Dentistry

A dental emergency is a frightening and often painful experience. Seeking treatment as soon as possible is is the best way to alleviate pain and to give the effected tooth or teeth the best possible chance of survival.

Teeth can become fractured by trauma, grinding, or biting on a hard object. Sometimes fillings, crowns, and other restorative devices can be damaged or fall out of the mouth completely. If there is severe pain, it is essential to contact your dentist immediately!

Pain from a dental emergency will almost always get worse without treatment, and dental issues, particularly infections can also cause other serious health issues!

Possible dental emergencies and how to deal with them

Tooth knocked out (avulsed)
It is essential to see a dentist immediately. Once out of the mouth, tissues, nerves, and blood vessels become damaged. If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Here are some steps to take:

Call your dentist immediately.
Pick up the tooth by the crown and rinse it under warm water. DO NOT touch the root.
If possible, place it back into its socket – if it can not, tuck it into the inside of your cheek pouch.
If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort. It is important to keep the tooth from drying out.
Get to your dentist, quickly and safely.
They will try to replace the tooth in its natural socket. In some cases, the tooth will reattach, however, root canal therapy might be necessary.

Dislodged/loose teeth
When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it. If the tooth remains in the mouth still attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.
It is important to call your dentist immediately to make an appointment. In the meantime, use a cold compress and over-the-counter medications to relieve pain. Your dentist will reposition the tooth and may be able to splints the tooth to stabilize it. If the tooth fails to heal, root canal therapy might be required.

Lost filling or crown
Usually, a crown or filling comes loose while eating. The tooth may be incredibly sensitive to temperature changes and pressure.

What to do: Make a dental appointment as soon as possible. Keep the crown in a cool, safe place because there is a possibility that may be recemented. If the crown is out of the mouth for a long period of time, other teeth may shift or sustain damage.
If your dentist is not immediately accessible, here are the steps to take:

Clean the crown, and affix it onto the tooth with dental cement. This can be purchased at a local pharmacy.
If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
DO NOT use any kind of glue to affix the crown.
Your dentist will check the crown to see if it still fits. If it does, it will be recemented to the tooth. If decay is noted (which often is the reason the crown became loose) this will be treated and a new crown will be made.

Cracked or broken teeth
Teeth are strong, but they may still fracture, crack or break. Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme. Fractures, cracks, and breaks can take several different forms, but are generally caused by trauma, grinding, and biting.

What to do:
Schedule an appointment as soon as possible!

If a portion of the tooth has been broken off, here are some steps that can be taken at home:

Call your dentist.
Rinse the tooth fragment and the mouth with lukewarm water.
Apply gauze to the area for ten minutes if there is bleeding.
Place a cold, damp dishtowel on your cheek if there is any swelling or pain.
Cover the affected area with over-the-counter dental cement if you cannot see us immediately.
Take a topical pain reliever.
The nature of the break or fracture will dictate what your dentist is able to do. If a fracture or crack extends into the root, root canal therapy is often the most effective way to retain the tooth. Some fractures may cause either eventual or immediate loss of a tooth. The extent of damage from a fracture can often be determined with radiographs or a CT scan.

If you have questions or concerns about dental emergencies, please contact our office or your restorative dentist.

For more information call our office at (727) 586-2681.

Oral Health for Older Adults

Self-Care

“What Can I Do To Maintain Good Oral Health?

Drink fluoridated water at recommended level and brush with fluoride toothpaste twice a day. Fluoride protects against dental decay at all ages. Bottled water may not contain fluoride.

Practice good oral hygiene. Careful tooth brushing and flossing to reduce dental plaque can help prevent gum disease. Caregivers need to help with daily oral hygiene routines of elders who are unable to perform these activities independently.

Eat a balanced diet low in sugar and starches.

Avoid tobacco. Smokers have seven times the risk of developing periodontal disease compared to non-smokers.

Limit alcohol. Drinking high amounts of alcohol is a risk factor for oral and throat cancers. Sudden changes in taste and smell need not be considered a sign of aging, but a sign to seek professional care. Alcohol dries the mouth and can make a person more prone to cavities.

Professional care helps maintain the overall health of the teeth and mouth, and provides for early detection of precancerous or cancerous lesions. Make sure that you or your loved one gets dental care prior to having cancer chemotherapy or radiation to the head or neck. See your dental provider on a regular basis, even if you have no natural teeth and have dentures.”

-courtesy of the Washington State Dept. of Health

For Caregivers

“Wear clean, disposable gloves.
Sit loved one/patient upright or bring them to a sink. Have a towel handy and a disposable cup for potential spills. If sitting in a chair, stand behind them and cradle their head.

Using a soft bristle toothbrush, brush each tooth with a small circular motion and gentle pressure. Angle the brush towards the gums as you brush the outside, inside, and chewing surface of each tooth. Brush for two minutes, at least twice a day. If available, electric toothbrushes are typically more effective.

Gently brush the tongue and roof of the mouth.

Have them rinse with water or an alcohol-free germ-fighting mouthwash.

Take a look at their lips and inside of the mouth. If you notice any cracking, lumps, white or red lesions, or sores that do not heal within 2 weeks, you should consult a dentist or doctor.

Floss all teeth, dental bridges, and implants. Other
dental aids such as interproximal brushes, floss
threaders or softpicks may also be helpful

Clean dentures daily and remove at night.

If they are unable to rinse, ask them to spit out any excess toothpaste and debris. (Leaving a film of fluoridated toothpaste on the teeth can be beneficial.) If your loved one/ patient is resistant to your assistance, be patient. Consistency, repetition, and encouraging words will help them adjust.

After Eating:

Remove any remaining food from your loved one’s mouth. Gauze or a soft cloth can be helpful to wipe away excess food. If brushing is not an option, ask them to rinse with a cup of water then spit back into the cup. Frequent sips of water throughout the day will help cleanse the mouth. Gum with xylitol is also a good option to help cleanse the mouth.

If Cleaning Problems Persist:

Ask your dentist about germ fighting rinses. They may also prescribe a stronger toothpaste that contains more fluoride to prevent cavities.

Professional Dental Care:

Even if there are no problems, everyone should visit the dentist for a professional cleaning and exam twice a year. Even those who wear dentures are in need of an annual dental exam.”

-courtesy of Elizabeth Southern Puette, RDH, BSDH, MS
Member of the American Dental Hygienists’ Association

“Healthy Teeth are necessary for a healthy body. With good habits at home like brushing, flossing, fluoride, regular dental care, and avoiding tobacco products, older adults are able to keep their teeth a lifetime.”

–courtesy of the Washington State Dept. of Health

For more information on oral health, email us at or call us today at 727-586-2681.

Many people clench or grind their teeth whether they realize it or not. Clenching and grinding can be detrimental to your teeth and to their supporting structures (gum tissues and bone).
It can cause wear on the biting surfaces, root defects, gum recession, contribute to gum disease and tooth shifting and mobility, and cause muscular and TMJ (joint) issues.
Most people are completely unaware that they do it, because it happens while they are sleeping. Many patients do not realize they grind their teeth and find the thought of wearing a night guard very unappealing.

Nightguards purchased online or at the drug store are not custom fitted, they are usual one size fits all or boil & bites. They can be large, unattractive, poorly fitting and may even come out during the grinding.

Your dentist is trained in how a persons’ bite should function, how the teeth should come together and will take into account your specific situation and grinding pattern. Your dentist’s office will take impressions of your teeth so that the dental lab can make a might guard that is the exact match to your teeth.

Although the initial investment may be greater, a custom fit nightguard can be an extremely worthwhile investment in the long run. It is designed by your dentist to fit your teeth exactly and is much more likely than a store bought guard to prevent you from needing more expensive dental work in the future. In many case, dental insurance covers all or part of the cost.
Dr. Britten can check your teeth and bite for signs of abnormal clenching and grinding and work with your dentist to fabricate the right appliance for you. Contact our office at 727-586-2681, or via email at .

From Colgate.com

“Your teeth can become discolored by stains on the surface or by changes inside the tooth. There are three main types of tooth discoloration:

Extrinsic — This occurs when the outer layer of the tooth (the enamel) is stained. Coffee, wine, cola or other drinks or foods can stain teeth. Smoking also causes extrinsic stains.

Intrinsic — This is when the inner structure of the tooth (the dentin) darkens or gets a yellow tint. You can get this type of discoloration if:
You had too much exposure to fluoride during early childhood.
Your mother used tetracycline antibiotics during the second half of pregnancy.
You used tetracycline antibiotics when you were 8 years old or younger.
You had trauma that affected a tooth when you were a young child. A fall, for example, may damage the developing permanent tooth.
You had trauma in a permanent tooth, and internal bleeding discolored the tooth.
You were born with a rare condition called dentinogenesis imperfecta. This causes gray, amber or purple discolorations.

Age-related — This is a combination of extrinsic and intrinsic factors. Dentin naturally yellows over time. The enamel that covers the teeth gets thinner with age, which allows the dentin to show through. Foods and smoking also can stain teeth as people get older. Finally, chips or other injuries can discolor a tooth, especially when the pulp has been damaged.
Symptoms
Symptoms include stains on the enamel. They can range from white streaks to yellow tints or brown spots and pits. If the enamel has worn away, and dentin is showing through, you may notice a yellow tint.

Diagnosis
No special tests are needed. A dentist or other dental professional can diagnose tooth discoloration by looking at the teeth.

Expected Duration
Some tooth discoloration can be removed with professional cleaning. An example would be the stains caused by coffee. Many stains are permanent, however. Teeth sometimes can be whitened with a bleaching gel. In some cases, if the discoloration is severe, a crown or veneer may be required to cover it.

Prevention
Brushing your teeth after every meal will help to prevent some stains. Dentists recommend that you rinse your mouth with water after having wine, coffee or other drinks or foods that can stain your teeth. Regular cleanings by a dental hygienist also will help to remove surface stains.

Intrinsic stains that are caused by damage to a nerve or blood vessel in a tooth sometimes can be prevented. You may need to have root canal treatment to remove the inner part of the tooth (the pulp) before it has a chance to decay and darken. However, teeth that have root canal treatment may darken anyway.

To prevent intrinsic stains in children, avoid too much early exposure to fluorides. Once the enamel is formed, fluoride will not discolor teeth.

Treatment
Many extrinsic stains caused by food and drink can be removed by regular professional cleanings and home care. Good home care includes brushing, flossing and rinsing after meals.

Discoloration often can be removed by applying a bleaching agent to the tooth enamel. One technique is called “power bleaching.” With this method, the dentist applies a light-activated bleaching gel. It causes the teeth to get significantly whiter in about 30 to 45 minutes. Several follow-up treatments may be needed, or take-home bleaching trays may be provided.

It’s also possible to remove discoloration at home. You will use a bleaching gel and a mouth guard given to you by your dentist. The bleaching gels designed for use at home aren’t as strong as those applied by your dentist. This means that the process takes longer — usually two to four weeks.

You also can buy whitening products over the counter. They contain a weaker bleach than the products you can get from your dentist. The whitening agent is applied as a gel placed in a mouthpiece or as a strip that sticks to your teeth. Over-the-counter mouthpieces fit less securely than the kind you get from your dentist, but they will lighten your teeth over time.

Whitening toothpastes may remove minor stains. They do not actually change the overall color of your teeth.

If your tooth has darkened after a root canal, bleaching the enamel won’t help. Your dentist can apply a bleaching material to the inside of the tooth, or you may consider a crown or veneer.

Bleaching will not lighten some stains, such as tetracycline stains. In this case, your dentist may recommend covering the discolored areas. This also may be useful when the tooth is chipped or badly damaged.

A tooth can be covered with a color-matched composite bonding material. Another option is to get veneers. These are thin ceramic shells that cover the outer surfaces of the teeth.

When To Call a Professional
Tooth discoloration is mainly a cosmetic problem. Visit a dentist if you’re unhappy with how your teeth look. Any change in a child’s normal tooth color should be evaluated by a dentist.

Prognosis
The prognosis is very good for extrinsic stains. Intrinsic stains may be more difficult or take longer to remove.”

Dr. Britten works with excellent pediatric dentists, general dentists and orthodontists in our area to surgically intervene in case of an impacted tooth.  Call us today if you have any questions!  727-586-2681.

A diet high in sugar certainly promotes the formation of cavities, but sugar itself isn’t the only culprit behind tooth decay.

Cavities are formed when bacteria living in the mouth digest carbohydrates left on the teeth after you eat. This includes refined sugars found in cookies, candy or other treats, however they may also come from healthy foods like whole grains, vegetables and fruits.

When digesting carbohydrates, bacteria in your mouth produce an acid that combines with food debris and saliva and forms plaque.

It’s the plaque — not sugar — that directly leads to tooth decay. Plaque starts building up after every meal, and if it isn’t brushed away frequently, it can erode the hard, outer enamel of a tooth, resulting in tiny holes in the tooth’s surface. These holes mark the first stage of cavities and can do a lot of damage to a tooth if left untreated.

Eventually, acid and bacteria in plaque can eat through the other layers of your teeth, as well — from the softer layer of teeth under the enamel, known as dentin, to the third layer (the pulp), which contains your teeth’s blood vessels and nerves. Cavities affecting the pulp of a tooth, as well as the bone supporting the tooth, can cause severe toothaches, sensitivity, pain when eating and even abscesses in the mouth.

It is important to know that the kinds of foods and drinks you consume, and how you are consuming them is also important to oral health.

Sticky foods — like hard candy, breath mints, raisins and dry cereal — can get stuck in the grooves and crevices of your teeth, where they could cause decay. Fruit and yogurt, on the other hand, wash away easily with saliva and are, therefore, less likely to cause plaque buildup.

QUickly finishing a can of soda does less damage to your teeth than sipping on it throughout the day, because the acid created by mouth bacteria stays in the mouth around 20 minutes after eating or drinking. Every time you eat carbohydrates, sugary food, or take a sip of soda, you restart the plaque-production clock and increase your risk of developing cavities.

In addition to a high sugar content, soft drinks and sports drinks also contain phosphoric and citric acids that erode tooth enamel. Eating or drinking highly acidic foods — even healthy foods, like citrus fruits — can lead to tooth decay if oral hygiene is not properly maintained.

None of us can totally avoid eating all carbohydrates, sugars, or acidic foods all of the time but we can limit the amount and more importantly the frequency of consumption. And we can also work on effective and regular plaque control by using oral hygiene aids to remove the plaque colonies which are forming constantly on the teeth.

Dr. Britten recommends brushing at least twice a day with a power toothbrush for two minutes as well as cleaning between the teeth at least once a day using floss or other interdental aids.

“Delivering Valentine’s is a simple gesture to remind all of us that we are loved.” –Matt Garcia, a former nursing home administrator.

Britten Periodontics & Implant Dentistry is a Periodontal Specialty office located in Clearwater, FL.  It is run by Todd M. Britten, DMD, MS and his incredible staff.  The office’s vision is to work together to provide excellent care to each person who walks through their door.  Their goal is for their patients to become family and have the best oral healthcare possible.  Being part of the community and giving back is a top priority for Britten and his team.

This Valentine’s Day, the staff was trying to figure out new ways to get involved and get out into the community.  One staff member, Julia May, had the great idea to deliver Valentine’s to older adults at a local memory center.

In order to make these valentines extra special a few team members enlisted the help of some very special students. The 2^nd graders from Oakhurst school in Pinellas County and the Primary class at Beach Park Montessori in Hillsborough County.  “The teachers and students were so excited to get involved and contribute to help brighten up someone’s day!”  said Meg Britten.

Matt Garcia, a former nursing home administrator found out about what the staff at Britten Periodontics had planned and stated, “Delivering Valentine’s is a simple loving gesture to remind all of us we are loved.  What a great gift from the Britten Periodontics team!”

Being a periodontist office, one of their main specialty areas is gum disease.  Gum disease is very common in older adults.  “As we age, the conditions of our mouths change. Add to that any medications you may be taking and your mouth can seem quite different from when you were younger. Gum disease and cavities are common among older adults,” said Kendal at Home Blog (a blog “Dedicated to transforming the experience of aging.”)

Dr. Britten went on to say, “When a person ages their dexterity and ability to care for their teeth may change, making it more difficult to keep up with their oral hygiene.  In order to help care givers assist the residents at the memory care center we not only delivered valentines filled with love and good cheer, but we included toothpaste, floss and a pamphlet with ideas and techniques to help the older adults and their caregivers better care for their teeth.”

Research shows that oral health is connected to our overall systemic health.  Dental care is preventative care.

Here is some information that we shared with the residents:

Oral Health for Older Adults

What Can I Do To Maintain Good Oral Health?

For Seniors:

Drink fluoridated water at recommended level and brush with fluoride toothpaste twice a day. Fluoride protects against dental decay at all   ages.

Practice good oral hygiene. Careful tooth brushing and flossing to reduce dental plaque can help prevent gum disease. Caregivers need to help with daily oral hygiene routines of elders who are unable to perform these activities      independently.

Eat a balanced diet low in sugar and starches.

Avoid tobacco. Smokers have seven times the risk of developing periodontal disease compared to non-smokers.

Limit alcohol. Drinking high amounts of alcohol is a risk factor for oral and throat cancers. Sudden changes in taste and smell need not be considered a sign of aging, but a sign to seek professional care.

Professional care helps maintain the overall health of the teeth and mouth, and provides for early detection of precancerous or cancerous lesions. Make sure that you or your loved one gets dental care prior to having cancer chemotherapy or radiation to the head or neck. See your dental provider on a regular basis, even if you have no natural teeth and have dentures.

-courtesy of the Washington State Dept. of Health

For Caregivers

Wear clean, disposable gloves.

Sit loved one/patient upright or bring them to a sink.  Have a towel handy and a disposable cup for potential spills.  If sitting in a chair, stand behind them and cradle their head .

Using a soft bristle toothbrush, brush each tooth with a small circular motion and gentle pressure.    Angle the brush towards the gums as you brush the outside, inside, and chewing surface of each tooth.  Brush for two minutes, at least twice a day.  If available, electric toothbrushes are a good option.

Gently brush the tongue and roof of the mouth.

Have them rinse with water or a germ-fighting mouthwash.

Take a look at their lips and inside of the mouth.  If you notice any cracking, lumps, white or red lesions, or sores that do not heal within 2 weeks, you should consult a dentist or doctor.

Floss all teeth, dental bridges, and implants.  Other

dental aids such as interproximal brushes, floss

threaders or softpicks may also be helpful

Clean dentures daily and remove at night.

If they are unable to rinse, ask them to spit out any excess toothpaste and debris.  (Leaving a film of fluoridated toothpaste on the teeth can be beneficial.)   If your loved one/ patient  is resistant to your assistance, be patient.   Consistency, repetition, and encouraging words will help them adjust.

After Eating:

Remove any remaining food from your loved one’s mouth.  Gauze or a soft cloth can be helpful to wipe away excess food.  If brushing is not an option, ask them to rinse with a cup of water then spit back into the cup.  Frequent sips of water throughout the day will help cleanse the mouth.  Gum with xylitol is also a good option to help cleanse the mouth.

If Cleaning Problems Persist:

Ask your dentist about germ fighting rinses.   They may also prescribe a stronger toothpaste that contains more fluoride to prevent cavities.

Professional Dental Care:

Even if there are no problems, everyone should visit the dentist for a professional cleaning and exam twice a year.  Even those who wear dentures are in need of an annual dental exam.

-courtesy of Elizabeth Southern Puette, RDH, BSDH, MS
Member of the American Dental Hygienists’ Association