E-Cigs & Oral Health

Posted on Dec 23, 2021 by William J. Claiborne, DDS MS

When it comes to vaping (using e-cigs) health risks to the heart and lungs are what tend to be the focus. However, vaping poses a number of other health risks, one being to your smile.

Risks to your oral health makes perfect sense. Think about it – the damage from vaping would naturally begin at its entry point: your mouth.

Although e-cigarettes do not contain tobacco, they are still delivery systems for nicotine. In addition to being addictive, studies show that the inhaled nicotine through vaping can alter the genetic makeup of your cells. This, in turn, stimulates the growth of cancerous cells in the body and increases your risk of developing cancer.

This can lead to tumor growth in the following types of cancer:

• Lung cancer
• Gastrointestinal cancer
• Pancreatic cancer
• Breast cancer

While much remains to be determined about the hazards surrounding this “alternative” delivery system to nicotine, more and more studies are showing unfavorable outcomes. When it comes to oral health, studies are culminating in a mountain of evidence that links e-cigarettes with poor oral health.

A study published earlier this year (iScience) showed that 43 percent of people using e-cigarettes had gum disease and oral infections. That figure jumped to 73 percent among smokers.

Nicotine (inhaled by any means) restricts blood flow to the tissues in the mouth. These tissues are moist by nature and designed to absorb moisture. Because of nicotine’s harmful contents, blood flow is restricted and oral tissues become dryer.

Today’s e-cig user is likely unaware of what’s in the fluid being inhaled. The vaping mist can contain propylene glycol, benzene, formaldehyde and other chemicals.

When the oral tissues repeatedly endure hazardous components, resulting issues can be inflammation, cavities, bone loss of the structures that support teeth, advanced gum disease (known as periodontitis), and oral cancer.

Because vaping is still a recent agent for nicotine, studies on the long-term effects are underway. Still, even without a long history of findings, early studies show concerning results.

When it comes to your oral health, studies indicate that vaping increases the risk of gum disease by causing gum inflammation and swelling. When these issues are combined with a dry mouth and higher levels of bacteria, the likelihood for developing gum disease shoots up significantly.

The common symptoms of gum disease for vapers include:

• Persistent bad breath
• Gums that bleed when brushing teeth
• Tender or swollen gums
• Loose or shifting teeth
• Receding gums

The effects of vaping on the teeth and gums can cause:

Dry mouth – Nicotine from e-cigarettes reduces the saliva in your mouth, your mouth’s rinsing agent. Too little saliva can lead to dry mouth, accumulated plaque (and subsequent development of tartar), increased bacteria, and tooth decay.

Receding gums – Nicotine restricts blood vessels, reducing blood flow to the teeth and gums. Without adequate blood flow, the gums fail to get sufficient oxygen and nutrients. This can cause the gum tissues to decline, which can lead to gum recession. This can result in tooth sensitivity, a higher risk of cavities and even tooth loss.

Bruxism and tooth damage – Nicotine acts as a muscle stimulant, which can lead to tooth grinding (bruxism) or worsen already-existing problems. Grinding or clenching can lead to tooth damage, such as chipped, fractured or broken teeth.

Oral health is a critical element of whole-body health. Two preliminary studies (presented at the American Stroke Association’s International Stroke Conference) linked gum disease with a higher rate of strokes caused by hardening of large arteries in the brain and with severe artery blockages.

A 2018 study in the American Heart Association’s journal Hypertension found that gum disease appears to worsen high blood pressure and interferes with medications to treat hypertension.

It is a misconception to believe that e-cigarettes are healthier than traditional cigarettes, or that vaping isn’t bad for your smile. If you’re a smoker or vaper, be highly committed to having regular dental cleanings and exams as well as your twice-daily oral hygiene routine at home.

If, however, signs of gum disease are already present, have a periodontal examination as soon as possible. Once underway, gum disease will only worsen without treatment. Call 828-274-9440 to schedule or to learn more. As an Asheville periodontist, I have advanced skills in treating all stages of periodontal (gum) disease and in the placement of dental implants.

Our Western NC periodontal dental office also places an emphasis on advanced technology and in comfort options, including oral and IV sedation (twilight sleep).

https://www.heart.org/en/news/2020/08/26/need-another-reason-not-to-vape-your-oral-health-is-at-risk

https://www.deltadentalwa.com/blog/entry/2018/06/ecigarettes-vaping-dental-health

Cut Dental Costs With Simple Steps

Posted on Dec 15, 2021 by William J. Claiborne, DDS MS

In order to avoid costly repairs on our vehicles, we rotate our tires, have the oil changed periodically, and make sure certain fluids are at sufficient levels. This is why our annual inspections are so important; risks can be pointed out to keep us safely on the road.

The same is true with our family’s health. We stay proactive by eating healthy, staying active and having regular check-ups along with periodic screenings.

It simply makes sense to be committed to preventing problems or catch any that do arise at early stages. Research has shown that your oral health deserves the same commitment you give to maintaining a healthy body.

Studies have found a correlation between the bacteria of periodontal (gum) disease and serious problems elsewhere in the body. These include heart disease, stroke, diabetes, arthritis, preterm babies,  impotency and more.

Another reason to maintain a healthy smile is to save money. By devoting about 5 minutes per day to your oral hygiene routine, coupled with having dental exams and cleanings every six months, you can prevent many problems from occurring in the first place. The reward is a savings in time and expense that may be needed for repairs – repairs that may have been prevented from occurring in the first place.

Your twice-a-year dental check-ups are opportunities to remove tartar. Tartar is a cement-hard mass of oral bacteria that forms when plaque (the sticky film that coats teeth and gums) is not removed thoroughly attaches to teeth and can no longer be brushed or flossed away.

Both plaque and the hardened mass of tartar are the result of accumulated bacteria. Oral bacteria continually reproduce in the mouth, which provides a warm, dark and moist environment. As they thrive and reproduce, they attack gum tissues.

As they amass to levels beyond what the immune system, oral bacteria can lead to gingivitis (an early stage of gum disease). Unresolved, gingivitis can develop into periodontal disease, an infection. Eventually, periodontitis develops, which is an advanced level of gum disease. At this level, teeth often loosen and must be removed.

While gingivitis causes tender gums to bleed when brushing, periodontal disease symptoms are more severe, including persistent bad breath, sore gums that bleed easily, gums that darken in color, receded gums, and pus pockets that form between teeth.

As devastating as adult tooth loss can be, the potent bacteria of gum disease can enter the bloodstream through tears in disease gum tissues. Research has shown the infectious bacteria of gum disease can activate or worsen the development of certain pathogens.

Obviously, oral bacteria is highly potent. However, it’s easy to control with twice daily brushing and daily flossing combined with regular dental checkups. For added protection, limit sugary snacks and either swish after eating or chew sugarless gum when brushing is inconvenient. Not only will you help to reduce your risk for cavities and gum problems, you’ll be able to enjoy fresher breath and smiling confidence.

It is also important to respond early to signs and symptoms of gum disease. As mentioned above, things like frequent bad breath or seeing blood in the sink when brushing are warning signs that something is wrong.

A periodontist is a dentist who has specialized skills in the diagnosis and treatment of all levels of periodontal disease. He or she can also recontour the shape of gums and place dental implants for optimal results.

If you have not seen a dentist on a regular basis, you may be experiencing symptoms that indicate gum disease. As you would respond to a warning sign with your overall health, so should you with your oral health.

Begin with a thorough examination to determine what your needs are and the best way to achieve and maintain good oral health. You’ll be supporting your overall health in addition to having a confident smile.

If dental fear has prevented you from having regular dental care, ask about sedation options. We offer both oral sedation and IV sedation (twilight sleep). Both are safely administered and you are closely monitoring throughout treatment.

You may wish to begin with a consultation. To schedule, call 828-274-9440.

Dental Fear Can Lead To Gum Disease, Tooth Loss

Posted on Nov 23, 2021 by William J. Claiborne, DDS MS

Fear is a natural reaction to things that may harm us; it’s a safety mechanism activated by the brain. Take snakes, for instance. Even harmless snakes tend to provoke an initial reaction that warns of impending danger.

Some fears are learned, however. Some people are afraid of dogs, usually stemming from a frightful encounter as children. The incident triggers something in the brain that reminds the individual, even into adulthood, that dogs are to be feared.

When it comes to the fear of dentistry, it often exists because of a traumatic incident in the patient’s past. Or, in some cases, it exists for unknown reasons. Too, certain smells, sounds or sights can trigger the “panicky” reaction some people have to dental visits.

As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss.

Typically, adults who avoid dental visits feel they are doing an adequate job maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass recommended 6-month dental check-ups and cleanings.

Yet, even the best of at-home dental hygiene can be insufficient to the buildup of tartar.

Tartar is the hardened form of plaque, which is a sticky film of bacteria that accumulates in the mouth. In the form of tartar, this cement-hard mass of bacteria cannot be brushed or flossed away. It can only be removed by a dentist or hygienist using special tools.

While plaque can cause bad breath and a “furry” feeling mouth, tartar eats away at tender gum tissues and bores into tooth enamel. As it grows, it works its way below the gum line, creating inflammation in the gum tissues.

Early symptoms of gum disease, known as gingivitis, are tender or swollen gums. You may see blood in the sink when brushing teeth. Breath odor may be bad on a regular basis.

At this point, proper measures may be able to reverse the progression of these rapidly-reproducing bacteria. This requires thorough brushing (twice a day, at the very least), daily flossing, drinking lots of plain water, and using an oral rinse to control bacteria levels.

However, if tartar exists, it’s not going to go away. It will continue to amass and attack the gums and work its way into the tissues below. When the bacteria reach an uncontrollable level, they become infectious.

Think of gum disease bacteria as you would water in a pan on the stove. The heat will eventually cause bubbles to form on the bottom of the pan. This can be likened to gingivitis.

However, as the water heats more, bubbles start to move to the surface. This can symbolize the development of gum disease. The symptoms of gum disease include gums that turn red and bleed easily and persistent bad breath.

When advanced stage periodontal disease develops (periodontitis), imagine the water at full boil. Unfortunately, once aboil, the roil continues even after you remove the pan from the heat. This is known as systemic inflammation.

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 remain confined to the mouth. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.

Research has correlated oral bacteria to a long list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. These include heart disease, stroke, Alzheimer’s disease, arthritis, diabetes, preterm babies, erectile dysfunction (ED), some cancers (including pancreatic), and more.

Obviously, these bacteria are potent and a threat to overall health. For those who avoid dental care due to anxiety or fear, knowing all this is not necessarily going to change their resistance. We understand that it’s still difficult to overcome the challenges even knowing there are risks.

There are options, however, for even high fear dental patients.

In our office, we offer I.V. sedation (“twilight sleep”) as well as oral sedation. Oral sedation is in pill form and creates a totally relaxed feeling. It enables patients to recover quickly and offers an amnesiac effect.

I.V. sedation is a deeper level of sedative. This places patients in a sleep state and erases most or all memory of the procedure after. With both sedations, however, we apply numbing medications to the area being treated to create optimal comfort for patients. We want patients to be in total comfort throughout their treatment, regardless of the addition of sedation.

We also have a reputation for treating our patients with respect and a gentle touch. We are just as committed to comfort for patients who do not want to be sedated as we are for those who are. Our goal is to help each person achieve a healthy, confident smile.

One of the most satisfying parts of my specialty is helping a once-fearful patient achieve a healthy, confident smile and see dental care as a welcomed part of their health care commitment.

If you are ready to get past your dental fears so you can have the smile you desire, begin by calling our Asheville periodontal office at: 828-274-9440 and speaking with our friendly staff. You can begin with a consultation, if desired.

 

Mouth Sores – What Is Harmless & What To Watch Closely

Posted on Nov 04, 2021 by William J. Claiborne, DDS MS

As the holiday season approaches, our risk for illness goes up. Our chances for picking up colds or the flu increases, which is worrisome on its own. Add that to already-high concerns surrounding exposure to COVID, and we’re all taking added precautions to protect our health.

As in any year, colder months mean we’re more confined to the indoors and in closer proximity to others. With heightened potential for illness, the holidays simply create more stress to our lives. Stress is a contributor to our health as it compromises the immune system. This, in turn, lowers our resistance to fight off illness.

After the holiday mingling constraints endured in 2020, people are trying to take added precautions in 2021 so our “togetherness” is not overshadowed with worries about exposure to illness. To bolster our resistance, many people have had their Covid booster and flu vaccines, practice frequent hand washing, take vitamin supplements such as C, and are trying to stay active physically inside and out-of-doors.

Certainly, we applaud the health safety efforts taken by our Northwest NC population. As an Asheville periodontist, just a added tip for your overall health and well-being: Don’t forget to monitor the inside of your mouth while being committed to the other health measures you’re taking. You may be surprised at what your mouth reveals.

In busy times of year like the holiday season, we see a greater number of individuals who develop canker and cold sores.  As stress goes up, your likelihood of getting a cold or canker sore increases as well.

The difference between Canker and Cold sores is:

Canker Sores
These are small ulcers that typically have a white or gray base and red border. Unlike cold sores, canker sores appear inside the mouth and are not contagious. The exact cause of canker sores is uncertain but fatigue, stress or allergies can increase the likelihood of a canker sore. Some experts suspect immune system problems, bacteria or viruses can also spurn eruption. A cut caused by biting the tongue or inside of the cheek as well as hot foods or beverages may contribute to canker sore development. Canker sores usually heal on their own in a week or two. Over-the-counter topical anesthetics, steroid preparations,  and antimicrobial mouth rinses can provide temporary relief. As a holistic method, you may try swishing with plain, sugar-free yogurt for a minute or so. This helps to restore a healthy bacteria balance in the mouth while soothing discomfort.

Cold Sores
These are also referred to as fever blisters or Herpes simplex and are located around the lips, under the nose or on the chin. Caused by herpes virus type 1, cold sores are very contagious. These are clusters of fluid-filled blisters that often erupt since are they are most commonly found around the edge of the lips. Cold sores are Herpes lesions that may follow a fever, sunburn, skin abrasions or emotional upset. Because cold sore blisters are on the outside of the mouth, they can be embarrassing and uncomfortable. Although they usually heal in a week, over-the-counter topical anesthetics may speed the process while providing some relief. In our office, we can use a dental laser to hasten healing, often within a couple of days. If occurrences are frequent, ask about prescription drugs that can help reduce the duration of these viral infections.

Other issues your mouth’s interior can reveal include:

White Coating On Tongue
The tiny, bumpy protrusions on the tongue’s surface are papillae. Papillae are our source for taste and touch, allowing for feeling food’s form and texture. Saliva and food residue can become embedded in the grooves between the papillae, especially on the back portion of the tongue. This can create areas for rapid bacterial growth. As bacteria accumulate, a whitish film coats the tongue, which leads to bad breath. Let your white tongue be a warning sign of too much bacteria and take measures to manage it before cavities and gum disease develop. It’s important to keep the mouth moist since a dry mouth provides a breeding ground for bacteria reproduction. Drying sources, in addition to age, include smoking, alcohol consumption, caffeinated foods and beverages, and many prescription and OTC medications. Uproot bacteria in the tongue daily by brushing the tongue with your toothbrush after brushing teeth. Some toothbrushes have a tongue scraper on the back side of the bristles or you may want to purchase a tongue scraper. These are flexible strips you use to scrape over the tongue’s surface in a back to front motion.

Cheek Biting
Cheek biting can occur from a minor accident, such as during a fall. It can also occur from careless chewing or talking while eating. Cheek bites can occur more frequently due to a bite that is misaligned. A disparity in the bite can disrupt the harmonious congruency of upper and lower teeth while chewing and speaking. Cheek biting can be a symptom of bite misalignment. Other signs may indicate temporomandibular joint (or TMJ) disorders, which often result from a misaligned bite. Thus, cheek biting can be related. Too, TMJ disorders can cause night-time clenching or grinding of teeth. During these actions, you may be unknowingly biting the inside of your cheek while asleep. Cheek biting can cause inflammation at the location of the bite and can also result in canker sores. Chronic cheek biting can result in redness, painful sores, and tears in the mouth’s inner lining. Repeated bites can cause the oral tissues to become thick, scarred, and paler in the affected area. This surface can prompt the individual to continue biting in an attempt to create a smooth surface. If cheek biting has become habitual, there may be an emotional cause, such as  stress, anxiety, depression, or even genetics. This should be discussed with your primary care physician.

Oral Cancer
It is important to pay close attention to any change to oral tissue that does not heal within 10-14 days. When oral tissue does not repair on its own in a week or so, it should be examined by your dentist or periodontist without delay. Some of these spots can be a symptom of oral cancer.
Oral cancer has one of the worst survival rates of all cancers. Because symptoms can mimic a bite on the inside of your cheek, more obvious symptoms often do not emerge until the cancer has reached advanced stages. Of those who acquire oral cancer, only 57% are estimated to still be alive 5 years later. Know the signs of oral cancer, which include:

• white or red patch of tissue
• unusual lesion in the mouth
• difficulty or discomfort when swallowing
• persistent sore throat or feeling something is stuck in the throat
• a lump or mass inside the mouth or neck
• wart-like mass
• numbness in the mouth or face

Lesions or discolorations that are early warning signs are not always visible, particularly in the back portion of the mouth. Because symptoms emerge slowly, the delay in early diagnosis and treatment can have deadly consequences. This reinforces the need to maintain regular oral hygiene exams and cleanings every six months. During these times, unusual changes in the mouth can be noted and, if concerning, further steps can be taken. Remember, never wait until your next dental check-up appointment to have anything unusual examined.

Bleeding Gums
Contrary to what some people believe, having gums bleed at any time is not normal. Seeing blood in the sink when you brush is not a sign you’re doing a good job. It’s a sign that the gum tissues are either being scrubbed too harshly or the gum tissues are infected by accumulated oral bacteria. If you notice bleeding – at all – take extra measures to maintain excellent oral hygiene at home. This includes twice daily brushing, daily flossing, using an oral rinse, keeping the mouth moist (ideally by drinking plain water), and limiting sugar. If bleeding continues for more than a couple of days, make a dental appointment. You may have developed Gingivitis, which is an early stage of gum disease. Halting this in its tracks early can save you greatly in treatment time and expenses.

The interior of your mouth can be a great indicator of your health in other areas. Just be sure to look inside and stay proactive on steps needed to keep the interior “in the pink”. Again, if an unusual spot or sore is still present after two weeks, call 828-274-9440 immediately for an appointment.