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.)

Vape? Toke? Smoke? Give Added Focus To Oral Health.

Posted on Oct 10, 2022 by William J. Claiborne, DDS MS

Everyone has unique issues that can affect overall health. By knowing the specifics that are seemingly unrelated to your smile (such as certain medications, alcohol use, smoking and drug use), we can better tend to individual needs by helping to incorporate proactive measures into their oral care.

Rest assured that this information is confidential between you and your caregivers. It is not used to cast judgement. Your dental care team appreciates having this information and it’s certainly to your benefit when they do. It has been determined that marijuana use, even medical marijuana, can negatively affect your oral health.

Most dental offices are aware that the use of cannabis has become far more common over the years. According to data from the Centers For Disease Control & Prevention (CDC) from 2002 to 2014:

• Adults ages 35 – 44 showed a 43 percent increase in usage
• Adults ages 45 – 54 had a 48 percent increase
• Adults ages 55 – 64 had a 455 percent increase
• Adults over 65 had a 333 percent

https://drugabuse.com/whos-smoking-weed-these-days-you-asked-the-cdc-answered/

This increase is in contrast to the decrease in cigarette smokers, which may seem to be a positive switch for your oral health. However, all forms of smoking  have a drying effect on oral tissues. This includes the use of e-cigarettes – known as vaping.

The CDC has found that tobacco cigarette smoking is at its lowest level ever recorded among U.S. adults. Still, about 1 in 5 adults in the U.S. reported using a tobacco product in 2017 (including smokeless products).

An estimated 14 percent of these adults who were every day or frequent cigarette smokers in 2017 was down by 67 percent since 1965. The CDC shares: “Another notable decline has been seen among young adults between 2016 – 2017: about 10 percent of young adults between 18 to 24 years smoked cigarettes in 2017, down from 13 percent in 2016.”

https://www.cdc.gov/media/releases/2018/p1108-cigarette-smoking-adults.html

Yet, marijuana use is not a healthy alternative for your smile. The risks to your oral health associated with cannabis use include:

• Compromised Saliva Flow: Saliva acts as a continual oral rinsing agent, moving bacteria and food particles that support bacteria growth out of the mouth. When saliva flow is insufficient, bacteria in the mouth are able to breed quickly. This becomes the source for bad breath, formation of cavities and periodontal (gum) disease.
• Increased Oral Health Problems: Oral bacteria feed on gum tissues, which enables them to thrive and accumulate quickly. The sticky film you feel on teeth at the end of the day is actually a coating of accumulated oral bacteria. When not removed daily through thorough brushing, this film can harden on tooth surfaces. Known as tartar, or calculus, this is a cement-hard mass of bacteria that eats into tooth enamel and destroys gum tissues.
• Risks For Serious Overall Health Problems: While your oral health undergoes a number of risks from oral bacteria overload, the potential for other serious health conditions has been found to originate with the infectious bacteria of gum disease. Because the bacteria of gum disease are able to enter the bloodstream through weakened tissues, research has shown inflammatory reactions can occur elsewhere in the body. This inflammation has been linked to heart disease, some cancers, stroke, diabetes, arthritis, preterm babies and more.

Marijuana may also cause additional risks that some people are unaware. For instance, the action of deeply inhaling marijuana smoke and holding it means the volume of intake is up to four times higher than with tobacco. This results in more poisonous carbon monoxide and tar entering the lungs.

Too, the tar in a marijuana joint contains many of the same carcinogens as tobacco smoke. These concentrations can be up to 50 percent higher in the smoke of a cannabis cigarette. For example, smoking just three joints a day can cause the same damage to the lungs as a pack of 20 cigarettes.

In order to maintain good oral health, for all individuals, a thorough at-home oral care regimen along with regular dental checkups and cleanings are important. However, for users of tobacco or cannabis, we advise having an examination by a periodontal specialist. A periodontist is a dentist who has received advanced training in the diagnosis and treatment of all stages of gum disease as well as in the placement of dental implants.

Because the symptoms of gum disease are not always obvious, a periodontist can ensure gum disease does not already exist. If it does, however, he or she can discuss treatment to restore your gums to good health and develop a program to help keep them healthy.

Also, be especially committed to your oral hygiene at home. This includes twice daily brushing, daily flossing and drinking plain water throughout the day. Another way to combat dry mouth is to use an oral rinse that is specifically formulated to replenish moisture. There are several OTC (over-the-counter), available in most drug stores.

Our goal is to help each patient achieve a healthy smile for life. For patients who wish to achieve this, we work with them according to individual needs. Through a customized treatment plan, your oral health can be a positive part of your overall health regardless of personal preferences. Call our Asheville periodontal dental office at 828-274-9440 to learn more or tap here to begin.

 

Does Obesity Lead To Gum Disease?

Posted on Sep 21, 2022 by William J. Claiborne, DDS MS

What are the two most common diseases in the U.S. today? Obesity and gum (periodontal) disease. Studies are now showing that these two conditions may be related.

However, tracking down “cause and effect” have not been achieved as yet. What is known, however, is that changes in body chemistry affect metabolism, which, causes inflammation, a common element they share. People who have periodontal disease are more susceptible to inflammation, which in turn makes them more susceptible to obesity.

One new study analyzed data from population subsets at one point in time in order to explore potential connection of pathways between obesity and gum disease. Researchers noted an increased risk to develop gum disease for those with higher body mass index (BMI), waist circumference and percentage of body fat.

Certainly, there are a number of risk factors for developing periodontal disease. These include:

• Smoking or chewing tobacco
• Poor oral hygiene and lack of dental care
• Consumption of sugar and other foods that increase oral acid levels
• Aging
• Being diabetic
• Many medications (including steroids, antidepressants, cancer therapy drugs, some calcium channel blockers and oral contraceptives)
• Improper fitting of dental appliances (dentures or partials)
• Pregnancy

Common signs and symptoms of gum disease are:

Gums that bleed easily
Red, swollen, tender gums
Persistent bad breath
Gums that pull away from the teeth (recede)
Changes in the way teeth fit together when biting
Changes in the fit of partial dentures
Permanent teeth that loosen or separate

Initially, gum disease begins with plaque accumulation. Plaque is the sticky film that coats teeth and gums that is usually most obvious when first waking in the morning. The film consists of bacteria, which can penetrate below the gum line. If not removed on a regular basis (preferably daily), plaque will harden into a bacterial mass known as tartar.

Plaque and tartar bacteria cause the gums to become inflamed. The tight grip around the base of teeth (which helps to seal out bacteria) will loosen. Thus, “pockets” of bacteria are able to form between the teeth and gums that become infected. As the disease worsens, these pockets deepen and gum tissues and the structures that support teeth are destroyed. Teeth can become loose and may have to be removed.

Gum disease is the nation’s leading cause of tooth loss. Research has also found links between the infectious bacteria of gum disease to other diseases affecting overall health. These include an increased risk of heart disease and stroke, diabetes, respiratory disease and preterm babies.

The prevalence of gum disease in the U.S. is at an alarming rate – affecting up to 50% of the adult population (ages 30-70) and 90% of adults over the age of 70. Yet, the obesity rates in America are at concerning rates as well.

According to the Centers for Disease Control & Prevention, U.S. obesity prevalence increased from 30.5% to 41.9% from 2000 – 2020. The highest percentage was among adults aged 40 to 59 years – 44.3%. (North Carolina ranks at 33.6%.) A healthy BMI is 18.5 – 24.9.

But, back to the gum disease-obesity connection…

A 2009 study showed that individuals with excess weight had twice the rate of periodontitis (advanced gum disease) and triple the rate for individuals with severe obesity. This was shown even after adjustments for other risk factors such as smoking, age and other medical conditions.

A leading factor lies in the fat cells, which were previously thought of as storage for energy. Now science has determined that fat cells produce a number of chemical signals and hormones, substances that lead to higher inflammation in the body. This, in turn, hampers the ability of immune system effectiveness. The inflammation add to the likelihood of periodontal disease.

As a periodontist in Asheville NC, I utilize some of the most advanced technology in the region to detect all stages of gum disease and restore the gums to a healthy state. This is true for all stages of gum disease, even the advanced level of periodontitis.

Depending on the level of disease, we can restore the tooth supporting structures (bone, gum tissue and ligaments) through thorough cleaning, tartar and plaque removal, and treating the deep pockets of infected tissue. Treatment is performed safely and comfortably, with oral and I.V. sedation (twilight sleep) available as needed.

When the severity of the disease requires surgical measures, we are fully skilled and equipped to restore oral health. We also assist restored patients with maintenance of proper oral hygiene for long-term success.

Understanding the relationship between obesity and risk factors that lead to periodontal disease is very important. If you have signs or symptoms of gum disease, please know that this condition will only worsen without treatment. The earlier your treatment, the less complex the treatment will be.

Call 828-274-9440 or visit: https://www.biltmoreperiodontics.com/services/periodontal-gum-treatment/

 

Sources:

https://www.colgate.com/en-us/oral-health/threats-to-dental-health/periodontal-disease-and-obesity

https://www.obesityaction.org/resources/obesity-and-periodontal-disease/

https://www.sciencedaily.com/releases/2019/12/191203082858.htm

https://www.cdc.gov/obesity/data/adult.html

Dental Pain Relief With Patient’s Well-Being In Mind

Posted on Aug 19, 2022 by William J. Claiborne, DDS MS

The body relies on a nervous system for many reasons; one reason being to alert us that something is wrong. For example, when we burn our finger on the stove, the brain quickly sends pain sensations so we can remove the finger and take action to help it repair.

As a periodontal specialist in Asheville NC, I know how sensitive the gums can be, as well as teeth. A toothache or a cut in the mouth can be miserable for days. As a periodontist, ideally my skills allow patients to avoid being in pain by keeping their mouths healthy. When an individual maintains a clean mouth that has a low level of bacteria, they can avoid developing cavities and gum disease, which can both result in a significant amount of constant pain.

Yet, caregivers in the American healthcare system are very much aware of the opioid epidemic. We don’t want to deny legitimate patients the medications they need to get them out of pain, however, neither do we want to be a catalyst or contributor to an individual who becomes dependent on these or is trying to feed an already existing habit.

The dental profession has been very careful in this regard, according to the American Journal of Preventive Medicine. In 2012, dentists in the U. S. prescribed only 6.4% of the total opioid prescriptions. For procedures such as root canals or extractions, they help patients get through the initial part of recovery when pain levels are most extreme.

As opioid abuse became such a significant problem, dentists became more sensitive to prescribing these medications. In 2016, American Dental Association (ADA) issued a Statement on the Use of Opioids in the Treatment of Dental Pain.

“Dentists should consider non-steroidal anti-inflammatory analgesics as the first-line therapy for acute pain management … [and]should recognize multimodal pain strategies for management for acute postoperative pain as a means for sparing the need for opioid analgesics.”

Non-steroidal anti-inflammatory analgesics are commonly known as NSAIDs. These are typically over-the-counter meds, such as Advil, Aleve, Motrin, etc. These are non-opioid, oral medications for temporary relief of acute dental pain.

NSAIDs work to provide effective pain relief by reducing inflammation in the bone, dental pulp, and gum tissues. The ADA encourages dentists to consider NSAIDs as the preferred go-to method for managing acute pain. When NSAIDs are taken after a dental procedure, they have been shown as effective as opioids for reducing pain intensity. For some pain levels, the dentist may prescribe a higher dose (by prescription).

Although NSAIDs are effective and less likely to cause dependency, they can also inhibit the an enzyme responsible for producing other prostaglandins that provide numerous beneficial effects. This includes those that protect the gastrointestinal mucous lining, blood flow to the kidneys, and blood clotting.

NSAIDs could also heighten the risks for serious cardiovascular issues, including heart attack and stroke. NSAIDs gave the potential to trigger issues that complicate the effects of low-dose aspirin.

Another option for managing dental pain is the use of Acetaminophen (such as Excedrin and Tylenol). Acetaminophen is an internal analgesic available in over-the-counter medicines for the temporary relief of minor aches and pains and helping to reduce fever. It can also be found in medicines that contain more than one active ingredient to treat migraines.

Acetaminophen is often used for things like headaches, muscle aches and menstrual cramps. It can also be an ingredient in other medicines.

Please know that I want no less for my patients’ comfort than I would want for myself or loved ones. Pain can be an overwhelming problem, although gum disease and cavities are highly preventable. With proper at-home oral hygiene and regular dental check-ups, an individual can keep a healthy smiles and prevent tooth loss (to a signifiant degree).

Even so, the Agency for Healthcare Research & Quality shared that there were more than 615 emergency room visits for every 100,000 people in the U.S. in 2018. The statistic is much higher for low-income and minority groups.

Let’s work together to protect our population from the impact it has endured from opioid addiction. Prior to treatment, we will discuss the potential for discomfort or pain afterward and standard treatment options to help ease you through recovery.

If you are experiencing sore, tender gums that bleed easily when brushing or a deep ache like a toothache, do not delay in seeking dental care. When something is wrong in the mouth, there are very few instances that will go away on their own. Most problems worsen over time, leading to higher levels of discomfort and more-involved treatment to resolve the problem.

In our Asheville eriodontal dental office, we offer some of the most advanced technology available in dentistry, including ConeBeam 3D imaging, laser dentistry, and computerized dental implant placement technology. Additionally, we provide oral and I.V. sedation, safely and monitored closely.

Call 828-274-9440 or tap here to arrange an appointment.

Sources:

https://www.rdhmag.com/patient-care/article/14279378/the-dental-hygienists-guide-to-dental-pain-and-pain-management

https://www.deltadentalwa.com/blog/entry/2019/09/dental-pain-management

https://hcup-us.ahrq.gov/reports/statbriefs/sb280-Dental-ED-Visits-2018.pdf