When Dentures Are “Slippery,” “Wobbly, or “Rocky”…

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

A periodontal specialist has advanced training in the selection and placement of all dental implant types. Also a specialist in the treatment of all stages of periodontal (gum) disease and the contouring of gum tissues (such as to correct a “gummy smile”), many patients who come to us have lost teeth due to gum disease.

Gum disease is the nation’s leading cause of adult tooth loss. Sadly, over 47% of Americans over the age of 30 have some level of gum disease. Many do not realize they have developed gum disease since it can begin without obvious symptoms.

Periodontitis is the advanced stage of gum disease. Its symptoms are hard to ignore. Breath odor is putrid. The gums bleed easily, at times even when eating. The gums are a dark red and may have a spongy texture. Some teeth may loosen or shift. Pus pockets form around the base of some teeth.

In this advanced stage, some (or all) natural teeth may require removal. For those who choose to replace teeth with a denture or partial (versus dental implants), something occurs below the gums that cannot be seen. However, over time, the repercussions can be quite severe.

What I’m referring to is “resorption.” This is the term used for a shrinking jaw bone.

Resorption occurs when natural tooth roots are no longer present in the jaw bone. These tooth roots actually help to provide stimulation to the bone. Tooth roots also nourish the bone mass through connective tissues that extend down through a tooth’s interior.

When a tooth is removed, the stimulation and nourishment to that area of the jaw bone is taken away. Without it, the bone begins to shrink. As it declines in height, the adjacent teeth are more vulnerable to loss. Statistics show that teeth neighboring areas where natural teeth are missing will be the most likely to be lost next.

Although a denture or partial can mimic the presence of teeth above the gum line, there is nothing to keep the jaw bones healthy beneath, which is the sturdy foundation for biting and chewing strength. As tooth loss continues, one can go from losing a few teeth to losing all teeth (being “edentulous”).

Many people are unaware that the pressure of wearing dentures or partials accelerates the pace of resorption. For people who sleep in their dental prosthetic, the 24/7 pressure applied to the jaw bones speeds up the rate of bone decline even more.

Sleeping in a denture can also add to higher risks for the flu and pneumonia. A 3-year study of more than 500 adults was published by the Journal of International Oral Health. Of the 186 (of 453 denture wearers) who did not remove their dentures for sleeping, they had over twice the risk for pneumonia than those who did. Sleeping in dentures also led to higher levels of tongue and denture plaque, gum inflammation and other oral issues.

For those who wear a denture or partial, losing jaw bone mass also causes a change in the way the denture or partial fits. For example, a denture may fit fine the first year after teeth are removed and a denture is custom-fitted. However, people eventually notice slips when biting or chewing. This is because the bone under the “arch” that supports the denture or partial is declining in height.

The changing foundation for the denture (also known as a ridge) allows it to “slip” or become “wobbly.” As bone loss continues, it causes uncomfortable rubbing on tender gums while eating.

As a result, people often adjust their diet to avoid foods that require rigorous chewing, opting for softer foods that require less chewing. Outings with friends and family become overshadowed by the fear of embarrassing slips.

Eventually, even frequent applications of denture pastes or adhesives are of little help. A reline may be recommended by your dentist to reshape the contours of the denture or partial to the slowly declining arch. Unfortunately, this process will continue as bone loss requires periodic relines as the arch flattens further.

The solution?

For most individuals who are missing one or more natural teeth, we advise replacing teeth with dental implants. A dental implant recreates the presence of a natural tooth. It provides stimulation to the bone, halting the process of bone loss.

Dental implants do not rely on neighboring teeth for support, as in a crown-&-bridge combination. The crowning of bordering natural teeth to support a bridge is not needed. Thus, the integrity of surrounding teeth is protected.

Because dental implants are supported by the jaw bone, sturdy and dependable biting and chewing strength is restored. Eating a healthy diet of the foods you love is again possible.

And, dental implants also have an exceptional success rate, higher than any implant-in-bone option. They are designed to last a lifetime, making them an excellent investment.

If you are considering dental implants to replace missing teeth, we invite you to begin with a consultation appointment. This will take place in a private room where we can discuss your needs and concerns. Call 828-274-9440 to schedule, or tap here for more contact information.

 

Mental Health Can Adversely Affect Oral Health

Posted on Mar 06, 2023 by William J. Claiborne, DDS MS

It seems almost every week that I read findings of recent studies that correlate oral health to overall health. It is not surprising that research newly shared reveals connections of how mental health can affect oral health, and vice versa.

It shows that people with mental conditions can be a contributing factor to poor oral hygiene. These conditions include depression, mood disorders, anxiety, OCD (obsessive-compulsive disorders), mood disorders, and eating disorders. These individuals are 2.7 times more likely to experience tooth loss early.

One factor is anxiety and panic, which are often associated with dental treatment.

According to the National Institute of Mental Health, mental illnesses in the U.S. Nearly 1 in 5 adults have with a mental illness (52.9 million in 2020). These numbers have increased post-pandemic.

The Mayo Clinic shared:
“Surveys show a major increase in the number of U.S. adults who report symptoms of stress, anxiety, depression and insomnia during the pandemic, compared with surveys before the pandemic. Some people have increased their use of alcohol or drugs, thinking that can help them cope with their fears about the pandemic. In reality, using these substances can worsen anxiety and depression.”

Poor dental health can be seen in depressed people by a dentist. For example, over 46% of depressed people report tooth pain without apparent cause, known as atypical odontalgia. Too, burning mouth syndrome is an oral condition more common with adults suffering from depression.

Additionally, mental conditions have been linked to oral conditions, such as:
Gum inflammation
Periodontal disease
Cavities
Dry mouth
Chronic jaw and facial pain
Oral ulcers

The relationship between the two – oral health and mental health – seems to lie in cortisol levels. Cortisol is a stress hormone. Stress and anxiety cortisol levels that are too high adversely affect the immune system. This increases the risk of gum disease, oral sores, and infections.

Seeking professional help at the right time is essential to manage an excellent oral and mental state and overall health.

There is also a domino effect once depression or anxiety trigger an imbalance in cortisol. When one’s smile is in poor condition (cavities, stained teeth, missing teeth, bad breath), it can lead to low self-esteem and social isolation. This contributes to a lower quality of life and, in turn, disrupted mental health.

Mental health status has been shown to activate, aggravate or worsen oral problems. These include…

•Gum health and periodontitis (advanced gum disease)
When stress and periodontal disease negatively impact the body’s immune system, inflammation often worsens gum disease. Too, people who endure ongoing stress are more likely to smoke, drink alcohol, or take drugs. These can cause people to neglect maintaining good oral hygiene and be less committed to having regular dental checkups.

•Dry mouth
Eating disorders (such as anorexia nervosa and bulimia) can reduce the amount of saliva – the mouth’s bacteria-rinsing agent. A dry mouth enables the growth of bacteria. Add to this is how many antidepressant medications have a side effect of causing oral dryness.

•Pain in jaw joints
Chronic stress and anxiety are frequent contributors to facial and jaw pain. Teeth grinding and clenching are not uncommon among people with mental conditions. These actions can cause broken, worn or chipped teeth in addition to the painful conditions associated with TMJ disorders.

•Oral ulcers
Lip, tongue, and ulcers inside the mouth can occur more often in people under frequent or chronic stress.

•Developing Cavities
Individuals with mental illnesses are more likely to have dental decay due to a rise in cavity-causing bacterium with a reduced saliva flow – a recipe for developing cavities.

•Tooth erosion
Bulimia is an eating disorder in which vomiting is used to lose weight. Over a third of bulimia patients with eating disorders suffer from tooth erosion due to regurgitated stomach acids that cause tooth erosion.

•Oral cancer
When dental health neglect is coupled with heavy consumptions of alcohol and smoking, the risk of oral cancers increases. Persons who are heavy smokers and drinkers are 50 times more likely to get oral cancer compared to those who never smoke or drink heavily.

Obviously, mental health is closely connected to your oral health. Begin by speaking with a therapist or mental health specialist. Taking care of your mental health is vital to overcome related dental issues.

If you are noticing any of the signs of oral health problems, you should see a periodontal specialist as soon as possible. These signs and symptoms include:
– Bleeding gums when brushing
– Frequent bad breath
– Red, swollen gums
– Gums that are tender or sore
– Gums that pull away from the base of teeth
– Loose teeth

A periodontist is a dental specialist who can help you restore your oral health and enjoy a confident smile. If you’ve experience tooth loss, a periodontist also specializes in the placement of dental implants.

Our Asheville periodontal office also provides sedation options. These include oral and I.V. sedation (“twilight sleep”). These are administered safely by a doctor of anesthesiology who uses advanced safety equipment to monitor you throughout your procedure.

Call 828-274-9440 to schedule an exam or an initial consultation to get to know us better.

Sources include:

https://healthnews.com/family-health/dental-and-oral-health/how-mental-illness-affects-your-oral-health/

https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/mental-health-covid-19/art-20482731

https://health.uconn.edu/sbirtacademy/wp-content/uploads/sites/101/2016/08/Dental-brochure.pdf

How Good Oral Health Protects Your Heart

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

Having just celebrated Valentine’s Day, hearts were everywhere. The heart was mentioned in poems, cards, gifts and even in the shape of boxes that contained candy.

Your heart (the one in your chest) and your oral health are actually very much related. You may not realize how connected your mouth is to your heart.

Bacteria in our bodies is not always a bad thing. For example, certain bacteria in the gut actually enhance the process of digestion and help to keep the digestive system operating efficiently.

However, certain bacteria are bad. When too much bacteria invade the body, the immune system becomes overburdened. In bacteria overload, the body’s natural defense response, white blood cells, aren’t always able to conquer infection. This is when your doctor may prescribe an antibiotic – to give the immune system added reinforcements.

According to a report on the health of Americans (published by the Centers for Disease Control & Prevention), it is estimated that over 47% have some form of gum disease. Although we all aspire to have a smile that is appealing, it is what lies beneath the teeth and gums that can wreak havoc on one’s overall health.

Over time, inadequate daily oral hygiene enables an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even more susceptible to this bacterial buildup.

This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to ‘wash away’ bacteria at sufficient levels, the accumulation runs rampant.

Oral bacteria are living, eating, and reproducing organisms. They thrive on rotting food particles caught between teeth. They attack gum tissues and tooth enamel. Eventually, they can work their way down tooth roots and attack the bones and tendons that support teeth.

Through tears in diseased gum tissues, this infectious bacteria can enter the bloodstream. This potent bacteria are now associated with a number of serious health conditions due to their ability to trigger systemic inflammation.

When the gum tissues can no longer combat the onslaught of bacteria, there can be very few signs of periodontal (gum) disease initially. Signs that emerge are typically frequent bad breath along with swollen, tender and beefy red gums that bleed when you brush. As they grow in number, the gum tissues become weaker and they can penetrate the bloodstream.

According to the American Academy of Periodontology (www.perio.org),

“Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.

“Scientists believe that inflammation caused by periodontal disease may be responsible for the association.

“Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.”

For this reason, cardiologists are more often advising their patients to be evaluated by a periodontist prior to heart surgery. As mentioned above, gums that bleed are a sign of gum disease. These oral bacteria, given an opportunity to enter the bloodstream, are able to travel anywhere, including the heart. They can reach the heart muscle and cause a severe infection.

As an Asheville periodontal specialist, I have an up-close view of the damaging affects of insufficient oral hygiene. If you are experiencing any of the following symptoms of gum disease, please know that it will only worsen without treatment.

Common signs are:
• Gums that bleed easily when brushing
• Tender or swollen gums
• Gum recession
• Frequent bad breath
• Gums that darken in color from a healthy pink to red
• Gus pockets that form near the base of some teeth

Gum disease is also the nation’s leading cause of adult tooth loss. And, studies have shown that the loss of natural teeth compromises the digestive process, social confidence and one’s lifespan.

If you’ve failed to be fully committed to your oral health, there is no better time to begin than the present. Start with a thorough periodontal examination. Call 828-274-9440.

If dental fears have prevented you from having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. Let’s protect you, top to bottom, beginning with your smile!

“Gray Tsunami” Brings New Numbers in Dementia, Alzheimer’s

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

The American Academy of Periodontology (perio.org), defines a periodontist as:
“A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”

As an Asheville periodontal specialist for over 25 years, my advanced skills help patients with a variety of needs that involve the gum tissues. These include:- Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)
– Diagnosis and placement of dental implants
– Treatment of lesions or cysts in oral tissues

Why should you be concerned about the health of your gums?

Gum disease is an inflammatory disease that attacks gum tissues, teeth, and the structures that support them. It is the nation’s leading cause of adult tooth loss. As if that weren’t bad enough, research has shown that these potent bacteria are able to activate the development (or worsen the progress) of other diseases.

Past studies have shown oral bacteria from gum disease can be a contributing factor to heart disease, stroke, some cancers, diabetes, preterm babies, erectile dysfunction (ED), high blood pressure, and impotency. Studies have begun to closely study the links between gum disease and Alzheimer’s disease.

In the U.S., the growing prevalence of dementia and Alzheimer’s disease is an especially concerning issue as our aging population grows. If you are a “baby boomer” (born between the years 1946 – 1964), you make up a significant percentage of adults. Within 7 years, boomers” will comprise 21% of the population. By 2060, nearly 1 in 4 Americans will be 65 years and older, dubbed the “gray tsunami.” Seniors over the age of 85 will have tripled, with half a million adults having reached age 100-plus.

While the statistics of aging adults increase, these stats for ALL adults over the age of 30 should set off some alarms. Nearly half of the adult population has some level of gum disease, over 47%.

There is a misconception many have when it comes to the serious nature of gum disease. Too often, people perceive “if it doesn’t hurt, then nothing is wrong” when it comes to their oral health. Although symptoms of gum disease may include tender gums that bleed when brushing, gum disease can begin without any obvious signs.

This is true for many health problems. For instance, when cancer forms in the body, its initial presence isn’t obvious. This is why annual or periodic screenings are urged since treatment is typically minimal during early stages.

Early treatment, including that for gum disease, helps to resolve the problem without complex measures. This is why it is so important to have 6-month dental check-ups. These visits allow your dentist to catch gum disease early so treatment needs and expense can be minimal.

Yet gum disease is a hazard for your overall health as well. While gum disease forms in the mouth, that’s not necessarily where it remains without proper treatment. The bacteria of gum disease can enter the bloodstream. It has been found to trigger serious reactions elsewhere in the body. Some of these lead to the formation of cancer (oral, throat, pancreatic, lung) and some activate conditions such as diabetes and arthritis.

Obviously, the health of your mouth is an important part of supporting a healthy body, especially in disease prevention. To illustrate the extent of gum disease’s damaging impact to health, research is tracking its correlation to dementia and Alzheimer’s disease.

In a recent study that included over 8,200 adults, an increased risk for developing dementia was found in those having severe gum disease and missing teeth. Participants in the study had an average age of 63 at the study’s onset.

In a follow-up after 18 years, those who had severe gingivitis in addition to tooth loss had a 22% higher risk for developing Alzheimer’s disease or dementia. Having no natural teeth was associated with a 26% increased risk.

Broken down, 14% of individuals with healthy gums and all their teeth at the start of the study developed dementia by the end of the study. For those with mild gum disease, 18% (623 out of 3,470) developed dementia. Twenty-two percent of participants with severe gum disease developed dementia. For those who had no remaining teeth, 23% developed dementia – nearly 17 cases for every 1,000 persons.

They found the bacteria present in periodontal disease can travel through the mucous membranes of the mouth to the brain, potentially causing brain damage.

In the study, participants were carefully assessed based on age, gender, education, cholesterol, high blood pressure, coronary heart disease, smoking and body weight. (https://psychcentral.com/news/2020/07/30/gum-disease-may-be-linked-to-later-dementia/158497.html?MvBriefArticleId=25473)

Prior studies have led researchers to be more focused on tracking oral tissue related factors that may contribute to dementia and Alzheimer’s disease, which is affecting a growing percentage of American adults (as well as those globally). Currently, 10% of adults age 65 and over have Alzheimer’s disease. For people ages 85 and older, this increases to 32 percent. In the U.S., it is the 6th leading cause of death. (https://www.alzheimers.net/resources/alzheimers-statistics/)

By the year 2025, the number of people 65 and older with Alzheimer’s disease is expected to reach 7.1 million people, a 27 percent increase from the 5.6 million age 65 and older in 2019.

Let us help you minimize the risks associated with oral bacteria. If dental fear has kept you from having regular dental care, we will be happy to discuss our many comfort options in our comfortable Asheville office, including Oral and I.V. sedation (“twilight sleep”).

Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. 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.

Here, our Western North Carolina periodontal dental office also features some of the most advanced technology in dentistry. Many of these are not available in other dental offices elsewhere. Some of these features include LANAP (Laser-Assisted New Attachment Procedure. This is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. We also have 3-D Cone Beam Imaging, computerized Tomography imaging and one of the latest in intraoral scanners.

Now, more than ever, we know that maintaining a healthy smile is important and achievable for every adult. If you suspect you have gum disease (gums that bleed when brushing, tender or swollen gums, gums that have reddened or receded from teeth), it is important to be seen by a periodontist. A periodontal specialist is the best way to restore any level of gum disease to help you regain a healthy smile.

Be committed to having excellent oral health as and make it a priority as an important part of your overall health. For a consultation to discuss how a periodontist can help you, call 828-274-9440.