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As a gum specialist, we often see and help treat changes in patient’s gum tissues related to certain medications they are taking.  One of the main issues we come across is gingival overgrowth, or hyperplasia. 

Gingival hyperplasia is an overgrowth of the gum tissue around your teeth.  In our practice, we sometimes see that certain medications our patients are taking contribute to gingival hyperplasia.  Other factors can include orthodontic treatment or certain medical issues, such as hormonal imbalances, leukemia, a genetic condition or the growth can sometimes be due to a benign or malignant lesion.  Inflammation of the gums and poor plaque control are often a main contributor for gum overgrowth.  Poor oral hygiene also can increase inflammation which may also play a role.

Medications associated with gum enlargement fall into three main categories:

  1. Anti-seizure medications
  2. Immunosuppressant medications (used in transplant patients),
  3. Calcium channel blockers used to treat certain heart conditions, most commonly high blood pressure.

It is important to notify your dentist or dental hygienist if you take any of these medications so they can watch for changes in your gum tissues.  Many of our patients are on some form of calcium channel blocker such as Amlodopine (Norvasc) or Diltiazem for high blood pressure. 

A more severe case of gingival overgrowth could effect a person’s appearance when they smile or talk.  Enlarged gum tissue will complicate and sometimes completely prevent patients from being able to remove harmful plaque bacteria at and below the gum line and in between their teeth.  The tissues become enlarged, grow over the surface of the teeth and can become fibrotic, or tough.  Once overgrowth has started, it becomes more difficult to maintain good oral hygiene.  This will lead to retaining more damaging periodontal bacteria under the gum line, which can in turn worsen the gingival hyperplasia. 

If a big factor of the gum overgrowth is a medication, your physician may need to be consulted. Stopping or changing the medication can help limit the overgrowth, but do NOT stop the medication on your own.  Your dentist or periodontist can communicate with your medical doctor to see if your medication can be altered.  In some cases, a person’s medical professional will advise against altering a medication, most often in seizure disorders, immunosuppressed patients, and certain heart conditions or difficult to manage blood pressure.  If this is the case, we have to handle the gingival overgrowth as best we can.  Options include increased oral hygiene, non-surgical, or surgical periodontal therapy. 

Even if the medication causing this condition can be altered or discontinued, this will not necessarily reverse the overgrowth.  Additional treatment is sometimes required and often includes:

AT-HOME CARE Good oral hygiene, especially the effective removal of plaque between the teeth and at the gum line, can alleviate the condition in early or very mild cases.

NON-SURGICAL THERAPY

In a mild to slightly moderate condition, a series of scaling and root planing procedures (commonly known as a “deep cleaning”) can be performed, often by a dental hygienist using local anesthesia.

Your dentist or periodontist may have you return every three months for dental hygiene visits to limit the effects of inflammation on the soft tissues.

SURGICAL REMOVAL

In severe cases, the enlarged or hyperplastic gum tissue may need to be removed surgically. In the case of drug-induced overgrowths, if patients are not able to discontinue the medication, surgical removal may be the only effective treatment. This can be done with a scalpel or laser.

If you think you have an area of overgrowth, visit your dentist for an evaluation of your condition. If you are now taking medications that can cause gingival overgrowth, consult with your dental professional and physician.  If you have questions about gingival hyperplasia you can contact us at 727-586-2681 or https://brittenperio.com

A moderate case of gingival hyperplasia
A moderate case of gingival hyperplasia
A mild case of gingival hyperplasia
A mild case of gingival hyperplasia
Localized hyperplasia of the lower front teeth
Localized hyperplasia of the lower front teeth
Severe gingival hyperplasia
Severe gingival hyperplasia

About 30 million people suffer from Type 1 or 2 diabetes in the United States. You may have a friend, family member or even you may be affected yourself by this condition. Most people are familiar with the basics of diabetes: your body either doesn’t make enough insulin or responds to insulin improperly, leading to high amounts of sugar in the blood (known as high blood glucose). Diabetes effects all parts of the body: the heart, muscles, limbs and even the mouth.

Diabetes also has a significant effect on the health of the gums and bones. Poorly controlled diabetes has a particularly negative effect on your teeth and gums. Periodontal disease is typically worse in patients with diabetes. Additionally, all types of dental surgeries (tissue grafts, implants, sinus lifts, etc.) may take longer to heal and have a higher chance of failure in diabetic patients. The high concentration of blood glucose decreases your body’s ability to heal, and may even interfere with a procedure’s success, particularly in poorly controlled Diabetes.

Controlling periodontal disease has a positive effect on managing blood glucose in diabetics. By removing and controlling chronic inflammation and active infection in the gum tissues, your body may likely better regulate its response to insulin. This will have a positive effect on the management of diabetes due to the connection between the health of your mouth and your overall health. Some health insurance companies are beginning to offer coverage for a yearly hygiene visit to their patients with diabetes, due to better gum health results in better diabetes control and lower medical costs.

Of course, diabetes is only one of many conditions that can affect your oral health. Many health conditions, medications, habits, and even stress can effect your oral health and how your body responds to dental treatment. Therefore, please keep us updated on all aspects of your health history- even the parts that may seem irrelevant.

If you would like to know more about the importance of oral health to overall health, please contact our office today at 727-586-2681.

Clearwater Periodontist Dr. Todd Britten is using Platelet Concentrates (L-PRF, or Leukocyte-Platelet Rich Fibrin) to promote healing in dental procedures in his Clearwater, FL periodontal practice.

Concentrated blood has been used in hospitals for a long time to accelerate healing.  Leukocyte Rich Platelet Rich Fibrin (L- PRF) is a by-products of a patient’s own blood that can help healing after dental procedures such as a tooth extraction, as well as promote healing around bone or tissue grafts and dental implants.

L-PRF™ is a 3-D autogenous combination of Platelet Rich Fibrin derived from a patient’s blood.  First, it is determined if patient is a candidate for L-PRF treatment.  If so, blood is then drawn in Dr. Britten’s office from a patient’s arm. The blood is then immediately placed into a centrifuge to separate the blood into layers.  This thin, compressed layer of platelet rich fibrin is strong, pliable and even suitable for suturing. This natural fibrin network is rich in platelets, growth factors (PDGF, BMP, VEGF)  and cytokines derived from the blood platelets and white blood cells called leukocytes. These proteins promote rapid healing, especially during the critical first seven days after they are placed.

Growth factors are triggered and released and clot formation is stimulated by blood platelets, fibrin and growth factors to help heal wounds.  Growth factors stimulate stem cells to produce new host tissue quickly, making L-PRF effective in the healing process.

Advantages of using L-PRF also include lower infection risk after surgical dental procedures by sealing a treatment wound from bacteria after treatment.  Saturation of the surgical area, bone graft material and/or dental implant helps increase tissue formation due to its growth factors such as BMP, VEGF and PDGF, and this, in turn, results in faster gum and bone regeneration. Speedier healing decreases the risk of later infections, complications, and discomfort.  “The use of this technology has been shown to lower the chance of dry sockets after extraction, which can be very painful.” Dr. Britten said.

L-PRF treatments are often used for greater success for necessary procedures for dental implant placement,  including socket bone grafts, sinus lifts, ridge augmentation, correcting peri-implantitis, block bone grafts and extraction sites prior to implant placement.

Dr. Britten explained,  “L-PRF technology is used to quicken the healing process and is completely safe. Disease transmission is not a factor since blood is drawn from a patient’s own body.  Most patients report a greater degree of comfort during healing even immediately after their procedure. The amount of blood needed is minimal and can be collected easily.”

If you have any questions about treatment with platelet rich fibrin/plasma or would like to find out if you are a candidate and can benefit from this treatment, you can contact Dr. Todd Britten in his Clearwater, Florida periodontal practice at 727-586-2681. 

Clearwater FL Periodontist Dr. Todd Britten, Offers Laser Dental Surgery As a Successful Treatment for Periodontal Disease

Dr. Todd Britten is offering patients at Britten Periodontics & Implant Dentistry surgical treatment utilizing the PerioLase and LANAP® protocol for treatment of periodontal disease. LANAP, or the Laser Assisted New Attachment Procedure, is an alternative to traditional periodontal surgery for the treatment of gum disease. Dr. Britten also offers LAPIP®, the Laser Assisted Peri-Implantitis Procedure, to treat infected and/or save failing dental implants.Dr. Todd Britten, DMD, M.S., a board-certified periodontist, provides LANAP therapy as an option to traditional surgery for patients who suffer from gum or periodontal disease. Dr. Britten received special training on the procedure, which uses the PerioLase MVP-7 laser for periodontal disease treatment. This procedure kills harmful bacteria and removes unhealthy gum tissue without harming bone or healthy tissue.

At Britten Periodontics & Implant Dentistry, Dr. Todd Britten and his staff care about their patients’ total oral and systemic health and are concerned that nearly half of American adults have some form of gum disease and many don’t even know it. Gum disease can cause serious oral health problems, and has been connected to a number of other major health issues, such as heart disease and Diabetes. The uses a laser instead of scalpel, so it is minimally invasive. Patients who have undergone this periodontal disease treatment have reported little, if any, discomfort or pain and a shorter recovery period.

The laser dental surgery procedure begins with Dr. Britten using a periodontal probe to determine the depth of the pockets between the teeth and gums that contain bacteria. He then uses the PerioLase laser to eliminate those harmful bacteria, tartar and diseased gum tissue in the pockets. The healthy tissue is compressed and stimulated to attach to the tooth and bone regeneration may also stimulated by the laser.

The LANAP procedure is fully cleared by the FDA for periodontal disease treatment and has been shown to be quite effective. Patients who suffer from gum disease can now be evaluated to determine whether they are candidates for this new treatment procedure.

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

Dr. Todd Britten is now offering this FDA-cleared laser procedure for gum disease and periodontal treatment. To learn more about Dr. Britten and his dental services visit call (727) 586-2681.

Your dentist and/or dental hygienist routinely perform an examination of your gum tissue health which includes periodontal probing, or measuring of the depth of your gums.

Unhealthy gums pull away from the teeth and form “pockets” that are infected. The body’s immune system fights bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s own enzymes fighting the infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Periodontal disease – and the harmful affects to the gums and supporting structures of the teeth – can be controlled and treated. Improvement to our patients’ overall health is also often dramatically improved.

The health improvement is easy to appreciate when you consider living with an active bacterial infection, easily exposed to one’s bloodstream, can have a detrimental affect beyond the harm to the tooth and gums.

If you have symptoms of gum disease, contact us immediately. Gum disease addressed early can be reversed – and gum disease addressed later can be controlled. For more information, please contact our office at 727-586-2681

Dental implants have become a vital and mandatory option for tooth replacement in recent years. While modern implant dentistry has seen major advancements in popularity and success, we must stress that not all dental implants are created equal, and no dental implants are guaranteed to last forever.  However, using a high quality implant as well as a highly trained implant surgeon and restorative dentist, can make a big difference as to whether the implant will last for many years (and preferably a lifetime), which is always our goal.

The best way to ensure implant success is to use a high quality implant and to have the implant properly placed by a highly experienced dentist, or even better – an implant specialist and restored by a highly experienced restorative dentist. Oral surgeons and periodontists have extensive training and have also developed more predictable implant placement technique.

Low-budget implants have poorly designed screws (the portion of the implant that goes into the bone) or may move (even microscopically) when you chew. How an implant crown (the portion of the implant you see above the gumline, or the “tooth”) is made is also critical for the longevity of dental implant health in the bone.

Some of the things we look for in a high-quality implant system are:

1.  They should have a very natural look and function just like real teeth.

  1. Strength and reliability of the bond between the abutment and the implant that provides support to the restoration or crown. This bond is so strong that they ultimately unite to form a single unit.
  2.  They should be made from neutral titanium. It is accepted by the human body and therefore the chances of long-term success are increased.
  3. The implants are completely sterile and are opened only just before the implant placement begins. Your highly trained dentist or implant specialist and his assistant maintain sterile procedures as the implant is placed
  4. A great quality of the implants we prefer to place is a rough surface which means that it will fit perfectly and heals the new root easily. They are also designed to ensure a perfect fit after restoration and will bond with a patient’s jaw bone.
  5. The implant screw is designed so that the biting forces do not traumatize the surrounding bone.
  6. Implants can be customized for an individual patient’s needs and are selected by length and diameter especially for this patient.
  7. Ideally, implants should be placed around 2mm below the bone crest to get maximum benefits.
  8. The implants system we use in our office have tapered conical connectors to avoid a gap between the restoration and the implant.  This keeps bacteria from collecting where the implant and abutment meet and prevent microscopic movements which over time would put strain on the implant and surrounding bone.
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 andFlorida West Coast Dental Association.  Dr. Todd Britten also routinely uses a 3D GREEN Cone Beam CT Scanner in his office which offers fantastic imaging detail to assist in the digital planning of dental implants for precise accuracy, safety and optimal results.  For more information, call 727-586-2681 or email at .

The Oral Cancer Foundation states: “Close to 45,750 Americans will be diagnosed with oral or pharyngeal cancer this year. It will cause over 8,650 deaths, killing roughly 1 person per hour, 24 hours per day.”

While smoking and smokeless tobacco use is certainly a major risk factor for Oral Cancer, there are other lifestyle, genetic and even viral causes that contribute this often disfiguring and sometimes deadly disease.

Your dentist, dental specialist and dental hygienist are your first line of defense for early detection of Oral Cancer. Dr. Britten routinely performs systematic examination of all the soft tissues of the mouth, including the tongue, floor of the mouth, as well thorough examination of the borders of the tongue, and the lymph nodes surrounding the oral cavity and in the neck.

If you have any questions about Oral Cancer, please feel free to contact us via email at or call at 727-586-2681.

Do you ever wake up with an aching jaw, tooth sensitivity or notice that your teeth seem to be shifting or loosening? Clenching or grinding your teeth can put excessive force on the supporting tissues of the teeth and could speed up the rate at which periodontal tissues are destroyed. Teeth grinding or clenching can also cause abnormal wear and tear on the teeth which will prematurely age and loosen them, causing problems such as hypersensitivity (from the small cracks that form, exposing your dentin). Clenching or grinding, known as bruxism, can also lead to chronic jaw and facial pain, as well as headaches.

If no one has told you that you grind your teeth, here are a few clues that you may suffer from bruxism:

Your jaw is sore often, or you hear popping sounds when you open and close your mouth.

Your teeth look short or worn down.

You notice dents in your tongue, especially along the edges.

A common therapy involves use of a special appliance worn while sleeping which your dentist can custom fit for you.

Dr. Britten can evaluate you for evidence of clenching or grinding and make the appropriate recommendation to avoid further damage to your teeth, gums and TMJ.

If you have any questions or concerns about bruxism, please contact our office at 727-586-2681.

Dental anxiety affects many patients and can hinder them from taking the next step to achieve their oral health care goals.

Dental anxiety and dental phobia are extremely common. Many people have at least some anxiety about visiting the dentist.  But for a patient with a dental phobia, a dental visit can be terrifying. Up to 15 percent of Americans report they avoid seeing the dentist due to severe dental anxiety or dental phobia.  Some people will put off dental care for years or sometimes even decades! This can lead to advanced gum infections (periodontal disease), pain, or even broken or decayed teeth.  The price of dental phobia can include a higher risk of gum disease and can lead to tooth loss. Other people have to live with a loss of self-esteem or reduced quality of life due to embarrassment over how their smile looks, inability to eat well, or discomfort.

There are many different degrees of dental anxiety or phobia. In the case of a dental phobia, there can be a complete avoidance of the dentist – sometimes for years! Some will go to their appointment, but they may not sleep the night before or feel sick before or during their dental appointment.

When people are feeling tense, they may have a lower threshold for pain and may need extra anesthetic or other pain treatments. They may also suffer from headaches or muscle tension in their back, neck, arms or legs while in the dental chair.

Symptoms of dental phobia or anxiety

  • Tense muscles or trouble sleeping the night before a dental appointment
  • Increasing nervousness or feeling ill while in the waiting room.
  • Feeling like crying or getting overly emotional when you think of going to the dentist.
  • You panic, gag excessively, or have trouble breathing during a dental appointment.

What are the causes?

Those suffering from dental anxiety or phobia report the main triggers as:  pain, a feeling of helplessness and loss of control, embarrassment, or negative past experiences as the cause for their fear of the dental office.

The major triggers of dental anxiety or phobia, and how they may be handled:

Pain – Some people have had a previous dental experience that may have been uncomfortable, had trouble getting numb or have very sensitive teeth or gums.  Some of these experiences may have happened before many of the advances in “pain-free” dentistry.  These days, we have many pain control techniques, analgesics and anesthetics available.

  • Before and during the appointment: different comfort choices can be offered including headphones, music, blanket, a relaxed environment, distraction, mental imaging, sleep mask, breathing techniques, a bite block, or other comfort measures. Dental professionals have different local anesthetic and topical rinses, liquids, sprays or subgingivally applied gels that can be used.  Tooth desensitizing agents are also available.  Your dental professional will be very knowledgeable about what is available and can select the appropriate method based on the type of procedure, length of procedure as well as your individual needs and preferences.
  • For surgical or more intensive procedures, IV conscious sedation or oral sedation is often an option. Sedation dentistry can provide a calming experience for patients who have experienced high levels of anxiety related to dental treatment.  Some dentists are highly trained and certified in IV conscious sedation or oral sedation.

IV CONSCIOUS SEDATION

Intravenous (IV) Sedation helps even our most anxious patients remain relaxed and comfortable during procedures. Many patients feel as though they, “went to sleep” during the sedation. The goal of IV conscious sedation is not to provide general anesthesia but instead to allow patients to remain conscious and relaxed with minimal risk during the procedure.

ORAL SEDATION

A prescription medication can be given that can relieve anxiety patients feel before and during their dental procedure. It allows patients to respond verbally and physically to directions all while in a very “restful” state. Patients using oral sedation will need to be driven to and from the procedure.

  • After the appointment: Warm saltwater rinses, over the counter or prescription pain medications are available to assist in a person’s recovery after the procedure. Having post-appointment care information in writing as well as given verbally is also helpful.

Helplessness or loss of control — in the dental chair, a patient has to stay still, they can’t see what’s going on or predict any potential discomfort.  It’s common for people to feel helpless and out of control, which may trigger anxiety.  A patient’s state of mind is very important especially when one has dental anxiety or phobia.  For some patients, a clear explanation of what procedures will be done, what to expect, and how to indicate if they need the operator to stop or give them a rest can help immensely.

Embarrassment — People may feel ashamed or embarrassed to have a stranger looking in their mouth.  Some people lack self-confidence or are ashamed of how their teeth look, and may be afraid they’ll be judged or ridiculed. Dental care also involves an invasion of a person’s personal space as dental treatments require physical closeness. During a treatment, the hygienist’s or dentist’s face may be just a few inches away. This can make people anxious and uncomfortable.

Negative past experiences — many that have had pain or discomfort during a previous dental procedures, often in childhood, but it could be any other time, are likely to be more anxious.

To cope with dental fear, it is best to tell your dentist about your feelings, concerns and fears so they can help you overcome these feelings by adjusting your comfort and care in the dental office.

Through the specialty of periodontics & implant dentistry, we at Britten Periodontics strive to deliver comfortable care and ethical treatment in a welcoming environment.  Our goal is to deliver exceptional dental care with compassion, using the latest research based techniques. With education and encouragement, our goal create a strong relationship with our patients and a comfortable experience.

Our team members understand that the treatment provided is not always pleasant or comfortable but they possess the personality to make the patient feel at ease in spite of this.   As a team, we partner with other caring healthcare providers to deliver patient treatment with honor and dignity. A healthy, satisfied patient is our ultimate reward!  For our surgical procedures, Dr. Britten is highly trained and certified in both IV conscious sedation and oral sedation. He is one of the few Periodontists in the Tampa Bay area who offers IV sedation.

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.

To learn more about Dr. Britten and his dental services visit his website at https://brittenperio.com or call (727) 586-2681.

Dr. Todd M. Britten and his staff at Britten Periodontics & Implant Dentistry are gearing up for their 2nd annual Free Dental Day for Veterans. The event will be held in Dr. Britten’s Clearwater office on Friday November 11, 2016.

Last year was the inaugural event and it was a great success. Dr. Britten, his staff, as well as volunteers from Clearwater Dental Associates and Britten Dental Associates worked together to provide four very deserving veterans with periodontal and general dental care. When asked about the previous event Dr. Britten said, “It was such a great feeling to help these patients’ oral health improve and help them keep teeth that they were in danger of losing. Veterans and their families make so many sacrifices for us all and we were so honored we were able to give something back to them.”

For one veteran in particular, treatment included IV sedation (due to the need for extensive treatment and intense dental phobia), extraction of all of this patient’s remaining teeth which were badly broken and excessive bone growth throughout his mouth. Dr. Jim Hayslett of Clearwater Dental helped Dr. Britten restore this patient’s smile with complete upper and lower dentures. Dr. Britten stated, “All he wanted to do again was eat a steak dinner. We were able to get a patient out of pain and help him to be able to chew again and smile with confidence.”

Dr. Britten and his staff have been working with The Community Dental Clinic to match patients with periodontal needs with the Clearwater Periodontist’s office. Allison Sapiega, the executive director at the clinic stated, “The Community Dental Clinic has enjoyed the privilege of working with Britten Periodontics for the last few years on their Free Dental Event for Veterans. We are so proud to call them a community partner as we strive together to serve those that fall into the dental services gap. Nearly 95% of veterans are without dental coverage, so events like Britten Periodontics’ Free Dental Day for Veterans are imperative in serving those that have served us.”

Dr. Todd Britten explained how glad he is to be doing this the second 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. We are happy to host this annual event, and hope to do it for many years to come.”Screenshot_2016-09-05-08-39-28[17758]

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.

To learn more about Dr. Britten and his dental services visit his website at https://brittenperio.com or call (727) 586-2681.

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