Connections of Oral Wellness and Overall Health

Posted on Aug 08, 2024 by William J. Claiborne, DDS MS

Over the past few decades, an increased number of studies have pursued the many connections of periodontal (gum) disease and our overall health. With the findings, research has become more focused with links found between infectious oral bacteria and a growing list of serious health problems.

Periodontitis is the most severe form of periodontal disease. It is a severe form of gum infection that damages soft tissues and destroys the bone that supports teeth. This occurs when toxins produced by the bacteria in plaque irritate the gums.

These toxins activate a chronic inflammatory response in which the body, which turns on itself. This systemic inflammation leads to break down and destruction of tissues and bone that support the teeth.

The potent bacteria of gum disease are able to enter the bloodstream through tears in weakened tissues. It is now known that it can trigger inflammatory reactions that are related to the development of the conditions mentioned above. While it can activate the development of serious health problems far beyond the mouth, it can also worsen others already underway.

The initial stage of periodontal disease is gingivitis. This may have mild symptoms or even some deemed “normal.” These include areas where the gums are tender or seeing blood in the sink when brushing teeth. However, gingivitis, if not halted, can soon progress to periodontal disease.

Gum disease symptoms include:

• Gums that loosen from teeth (or “recede”)
• Red or swollen gums
• Gums that bleed when flossing or brushing
• Persistent bad breath 

• Teeth that may loosen or drift

Without treatment, gum disease worsens. Many people are unaware of the severity of damage capable by these infectious bacteria. Below are some of the correlations that may surprise you.

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Using findings from previous research, studies have closely scrutinized two types of oral bacteria pathogens. Researchers found that one pathogen was far more prevalent in the saliva of participants who developed pancreatic cancer with a 59% increased risk of developing the deadly cancer. Just as alarming was that the second pathogen was shown to increase this risk by 50%.

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The connections between periodontal disease and other diseases in the body also include a link between oral health and psoriasis. Psoriasis is a chronic disease that affects the skin. Its cause isn’t fully understood but seems to relate to the immune system turning on itself.

This condition causes the life cycle of skin cells to accelerate beyond normal. Cells build up rapidly on the skin’s surface, forming scales and red patches that are often itchy and sometimes painful.

In one study, researchers found that while “people with psoriatic arthritis had about the same rate of gum disease as those without joint inflammation, people with psoriatic arthritis were more likely to have severe gum problems.”

https://www.psoriasis.org/advance/prevention-tips-for-uveitis-stroke-and-gum-disease

Other studies have shown that people with periodontitis (advanced gum disease) are nearly 1.5 times more likely to develop psoriasis than people with healthy gums. Could one trigger the other, and vice versa?

Another study showed that 36% of people with psoriasis had one or more sites of bone loss measuring at least 3 millimeters (over a tenth of an inch). This was compared to 13% of people without psoriasis.

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For people who have rheumatoid arthritis (RA), many are learning that research is noting close connections with arthritis and gum disease, too.

RA is a debilitating, painful disease that destroys joints. RA often emerges gradually, initially causing morning stiffness and weak, sore muscles. As inflammation from RA worsens, joints become swollen.  Joints become achy and stiff most often in the fingers, wrists, elbows, hips, knees, ankles, toes, and neck. Unfortunately, there is no cure for RA.

Apparently, gum disease and RA share a genetic similarity. The clinical makeup shows similar structures, primarily in pathogens that spark disease or illness. Research has found that the pathological process that occurs in both gum disease and RA are nearly identical.

Both conditions cause chronic inflammation in tissues that connect to bone with both diseases having a similar inflammatory trigger. Even more similar is the particular species of bacteria found in periodontally-diseased tissues when compared with tissues around arthritic joints. In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis.

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Another example of damage possible by the infectious bacteria of periodontal disease is coronary artery disease. The heart disease connection, as explained by Harvard Medical School’s newsletter, states:

“In people with periodontitis (erosion of tissue and bone that support the teeth), chewing and toothbrushing release bacteria into the bloodstream. Several species of bacteria that cause periodontitis have been found in the atherosclerotic plaque in arteries in the heart and elsewhere. This plaque can lead to heart attack.

“Oral bacteria could also harm blood vessels or cause blood clots by releasing toxins that resemble proteins found in artery walls or the bloodstream. The immune system’s response to these toxins could harm vessel walls or make blood clot more easily. It is also possible that inflammation in the mouth revs up inflammation throughout the body, including in the arteries, where it can lead to heart attack and stroke.”

http://www.health.harvard.edu/press_releases/heart-disease-oral-health

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And the list goes on, even including connections between periodontal disease and erectile dysfunction (ED). For men in the 40 – 70 age group, ED affects over 40% with nearly 70% of men at age 70 affected.

https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/erectile-dysfunction/

One study of 162 males ages 30 to 40 by Turkish researchers, 82 of the participants had normal erection function while 80 who complained of ED, nearly half. Some men in both groups had chronic periodontitis, but the condition was more than twice as prevalent in the ED group.

In another study, 80 male participants who had severe gum disease were more than twice as likely to suffer from erectile dysfunction. This was true even after adjustments were made for other issues that could distort the findings.

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Gum disease affects nearly 47% of American adults. It will worsen without treatment and, to no surprise, is the nation’s leading cause of adult tooth loss. As an Asheville periodontal specialist, I have an up-close view of the damaging effects of gum disease.

If you are experiencing signs of gum disease, start with a thorough periodontal examination. Call 828-274-9440 or ask our friendly staff about beginning with a consultation.

If dental fears have caused you to delay or avoid having regular dental care, many treatments can include oral or I.V. sedation (sleep dentistry, or “twilight sleep”).

And, if financial constraints are an obstacle in receiving treatment, we offer several payment plans. Most are interest-free with no down payment required (for qualified individuals). Feel free to ask about these during your consultation.

When Trepidation Keeps You From Going Further For The Smile You Desire

Posted on Jul 31, 2024 by William J. Claiborne, DDS MS

In my 30-plus years as a periodontist in Asheville, I’ve treated hundreds of patients who comes with a variety of needs. Some need treatment that involves the gum tissues, including:

• all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
• reshaping gum tissues for esthetic enhancement (crown lengthening, correcting ‘gummy smiles’, repairing gum recession)
• diagnosis and placement of dental implants
• treating lesions or cysts in oral tissues

Over the years, I’ve seen adults of all ages who have the ultimate desire for a healthy, confident, and even more attractive smile. While many come to our Western NC periodontal dental office through the referral of their general dentist or another dental specialist, we also see a number who are referred by someone they know (often a past patient) or those who have found us online.

We are happy to welcome all new patients, even those who come to us with trepidation. And, trepidation is something my team and I understand.

While some individuals admit to having dental anxiety or fear, others aren’t in the category of being a fearful patients. Some are holding something in that even they cannot pinpoint, although its a reservation that we can often work through. Their trepidation tends to wane once the patients become more familiar with our skills, technology, and unique features.

To begin, patient comfort is a high priority in our our Asheville periodontal practice. While we are widely known for an environment of comfort and respectful care. This is because, in part, over 70% of the adult population have some level of dental fear or anxiety. The other part is that we would want such an approach to care for ourselves and our loved ones.

For optimal comfort and relaxation, 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 Medical Doctor (MD) who is a board certified Anesthesiologist.

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

We also have a reputation for featuring some of the most advanced technology available, much of which is not available in other dental or periodontal offices in this region. These features help to diagnose with precision, treatment plan with superior accuracy and reduces the patient’s treatment time while optimizing comfort.

Advancements in today’s dental technology are remarkable. Whether the patient’s need is the restoration of gum health or the replacement of missing teeth through dental implants, the advanced skills of a periodontist can help minimize treatment time and complexity of treatment.

In our periodontal dental office, some of the features that help enhance comfort, optimize treatment outcomes, minimize treatment, and speed healing include:

LANAP Protocol Using PerioLase MVP-7: Efficiently and effectively treats periodontitis (advanced gum disease) with laser technology. It causes very little discomfort and has a quick recovery time. This has also been found to stimulate bone regrowth in damaged areas.

Dental Radiology With 3-D Cone Beam Technology: This imaging is ideal for diagnosis and treatment planning. The imaging covers the entire dentition area with clear views of the mandible and maxilla (upper and lower jaw).

CareStream Cone Beam Computer Tomography Imaging: This computerized tomography provides imaging in exceptional detail and range.

CS 3600 intraoral scanner: Patients no longer have to endure having impressions made with bulky, gloopy trays held in their mouths! This quickly and comfortably scans the mouth’s interior for digital impressions using a small, handheld scanner. It can also reach difficult–to–access areas in the patient’s mouth with improved patient comfort.

Simplant Dental Software for Computerized Dental Implant Placement: This system helps in pre-surgical positioning of dental implants on the computer, using a 3D model of the patient’s jaw. This aids in the selection of the implant type that ensures a precision fit.

Intraoral Camera Technology: This provides outstanding quality of images within the mouth. These images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment issues.

Computer Imaging In Treatment Suites: Treatment suites are equipped with computers for convenient image sharing with patients.

Advanced Sterilization: Our custom sterilization unit adheres to (or exceeds) CDC guidelines for instrument processing protocols, particularly in the cleaning of instruments.

Fully-Equipped Surgical Suites: Relax during treatment while surrounded by beautiful mountain views of Asheville.

Once a patient who had reservations understands the amazing environment we offer for their periodontal dental needs, they tend to relax. For those who have periodontal (gum) disease, proceeding with treatment has a more urgent timetable, which has to do with their overall health.

Gum disease is the nation’s leading cause of adult tooth loss. Yet, the bacteria that destroy gums and the structures that support natural teeth don’t always remain confined to the mouth. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.

Once blood borne, the bacteria are able to activate or worsen serious conditions in the human body. Research has correlated oral bacteria to a long list of serious health problems. These include heart disease, stroke, Alzheimer’s disease, arthritis, diabetes, preterm babies, erectile dysfunction (ED), some cancers (including pancreatic), and more.

It is estimated that over 47% of American adults have some level of periodontal (gum) disease. This disease is the nation’s number one cause of adult tooth loss. However, gum health needs to be seen by the general population as a vital player in one’s overall health.

I believe that our population would be more committed to their oral wellness with a more widespread understanding of the hazards of gum disease in the U.S. This is why it is important to be familiar with the signs and symptoms, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding (pulling away from the teeth) or make the appear teeth longer than normal
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

If you have any of these, you are urged to seek periodontal care as soon as possible. This disease will only worsen without treatment.

There are so many connections between your oral health and your overall health that are yet to be known. Yet, the more research delves into this, the more comes to light. An illustration of this is research at Case Western Reserve University School of Dental Medicine. In this recent study, they found that humans with fewer fat cells are better able to combat periodontal (gum) disease. This is because fat cells trigger inflammation in the body.

In the study, 31 obese people who had clear indications of gum disease were monitored. Half of the group had gastric bypass surgery with fat cells removed from the abdomen. Those in the other group had not had gastric bypass surgery or fat removed.

Researchers noted that the majority of the bypass surgery group had a drop in their glucose levels following the procedure. This is a positive outcome based upon the higher risk of overweight people for diabetes and insulin-related problems.

All study participants underwent non-surgical periodontal treatments and were provided oral hygiene instructions for at-home care. While both groups showed improvement, the surgery group had better results.

https://www.sciencedaily.com/releases/2011/11/111109111540.htm

If you have oral wellness needs, want to replace teeth through dental implants, esthetic goals with the involvement of gum tissues, or have dental fear that has prevented you from receiving regular dental care, let’s sit down together and discuss ways we can help you.

If financial concerns are an issue, we offer several payment plans. These often break treatment fees into monthly payment amounts that are manageable to most budgets. Most have no down payment required and are interest-free.

Call our Asheville periodontal office at: 828-274-9440 and speak with our friendly staff. You can begin with a consultation, if desired.

Energy Drinks Are Erosive To Tooth Enamel

Posted on Jul 12, 2024 by William J. Claiborne, DDS MS

In the U.S., over one-third of adults ages 18 to 29 admit to being regular consumers of energy drinks. For those in the 30 to 49 age group, that number jumps to nearly 42%.
https://www.statista.com/forecasts/228168/energy-drinks-consumption-usa

While many adults like having an afternoon pick-me-up readily available through a beverage, there is growing concern regarding the potential of these drinks to erode tooth enamel.

To begin, most energy drinks are high in sugar as well as highly acidic. The acidity is a particular problem because acid is destructive to tooth enamel as soon as it makes contact. Its damage begins as soon as it reaches enamel and continues with each sip.

The American public is likely unaware of just how acidic these energy drinks are. To acknowledge the extent of acidity in these beverages, the pH levels typically range from 1.5 to 3.3, which is exceptionally acidic. These include common brands such as TNT Energy Drink®, Red Bull®, and Monster Energy®.

Comparatively, fairly neutral levels for foods or beverages range 6 to 8 pH. The closer to 0, the more acidic, meaning the 1.5 – 3.3 levels of energy drinks are cause for concern. Because the pH level of the mouth is directly affected by the foods and drinks we eat, oral pH levels directly effect the health of teeth and gum tissues.

“Normal” saliva pH is generally 6.2 – 7.6. When the pH levels in your mouth go below 5.5, the higher acidity starts to break down the protective enamel on teeth, leaving you at a higher risk of developing cavities.
https://periodontalhealthcenter.com/blog/how-energy-drinks-affect-teeth-and-gums/t

As acidity of a liquid increases, the pH number rises. For example, water and milk have a pH of 7.0, very low acidity. Lemon juice has a pH of around 2.0. Battery acid has a pH of 0.0. With the numbers of energy drinks in the 1.5 to 3.3 range (Red Bull has a pH of 3.3 and Monster Energy has a pH of 2.7) erosion of tooth enamel is almost a given for regular consumers.

Because of the erosive effects to teeth from energy and sports drinks, a study was recently conducted to evaluate the true severity.

In the analysis, pH values, titratable acidity, and buffering capacity of energy beverages were measured. For the erosive test, specimens were immersed in the beverages for 30 minutes at room temperature with gentle shaking (to mimic consumption). Loss of surface hardness was calculated at various points of the time period.

The energy drinks had pH values ranging from 2.36 to 3.41 (with the lowest acidity for Monster Energy® and the highest for TNT Energy Drink®). All the energy drinks were shown to be erosive to tooth enamel with TNT Energy Drink® showing the worst behavior.

Journal of Clinical & Experimental Dentistry
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601704/

It’s not unusual for some people to consume up to four energy drinks a day, which creates a flood of acid coating teeth several times in extended periods (since these drinks are typically consumed over a period of time rather than downed quickly). When you consider that these drinks can be as corrosive as battery acid, it’s easy to see how tooth enamel can be vulnerable.

Ninety-six percent of tooth enamel is mineral content. Tooth enamel is the outer protective coating of teeth. Tooth enamel is the hardest substance in the body and has the most minerals in the body.

Signs that your tooth enamel is damaged and eroded are:
• Sensitive teeth
• Teeth turning yellow
• Transparent tips of teeth
• Teeth developing cracks or dents
• Cavities

Tooth enamel is irreplaceable. Once it’s gone, it’s gone forever. Protecting your teeth and gums requires more than just a couple of brushings per day. Good dental hygiene depends on several factors including what you eat/drink, genetic make-up, lifestyle, personal hygiene and susceptibility to dental problems in general. However, subjecting your teeth to frequent onslaughts of acid washes is going to eventually catch up to you in ways that are expensive and time-consuming to repair.

And, before rushing to the sink after downing an energy drink to ward off potential damage, hold off a bit or you may simply add to the damage. If you brush your teeth after consuming anything acidic (including citrus, colas, coffee, tea, tomatoes), the bristles of a tooth brush and abrasive substance of toothpaste against weakened enamel will merely add to the destruction.

Wait at least 20 minutes after eating and drinking so you don’t damage the enamel. This allows the acid levels to re-elevate. It is wiser to drink a glass of water to wash away food residue and acid remaining on teeth or in your mouth.

If you have not received regular dental care or have concerns that your oral health is at risk (perhaps due to the effects of what you eat, your overall health, or things like smoking, etc.), it is recommended that you have a thorough periodontal examination.

A periodontist is a dentist who has continued in education to specialize in the diagnosis and treatment of all areas of the tissues in the mouth. In addition to treating all phases of periodontal (gum) disease, we are uniquely qualified to reshape gum tissues. We also have advanced training in the diagnosis and placement of dental implants.

Although gum disease can begin without obvious signs or symptoms, the most common are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

If you are experiencing symptoms of gum disease or have not received regular dental care, call 828-274-9440. We’ll arrange a periodontal exam in our comfortable Asheville periodontal office. Oral and I.V. sedation (“twilight sleep”) are available and safely administered.

If you have already experienced tooth loss, let’s discuss replacing missing teeth with dental implants. Designed to last a lifetime, dental implants are the ideal tooth replacement option and restore the natural look feel and function like that of natural teeth.

Our Western NC periodontal dental office offers some of the industry’s most advanced technology in dentistry including that to diagnose and select (and guide) ideal implant placement angles and depths.

You can also begin with a consultation appointment to get to know us and learn about our advanced technology, often saving our patients treatment time while enhancing comfort.

If financial constraints are a concern, ask about our easy payment plans. These can break treatment fees into monthly payments that are manageable to most budgets.

 

 

The “Risk vs. Reward” of Oral Health

Posted on Jun 25, 2024 by William J. Claiborne, DDS MS

Risk versus reward.

This is a phrase that’s often associated with decision-making, such as stock market investments. While certain strategies can increase the potential for “reward,” there is still an element of “risk” in losing part or all of the investment.

As a periodontist in Asheville, I see this in how it relates to decisions in dentistry. This is the case in replacing lost teeth. As a periodontal specialist, I place many dental implants in patients who’ve lost teeth that likely could have been kept had the patient made different decisions.

I also see this is in the decision of patients to have a crown (“cap”) placed on teeth. When a dentist recommends a crown, it is typically to keep the existing tooth structure intact and protected. So, when a tooth that’s been filled and needs yet another filling, the dentist may advise crowning the tooth instead. This preserves the remaining structure by avoiding the “risk” of tooth from breaking off.

Or, when a tooth shows signs of fracture(s), crowning may prevent the tooth from the need for removal. This is because a tooth that eventually breaks below the gum line can no longer be saved. Once removed, tooth replacement brings on an entirely new set of decisions, and costs.

Your general dentist’s goal, like yours, is to help you achieve and maintain a healthy smile. He or she wants you to keep your natural teeth or, if tooth loss does occur, replace them in a way that supports your overall oral health. A periodontist can be a strong team player in this goal.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease and in the placement of dental implants. A periodontist is also a specialist in reshaping gum tissues, for reasons that may include esthetics as well as maintaining oral wellness.

I place many dental implants and am a proponent of them as a superior tooth replacement option. However, as ideal as an implant is, there is nothing as good for your oral health as natural teeth. This is why it’s so important to keep them. This may, for certain teeth, require the placement of a crown.

A periodontist may be involved in certain aspects of treatment to optimize a patient’s results and success level while minimizing discomfort. For instance, a periodontist may work with your general dentist to help save a tooth from removal when a tooth has broken close to the gum line. This is accomplished through crown lengthening procedures where gum tissues are removed to expose more of the tooth. This may be able to make sufficient tooth structure available to support a crown.

Crown lengthening is also beneficial in sealing gum tissues surrounding a tooth at its base. By securing the tissue around the tooth or crown, bacterial entry is avoided and the risk for periodontal (gum) disease decreased. This is especially beneficial in cases where gum tissues have receded, exposing sensitive tooth root sections that are easily affected by oral bacteria.

In some cases, gum tissue height can be corrected by careful removal in a procedure known as a gingivectomy. To enhance the appearance of a smile with an esthetically-pleasing smile line, combined with the placement of crowns, the tooth-to-gum ratio is rebalanced.

This is what is often referred to as a “gummy smile.” Crown lengthening is a common method that teams your general dentist with a periodontist to create a smile that looks natural and is beautifully flattering.

Another look at the risk-reward consideration, the “risk” of not caring properly for oral health can easily upend the “reward” of having a healthy smile. Regular dental check-ups and a thorough at-home oral hygiene regimen can prevent the development of cavities and periodontal disease.

When oral bacteria levels in the mouth are not managed, the teeth and gums pay the price, often through the need for costly treatment that may have been prevented. Periodontal disease is the nation’s leading cause of adult tooth loss.

Research has also found that the inflammatory bacteria of gum disease can enter the bloodstream, triggering or worsening a long list of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.

Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

As a periodontist in Asheville, we want everyone to know the benefits of a healthy, confident smile. Maintaining healthy gums and keeping your natural teeth is important to every individual.

If your gum health needs improvement or there are signs of gum disease, we can structure a program that restores healthy gums and helps you maintain your oral health between visits.

For those who have already experienced tooth loss, we are happy to discuss the process to replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing. Too, dental implants are designed to last a lifetime, making them an excellent investment.

With proper measures, you can enjoy healthy gums and natural teeth throughout your lifetime. Call 828-274-9440 to schedule a periodontal examination or ask for a consultation to get to know us. A referral to our office is not required.

If dental fear or anxiety has kept you from receiving regular dental care, please ask us about oral or I.V. sedation (“twilight sleep”). Both are administered safely with patient comfort always a priority.