Why Floss?

Posted on Apr 14, 2020 by William J. Claiborne, DDS MS

As a periodontist, I treat all stages of periodontal (gum) disease. Over the years, I’ve helped patients save natural teeth and restoring their ability to enjoy healthy, confident smiles.

When people come close to losing their teeth or find themselves in need of replacing them with something more dependable than dentures or partials, I hear nearly every one express the same regrets: “I wish I’d taken better care of my teeth when I could.”

Hindsight may be 20-20, but it’s never too late. I know patients can go from having gum disease and losing teeth because of it to having excellent oral health – and end up having a renewed commitment to their smiles.

In my dental specialty, I know it begins by helping patients to understand how the problem starts in the first place. When people know the HOW, they can implement measures to bypass the repercussions of gum disease.

I’ve found that most people actually have very little awareness of how the inside of their mouth looks. We smile with lips and front teeth that show very little (if any gums). So, it stands to reason that, if a smile looks good, it’s probably healthy.

Until dental offices began using intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for a condition that didn’t hurt. There were not obvious signs initially, so nothing is wrong – right?

Intra-oral cameras are able to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual has this firsthand view of spongy, receded gums, the decision to treat often go from IF to WHEN.

Although it helps to be able to show patients the signs of gum disease, these emerged signs are indications of long-standing periodontal disease. By the time these signs appear, the early stage of gum disease, gingivitis, is past.  This is unfortunate, since early-stage gum disease can be halted with prompt measures.

Gingivitis causes the gums to become tender and swollen in some areas. You may see blood in the sink when brushing. These signs indicate that oral bacteria has accumulated in the mouth beyond the means of your immune system’s ability to manage it.

Twice daily brushing and flossing are important steps in keeping bacteria levels in the mouth under control. Brushing sweeps away built up bacteria on the surface of teeth, which is a sticky film known as plaque. Plaque, just over the course of a couple of days, can harden on teeth where build up is allowed to remain. This cement hard mass of bacteria is tartar, or also known as calculus.

The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.

Yet, try as we might, there are simply angles in the mouth that are difficult to reach with a toothbrush, manual or electric. Say you have an area of jumbled or crooked teeth. Even as you adjust the angle of the toothbrush differently to maneuver the bristles into these areas, it is often difficult to continually keep these areas clean.

This is where flossing comes in, and important step in daily, oral hygiene.

Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.

If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a jolting view of exactly what you do NOT want crawling around and breeding in your mouth. These living and breeding organisms can be highly destructive as they amass.

As research has shown for many years, your overall health is intricately linked to your oral health. The bacteria of gum disease has been linked to a long list of serious health problems, including heart disease, stroke, arthritis, some cancers, diabetes, and preterm babies. Studies are underway to track gum disease bacteria to the path of Alzheimer’s disease.

Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.

Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits): “Only four of 10 Americans floss at least once a day, and 20 percent never floss.”

Perhaps this is one reason why over 47 percent of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.

Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued.

It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.

Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. For our patients, we help them develop an at-home care regimen to maintain a healthy mouth and fresh breath between regular dental check-ups.

Be aware of the signs and symptoms of periodontal disease. Knowing them will allow you to react quickly to minimize the extent of damage and treatment needed to rid it. They include:

• Tender or swollen gums
• Gum tissues that turn red
• Gums that are tender to the touch
• Gums that bleed easily
• Spitting out blood when brushing or flossing your teeth
• Frequent bad breath
• Pus pockets that form between teeth and gums
• Teeth that loosens or shift
• Painful chewing
• Gums that pull away from your teeth (recede), making your teeth look longer than normal

These are all warning signs that bacteria overload is occurring in your mouth. It is a disease, and will only worsen without treatment.

If you suspect you have any stage of gum disease, call 828-274-9440 to schedule a thorough periodontal examination.

 

 

Be In-The-Know To Avoid Cavities, Gum Disease

Posted on Apr 02, 2020 by William J. Claiborne, DDS MS

During this highly unusual time, people are relying on the internet for communication (work and social), information, and entertainment. Computers, tablets and smart phones are keeping us connected as we ‘shelter in place’ until this global pandemic is under control.

A lot of Americans are using their “stuck inside” time to expand their minds. Whether it’s to enjoy an audio book, watch PBS specials, or learn how to do something on YouTube, using the time positively is helping people avoid getting mired down in worry and anxiety.

As a periodontal specialist in Asheville, NC, I hope adults will use some of their time to become more aware of the hazards of gum disease. The damage that periodontal disease (‘perio’) can have far reaching consequences, affecting the health inside and mouth and overall health, as I’ll explain.

People are often surprised to hear that they have developed gum disease since it is often without obvious symptoms in early stages. Once it’s fully underway, however, many people ignore the warning signs or assume they’ll “go away”.

In my dental specialty, I believe that by keeping Americans informed of how the progression of gum disease occurs could help to greatly reduce the extent of this disease, which plaques over 47 percent of adults.

Let’s begin by looking at the process of gum disease:

•  Oral Bacteria: The mouth is a warm, dark and moist environment — perfect for harboring bacteria. The mouth is the first point of contact for a large extent of the bacteria that enters the body. Bacteria is on food, utensils, lip gloss and even your tooth brush. All mouths have bacteria, some of it are beneficial. Although bacteria in the mouth are perfectly ‘normal’, the problem begins when too much bacteria accumulate.

•  Plaque: Without proper brushing, flossing, saliva flow and diet, oral bacteria can reproduce rapidly. For an example of just how quickly these bacteria accumulate, run your tongue over your teeth after brushing in the morning. They should feel slick and clean. Then, before brushing at bedtime, run your tongue over your teeth again. The accumulation of oral bacteria over the mere course of a day has likely formed a sticky film on teeth. This is known as plaque. This film is actually a coating of bacteria.

•  Tartar (or Calculus): In just 48 hours, unremoved plaque can harden into tartar. These ‘chunks’ are colonies of oral bacteria and typically attach to the base of teeth near the gum line. These cement-hard masses can no longer be brushed or flossed away. They must be removed by a dentist or hygienist with special tools. If allowed to remain, like plaque, tartar will continue to multiply as these bacterial colonies feed on tooth enamel and tender gum tissues.

•  Gingivitis: This is the first stage of gum disease. At this level, gum tissues are under attack and become sore. They may bleed easily when brushing and you may experience an aching sensation in some areas. Breath odor is stronger, even soon after brushing. At this point, with proper measures, you can restore your gums to a healthy state. However, the window of opportunity to combat gingivitis is brief.

•  Periodontal (Gum) Disease: At this stage, the gums are inflamed and tender. They begin to darken in color and the seal of gum tissues surrounding teeth begins to loosen. The breath is persistently bad. As this stage of gum disease worsens, it can lead to severe health risks elsewhere in the body.

•  Periodontitis: This is the advanced stage of gum disease. The gums are so tender that eating becomes difficult. Breath odor is putrid, as it reflects the rotting state in your mouth. The gum tissues are highly inflamed. Pus pockets may form on the gums near the base of teeth. Eventually, teeth will loosen as the gum tissues and bone structures that support them are destroyed. Tooth removal at this stage is not uncommon.

To no surprise, gum disease is the nation’s leading cause of adult tooth loss. Yet, it’s one of the most preventable diseases with simple measures.

An even more concerning aspect of gum disease is its ability to enter the bloodstream. Once bloodborne, these infectious bacteria can trigger inflammatory reactions elsewhere in the body. Gum disease bacteria has been linked to heart disease, diabetes, arthritis, stoke, memory loss, preterm babies, impotency, some cancers and even Alzheimer’s disease.

This is why we want you to be aware of the importance of having a healthy mouth. We realize there are financial obstacles for some people. However, most dental and specialty offices offer payment plans, many are interest free with no down payment required.

Some people avoid dental visits because they have anxiety or fears. Dental fear is fairly common, even in America where dental care is so advanced (in most practices). If deep fear or anxiety has prevented you from regular dental visits or having much-need treatment, finding a dentist who is experienced in caring for fearful patients is easier today.

Using advanced technology, such as laser dentistry, cone beam imaging, and other features, we are able to diagnose problems more precisely, which helps to minimize treatment. Many options enhance patient comfort and speed healing time.

For many fearful patients, we also offer oral or IV sedation (“twilight sleep”). We are fully equipped for the safety and comfort of administering sedatives for our patients for treatment in our office. Here, patients know us for our gentle touch and respectful, attentive care for each individual.

Occasionally, I hear a patient relay their impression of tooth loss being “just part of growing older.” That is far from the truth. The human body does ‘break down’ here and there but keeping your teeth for a lifetime is a reasonable expectation with proper measures.

Having healthy gums that support teeth can be achieved with an involved relationship with a dentist and a committed oral hygiene routine at home. With proper care, you can easily enjoy a smile of natural teeth all your life.

Twice daily brushing (at least two minutes per time), daily flossing, drinking ample water and limiting sweets and caffeine are simple ways to keep your mouth healthy between regular dental check-ups and cleanings. And, those 6-month check-ups are important. At this time, any tartar that has accumulated can be removed and signs of early gum disease can be noted.

Losing teeth due to gum disease leads to expensive and lifelong upkeep with crown-&-bridge, partials, full denture or dental implants. These tooth replacement needs can be avoided.

If you are experiencing symptoms of gum disease, call 828-274-9440. If fear is an obstacle to having a healthy, confident smile, begin with a consultation to discuss your needs.

 

Could Poor Gum Health Increase Stroke Risk?

Posted on Mar 12, 2020 by William J. Claiborne, DDS MS

The human body is a complex structure on the inside and out. Each body is built for movement and action, its parts governed by a central control system – the brain.

Like any complex machine with its many intricate parts, there is a delicate balance. Working together, the body stays interconnected and functioning properly.

When any part malfunctions, the problem seldom stays within its own realm. Other areas are typically affected, which is what research is finding when it comes to the health inside your mouth, or your oral health.

For decades, it has been shown that the bacteria of periodontal (gum) disease can enter the bloodstream through tears in weakened gum tissues. Research has found that this bacteria can trigger harmful reactions.

For example, the bacteria can trigger inflammation that sets into motion risks factors connected to arthritis and diabetes. Some cancers have also been correlated to this bacteria. Heart disease and high blood pressure been as well.

Stroke, too, is among the long list of serious health problems associated with the potent bacteria of gum disease. While there is no clear pathway to verify gum disease bacteria are the “cause” of these serious conditions, research has continually shown they are linked, which can greatly increase one’s potential for having these problems develop (or worsen).

Say the word “stroke” and people immediately think of a deadly or debilitating, disfiguring episode that may never be recoverable. Strokes are the third leading cause of death in the United States.

There are several types of strokes. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. These cause death in about 50 percent of cases.

However, most strokes are Ischemic strokes, caused by an abrupt blockage of arteries leading to the brain. These occur when the brain’s blood vessels become narrowed or blocked, severely reducing blood flow.

Blocked or narrowed blood vessels are caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through your bloodstream and lodge in the blood vessels in your brain.

https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

In one study, 265 patients who experienced a stroke between 2015 and 2017 were followed. Researchers noted that large artery strokes – those located inside the brain – were twice as common in patients with gum disease as in those without gum disease.

https://www.health.harvard.edu/heart-health/gum-disease-and-heart-disease-the-common-thread

What connection could gum disease bacteria have with arteries in the brain?

Let’s step back and look at the makeup of bacteria found within gum disease.

It all begins when plaque, the sticky film that builds up around teeth, is allowed to remain and multiply. In the meantime, the  plaque found in blood can accumulate inside arteries. Known as atherosclerosis, this fatty plaque is the hallmark of coronary artery disease.

People with gum disease have 2 – 3 times the risk of having a heart attack, stroke, or other cardiovascular event. Still, finding a direct connection has yet to be determined. Although researchers have taken into consideration factors like smoking or a poor diet, there is an emerging concern that gum disease may be a factor – on its own – when it comes to heart disease.

Gum disease is an inflammatory disease that starts as gingivitis, the initial stage of periodontal disease. This causes gum tissues to turn red, swell and bleed sometimes when brushing. Untreated, gingivitis will progress to periodontitis, advanced gum disease.

The inflammation of periodontitis can destroy tissue and bone in the mouth, causing gums to separate from the teeth. This separation allows bacteria to infect the gums, and, over time, can lead to tooth loss.

Although we recommend that people react promptly to signs of gum disease, we also felt it beneficial to provide the signs and symptoms of stroke (for you or someone else). These include:

• Trouble speaking and understanding what others are saying. This may include confusion, slurring or having difficulty understanding speech.
• Paralysis or numbness of the face, arm or leg, typically on one side of the body.
• Vision problems in one or both eyes. This may cause blurred or blackened vision in one or both eyes, or seeing double.
• Headache, which may be sudden and severe. This may cause vomiting and/or dizziness.
• Trouble walking, sudden dizziness or loss of coordination.

Some studies indicate that treating gum disease (with other stroke risk factors) could reduce your risk for stroke.

While the direct path of gum disease to stroke may not be known at this time, research has clearly shown that the bacteria of periodontitis is harmful far beyond the mouth.

If you would like a periodontal evaluation, call our Asheville periodontal dental office at 828-274-9440. As a periodontist, my specialty is the treatment of all stages of gum disease. Through our advanced skills and technology, we can restore your smile to a healthy state and give your overall health a leg up!

 

What You Eat & Drink May Be Compromising Your Oral Health

Posted on Mar 05, 2020 by William J. Claiborne, DDS MS

Everyone would like to have healthy bodies and brains. We all know that the best way to enjoy a full, active life is to eat a nutritionally balanced diet, get regular exercise, have periodic screenings and checkups, and stay socially involved.

Yet, in our attempts to live as we should, things like improper movements while exercising or an overloaded social calendar can actually backfire on us, having negative results. Sometimes, it’s what we don’t know in our quest for bettering our lives that can lead to damaging consequences.

Take, for example, your diet. Do you squeeze lemon in your water? Do you relax with a glass of wine each evening? Are you a chocolate lover who has switched to dark as a healthier choice?

Although these are all good for you in some ways, when it comes to your teeth and gums, they can cause problems over time. Knowing what can occur may save you much in costly dental treatment in the future.

There are a number of foods and beverages that contribute to periodontal (gum) disease, cavities, and tooth loss. Some may even surprise you, which include:

Caffeine: Caffeinated beverages such as coffee, tea, colas, and many energy drinks can have a drying effect on oral tissues. Having “dry mouth” means there is insufficient saliva flow. This leaves the mouth without its natural ‘rinsing’ agent, which is what helps to flush out bacteria to maintain manageable levels. Without this, oral bacteria have an environment where they can rapidly breed and thrive. Since bacteria accumulation is the origin of most oral problems, this heightens the risks for your oral health.

Wine: Although wine (especially red) is believed to be a healthy drink, it is the way it is consumed that makes it a particular problem for teeth and gums. Whenever you eat or drink something, an acid attack begins in the mouth. While this is an initial part of digestion, this acid is highly potent; so much that it can soften tooth enamel for up to 30 minutes after. This makes teeth more prone to decay. Because most people drink wine in sips over time, this merely extends the acid surge period. When wine’s acidity combines with digestive acids in the mouth, you place teeth at a doubly higher risk for decay. (This also applies to any alcoholic beverage, especially drinks with sweetened mixers.)

Citrus & Acidic Foods & Beverages: The acidity in citrus (such as oranges, lemons, and grapefruit) can be tough on tooth enamel and tender gum tissues. This also includes tomatoes and tomato-based foods such as spaghetti sauce, catsup, salsa, etc. that can have a highly acidic effect.

Sugar & Carbohydrates: Globally, Americans are the leading nation for sugar consumption. We also love our carbs, which essentially break down as sugar in the mouth. Oral bacteria love these foods, too, because they supercharge their ability to reproduce. Because many sweet and carb-laden foods stick to teeth longer, their ability to cause damage is even greater.

Snacking: As mentioned earlier, eating or drinking triggers an acid attack in the mouth. This means for every sip of cola or granola bar bite, an acidic bombardment occurs in the mouth for approximately 30 minutes. When the mouth endures these frequent acid attacks, the damage to precious tooth enamel will catch up to you in the form of cavities.

Research has shown that the health of teeth and gum tissues is intricately connected to your overall health. Serious diseases have been linked to the bacteria of gum disease. These include heart disease, stroke, diabetes, arthritis, some cancers, preterm babies, impotency, and Alzheimer’s disease. These bacteria, once in the bloodstream, trigger serious reactions that are obviously harmful far beyond the mouth.

Start by reading these tips on maintaining a healthy mouth…

• When snacking, eat what you wish in a brief amount of time rather than pace eating over an extended time.
• Be conscious of what alcohol you drink. Try to limit your drinks to 1 or 2 a day and omit sweet mixers. Between each drink, take gulps of plain water and let it linger in the mouth for a few seconds before swallowing. Or, swish in the bathroom between each drink. This helps dilute oral acids and rinse them from the mouth before they can damage tooth enamel.
• Brush at least twice a day and floss daily. By removing bacteria that has accumulated in the mouth, you’ll help to decrease the risk for gum disease and cavities. Although many people feel wine is a healthy drink, remember – it is highly acidic. When this acidity mixes with oral acids, your mouth is bombarded with a potent assault strong enough to soften tooth enamel.
• Limit sugar and snacking. If you like a sweet treat during the day, choose an apple or wait until a meal and have the treat while an acid attack is already underway. This will help you avoid triggering a new one.

Having a healthy mouth will help you to smile more confidently and give your overall health a leg up by minimizing bacteria that originate in the mouth.

If you have signs of gum disease (tender, bleeding gums and frequent bad breath), you should see a periodontal specialist as soon as possible. Gum disease does not improve without treatment and is the nation’s leading cause of adult tooth loss.

Call 828-274-9440 to schedule an appointment.