E-Cigs & Oral Health

Posted on Dec 23, 2021 by William J. Claiborne, DDS MS

When it comes to vaping (using e-cigs) health risks to the heart and lungs are what tend to be the focus. However, vaping poses a number of other health risks, one being to your smile.

Risks to your oral health makes perfect sense. Think about it – the damage from vaping would naturally begin at its entry point: your mouth.

Although e-cigarettes do not contain tobacco, they are still delivery systems for nicotine. In addition to being addictive, studies show that the inhaled nicotine through vaping can alter the genetic makeup of your cells. This, in turn, stimulates the growth of cancerous cells in the body and increases your risk of developing cancer.

This can lead to tumor growth in the following types of cancer:

• Lung cancer
• Gastrointestinal cancer
• Pancreatic cancer
• Breast cancer

While much remains to be determined about the hazards surrounding this “alternative” delivery system to nicotine, more and more studies are showing unfavorable outcomes. When it comes to oral health, studies are culminating in a mountain of evidence that links e-cigarettes with poor oral health.

A study published earlier this year (iScience) showed that 43 percent of people using e-cigarettes had gum disease and oral infections. That figure jumped to 73 percent among smokers.

Nicotine (inhaled by any means) restricts blood flow to the tissues in the mouth. These tissues are moist by nature and designed to absorb moisture. Because of nicotine’s harmful contents, blood flow is restricted and oral tissues become dryer.

Today’s e-cig user is likely unaware of what’s in the fluid being inhaled. The vaping mist can contain propylene glycol, benzene, formaldehyde and other chemicals.

When the oral tissues repeatedly endure hazardous components, resulting issues can be inflammation, cavities, bone loss of the structures that support teeth, advanced gum disease (known as periodontitis), and oral cancer.

Because vaping is still a recent agent for nicotine, studies on the long-term effects are underway. Still, even without a long history of findings, early studies show concerning results.

When it comes to your oral health, studies indicate that vaping increases the risk of gum disease by causing gum inflammation and swelling. When these issues are combined with a dry mouth and higher levels of bacteria, the likelihood for developing gum disease shoots up significantly.

The common symptoms of gum disease for vapers include:

• Persistent bad breath
• Gums that bleed when brushing teeth
• Tender or swollen gums
• Loose or shifting teeth
• Receding gums

The effects of vaping on the teeth and gums can cause:

Dry mouth – Nicotine from e-cigarettes reduces the saliva in your mouth, your mouth’s rinsing agent. Too little saliva can lead to dry mouth, accumulated plaque (and subsequent development of tartar), increased bacteria, and tooth decay.

Receding gums – Nicotine restricts blood vessels, reducing blood flow to the teeth and gums. Without adequate blood flow, the gums fail to get sufficient oxygen and nutrients. This can cause the gum tissues to decline, which can lead to gum recession. This can result in tooth sensitivity, a higher risk of cavities and even tooth loss.

Bruxism and tooth damage – Nicotine acts as a muscle stimulant, which can lead to tooth grinding (bruxism) or worsen already-existing problems. Grinding or clenching can lead to tooth damage, such as chipped, fractured or broken teeth.

Oral health is a critical element of whole-body health. Two preliminary studies (presented at the American Stroke Association’s International Stroke Conference) linked gum disease with a higher rate of strokes caused by hardening of large arteries in the brain and with severe artery blockages.

A 2018 study in the American Heart Association’s journal Hypertension found that gum disease appears to worsen high blood pressure and interferes with medications to treat hypertension.

It is a misconception to believe that e-cigarettes are healthier than traditional cigarettes, or that vaping isn’t bad for your smile. If you’re a smoker or vaper, be highly committed to having regular dental cleanings and exams as well as your twice-daily oral hygiene routine at home.

If, however, signs of gum disease are already present, have a periodontal examination as soon as possible. Once underway, gum disease will only worsen without treatment. Call 828-274-9440 to schedule or to learn more. As an Asheville periodontist, I have advanced skills in treating all stages of periodontal (gum) disease and in the placement of dental implants.

Our Western NC periodontal dental office also places an emphasis on advanced technology and in comfort options, including oral and IV sedation (twilight sleep).

https://www.heart.org/en/news/2020/08/26/need-another-reason-not-to-vape-your-oral-health-is-at-risk

https://www.deltadentalwa.com/blog/entry/2018/06/ecigarettes-vaping-dental-health

Cut Dental Costs With Simple Steps

Posted on Dec 15, 2021 by William J. Claiborne, DDS MS

In order to avoid costly repairs on our vehicles, we rotate our tires, have the oil changed periodically, and make sure certain fluids are at sufficient levels. This is why our annual inspections are so important; risks can be pointed out to keep us safely on the road.

The same is true with our family’s health. We stay proactive by eating healthy, staying active and having regular check-ups along with periodic screenings.

It simply makes sense to be committed to preventing problems or catch any that do arise at early stages. Research has shown that your oral health deserves the same commitment you give to maintaining a healthy body.

Studies have found a correlation between the bacteria of periodontal (gum) disease and serious problems elsewhere in the body. These include heart disease, stroke, diabetes, arthritis, preterm babies,  impotency and more.

Another reason to maintain a healthy smile is to save money. By devoting about 5 minutes per day to your oral hygiene routine, coupled with having dental exams and cleanings every six months, you can prevent many problems from occurring in the first place. The reward is a savings in time and expense that may be needed for repairs – repairs that may have been prevented from occurring in the first place.

Your twice-a-year dental check-ups are opportunities to remove tartar. Tartar is a cement-hard mass of oral bacteria that forms when plaque (the sticky film that coats teeth and gums) is not removed thoroughly attaches to teeth and can no longer be brushed or flossed away.

Both plaque and the hardened mass of tartar are the result of accumulated bacteria. Oral bacteria continually reproduce in the mouth, which provides a warm, dark and moist environment. As they thrive and reproduce, they attack gum tissues.

As they amass to levels beyond what the immune system, oral bacteria can lead to gingivitis (an early stage of gum disease). Unresolved, gingivitis can develop into periodontal disease, an infection. Eventually, periodontitis develops, which is an advanced level of gum disease. At this level, teeth often loosen and must be removed.

While gingivitis causes tender gums to bleed when brushing, periodontal disease symptoms are more severe, including persistent bad breath, sore gums that bleed easily, gums that darken in color, receded gums, and pus pockets that form between teeth.

As devastating as adult tooth loss can be, the potent bacteria of gum disease can enter the bloodstream through tears in disease gum tissues. Research has shown the infectious bacteria of gum disease can activate or worsen the development of certain pathogens.

Obviously, oral bacteria is highly potent. However, it’s easy to control with twice daily brushing and daily flossing combined with regular dental checkups. For added protection, limit sugary snacks and either swish after eating or chew sugarless gum when brushing is inconvenient. Not only will you help to reduce your risk for cavities and gum problems, you’ll be able to enjoy fresher breath and smiling confidence.

It is also important to respond early to signs and symptoms of gum disease. As mentioned above, things like frequent bad breath or seeing blood in the sink when brushing are warning signs that something is wrong.

A periodontist is a dentist who has specialized skills in the diagnosis and treatment of all levels of periodontal disease. He or she can also recontour the shape of gums and place dental implants for optimal results.

If you have not seen a dentist on a regular basis, you may be experiencing symptoms that indicate gum disease. As you would respond to a warning sign with your overall health, so should you with your oral health.

Begin with a thorough examination to determine what your needs are and the best way to achieve and maintain good oral health. You’ll be supporting your overall health in addition to having a confident smile.

If dental fear has prevented you from having regular dental care, ask about sedation options. We offer both oral sedation and IV sedation (twilight sleep). Both are safely administered and you are closely monitoring throughout treatment.

You may wish to begin with a consultation. To schedule, call 828-274-9440.

Even OTC Pain Relievers Have Risks.

Posted on Dec 09, 2021 by William J. Claiborne, DDS MS

When we see new patients in our Asheville periodontal dental office, it’s common to hear comments about how the appointment was the most thorough they have ever experienced. We pride ourselves on our dental hygienists’ skills for dental cleanings, exams of gum tissues, and in advising patients of ways to maintain good oral health at home.

As a periodontal specialist, I perform a thorough examination of the teeth and oral tissues, both visually and through digital imaging (x-rays). In some cases, we use Cone Beam 3D imaging. Our goal is to have an in-depth view of each patient’s oral anatomy and intricate areas that can reveal problems, both potential and existing.

Our hygienists also work to consider the patient’s whole health so we can tailor their treatment to unique needs. They typically begin by noting any medications the patient takes, both over-the-counter or prescription. Herbal supplements taken regularly are also noted. Why?

The number of American adults who regularly use medications for pain relief has significantly expanded. For most mild to moderate pain, preferences for non-prescription pain relievers (analgesics) now lean towards non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen.

There are a wide variety available over-the-counter (OTC), which means they are readily available without a prescription. Because these can be purchased right off the shelf, many people assume these medications are safe.

What consumers often miss, however, is the fact that many of these can have side effects. They can also interact with other medicines, dietary supplements, and alcohol consumption. Because pain medications contain the same ingredients found in a number of prescription drugs, adults may actually be taking a risky dose when combining medications.

According to a report from NBC News, Americans are taking too much of over-the-counter pain relief meds. In a study conducted by a Boston University School of Health researcher, nearly one in five users of popular headache remedies like Advil or Aleve admitted exceeding the recommended daily maximum dose during a one-week period.

Due to the side effects and without medical oversight, this can lead to higher risk for serious health problems, including gastrointestinal bleeding and heart attacks.

https://www.nbcnews.com/storyline/americas-heroin-epidemic/americans-are-abusing-over-counter-drugs-well-opioids-study-shows-n846401

Before taking these meds, it’s important to get to know the types of pain medications (also known as analgesics) and how they work.

NSAIDs are an acronym for non-steroidal anti-inflammatory drugs. In this category are pain relievers that include aspirin, ibuprofen (Advil, Motrin), and naproxen sodium (Aleve, Naprosyn), and ketoprofen (Orudis).

Non-steroidal anti-inflammatory drugs reduce pain and inflammation by inhibiting production of prostaglandins, which are the hormone-like substances that cause them. Unfortunately, NSAIDs also block other prostaglandins that protect the stomach lining, regulate blood flow to the kidneys, and support blood clotting.

This is bad news for people who are regular users of NSAIDs or those who take high doses since they increase the potential for stomach inflammation, peptic ulcers, and intestinal bleeding. This is especially true for older adults. Taking NSAIDs in high doses or for an extended time can increase this risk even more.

An alternative is acetaminophen (Tylenol, Anacin-3, etc.), which relieves pain by affecting the areas of the brain that receive pain signals. Acetaminophen is best when the need is to reduce pain and fever, but is essentially ineffective in calming inflammation. The up side, however, is it will not cause the bleeding or clotting problems that have been associated with NSAIDs.

Yet, just as NSAIDs have a down side, so does acetaminophen. This analgesic is metabolized by enzymes in the liver. Taking too much can lead to liver damage in susceptible people, such as those who drink alcohol regularly. This is why it is important to read the labels of any medication so you don’t exceed the maximum daily dose of acetaminophen.

For most, taking non-prescription pain relievers – as directed on the label – is generally safe. The potential for trouble arises when you combine the following:

• Some NSAID and acetaminophen products, as well as cold, sinus, and allergy remedies, contain a blend of pain relievers. Kidney damage can result from extended use of painkillers that combine analgesics from different sources.

• A wide number of prescribed painkillers contain acetaminophen, such as Darvocet and Vicodin. Some prescriptions contain NSAIDS, including Celebrex and Percodan. Before you combine prescription medications with over-the-counter painkillers, be sure to check with your prescribing doctor first.

• NSAIDs can interact with other drugs, especially ACE inhibitors, anticoagulants, beta blockers, lithium, and methotrexate. Aspirin interacts with anticonvulsants, corticosteroids, insulin, and sulfa antibiotics. If you take any of these prescription medicines, check before using NSAIDs or aspirin.

• People are often surprised to learn that some herbal supplements, including garlic, ginger, feverfew, ginkgo, and ginseng, can thin blood. You should avoid taking these supplements while taking NSAIDs. When having procedures that may involve bleeding gums, these supplements, or combining them with NSAIDs, can complicate your procedure and the healing process.

One of the reasons we request updates on the medications you take at each visit is to provide you with optimal care. We want your oral health to support your overall health, and vice versa. Be a careful consumer of the medications you take, whether OTC or prescribed.

If you have questions, call 828-274-9440. You may want to begin with a free consultation to get to know us, or schedule complete periodontal examination, especially if you have signs or symptoms of periodontal (gum) disease. These include:

• Sore, tender gums that bleed easily while brushing teeth
• Frequent bad breath
• Gums that recede from the base of teeth, exposing darker, more sensitive sections of the tooth’s root
• Gums that are swollen
• Gum tissues that darken to more of a red color versus a healthy pink

If these signs exist, it is important to seek a periodontal evaluation as soon as possible. Gum disease will only worsen without treatment and is the nation’s leading cause of adult tooth loss.

At Biltmore Periodontics in Asheville, we are always happy to see new patients. A referral is not always needed.

Dental Fear Can Lead To Gum Disease, Tooth Loss

Posted on Nov 23, 2021 by William J. Claiborne, DDS MS

Fear is a natural reaction to things that may harm us; it’s a safety mechanism activated by the brain. Take snakes, for instance. Even harmless snakes tend to provoke an initial reaction that warns of impending danger.

Some fears are learned, however. Some people are afraid of dogs, usually stemming from a frightful encounter as children. The incident triggers something in the brain that reminds the individual, even into adulthood, that dogs are to be feared.

When it comes to the fear of dentistry, it often exists because of a traumatic incident in the patient’s past. Or, in some cases, it exists for unknown reasons. Too, certain smells, sounds or sights can trigger the “panicky” reaction some people have to dental visits.

As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss.

Typically, adults who avoid dental visits feel they are doing an adequate job maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass recommended 6-month dental check-ups and cleanings.

Yet, even the best of at-home dental hygiene can be insufficient to the buildup of tartar.

Tartar is the hardened form of plaque, which is a sticky film of bacteria that accumulates in the mouth. In the form of tartar, this cement-hard mass of bacteria cannot be brushed or flossed away. It can only be removed by a dentist or hygienist using special tools.

While plaque can cause bad breath and a “furry” feeling mouth, tartar eats away at tender gum tissues and bores into tooth enamel. As it grows, it works its way below the gum line, creating inflammation in the gum tissues.

Early symptoms of gum disease, known as gingivitis, are tender or swollen gums. You may see blood in the sink when brushing teeth. Breath odor may be bad on a regular basis.

At this point, proper measures may be able to reverse the progression of these rapidly-reproducing bacteria. This requires thorough brushing (twice a day, at the very least), daily flossing, drinking lots of plain water, and using an oral rinse to control bacteria levels.

However, if tartar exists, it’s not going to go away. It will continue to amass and attack the gums and work its way into the tissues below. When the bacteria reach an uncontrollable level, they become infectious.

Think of gum disease bacteria as you would water in a pan on the stove. The heat will eventually cause bubbles to form on the bottom of the pan. This can be likened to gingivitis.

However, as the water heats more, bubbles start to move to the surface. This can symbolize the development of gum disease. The symptoms of gum disease include gums that turn red and bleed easily and persistent bad breath.

When advanced stage periodontal disease develops (periodontitis), imagine the water at full boil. Unfortunately, once aboil, the roil continues even after you remove the pan from the heat. This is known as systemic inflammation.

Gum disease is the nation’s leading cause of adult tooth loss. Yet, the bacteria that destroy gums and the structures that support natural teeth don’t remain confined to the mouth. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.

Research has correlated oral bacteria to a long list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. These include heart disease, stroke, Alzheimer’s disease, arthritis, diabetes, preterm babies, erectile dysfunction (ED), some cancers (including pancreatic), and more.

Obviously, these bacteria are potent and a threat to overall health. For those who avoid dental care due to anxiety or fear, knowing all this is not necessarily going to change their resistance. We understand that it’s still difficult to overcome the challenges even knowing there are risks.

There are options, however, for even high fear dental patients.

In our office, we offer I.V. sedation (“twilight sleep”) as well as oral sedation. Oral sedation is in pill form and creates a totally relaxed feeling. It enables patients to recover quickly and offers an amnesiac effect.

I.V. sedation is a deeper level of sedative. This places patients in a sleep state and erases most or all memory of the procedure after. With both sedations, however, we apply numbing medications to the area being treated to create optimal comfort for patients. We want patients to be in total comfort throughout their treatment, regardless of the addition of sedation.

We also have a reputation for treating our patients with respect and a gentle touch. We are just as committed to comfort for patients who do not want to be sedated as we are for those who are. Our goal is to help each person achieve a healthy, confident smile.

One of the most satisfying parts of my specialty is helping a once-fearful patient achieve a healthy, confident smile and see dental care as a welcomed part of their health care commitment.

If you are ready to get past your dental fears so you can have the smile you desire, begin by calling our Asheville periodontal office at: 828-274-9440 and speaking with our friendly staff. You can begin with a consultation, if desired.