A Primer of Senior Dental Concerns

The term “long in the tooth” originates from the practice of judging a horse’s age by examining its teeth. Likewise, human teeth may also exhibit tell-tale signs of aging.

As we mature, many of us experience bone loss around the base of our teeth. The gum tissue recedes along with it, which exposes the root surfaces of our teeth. Since the root is not covered with enamel, it is more susceptible to tooth decay and is marked by a yellower color as well. Following are a few issues associated with bone loss and gum recession.

Root Caries

As mentioned above, root surfaces are at a greater risk of decay since they are not protected by enamel. This can happen under existing fillings and crowns and highlights the need for meticulous cleansing, as well as frequent radiographic exams to address problems while they are small. A fluoride toothpaste is a must for seniors, and many can benefit a daily fluoride gel application as well.

Exposed Crown Margins

As the gums recede, margins of crowns that were previously camouflaged by the gum tissue become visible. This appears as a dark line under the base of a crown and is unsightly to many. Tooth decay may start here and progress to the interior of the tooth. Depending on the location and severity, a cavity may necessitate a filling or replacement of the crown.

Yellow or Dark Teeth

As we age, our teeth, as well as our bones become more mineralized. This leads to a darker, or yellow appearance in the teeth. Coupled with a lifetime of eating and drinking chromogenic substances such as coffee, tea, berries, and so on adds to the discoloration. Tobacco users will experience even more severe discoloration due to tar and nicotine being incorporated into the teeth.

Multi-colored Teeth

Crowns and fillings are matched to the shade of teeth at the time the restorations are placed.  When older dental work is adjacent to age-related dark teeth, the smile can take on the appearance of calico corn since the restoration is likely to reflect the lighter shades of youthful teeth. In other words, the teeth changed color but the dental work didn’t.

Worn and Obsolete Dental Work

Teeth are subjected to an excessive amount of wear and tear on a daily basis. Think of the grinding, chewing, and pressure they are subject to over a lifetime. Therefore, teeth chip and break, as do dental repairs. Restorations are constructed of man-made materials and will fail at some point. Man-made materials have a lifespan, and as they break down, they can chip, break, and become discolored.

To discuss solutions for your dental issues, age-related or otherwise, feel free to call us for a dental consultation. All of the above concerns have their related treatments and we have 26 years of experience!

Following recommendations from the American Dental Association and Centers for Disease Control, we are asking each patient to rinse for 1 minute with a 1.5% hydrogen peroxide rinse prior to treatment.

What is the reason for this recommendation?

Hydrogen peroxide is proven to have virucidal properties. While no studies show its’ particular effectiveness against COVID-19 in the mouth, it is known that the novel coronavirus is easily destroyed by most disinfectants. A hydrogen peroxide concentration of 0.5% has shown to be effective against COVID-19.

By having our patients pre-rinse with a hydrogen peroxide solution, we are reducing the potential viral load in the patient’s saliva and oral tissues.

Is the pre-rinse harmful to the mouth?

It is not recommended you use a concentration of over 5% hydrogen peroxide in the mouth. The drugstore version you find in brown bottles is 3% and is safe to use full strength, although you should dilute it. The concentrations we use as a pre-rinse are in formulations of 1.5%.

Used as directed, hydrogen peroxide breaks down into water and oxygen in the mouth and is therefore very safe.

What is the proper use?

It is recommended you rinse for 1 minute then spit out the excess.

Hydrogen peroxide is quickly degraded by elements in saliva, so the effects are not long lasting. But by starting treatment with a “clean slate”, we are reducing aerosol transmission that may occur during your procedure.

Can hydrogen peroxide cure someone if they have COVID-19?

No. It cannot cure someone if they are already infected, but is used to reduce the spread of the virus.

Do all mouth rinses have hydrogen peroxide in them?

No. In fact, most do not have hydrogen peroxide in them. Brands such as Scope and Listerine use essential oils and alcohol. In fact, the original Listerine formula is 54 proof!

Are there other mouth rinses that are effective?

Yes, there are several rinses that provide a similar effect, such as povidone iodine and chlorhexidine gluconate. Hydrogen peroxide is preferred since it is clinically acceptable for virucidal activity, is commercially available, inexpensive, and doesn’t have a terribly displeasing taste.

Where can I find it for home use?

We use Listerine Whitening Mouth Rinse for office use. You can find it, or a variant, at your local grocery and drug stores. Colgate Peroxyl is another great product but is less available in the retail market.

To make your own pre-rinse, dilute generic 3% hydrogen peroxide in a ratio of 2 parts water and 1 part hydrogen peroxide. Rinse for 1 minute and expectorate. If you want to get fancy, add some peppermint oil!

A few years back, a dental school professor began his lecture in startling fashion. “There are 76 of you here today”, he stated, “and at some point, 18 of you will die of heart disease and its complications.”

               This captured the attention of my classmates and I, most of us in our mid-twenties and just beginning to marry and start families.

               “Sixteen of you will die from some form of cancer. Lung cancer is most likely, but some of you women may develop breast cancer. Men, you may develop prostate cancer, but colorectal cancer will also take out a few of you,” the professor continued.

               The old doctor presented these statements with no hint of emotion or care for our sensitive feelings. He just laid them out there dryly, as if they were facts and statistics. Which, of course, they were.

               “Five of you will die of unintentional injuries. It may be a motor vehicle accident, a fire, or accidental poisoning. It may be that you drown while boating with your friends. Five of you will die from a respiratory condition.”

               “Four of you will not recover from a stroke. Three will die from Alzheimer’s, and three will die from complications due to diabetes. If statistics hold true, two of you will die from influenza and pneumonia and two from kidney disease. At least one, if not two of you will commit suicide. The remainder will die from other causes such as a natural disaster, alcohol and drugs, or assault. Maybe you’ll get malaria or be hit by something falling from the sky.”

               “The good news is that most of you will live to 81 years of age. Most of you ladies, that is. Men, your life expectancy is 76, so you have about 50 years to do whatever it is you want to do.”

Fast-forward to Spring 2020. Thanks to COVID-19, we now have another concern to add to Dr. Death’s List of Doom. Depending on your point of view, COVID could be included in the “Influenza and Pneumonia” group but may also be at home in “Other Causes.” We’ll know in a few months where COVID-19 fits into our statistics and whether it will give the big boys a run for their money.

               In the meantime, we can control those things we can control, and leave the rest to God, the universe, or the powers that be. As it pertains to the most common causes of death, the main action we can take is to maintain a healthy body weight through proper diet and exercise, avoid smoking and alcohol, and refrain from risky behaviors. We can’t wash heart disease and cancer away or shut them out with a mask, but if we approach the other causes of death with the zeal in which we have challenged COVID-19, we have a fighting chance of arriving at 76 or 81, or 58 or 94 with no regrets.

               The mouth is the gateway to good health, and we stand ready to help you live the happy, healthy life you deserve. Call to schedule an appointment that could change your life!  

Martha Stewart may cringe, but sometimes you need to be a rude host. When a known freeloader with a reputation for wrecking everything in its path shows up, it’s best to pull in the WELCOME mat.

Such is the case with COVID-19. Like other viruses, COVID-19 cannot live on its own. It must inject itself into an existing household, or cell, in order to use the host cell’s goodies. Imagine a rude guest moving into your house, cooking smelly fish in the kitchen and refusing to clean up, not flushing the toilets, and leaving soiled laundry on the living room furniture. And imagine exhausting yourself trying to keep the mess to a manageable level, but the freeloader is moving so fast that you can’t keep up. At some point, you take a breather but the mess piles up so high that you can’t deal with it any longer.

A Little Hostility Never Hurt Anyone

The key here is to be an inhospitable host. When the freeloader shows up, let them find a hostile environment that is not suitable for their shenanigans.

Our bodies are a tightly regulated network of interlocking systems and they don’t like strangers showing up to throw a wrench in the works. When our bodies recognize an unwanted guest, they immediately send out the Unwelcoming Committee, also known as the immune system. These are specialized cells that use any means necessary to expel the freeloader. The fever we experience is the body literally turning up the heat to kill off the virus. Likewise, a runny nose, cough, and diarrhea are attempts to wrap up the freeloader and give them the bum’s rush out the front door, back door, attic, and basement!

So how do we make sure the Unwelcoming Committee is in tip-top shape? Believe it or not, this is all information you have heard before. But faced with a new and dangerous foe, many of us will hopefully begin to heed this simple message.

• Eat a healthy diet full of fresh fruits and vegetables. Avoid processed, chemically-laden foods and sugars. These cause inflammation in our bodies, and our immune systems don’t need to be fighting a war on too many fronts.
• Exercise daily. You don’t need to be Arnold Schwarzenegger or Jillian Michaels, but anything helps. There are many yoga and body weight routines that can be done without joining a gym. Walking is also an excellent exercise. Humans are designed to walk long distances, and this is also a way to get outside, breathe in fresh air, soak up some Vitamin D in the form of sunshine, and enjoy nature.
• Wash your hands frequently with soap. This breaks up the proteins in the virus and washes them down the drain. Avoid shaking hands as well as putting your fingers into your nose and eyes. Doing this inoculates you with whatever contaminants are on your hands.
• Sleep well. Our bodies are very active during sleep as that is when our immune systems take out the garbage of used up cells and by-products of the day’s battles. Don’t drink caffeine after lunch, turn off the light-glaring phones and tablets an hour before bedtime, and sleep in a slightly cool room.

It is thought that each of us has either already had COVID-19, or will get it before all is said and done. When COVID-19, the flu, or the common cold come visiting, be sure you have put out the UNWELCOME Mat.

Stay healthy, stay optimistic, and BE RUDE!

PS. I invite you to watch this video by another Dr. G. I felt this program cut through a lot of the noise we are hearing and gives us practical tips on taking care of our health during this sketchy time.

Let’s “Flatten the Curve”

Following recommendations from the North Carolina Board of Dental Examiners, the American Dental Association, and the Center for Disease Control our office will be closed for elective dental services from Thursday, March 19 at 5:00 pm until Monday, April 6 at 8:00 am.

HOWEVER, we remain open during normal business hours to treat dental emergencies, to provide services to patients in mid-treatment, and for urgent dental services. Urgent services are defined as those procedures that are deemed necessary to reduce the risk of harm to the patient in the future. This will alleviate the need for patients to visit the Emergency Room, preventing overload at those facilities and conserving resources for those in need of treatment due to COVID-19, flu, and other illnesses. This treatment will be by appointment only, and we cannot accept walk-ins. Please call our office during regular hours for instructions on scheduling one of these appointments.

We are unable to see patients who:

• Have a temperature 100.4 or higher. We will take your temperature with a no-contact thermometer when you arrive at our office.
• Are experiencing shortness of breath or coughing.
• Have traveled internationally or to a city/state/region with a significant number of COVID-19 cases within the past 14 days.
• Have been in contact with a person who is infected or presumed infected with COVID-19 within the past 14 days.

Our team is appreciative of the support of our patients and community and would like to be a resource for you. Please don’t hesitate to let us know how we may help!

At the time of this writing, 522 Americans have been diagnosed with coronavirus, while 22 have died from complications of its’ effects. Out of an abundance of caution, we are practicing an alternative to hand-shaking: elbow bumps and jazz hands! We are also ramping up our efforts to keep the public areas of our office disinfected and free of germs, whether they be corona, flu, common cold, or the crud.

Door knobs, faucet handles, counter tops, and other commonly touched areas will be, as Mama used to say, “swarped down” at pre-set intervals during the day using disinfectant wipes. We will also have hand sanitizers in conspicuous places, and encourage thorough handwashing in our public restrooms.

Rest assured that our clinical areas are already clean due to our usual infection control routine to prevent the spread of pathogens from patient to patient, as well as between provider and patient. We employ single use disposable items where we can, and re-usable instruments are sterilized in an autoclave that reaches 275 degrees Fahrenheit. Treatment chairs and room surfaces are disinfected between patients using a professional strength disinfectant designed for healthcare use.

If you are ill, we encourage you to let us know before your visit. Depending on your symptoms, we may recommend that your appointment be rescheduled until you are free of illness. Likewise, we will ask our employees who are ill or have been exposed to illness to stay home. That way we can all be confident that we are doing our best to contain any form of sickness and prevent its’ spread.

So if we offer up a different greeting, please know that we still love you. We just want each of us to enjoy good health until this all blows over. Until then—JAZZ HANDS!

Dr. Michael Gillespie has practiced dentistry in Waynesville, NC for 26 years. Our team has been recognized as “Best Dentist” multiple times. If you would like to join our family of patients, please give us a call!

A beautiful, white smile is a sign of youth, health, and is a social asset. Most would agree that a person’s smile is one of the first things they notice. Tooth whitening, or “bleaching”, is a popular dental treatment and there are several methods achieve a whiter smile. Following are several common questions that are asked when a patient considers brightening their smile.

What is the procedure?

For traditional take-home systems, impressions are made of your teeth and a set of custom gel carriers, or trays are fabricated. The whitening gel is applied inside the trays and inserted onto the teeth.

How long do you wear the trays?

We typically recommend the patient wear the trays overnight so they do not disrupt daily activities. You also salivate and swallow less while sleeping, so the procedure is more comfortable. For those who cannot tolerate the trays at night, we recommend several consecutive hours daily. The more you keep them in place, the better your result will be.

How long does it take?

The take-home kit generally takes a week to ten days. Depending on the severity of discoloration, you may need several additional applications. You may also elect to “touch up” every few months or so. You can buy gel refills without having new trays made.

Can you eat or drink with the trays in place?

It is recommended that you do not drink while wearing bleaching trays. Pigmented drinks and foods may enter the trays and negate the effects of the whitening gel.

Does it hurt the enamel?

The gels used to whiten teeth do not hurt enamel. The whitening gel works by entering microscopic channels in the enamel and interacting with pigmented molecules that reside there. Whitening gels are specially formulated compounds that break down into hydrogen peroxide and are not corrosive to tooth enamel.

Does it damage the gums?

The whitening gels designed for take-home use are not damaging to gum tissue. However, those used for in-office procedures contain a higher concentration of the active ingredients and can be harmful to gum tissues. Your dental professionals will apply a protectant to your gums and closely supervise any in-office treatment to ensure safety.

What is “power bleach”?

Power bleaching is an in-office procedure that may be combined with take-home systems for increased effect. Power bleach is a higher concentration gel and can only be used under professional supervision. While it may be combined with a light, studies show light-acceleration does not increase the whitening effect.

Each tooth whitening case is different and there is no substitute for a professional consultation to determine the treatment that will provide the best result for you. Don’t hesitate to call if we may answer more questions on how to beautify your smile!

Dr. Michael Gillespie has practiced dentistry for over 25 years! The office is located at 611 S. Haywood St. in Waynesville, NC and can be reached at 828-456-9007.

Many people started 2020 with a resolution to get fit and lose weight. (Just like last year, right?) If you chose the Keto Diet for weight loss, you may be noticing an unexpected side effect known as “Keto Breath”.

Blinding You with Science

The basic tenet of the ketogenic diet is that it reduces or restricts carbohydrate intake, so the body begins to burn stored fat in place of dietary glucose. When the body makes this change in its fuel source for energy, you enter a state of ketosis. The burning of fat in ketosis produces several byproducts: acetoacetate, beta-hydroxybutyrate, and acetone.

The acetone produced with the ketogenic diet cannot be used for energy storage, so it is released from the body from the lungs or by urination. Acetone is the cause of a sweet or fruity oral odor from those in a state of ketosis.

Another reason for bad breath while participating in a keto diet, as well as many other low-carb diets is dehydration and dry mouth. Carbohydrates cause the body to store water in muscle and fat, so their absence can lead to a mild dehydration. If you have been on the keto diet or another low-carb diet for very long, you have probably noticed that you are thirsty more often.

So, What to Do?

Good oral hygiene is the most important first step to combat bad breath, no matter its origin. Regular brushing, flossing, and use of a tongue scraper keeps smelly bacteria from colonizing on your teeth and oral tissues. Since the keto halitosis originates from the lungs, try chewing sugar-free gum or adding herbs such as clove, mint, or cinnamon to your drinking water to mask the odors.

Other than weight loss, a positive side-effect of a low-carb diet is that it can improve your overall oral health. In fact, research has shown that a low-carbohydrate, low-sugar diet can reduce tartar formation, dental decay, and gingivitis by more than 50% without changing normal oral hygiene habits! Many of the vegetables that are approved for the keto diet are also dental-friendly, containing the vitamins and nutrients that promote healthy gums and teeth.

Dr. Michael Gillespie has practiced dentistry in Waynesville, NC for over 25 years. Continue your commitment to overall health and fitness by scheduling a dental exam and cleaning appointment with us. You can contact our office at 828-456-9007.

Ever get an “OWWIEE!” when eating something cold or sweet? Sensitive teeth are bothersome and can cause a great deal of discomfort. Following are several possible causes of sensitive teeth and their associated treatments.

Gum Recession

Receding gums leave the root surfaces exposed, allowing temperature changes to be transmitted directly to the nerve through microscopic tubules in the tooth. Gum recession is often present in those who had orthodontic treatment in youth, aggressive brushers, maturing individuals, and those with gum disease.

Treatment: Toothpastes for sensitive teeth act by blocking the tubules in the root surface by chemical reaction and are recommended as a first line of defense. Other cases may require professional application of an in-office desensitizer, and sometimes the root surfaces must be bonded with resin filling material.

Cracked Tooth

Most adults have dealt with a cracked tooth or two, as this commonly occurs through normal wear and tear of the teeth. Teeth with large fillings are particularly prone to cracking, and cycling between hot and cold items, as well as items such as hard candies and ice can lead to cracked teeth.

Treatment: These teeth generally need a protective helmet, also known as a crown or cap. If the nerve has been sufficiently traumatized, root canal therapy may be indicated.

Cavity

Enamel is the hardest substance in the body, but a break in this surface caused by acids can expose the underlying dentin. The acids are the by-product of the bacteria that comprise dental plaque.

Treatment: The decayed section of tooth must be removed and replaced with a dental filling material. If the decay is large or deep enough, the tooth may again require a crown and/or root canal therapy.

Clenching

Grinding your teeth puts a tremendous amount of pressure on the small ligaments which anchor the tooth in the jawbone. This can cause inflammation around the roots of the teeth, leading them to become sensitive to biting, as well as changes in temperature.

Treatment: Many cases require a mouth guard that acts as a shock absorber against the forces of clenching. Severe clenching and grinding can lead to cracked teeth which must be treated as stated above.

If you are experiencing any of the afore-mentioned symptoms, do not delay in having a dental examination. Early treatment is always ideal and can prevent more extensive, as well as expensive dental treatment! Dr. Michael Gillespie has practiced dentistry for 25 years and has been named Best Dentist in Waynesville, NC multiple times!

Some of our patients experience anxiety when presenting for a dental appointment. For a few of them, it is the memory of a bad childhood dental experience. For others it is fear of the unknown or a loss of control. Whatever the reason, the mental anxiety they experience results in physical symptoms that are very real.

Thoughts are very powerful, and by visualizing untoward events, we can actually initiate a cascade of neurotransmitter activity within our bodies. When worrying about a potential threat, our breathing becomes more rapid, our heart rate quickens, and our adrenal glands dump adrenaline and cortisol into our system. All of a sudden, we are in fight-or-flight mode.  

The body is responding to a perceived threat by increasing its oxygen intake in order to direct energy to the muscles and extremities. In a real-life situation, this allows us to either face the threat head-on or quickly remove ourselves from the situation. The problem is, our body doesn’t know that the threat was conjured up by our imagination. It is simply providing an adequate response to the perceived threat.

Take Control

The Navy SEALs, law enforcement officers, and others who are frequently in high-stress situations use a scientifically-proven method to mitigate the fight/flight response. It is a simple technique that will re-set the runaway nervous system, and can be done anytime, anywhere. The method is called box breathing, and is also known as four-square breathing. By consciously taking control of our breathing, we signal to our body that the threat has passed and our situation has returned to normal.

BOX BREATHING PROCEDURE

• Take a long, slow deep breath into the belly over four counts.
• When you reach the apex of the breath, hold for four counts.
• Release the breath over four counts.
• When you reach the bottom of the breath, hold for four counts.

Repeat this procedure 5-6 times or until you feel more relaxed.

See it, Speak it

It is also helpful to feed your mind with positive imagery. Visualizing your “happy place”, such as a beach or mountaintop, or playing with your children and pets can release endorphins that make you feel happy. You may also think back to a time when you conquered a personal obstacle. The purpose is to replace the mental image that is causing you anxiety with one that shows you in a more pleasing spot.

Additionally, using a positive vocabulary changes your mental state. Instead of saying “I can’t do this”, declare to yourself that “I’ve got this!” Instead of repeating “I can’t wait for this to be over”, state that “When this is over I will be healthier. I am taking control of my well-being.” This, again, is a method in which you control your thoughts rather than letting them control you. Just as your body responded to your thoughts of a perceived threat, it will now respond to the stimuli you provide for it, leading to a calmer state.

Music Soothes

Finally, listening to your favorite music instantly takes you to another level. Our musical touchstones take us to specific times in our lives and set up particular mood states. Feel free to bring your headphones with you and access your favorite music on Spotify or iTunes while in our office.