Dental Pain Relief With Patient’s Well-Being In Mind

Posted on Aug 19, 2022 by William J. Claiborne, DDS MS

The body relies on a nervous system for many reasons; one reason being to alert us that something is wrong. For example, when we burn our finger on the stove, the brain quickly sends pain sensations so we can remove the finger and take action to help it repair.

As a periodontal specialist in Asheville NC, I know how sensitive the gums can be, as well as teeth. A toothache or a cut in the mouth can be miserable for days. As a periodontist, ideally my skills allow patients to avoid being in pain by keeping their mouths healthy. When an individual maintains a clean mouth that has a low level of bacteria, they can avoid developing cavities and gum disease, which can both result in a significant amount of constant pain.

Yet, caregivers in the American healthcare system are very much aware of the opioid epidemic. We don’t want to deny legitimate patients the medications they need to get them out of pain, however, neither do we want to be a catalyst or contributor to an individual who becomes dependent on these or is trying to feed an already existing habit.

The dental profession has been very careful in this regard, according to the American Journal of Preventive Medicine. In 2012, dentists in the U. S. prescribed only 6.4% of the total opioid prescriptions. For procedures such as root canals or extractions, they help patients get through the initial part of recovery when pain levels are most extreme.

As opioid abuse became such a significant problem, dentists became more sensitive to prescribing these medications. In 2016, American Dental Association (ADA) issued a Statement on the Use of Opioids in the Treatment of Dental Pain.

“Dentists should consider non-steroidal anti-inflammatory analgesics as the first-line therapy for acute pain management … [and]should recognize multimodal pain strategies for management for acute postoperative pain as a means for sparing the need for opioid analgesics.”

Non-steroidal anti-inflammatory analgesics are commonly known as NSAIDs. These are typically over-the-counter meds, such as Advil, Aleve, Motrin, etc. These are non-opioid, oral medications for temporary relief of acute dental pain.

NSAIDs work to provide effective pain relief by reducing inflammation in the bone, dental pulp, and gum tissues. The ADA encourages dentists to consider NSAIDs as the preferred go-to method for managing acute pain. When NSAIDs are taken after a dental procedure, they have been shown as effective as opioids for reducing pain intensity. For some pain levels, the dentist may prescribe a higher dose (by prescription).

Although NSAIDs are effective and less likely to cause dependency, they can also inhibit the an enzyme responsible for producing other prostaglandins that provide numerous beneficial effects. This includes those that protect the gastrointestinal mucous lining, blood flow to the kidneys, and blood clotting.

NSAIDs could also heighten the risks for serious cardiovascular issues, including heart attack and stroke. NSAIDs gave the potential to trigger issues that complicate the effects of low-dose aspirin.

Another option for managing dental pain is the use of Acetaminophen (such as Excedrin and Tylenol). Acetaminophen is an internal analgesic available in over-the-counter medicines for the temporary relief of minor aches and pains and helping to reduce fever. It can also be found in medicines that contain more than one active ingredient to treat migraines.

Acetaminophen is often used for things like headaches, muscle aches and menstrual cramps. It can also be an ingredient in other medicines.

Please know that I want no less for my patients’ comfort than I would want for myself or loved ones. Pain can be an overwhelming problem, although gum disease and cavities are highly preventable. With proper at-home oral hygiene and regular dental check-ups, an individual can keep a healthy smiles and prevent tooth loss (to a signifiant degree).

Even so, the Agency for Healthcare Research & Quality shared that there were more than 615 emergency room visits for every 100,000 people in the U.S. in 2018. The statistic is much higher for low-income and minority groups.

Let’s work together to protect our population from the impact it has endured from opioid addiction. Prior to treatment, we will discuss the potential for discomfort or pain afterward and standard treatment options to help ease you through recovery.

If you are experiencing sore, tender gums that bleed easily when brushing or a deep ache like a toothache, do not delay in seeking dental care. When something is wrong in the mouth, there are very few instances that will go away on their own. Most problems worsen over time, leading to higher levels of discomfort and more-involved treatment to resolve the problem.

In our Asheville eriodontal dental office, we offer some of the most advanced technology available in dentistry, including ConeBeam 3D imaging, laser dentistry, and computerized dental implant placement technology. Additionally, we provide oral and I.V. sedation, safely and monitored closely.

Call 828-274-9440 or tap here to arrange an appointment.

Sources:

https://www.rdhmag.com/patient-care/article/14279378/the-dental-hygienists-guide-to-dental-pain-and-pain-management

https://www.deltadentalwa.com/blog/entry/2019/09/dental-pain-management

https://hcup-us.ahrq.gov/reports/statbriefs/sb280-Dental-ED-Visits-2018.pdf

What Is Causing You To Have Bad Breath Odor

Posted on Aug 09, 2022 by William J. Claiborne, DDS MS

It’s one thing to have “coffee mouth” or give off telltale signs of having onions on a burger at lunch. It’s another to be “that person” who has an embarrassing reputation for bad breath.

Bad breath happens to us all. After all, waking up first thing in the morning reminds us that our mouths are “not so fresh.” However, bad breath is generally easy to avoid. Below, I’ll share some ways to feel confident in closeness.

But first, let me explain how bad breath begins. The origin of most bad breath occurs from too many bacteria in the mouth. On a day-to-day basis, oral bacteria are normal and not problematic. However, when the mouth contains an overload of oral bacteria.

Bacteria thrive in warm, dark, moist places. That’s precisely the environment they have in the oral cavity (the mouth). Bacteria are living, eating and reproducing organisms. They thrive on rotting food particles in the mouth and attack tender gum tissues.

As they amass, a sticky film forms, known as plaque. If not brushed away daily, plaque hardens on teeth into tartar (or calculus). This cement-hard form of bacteria attacks tooth enamel and gums.

The faster bacteria reproduce, the faster is the damage potential caused by these destructive organisms. The accumulation of these bacteria results in the production and release of volatile sulfur compounds (VSCs), which causes a smelly breath odor.

The most common causes of bad breath include poor oral hygiene, gum diseases and dry mouth, a condition in which the salivary glands cannot make enough saliva to keep the mouth moist.

Not surprisingly, one of the symptoms of periodontal (gum) disease is persistent bad breath. This is a foul odor in the mouth that exists even shortly after brushing. Gum chewing and mints may mask it temporarily, but it is actually the scent of gum tissues being destroyed in the mouth. You may also notice tender gums that bleed easily when brushing.

Dry mouth is another contributing factor to bad breath, primarily because oral bacteria thrive when they are not being rinsed away through saliva. Saliva is the mouth’s natural rinsing agent and sweeps bacteria out on a continual basis. Without sufficient saliva, bacteria are able to reproduce at a more rapid pace.

Several causes for dry mouth are smoking, some illnesses, snoring and mouth-breathing, and certain medications. The aging process also leaves adults with less saliva flow. Drinking alcohol and caffeinated beverages are drying to the mouth as well.

When you feel your mouth is dry, the ideal aid to the saliva you have is drinking filtered water. Water is the perfect beverage when it comes to supporting your oral health. It also helps to keep your body more hydrated, which aids in overall function. Chewing sugarless gum also enhances saliva flow and is advised after meals when brushing is not possible.

The tongue is also a tremendous source of oral bacteria. With its tiny grooves, bacteria embed in the tongue and enjoy a warm, moist haven for reproduction. This is why using a tongue scrapper daily or brushing the tongue with your tooth brush can help reduce the amount of bacteria in your mouth quite a bit. Be sure to get to the back of the tongue where the majority of oral bacteria live (even though you may cause some slight gagging while doing so).

If you want fresh breath, the key, obviously, is to control the amount of bacteria in your mouth. Begin with a clean mouth through your six-month dental cleanings and exams. These appointments help to remove buildup that has accumulated between visits, reducing the amount of bacteria in the mouth.

Then, twice daily, brush for at least two minutes, floss daily and use a tongue scraper or brush your tongue. Drink lots of water during the day. Limit sugary treats or drinks since bacteria are super-charged by sugars and carbohydrates. Swish after eating or drinking, especially coffee or a glass of wine to counteract drying effects.

If you are dealing with bad breath on a persistent basis, a periodontal exam is recommended. Through this, we can determine its cause and help to remedy or control it so you have worry-free closeness. The specialized skills of a periodontist provides you with a direct path to fresh breath.

Call our Asheville periodontal dental office at 828-274-9440. If fear or anxiety associated with dental visits has kept you from having regular dental care, please mention this when you schedule as well as during our initial consultation. We have an exceptional track record in caring for fearful dental patients and also offer oral or I.V. sedation, when desired.

 

 

Dental Implants’ Value Gives ‘Priceless’ Smiles

Posted on Jul 25, 2022 by William J. Claiborne, DDS MS

Times are tight. With the higher cost of gas, groceries and utilities, people are getting very value-conscious with their dollars. The ‘frills’ we once indulged in are now being scrutinized as to the value they truly bring.

Yet, there is no better time to explain the wisdom of investing in dental implants. For people who have shed dentures, partials, and gaps in their smiles with this ideal tooth replacement option, they are “priceless.”

Although our ‘permanent’ teeth are intended to last a lifetime, we know that not all of them do, no matter how diligent we are with at-home oral hygiene and regular dental check-ups. Teeth can break or be “knocked out.” Cavities can weaken a tooth, even after it’s been ‘filled.’ That’s why your general dentist may advise a crown, to help you avoid this risk.

A general dentist is a proponent of helping patients keep their natural teeth healthy. Your dentist knows that a lost tooth can lead to a long list of time and expense in the future. And, not promptly replacing a tooth can lead to a higher risk for adjacent teeth to be lost as well.

The teeth you see in the mirror are held in stable position because of the roots that are firmly embedded in the jaw bone. In these roots are veins and nerves that extend into the bone that supports them. From this, the jaw bone is supplied with blood while the presence of the roots provide stimulation that helps the bone to maintain its mass.

The stimulation that tooth roots provide is similar to how muscle will atrophy if not used. For example, when an arm or leg is confined to a cast for an extended time, the doctor will often advise physical therapy to rebuild the muscle after its removed. Unused, the muscle mass declines.

Unfortunately, when the jaw bones decline in mass, rebuilding requires the intervention of a periodontal specialist. (Fear not, however. A periodontist can provide this.)

Bone loss is what causes a change in how partials and dentures fit. These appliances, when first made, are custom-made for the unique contours of your gum “ridge.” A ridge is the raised arch in your mouth where tooth roots are (or were once) held.

As the bone height declines, the denture or partial becomes less secure as the foundation flattens.  Adhesives or pastes are needed more frequently. Relines may help, but only temporarily.

And, the down side continues. When bone loss begins, it accelerates with each passing year. Eventually, a shrinking jaw bone reveals itself in changes in facial appearance. Initially, there may be deep wrinkling around the mouth. The corners of the mouth turn downward. Jowls form and the chin becomes pointed.

As bone loss becomes more severe, the mouth seems to sink into the face. The nose and chin get closer, giving a “granny look”. A thin jaw bone is also more vulnerable to breaks.

This is where dental implants have a particular edge (amongst other things). Like natural teeth, implants are held by the upper or lower jaws. Dental implants are able to mimic the stimulation needed to prevent the process of “resorption,” as its known.

Another bonus of dental implants is their ability to help surrounding natural teeth remain healthy. Unlike a crown-&-bridge combination, dental implants do not rely on neighboring teeth for support. 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. For people who experienced the frustrations of trying to eat with a “wobbly” or “slippery” denture, they love the restored ability to eat a healthy diet. And, the shadow of embarrssment no longer looms when eating out with friends.

Dental implants come in many sizes and shapes, each system designed to accommodate various needs and preferences. Couple this with the extremely high success rate of dental implants, higher than any implant-in-bone option.

Dental implants are also designed to last a lifetime. I can think of very few things that provide this kind of value. With proper selection and maintenance, they will never need replacing or repair. This makes them an excellent investment.

A periodontist is a dental specialist who is trained to understand the intricate concepts involved in selecting the proper type of implant and skilled at placing implants at proper depths and angles. A periodontist is also able to optimize patient comfort during treatment and throughout the healing phase.

In addition to this advanced training, our dental office offers some of the most advanced technology available. This aids in the diagnosis and treatment planning of dental implants, providing patients with optimized comfort and outcomes. This technology, combined with our advanced skill level, can help you enjoy a comfortable, efficient experience that allows you to enjoy a lifetime of confident smiles.

As a periodontist in Western NC, we have also developed a reputation for respectful, gentle care. Here, oral and IV sedation are available as needed, administered safely and to the highest standards by a doctor of anesthesiology. If fear or anxiety is a concern, feel free to mention these during a private consultation.

To learn more or to schedule a consultation, call 828-274-9440. Or, ask to begin with an initial periodontal examination.

Pregnancy Gingivitis Can Affect More Than The Mother’s Health

Posted on Jul 14, 2022 by William J. Claiborne, DDS MS

Is there any other time in a female’s life when they must be as health conscious as during pregnancy?

Pregnant women, it seems, are given a long list of guidelines to follow… What they should not eat or drink, what medications to avoid, and even down to what beauty products to give up. Yet, the 9 months of discipline is well worth the greater potential to bring a healthy baby into the world.

Along with the other health guidelines, obstetricians are now urging pregnant women to pay particular attention to their oral health. For decades, research has tracked a correlation between inflammatory bacteria in the mouth to a number of serious health problems, including many far beyond the mouth.

Once the infectious bacteria of gum disease enter the bloodstream (typically through tears in weakened gum tissues), it can trigger inflammatory reactions, many serious and some that can have deadly consequences. It is the nation’s’ leading cause of adult tooth loss and has been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

However, because of their susceptibility, the risk for full-blown gum disease is higher for pregnant females with nearly a third developing gum disease. Yet, it’s not just the oral (and overall) health of the mother that can be affected.

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

One study showed that pregnant women with gum disease were 4 – 7 times more likely to deliver prematurely (before week 37) and underweight babies than mothers with healthy gums. Too, the women with the most severe periodontal (gum) disease delivered most prematurely, at 32 weeks.

Other findings show that gum disease increases the risks of late-term miscarriage and pre-eclampsia. When oral bacteria reach placental membranes via the bloodstream, inflammatory reactions can trigger pre-eclampsia or early labor.

In one study, for example, pregnant females with higher blood levels of antibodies to oral bacteria also had higher rates of preterm birth and babies of low birth weight. These elevated antibodies have been found in amniotic fluid and fetal cord blood samples of infants who were preterm or of low birth weight at birth.

Oral problems in pregnant females can begin even when the mother-to-be is following the same oral hygiene routine as they have previously. The greater susceptibility can be blamed on fluctuating hormone levels during pregnancy. These changes increase the risk for gingivitis (inflammation of the gums) and periodontal disease.

This is why approximately 40% of women develop gingivitis during pregnancy, known as pregnancy gingivitis. Pregnancy gingivitis is a mild form of gum disease that causes gums to become swollen, tender and bleed easily when brushing.

This is the result of an increased level of progesterone in pregnancy, which makes oral bacterial growth easier. Progesterone also makes gum tissues more sensitive to plaque. For those who have significant gum disease prior to pregnancy, being pregnant can make the condition worse.

Gum inflammation typically appears between months 2 and 8 of pregnancy. Signs of pregnancy gingivitis range from gums that are red rather than a healthy pink. Gums will often bleed when brushing teeth and be swollen and tender in spots.

The goal is to prevent pregnancy gingivitis before it occurs. Be committed to a thorough oral hygiene regimen at home, which includes brushing twice a day, flossing daily and swishing with an antimicrobial mouth rinse. Be sure to keep your 6-month cleanings and exams. These will remove any plaque buildup that has occurred between visits.

A periodontist has specialized training in the diagnosis and treatment of all levels of gum disease – in a way that is safe for pregnant women (as well as all patients). Signs and symptoms of gum disease include gums that bleed when brushing, frequent bad breath, swollen or tender gums, gums that loosen or pull away from the base of teeth, or gums that darken in color.

If you have any of these symptoms (whether pregnant or not), you are urged to schedule an appointment at your earliest convenience. Call our Asheville periodontal dental office at 828-274-9440 to arrange an examination to begin.