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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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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!

Clearwater FL Periodontist Dr. Todd M. Britten and the team at Britten Periodontics & Implant Dentistry are holding their 3rd annual Free Dental Day for Veterans on Friday, November 3rd

Clearwater FL Periodontist Dr. Todd M. Britten and the team at Britten Periodontics & Implant Dentistry are holding their 3rd annual Free Dental Day for Veterans this Friday, November 3rd, 2017. “The sacrifices made by veterans and their families are truly astounding. I am aware that dental coverage for veterans is very hard to attain, so each year, we have hit the ground running trying to deliver periodontal care to as many veterans as we could.” 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.

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.”  “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,” Dr. Britten expressed his concern. “Even though we sometimes have to remove some teeth we felt better knowing these veterans do not have to be in discomfort anymore.” 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 need extensive surgical treatment.

For Britten and his team this event is something they look forward to all year long. They keep in touch and have provided follow up care for many of the veterans. “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.

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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L-PRF Technology for Better Healing

Dr. Todd Britten is happy to announce that we are using Platelet Concentrates (L-PRF, or Leukocyte-Platelet Rich Fibrin) to promote healing in dental procedures.

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.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.

Healing From Within With L-PRF

  • Only requires a small blood sample – Virtually painless!
  • 100% natural, 100% you –
  • No additives, chemicals, or foreign substances – Lowered risk for complications
  • Contains your unique healing properties – Promotes Recovery!
  • Simple procedure – FDA Cleared

Tooth loss and damage to the jaw bone and tissues are often challenging for your dentist during oral surgery or implant placement. Without enough support in the jawbone, dental implants cannot be immediately stabilized and tissue healing can be a long process. The solution to these and other difficult situations is a new Platelet Therapy created from your own blood. Leukocyte –Platelet Rich Fibrin (L-PRF) changes all the rules as it promotes healing and bone growth from within your own body. Unlike other treatments that use artificial components, Platelet Therapy with L-PRF uses only your own blood. With a simple blood draw and an advanced technology protocol, L-PRF is individually made for you – from you. The end results are improved healing response and significantly less recovery time.

L-PRF™ is basically a bioactive “band-aid” that is created from your own blood and then placed in your surgery sites to promote healing. A sample of your blood is collected in a tube, just as it would be for a blood test. The dentist then uses the unique IntraSpin™ System to separate and concentrate certain important cells and active proteins by spinning your own blood in a dedicated centrifuge. After a fast preparation the bioactive clot, created just from your own blood, is now ideal for your procedure. After your L-PRF is created, it can be placed directly in/on surgical sites to immediately promote healing. When placed in surgery sites, L-PRF releases your body’s own natural healing proteins, creating a more efficient network for cells to enhance the healing process. Depending on your situation, the doctor may supplement your L-PRF clot with different biomaterials customized for your needs. For patients with significant bone loss, a combination of L-PRF and bone growth material may also be used to promote natural bone regeneration.

The therapy is 100% natural and additive-free. Natural growth factors present in your body are concentrated using L-PRF. Your own concentrated platelets and other key blood cells and their unique healing abilities are simply re-introduced at the site of your surgical procedure. As a result, your own body releases powerful healing proteins, and creates a scaffold for healing.

If you have any questions about treatment with platelet rich fibrin/plasma or would like to find out if you can benefit from this treatment, please contact us at 727-586-2681.

Dr. Britten’s Favorite Oral Hygiene Products Revealed

Toothbrush

For most patients, a power toothbrush is the best choice. Studies show power toothbrushes are much more effective at cleaning teeth by removing plaque and stain effectively, particularly for those who have a history of tooth decay, gum disease, difficulty brushing or who have limited manual dexterity. Dr. Britten often recommends the Sonicare® Platinum toothbrush, as it is shaped like a traditional toothbrush head, and aids in effective plaque removal and gum stimulation and massage.

If not using a power toothbrush, a soft-bristled brush is best for removing plaque and debris from your teeth and along the gum line. Small-headed soft bristled toothbrushes are also preferred, as they can reach areas way in the back of the mouth.  Dental professionals generally encourage their patients to pick whatever shape and size is most comfortable. The best toothbrush is one that fits your mouth and allows you to reach all teeth easily.

Replace your toothbrush (or power toothbrush head) when it begins to show wear, or every three months, whichever comes first, or after any illness.

Toothpaste

Unless your dentist recommends otherwise, it’s important to use toothpaste that contains fluoride, which helps to strengthen the outer tooth enamel of our teeth. However, if you are allergic to fluoride, you may want to choose a different toothpaste. Be sure to speak to your dentist or physician before making this switch.

Sometimes a higher, or prescription-level dosage of fluoride is necessary for patients with sensitive teeth, exposed roots, or at greater risk for tooth decay.  Dr. Britten often prescribes Clinpro 5000 toothpaste, which contains a therapeutic level of fluoride, in addition to calcium and phosphate, other minerals that help strengthen enamel and the roots of the teeth.

Dr. Britten prefers toothpastes without added harsh chemicals. Some tartar control, whitening, or flavorings burn or irritate the soft tissues of the mouth (inside of lips, cheeks, the tongue, or even the gum tissues). Some toothpastes, especially those with added whitening agents, are abrasive to the enamel and over time can wear it away slowly. Ask your dental professional which products they recommend for whitening or tartar control.

Rinses

Mouthwash and fluoride mouth rinse are two different products. Anti-bacterial mouthwashes (like Listerine) are more effective in controlling plaque than fluoride rinses, and also freshen breath. Fluoride rinses (like ACT brand) coat the teeth with fluoride to strengthen teeth to prevent tooth decay and cavities. They also freshen breath.

Many mouthwashes contain alcohol, so always read the label before giving mouth rinse to a child or someone with a history of substance abuse. Your dental professional may recommend an alcohol-free mouthwash, or to dilute with 1:2 or 2:3 parts’ water.

There are other antimicrobial (Chlorhexidine) or fluoride (Perio-Med) rinses that Dr. Britten recommends available by prescription as needed.

Clean between the teeth at least once per day to remove dental plaque from areas not reached by tooth brushing alone and where tooth decay and gum disease often occur!

Floss

Flossing is critical for healthy gums. Floss is available in many different sizes, coatings, flavors and forms. If you have trouble using the floss around your fingers, you can purchase floss holders in most drugstores and grocery stores. Dr. Britten recommends a floss with texture, rather than a slippery, waxy floss, which will leave a plaque residue behind.

Two of our favorites:  Listerine “Gentle Gum Care” , (formerly Reach brand) woven floss.  The soft cloth material protects your sensitive gums while effectively removing sticky plaque build up. This soft, springy and resilient dental floss removes plaque effectively and is easier on the gum line.

POH No Wax floss has many thin strands of nylon which enable our floss to disrupt and disorganize sticky bacterial plaque, which is the key to preventing tooth decay and gum disease. It won’t just slide over plaque. The multiple strands of tiny nylon slip easily between the closest teeth, able to get just under the gum line.

LISTERINE® ULTRACLEAN® Dental Floss has shred-resistant technology to stretch, flex and glide for an ultimate clean. Its MICRO-GROOVES® technology removes 2x more plaque than Glide® Mint Floss.

How to floss:  Place the floss around your index and middle fingers, make a C shape around each tooth and use a push-pull and up and down motion to remove plaque at and below the gum line and between the teeth. Try to be gentle when placing the floss below the gum line.

Children should floss once a day with the assistance of their parents. Many people floss just before bedtime. But if another time is more convenient for you, do it then.

Water Irrigation Devices (such as Sonicare Air Flosser or Waterpik)

Water irrigation devices can remove food from between teeth. Children or teenagers with braces or other orthodontic appliances may find these devices useful to remove food debris and plaque from the teeth and gum line. These devices have shown reductions in bleeding, gingivitis (inflammation of the gums) and plaque accumulation.

Water irrigation devices are most effective when used along with tooth brushing and manual removal of plaque between the teeth with dental floss or other interdental aids and should not ever replace your toothbrush or floss!  Also, proper angulation and power settings will avoid injuring thin gum tissues, which may lead to gum recession.

Interdental Brushes or Picks

Dr. Britten recommends using plaque between the teeth using interproximal brushes, go-betweens or soft-picks.  These are great tools which remove dental plaque from areas between the teeth most commonly missed by toothbrushing alone. As a popular and effective alternative or addition to dental floss, we recommend GUM® brand Proxabrushes®, Soft-Picks ® or Go-Betweens® are safe and easy to use for cleaning between natural teeth and around crowns, bridges, dental implants and orthodontic appliances.

Proxabrush (Interdental brushes)

Between-teeth cleaning with interdental brushes such as GUM® Proxabrush Go-Betweens® cleaners is as effective as dental floss in removing plaque but is perceived to be much easier and more convenient.

These products are available on long handles (size of a toothbrush handle) or travel-size making it easy to carry the Go-Betweens® cleaners in your pocket or purse for use outside of the home.

The soft nylon bristles have an antibacterial coating** to help keep the brush clean and hygienic between uses. Different sizes of brush heads are available to fit from the tightest to widest of between teeth spaces. Tight brush heads are designed to clean the tooth and gum surfaces adjacent to the tight spaces.

In four diameters: Ultra Tight, Tight, Moderate and Wide brush heads. Choose the diameter that easily fits into the spaces between the teeth, under the bridge, or around the wires and brackets of an orthodontic appliance.

HOW TO USE

Use gentle in-and-out motions in the spaces between teeth and implants and around crowns and bridges to remove dental plaque and food particles.

  1. Never force the brush into tight spaces.*** Do not bend or twist wires during use.
  2. Rinse the brush and handle after each use.

***If a space is too tight to accommodate the smallest Ultra Tight brush, consider using string floss of a Soft-Pick in that space.

GUM® Soft-Picks®: For healthy gums and a great-looking smile, GUM® Soft-Picks® are the convenient way to effectively remove food, plaque and massage gums.

GUM® Soft-Picks®: For healthy gums and a great-looking smile, GUM® Soft-Picks® are the convenient way to effectively remove food, plaque and massage gums.

Dr. Britten and his hygienists are trained to help you select the appropriate oral hygiene aids for your maximum oral health and plaque removal. For more information regarding other oral hygiene aids that Dr. Britten recommends, visit  https://brittenperio.com/oral-health/oral-hygiene/

This is the difference between plaque… and tartar!

During a dental hygiene visit, patients often ask our hygienists, “Do I have a lot of plaque?” Or, your hygienist or dentist may you that during your exam they are checking your “plaque score” and give you a grade, based on a percentage. This helps them to see how you are doing with your daily oral hygiene and how they can help you improve it to prevent cavities or gum disease.  What exactly is plaque? And what can you do about it?

Plaque is a sticky, colorless film of bacteria that constantly forms on teeth and makes its way down and under the gum line. Plaque contains bacteria that cause cavities and gum disease. If it is not removed by regular and effective brushing and flossing, it can harden into tartar — sometimes called calculus — which is calcified (or hardened) bacteria which attaches to the enamel on your teeth, as well exposed roots and can also travel under the gum line.

Bacteria are constantly growing in our mouths, in fact up to hundreds of different strains. When plaque is not removed from near or under the gum line it will cause inflammation and irritation to the gums around teeth, leading to gingivitis (red, swollen, bleeding gums). Gingivitis is reversible.  But if gingivitis is not treated, it can progress to periodontal disease and, possibly, tooth loss.

Tartar is a mineral buildup. The most common sign of tartar is a white, yellow or brown deposit between the lower front teeth or along the gum line.  Some people notice that they build tartar on the inside of their lower front teeth and can feel it with their tongue. While plaque can be removed with tooth brushing and interdental aids like floss or brushes that go between the teeth, the only way to remove tartar completely is to see your dentist or dental hygienist for a professional hygiene visit.

What we eat and drink remains in our mouths after we are done eating and bacteria also live on these foods – especially sugars and carbohydrates – and produce acids that can attack the tooth surface. If proper flossing and tooth brushing are not conducted efficiently every single day this leads to more plaque and tartar on the teeth.  When plaque builds up on the teeth, the bacteria can infect not only your gums and teeth, which can cause periodontal disease – an immune response by the body which will attack the gum tissue and bone that support the teeth. The acids from foods or drinks in the mouth, along with acids produced by bacteria in the mouth, can cause tooth decay.

When your dental hygienist or dentist checks your plaque score, they are swiping 5 teeth in the mouth along the gum line, counting 4 surfaces (front, back and in between) for each tooth. For every surface that has plaque accumulation just below the gum line, 5 points are added to your plaque score.  A good plaque score would be under 20%, an excellent score would be 5 or 10%. This gives them a good idea of how your brushing is in between each visit, as plaque above the gum line can be removed effectively just before the appointment, but plaque sitting under the gum line has accumulated for a period of time.

To improve your plaque score and prevent tooth decay, gingivitis, and periodontal disease.  Make sure to:

  • Brush thoroughly at least twice a day for 2 minutes with a power toothbrush to thoroughly remove plaque from all surfaces of your teeth. You will need to brush 4 minutes with a manual brush, and probably not do it as effectively. Many studies show power toothbrushes remove plaque much more effectively than a manual brush.
  • Floss daily or use other dental aids recommended by your dentist or hygienist to remove plaque from between your teeth and under your gum line, where your toothbrush may not reach.
  • Limit sugary, starchy or acidic foods, especially sticky snacks.
  • Schedule two to four regular dental visits for professional cleanings and dental examinations each year, depending upon the recommendations from your healthcare provider. Many patients require three to four visits a year due to a high risk for dental decay and to manage periodontal disease.

For more detailed oral hygiene instructions, visit https://brittenperio.com/oral-health/oral-hygiene/

The Dangers of Smoking and Periodontal Health

Advanced Periodontal Disease and Tooth Loss in Smokers

Quitting smoking can be very difficult to committing to, even if you know the health risks and potential benefits of giving up. Most people are all too well aware of  the links of smoking to lung cancer and advanced periodontal disease, but one of the major problems with smoking is that it tends to mask the damage being caused to teeth and gums. Reduced blood flow in the inflammatory lesions of smokers makes it harder for the body to fight infection by reducing the flow of essential nutrients to damaged tissues. At the same time the body is also less able to transport toxins away from the infection site. Smoking makes it harder to see the damage being caused to gums, so if you have any signs of active gum disease, then these will be far less visible.

Other chemicals contained within the smoke will combine with plaque bacteria and this is dangerous because x-rays taken of smoker’s teeth often shows that the jawbone has begun to shrink away from their teeth. This damage can be difficult to detect, producing very few early warning signs of advanced periodontal disease.

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.

Developing Advanced Periodontal Disease

This is a major problem and as a top periodontist in Clearwater, Florida, Dr. Todd Britten is highly concerned when seeing patients who smoke. The likelihood of developing advanced periodontal disease or gum disease is 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.

Will You Lose Your Teeth If You Have Periodontal Disease?

In advanced cases, Britten may have little choice but to extract teeth that have already become loose. Smoking masks one of the major signs of gum disease which is bleeding gums and as a result periodontal disease can be very advanced before a smoker notices there is something wrong with their dental health. Although diligent brushing and flossing may slow down deteriorating gums, it’s often difficult for smokers to thoroughly remove all the plaque from the teeth due to smoking decreasing sensations in the mouth, making it difficult for them to detect areas that may not have been properly brushed.

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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