3 Things You’re Doing To Up Your Risk for Gum Disease


Posted on May 15, 2023 by William J. Claiborne, DDS MS

In life, we don’t know what we don’t know. As a periodontal specialist in Western NC, I see this a lot with adults who develop periodontal (gum) disease. Many go most of their lives unaware that certain things they’ve been doing all their lives led (or can lead) to the development of gum disease and often, tooth loss as a result.

According to a report on the health of Americans (published by the CDC, the Centers for Disease Control & Prevention), it is estimated that over 47% have some form of gum disease. Although we all aspire to have a smile that is appealing, it is what lies beneath the teeth and gums that can wreak havoc on one’s overall health.

Over time, inadequate daily oral hygiene enables an overload of bacteria in the mouth. Oral bacteria are living, eating, and reproducing organisms, thriving on rotting food particles caught between teeth. They attack gum tissues and tooth enamel and eventually work down tooth roots and attack the bones and tendons that support teeth.

Early signs of gum disease are frequent bad breath along with swollen, tender and beefy red gums that bleed when you brush. As they grow in number, the gum tissues become weaker and they can penetrate the bloodstream.

Through tears in diseased gum tissues, this infectious bacteria can enter the bloodstream. This potent bacteria are now associated with a number of serious health conditions due to their ability to trigger systemic inflammation. These include heart disease, stroke, some cancers, Alzheimer’s disease and more.

According to the American Academy of Periodontology (www.perio.org),

“Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.

“Scientists believe that inflammation caused by periodontal disease may be responsible for the association.

“Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.”

Obviously, the goal is to prevent the onset of gum disease. This can be done easily with the investment of just minutes per day and regular dental check-ups and cleanings. The following can give you a good idea as to what you may be doing to make you vulnerable and how to lessen your risks.


• FREQUENT SNACKING

Snacking has become pretty common over the years. Many Americans snack, with such things as a mid-morning latte or afternoon candy bar topped off by a bowl of ice-cream after dinner. All these add-in’s to three meals a day lead up to a bombardment of oral acids in the mouth.

Anytime you eat or drink, an acid attack begins in the mouth. This is a normal part of the digestive system, starting the break-down of foods during the chewing process. However, this also means that every sip of cola or bite of granola bar, an acidic bombardment occurs in the mouth for about 20-30 minutes. When the mouth endures frequent acid attacks during the day, damage to precious tooth enamel will lead to cavities.

Although Americans are the leading nation for sugar consumption, carbs also break down as sugar in the mouth. This means that the potato chips and popcorn you munch on are adding to these risks as well.


• ORAL DRYNESS

Xerostomia, commonly known as “dry mouth,” is a frequent state of oral dryness. Saliva is your mouth’s natural rinsing agent that helps cleanse oral bacteria from the mouth. This keeps bacteria to a minimum.

When saliva flow is depleted, bacteria linger in the mouth longer, giving them more time to multiply. As oral bacteria thrive, reproduce and amass, the initial result is plaque. Plaque is the sticky film you can feel on teeth.

Periodic dry mouth can occur from consuming alcoholic beverages, coffee and certain medications. Although sugary drinks don’t necessarily dry oral tissues (unless they contain caffeine), sugar enhances growth of bacteria reproduction. When food and beverages contain caffeine AND sugar, this hits the mouth with an even higher risk for oral bacteria growth.

Other causes of dry mouth include medications, such as antihistamines and some prescribed for depression and urinary incontinence. Medical conditions, including acid reflux, sinus infections, diabetes and bronchitis are also contributors. 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 – is smoking.


• INADEQUATE ORAL HYGIENE AT HOME

Bacteria are living organisms that eat, reproduce and emit waste. Their ability to reproduce is astounding, resulting in a consistently growing number of waste-producing creatures. And they stink, causing bad breath.

Poor oral hygiene is the most common cause for bad breath. Not brushing and flossing or doing so adequately allows oral bacteria to reproduce, which leads to plaque.

When plaque is not removed thoroughly on a daily basis, it turns into a cement-hard substance known as tartar. This mass is actually a solid colony of oral bacteria that attaches to teeth. Once in the form of tartar, it can no longer be brushed or flossed away.

Tartar attacks enamel and gum tissues, causing the gum tissues to become inflamed. This inflammation can quickly develop into gingivitis, an early form of gum disease. If not resolved fully, however, gingivitis can lead to full-blown periodontal disease.

It is estimated that nearly a third of American adults brush their teeth for an insufficient amount of time. Even worse, about that same amount fail to brush twice a day. This means that an alarming amount of bacteria remain to grow and thrive in the mouth.

Proper brushing includes brushing for at least two minutes twice daily with thorough swishing afterwards. Brush using a circular motion rather than scrubbing teeth back and forth (which can damage and wear away tender gum tissues). Never use a hard bristle tooth brush or brush with harsh substances (such as baking soda).

You may be surprised to learn that brushing only tackles about half the amount of oral bacteria. The tongue actually harbors 58 – 65 percent of the bacteria in the “oral cavity.”

Oral bacteria, which take up residence in the tiny bumps and grooves of the tongue, are not easily dislodged. Thus, it is necessary for tongue cleaning to be a part of your oral hygiene regimen at home.

Some toothbrushes have a “tongue scraper” on the reverse side of the bristles that’s an effective option. Or, you can brush your tongue with the bristles after your teeth are brushed. Be sure to reach towards the back of the tongue where the majority of bacteria exist.


If you are experiencing symptoms of gum disease or have not received regular dental care, call 828-274-9440. We’ll arrange a periodontal exam in our comfortable Asheville periodontal office. Or, you can request a consultation appointment to begin. This time will allow you to get to know us and our advanced technology, often saving our patients treatment time while enhancing comfort.

If financial constraints are a concern, ask about our easy payment plans. These can break treatment fees into monthly payments that are manageable to most budgets.

Amazing Technology In Treating Gum Disease


Posted on May 09, 2023 by William J. Claiborne, DDS MS

Recently, an episode of the CBS News’ television program “60 Minutes” provided an in-depth update on the development of prosthetic limbs. Now “robotic” in description, advancements are making it possible for people with spinal cord injuries and amputations to control prosthetic limbs with their minds, including grasping objects.

What is miraculous, however, is how these advanced prosthetics can also restore a sense of touch to their brains. The decades-long project is due in most part to the Defense Department.

https://www.cbsnews.com/news/advancements-in-prosthetics-limb-technology-allow-feeling-control-60-minutes-transcript-2023-03-26/

https://www.gao.gov/products/gao-22-106118

Technology today is remarkable. Advancements are moving forward at an impressively accelerating pace. We are witnesses to the the repair and rejuvenation of bodily parts in almost a “good as new” state. This is also true in the area of dental technology.

A periodontist is often a “behind the scenes” dental specialist, working with general dentists and various other dental specialists. While periodontists may be in the background, they stay busy. In addition to treating all stages of gum disease, these specialists have advanced skills in the placement of dental implants.

It is estimated that over 47% of American adults have some level of periodontal (gum) disease. This disease is the nation’s number one cause of adult tooth loss. However, gum health needs to be seen by the general population as a vital player in one’s overall health.

The destruction of periodontal disease is not just confined to the mouth. It spreads. Gum disease destroys bone structures below the gums. These structures are the upper and lower jaw bones, which support natural tooth roots.

The jaw bones are actually kept healthy by the presence of tooth roots. These roots provide stimulation to the bone as well as nourishment that feeds through the tooth’s interior.

By holding their roots securely, the jaw bones provide natural teeth with a sturdy foundation. This enables the ability to bite and chew comfortably and dependably.

However, when a natural tooth is lost, so is the stimulation and nourishment to that area of the jaw bone. Without it, the bone begins to shrink. As it declines in mass, the adjacent teeth are more vulnerable to loss. Statistics show that teeth adjacent to areas where natural teeth are missing will be the most likely to be lost next. This creates somewhat of a domino effect.

Dental implants were designed to recreate the presence of natural teeth both above and below the gum line. Because teeth attached to dental implants are supported by the jaw bones, the study foundation as was had by natural teeth is restored, along with the ability to bite and chew without movement or embarrassment when dentures (or partials) slip.

In addition to tooth loss, gum disease is a serious health threat. Although people are often aware of the issues that come with wearing dentures and partial, many are not familiar with the health problems associated with gum disease bacteria.

This infectious bacteria of gum disease are capable of causing inflammatory reactions elsewhere in the body. Systemic inflammation is the now-known epicenter of a number of major health problems, including heart disease, stroke, high blood pressure, diabetes, arthritis, impotency and more.

Whether the patient’s need is the restoration of gum health or the replacement of missing teeth, the advanced skills of a periodontist can be highly advantageous. Through their unique understanding, they can help to minimize treatment time and complexity of treatment.

In our Asheville NC periodontal dental office, we feature some of the most advanced imaging and computerized technology available in the industry. These include:

LANAP Protocol Using PerioLase MVP-7: Efficiently and effectively treats periodontitis (advanced gum disease) with laser technology. It causes very little discomfort and has a quick recovery time. This has also been found to stimulate bone regrowth in damaged areas.

Dental Radiology With 3-D Cone Beam Technology: This imaging is ideal for diagnosis and treatment planning. The imaging covers the entire dentition area with clear views of the mandible and maxilla (upper and lower jaw).

CareStream Cone Beam Computer Tomography Imaging: This computerized tomography provides imaging in exceptional detail and range.

CS 3600 intraoral scanner: Patients no longer have to endure having impressions made with bulky, gloopy trays held in their mouths! This quickly and comfortably scans the mouth’s interior for digital impressions using a small, handheld scanner. It can also reach difficult–to–access areas in the patient’s mouth with improved patient comfort.

Simplant Dental Software for Computerized Dental Implant Placement: This system helps in pre-surgical positioning of dental implants on the computer, using a 3D model of the patient’s jaw. This aids in the selection of the implant type that ensures a precision fit.

Intraoral Camera Technology: This provides outstanding quality of images within the mouth. These images are sent to screen for a clear, crisp view so we can confer with patients on specific treatment issues.

Computer Imaging In Treatment Suites: Treatment suites are equipped with computers for convenient image sharing with patients.

Advanced Sterilization: Our custom sterilization unit adheres to (or exceeds) CDC guidelines for instrument processing protocols, particularly in the cleaning of instruments.

Fully-Equipped Surgical Suites: Relax during treatment while surrounded by beautiful mountain views of Asheville.

My staff and I also take great pride in providing patients with optimal comfort, along with an environment of respect. Some adults comes to us embarrassed by the condition of their oral health or missing teeth. Here, we strive to make patients feel they are not only in the right hands, but they are in the right place.

Comfort is supported by our sedation options. These include oral and I.V. sedation. Also referred to as “twilight sleep” or “sleep dentistry,” these sedatives are administered by skilled professionals who utilize advanced safety monitoring equipment.

I believe that the rampant number of people who have gum disease in the U.S. is largely in part due to being unaware of the symptoms. Some are easily ignored or “brushed off” as normal.

This is why it is important to be familiar with the signs and symptoms, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding (pulling away from the teeth) or make the appear teeth longer than normal
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

If you have any of these, you are urged to seek periodontal care as soon as possible. This disease will only worsen without treatment.

Call 828-274-9440 to schedule a consultation in our state-of-the-art Asheville periodontal dental office.

Heightened Oral Cancer Risk From HPV Virus


Posted on Apr 10, 2023 by William J. Claiborne, DDS MS

April is National Oral Cancer Awareness Month. There is good reason that an entire month has been devoted to this dire health problem. With the growing statistics surrounding HPV and its ties to Oral Cancer, especially amongst adolescents, the need for education and clear, straight-forward discussions are needed.

First, know that the human papilloma virus (HPV) is the nation’s most common sexually transmitted virus. At least 50% of sexually active people will have genital HPV at some time in their lives. While awareness of HPV risk is gaining ground, it is not commonly known that the virus can spread through oral sex and linked to diseases in the mouth.

An estimated 20 million Americans are infected with the human papilloma virus. HPVs, which are a group of more than 200 viruses with 40 types, can easily spread through direct sexual contact, including vaginal, anal, and oral sex.

Virtually all cases of cervical cancer are caused by HPV. In the 1980’s, HPV was attributed to around 16% of mouth and throat tumors. Within two decades, that figure had increased to nearly 75%. According to the World Health Organization (WHO):

“Almost all cervical cancer cases (99%) are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact.”

A particular type of HPV, the high risk HPV 16, is found in cancer of the tonsils, vocal cords, base of the tongue, and oesophagus. A low risk HPV that causes genital warts may also be found in some cases of cancer of the vocal cords.

Oropharyngeal cancers include malignancies of the tonsils, soft palate, base of the tongue and throat. HPV is commonly transferred through genital contact but HPV spread through oral sex is what increases the risk of mouth and throat cancers.

Another fact that is not widely known is the higher risks for males. Oral cavity and oropharyngeal (throat) cancers are twice as common in men than in women. HPV-related oropharyngeal cancers occur more often in men. The development of oropharyngeal cancer due to HPV is about three times less prominent in females than in men of the same age.

About 10% of men and 3.6% of women have Oral HPV, which is transmitted through sexual or skin-to-skin contact. Oral HPV can spread through deep tongue kissing and oral sex. In men, symptoms may appear in the form of warts, growths, lumps, or sores on the penis, scrotum, anus, mouth, or throat.

Other factors that can heighten the risk that HPV will develop into cancer include:
• Smoking or chewing tobacco (increases oropharyngeal cancer risk)
• Weakened immune system
• Having many children (increases cervical cancer risk)
• Long-term oral contraceptive use (increases cervical cancer risk)
• Poor oral hygiene (increases oropharyngeal cancer risk)
• Chronic inflammation

The spread of HPV is said to be at an epidemic level. Thus, the Centers For Disease Control & Prevention (CDC)  which has prompted the recommendation for HPV vaccinations for ages 11 – 12 year olds. Being vaccinated before becoming sexually active can lower one’s risk of being infected by HPV types and several types of cancers associated with HPV.

Regardless of age, vaccines are available, which many doctors encourage for sexually active patients who have multiple partners. For those who are not vaccinated against HPV, condoms can lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer.

However, HPV can infect areas that are not covered by a condom. Therefore, the risk remains high for many even with the use of condoms. Condoms do not give complete protection against HPV transmission, which can mean potential infection of areas not covered.

When it comes to oral cancer, alert us immediately if you experience any of the following symptoms that do not clear up within two weeks:
• Have difficulty swallowing
• Have lumps in the neck
• Experience pain in the mouth or ear
• Notice unusual spots inside the mouth (including the tongue) or on the lips

A periodontist is a specialist in the treatment of oral gum tissues and in the placement of dental implants. This dental specialist understands the unique health and risks to gum tissues.

In our Asheville periodontal dental office, we also offer some of the industry’s most advanced digital technology available. These features often minimize the extent of treatment needed, speed healing, and enhance comfort.

We also offer oral and IV sedation for many procedures. These sedatives are safely administered by professionals who are specifically trained in the administration of anesthesia. Here, patient safety and comfort are always priorities.

If you have ANY symptoms that may indicate oral cancer, do NOT wait until your next check-up to have these evaluated. Call 828-274-9440 for an immediate appointment.

Sources:

https://www.who.int/health-topics/cervical-cancer#tab=tab_1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544688/

https://pubmed.ncbi.nlm.nih.gov/20116657/

https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/risk-factors.html#:~:text=Oral%20cavity%20and%20oropharyngeal%20cancers%20are%20twice%20as%20common%20in,seen%20more%20often%20in%20men

https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet

https://www.colgate.com/en-us/oral-health/hiv-aids-and-stds/dental-care-hpv-and-men#

Mental Health Can Adversely Affect Oral Health


Posted on Mar 06, 2023 by William J. Claiborne, DDS MS

It seems almost every week that I read findings of recent studies that correlate oral health to overall health. It is not surprising that research newly shared reveals connections of how mental health can affect oral health, and vice versa.

It shows that people with mental conditions can be a contributing factor to poor oral hygiene. These conditions include depression, mood disorders, anxiety, OCD (obsessive-compulsive disorders), mood disorders, and eating disorders. These individuals are 2.7 times more likely to experience tooth loss early.

One factor is anxiety and panic, which are often associated with dental treatment.

According to the National Institute of Mental Health, mental illnesses in the U.S. Nearly 1 in 5 adults have with a mental illness (52.9 million in 2020). These numbers have increased post-pandemic.

The Mayo Clinic shared:
“Surveys show a major increase in the number of U.S. adults who report symptoms of stress, anxiety, depression and insomnia during the pandemic, compared with surveys before the pandemic. Some people have increased their use of alcohol or drugs, thinking that can help them cope with their fears about the pandemic. In reality, using these substances can worsen anxiety and depression.”

Poor dental health can be seen in depressed people by a dentist. For example, over 46% of depressed people report tooth pain without apparent cause, known as atypical odontalgia. Too, burning mouth syndrome is an oral condition more common with adults suffering from depression.

Additionally, mental conditions have been linked to oral conditions, such as:
Gum inflammation
Periodontal disease
Cavities
Dry mouth
Chronic jaw and facial pain
Oral ulcers

The relationship between the two – oral health and mental health – seems to lie in cortisol levels. Cortisol is a stress hormone. Stress and anxiety cortisol levels that are too high adversely affect the immune system. This increases the risk of gum disease, oral sores, and infections.

Seeking professional help at the right time is essential to manage an excellent oral and mental state and overall health.

There is also a domino effect once depression or anxiety trigger an imbalance in cortisol. When one’s smile is in poor condition (cavities, stained teeth, missing teeth, bad breath), it can lead to low self-esteem and social isolation. This contributes to a lower quality of life and, in turn, disrupted mental health.

Mental health status has been shown to activate, aggravate or worsen oral problems. These include…

•Gum health and periodontitis (advanced gum disease)
When stress and periodontal disease negatively impact the body’s immune system, inflammation often worsens gum disease. Too, people who endure ongoing stress are more likely to smoke, drink alcohol, or take drugs. These can cause people to neglect maintaining good oral hygiene and be less committed to having regular dental checkups.

•Dry mouth
Eating disorders (such as anorexia nervosa and bulimia) can reduce the amount of saliva – the mouth’s bacteria-rinsing agent. A dry mouth enables the growth of bacteria. Add to this is how many antidepressant medications have a side effect of causing oral dryness.

•Pain in jaw joints
Chronic stress and anxiety are frequent contributors to facial and jaw pain. Teeth grinding and clenching are not uncommon among people with mental conditions. These actions can cause broken, worn or chipped teeth in addition to the painful conditions associated with TMJ disorders.

•Oral ulcers
Lip, tongue, and ulcers inside the mouth can occur more often in people under frequent or chronic stress.

•Developing Cavities
Individuals with mental illnesses are more likely to have dental decay due to a rise in cavity-causing bacterium with a reduced saliva flow – a recipe for developing cavities.

•Tooth erosion
Bulimia is an eating disorder in which vomiting is used to lose weight. Over a third of bulimia patients with eating disorders suffer from tooth erosion due to regurgitated stomach acids that cause tooth erosion.

•Oral cancer
When dental health neglect is coupled with heavy consumptions of alcohol and smoking, the risk of oral cancers increases. Persons who are heavy smokers and drinkers are 50 times more likely to get oral cancer compared to those who never smoke or drink heavily.

Obviously, mental health is closely connected to your oral health. Begin by speaking with a therapist or mental health specialist. Taking care of your mental health is vital to overcome related dental issues.

If you are noticing any of the signs of oral health problems, you should see a periodontal specialist as soon as possible. These signs and symptoms include:
– Bleeding gums when brushing
– Frequent bad breath
– Red, swollen gums
– Gums that are tender or sore
– Gums that pull away from the base of teeth
– Loose teeth

A periodontist is a dental specialist who can help you restore your oral health and enjoy a confident smile. If you’ve experience tooth loss, a periodontist also specializes in the placement of dental implants.

Our Asheville periodontal office also provides sedation options. These include oral and I.V. sedation (“twilight sleep”). These are administered safely by a doctor of anesthesiology who uses advanced safety equipment to monitor you throughout your procedure.

Call 828-274-9440 to schedule an exam or an initial consultation to get to know us better.

Sources include:

https://healthnews.com/family-health/dental-and-oral-health/how-mental-illness-affects-your-oral-health/

https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/mental-health-covid-19/art-20482731

https://health.uconn.edu/sbirtacademy/wp-content/uploads/sites/101/2016/08/Dental-brochure.pdf

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