What Smoking Does To Your Oral Health

Posted on Mar 13, 2018 by William J. Claiborne, DDS MS

I saw a television commercial recently that caught my attention. It was a court mandated announcement on how low-tar and ‘light’ cigarettes were just as harmful as regular cigarettes.

The announcement, to me, was a reminder of just how much major tobacco companies have concealed the true harm that comes from inhaling cigarette smoke. Although the lungs are assumed to take the greatest impact from these toxic fumes, remember – it is your mouth that is the initial recipient of the poisons from this smoke.

Oral tissues (the soft, pink tissues in your mouth) are moist because they are absorbent. Saliva flow helps to keep the mouth moist along with the liquids you consume that keep the mouth and your body hydrated. Because gum tissues absorb, they take the brunt of the toxic smoke that enters the mouth with each puff.

Tobacco contains chemicals that are known to be harmful, including:

•Nicotine (a rapidly-addictive drug)
•Hydrogen cyanide
•Formaldehyde
•Lead
•Arsenic
•Ammonia
•Benzene
•Carbon monoxide
•Radioactive elements, such as uranium (see below)
•Nitrosamines
•Polycyclic aromatic hydrocarbons (PAHs)

https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/carcinogens-found-in-tobacco-products.html

Smokers shorten their life expectancy by an average of 10 to 15 years. Smoking is responsible for an estimated 30 percent of all cancer deaths and is the reason for 90 percent of all lung cancers.

Smoking increases the likelihood of leukemia as well as pancreatic, liver, cervical, kidney, bladder and stomach cancers. Additionally, it causes emphysema and heart disease, stroke, and diabetes. Smoking and chewing tobacco also causes 80 – 90 percent of oral cancers (mouth, lips, throat).

Second-hand smoke is harmful to those in range of your smoking. Your exhaled smoke can lead to the development of numerous diseases in loved ones, including cancer and heart disease. Young children take the biggest brunt of secondhand smoke with studies showing children of smoking parents being sick more often, having more respiratory infections (including bronchitis and pneumonia), and having ear infections more often.

As a periodontist, my dental specialty focuses on the diagnosis and treatment of all stages of periodontal (gum) disease as well as the placement of dental implants. When it comes to smokers, I have a unique view of what this does to one’s oral health.

When it comes to a smile, smokers have a higher risk for gum disease, bad breath, stained teeth, and higher levels of dental plaque. A smoker requires longer healing periods after extractions, oral surgery or gum therapy. Smoking is also a noted cause for dental implant failure.

The increased risk for gum disease is primarily the result of the drying effects that cigarette smoke has on oral tissues. A dry mouth creates a welcoming environment for oral bacteria accumulation and reproduction.

In its initial stages, gum disease causes persistent bad breath, tender gums that bleed when brushing, and gums that turn red in color. As it worsens, pus pockets form on gums and the infectious bacteria destroy bone and tissue structures that support tooth roots. Eventually, teeth will loosen and require removal.

In our office, we do not lecture patients. We respect individual preferences and feel it is our job to help patients to be informed rather than reprimanded. However, if you have not included your smile as one of the many reasons to kick the habit, you should.

Please note – Not only is gum disease an inflammatory disease, it has been associated with a number of serious health problems. These include heart disease, stroke, Alzheimers disease arthritis, diabetes, preterm babies, erectile dysfunction, and impotency. Add these to the long list associated with cigarette smoke and you have even more reasons to quit. Although, we know it is not an easy thing to do.

There are a number of online support sources for those who do wish to quit. Consider starting with the American Cancer Society’s online support at:

http://www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/index

If you smoke or have noticed signs of gum disease, call for an examination. Be aware that gum disease only worsens without treatment and is the nation’s leading cause of adult tooth loss. Call 828-274-9440 to schedule.

Stroke Risk Higher Due To Gum Disease

Posted on Mar 07, 2018 by William J. Claiborne, DDS MS

Ischemic stroke happens because of a blocked artery to the brain. Because the brain relies on oxygen and nutrients carried through blood, a blocked artery means the brain cells struggle. Thus, a blocked artery can eventually lead to dying brain cells and stroke.

Ischemic stroke is the most common kind of stroke and about 88 percent of all strokes. Most people with ischemic strokes are over the age of 60 and the risk goes up with each year. Certain conditions increase one’s risk for stroke, including high blood pressure, heart disease, smoking, and diabetes.

Having certain health conditions also make an individual more susceptible to stroke. These include narrowing of the arteries, an irregular heartbeat (a-fib), heart attack, abnormal heart valves, injury to blood vessels in the neck, or blood clots.

The very word ‘stroke’ conjures up the image of an individual with a droopy face and a dangling arm that fails to function. Some of us can remember a grandparent going from a busy, self-sufficient person to one who became bed-ridden or was never the same because of a stroke.

Although stroke recovery today is more successful, it remains a dreaded episode with life-altering outcomes in many instances. Of course, the goal is to prevent a stroke from ever occurring. There are a number of ways that today’s adults can lessen the risk, one being good oral health. Does that surprise you?

The oral health-overall health connection has become more front-&-center in scientific research. About half of Americans aged 30 years or older have periodontitis, which is an advanced level of gum disease. Obviously, this has given cause to a diligent pursuit in finding paths of its associated hazards.

Gum disease is actually an inflammatory disease, which has a strong association to one’s risk for stroke. Periodontal disease occurs when oral bacterial accumulate, eventually attacking the soft and hard structures that support teeth. Think of the inflammatory triggers of gum disease as similar to those of high blood pressure, for instance.

Periodontal disease is an inflammatory disease of the oral gum tissues. It can be mild or severe and begins with swollen, tender gums that may eventually lead to tooth loss. The oral bacteria of gum disease has been linked to a wide array of serious health conditions through past research.

These include heart disease, some cancers, Alzheimers disease, diabetes, preterm babies, arthritis and erectile dysfunction (ED). These are in addition to already-established links between gum disease and heart disease, high blood pressure and stroke.

Prior studies have also shown an association between periodontal disease and incident stroke risk. While a recent, U.S. based study reinforces the link between gum disease and the risk for stroke, it also shows that regular dental care may actually lower the risk for stroke. (https://www.diabetesdaily.com/blog/research-shows-link-between-periodontal-disease-and-stroke-538122/)

Researchers in the ARIC study (Atherosclerosis Risk in Communities), beginning in the 1980s, analyzed data from 10,362 middle-aged adults. None had experienced a previous stroke and participants were given dental evaluations and regular follow-up.

All were screened on their level of dental care and classified as either ‘regular’ (having routine dental visits more than once a year) or ‘episodic’ (those who saw a dentist only when something hurt, required repair, or didn’t see a dentist at all).

Researchers noted that the relationship between gum disease and myocardial infarction has been shown through previous studies as well as an association between gum disease and stroke.

So, could having good periodontal health reduce the stroke risk?

During the 15-year follow-up period, 584 participants had an incident ischemic stroke. The results indicated that adults who had regular dental care had half the stroke risk of those in the episodic category.

The study also showed that the more severe the periodontal disease was present, the higher the risk of future stroke.

Researchers surmised that a proper dental hygiene regimen combined with regular dental care can lower the risk of heart disease and stroke. (https://www.medscape.com/viewarticle/891550#vp_2)

Even after adjustments were made for race, age, sex, body mass index, hypertension, being diabetic, smoking, and education, those receiving regular dental care showed lower rates of ischemic stroke. The highest rate of stroke was seen among those who developed the more advanced levels of gum inflammation.

We all want to avoid health problems, especially something with consequences as severe as stroke. That’s why we have annual physicals, periodic screenings, and tests that can catch problems at early stages so only minimal treatment is needed.

Apparently, regular dental checkups play a major role in helping you avoid problems far beyond the mouth. As a periodontist, I have a unique understanding for how intricately the health of your mouth effects the health of your body.

When it comes to your overall health, good oral health obviously gives you a ‘leg up’ for whole-body health. If you’re behind on having 6-month dental checkups and cleanings, call 828-274-9440 to schedule a complete periodontal exam. Or, begin with a consultation. I’ll be happy to answer your questions and discuss treatment and comfort options during this time.

Dental Fears And Periodontal Disease – Likely Partners.

Posted on Mar 01, 2018 by William J. Claiborne, DDS MS

I’m not afraid of spiders. I don’t necessarily welcome them into my home but seeing one doesn’t ‘freak me out,’ either. However, I know several people who have a fear of spiders that goes beyond simply feeling creeped out by them.

Most of these individuals aren’t certain when or why their fear of spiders began. They just know they have it. For some people, it’s the same with fear of dentistry. While some adults can track back to precisely when and why their dental fears began, others aren’t quite sure.

In a dental office, some people react negatively but uncontrollably to sounds, smells and sights. However, when dental fears exist because of a traumatic experience in a dental chair (often as a child), we know the element of trust between the individual and his/her dentist was broken.

A dentist who continues a procedure on a patient while the patient is uncomfortable – whether an adult or child – can create an everlasting fear associated with dental visits. This moment is forever in the corners of a patient’s mind, evoking anxiety or fearful sensations every time a dental visit is considered. It’s the body’s way of triggering its ‘fight or flight’ response. Like shivering in the cold, it’s a reaction that is not easily controlled.

Although we cannot erase traumatic moments from one’s subconscious, we can help patients get past their fears and achieve healthy, confident smiles. And, the need for a healthy mouth is rising to the top as one of the most important aspects of having good, overall health based on a remarkable amount of research.

Research has found that certain strains of oral bacteria from gum disease create reactions in the body that can trigger systemic inflammation. Thus far, research findings have shown a correlation between periodontal disease bacteria and some cancers (including pancreatic and lung), Alzheimer’s disease, pre-term babies, heart disease, stroke, diabetes, arthritis and erectile dysfunction (ED).

As if all that weren’t bad enough, one study suggests that gum disease relates to a reduction in one’s quality of life: “Periodontal disease has been linked to lower quality of life.” “Quality of life encompasses several domains, including psychological functioning and social relationships among others. Oral health-related quality of life has been shown to be reduced in patients with periodontal disease.” (https://www.hindawi.com/journals/prm/2017/5491923/)

While estimates show about 75 percent of American adults have some degree of dental fear or anxiety, over 47 percent have some level of periodontal disease. As a periodontist, both are alarming numbers. Nearly half our nation is walking around with a potentially life-threatening disease in their mouths. Yet, many are unaware of its presence.

The symptoms of gum disease begin silently. When they do emerge, some people ignore them, such as seeing blood in the sink when brushing. There is a misconception that this is a sign of brushing thoroughly. (Wrong! See below for helpful tips for proper brushing.*) Other symptoms, such as sore, swollen gums and frequent bad breath may be assumed to be temporary problems.

If dental fears or anxiety have kept you from regular dental checkups for a year or more, it would be rare to NOT have some level of gum disease. Quite frankly, some people with high fear levels avoid seeing a dentist for decades. Those visits are vital in one’s ability to have healthy gums.

While twice daily brushing and daily flossing are necessary components for having good oral health, the routine alone isn’t enough to combat a number of additional factors that make one vulnerable to the disease.

For example, snacking on sweets or carbohydrates super-charges the oral bacteria in your mouth. And, these between-meal munchies set off an added acid attack in the mouth (as occurs any time we eat or drink as part of the digestive process). Couple this oral acid with sugar-loving bacteria and perhaps the extra acidity of a cola or catsup and WHALLAH you have a perfect recipe for destructive bacteria in the mouth.

What creates even more vulnerability is the lack of proper brushing techniques. A number of people swipe a toothbrush over easy-to-reach teeth, do a quick swish, and they’re done. And, as a study by Delta Dental revealed, only 7 out of 10 adults are brushing twice a day. This means that 30 percent aren’t brushing enough. (https://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits)

Like anything, using proper measures makes all the difference.

* Begin with a soft to medium bristle toothbrush and a fluoridated toothpaste. Pretend your mouth is divided into four sections and spend 30 seconds in each area. Swirl the toothbrush around all sides of your teeth, including the tops that have deep pits and crevices where bacteria can hide.

Hint: if your bristles are bent to the sides after a month or so, you’re pressing down too hard. Lighten up so the tips of the bristles swipe over the surface.

Floss daily to dislodge food particles caught between teeth. These bits can rot quickly and add to bacteria levels in the mouth. What’s that? Flossing is a pain? Electronic water flossers are affordable, easy to use, and do an effective job.

Once your teeth are brushed, brush the tongue to remove oral bacteria that burrow into its grooves. Be sure to reach the back portion where the majority exist. Swish and spit several times.

Hint: Consider purchasing a toothbrush that has a tongue scraping section (typically the reverse side of the bristles). For some people, this is more comfortable than brushing.

If you are one of the 75 percent who have dental fear or anxiety OR one of the 47 percent who have some type of periodontal disease OR – even worse – have BOTH, please call us to schedule a consultation to discuss restoring the health and appearance of your smile.

In addition to providing a specialized environment for treating all stages of gum disease, we are also experienced in helping fearful adults achieve good oral health and smiling confidence. We offer a respectful, compassionate staff, an inviting office setting as well as Oral and I.V. sedation (twilight sleep), if desired.

Call 828-274-9440.

Is Your Face Melting?

Posted on Feb 27, 2018 by William J. Claiborne, DDS MS

In dentistry, the term used for bone loss is resorption. This describes the melting away of bone structures that support teeth, caused by the loss of natural tooth roots.

The relationship that tooth roots have with the bone structures that support them is not something most people think about. We tend to focus on the teeth we see in a smile. Yet, loss of bone mass of the upper or lower jaws can create a number of problems – some related to oral health and some related to facial appearance.

To begin, understand that tooth roots provide nourishment and stimulation to the jaw bones. This helps the jaws to maintain a healthy depth. When tooth roots are removed, the bones slowly begin to shrink. This bone loss begins almost immediately, yet most don’t notice it until it reaches problematic levels.

Because we humans are visual creatures, I’ll begin by explaining the ‘look’ of bone loss, which results from changes in facial structures. Initially, you may only notice more wrinkles around the mouth. Later, you may realize that the corners of your mouth are turning downward, even in a smile.

The extreme visual change of bone resorption is referred to as a ‘granny look.’ This is when the shrinking jaw bones have caused the chin to become pointed and the mouth appears collapsed into the face. The nose gets closer to the chin and jowls form from the detachment of facial muscles. None of this is a good look.

Yet, what’s taking place beneath the gum tissues should be cause for even more concern.

For those who wear a denture or partial, losing jaw bone mass will cause a change in the way the denture or partial fits. For example, your denture may fit fine the first year after your teeth are removed and a denture is fitted. However, you’ll eventually notice slips when biting or chewing.

As bone loss continues, you’ll likely experience uncomfortable rubbing on tender gum tissues while eating. You may start to bypass foods that require rigorous chewing, such as a crusty bagel or thick pork chop. You may also worry about embarrassing slips when dining with friends or family.

When frequent applications of denture pastes or adhesives are of little help, a reline may be recommended by your dentist. Of course, this simply readjusts your denture or partial to fit the current contours of your gum ridge (the raised arch that your denture sits on). Eventually, continued bone loss will require yet another reline as the ridge flattens further.

Denture wearers are typically unaware that the pressure on the gums from wearing a denture actually speeds up the rate of resorption. This means that the problem will only continue, unless stimulation to the jaw bones is recreated.

One of the reasons we recommend dental implants is because of their ability to halt bone loss. Dental implants act as replacement tooth roots, thus restoring stimulation to the jaw bones. Additionally, dental implants use the same, sturdy foundation as natural teeth once had. This means you can bite and chew the foods you love without worrying about embarrassment or uncomfortable movement.

A Periodontist is a dental specialist who has advanced training in the treatment of gum diseases as well as in the diagnosis and placement of dental implants. He or she is specially trained to determine the best implant system for your needs. And, a periodontal specialist can enhance your outcome through proper placement.

If you are missing natural teeth or have become frustrated with a denture or partial, call 828-274-9440. You can begin with a consultation to discuss the type and number of implants most appropriate for your needs. We can also explain the procedural process, comfort options, and review easy payment options.

Your smile goes much deeper than what you see in the mirror. Make sure its structure is solid. Dental implants, which are designed to last your lifetime, can help you enjoy a confident, worry-free smile through your life.