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Why Are My Teeth Sensitive to Cold?

Why Are My Teeth Sensitive to Cold?

One question we get asked often is why teeth might feel sensitive. The answer to this question depends on the ailment, as will the treatment.

To understand the answer to this question, it helps to know a little about the structure of your teeth. Each tooth consists of the crown, which is the visible part of the tooth, and the root, which anchors each tooth into your jaw. Components of the crown include:

  • Tooth enamel– The hard, white-looking layer that protects the sensitive inner parts of each tooth. Tooth enamel is the hardest material in your body – even stronger than bone.
  • Cementum– A thin, protective layer of bone-like tissue under the gum line that protects the tooth root.
  • Dentin– A layer of softer tissue which contains tiny canals or ‘tubules’.
  • Pulp– The soft tissue deep inside each tooth that contains blood vessels, connective tissue and nerves.

If for any reason the enamel starts to wear way or erode, your tooth’s dentin is exposed. When this happens, nerve signals pass to the tooth root and from there to the brain – meaning that things like eating popsicles or drinking hot drinks, which normally don’t cause a reaction, can suddenly trigger pain.

What Causes Sensitive Teeth?

A range of factors can lead to tooth sensitivity, but there are two main underlying reasons: enamel loss and gum recession.

Causes of enamel loss include: 

  • Over-zealous brushing:Brushing too vigorously or too often.
  • Acid erosion:From acidic foods and drinks such as sugary sports drinks and sodas.

Causes of gum recession include:

  • Using a hard bristle toothbrush– This can injure the gum tissue.
  • Gum disease– A common oral health disease that can cause receding gums.
  • Your genes– Regardless of how you care for your teeth, you may be genetically susceptible to gum recession.
  • Smoking– Tobacco products increase plaque build-up on teeth which over time can lead to a greater risk of gum recession.

Professional and at-home teeth whitening (bleaching) treatments may cause temporary sensitivity, although this should disappear within a short time of stopping treatment.

Ways to Keep Your Mouth Healthy

If you’re wondering how to manage tooth sensitivity or how to soothe a sensitive tooth, there are a number of ways:

  • Start using an over the counter toothpaste such as Sensodyne or your dentist may give you a prescription fluoride toothpaste with other minerals that can help.
  • Brush twice a day, every day. Brush gently with a soft-bristled toothbrush for four minutes each time to keep teeth and gums clean and healthy. We often recommend the Philips Sonicare powerbrush to our patients as it is safe and effective in cleaning around both the teeth and gums.
  • Floss daily, or use interdental aides such as softpicks or proxabrushes.Making cleaning between your teeth a part of your daily tooth care routine helps maintain healthy gums.
  • Visit your dentist regularly. Schedule checkups for every six months or more often, as advised by your dentist.

How often should I see my dentist?

Many people are afraid or experience anxiety about going to the dentist, and because of this, some patients will try to go as infrequently as possible. The answer to how often you should see your dentist actually varies, depending on the state of your mouth.

If your teeth and gums are very healthy, you should visit your dentist at least twice a year for dental exams and cleaning. If you have a history of gum disease or other problems, you may need to visit your dental hygienist more often, often anywhere from 3 or 4 up to 6 times a year. Periodontal patients often see their dentist or periodontist every 3 months for hygiene visits, as many studies have shown that more harmful periodontal bacteria repopulate in the mouth in only 11 weeks time.

Frequent dental visits (particularly those for dental cleanings and periodontal maintenance visits) are in your best interest to prevent breakdown of the health of teeth and gums.

What is Peri-Implantitis?

What is Peri-Implantitis?

Peri-implantitis is an infection that hurts gums, bones and other tissues surrounding dental implants. It is very similar to gum disease. Severity can range from minor inflammation of the gums to severe degradation of the teeth and jaw. If left untreated, this often leads to patients losing their dental implants and developing other serious dental problems.

Peri-implantitis is caused by the bacteria and food particles that gradually accumulate around dental implants and gum lines. For this reason, peri-implantitis tends to grow unnoticed in its early stages. However, later symptoms can become severe. Ranging from minor to dangerous, symptoms include:

  • Redness and inflammation of the surrounding gum tissue.
  • Deepening of the gum pockets around the implant.
  • Exposure or visibility of the implant threads.
  • Loosening of the implant.
  • Pus discharging from the tissues around the implant.
  • Loss of supporting bone.
  • Bleeding upon being probed.
  • Swollen lymph nodes around the neck.

Peri-implantitis if left untreated can progress to severe stage and eventually lead to implant loss.  If caught early, and with adequate supervision from a competent dentist, peri-implantitis can be treated before it ever causes undue discomfort or embarrassment.

What is the cause of peri-implantitis?


There are three primary factors that influence your susceptibility to peri-implantitis:

  • Prior disease: patients affected by a disease that affects the whole body (known as systemic disease) can be extra susceptible to peri-implantitis. If you have diabetes or another systemic disease, consult with your dentist about your dental implants. Patients with periodontal disease can be at a higher risk to developing another mouth infection, like peri-implantitis.
  • Oral hygiene: If not cared for, plaque and tartar that are full of harmful bacteria and pathogens can easily build up around teeth and gums. These degrade tissue and cause irritation and infection. Other social factors can cause peri-implantitis, like smoking and drug abuse. What you put in your mouth affects your mouth; we advise extreme caution regarding what you place in your body.
  • Parafunctional habits: an easier term for this is “involuntary habit.” In this case, peri-implantitis is isolated to habits like involuntarily grinding your teeth in your sleep (bruxism), poorly positioning your teeth – either due to misalignment or poor muscle control – when the jaw is fully closed (malocclusion), nail biting and thumb sucking.

How can I avoid peri-implantitis?

Ways to avoid peri-implantitis:

  • Good oral hygiene:
  • Brush your teeth frequently (at least 2 x a day for 2 minutes with a powerbrush – Sonicare is preferred)
  • Use dental floss or other aides recommended by your dentist or dental hygienist, such as Proxysoft Bridge and Implant Floss or TEPE compact tuft brush.
  • If you suffer from any oral parafunctional habits (unconscious or involuntary habits with your mouth), like teeth grinding, poor jaw alignment or nail biting, seek help. Your dentist can provide several suggestions or treatments for these habits before they adversely affect your health.
  • Make sure you have a dental specialist perform dental implant surgery or to treat your peri-implantitis.  Periodontists are also implant specialists, with solid experience and advanced training in proper techniques.  Poor dental work can make your personal oral hygiene difficult and painful, and can expose you to pathogens later.If you are considering dental implants or if you feel you may have peri-implantitis, give us a call! You will receive excellent care. We want you to have a healthy mouth, and we know how to help you get it!

How is peri-implantitis treated?

Sometimes, surgical therapy is necessary to repair the damage from peri-implantitis.  Dr. Britten offers the latest technology in dental implant surgery, using both a “flap” type of procedure, or the use of  Laser Assisted Peri-Implantitis Protocol, or LAPIP. The LAPIP protocol uses a laser to target the bacteria that cause peri-implantitis without disrupting the stability of the implant itself. Using a laser, we can remove necrotic tissue, infection, anaerobes and other undesirables from the implant surface and surrounding periodontal structures.

Why Should Gum Recession be Taken Seriously

Gum recession refers to the loss of gum tissue along the gumline. This can occur as a result of periodontal disease (gingivitis, periodontitis, advanced periodontitis), the natural aging process, or abrasive habits when it comes to brushing the teeth.

Why should gum recession be taken seriously?

When gum recession occurs, the root structure of the tooth becomes exposed. This means that tooth decay and other problems can affect the teeth along the gumline and beneath it. Since healthy gums are essential for a healthy mouth, getting gum recession treated is important for lasting dental wellness. When recession occurs to the point that no firm gum tissue remains, this leaves the roots of the teeth and the underlying bone relatively unprotected, which could result in root sensitivity, bacterial penetration, decay and even loss of teeth.

A gingival graft is designed to address these problems. 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 gingival graft may be placed in such a way as to cover the exposed portion of the root, however, the main objective is to re­establish the protective barrier or layer of the gum around the tooth. Occasionally, the patient may need multiple procedures to achieve the ideal amount of root coverage.

Dr. Britten has trained in the latest minimally invasive techniques of gum grafting and can often perform the entire procedure through a pinhole incision.

Laser Assisted Periodontal Therapy

Laser Assisted Periodontal Therapy

Laser therapy uses intense beams of light projected by a dental laser.  Dental lasers can be used to perform a wide variety of treatments.

Minimally Invasive gum disease treatment for moderate to severe cases

Laser Assisted Periodontal Therapy, is an advancement in periodontal infection removal. ™ laser uses a specific wavelength that targets and destroys diseased tissue and bacteria from periodontal pockets.

In Laser Assisted Periodontal Therapy there is no cutting away of the gums or bone as in traditional treatment.  The PerioLase MVP-7 laser is used in our office for periodontal disease treatment. This procedure kills harmful bacteria and removes unhealthy gum tissue without harming bone or healthy tissue.  In ideal candidates, LANAP Periodontal Therapy can be a gentler, more precise treatment that conserves healthy tissue and minimizes pain and discomfort.

Laser Assisted Periodontal Therapy is:

  • More Comfortable 
  • Minimally Invasive
  • Less Damaging
  • Safe
  • Biologically Healthy

The beauty of dental lasers is that they damage far less of the surrounding tissue than traditional techniques – which means less discomfort and pain.

A small laser fiber is inserted into the diseased gum pocket.  This precise laser disintegrates the bacteria and diseased tissue without harming any of your healthy tissues.  The disease is removed and healthy gums and bone are given a good chance to regenerate.

In addition, the laser sterilizes as it removes diseased tissue and provides a sealing clot that inhibits reinfection.

is safe for patients with health concerns.  In addition, patients taking blood thinning medications (e.g. Coumadin, aspirin, Plavix) need not go off of these medications to receive treatment.  It is also more indicated for smokers as gum recession is less prevalent in laser dentistry.

Gingival (Gum) Excess

Gingival (Gum) Excess

Healthy gums are an important part of a person’s general oral hygiene and appearance.  Sometimes in certain people the gums can grow and build up over the front surface of a tooth. This can often occur when patients have braces on their teeth. This formation of extra gum can change the balance between the length of the teeth and the height of the gum line, leading in some cases to a person having an uneven smile.

Before and After Ginigvectomy by Dr. Todd Britten

Gingivectomy is best described as the surgical removal of excess gum tissue.

Your orthodontist or family dentist may recommend gingivectomy for several reasons:

  • Prevent teeth from shifting after orthodontic appliances have been removed.  Excess tissue can cause the teeth to separate even though braces have brought the teeth together. 
  • There are gaps or pockets that have formed between your teeth and your gums. These pockets will trap food particles, harbour colonies of bacteria, and make it difficult for you to clean. If the pockets only involve soft tissues then these gaps may be removed by simply trimming the gums through gingivectomy.
  • There is too much gum tissue for your teeth. Aside from cosmetic reasons, too much gum tissue for your teeth will make it hard for you to keep your mouth clean. In severe situations, this condition can interfere with the way you eat and the way you talk.

Soft Tissue Grafting: What to know

Soft Tissue Grafting

A gum graft (also known as a gingival graft or periodontal plastic surgery), is a collective name for surgical periodontal procedures that aim to cover an exposed tooth root surface with grafted oral tissue.

Exposed tooth roots are usually the result of gingival recession due to periodontal disease.  There are other common causes, including overly aggressive brushing and trauma.

Here are some of the most common types of gum grafting:

  • Free gingival graft – This procedure is often used to thicken gum tissue.  A layer of tissue is removed from the palate and relocated to the area affected by gum recession.  Both sites will quickly heal without permanent damage.
  • Subepithelial connective tissue graft – This procedure is commonly used to cover exposed roots.  Tissue is removed fairly painlessly from the outer layer of the palate and relocated to the site of gum recession.
  • Acellular dermal matrix allograft – This procedure uses medically processed, donated human tissue as a tissue source for the graft.  The advantage of this is procedure is that there is no need for a donor site from the patient’s palate (and thus, less pain).

Reasons for gum grafting

Gum grafting is a common periodontal procedure.  Though the name might sound frightening, the procedure is commonly performed with excellent results.

Here are some of the major benefits associated with gum grafting:

  • Reduced sensitivity – When the tooth root becomes exposed, eating or drinking hot or cold foods can cause extreme sensitivity to the teeth.  Gum grafting surgery permanently covers the exposed root, helps reduce discomfort, and restores the good health of the gums.
  • Improved appearance – Periodontal disease is characterized by gum recession and inflammation.  Gum recession and root exposure can make the teeth look longer than normal and the smile to appear “toothy.”  Gum grafting can make the teeth look shorter, more symmetrical and generally more pleasing to look at.  In addition, adjacent tissue can be enhanced and augmented during the procedure for aesthetic purposes.
  • Improved gum health – Periodontal disease can progress and destroy gum tissue very rapidly.  If left untreated, a large amount of gum tissue can be lost in a short period of time.  Gum grafting can help halt tissue and bone loss; preventing further problems and protecting exposed roots from further decay.
Before and After – Free Gingival Graft by Dr. Todd Britten
Before and After – Connective Tissue Grafting by Dr. Todd Britten

Britten Periodontics is excited to host another Holiday Food Drive with Metropolitan Ministries!

Britten Periodontics is excited to host another Holiday Food Drive with Metropolitan Ministries!

Thanks to Metropolitan families will find HOPE through receiving much-needed commodities!

Metropolitan Ministries’ greatest holiday food needs: Frozen protein (turkey, ham, chicken), yams, cereal, stuffing, and cranberry sauce.

Additional food needs: Canned beans, soup, bags or boxed rice, boxed/canned potatoes, packets of gravy, and dessert mixes

 The greatest toy needs are “teen” toys with a focus on Ages 10 – 12 (boys and girls), and our additional age group needs: 0-2, 3-9, and 13-17 (boys and girls).

 Please drop off your donations from October 24th -November 17th at our office at:

 1472 Jordan Hills Court

Clearwater, FL 33756

 727-586-2681 

 #BeHope #InspireHope

 

Healthy Teeth Vs. Acid Erosion & Wear

Healthy Teeth Vs. Acid Erosion & Wear

From Colgate.com:

“Tooth erosion is a common dental concern. The American Dental Association (ADA) reports that more than one third of children and adults worldwide may exhibit dental erosion. Tooth wear can take a number of forms, all of which may cause sensitivity and discomfort. Knowing how to prevent tooth erosion can help your teeth stay strong and healthy!

Why Is Your Tooth Wearing Away?

Dental erosion is the irreversible loss of tooth enamel caused by acids in the mouth. It occurs in populations across the globe and affects people of all ages. Dietary habits, conditions such as bulimia and poor oral care can all lead to tooth erosion.

Erosion caused by diet often appears as a hollowed-out area on the chewing surface of the tooth. Drinking sodas, alcohol or energy drinks increases the likelihood of eroding your teeth, especially if you swish the liquids prior to swallowing. This causes the acid to wash across the surface of the teeth and wear away the enamel. While consuming these drinks does not always lead to erosion, it affects the pH of the mouth and contributes to an acidic environment.

Having these drinks with a meal may help balance the amount of acid in the mouth. It is also possible to reduce the acidity level by consuming the drink in a short period of time, as opposed to sipping it. This allows the oral cavity to restore a normal pH balance.

Those who are regularly exposed to environments with higher levels of acid, such as factory workers or swimmers, may have increased dental erosion, reports the ADA. Patients who have bulimia, reflux or digestive disorders may notice erosion on the tongue and interior palate side of the tooth, as opposed to the side of the tooth that sits against the cheeks and lips.

3 Types of Tooth Wear

Dental erosion occurs when acid comes in contact with the teeth. Three other kinds of tooth wear include attrition, abfraction and abrasion.

  1. Attrition involves tooth-to-tooth contact, most often teeth grinding or improper biting. This type of tooth wear breaks down and flattens the chewing surfaces of the teeth.
  2. Abfraction occurs when regular grinding or a misaligned bite create an abnormal load on the tooth. This results in a notch on the side of the tooth near the gumline. A dentist or dental hygienist will often recommend a night guard for patients exhibiting abfraction. Orthodontic treatment can help align the teeth to ensure they come together properly.
  3. Abrasion can appear similar to abfraction, but it is caused by an external mechanical force, such as a toothbrush. If a patient is brushing too hard against the surface of the tooth or using a toothbrush with hard bristles, the constant wear can cause a notch-like surface at the gumline. Your dental hygienist can give you instructions on proper brushing techniques to avoid continued wear on the tooth surface.

Treatment for Tooth Wear

Those with abfraction or abrasion can have a filling placed on the side of the tooth over the damaged surface to help protect against continued wear, although it may not be medically necessary. Alternatively, a patient may choose to have fluoride applied at their six-month preventive care appointments or use a toothpaste that contains fluoride to help with sensitivity. Your dentist or dental hygienist may also continue monitoring the site of the tooth wear to ensure it doesn’t worsen.

Your enamel won’t grow back, but not all is lost! You can take measures to prevent further erosion and preserve your smile. Knowing how to take care of your teeth and practicing good habits recommended by your dental professionals can help your smile last a lifetime!”

Normal Teeth vs Wear from grinding
Normal teeth vs acid attack
Normal teeth vs soda destruction

Tori Removal or Reduction

What are Tori?

Tori are excess bone that develops either in the upper or lower jaw. When present in the roof of the mouth (palate), the condition is referred to as torus palatinus. When present in the lower jaw, it is called torus mandibularis. Tori may develop due to genetic or environmental influences such as local irritation, grinding your teeth (bruxism), or misaligned teeth causing an uneven bite (malocclusion).

In most cases tori are benign and do not require treatment. However, tori will need to be surgically removed to accommodate upper or lower dentures and upper or lower partial dentures (flippers). Tori may also be removed to aid in minimizing food impaction under the excess bone, which will promote improved home care. In certain cases tori may contribute to plaque accumulation and periodontal pockets, and therefore will require removal to improve oral hygiene by allowing better angulation of the toothbrush. Once tori are removed, recurrence is rare. In situations where tori do reappear, regrowth is typically very slow.

Tori Removal On One Side performed by Dr. Todd Britten

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