Save Money & Time At The Dentist! Practice Effective Home Care.

Posted on Sep 22, 2020 by William J. Claiborne, DDS MS

If you could prevent a deadly disease by devoting 5 or so minutes a day to a few at-home basics, you’d probably be all in. Of course, we know that ample sleep, daily exercise and a healthy diet is beneficial to our health. What some people don’t know is the intricate connection between oral health and overall health.

Adults are becoming more aware of how the health in their mouths impacts the risk of developing serious, and even deadly, diseases. To begin, periodontal (gum) disease is the nation’s leading cause of adult tooth loss. The challenges associated with dentures and partials can cause a lifetime of frustrations, costs and psychological woes.

As devastating as tooth loss can be to one’s overall health, it is now known that the bacteria of gum disease can become blood borne. Research has shown this infectious bacteria can trigger inflammatory reactions elsewhere in the body, correlating to heart disease, stroke, high blood pressure, some cancers, diabetes, arthritis, impotency, preterm babies and more.

It is wise to have regular dental check-ups without fail. These 6-month visits can remove built-up plaque from teeth, tend to gum inflammation, and catch small problems before they become big ones. However, what you do in-between these visits can have a major impact on your oral health.

Below are some tips to make your oral care at home more effective …

• Your Toothbrush – Plaque is a buildup of oral bacteria that coats teeth and gums. If not removed daily, it forms a hardened mass of calculus (or tartar) attached to teeth. Calculus cannot be brushed or flossed away (and is what your hygienist is scraping off teeth during cleanings).
– An electric toothbrush can help in the prevention of tooth loss. Studies have shown that electric brushing promotes better gum health and slower progression of gum disease. It is also said to reduce tooth loss by 20 percent. Many of the newer models include timers to indicate the time needed for each quadrant of your mouth. This is your teeth divided into 4 sections. Some also warn when using too much pressure.
– If you prefer a manual toothbrush, stay away from stiffer bristles, which can be damaging to tooth enamel. Also, avoid pressing down firmly or using a scrubbing, ‘back & forth’ motion. Hard bristle toothbrushes can also damage tender gum tissues. Use a circular motion over both sides of each tooth and along the tops with gentle pressure. (Hint: if your bristle are flayed out after a couple of months, you’re pressing down too hard.)
– Whether using a manual or electric tooth brush, it is necessary to brush twice a day for effective results. In order to thoroughly remove the sticky film of plaque from teeth, brush at least two minutes each time.
– After each brushing, brush your tongue with your toothbrush. The tongue has grooves and pores where oral bacteria breed and thrive. Brushing the tongue will uproot these organisms and help to significantly reduce the bacteria level in your mouth.

• Your Dental Floss – Another way to improve gum health, lower cavity risk, and prevent tooth loss is through flossing. It is estimated that only 31 percent of American adults floss on a daily basis. Because brushing cannot dislodge all food particles caught between teeth, daily flossing should be a part of oral hygiene routines.
– Proper flossing is easy for those who are in the habit of it and takes less than a minute. However, the key word here is “proper.” Flossing is best done with about 18 inches of floss. We recommend unwaxed but people with tight teeth find waxed helps them avoid having to ‘pop’ in-between teeth, which can cut into tender gum tissues. Wrap both ends of the floss around the forefingers. Use the thumbs and middle fingers to help maneuver the floss.
– Go slowly as you move the floss back and forth to get in-between and scrape down each tooth’s side several times. Move the floss just slightly below the line where teeth meet gum tissues to dislodge bacteria at the base of teeth. Adjust the floss so you have a clean section after flossing every 3-4 teeth. Be sure to scrape the backs of molars (or the farthest back teeth) on top and bottom.
– For those who have problems with manual dexterity or find the maneuver awkward, water flossers are effective alternatives (shown to be just as effective as manual flossing) and easy to use. A water flosser pulsates a stream of water between teeth that is forceful enough to dislodge trapped food bits but without harming teeth or gums. They are affordable, easy to purchase online or in many stores, and easy to use.

• Your Oral Moisture – Having ‘dry mouth,’ the frequent state of oral dryness, can cause bad breath and lead to higher risks of cavities and gum disease. Saliva is your mouth’s natural rinsing agent that helps cleanse oral bacteria from the mouth. This keeps bacteria to a minimum and their ability to cause problems at lower risk.
– When saliva flow is insufficient, however, bacteria ‘hang around’ in the mouth longer and multiply rapidly. Periodic dry mouth can occur from consuming alcoholic beverages, caffeine and is a normal part of the aging process. Certain medications can also cause oral dryness. These include antihistamines and some prescribed for depression and urinary incontinence. Medical conditions, including acid reflux, sinus infections, diabetes and bronchitis can also cause dry mouth. A bad cold, snoring or just being in the habit of breathing through the mouth are drying as well.
– And the worst culprit of all for dry mouth? Smoking.
– Drink lots of water throughout the day. (Sports drinks and colas don’t count.) If you take medications that have drying side effects, use an oral rinse that replenishes saliva. There are several available over-the-counter.

• Your Diet – What you eat and drink can easily undo all the good you’ve done in your oral home care routine that day. And, you may not even know some of these consumables are putting your smile at risk. These include:
     Sugar & Carbs: The American population over-indulges in sweets and carbohydrates to an often unhealthy extent. The obesity rate in the U.S. (nearly 40% of adults) makes it pretty clear this isn’t occurring from eating green beans and grilled fish. The problem for your smile is how oral bacteria are super-charged by the foods we should be avoiding or enjoying on a limited basis. Our diets now are boosting the reproductive ability of oral bacteria. And, since many of these foods stick to teeth, the potential for damage is much higher.
     Caffeine: Caffeine has a drying effect on oral tissues. A dry mouth means less saliva flow, which gives oral bacteria less opportunity to be rinsed from the mouth efficiently. Caffeinated beverages include coffee, tea, colas, and many energy drinks. While not caffeinated, alcoholic beverages are also drying to oral tissues. Remember, oral bacteria is the source of the majority of problems in the mouth.
     Wine (and other alcoholic beverages): While wine is said to be good for you, how it is consumed creates a particular problem when it comes to your smile. Anytime you eat or drink, your mouth experiences an acid attack, which is a normal part of the digestive process. However, this acid is so potent that it can soften tooth enamel, leaving teeth vulnerable to decay for about 30 minutes. As most people do, sipping wine over a period of time simply draws out this acid bath. Add to that the acidity of wine and your smile gets a one-two punch for a higher risk of decay.
     Citrus & acidic foods and beverages: The acidity in citrus (oranges, lemons, grapefruit, etc.) can erode tooth enamel, leaving them more susceptible to decay. And, it’s not just tart-tasting fruits that bring this risk. Foods with vinegar (pickles, salad dressings, etc.) and tomatoes or tomato-based foods (red pasta sauce, catsup, etc.) have an acidic effect on tooth enamel that heightens the risk of decay.
     Snacking: As mentioned above, every time you eat or drink, an acid attack begins in the mouth. This means that when you sip your soda or nibble on a cookie, an acid attack kicks in. When your mouth is experiencing frequent acid attacks during the day, it’s easy to see why the damage can cause such high risks to tooth enamel and gum tissues.

Be aware of the recommendations above to do a better job at having a clean mouth. If you feel you may be experiencing symptoms of periodontal disease, however, don’t delay. You should be seen at your earliest convenience for treatment since this disease will only worsen over time.

Signs of gum disease include tender gums that bleed easily when brushing, gums that darken in color to red (versus a healthy pink), frequent bad breath, and gums that pull away from teeth (receded gums) and expose darker, root areas of the tooth.

As a periodontist, I specialize in gum tissues (as well as dental implants). Our environment optimizes patient outcomes and comfort throughout treatment. Call (828) 274-9440 to schedule an examination or begin with a consultation appointment.

 

Smoking, Vaping Lead To Gum Disease, Tooth Loss.

Posted on Sep 15, 2020 by William J. Claiborne, DDS MS

With all good intentions, adults occasionally trade one bad habit for another. For instance, a commitment to exercise more often for weight loss can easily backfire when justifying a thick smoothie as a daily reward.

This is what worries me about Vaping. Vaping, the use of e-cigarettes, hit the market around 2007. It is designed to deliver nicotine through a vapor. Although the vapor is generally not labeled as harmful (it’s not “safe”, either), its nicotine is no less harmful to the user as that delivered via cigarette smoke.

Unfortunately, many cigarette users switched to vaping based on the perception that “e-cigs” were a safer alternative. For those who wanted to wean themselves off of cigarettes through this switch, very few achieve that goal as a result.

A 2018 report by the National Academy of Sciences, Engineering, and Medicine concluded there was “evidence that e-cigarette use increases the frequency and intensity of cigarette smoking in the future.”

Teens have been most susceptible to the hazards of vaping. It is the most commonly used tobacco product among U.S. youth. E-cigarette use among middle and high school students increased 900 percent during 2011-2015. According to the Surgeon General, 1 in 5 high school students and 1 in 20 middle school students were using e-cigarettes in 2018.

Unfortunately, nicotine exposure can harm the brain as it develops, until about age 25. During adolescence, nicotine use can affect learning, memory and attention span as well as increase their risk for future drug addictions. (https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf)

As a periodontist in Asheville, NC, my concern when it comes to oral health is what many cigarette smokers and vapers don’t realize when it comes to high risks to their smiles.

In our periodontal dental office, I’ve seen how significantly the habit of cigarette smoking can have on one’s smile. It’s no secret that smoking cigarettes can stain teeth and cause bad breath. However, nicotine in any form is a hazardous force in the mouth.

According to the American Dental Association (ADA), smoking can cause the gums to recede from teeth, exposing vulnerable tooth root sections. This enables easier entry of oral bacteria into the structures that support tooth roots. Smoking can also delay healing following periodontal therapy, extractions or implant placement. The longer it takes oral tissues to heal, the greater the risks for infection to develop.

Additionally, smoking increases the risks of oral cancer, lesions inside the mouth, periodontal (gum) disease, enamel erosion and tooth loss. It greatly reduces saliva flow in the mouth, which is a tremendous aid in removing bacteria and food particles from the mouth, helping to control bacteria levels. The condition of “dry mouth” also causes bad breath.

Because of the vape’s moist presence in the mouth, the assumption with vaping over smoking cigarettes is the “benefit” of oral dryness. However, this is easily dispelled when looking at the true facts.

While there are more than 7,000 chemicals found in the smoke of tobacco products, (including nicotine, tar, carbon monoxide, acetaldehyde and N-nitrosamines),  nicotine is the primary addicting component. A study of some e-cigarette products found the vapor contains known carcinogens and toxic chemicals, as well as potentially toxic metal particles from the device itself.

The e-liquids delivered by these devices typically contain nicotine, propylene or polyethylene glycol, glycerin, and additives. Sound safe? Not at all.

According to the Centers for Disease Control & Prevention (CDC), a smoker has twice the risk for gum disease compared with that of a nonsmoker. (https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html)

When a patient is diagnosed with advanced periodontal disease (periodontitis), they must make a commitment of time and expense to rid this inflammatory disease from their mouths. For those who ignore its presence or assume it will get better on its own, the disease will simply progress further.

Gum disease begins with sore gums that may bleed while brushing teeth. Or, it may cause no noticeable symptoms at all in early stages.

As it worsens, gum disease will cause frequent bad breath, tender gums that turn red, gum recession, and gums that bleed easily when brushing. Pus pockets may form on the gums. As it attacks the structures beneath the gum line, teeth may loosen or shift.

As the nation’s leading cause of adult tooth loss, it brings the hard decisions (and expense) for replacement. After all, you need teeth for eating and speaking. Do you go with dental implants? Or, do you take on the challenges that come with dentures and partials? As hard as the decisions of replacing teeth can be, gum disease can bring even more devastation with it.

Research has linked the bacteria of gum disease to serious health problems. These include heart disease, stroke, preterm babies, arthritis, diabetes, impotency, some cancers and even Alzheimer’s disease. These connections occur through the infectious bacteria of gum disease entering the bloodstream through tears in diseased gum tissues.

Once in the bloodstream, the bacteria can travel throughout the body and create inflammatory reactions. This “systemic inflammation” is able to trigger the onset of some diseases and conditions or even further the development of others.

Certainly, we all have the right to determine what is in our best interest as far as our own health goes. However, I believe that many individuals end up in our office with serious gum problems and facing tooth loss because of what they did not know. Having factual information allows us to make wise decisions for our health and well-being.

As a periodontist, I have advanced skills in the treatment of all stages of periodontal (gum) disease. My dental specialty also includes the diagnosis and placement of dental implants. Here, our patients can relax under Oral or IV sedation (“twilight sleep”) while having their smiles restored. We also create a customized care program that allows each person to maintain good oral health once their treatment is complete.

If you smoke or vape, don’t assume “that won’t happen to me.” The reason we wear seat belts in cars is because there are great risks when we do not. The risks for losing your teeth and having potent bacteria running rampant through your system is something you can take easy measures to prevent.

Experiencing symptoms associated with gum disease? We urge you to schedule an examination appointment as soon as possible. Call our beautiful, comfortable Asheville office at 828-274-9440. A referral is not necessary.

 

 

 

How To Avoid Thinning Jaw Bones That Cause “Granny Look”

Posted on Sep 10, 2020 by William J. Claiborne, DDS MS

Imagine your mouth begins to sink into your face. Deep wrinkles form around your mouth and the corners of the mouth begin to turn downward, even when you smile. Jowls form, allowing skin to seem to loosen and hang on both sides of the face. The chin becomes more pointed and the nose and chin get closer and closer.

This sounds pretty awful. It is like a disfigurement of the face. It’s not a horror movie, though. This is real, caused by one of the most preventable of all diseases afflicting American adults. It’s a disease that affects over 47 percent of all adults over the age of 30. For adults over the age of 65, the figure rises to over 70 percent. (https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html)

Amazingly, this highly prevalent disease is simply periodontal disease. Often referred to as gum disease, some people also refer to it as “perio.” These are fairly familiar terms when it comes to what adults endure. Yet, it seems to be easily ignored, which merely allows it to progress further.

Before we get into the causes (and easy prevention measures) of gum disease, let’s examine how the dreaded changes in facial appearance are related to it.

Gum disease is the nation’s leading cause of adult tooth loss. Assumed to be a normal part of the aging process, it is anything but. Yes, older adults are more prone to acquiring gum disease due to a reduction in saliva and perhaps being less efficient at oral hygiene. But losing teeth can be prevented, and should be.

The problem with losing natural teeth has to do with their roots. It is the roots of a tooth that serve a much greater purpose than most people realize. While the appearance and function of dentures and partials (albeit reduced) can be replaced, they do nothing to replace what is lost beneath the gum line.

Simply put, the lack of tooth roots is the beginning of a “melting face.” This leads to bone loss and is known as resorption. Resorption is the shrinking of the bone structures that support teeth. As tooth roots are absent, the loss of bone mass can create a number of problems – both related to oral health and in facial appearance.

Tooth roots are a living part of your skeletal structure. Tooth roots are what provide nourishment and stimulation to the jaw bones. This helps the jaws to maintain a healthy mass. When tooth roots are removed, the bones slowly begin to shrink. Although most people don’t notice anything different for a while, bone loss begins almost immediately.

As described at the beginning of this article, there is a ‘look’ of bone loss, which causes changes in facial structures. This is because the bone mass is shrinking. As it shrinks, muscles detach and facial skin hangs looser.

Initially, you may only notice more wrinkles around the mouth. As it worsens, you may realize your chin seems to be more pointed. The extreme visual change of bone resorption is referred to as a ‘granny look.’ This causes people to appear far older than their actual age.

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 fitted. However, you’ll 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 allows it to “slip” or become “wobbly.” As bone loss continues, you may experience uncomfortable rubbing on tender gum tissues while eating. You may start to bypass foods that require rigorous chewing, opting for softer foods that dissolve quickly in the mouth. Outings with friends and family seem to be 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 your denture or partial to fit the reduced contours of the gum ridge (or “arch”). 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 accelerates the rate of bone loss. For those who sleep in their dentures, this means that pace of bone loss occurs 24/7.

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, gun inflammation and other oral issues.

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295446/)

When it comes to replacing natural teeth, there are many reasons we recommend dental implants, a major advantage being their ability to halt bone loss. Because dental implants act as replacement tooth roots, they are able to restore 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 (including that thick steak) without fearing embarrassment or uncomfortable rubbing against tender gum tissues.

Dental implants are also designed to last a lifetime, making them a wise investment.

A particular skill of the periodontal specialty is the advanced training in the diagnosis and placement of dental implants. This training allows the specialist to determine the best dental implant type for your needs. A periodontist can also 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 for a consultation in our Asheville periodontal dental office. During this time, we can discuss the implant system that may be most appropriate for your needs. I’ll also be happy to explain the procedural process, comfort options, and easy payment plans.

For a smile that looks beautiful and functions to support good health, don’t let the detrimental effects of dentures lead to a “granny look”. Dental implants can help you enjoy a confident, worry-free smile through your lifetime.

 

 

How Menopause Can Put Oral Health At Risk

Posted on Aug 31, 2020 by William J. Claiborne, DDS MS

According to the Mayo Clinic, “Menopause is the time that marks the end of your menstrual cycles. It’s diagnosed after you’ve gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States.” (https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397)

Physical symptoms of menopause can include hot flashes, night sweats, fatigue and moodiness. Hot flashes typically last about two years, but for 15 – 20 percent of women, they never go away. Insomnia or sleep disturbances may can also continue unless the woman takes hormones or other medications.

Now, add to this findings of research that shows post-menopausal women are at high risk for tooth loss.

Studies have revealed that bone loss in postmenopausal women can be accompanied by a greater risk for periodontal (gum) disease. A study published by the National Institutes of Health cited that post-menopausal females with signs of osteoporosis had an increased risk of gum disease when compared to post-menopausal women with no signs of osteoporosis.

It has long been known that a reduction in estrogen levels contributes to bone loss. According to the web site of the American Academy of Periodontology, challenges may go further:

“Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.

“In addition, Menopausal Gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition. Most women find that estrogen supplements help to relieve these symptoms.” (https://www.perio.org/consumer/gum-disease-and-women)

Decreases in estrogen due to menopause also increase the risk for heart disease and Alzheimer’s disease. While hormone replacement therapy (HRT) can alleviate symptoms associated with estrogen deficiency, replacing estrogen may also prevent some of the chronic illnesses common to postmenopausal women.

At our Asheville periodontal office, we structure each patient’s care according to individual aspects of both oral and overall health. In addition to careful review of a new patient’s health history and medication list, we request any updates to the information at each visit. This allows us to customize your care so your treatment needs are minimized.

Periodontists receive extensive training in the diagnosis and treatment of gum disease and in dental implants, 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 highly-skilled in performing cosmetic periodontal procedures.

If you are post-menopausal, be particularly aware of the signs of gum disease. These include gums that bleed when brushing, sore or tender gums, receded gums that expose darker tooth root sections, gums that darken in color, persistent bad breath or pus pockets that form at the base of some teeth.

Call 828-274-9440 to schedule an examination at your earliest convenience. These symptoms will not improve without treatment. Delayed treatment may also result in more extensive treatment needs in the future.

Although a referral by a general dentist or another dental specialist is not required, we encourage patients to develop a relationship with a generalist in order to maintain a healthy smile on an ongoing basis.

If you have already experienced tooth loss, remember that a periodontist also specializes in the placement of dental implants. This dental specialist can help to restore the health of your smile as well as the look and function.