The “Why” & “How” of Dental Implants

Posted on Nov 09, 2022 by William J. Claiborne, DDS MS

According to the Centers for Disease Control & Prevention (CDC), over one-fourth (26%) of American adults ages 65 and older have 8 or less natural teeth. The CDC equates this number (having 8 or fewer teeth) as “severe tooth loss” since it impacts an individual’s ability to thoroughly eat a healthy diet.

An even worse statistic shared by the CDC is 1 in 6 (17%) adults ages 65 and older have lost all of their teeth.

When it comes to losing natural teeth, they also share that the most vulnerable older adults are those who are poor, have less than a high school education, or are cigarette smokers.

Being totally edentulous (having lost all teeth) amongst the 65 or older age group has fortunately declined over the years. The CDC shared that the figure dropped by more than 30% from 1999–2004 (when it was 27%) to 17% in 2011–2016. At least American adults are moving in the right direction.

https://www.cdc.gov/oralhealth/fast-facts/tooth-loss/index.html

Tooth loss is a bigger deal than is assumed by a large segment of the population. When a natural tooth is removed, its absence causes a reaction that begins below the gum line. What occurs initially is typically not obvious. Yet, the repercussions of “resorption” can become quite the dilemma.

The absence of a tooth root in the upper or lower jaw bone is a loss of stimulation to the bone mass where it was once positioned. These roots provide both stimulation and nourishment that enables the bone to maintain a healthy mass. Without the presence of tooth roots, the bone begins to “melt away.” This process is known as resorption.

Think of the stimulation that tooth roots provide to how you might muscle atrophy. We all know that muscles, not used, will shrink in mass. When the jaw bones are lacking stimulation by the tooth roots they’re designed to hold, bone mass begins to shrink.

Resorption begins shortly after the tooth root is removed. Once it starts, it continues at an ever-increasing pace. For example, the first year after a tooth root is missing, the loss of bone may be minimal. With each passing year, the pace of loss accelerates.

As the bone shrinks in height, the natural tooth roots adjacent to the area of missing teeth are subject to movement and root damage. On average, the next teeth you’re most likely to lose are the ones bordering areas of missing teeth.

Obviously, it is important to replace lost teeth before bone loss begins. For the support of remaining natural teeth, it’s also important to replace missing teeth as soon as possible so adjacent teeth can retain their proper positions. And, it’s HOW you replace them that’s most important.

Because dental implants replace the tooth above the gum line AND the root portion below it, the bone is able to retain its mass. Through the sturdy foundation of the jaw bone, dental implants are able to restore the look, feel and chewing stability like that of natural teeth.

As a periodontist, I specialize in the prevention, diagnosis, and treatment of all stages of periodontal (gum) disease. I also have advanced training and skills in the selection and placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures.

Our Western NC periodontal dental office features some of the most advanced technology available. This cutting edge technology is beneficial in a number of ways, with much specifically helpful in optimal dental implant diagnosis and planning. This includes:

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. For patients who are preparing for dental implant placement, resolving gum disease prior to treatment is mandatory. LANAP offers a non-surgical alternative for patients with moderate to severe periodontal disease with very little discomfort and a quick recovery time.

Cone Beam Imaging – These amazing 3D “x-rays’ are ideal for diagnosing and treatment planning. The highly-detailed images provide a clear view of the upper and lower jaw. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The images are captured in a quick, painless process and at minimal levels of radiation.

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

Computerized Dental Implant Placement – This system provides the futuristic ability to position dental implants before the process actually begins. Through computerized technology, the implants are selected and “ideally positioned” on a 3D model of the patient’s jaw. From this, a template is developed for optimal treatment success, even for complex cases.

CS 3600 Intraoral Scanner – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily. These are used to create precision models or appliances (dental implant crowns, bridges, or full arches). The scanner can also reach hard–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Sedation – Our Asheville periodontal practice is known for its environment of comfort and respectful care. We understand that over 70 percent of the adult population have some level of dental fear or anxiety. For optimal comfort and relaxation, we offer several sedation options, including oral and IV sedation. With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.
• 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 Medical Doctor (MD) who is a board certified Anesthesiologist.

Ideal diagnosis is important, and can save the patient much in overall treatment costs. For example, when missing more than one tooth in one area, one implant can often hold two or a bridge of teeth. Several strategically-placed implants may also be used support a full arch of teeth.

Dental implants restore the ability to eat with stability, chew comfortably, laugh and speak with confidence. Dental implants do not decay and will never need root canals. They have an extremely high success rate, higher than any implant-in-bone option. And, Dental Implants are designed to last a lifetime. With proper selection and maintenance, they will never need replacing or repair.

Dental implants come in many sizes and shapes, each system designed to accommodate various needs and preferences. This means your implant can be chosen to suit your long-term goals.

Proper placement and support in caring for implants is an important part of a successful outcome. However, dental implants can fail. This is why a periodontal specialist can be an asset to your investment. When dental implants are chosen and placed by a Periodontist, he or she can select the one that will work best for you now and throughout your lifetime.

In our Asheville periodontal dental office, we combine technology with our advanced skills and compassionate approach to care so you can enjoy a comfortable, efficient experience that allows you to have optimal success.

Call 828-274-9440 to arrange a consultation. During this time, we can discuss treatment that can achieve your needs and goals as well as the process and anticipated costs.

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#

 

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.