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When digesting carbohydrates, bacteria in your mouth produce an acid that combines with food debris and saliva and forms plaque.
It’s the plaque — not sugar — that directly leads to tooth decay. Plaque starts building up after every meal, and if it isn’t brushed away frequently, it can erode the hard, outer enamel of a tooth, resulting in tiny holes in the tooth’s surface. These holes mark the first stage of cavities and can do a lot of damage to a tooth if left untreated.

Eventually, acid and bacteria in plaque can eat through the other layers of your teeth, as well — from the softer layer of teeth under the enamel, known as dentin, to the third layer (the pulp), which contains your teeth’s blood vessels and nerves. Cavities affecting the pulp of a tooth, as well as the bone supporting the tooth, can cause severe toothaches, sensitivity, pain when eating and even abscesses in the mouth.

It is important to know that the kinds of foods and drinks you consume, and how you are consuming them is also important to oral health.

Sticky foods — like hard candy, breath mints, raisins and dry cereal — can get stuck in the grooves and crevices of your teeth, where they could cause decay. Fruit and yogurt, on the other hand, wash away easily with saliva and are, therefore, less likely to cause plaque buildup.

Quickly finishing a can of soda does less damage to your teeth than sipping on it throughout the day, because the acid created by mouth bacteria stays in the mouth around 20 minutes after eating or drinking. Every time you eat carbohydrates, sugary food, or take a sip of soda, you restart the plaque-production clock and increase your risk of developing cavities.

In addition to a high sugar content, soft drinks and sports drinks also contain phosphoric and citric acids that erode tooth enamel. Eating or drinking highly acidic foods — even healthy foods, like citrus fruits — can lead to tooth decay if oral hygiene is not properly maintained.
None of us can totally avoid eating all carbohydrates, sugars, or acidic foods all of the time but we can limit the amount and more importantly the frequency of consumption. And we can also work on effective and regular plaque control by using oral hygiene aids to remove the plaque colonies which are forming constantly on the teeth.

Dr. Britten recommends brushing at least twice a day with a power toothbrush for two minutes as well as cleaning between the teeth at least once a day using floss or other interdental aids. For more information on effective oral hygiene and plaque control visit our website atwww.brittenperio.com or call the office at 727-586-2681


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Did you know? Periodontal disease is usually more severe towards the back of the mouth and between the teeth because these areas are more difficult to keep clean and free of plaque.  Just look at these very differently shaped molars!

Interdental brushes serve as an alternative or even great addition to brushing and flossing. They can be used daily and can be effective for plaque removal. Proxabrushes, or interdental brushes, are a type of interdental cleaner, meaning it is used to brush between the teeth.  For many patients, they are easier to use than dental floss. There must be at least a small space between the tooth and gum for the brush to pass, so it is ideal for back teeth and/or areas where there has been bone loss, and wider spaces between the teeth.  For most people with treated Periodontal Disease there is no other interdental cleaning aid that works as well as an interdental brush.  A proxabrush typically wears out within two weeks when used daily. A supply of replacement brushes should be kept for ease and speed of brush renewal.

They are available on handles (similar to length of toothbrush handles) or in travel sizes.  A travel proxabrush is covered by a cap that sheaths over the brush. This form of ProxaBrush is conveniently kept in ones pocket or purse, and thus is good for those individuals who want to clean between their teeth during the day, or to take to restaurants or trips.

Who Should Use Them?

  • Anyone who finds flossing difficult
  • People who don’t like to floss
  • People with exposed roots
  • Deep dental pockets
  • Areas of bone loss or gum recession
  • Areas where teeth are missing
  • Previous gum surgery which has exposed more tooth and root anatomy
  • Larger spaces between the teeth
  • Grooves and concavities in teeth and roots
  • People with braces – great around brackets and wires

How To Use Them



For more questions about oral hygiene and interdental care, periodontal disease of dentistry, visit www.brittenperio.com


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“All those bumps and grooves on your tongue are a haven for bacteria and could be contributing to your bad breath because of the gases they give off, says Dr. Matthew Messina, a consumer advisor for the American Dental Association. It’s important to take care of the tongue in addition to regular brushing and flossing.”-from Colgate.com

The front portion of the tongue is pretty self-cleansing, however, the back portion can often collect more bacteria. You can use a toothbrush or a special tongue scraper. Tongue scrapers come in various designs.

Some tips:

1-Clean any area where there is a coating. This is usually found on the back portion of your tongue.

2- Be gentle. Don’t go too far back and stick to the center of the tongue and not the sides which are more delicate and prone to injury. If you have a sensitive gag reflex a tongue scraper will probably work better for you.

3- Do it daily. Just like brushing and flossing, frequency is key. Oral bacteria are constantly reproducing. Once you start doing it daily, you may find that your mouth just doesn’t seem as clean without doing it

If you’re tired of high maintenance and uncomfortable dentures, you might be able to have implants placed to support your denture. An implant-supported denture is used when a person doesn’t have any teeth in the jaw, but has enough bone to support implants. An implant supported denture snaps into place on dental implants. This prevents the denture from slipping or coming loose in the mouth. It also removes the need for denture paste or adhesives. The implant supported denture can be removed at night for cleaning or, if you have a fixed implant supported denture placed, your dentures will act as permanent teeth.

There are two types of implant supported dentures, bar-retained dentures and ball-retained dentures. Both types of dentures require two or more dental implants to be placed and both will provide you with a beautiful, natural smile.

Bar-Retained Dentures

In the bar-retained type of denture, three or more implants are surgically placed in the gums. Attached to these implants is a metal bar that runs along the gum line. The denture then rests on the metal bar and is attached using clips or other types of attachments. This type of implant-supported denture holds the denture in place without the steel studs used in ball-retained dentures.

Ball-Retained Dentures

Ball-retained dentures, also called stud-attachment dentures, use a ball-and-socket design to attach the dentures to the implants surgically placed in the gums. Traditionally, the denture is fitted with sockets and the implants have a ball on top of them. The denture and implants snap together where the ball and sockets meet.

Many patients prefer implant-supported dentures to traditional dentures because they alleviates much of the discomfort and rubbing of traditional dentures. The denture is held in place far more securely and is less likely to come loose. Dr. Britten is a dental implant specialist who can evaluate to see if you are a candidate for implant-supported dentures. Call us today 727-586-2681 or visit www.brittenperio.com


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The maxillary sinus is a hollow chamber lined by pseudostratified columnar epithelial cells that make up the Schneiderian membrane.  In a healthy sinus, mucous production helps clear the sinus of foreign particles and microbes.  The base of the maxillary sinus often rests on the bone superior to the roots of the maxillary teeth.

The posterior maxilla consists of bone that is highly trabeculated and often has the lowest density in the mouth.  While the mandibular bone can be as dense as oak wood, in comparison, the posterior maxilla can have the density of pine or even balsa wood.  To further complicate matters, after the loss of the posterior teeth the maxilla resorbs in a palatal and superior direction, and the maxillary sinus elongates down to reduce the available native bone height.

These unique challenges in native bone availability combined with the higher occlusal forces in the posterior jaw lead to the posterior maxilla traditionally experiencing the highest dental implant failure rate.  This is especially true when the limits are pushed, i.e. a very short implant is used with a long crown height.  However, through innovation in bone augmentation techniques patients can have implant restorations in this region now with equal success rates to all other areas of the mouth.  Sinus lift or augmentation surgery can assist implant placement by raising the sinus floor to develop more bone.

Two general techniques for a sinus augmentation exist.  The first, called a crestal approach or indirect sinus “tap” involves drilling the planned implant osteotomy short of the sinus floor, then using an osteotome or other instrument to elevate the remaining bone, add additional bone graft in the site, then place the dental implant.  This technique is appropriate for sites where 7+ mm of native bone remain before the procedure.

The second technique, called a lateral window or direct sinus graft, involves elevating a periodontal flap and creating an osteotomy window at the lateral aspect of the maxillary sinus in order to elevate the sinus membrane and add bone graft.  This may be done as a separate procedure or together with placing the dental implant.

Between 5-8 months is expected for complete healing of the graft.  The lateral window sinus graft is appropriate when 6 mm or less of native bone exist as seen on a CT scan.  Both sinus augmentation techniques are most often done under conscious sedation in our office.

Since 2015, we have added L-PRF technology to all of our sinus grafts.  Leukocyte-Platelet Rich Fibrin is derived from the patient’s own blood. A simplified chairside procedure results in the production of a thin, compressed layer of platelet rich fibrin that is strong, pliable and suitable for suturing. This natural fibrin network is rich in platelets, growth factors and cytokines that are derived from the blood platelets and leukocytes, improving not only bone growth but also natural infection defense.  This is typically combined with a 50:50 mixture of bovine (cow) and human donor bone graft material.  The results have been excellent!  Our lateral window sinus grafts have shown a 98% infection free success rate in that time.  Healing is typically easier than expected and many patients even report that their sinuses actually feel better and clearer than before the surgery!

If you or your team have any question about sinus augmentation procedures, please contact us at any time. As always, we are committed to continuing to work with all of you to provide our patients with the highest level of care available.

Click here for a Zimmer Sinus Augmenation Brochure for Patients

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Dr. Todd Britten performs the latest techniques in gingival grafting, or gum grafting, and other gum recession procedures to treat patients suffering from loose, sensitive teeth and receding gums in Clearwater, Florida. “Recent surgical innovations have made this procedure safer and more effective than ever before,” says Dr. Todd Britten.

Gum grafting involves carefully placing a small amount of new gum tissue in an area where little or no gum tissue currently exists to prevent further gum recession or to cover root surfaces of the teeth that have become exposed. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gum tissue around the tooth. The tissue used in this procedure may be obtained from a variety of sources: an area of tissue nearby, the hard palate (roof of mouth), or donated tissue from another person, which has been medically processed. The gingival graft may be placed in such a way as to cover the exposed portion of the root, however, the main objective is to re¬establish the protective barrier or layer of the gum around the tooth. Occasionally, a patient may need multiple procedures to achieve the ideal amount of root coverage. The tissue is then delicately sutured (stitched) in place where it’s needed, using very fine suturing material.

Gum recession can occur for a variety of reasons, including genetics or age, oral trauma, and periodontal disease. Patients experiencing signs of gum recession are encouraged to seek treatment right away. Gum recession is not only a cosmetic problem – but it can also affect oral and periodontal health. A successful graft can reduce or eliminate problems like tooth sensitivity and further gum recession, as well as improve the aesthetics of a person’s smile. When a tooth loses the natural protection of healthy gum tissue, they become extremely sensitive to hot or cold temperatures, causing pain when drinking or eating, or even to cold air. Missing gum tissue also makes it easier for bacteria to penetrate the roots and cause decay — or for minor trauma to result in rapid gum recession. The eventual result is often tooth loss.

Dr. Britten offers a variety of modern and effective treatment options for receding gums in his Clearwater, Florida periodontal practice, including gum grafting procedures and the minimally invasive Pinhole® Surgical Technique. For more information on the progression of gum disease, scaling and root planing procedures, or periodontal surgical treatment options, contact us today at 727-586-2681. Britten Periodontics & Implant Dentistry is a periodontal practice offering patients personalized dental care in implant dentistry in Clearwater, Florida. Dr. Todd Britten received his Bachelor of Science & Doctorate of Dental Surgery from University of Florida, a Master’s Degree and Certificate in Periodontology and Implant Dentistry; and completed extensive training at the Institute of Advanced Laser Dentistry. He is one of the only board-certified periodontists in Pinellas County. He is a member of the American Academy of Periodontology, American Dental Association, Florida Association of Periodontists, Upper Pinellas County Dental Association, Hillsborough County Dental Association, Hillsborough County Dental Research Association and Florida West Coast Dental Association.

1st row:  The top illustrations show abrasions in the enamel at the gumline from using a toothbrush that was too hard. Defects in the enamel at the gumline are also caused by a bad bite from misaligned teeth, or clenching and grinding habits, or can even be from decay. In the top illustration, the teeth are being filled in with tooth-colored filling, known as composite resin.

2nd row:  When bonded to the surface of teeth, porcelain veneers improve the outer appearance by camouflaging discoloration. They can also be used to close gaps or when other cosmetic improvement is needed.

3rd row:  Dental crowns are used to repair and restore larger areas of decay or damage for which tooth-colored fillings or dental bonding will not suffice. The crown covers and strengthens the natural tooth. A crown can be made from a variety of materials, based on the location of the repair and patient needs, including porcelain, ceramic, and zirconia.

We don’t do this type of restorative work in our office, but we like to use illustrations and videos to help our patients understand how the wonderful restorative dentists we work with can fix their teeth. If you have questions about your teeth or gums, contact us today at 727-586-2681 or visit our website www.brittenperio.com

Dr. Todd M. Britten and the team at Britten Periodontics & Implant Dentistry held their 4th annual Free Dental Day for Veterans on November 9, 2018. The team at Britten Periodontics had overwhelming offers to help from many dental professionals in the community willing to donate their time and resources to provide free dental care. This year’s event was assisted by local family dentists and restorative specialists Dr. Jeffrey Ellenberg and Dr. Michael Podlusky. “Having local dentists involved enables us to provide more comprehensive care to our veterans,” Dr. Todd Britten said.

“The Community Dental Clinic in Clearwater helped us to coordinate this year’s event. We are so happy to help provide care for their patients who need to see a periodontist,” said one of Dr. Britten’s team members. “Once again this year, with the help of our restorative dentists, we were able to provide extractions, full dentures, fillings, dental implants, dental cleanings, x-rays and exams,” said another team member.

Air Force Veteran John Fallon was looking forward to his new smile, provided by Dr. Michael Podlusky who practices in Largo, Florida.  When asked what the dental care provided by this event means to him, Fallon said, “Going out more, being able to talk to people and not running away because I get self-conscious with no teeth.”

Dr. Jeffrey Ellenberg of Clearwater, Florida, was helping in the care of Navy Veteran Ernest Bach. Bach said, “This Veteran’s Day is very special to me specifically because of the generosity of the dentists who are donating their time and talents to give this veteran a new perspective and the ability to socialize and participate as I once used to!”

Check out the Video here:


Britten Periodontics & Implant Dentistry is a periodontal practice offering patients personalized dental care in implant dentistry in Clearwater, Florida. Dr. Todd Britten offers sedation dentistry, which can be very helpful for those needing advanced treatment, suffer from PTSD or have a fear of the dentist. For more information, contact us today:


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Fixed Bridge

A bridge is an option when there are teeth on either side of the missing tooth.

It stays cemented in the mouth and does not come out.

This does involve cutting down the teeth on either side of the missing tooth to be able to connect them together. Floss threaders, which slide under the bridge, should be used daily, to keep it clean.

The disadvantages for bridges are cutting down teeth that might be perfectly healthy. If there is a leak under the anchor teeth of the bridge, decay can occur below. A bridge can replace one or two missing teeth easily, and sometimes more if there is enough support.

Removable partial denture

A removable partial denture is worn during the day. This is used to replace one or many missing teeth.

-Sometimes amay need metal clasps to help it stay in the mouth which may be visible when speaking or smiling.
– They move a little when speaking or eating, which can be uncomfortable.
-We recommend taking them out at night and soaking them in a cleaning solution.

There is no need to file down any teeth, and this option is usually the most economical. A full denture can replace all missing teeth.

Dental Implant

An implant is a great way to replace a missing tooth.

This solution feels and acts the most like a natural tooth when chewing, brushing or smiling. A major advantage is no need to alter any other teeth when placing an implant. An implant is a great solution for a single missing tooth, and even more implants can replace many missing teeth. When smiling or talking there is no way to tell the difference between an implant and a natural tooth.

The implant replaces the actual root of the missing tooth and heals in the bone for 3 to 7 months and we then begin the restorative phase. We or your dentist then place an abutment, to which a crown will be cemented. Dental implants are usually a more costly option, at least initially, but are often the best long-term investment.

Do Nothing

There is always the option to do nothing.

Saves money, at least initially

When a tooth is removed, the bone shrinks away and the other teeth in the area will shift to fill the gap. This can sometimes lead to other problems like shifting of other teeth, causing bone loss or decay around the existing teeth as they become more difficult to clean.

If you have questions about replacing teeth lost to fractures, decay or gum disease, contact us today at 727-586-2681.


Our team at Britten Periodontics & Implant Dentistry is gearing up for the 4th annual Free Dental Day for Veterans. The event is scheduled for November 9, 2018. We provide dental cleanings, checkups for Veteran’s from our previous events, and xrays. Surgical procedures are also performed here in our office.

This year’s event is being assisted by local general dentists Dr. Michael Podlusky and Dr. Jeffrey Ellenberg. Having local dentists involved enables us to provide more comprehensive care to our veterans. Being a periodontist, Dr. Britten’s specialty is really the surrounding structures of the teeth; roots, gum and bone. Our job is to help with the foundation. Having restorative specialists involved helps us to treat the whole mouth and really deliver comprehensive care to these veterans.

Britten Periodontics & Implant Dentistry is a periodontal practice offering patients personalized dental care in implant dentistry in Clearwater, Florida. Dr. Todd Britten offers sedation dentistry. For more information, visit http://www.brittenperio.com