boomers” will comprise 21% of the population. By 2060, nearly 1 in 4 Americans will be 65 years and older, dubbed the “gray tsunami.” Seniors over the age of 85 will have tripled, with half a million adults having reached age 100-plus.

While the statistics of aging adults increase, these stats for ALL adults over the age of 30 should set off some alarms. Nearly half of the adult population has some level of gum disease, over 47%.

There is a misconception many have 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. Although symptoms of gum disease may include tender gums that bleed when brushing, gum disease can begin without any obvious signs.

This is true for many health problems. For instance, when cancer forms in the body, its initial presence isn’t obvious. This is why annual or periodic screenings are urged since treatment is typically minimal during early stages.

Early treatment, including that for gum disease, helps to resolve the problem without complex measures. 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.

Yet gum disease is a hazard for your overall health as well. 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% higher risk for developing Alzheimer’s disease or dementia. Having no natural teeth was associated with a 26% increased risk.

Broken down, 14% 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% (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% 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. (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 be more focused on 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% 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.

Let us help you minimize the risks associated with oral bacteria. 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”).

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 (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety.

Here, our Western North Carolina periodontal dental office also features some of the most advanced technology in dentistry. Many of these are not available in other dental offices elsewhere. Some of these features include LANAP (Laser-Assisted New Attachment Procedure. This is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. We also have 3-D Cone Beam Imaging, computerized Tomography imaging and one of the latest in intraoral scanners.

Now, more than ever, we know that maintaining a healthy smile 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. A periodontal specialist is the best way to restore any level of gum disease to help you regain a healthy smile.

Be committed to having excellent oral health as and make it a priority as an important part of your overall health. For a consultation to discuss how a periodontist can help you, call 828-274-9440.