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Britten Posts

Why Dental Sleep Medicine is Changing Treatment for Snoring and Sleep Apnea

The most successful treatment for Obstructive Sleep Apnea is a CPAP appliance, however, 60% to 83% percent of users cannot tolerate this device.

With the high rejection rate of the CPAP, the American Academy of Sleep Medicine designated dental sleep oral appliances as the No. 1 nonsurgical alternative for the CPAP intolerant. Numerous sleep appliances are available to the public and distributed through dentists.

Your dental professional can help you identify if a sleep appliance may help you. If you have any questions about OSA or dental sleep medicine, contact our office today at 727-586-2681

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What is Occlusal Therapy and how can it improve gum health?

Occlusal equilibration is a gentle procedure that allows your lower teeth to contact your upper teeth very evenly all the way around your mouth.

The goal of this treatment is to create a “solid bite” that prevents stress on individual teeth and reduces stress on the jaw muscles and jaw joint.

What’s involved? Dr. Todd Britten selectively and precisely reshapes the tiny bumps and valleys of the biting surfaces of individual teeth. Anesthesia is generally not needed, as this procedure is typically pain-free!

We will discuss the need to replace any dental work “that is too big for your bite”, before we begin the equilibration. The adjustments made to your teeth are generally too small to see any change in their appearance.

One or more of the following signs of an active dental problem are present:

1) Temporomandibular joint pain
2) Muscle-tension headaches around the sides of your head or around the jaw joint
3) Severe wear of your natural teeth
4) Loose teeth
5) Chipping teeth
6) Gum recession and other associated problems.
7) Grooves and chips forming at the gum line exposing root surfaces

Our occlusion (bite) forces are evenly distributed among all of our teeth. When something occurs to alter a healthy occlusion; like loss of a tooth, clenching and grinding, occlusal trauma can occur. There are several signs and symptoms of occlusal trauma including, wear or chipping of the teeth, sensitive crevices on the teeth, gum recession, shifting teeth, tender muscles, headaches, or a “popping” sound when opening and closing your mouth. This trauma places excessive pressure on teeth and these forces can contribute to bone loss and result in the loosening of the teeth. The goal of occlusal therapy is to create an even distribution of these forces allowing the bone and ligaments to heal. This is done by an occlusal adjustment or equilibration to divide the biting pressure evenly across all of the teeth by reshaping the biting surfaces of the teeth and eliminating spots of excessive pressure when the teeth are brought into contact. The use of an occlusal night guard may be needed to control the pressures generated by clenching and grinding. This critical procedure will help ensure optimal results, both immediately and long-term.

Is an uneven bite be related to gum disease?

Absolutely!  Biting unevenly on the teeth would have the same degenerative effect that hopping around all the time on one leg would have to your hip.  Studies have shown that bacteria pockets and bone loss is significantly deeper on teeth with uneven biting trauma.  Recreating biting harmony helps the jawbone heal and maximize results to periodontal therapy.

Fractured porcelain crown from bruxism (night clenching of the teeth) and occlusal trauma

For more information, visit our website at www.brittenperio.com

This is what happens when you need a root canal

What is a root canal?
When a cavity, or tooth decay, extends into the root, root canal therapy is often the most effective way to retain the tooth.
This video shows root canal therapy which can be performed by your general dentist, but in most cases referral to a root canal specialist, or endodontist, is recommended. A temporary filling is placed, and then a patient will see a general dentist for a permanent restoration, normally a crown.
At Britten Periodontics and Implant Dentistry, we do not perform root canals in our practice but work cohesively with the best endodontists and general dentists to provide you with the best care possible. This way, you can be seen by a team of dentists that focuses on the area that they are trained and most skilled at and work together to provide the best care.

If you have any questions about root canals (endodontic treatment), or any other aspect of dentistry that concerns you, contact our knowlegeable staff today at 727-586-2681.

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Gum recession

Gum recession is the process in which the gum tissue that which surrounds your teeth wears away, or pulls back, exposing the tooth’s root. If left untreated, gum recession may ultimately result in tooth loss.  Most people don’t notice their gums receding because it occurs very gradually. You may notice tooth sensitivity, or that your tooth looks longer than normal. Sometimes a notch can be felt near the gum line with your fingernail.  Gum recession is often caused by periodontal disease.

Causes:

Aggressive tooth brushing. If you brush your teeth too hard, it can cause the enamel on your teeth to wear away and your gums to recede.  Clenching and grinding of the teeth can also contribute to gum recession and defects in the tooth roots. Many people do not even realize they have this habit, and many do it in their sleep!

Insufficient dental care, Inadequate brushing, flossing, and rinsing with antibacterial mouthwash makes it easy for plaque to harden into tartar or calculus, a hard substance that builds on and between your teeth and can only be removed by a professional dental cleaning.

Gum recession is not something you want to ignore.  If untreated, gum disease leads to the destruction gum tissue and supporting bone that hold your teeth in place.  If you think your gums are receding, make an appointment. There are treatments that can repair the gum and prevent further damage.

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Be able to eat the cold foods you love again: with gum grafting procedures in Clearwater, Florida

Want to be able to eat ice cream again?
 
Tooth pain that you experience because of sensitivity to hot, cold, or acidic food or drink can be caused by decay, fractured teeth or worn fillings. But gum disease, causing exposed roots due to a receding gum line, along with with worn teeth or roots can also be the source of the problem.
 
Healthy teeth have a layer of enamel that protects the crowns of your teeth—the part you can see above the gum line. Below the gum line a layer called cementum protects the roots, and below the enamel and the cementum is dentin. Dentin contains microscopic tubules (small canals). If dentin loses its protective covering of enamel or cementum –or sometimes when gums recede — these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. The result can be hypersensitivity.
 
Sensitive teeth can be treated in a variety of ways. Dr. Britten will recommend the appropriate treatment based on the cause of your sensitivity. Those might include:
 
– A de-sensitizing or prescription toothpaste containing minerals or compounds that help block transmission of sensation from the tooth surface to the nerve. Repeated applications (4 to 6 weeks) are usually necessary before the sensitivity is reduced.
 
– Application of a fluoride varnish or Kuraray desensitizing mineral powder, an in-office treatment which strengthens tooth enamel and reduces the transmission of sensations.
 
– Sometimes gum grafting is needed. This is a surgical procedure to protect the root and reduce sensitivity by replacing gum tissue that has been lost from the root.
 
Proper oral hygiene can often prevent tooth pain not caused by trauma.  Contact us today if you have any questions about your daily oral hygiene routine or concerns about tooth sensitivity. 
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Exciting breakthrough: diabetes screening in the dental chair

Did you know?

Your dentist or dental hygienist may be able to tell if you have diabetes before you even know you do? Clues in the mouth, medical symptoms you are experiencing and reporting to them, and even a chairside test done right in the dental office can help your dentist determine that further testing for diabetes is necessary

A dentist can examine your mouth for clues of diabetes. There are signs in the mouth associated with diabetes:

-Periodontal disease
-Dental caries
-Burning mouth syndrome
– Oral candidiasis (common in those with poor glycemic control)
-Salivary dysfunction
-Neurosensory disorders
-Soft tissue abnormalities such as stomatitis or lichen planus
-Xerostomia
(Source: http://clinical.diabetesjournals.org/content/32/4/188.full)

Also, a patient that has 26% of periodontal pockets measuring 5 mm’s or greater or 4 or more missing teeth (not including the third molars), has a 72% chance of having a metabolic challenge. Diabetes is considered a metabolic disease.

Patients often see their dentist or dental hygienist more often than any other healthcare professional. Make sure to answer their questions thoroughly and accurately about your health.

Health risk factors for diabetes:

– Overweight or obese – BMI greater than 25
– High blood pressure
– Familial history of diabetes
– High cholesterol
– History of heart disease
– Other symptoms or complaints may include thirst, urinating frequently, constant fatigue, weight loss (Type 1), blurred vision, and uncontrolled infections even within the mouth (poorly controlled Type 2 diabetics).

Effective January 1, 2018, a chairside diabetes HbA1c (Hemoglobin A1c) test may be able to be performed by your dentist right in their office if they suspect diabetes or prediabetes. A patient with a test result of 5.7 or greater indicates a 92% chance the patient is metabolically challenged. At this point, your dentist can refer you to a physician for further testing.

Periodontal disease and diabetes have a direct effect upon one another. It is important to Dr. Britten to improve not only the oral health, but the overall health of each and every one of his patients. For more information on oral health and diabetes contact us at 727-586-2681.

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What Happens When Your Mouth is Too Dry

Dry mouth (reduced saliva, also known as xerostomia) is a problems because it creates a:
 
-Higher risk of cavities, because saliva neutralizes and buffers acids in the mouth caused by foods and bacteria, as well as cleanses the teeth
-Increased risk of oral infections
-Decreased sense of taste and enjoyment of food
-Bad breath
Causes of dry mouth
 
Medications seem to account for a substantial portion of dry mouth cases, especially among the elderly. Over 400 agents in drugs affect salivary levels, with evidence that the risk of xerostomia rises with the number of medications.
 
o Commonly used medications include those for those for acne, allergies (antihistamines), anxiety, asthma, depression, diarrhea, high blood pressure, incontinence, nausea, obesity, Parkinson’s disease. Other contributors are muscle relaxants and sedatives.
o Damage to salivary glands (Due to chemotherapy, radiotherapy, neck surgery)
o Dehydration (may be due to fever, sweating, vomiting, diarrhea, loss of blood)
o Habits, such as consumption of tobacco or methamphetamines (“meth”), breathing with mouth open, snoring.
o Diabetes, anemia, hypertension
 
Treatment of dry mouth should target its causes. For example, if your dry mouth is caused by medication, then an alternative medication or dosage change may help.
If a medication change or a health condition cannot be addressed to help with dry mouth, you can help promote saliva in the following ways:
• Sipping water or sugarless drinks often and during meals
• Avoiding drinks with caffeine, such as coffee, tea, and some sodas
• Professional recommendation for oral care products that will assist in moisturizing the mouth
• Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow citrus, cinnamon or mint-flavored candies are good choices
• Avoid tobacco or alcohol, which dry out the mouth
• Minimize spicy or salty foods, which may cause pain in a dry mouth
• Avoid sugar and acidic foods
• Using a humidifier at night
 
It is important to perform daily and effective removal of plaque, which is the main preventable cause of cavities and gum disease.
 
We have also found in our practice that a combination of over the counter Biotene products (gels, rinses, sprays, lozenges), a product available via prescription called Neutrasal, and PerioSciences’ Anti-Oxidant Gel can also be helpful for our patients suffering from dry mouth. For more information, call us today at 727-586-2681 or visit our website at www.brittenperio.com

Diabetes Awareness Month: Why your dentist might be the first one to suspect diabetes

Did you know that 90% of pre-diabetics are unaware of their condition and 25% of Type II diabetics are unaware they have the disease? Many patients see their dentist or dental hygienist more often than they see their primary care physician. This is particularly true for people with periodontal (gum) disease, who require more frequent dental hygiene visits or gum treatments. Your dentist or dental hygienist should take a thorough medical history at each visit.  Some of the things they should look for which could indicate diabetes or prediabetes. Risk factors that indicate a potential for diabetes or pre-diabetes include:

  • Overweight or obese – BMI greater than 25
  • High blood pressure
  • Familial history of diabetes
  • High cholesterol
  • History of heart disease
  • Other symptoms or complaints may include thirst, urinating frequently, constant fatigue, weight loss (Type 1), blurred vision, and uncontrolled infections even within the mouth (poorly controlled Type 2 diabetics).

There are also dental clues that may indicate diabetes.

  • A patient that has 26% of periodontal pockets measuring 5 millimeters or more or 4 or more missing teeth (not including wisdom teeth), has a high chance of having a metabolic problem – and diabetes is a metabolic problem.
  • Periodontal disease
  • Dental caries
  • Burning mouth syndrome
  • Oral candidiasis (common in those with poor glycemic control)
  • Salivary problems or dry mouth
  • Neurosensory disorders
  • Soft tissue abnormalities such as stomatitis or lichen planus
  • Dry mouth

A chairside diabetes HbA1c (Hemoglobin A1c) test may soon be able to be performed in our practice, or if you have had a recent test with your doctor showing a result of 5.7 or greater indicates a 92% chance the patient is metabolically challenged. At this point, the patient should be referred to their physician.

If you are concerned about your oral health or are experiencing symptoms in your mouth or health that could be related to diabetes, contact us today 727-586-2681.

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What We’ve Been Up To: 3rd Annual Veteran’s Day

Dr. Todd M. Britten and the team at Britten Periodontics & Implant Dentistry had an early start on Veteran’s Day which is Friday, November 11th. They held their 3rd annual Free Dental Day for Veterans on Friday, November 3rd, 2017. Britten Periodontics once again had overwhelming offers to help from many dental professionals in the community willing to donate their time and resources to provide free dental care. Patients were directed to the event this year from The Homeless Emergency Project in Clearwater, as well as local V.A. Branches from Pinellas, Pasco and Hillsborough counties.

“Once again, we have had an incredible response from the community and were able to get skilled and compassionate local restorative dentists involved.” For the third year in a row, Clearwater Dental Associates, Dr. Jim Hayslett and Dr. Keith Kiskadden and their staff are on board to help out with our event, seeing patients for fillings, crowns and even dentures. New to this year’s event, Dr. Michael Podlusky in Seminole, Florida, also reached out to Dr. Britten to also help, making upper and lower dentures at no-cost for one of the patients. “Many thanks to Dr. Britten for organizing the Veteran’s Day Event and graciously offering me the opportunity to help treat a patient. So glad to help at least one of our honored Vets. One person can’t do everything, but all of us working together surely can!” Said Dr. Mike Podlusky.

Dr. Britten’s dental specialty, periodontics, often involves managing and treating advanced gum disease. A periodontist is often able to help a patient in danger of losing teeth or with active oral infection to turn their health around. “Having Clearwater Dental Associates involved again this year, and the gracious help of Dr. Mike Podlusky and his team enables us to provide more comprehensive care to our veterans. Being a periodontist, my specialty is really the surrounding structures of the teeth; roots, gum and bone. My job is to help with the foundation. Having the restorative specialists involved helps us to treat the whole mouth and really deliver comprehensive care to these veterans.” Dr. Britten sees most patients for a comprehensive evaluation, radiographs and treatment consult prior to the event in order to determine what services he as the gum specialist can provide in his office, and make appropriate referral for restorative care from local dentists who have volunteered to help with the event.

Britten says being able to offer two different forms of sedation to Veterans for this event in his Clearwater, FL practice has helped for patients who have PTSD, dental anxiety, or may require extensive surgical treatment.  Dr. Britten expressed his concern. “Most of the time, periodontal disease is not painful until it gets to be very advanced. Some of the veterans had been dealing with painful teeth for a long time.”

For Britten and his team this event is something they look forward to all year long. They keep in touch with veterans from previous events and this year they were able to provide follow up exams, x-rays and periodontal maintenance procedures, which help prevent reinfection of the gums following treatment. “This year we were able to invite Veterans from previous events to receive follow up maintenance care at this year’s event,” said one dental hygienist at Britten Periodontics who helped organize this year’s event. “It was great to see them again and the progress they have made in their oral health. It is touching to be a part of something that has changed someone’s life in such a positive way.”

One patient returning this year received treatment at the inaugural event was John Smith, who served in the US Navy in Vietnam from 1965-1969. Dr. Britten explained that he was honored to be able to help Mr. Smith and to continue in his care since the 2014 event. The VFW Post 2473 in Clearwater where Mr. Smith serves as canteen manager does much to help local veterans.

When asked what this event meant to him in 2014, Smith had stated, “I get to keep my teeth and I can’t believe it’s free.” A patient new to this year’s event, Yvette said, “This was the most amazing dental cleaning I have had in my whole life!”

Dr. Todd Britten explained how glad he is to be doing this the third year in a row and would like to do it annually for the entirety of his career. When asked why this is a cause so near and dear to his heart he stated that his grandfathers and uncles served in the military and giving back to veterans in need is a top priority for him. Dr. Britten said, “The entire staff at Britten Periodontics is so grateful to the men and women in the military that make so many sacrifices for our freedom.”

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Our Website: www.brittenperio.com

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The Reason Why Your Dentist Recommends Daily Fluoride

From Colgate.com:

“After you eat, the small food particles left behind in your mouth break down into carbohydrates and sugars, which in turn the bacteria break down into cavity causing acids. These acids dissolve minerals from the tooth enamel, a process called demineralization. These acids, thus, can make teeth weaker, and can result in tooth decay. That’s where fluoride comes in.
When it reaches your teeth, fluoride is absorbed into the enamel. It helps to repair the enamel by replenishing the lost calcium and phosphorous to keep your teeth hard. This process is caused remineralization. When fluoride is present during remineralization, the minerals deposited into the tooth enamel help strengthen your teeth and prevent dissolution during the next demineralization phase. 

Thus, fluoride helps stop the decay process and prevent tooth decay.”

Most over the counter toothpastes carry the recommended daily dose of fluoride, if used properly twice a day. Prescription toothpastes are also available for those at higher risk for tooth decay. Ask your dentist what is best for you!

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