Missing Teeth? HOW You Replace Them Will Make the Biggest Difference.

Posted on Oct 23, 2023 by William J. Claiborne, DDS MS

I remember a time when people assumed they would lose their natural teeth as they aged. Wearing full dentures in one’s senior years was almost an expectation. However, today’s adults are less accepting of “false teeth.”

Over time, adults have learned that the removal of a natural tooth has lasting repercussions. Although the tooth may have been removed because of decay or a break, the long list of problems and associated expenses are generally far greater than what was anticipated. I’ll explain.

When a natural tooth is removed, its absence causes a reaction that begins below the gum line. Without the presence of tooth roots, the bone begins to “melt.” This process is known as resorption.

The absence of a tooth root in the upper or lower jaw bone removes stimulation to the bone mass where it was once positioned. Along with the stimulation, natural tooth roots channel nourishment needed for maintaining a healthy mass.

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. For people who sleep with their dentures, the 24/7 pressure on the gum ridge speeds up the pace even more.

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. Yet, merely replacing the presence of a tooth above the gum line leaves the underlying risk factors in place. Over time, problems arise for most individuals.

There are many reasons we recommend dental implants for tooth replacement, whether for one, several or a full mouth of missing teeth. Dental implants recreate stimulation to the jaw bone, thereby halting the pace of bone loss. When bone mass is maintained, neighboring teeth have a reduced risk for being lost as well.

Because dental implants are held in the jaw bone, they are able to restore a natural biting strength with dependable stability. Having the ability to bite and chew efficiently and enjoy a diet of foods you love enhances eating pleasure and proper digestion. It’s no surprise that people who wear dentures have more gastrointestinal problems than those who have their natural teeth.

Another advantage to dental implants is their longevity. When dental implants are properly selected, placed and maintained, they should last your lifetime. This is why it’s so important to have your implant treatment through a Periodontist.

A periodontal specialist has advanced training to properly diagnose and place the most appropriate dental implant system for your needs and goals. As an Asheville periodontist with over 30 years of experience in dental implants, I have a reputation for treatment that provides the most successful outcome based on each patient’s unique needs – and by the most conservative means possible. Thus, the patient avoids having more time and expense involved than is necessary.

We are also known for providing a high level of patient comfort through the administration of IV sedation (twilight sleep) with our on-site Board Certified Anesthesiologist. Additionally, diagnosis and treatment planning is backed by images from our on-site 3D Cone Beam imaging.

Our Western NC periodontal office is fully prepared for the placement of dental implants. We tend to our patients in an efficient and effective manner so treatment occurs in minimal time and to an exceptional level of comfort.

We receive many patients who have been referred by their physician, dentist, and past/present patients, often because of our advanced skills and the respectful environment we provide. Here, each patient is treated with the same respect, compassion and gentle hands that we would want for ourselves and our loved ones. We take great pride in knowing our patients experience the finest periodontal and implant care in the Southeastern U.S.

A periodontist is a dental specialist who is trained to understand the intricate concepts involved in selecting the proper type of implant and skilled at placing implants at proper depths and angles. A periodontist is also able to optimize patient comfort during treatment and throughout the healing phase.

In addition to this advanced training, our office offers some of the most advanced technology available. This aids in the diagnosis and treatment planning of dental implants, providing patients with optimized comfort and outcomes. This technology, combined with our advanced skill level, creates a comfortable, efficient experience that helps you enjoy a lifetime of confident smiles.

Dental implants are also designed to last a lifetime. I can think of very few things that provide this kind of value. With proper selection and maintenance, they will never need replacing or repair, making them an excellent investment.

If you are considering dental implants, increase your potential for a successful outcome by asking a Periodontist to join your dentist in team treatment. Most general dentists have close relationships with periodontal specialists for implant placement, gum reshaping and in the treatment of gum disease.

If you have lost natural teeth or are facing the potential of tooth removal, call 828-274-9440 to schedule a consultation. This will occur in a private, comfortable consultation room conveniently located in our Asheville periodontal dental office. During this time, we’ll discuss the implant systems that may work best for your needs and preferences. I’ll explain the treatment involved, sedation options and estimated fees.

It’s Flu Season – Why You Should Keep Your Oral Health In Tip-Top Shape.

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

It’s cold and flu season. Now having weathered the worst pandemic Americans have ever experienced, a new emphasis has taken hold for the need to have flu vaccines and the latest Covid booster.

Vaccines, of course, do not fully eliminate the potential to acquire these health conditions. While they lower the chances of their development, the immune system still relies on our own actions. This includes taking measures to avoid their development in the first place, such as frequent handwashing, eating a healthy diet, mask-wearing in crowds for vulnerable populations, etc.

We learned much about the immune system during the Covid pandemic. And, the need for keeping oral health in good condition became more clear than ever.

During the worst of the outbreak, a 2020 study found that individuals with gum disease who contracted COVID-19 were 9 times more likely to die. And, the study showed that COVID patients who already had periodontitis (the advanced form of gum disease) were 3 times more likely to end up in intensive care or on a ventilator.

Evidence shows, too, that avoiding dental care may actually increase the potential to contract the virus. And, poor oral health can increase its severity, and even fatality rates.
https://onlinelibrary.wiley.com/doi/10.1111/jcpe.13435

This is not only a concern for U.S. citizens, it’s a worldwide wake-up call. About 50% of the world’s population over the age of 30 suffer from periodontitis. Americans aren’t in much better shape – with over 47% having some form of gum disease.

Because gum disease can begin without obvious symptoms, or be present without having pain, it can be easily ignored. This allows the disease to progress further.

This is why dental care is deemed by Congress as “essential healthcare,” as it supports the need for preventive measures for gum disease and tooth loss. As a periodontist, I believe it is also important that Americans understand the signs and symptoms of gum disease as well as the overall health risks it brings.

Although gum disease can exist without obvious indication (typically in the early stage known as gingivitis), warning signs of gum disease usually begin with swollen and tender gums that bleed easily when brushing teeth.

As it worsens, the healthy pink hue of gums darkens to more of a red or purple color and breath odor is persistently bad. The gums begin to loosen their strong grip around the base of teeth, allowing infectious bacteria to reach bone structures that support tooth roots. In advanced stages, pus pockets form near the base of some teeth and gum tissues become spongy in texture.

The bacteria of periodontal disease don’t just damage oral health. This is where there is so much concern throughout the healthcare fields.

Through weakened oral tissues, the bacteria can enter the bloodstream and trigger inflammatory reactions. These reactions can worsen some serious health conditions and even activate others. Research has found correlations between these bacteria and heart disease, stroke, diabetes, arthritis, some cancers (including pancreatic), preterm babies, erectile dysfunction, and Alzheimer’s disease.

With such serious correlations, it should be common knowledge that oral wellness is a necessary part of maintaining good overall health. However, this isn’t necessarily the case. A report commissioned by Delta Dental Plans Association recently revealed concerning information regarding age groups and perceptions of oral health.

With over 1,000 online participants, 87% listed their priority for maintaining proper oral care was to save money or avoid unexpected expenses. Two-thirds of the group listed their commitment to at-home dental hygiene being to avoid tooth decay and gum disease. Yet, only 79% of adults stated they brushed their teeth twice a day with only 33% claiming to floss daily.

In reviewing age groups, the report found that baby boomers (those born between 1946 – 1964) understand there is a strong link between their oral and overall health but are less aware than other generations about the connection between poor dental health and chronic diseases (such as arthritis and diabetes).

Those listed in the Generation Z group (born between 1997 – 2012) showed less commitment to their oral health as the “boomers,” but were more focused on eco-friendly and nontraditional oral care products. Only 76% of Generation Z agreed that oral health is closely connected to overall health.

https://www.deltadental.com/content/dam/ddpa/us/en/state-of-america%27s-oral-health-and-wellness-report/DDPA_State%20of%20Oral%20Health%20Report_2023-Release_FINAL.pdfse-you

If you wear dentures or partials, keeping them clean is an important measure to take to avoid getting sick. Why?

One study (published in the Journal of The American Dental Association) assessed bacteria levels of the porous material that make up the gum base of dentures and partials. In the mouth, it becomes coated with a sticky bacteria known as biofilm.

One study found that wearing dentures while sleeping doubles the risk of pneumonia in elderly adults. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541085/)

It has also been found that this biofilm can harbor MRSA or bacteria that is resistant to antibiotics. It was also found that the bacteria in the biofilm doesn’t just stay in the mouth. It can be inhaled into the lungs where infections become much more difficult to treat. (https://www.nbcnews.com/healthmain/dirty-dentures-dangerous-mrsa-may-be-lurking-dentists-say-662637)

Regardless of age, Americans must maintain a healthy smile in order to support their immune systems. Research shows that oral bacteria are also connected to gut health, so keeping bacteria levels in the mouth in check can go a long way in healthy benefits far beyond the mouth.

For those who have avoided regular dental care due to dental fear or anxiety, we offer several comfort options, including oral and IV sedation.

Oral sedation is a pill that helps patients relax.  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 with patients closely monitored with advanced safety equipment throughout treatment.

Call 828-274-9440 to arrange an examination appointment or to learn more about our Asheville periodontal dental office.

 

A “Lecture-Free” Look At Cigarettes & Your Smile

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

In this article, I’m going to address cigarette smoking as it affects oral health. This is not intended to lecture or chastise an adult for making a choice to smoke or those caught up in the addictive grip of nicotine. My goal is to relay factual information regarding oral health for smokers so they can better protect their smiles.

Because I’m a native North Carolinian, I’ll begin by sharing some information on our State, as provided by 2018 stats from the CDC (Centers for Disease Control & Prevention).

In 2018, the percentage of adults in North Carolina who smoked was reported as 17.4% (of every 100 adults). The CDC shared findings of all states, with smoking ranged from nearly 9 of every 100 adults in Utah (9.0%) to 25 of every 100 adults in West Virginia (25.2%).

They also shared that cigarette smoking was lowest among those with a graduate degree (3.2%) and highest for those who had only achieved a GED certificate (30.7%). Those with a high school diploma showed a lower percentage of nearly half of the GED level adults at 17.1%.

As an Asheville periodontal dental specialist, smoking is a particular concern since many people are unaware of the oral health risks. While many smokers are familiar with the risks smoking poses related to cancer and other diseases, smoking is also terribly harmful to your smile.

For instance, smokers have a greater risk of periodontal (gum) disease. The drying effect that smoking has on the soft tissues in the mouth offers an ideal breeding ground for oral bacteria. This enables easier entry of oral bacteria into the structures that support tooth roots.

According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared to that of a nonsmoker.

As oral bacteria thrive and reproduce in the mouth, gum tissues become tender and inflamed. These are signs of gingivitis, the beginning stage of gum disease.

Gum disease at this stage can cause persistent bad breath, swollen gums and gums that bleed easily when brushing. As it progresses, gum tissues turn red or purple from inflammation. Pus pockets may form at the base of some teeth. This advanced stage is known as periodontitis.

Eventually, the infectious bacteria penetrate below the gum line and attack supporting bone and the tissues surrounding tooth roots. This can cause teeth to loosen and eventually require removal. Gum disease is the nation’s leading cause of adult tooth loss.

Losing teeth is detrimental to your overall health and not a normal part of the aging process. Studies have shown that people who wear dentures die an average of ten years earlier than those who keep their natural teeth.

Denture wearers also have higher incidences of pneumonia, and worse. A 2015 report by NBC News shared findings surrounding dentures and MRSA biofilm. The report included a dental specialist’s warning that, “Concern about biofilms on dentures is growing as researchers continue to identify links between oral bacteria and heart disease, chronic obstructive pulmonary disease or COPD, and respiratory diseases, including aspiration pneumonia.”

Many smokers are aware that they have stained teeth and more-frequent bad breath than non-smokers. They also have slower healing periods after procedures such as extractions, gum treatment and oral surgery.

Although a hygienist may go slowly and gently, dental cleanings are typically less comfortable for smokers. This is because smoking causes a greater buildup of plaque. With gum tissues already tender from the bacterial irritation of plaque, removing buildup from between and around the base of teeth adds to the discomfort of inflamed tissues.

According to the American Dental Association (ADA), smoking increases the risks of oral cancer, lesions inside the mouth, enamel erosion and tooth loss in addition to periodontal (gum) disease.

If you vape, remember that nicotine in any form is a hazardous force in the mouth. And the vapor itself is not safe for oral health.

Vaping (using e-cigarettes) delivers nicotine through an inhaled mist. Although the vapor is generally not labeled as “dangerous,” one study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, including, propylene or polyethylene glycol, glycerin, and additives. And, its nicotine is no less harmful to the user as that delivered via cigarette smoke.

Unfortunately, many cigarette users switch to vaping based on the perception that “e-cigs” are a safer alternative. For those hoping to wean themselves off cigarettes through this switch, very few achieve that goal as a result.

A 2018 report by the National Academy of Sciences, Engineering, and Medicine concluded there was “evidence that e-cigarette use increases the frequency and intensity of cigarette smoking in the future.”

Although the focus in this article is meant to be on oral health, allow me to reiterate some of the benefits of “kicking the habit” …

• Smokers have a decreased life expectancy of an average of 10–15 years compared to non-smokers.


• Smoking is linked to nearly a third of all cancer diseases and deaths.


• Pregnant women who smoke have a higher risk for first-trimester spontaneous abortion, preterm births, low birth weight babies and sudden infant death syndrome (SIDS).


• Women who smoke are at risk for early menopause while men who smoke are more at risk for impotency.


• People who breathe in your “second hand” smoke (what you exhale) are subjected to over 50 known carcinogens and other harmful chemicals.

For those who are able to give up smoking, the effort is well worth it. The positive effects can be felt almost immediately. In about 48 hours, damaged nerve endings begin to restore. The sense of smell and taste begin to return to normal.

“Quitters” also notice their breathing is easier in about 3 days and they have fuller air intake. Oral health improves within 2 weeks as blood circulation in the gums and teeth returns to nearly that of non-smokers. Heart attack risk also declines with blood flow greatly improving. Activities are easier and the constant smokers cough is gone.

In our Asheville periodontal office, our goal – for every patient – is to help each achieve optimal oral health and a smile he or she is proud to share. For those who smoke, we make individualized recommendations so the potential for achieving this is favorable.

If tooth loss has already occurred, we are specialists in the treatment of all stages of gum disease and in the diagnosis and placement of dental implants. We will be happy to discuss the dental implant system that may be best for your needs.

Or, if dental fear or anxiety have kept you from receiving regular dental care, ask us about oral or IV sedation (“twilight sleep”). These sedatives are delivered by an MD of anesthesia for your optimal safety and comfort. And, in all procedures, we make patient comfort a high priority.

Call 828-274-9440 to schedule an examination.

Sources:

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm#:~:text=This%20means%20an%20estimated%2028.3,with%20a%20smoking%2Drelated%20disease.&text=Current%20smoking%20has%20declined%20from,every%20100%20adults)%20in%202021.

https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html

https://www.sciencedaily.com/releases/2016/11/161116101821.htm

https://www.nbcnews.com/healthmain/dirty-dentures-dangerous-mrsa-may-be-lurking-dentists-say-662637

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm

Let’s Talk About Your Breath.

Posted on Sep 28, 2023 by William J. Claiborne, DDS MS

Who, me?

While many people may suspect their breath is less-than-fresh, most don’t realize that others are noticing. And, let’s face it – no one wants to be associated with bad breath.

Bad breath that is persistent, or halitosis, is not just the stale odor in your mouth when you wake up or the lingering scent of onions on a burger you had for lunch. Halitosis is typically a symptom that results from other conditions. While chewing gum and breath mints may temporarily improve the odor, going bad breath will continue until the root cause has been determined and treated.

I’ve often heard, “If you think you might have bad breath, you probably do.” To check your own breath, Colgate suggests: “Try the sniff test—there are a couple of ways to do it. If you lick your wrist, let it dry for a moment, then take a whiff, you should be able to get an idea if your breath has an odor too. Another method is to floss toward the back of your mouth, then smell the floss.”

If you feel bad breath is a constant problem, then halitosis is likely what needs to be the focus. And, where is it originating? Gum disease? GERD? Diabetes?

It may make you feel better to know that halitosis is actually fairly common. It is estimated to affect 1 in 4 people worldwide. It may be so common because the reasons it exists can vary widely. These can include:

• Poor oral hygiene – Without a thorough at-home oral hygiene routine, oral bacteria accumulate. At minimum, twice-daily brushing, flossing and 6-month dental cleanings are needed to keep harmful bacteria under control. If not, plaque forms, which is the sticky film that layers over teeth and gums. Plaque can harden into masses of bacteria known as tartar. Tartar can no longer be removed by brushing and flossing.

• Gum disease – The early stage of gum disease is gingivitis. This is an inflammation of gum tissues that cause gums to swell, become tender and bleed easily when brushing. Untreated gingivitis can lead to periodontitis, which damages gum tissue and can lead to tooth and bone loss of the structures that support natural teeth.

• Dry mouth – Saliva is the mouth’s natural rinsing agent, removing food particles and bacteria from the mouth. Without adequate saliva flow, it can lead to halitosis. Smoking, certain medications, and some foods and beverages contribute to oral dryness.

• Gastroesophageal reflux disease (GERD) – This digestive disorder allows stomach acids to seep back into the esophagus, the tube that takes food from your mouth to your stomach.

• Nasal and airway infections – When congestive mucus from conditions like sinus infections and pneumonia are coughed up, a foul odor can emerge from the mouth.

• Diabetes – People with diabetes have a higher risk of gum disease. By the same token, gum disease can make it harder to manage diabetes because of increased blood sugar.

• Liver disease or kidney disease – The liver and kidneys are designed to filter toxins out of your body. When people have liver or kidney disease, these toxic substances aren’t being cleared out, resulting in halitosis.

• Sjögren’s syndrome – This autoimmune disease can lead to muscle pain, dry eyes, dry skin and dry mouth (which is often linked to halitosis).

• Head and neck cancers – Oral or throat cancers cause sores that don’t heal, mouth pain, difficulty swallowing, a lump in your neck and unexplained weight loss.

If you have bad breath that doesn’t go away, schedule an appointment with your dentist. If halitosis is due to poor oral hygiene, a dental cleaning or periodontal (gum) procedure should help. If you have healthy teeth and gums, then halitosis may be linked to an issue in another part of your body.

If halitosis is a symptom of another condition somewhere in your body, your primary healthcare provider can help you with proper diagnosis and treatment. Once your physician determines the cause of your halitosis, he or she can develop a treatment plan tailored to your specific needs.

However, if gum disease is the cause, a periodontist can help resolve your problem in the most conversative yet effective process possible. If gum disease is the cause for your halitosis, a procedure known as scaling and root planing may be advised. This helps to reach inflammatory bacteria that have moved down below the gum line.

Once your gums are restored to a healthy state, your periodontist may advise added at-home steps, such as a special mouthwash to combat certain bacteria in your mouth. However, proper oral hygiene is the best way to keep your breath smelling clean and fresh. Here are some general guidelines:

• Use an alcohol-free antibacterial mouthwash.

• See your dentist regularly for checkups and cleanings. For some people, this may be every six months. But others may need more frequent visits to keep their oral health in check.

• Keeping a moist mouth is very important to oral hygiene. Drinking plenty of water during the day is advised. Colas, sweet tea, and energy drinks actually make dryness worse. You should also monitor the medications you take (both prescription and over-the-counter) and look for side effects that include oral dryness. And, smoking is one of the worst contributors of all to oral dryness.

• Proper brushing and flossing is necessary. Brush for at least two minutes twice daily and rinse thoroughly. Use a circular motion rather than scrub teeth back and forth to avoid damaging tender gum tissues. Never use a hard bristle tooth brush or brush with harsh substances such as baking soda!

• The tongue harbors a significantly high percentage of oral bacteria. After brushing, use a tongue scraper to uproot oral bacteria embedded in the grooves of the tongue. This will significantly lower bacteria levels. A study at the State University of New York at Buffalo School of Dental Medicine found that 80 to 90% of bad breath comes from bacteria on the tongue.

• Boost the production of saliva by using sugar-free chewing gum, sucking on sugar-free candy or eating healthy foods that require a lot of chewing. Your dentist might recommend or prescribe products that can produce artificial saliva or help your body produce saliva.

• Avoid alcohol, caffeine and tobacco products because they can dry out your mouth.

It is also important to know the signs of gum disease (bleeding or sore gums, persistent bad breath, receded gums, and/or gums that are red rather than a healthy pink). If these are present, 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 an examination or begin with 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. Call 828-274-9440.

Sources:
http://www.dentistryiq.com/articles/2014/04/a-deeper-look-into-tongue-cleaning.html
https://my.clevelandclinic.org/health/diseases/17771-bad-breath-halitosis
https://www.colgate.com/en-us/oral-health/bad-breath/how-to-tell-if-you-have-bad-breath#