Obesity Increases Risk Of Gum Disease.

Posted on Nov 20, 2019 by William J. Claiborne, DDS MS

Imagine one-third of your body being made up of maple syrup.

Sounds pretty absurd, doesn’t it? Yet, for Americans who are categorically obese, this imagery is actually a good description.

Obesity is when fat makes up over thirty percent of body mass. According to the Centers For Disease Control & Prevention (CDC), adults in the U.S. who are categorized as obese is at nearly 40 percent! Another 30 percent are categorized at overweight. That’s two-thirds of adults in the U.S. who have too much fat makeup.

And it’s not just adults over the age of 20 who have this problem. Sadly, nearly 30 percent of children are overweight or obese as well.

In North Carolina, over 63 percent of adults are either overweight or obese, according to a study by the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.  (https://onlinelibrary.wiley.com/doi/full/10.1002/oby.20451)

The problems associated with being overweight and obese are many, and can be deadly. Obesity seems to trigger a predisposition to a variety of serious health conditions and diseases. These include increased risk of stroke, certain cancers, coronary artery disease, and type 2 diabetes.

In addition to the added and unnecessary load that strains the back, knees and ankles, the challenges continue. Obesity decreases lifespan, up to an estimated 20 percent of people who are severely obese. (https://www.nejm.org/doi/full/10.1056/NEJMsr043743)

As 2019 holiday indulgences (often sugary and carb-laden) are before us, many of us also follow the season with with the traditional new year’s resolution of “lose weight” at the top of the list. Along with improved health and greater confidence in overall appearance, we’d like to add another reason to reach your goal.

Chronic inflammation is a known side effect obesity. Why does this matter to a Periodontist? Obesity is also known to exacerbate other inflammatory disorders, including periodontitis (advanced gum disease).  To be clear, periodontal disease is also the nation’s leading cause of adult tooth loss.

Research has shown that obese adults have a 6 times higher potential to develop periodontal (gum) disease. As a periodontal specialist my goal is always to help patients achieve optimal oral health. Although discussing the risks of periodontal disease with obese patients can be a sensitive issue, this is without judgement of why they are overweight but rather how we can help them enjoy a healthier smile.

Most of us know – losing weight is not a process that is either easy or quick. Add to this that research has shown that factors such as sleep quality and what we eat (as much as how much we eat) can cause the brain to make the challenges of weight loss even greater.

For one, studies have shown that sugar can be addictive. Sugar consumption even activates the same regions in the brain that react to cocaine. For individuals who admit to having a “sweet tooth,” trying to stay within the recommended 6 teaspoons per day limit can be a battle when we are truly “addicted.”  (https://www.brainmdhealth.com/blog/what-do-sugar-and-cocaine-have-in-common/)

Insufficient sleep also complicates the brain’s ability to regulate hunger hormones, known as ghrelin and leptin. Ghrelin stimulates the appetite while leptin sends signals of feeling full. When the body is sleep-deprived, the level of ghrelin rises while leptin levels decrease. This leads to an increase in hunger.

The National Sleep Foundation states that “people who don’t get enough sleep eat twice as much fat and more than 300 extra calories the next day, compared with those who sleep for eight hours.” (https://www.sleepfoundation.org/sleep-topics/the-connection-between-sleep-and-overeating)

As difficult as losing weight can be, it is important to be aware of risk factors that can make you more suspectible to gum disease. Initial symptoms include gums that are tender, swollen, and may bleed when brushing. This stage, known as gingivitis, is actually reversible with prompt, thorough oral hygiene.

As gum disease worsens, however, the inflammation of oral bacteria can lead to persistent bad breath, receded gums that expose sensitive tooth roots, and gums that darken in color. If untreated, pus pockets can eventually form and the base of some teeth and tooth loosening can require removal.

Armed with this information, we want to help all patients, with overweight or obese adults especially, to take added precautions to maintain good oral health, both at home and through regular dental check-ups.

Avoiding periodontal disease is particularly important since its infectious bacteria have been linked to serious health problems. These include heart disease, diabetes, arthritis, some cancers, preterm babies, impotency, and Alzheimer’s disease.

If you are experiencing symptoms of gum disease, however, it is vital to be seen by a periodontist as soon as possible to halt further progression. A periodontist is a dental specialist who has advanced training in treating all stages of gum disease as well as in the placement of dental implants. The earlier the treatment, the less involved treatment requirements will be. Gum disease will not improve without professional care.

Call 828-274-9440 to schedule an initial examination or begin with a consultation.

Rheumatoid Arthritis (RA) Linked To Periodontal Disease

Posted on Oct 02, 2019 by William J. Claiborne, DDS MS

As a periodontist, I specialize in the treatment of all stages of periodontal (gum) disease. Although this particular dental specialty is not as visible as a general dentist, we are very-involved members of the medical and dental community. According to the Centers for Disease Control & Prevention (CDC), over 47 percent of American adults have some level of gum disease.

Like the formation of cancer, many individuals are unaware when periodontal disease becomes active. When early symptoms appear (such as bleeding gums when brushing, bad breath and gum tenderness), many people shrug them off as temporary.

However, gum disease only progresses once underway. Eventually, gums become red in color and pus pockets form at the base of teeth. In advanced stages, teeth loosen and may require removal. Gum disease, to no surprise, is the nation’s leading cause of adult tooth loss.

The potent bacteria of periodontal disease can enter the bloodstream through tears in weakened gum tissues. This allows it to travel throughout the body. Research has shown it is able to trigger a number of serious health problems, including heart disease, stroke, diabetes, memory loss, and impotency.

Rheumatoid arthritis (RA), a condition seemingly unrelated to gum disease, is a debilitating disease that destroys joints. It is disabling and painful. In most cases, RA emerges gradually, often beginning with morning stiffness along with weak and aching muscles. Joint pain follows, with joints feeling sore and stiff. RA is typically found in the fingers, wrists, elbows, hips, knees, ankles, toes, shoulder and neck.

As inflammation from RA increases, joints become swollen with symptoms including fever, disfiguring of hands and feet, numbness and tingling. There is no cure for RA and lifelong treatment is required. Treatment may consist of medications, physical therapy, or even surgery.

Yet, like RA, gum disease causes pain, swelling, and tenderness. As it worsens, the associated inflammation can lead to destruction of the bone that supports teeth along with surrounding tissues. And, the similarities go much deeper.

Both gum disease and RA share a genetic likeness in clinical makeup and structures. This has been particularly apparent in pathogens, which are agents in the body that lead to disease or illness. The pathological processes that occurs in both gum disease and RA are almost identical.

Too, the particular species of bacteria found in gum-diseased oral tissues and tissues that surround joints in those who suffer with RA. Equally concerning is, while both conditions clearly cause chronic inflammation in tissues connected to bone, researchers have found the two diseases share a similar inflammatory trigger.

In one study, a particular pathogen associated with periodontal disease was found to activate the same destructive process of rheumatoid arthritis. It has also been shown that, by treating periodontal disease in RA patients, RA symptoms often improve ( likely due to the system’s reduced burden of oral inflammation).

These findings reveal just how closely our oral health correlates

to our overall health. This information should send up alarms that the presence of gum disease can greatly increase your risk for serious health conditions. Clearly, people who have RA should be particularly diligent when it comes to their oral health.

If you are experiencing symptoms of gum disease (as mentioned above), seek treatment at your earliest convenience. You can begin with a consultation appointment in our  comfortable Asheville periodontal office. A referral is not needed.

Call 828-274-9440 to learn more.

Using A Manual Or Electric Toothbrush Could Make A BIG Difference.

Posted on Sep 11, 2019 by William J. Claiborne, DDS MS

If you use an electric toothbrush, that can help in the prevention of tooth loss. However, it’s but one part of the steps needed for thorough oral hygiene at home.

Findings of an 11 year study published in the Journal of Clinical Periodontology tracked the oral health of over 2800 adults. Their use of electric toothbrushes was monitored to watch for periodontal disease, cavities, and the number of natural teeth.

Participants were examined in 2002 – 2006, with 18 percent being electric tooth brush users. Follow ups were conducted after six and 11 years. At the time of their 11 year follow up, 37 had converted to using electric toothbrushes.

The study showed electric brushing promoted better gum health and slower progression of gum disease. Electric tooth brushing also related to a reduction in tooth loss by 20 percent (compared to those who brush with manual toothbrushes). The study did not reveal measurable reduction in cavities, however.

Although more adults are using them, their long-term effectiveness has not been proven to be significant. It is suspected that this is due to technique more than the brushing tool itself. For manual brushers, a major hazard with manual brushes is one’s choice of bristles. Stiffer bristles can be very damaging.

If you use a hard bristle tooth brush, you may be damaging tooth enamel and gum tissues. People often feel they need to press down firmly as they brush and use a scrubbing, ‘back & forth’ motion. This action can wear down the protective shell of tooth enamel, leaving teeth more vulnerable to decay.

Another problem with using a hard bristle tooth brush is its ability to damage tender gum tissues. If the bristles on your toothbrush are fanned out after a couple of months, it’s because you are applying too much pressure when brushing.

The ideal technique for brushing teeth is applying gentle pressure on the brush in a swirling motion. By using a circular pattern over both sides of each tooth and along the tops, teeth are cleansed without wearing away gum tissues.

This is where electric toothbrushes can help greatly. 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. They also warn you when you are using too much pressure.

While tooth enamel is important, equally so are the health of your gum tissues. The gums provide a seal around the base of each tooth. This seal helps to prevent the entry of bacteria that can lead to periodontal (gum) disease, which the nation’s leading cause of adult tooth loss.

As devastating as tooth loss can be to one’s overall health, as we now know that the bacteria of gum disease can enter the bloodstream. 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.

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, you should also brush at least two minutes each time.

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) that attaches to teeth. This is what you may feel your hygienist scraping off teeth during cleanings since it cannot be brushed or flossed away.

Another place for oral bacteria to thrive are the grooves in the tongue. These offer a dark, warm and moist environment for bacterial reproduction. To uproot these organisms (that reproduce rapidly), use your toothbrush to brush your tongue after brushing teeth. Be sure to reach the back of the tongue where the majority of oral bacteria are embedded. Swish with water several times after.

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.

Flossing removes trapped bits of food remain in the mouth, which feeds oral bacteria and helps them to quickly multiply. Proper flossing is easy for those who are in the habit of it and takes under a minute each day. For those who have problems with manual dexterity or find the maneuver awkward, water flossers are effective alternatives and easy to use.

Practice the recommended techniques mentioned above and you’ll not only do a better job at having a clean mouth, you’ll find your time at the sink requires less effort. 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.

If you’ve noticed any of these, please know that the condition will only worsen without treatment. 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 learn more.

Men Have Greater Risks For Dental Problems.

Posted on Aug 20, 2019 by William J. Claiborne, DDS MS

Research has found that periodontal disease is higher in men (56.4 percent) than in women (38.4 percent). https://www.perio.org/consumer/gum-disease-and-men

The reason for this significantly higher number may be due to some findings revealed through some unsettling findings. According to a survey by the Centers For Disease Control & Prevention (CDC), only 66 percent of males brush their teeth twice or more a day compared with 86 percent of females who do so.

This was revealed through a study of over 800 participants. Evaluation included a written questionnaire on dental knowledge and oral health habits. It also included an oral exam of each participant to detect signs of periodontal disease. (https://www.perio.org/consumer/gender-differences)

Flossing had even worse numbers, but that pertains to both sexes. Only 49 percent in the survey stated they floss on a daily basis. Only 1 out of 3 assumed that seeing blood in the sink when brushing is normal and were unaware it is a sign of periodontal (gum) disease.

While women were as twice as likely to see their dentist for regular dental check-ups, they were also more likely to follow through with recommended dental treatment than men. As a result, the study revealed women had better levels of gum health with less dental plaque, calculus, and bleeding.

The Journal of Periodontology shared nine risk factors for tooth loss due to periodontal (gum) disease, including …

• Being over age 35
• Being male
• Not having professional dental care
• Not brushing teeth
• Smoking
• Being diabetic
• Having high blood pressure
• Having RA (rheumatoid arthritis)

Although age and gender are unchangeable, decisions to not brush your teeth or to smoke, for example, are something you can control. As of 2017, 18.6 percent of American men smoke, compared with 14.3 percent of women. (https://www.edrugstore.com/blog/current-health-news/men-smoke-more/) Because more males smoke cigarettes (or use tobacco in other forms), they are more likely to develop gum disease.

Why should you worry about gum disease? In addition to causing tooth loss, oral bacteria can enter then bloodstream through tears in diseased tissues in the mouth. Once in the bloodstream, this bacteria can trigger inflammatory reactions elsewhere in the body.

The bacteria of gum disease has been linked to heart disease, stroke, memory loss, preterm babies, arthritis, diabetes, and even impotency. According to the American Academy of Periodontology (perio.org), men who fail to maintain good oral health are also at higher risk for:

PROSTATE PROBLEMS – Prostate-specific antigen (PSA) is an enzyme created in the prostate that is normally secreted in very small amounts. However, when the prostate becomes inflamed, infected, or affected by cancer, PSA levels rise. Research has shown that men with indicators of periodontal disease such as red, swollen or tender gums  as well as prostatitis (inflammation of the prostate) have higher levels of PSA than men with only one of the conditions. This means that prostate health may be associated with periodontal health, and vice versa.

HEART DISEASE – Research indicates that periodontal disease and cardiovascular disease are associated; having periodontal disease may actually increase your risk of cardiovascular disease. Both diseases are chronic inflammatory conditions, and researchers believe that inflammation is the connection between gum disease and heart disease. Since men are already more likely to develop heart disease than women, maintaining periodontal health is another way to reduce this risk.

IMPOTENCE – Men with periodontal disease, especially those younger than 30 or older than 70, are at increased risk of developing impotence, according to research. Researchers believe that inflammation may be the link between the two conditions; prolonged chronic inflammation (the same type of inflammation that is associated with periodontal disease) can damage blood vessels leading to impotence.

CANCER – Research has found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. Specifically, men with periodontal disease may be 49 percent more likely than women to develop kidney cancer, 54 percent more likely to develop pancreatic cancer, and 30 percent more likely to develop blood cancers.

If you aren’t concerned about losing teeth, these overall health risks should get your attention. Treating gum disease before it becomes severe can be done comfortably and affordably. In our Asheville periodontal dental office, we use the latest technology and offer I.V. sedation for those who desire a “twilight sleep” state during treatment.

Gum disease will only worsen without treatment. Call (828) 274-9440 if you have tender, sore gums or see blood in the sink when brushing. You need to be seen promptly.