Pregnancy & Your Gum Health

Posted on Jul 09, 2020 by William J. Claiborne, DDS MS

Today’s American female has a long list of guidelines that enhance the potential to have a healthy, full-term baby. Even so, pre-term births in this country occur at a rather high rate for the advanced health care available to most.

According to data released in 2017 by the National Center for Health Statistics (NCHS), the U.S. preterm birth rate actually rose from 2015 -2016, from 9.6 percent of births to 9.8 percent.

There seems to be a rather close connection between gum disease and preterm babies, as unrelated as the two may seem. First, consider the risks cited by the Centers for Disease Control & Prevention (CDC). As far back as the year 2000, the Surgeon General warned that pregnant females who had gum disease had a far greater risk of a pre-term, low birth weight baby.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and low birth weight babies (less than 5.5 lbs.).

“Studies have found that expectant mothers with periodontal disease are up to seven times more likely to deliver premature, low birth weight babies.” (https://www.adha.org/resources-docs/7228_Oral_Health_Total.pdf)

One study showed the preterm birth rate for pregnant women with moderate to severe periodontal disease to be nearly 29%.

Estimates are that over half of pregnant women have some form of gingivitis (gum inflammation, an early stage of gum disease) or periodontitis (infectious, advanced gum disease). Nearly a third of pregnant females will acquire gum disease because of their higher vulnerability to inflammation.

Infections in the mother have been identified as increasing the risk for pregnancy complications. Due to varying hormone levels, nearly all females will develop gingivitis during their pregnancy.

Referred to as pregnancy gingivitis, symptoms include swollen, tender gums that bleed easily when brushing. The goal is to halt the inflammation before it progresses to a more infectious stage.

Most obstetricians now urge their pregnant patients (or those trying to conceive) to have a thorough periodontal examination. Even with no obvious signs, gum disease can still exist. It lies beneath the surface of the gum tissues and should be resolved before it worsens and is able to seep into the bloodstream.

Symptoms of gum disease include gums that bleed when brushing, swollen or tender gums, receded gums or gums that darken in color.

When periodontal disease is present, successful treatment has shown to lower the risk of preterm births. A periodontal specialist is trained to treat all levels of disease in a way that is safe for pregnant women (as well as all patients).

Pregnancy is not the sole risk factor for developing gum disease, of course. Most adults of both genders have at least one factor that heightens susceptibility to this oral infection. Among these are stress, poor diet with high sugar intake, smoking, obesity, age, and poor dental hygiene can all contribute to an increased potential for developing periodontal disease.

Other risk factors include clinching or grinding teeth, predisposition due to genetics, diseases such as diabetes or cancer, some medications, and changes in female estrogen levels (puberty, pregnancy, menopause).

Gum disease bacteria is obviously a potent threat to any individual. As the nation’s leading cause of adult tooth loss, oral bacteria of this disease have been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

If you have symptoms associated with gum disease, schedule an appointment at your earliest convenience by calling 828-274-9440. Gum disease will only worsen without treatment.

Pregnant? Make Oral Health A Particular Priority!

Posted on Apr 23, 2019 by William J. Claiborne, DDS MS

With pregnancy, there seems to be a long list of do’s and don’ts for the mom-to-be. For instance, pregnant women are advised to avoid most drugs, alcohol, certain foods, and all smoking! Proper exercise, a balanced diet, and plenty of sleep help to keep both mother and baby healthy when it comes time for delivery.

Now, obstetricians are urging their pregnant patients (or those trying to become pregnant) to add a very important item to this list. They are advising particular devotion to achieving and maintaining good oral health.

The reason to keep a healthy mouth is based on decades of research and findings related to how infectious bacteria of periodontal (gum) disease can penetrate the bloodstream. Once bloodborne, the bacteria are able to activate inflammatory triggers elsewhere in the body.

A mother-to-be is especially vulnerable to gum disease due to hormonal changes during her pregnancy. Almost 50 percent develop pregnancy gingivitis, a mild form of gum disease that causes gums to become swollen, tender and bleed easily when brushing.

However, because of their susceptibility, the risk for full-blown gum disease is higher for pregnant females with nearly a third developing gum disease.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and babies of low birth weight (less than 5.5 lbs.). One study showed the preterm birth rate for females without gum disease to be approximately 11 percent compared to nearly 29 percent for pregnant women with moderate to severe periodontal disease.

It has also been shown that gum disease increases the likelihood for late-term miscarriage and pre-eclampsia. When oral bacteria reach placental membranes via the bloodstream, inflammatory reactions were found to trigger pre-eclampsia or early labor.

One study showed that pregnant women with higher blood levels of antibodies to oral bacteria also had higher incidences of preterm birth and babies of low birth weight. These elevated antibodies have been found in amniotic fluid and fetal cord blood samples of infants who were preterm or of low birth weight at birth.

When periodontal disease is present, however, successful treatment has shown to lower the risk of preterm births.

For all individuals, however, the bacteria of gum disease is coming to light as a major contributor to a number of serious health problems. It is the nation’s’ leading cause of adult tooth loss and has been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

Once the infectious bacteria of gum disease enter the bloodstream (typically through tears in weakened gum tissues), it can trigger inflammatory reactions, many serious and some that can have deadly consequences.

It is important to know the signs and symptoms of gum disease. These include gums that bleed when brushing, frequent bad breath, swollen or tender gums, gums that pull away from the base of teeth, or gums that darken in color.

While any of these should prompt an individual to seek out periodontal treatment, pregnant women have a particular need to seek care. A periodontist has specialized training in the diagnosis and treatment of all levels of gum disease – in a way that is safe for pregnant women (as well as all patients).

If you have any of the symptoms mentioned above (whether pregnant or not), you are urged to schedule an appointment at your earliest convenience. Call 828-274-9440 to arrange an examination to begin.

Why You May Have A Metallic Taste In Your Mouth.

Posted on Sep 12, 2018 by William J. Claiborne, DDS MS

Occasionally, a patient will mention that they have been having a metallic taste in their mouth. After several questions, I’m usually able to determine that the condition is related to a prescription they’re taking. As a matter of fact, the majority of people who notice a metallic taste experience this due to a medication’s side effect.

The most common medications to cause a metallic taste in the mouth are antibiotics, antihistamines, some OTC supplements, and medications that treat blood pressure, neurologic and cardiac conditions.

Pharmacy Times states that “more than 300 drugs are associated with metallic taste” and that “as many as 11 percent of elderly patients who take multiple medications experience taste problems.” (https://www.pharmacytimes.com/publications/issue/2015/july2015/drug-induced-metallic-taste-no-irony)

This occurs when the body ingests and absorbs medications with iron, chromium, calcium, and zinc, which all cause a metallic taste in the mouth. The body absorbs these substances, which are released and excreted in the saliva, often resulting in a metallic taste. In addition to causing this taste, another common medication side effect is dry mouth, which can also cause a foul or metallic taste.

Dysgeusia is the medical term used to describe an abnormal or impaired sense of taste.

An excess of zinc in the body – or even lack of – can also cause taste changes. Malnutrition can lead to a zinc deficiency, slowing cell renewal that alters taste. Taking too much zinc (typically through supplements) can trigger dysgeusia that causes a metallic taste.

Another common source for a metallic taste are respiratory infections, including colds, sinus infections, and middle-ear infections. Anything that causes congestion and mucus may lead to having a foul or metallic taste in the mouth.

Pregnancy can also alter your sense of taste due to hormonal changes. Tasting metal in the mouth is not unusual. This usually occurs in the first trimester and subsides in the second.

Some people are surprised to learn that poor oral hygiene can cause a metallic taste in the mouth. When oral bacteria accumulate to the point of causing inflammation, a metallic taste may be detected in the mouth. This is why it is important to have dental check-ups every six months and be committed to a thorough, daily oral hygiene routine at home.

While chemotherapy is known to cause nausea, another common complaint of patients undergoing chemotherapy is having a metallic taste in the mouth. Just as certain components of oral medications can emerge in saliva, drugs administered intravenously can also emerge in the saliva, causing “metal mouth.”

Allergic reactions that trigger sinus reactions can lead to a metallic taste as well. Allergens most often associated with causing a metallic taste include tree pollen, tree nuts, and shellfish, according to Medical News Today. (https://www.medicalnewstoday.com/articles/313744.php) Some people may have a metallic taste in their mouths for up to 2 days after eating pine nuts, which are commonly used in salads and pesto.

Too, a side effect of mercury poisoning is a metallic taste in the mouth. Although the neurological issues associated with mercury poisoning are more concerning, tasting metal in the mouth may serve as an early warning sign. By recognizing this as one of the indications of mercury toxicity, it may hopefully motivate people to seek medical evaluation.

Finally, liver or kidney disease can cause a metallic taste in the mouth. These conditions create a buildup of chemicals in the body, which are released into the saliva. For patients with severe kidney disease, the excess production of ammonia shows up in the saliva, causing a metallic taste in the mouth.

It’s amazing at how intricately and integrally connected each part of the body is to all other parts. Just as a skin rash may indicate an allergic reaction to something eaten, the mouth can be an indication point of things off-kilter in other areas.

If you suspect that your “metal mouth” is the result of a medication, it may subside (or lessen) after a few weeks. If not, it may be wise to have other areas checked. Your zinc levels, hormones, oral health, and other items may need to be evaluated to ensure all parts of your body are in proper balance.

Women & Oral Health – Particular Challenges Exist At Many Ages.

Posted on Aug 20, 2018 by William J. Claiborne, DDS MS

The female body is a uniquely complex structure in its ability to produce offspring and feed their young. With this comes the integral interaction of much more than its housing, of course. Females have an intricate system of hormonal components that help to manage these systems in order to maintain their own health as well as that of their young.

As a male who spends the majority of his days surrounded by females – working with a mainly female staff during daytime hours and spending the rest of my hours with my wife – I have an appreciation for women of all ages. From the perspective of a periodontist, I also have an understanding of how our female patients can endure particular challenges as a result of hormonal fluctuations.

Unlike the skin, which may cause an obvious rash after consuming something that causes allergic response, the gum tissues don’t give obvious visual indications when oral health is effected. However, your gum tissues may be more reactive to hormone levels that you realize.

Although gum tissues tend to redden when inflamed, an oft first-noticed symptom is tenderness or swelling. These issues are usually accompanied by redness, which tends to be noticed after other symptoms emerge. And, these other symptoms may be much more attention-getting.

For example, tender gums that bleed when brushing are hard to ignore. While these are symptoms of early periodontal disease (also known as gingivitis), the color of gum tissues can be easily overlooked since they are hidden inside the mouth.

Yet, an imbalance in the body that lies far beyond the mouth can trigger oral symptoms that need prompt attention before worsening. For example, pregnancy gingivitis is not uncommon in women during pregnancy. If not treated and resolved, however, it can develop into full-blown periodontal disease, which is the nation’s leading cause of adult tooth loss.

Below are some of the different phases of life that can be accompanied by various challenges to a female’s oral health:

• Puberty: Estrogen and progesterone hormones produced during puberty increase blood flow to the gums. This changes how the gums respond to plaque, the sticky film of bacteria in the mouth. With this may be gums that bleed when brushing and become red, tender, and swollen.

• Menstruation: The menstrual cycle causes hormonal changes that cause some women to experience symptoms such as swollen gums that turn bright red, canker sores, or gums that bleed easily. Referred to as menstruation gingivitis, this usually occurs just prior to the onset of the period and resolves in a day or so.

• Oral Contraceptives: Taking birth control pills that contain progesterone also causes some women to have gum tissues that become inflamed. This occurs from heightened sensitivity to the toxins produced from the overload of bacteria that form plaque. For many women, the gums become less reactive after the first few months of starting birth control pills. Some medications, such as antibiotics, can lower the effectiveness of oral contraceptives. This is why it is important to keep your dentist updated on all medicines you take.

• Hormone Relationship to the TMJ: It has long been known that more women have TMJ disorders than men. This prompted researchers to look into a possible hormone-related connection. The temporo-mandibular joints (known as TMJ), are the jaw joints. These are located on each side of the head in front of the ears and hinge the lower jaw (the mandible) to the skull. These TMJ are designed to move harmoniously each time you speak, chew, yawn or laugh. Now, research has shown that the use of birth control pills can lead to decreased levels of producing natural estrogen. Studies have found that decreased natural estrogen with the combined effect of the joint compression from TMJ disorders can lead to increased inflammation. In some individuals, this inflammation can result in osteoarthritis in the joint.

• Pregnancy: With each trimester of pregnancy, hormonal levels can change. Pregnancy also causes an increased level of progesterone, which can increase your risk for the formation of plaque. This can lead to pregnancy gingivitis, particularly during the second to eighth month of pregnancy. This condition causes the gum tissues to become swollen and bleed easily. Because gingivitis is the first stage of gum disease, it is important to have it fully resolved so it does not progress further. Because studies have found that gum disease can cause a heightened risk for preterm and low birth weight babies, obstetricians are cautioning their pregnant patients to be particularly diligent in maintaining good oral health..

 • Menopause: As we age, a variety of changes can take place in our mouths, whether male or female. Saliva flow is less plentiful, the mouth is less moist, and side effects of taking medications can pose challenges to keeping the gums healthy. Dry mouth, a particular challenge, is a leading cause of gum disease. Without adequate saliva flow to keep the mouth cleansed and being efficient in neutralizing the acids from plaque, the risk for gum disease is greater for females, especially those in menopausal years. Declining estrogen levels also place women at greater risk for bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is bone loss of the jaw, it can result in tooth loss. Receding gums are a sign of this bone loss since more of the tooth surface is expose to the causes of tooth decay.

Regardless of where you are in your lifespan, if you are a female, it is especially important to be aware of the signs and symptoms associated with these conditions. Having healthy gums is even more important now that science has shown a link between many serious health problems.

If you suspect you have some level of gum disease or have delayed having regular dental check-ups, begin with a consultation appointment. During this time, we’ll discuss your unique needs and how we may be the best fit for your oral health goals. Call 828-274-9440 to schedule.