Understanding Terms Associated With Gum Disease

Posted on Jan 23, 2017 by William J. Claiborne, DDS MS

Occasionally, I catch myself using dental terminology during patient conversations. As a Periodontist, ‘perio-talk’ is second nature to me. Deep down, however, I know it isn’t always clear to my patients.

I believe that patients are better participants in their oral health when they understand specifics of their individual needs. When I say ‘perio’ instead of ‘gum tissue,’ the patient doesn’t always ask for a better explanation, even though they may not be sure of the term’s meaning. This leaves us both at a loss – the patient doesn’t fully grasp their needs and recommended solution and I have a patient who is unsure of the ‘why’ and ‘how.’

Although dental implant placement and gum recontouring are regular treatments we provide, periodontal (gum) disease is the most frequent problem we treat. Gum disease affects over 47% of American adults and is the nation’s leading cause of tooth loss. It has been linked to heart disease, high blood pressure, stroke, memory loss, arthritis, diabetes, preterm babies and impotency.

Because gum disease begins without obvious symptoms, people often ignore the warning signs. This tends to allow the disease to progress further. As a basic explanation of how gum disease forms, I’ve listed the progression below — with dental terminology omitted!

• Oral bacteria – Bacteria in our mouths is normal. However, an overload of bacteria is how the problem begins. When oral bacteria are not removed on a daily basis, they amass and form plaque.

• Plaque – This is a sticky film that coats teeth and covers the gums and tongue. It can be felt by running the tongue over teeth at the end of the day before you brush. Plaque forms quickly, from the time you brush in the morning to the time of your evening brushing. The presence of plaque signals that your mouth is harboring more bacteria than saliva flow can rinse away. When plaque is not removed on a daily basis, oral bacteria thrive, reproduce, and harden into calculus.

• Calculus – Also known as tartar, calculus is a cement-hard mass of bacteria that develops from plaque. This colony of bacteria attaches to tooth enamel and can only be removed with special instruments used by dental professionals. This is why your 6-month check-ups and cleanings are so important. By preventing the formation of calculus or having it scraped off on a regular basis, you can avoid damage to gums and enamel.

• Gingivitis – This is the first stage of gum disease. Here, oral bacteria reproduce at a rapid rate while attacking gum tissues and tooth enamel. Signs of gingivitis are gums that bleed easily when brushing, sore gums, and frequent bad breath. When tended to promptly, gingivitis can be halted and reversed. Treatment requires twice daily brushing (at least two minutes) with a soft to medium bristle tooth brush and flouride toothpaste. Daily flossing is also needed to remove food particles and bacteria between teeth. Tongue scraping is advised to remove oral bacteria embedded in the grooves of the tongue. An alternative to a tongue scraper is to brush the tongue with your tooth brush. Be sure to get to the back of the tongue where the greatest concentration of bacteria are embedded. Drink lots of water and swish daily with an oral rinse that kills bacteria. Limit sugar-laden foods and beverages as well as caffeine (which is drying to oral tissues).

• Periodontal (Gum) Disease – When gingivitis progresses, the next stage is periodontal disease. This is when oral bacteria are at a deeper level, eating gum tissues and tooth enamel while creating inflammation. Typical symptoms are red and swollen gums, gums that recede and expose sensitive tooth root areas, and persistent bad breath.

• Periodontitis – This advanced stage of gum disease includes infectious bacteria that cause the gums to be red and tender all the time. In addition to the symptoms of previous stages of gum disease, pus pockets form at the base of some teeth. Some teeth will loosen as bacteria attack the structures that support tooth roots. Eventually, teeth will require removal. Even worse, this potent bacteria can enter the bloodstream through tears in diseased gum tissues. This has been found to trigger internal inflammation that has been found to contribute to the severe health problems mentioned prior (heart disease, arthritis, etc.).

I believe if the general population were more aware of the sequence that leads to full-blown gum disease, we’d have healthier adults, far less people who wear dentures or partials, and people who are enjoying confident smiles. If you are experiencing symptoms of gum disease, please remember that these will only worsen when treatment is delayed.

I hope I’ve provided a helpful explanation of how oral bacteria progresses and how it effects your oral and overall health. For an examination to assess the health of your gums along with recommended treatment options, call 828-274-9440 to arrange a consultation appointment. We will discuss your current situation and potential treatment options.

To Floss Or Not. The Debate Goes On.

Posted on Jan 10, 2017 by William J. Claiborne, DDS MS

I’m not fond of taking out the trash. It’s one of those chores I don’t like to do and only do it because I know the consequences of ignoring a full trash can. I take the trash out each day because I’d rather spend those few minutes doing it than have smelly odors (and no telling what else!) emanating from the kitchen can.

As a specialist in treating periodontal disease, I have encouraged countless patients over the years to spend 1-2 minutes a day flossing their teeth. It’s not something anyone particularly enjoys. It’s just one of those things that, in my opinion, is well worth the time and energy.

Brushing teeth doesn’t always remove debris in the mouth. Flossing helps to remove food particles caught between teeth that a tooth brush cannot reach or dislodge. Removing this debris is important before the particles begin to break down and ‘feed’ oral bacteria.

As food particles remain in the mouth, oral bacteria thrive. While they consume, bacteria multiply. This means the more bacteria present, the more there are to multiply. This occurs so rapidly that the sticky film you feel on teeth at the end of a day is simply a coating of oral bacteria that has accumulated since your morning brushing.

This film, by the way, is known as plaque, which coats the teeth, tongue and gums. When not removed on a frequent basis, plaque can form cement-hard bacteria colonies that attach to teeth. This hardened form of bacteria is known as tartar (or calculus) and is what your hygienist is scraping off during dental cleanings. Once formed, tartar cannot be brushed or flossed away.

Obviously, keeping oral bacteria levels to a minimum is an important part of avoiding problems such as cavities and gum disease. Brushing and flossing are the tried-&-true standards for accomplishing this. However, like most things, a proper technique is needed to truly make a difference.

Just how important is technique? A study conducted by the University of Washington School of Dentistry found that when children between ages 4 – 13 had their teeth professionally flossed five days a week for a year and a half, there was 40% drop in cavity risk. The same age group who flossed on their own saw no such benefit.

This is one of the reasons many dentists and periodontists recommend water flossers. They are easy to use, affordable and often more effective than the flossing techniques of most people, adults and adolescents alike.

There have been debates in the dental profession on past studies that claim flossing provides little benefit. Some feel study participants were not followed long enough to determine true effectiveness and proper flossing techniques were not monitored. However, there is no debate regarding the benefits of keeping bacteria levels in the mouth to a minimum.

In spite of daily flossing and twice daily brushing, other factors can impact your potential for a healthy mouth. Every time you eat, an acid attack begins in your mouth. While this is the initial part of the digestive process, this acid places tooth enamel in a vulnerable position. For those who are frequent snackers, they have higher risk of oral problems since their frequent eating triggers more acid attacks during the day.

This is also true for people who sip colas during the day. When the acid in the soda combines with the drink’s sticky sugar, its potency doubles when it mixes with the acid in the mouth. This double-whammy of acid is a direct path to cavities and other problems.

If non-flossers could see the number of adults I’ve seen who have lost teeth due to insufficient oral hygiene, flossing wouldn’t look like such a chore. Regardless of the debate on flossing, taking an additional measure for fresher breath, fewer cavities and healthier gums is worth the small amount of effort needed.

Is It Your Bad Breath They’ll Remember?

Posted on Jan 05, 2017 by William J. Claiborne, DDS MS

Business Insider says you have just 7 seconds to make a first impression. (http://www.businessinsider.com/only-7-seconds-to-make-first-impression-2013-4). That’s not a lot of time, but just enough to make a lasting impression. If you’ve ever met someone who has bad breath, that memory seems to stand out far more than if they had a piece of spinach in their teeth, for example.

No one wants to be associated with bad breath. If you suspect you have bad breath, you probably do. We all have occasional bad breath, but frequent bad breath is a symptom of periodontal disease. This is often accompanied by tender gums that bleed when brushing. As the disease progresses, your gums will darken in color and recede from teeth. Without treatment, teeth will eventually loosen and may require removal.

However, occasional bad breath has one origin – oral bacteria. Accumulated oral bacteria are the source of about every problem that occurs in your mouth. A few simple measures can help you keep oral bacteria to a minimum an enjoy the confidence of fresh breath and being close with others.

Oral bacteria are living, eating and reproducing organisms that thrive on rotting food in the mouth. As they accumulate, a sticky film known as plaque forms. If not brushed away daily, plaque hardens on teeth into tartar (or calculus). This cement-hard form of bacteria attacks tooth enamel and eats away at tender gum tissues.

When gum disease is the source of persistent bad breath, it produces a foul odor in the mouth even shortly after brushing. Gum chewing and mints may temporarily camouflage the odor, but not for long. Because the tissues in the mouth are continuously being destroyed, the lingering odor prevails, even after brushing.

Dry mouth is a contributing factor to bad breath, primarily because oral bacteria can rapidly reproduce when not regularly cleansed away through saliva. Saliva is designed to sweep bacteria from the mouth on a consistent basis. Without sufficient saliva flow, bacteria are able to accumulate at a more rapid pace.

Some causes for dry mouth are smoking, certain illnesses, snoring, mouth-breathing, and side effects of some medications. Drinking alcohol and caffeinated beverages are also drying to the mouth. The aging process can leave adults with insufficient saliva flow as well.

When you feel your mouth is dry, the ideal aid to saliva is drinking filtered water. Water is the perfect beverage when it comes to supporting your oral health. It also helps to keep your body hydrated, which aids in its overall function. Chewing sugarless gum is another way to help saliva flow and advised after meals when brushing is not possible.

The tongue is another source of oral bacteria. With its tiny grooves, bacteria embed in the tongue and enjoy a warm, moist haven for reproduction. This is why using a tongue scrapper daily or brushing the tongue with your tooth brush can significantly reduce the amount of bacteria in your mouth. Be sure to get to the back of the tongue where the majority of oral bacteria are embedded.

The bottom line to having fresh breath is to control the bacteria levels in your mouth. Begin with a clean mouth through your six-month dental cleanings and exams. These appointments help to remove buildup that has accumulated between visits, reducing the amount of bacteria in the mouth.

Then, renew your commitment for a thorough at-home regimen. Brush for at least two minutes twice daily, floss daily and use a tongue scraper or brush your tongue. Drink lots of water throughout the day. Avoid sugary treats and drinks since bacteria are super-charged by sugars and carbohydrates. Limit caffeine and quit smoking. Swish after eating or drinking, especially caffeinated or alcoholic beverages, to counteract drying effects.

Love your mouth and your reward will be fresh breath and a healthy smile. If your breath is frequent or you are seeing blood in the sink when brushing, call 828-274-9440 to schedule an appointment. Gum disease will only worsen without treatment.

Study Links Pancreatic Cancer And Oral Health

Posted on Jan 02, 2017 by William J. Claiborne, DDS MS

Numerous studies have found links between oral bacteria and serious health problems that extend far beyond the mouth. The inflammation triggered by infectious oral bacteria have been linked to heart disease, arthritis, diabetes, stroke, high blood pressure, preterm babies and even impotency.

Now, findings from one study reveal periodontal (gum) disease bacteria as a potential contributor to pancreatic cancer. While this has been suspected from the results of previous studies, this long-term study focused primarily on how the risk exists.

The study analyzed DNA from saliva samples from over 360 adults who eventually developed pancreatic cancer. Researchers compared these samples to the DNA in saliva of a similar number of adults who remained healthy.

Adjustments were made in both groups for variations in age, race, sex and body mass as well as alcohol use, smoking and being diabetic. Subjects who developed pancreatic cancer within two years after the DNA samples were taken were omitted to eliminate pre-existing factors that could influence statistical outcomes.

With the findings from prior research, this study allowed researchers to zero in on two specific types of periodontal disease pathogens. Researchers noted that one pathogen was more prevalent in the saliva of participants who developed pancreatic cancer, who showed a fifty-nine percent greater risk of developing pancreatic cancer. The second pathogen was shown to increase this risk by fifty percent.

Because it is typically not diagnosed until at advanced stages, pancreatic cancer has a deadly track record. This year, over 50,000 people will be diagnosed with pancreatic cancer. Less than ten percent will survive more than five years.

For years, research showed that the infectious bacteria of periodontal disease could enter the bloodstream through tears in diseased gum tissues. It was found to be a trigger for inflammatory reactions elsewhere in the body. This has been linked to heart disease, stroke, high blood pressure, diabetes, arthritis, preterm babies, impotency and other cancers.

In early stages, periodontal disease begins with tender gums that bleed easily when brushing and frequent bad breath. As it progresses, the gums become tender and swollen, deepen in color from a healthy pink to red, and cause persistent bad breath. Eventually, teeth will loosen and may require removal. Because over sixty-five percent of American adults have some level of periodontal disease, it is the nation’s leading cause of adult tooth loss.

Hopefully, the general public will learn of extensive research results that show that periodontal disease bacteria is destructive and deadly. As findings from further studies continue to be revealed, it is important to be proactive when it comes to the symptoms of periodontal disease. Remember, gum disease will only worsen without treatment.

Call 828-274-9440 to arrange a consultation. I’ll be happy to answer your questions and recommend ways to help you achieve a healthy, confident smile.