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Non Surgical Periodontal Therapy also known as scaling and root planing or “a deep cleaning” is often recommended as the first step in periodontal therapy. Treatment is done by one of our hygienists using local anesthesia to provide comfort for the patient as the root surfaces in deep periodontal pockets are debrided to remove calculus or “tartar” and to smooth the root surfaces to remove bacterial toxins. This may take more than one visit with the hygienist and is followed up with a visit with Dr. Britten in four to six weeks to re­evaluate the periodontal tissues.


For more information about options for periodontal treatment, contact us today at 727-586-2681 or visit www.brittenperio.com


Jawbone is preserved through the pressure and stimulus of chewing. When that is removed through tooth loss, the bone “resorbs” (reabsorbs) into the body. In the first year after tooth extraction, normally 25% of jawbone is lost, and this bone loss continues on.

Careful management of extraction sockets after a tooth is removed prevents unsightly bone loss and provides a better cosmetic outcome for tooth replacement. To increase the possibility of future implant placement, and to prevent more bone resorption, a ridge preservation procedure may be recommended. Without the use of a bone graft and collagen barrier at the time of extraction, studies show that 30­-40% of the jaw bone is immediately lost. This is because your body perceives that once the root is removed, the bone is no longer needed and your body absorbs or removes it, creating a ridge deformity.

These ridge deformities leave you with inadequate bone and tissue thickness for either bridge or dental implant restoration. The defects may have been caused by trauma, developmental defects, periodontal disease, the wearing of dentures, or through previous tooth loss.

Ridge augmentation procedures have been shown to greatly enhance the cleansability and appearance of your restorations. They increase your chance for long term successful dental restoration, both esthetically and functionally. Ridge augmentation procedures may be performed with gum tissue and/or bone grafting materials.

For more information about periodontal regenerative procedures, ridge augmentation or dental implants, contact us today at 727-586-2681.


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From Colgate.com

“A root canal is a treatment to repair and save a badly damaged or infected tooth. The procedure involves removing the damaged area of the tooth (the pulp), cleaning and disinfecting it and then filling and sealing it. The common causes affecting the pulp are a cracked tooth, a deep cavity, repeated dental treatment to the tooth or trauma. The term “root canal” comes from cleaning of the canals inside the tooth’s root.

What to Expect During a ROOT CANAL
If you think you need a root canal, consult your dentist. There are a number of steps that occur over a few office visits.
X-ray – if a dentist suspects you may need a root canal, he will first take X-rays or examine existing X-rays to show where the decay is located.

Anesthesia – local anesthesia is administered to the affected tooth. Contrary to popular belief, a root canal is no more painful than a filling.

Pulpectomy – an opening is made and the diseased tooth pulp is removed.

Filling – the roots that have been opened (to get rid of the disease pulp) are filled with gutta-percha material and sealed off with cement.”

We work with some wonderful endodontists and general dentists that perform root canals and the procedures required following this procedure. Sometimes a root canal is necessary before or after a periodontal procedure. For more information, visit our website at www.brittenperio.com or call us at 727-586-2681

Abfractions and abrasions are nearly identical, their treatment options are often the same, and bruxism (tooth grinding) and improper alignment of the jaws and/or teeth (malocclusion) must be ruled out for both.
An abfraction is an angular notch at the gumline caused by bending forces applied to the tooth.
An abrasion is a rounded notch at the gumline that are generally not as angular and sometimes have more of a saucered appearance.  With abrasions, it is believed that heavy toothbrushing forces applied to exposed tooth roots may cause a rounded notch at the gumline.  Abfractions, on the other hand, are caused by one of two things:
  • Chronic heavy forces on teeth, such as may be produced by clenching or grinding the teeth (bruxing).
  • Normal forces on teeth which are improperly aligned (malocclusion).
Abfractions that have been present for awhile may become rounded through the abrasive movement a hard toothbrush agressive brushing and if the teeth are continually exposed to an acidic environment, which is known to soften tooth structure.

For information on prevention and treatment of tooth defects, contact us today at 727-586-2681

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Replacing a missing tooth with a fixed bridge requires preparation of at least one of the adjacent teeth on each side for a crown. It is important to still care for the teeth on each side of the bridge to prevent periodontal disease and tooth decay. This will require careful plaque control with brushing, using a floss threader under the bridge, and sometimes the addition of a rubbertip stimulator to clean under the margins of the abutment teeth (the teeth supporting the bridge which will now have full coverage restorations cemented on them).

Sometimes a bridge is the best option for a replacement of a missing tooth, but other options include a dental implant, which will not include reducing the structure of any other teeth, or a removable appliance, or partial denture. For more information, contact us at 727-586-2681 www.brittenperio.com

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Dental decay, or a cavity, is the bacterial infection of a tooth. When decay is small and limited to the enamel (outside layer) or dentin (second layer of tooth), it can be repaired by a filling or by an inlay or onlay, or crown if necessary. When the decay reaches the pulp (where the nerve and blood vessels are located), the pulp becomes infected and an abscess may develop at the edge of the root. A dental abscess often requires root canal treatment in addition to a crown on the tooth.
It is important to note that cavities and abscesses may develop slowly without causing any pain. Sometimes the infection gets trapped within the tissues with no way out, or if a live nerve of the tooth becomes exposed, it can cause swelling and a lot of pain. The best way to detect a cavity or an abscess is by undergoing a dental exam with x-rays. Catching tooth decay in its earliest stages will avoid more extensive treatment. #brittenperio #clearwaterperiodontist

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If you have a fracture in your tooth or in the root which extends below the gum line, your tooth is no longer treatable, and cannot be saved. The tooth will have to be extracted. A dental implant can be placed to replace your natural tooth. Dental implants take the place of your missing teeth. They act as your tooth’s new root and are placed securely in your jawbone for a lasting fit.

Here’s how a dental implant works: • Biocompatible titanium screws are surgically placed into the jawbone and act as the new root of your tooth.

• A healing period must pass so that the bone fuses with the titanium screws, allowing for a tight, lasting foundation.

• Following adequate healing, it will be time for the restorative abutment which includes customizing the abutment and placing a crown, which will be placed on top of the implant.

If you do not have enough bone to place dental implants, a bone grafting procedure may be necessary. For more information, contact us at 727-586-2681


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Dr. Britten is highly concerned about his patients who smoke. The likelihood of developing advanced periodontal disease or gum disease can be up to six times higher in smokers. Periodontal disease is an extremely serious condition affecting not only the gums, but also the membranes and ligaments and bone supporting the teeth.

Many studies on smoking and periodontal disease have concluded that smokers have:

  • Deeper probing depths and a larger number of deep pockets in the gums.
  • More attachment loss including more gingival recession
  • More alveolar boneloss & tooth loss
  • Less gingivitis and less bleeding on probing
  • One of the major problems with smoking is that it tends to mask the damage being caused to teeth and gums. This damage can be difficult to detect, producing very few early warning signs of advanced periodontal disease. For years it was thought that nicotine being a vasoconstrictor was causing less blood flow to the gums, causing less infection-fighting white blood cells to reach the area.  Newer studies are showing that smoking appears to have a long-term affect the inflammatory lesions, or diseased gums of smokers, which have less blood vessels in them than in non-smokers.
  • More teeth with furcation involvement (where the bone levels have been destroyed below the area where the roots of the teeth meet, leaving this area exposed, making it prone to further destruction as well as decay.
  •  Additionally, nicotine affects saliva, causing it to become thicker so it is less able to wash away acid created after eating. As a result heavy smokers can be more likely to suffer from tooth decay than non-smokers, even though they may practice good oral hygiene.Smoking has a profound effect on the immune and inflammatory system. Smokers have more infection-fighting cells in their body, but fewer of these helpful cells make it into the gingival pocket. Studies also show that these good cells have a decreased ability to accomplish their function, which is to destroy harmful periodontal bacteria. Adhesion molecules are being found within smoker’s tissues, in the white blood cells, in the inflammatory lesions, and even in the supporting gingival tissues. Studies have shown impairment in defensive functions of other defensive blood cells, even those using smokeless tobacco due to the high concentrations of nicotine.Smoking also impairs the healing of dental implants and even in the healing from all other aspects of peroidotnal treatment including non-surgical treatments (including scaling and root planing or “deep cleaning”), surgical treatment, bone grafting and tissue grafting. Studies have shown that tobacco smoke and nicotine affect blood vessels in the gums, healthy bone-building cells, connective tissue matrix, the jaw bone and even the root surface itself. Tooth root surfaces in smokers have actually been shown to be contaminated by products of smoking such as nicotine, cotinine, acrolein and acetaldehyde, which may inhibit the gum tissue from healing around the roots of teeth as they should.  Smoking has been shown to affect human bone, and is a risk factor for osteoporosis, which is also a risk factor for periodontal disease.

    As a periodontist, Dr. Britten is a specialist in treating advanced periodontal disease and is able to provide patients with the very latest techniques and treatments to help slow down this condition. Where teeth are lost then one option is to replace them with dental implants, but smoking is not advisable during this treatment because it does slow down healing.

    If you do currently smoke and value your smile, it’s worth thinking about quitting.

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Continuing education is a top priority at Britten Periodontics & Implant Dentistry. On April 19, 2018, we held our 4th educational seminar! Over 50 local dentists, dental assistants and hygienists attended. We love partnering with you to deliver exceptional care to our patients. Zimmer, Dentsply and Sonicare for sponsored a great food truck and raffles. Our team worked so hard organizing and planning this event.

The program entitled “Don’t Wait Until It’s Too Late: Periodontal Treatment in 2018” reviewed the basics of periodontal structures in health and in disease, how to perform a thorough periodontal examination, non-surgical treatment options, surgical options, the benefits of a good relationship between the restorative specialist and periodontist, and how we can improve our communication between the periodontist and restorative dentists to provide the best care to our patients.

Dr. Britten was our keynote speaker, and provided a terrific 2 hour lecture, with great pictures and videos of real cases.  It was very educational and informative, and so great to network and meet face to face with our colleagues that we work with every day in patient care.