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Dentistry

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 .

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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.”

Most people have heard of wisdom teeth that become impacted, however the upper canines, or eye teeth are the second most common impacted adult teeth. If a canine tooth does not erupt spontaneously, your orthodontist and periodontist or oral surgeon will work together to get these unerupted canine to erupt. Each case must be evaluated on an individual basis but treatment will usually involve a combined effort. The most common scenario will call for the orthodontist to place braces on the teeth (at least the upper arch). A space will be opened to provide room for the impacted tooth to be moved into its proper position in the dental arch. If the baby canine has not fallen out already, it is usually left in place until the space for the adult canine is ready. Once the space is ready, the orthodontist will refer the patient to the oral surgeon to have the impacted canine exposed and bracketed.

In a simple surgical procedure performed in the surgeon’s office, the gum on top of the impacted tooth will be lifted up to expose the hidden tooth underneath. If there is a baby tooth present, it will be removed at the same time. Once the tooth is exposed, your oral surgeon or periodontist will bond an orthodontic bracket to the exposed tooth. The bracket will have a miniature gold chain attached to it. The surgeon will guide the chain back to the orthodontic arch wire where it will be temporarily attached. Sometimes the surgeon will leave the exposed impacted tooth completely uncovered by suturing the gum up high above the tooth or making a window in the gum covering the tooth (on selected cases located on the roof of the mouth). Most of the time, the gum will be returned to its original location and sutured back with only the chain remaining visible as it exits a small hole in the gum.

Shortly after surgery (1-14 days) the patient will return to the orthodontist. A rubber band will be attached to the chain to put a light eruptive pulling force on the impacted tooth. This will begin the process of moving the tooth into its proper place in the dental arch. This is a carefully controlled, slow process that may take up to a full year to complete. Remember, the goal is to erupt the impacted tooth and not to extract it! Once the tooth is moved into the arch in its final position, the gum around it will be evaluated to make sure it is sufficiently strong and healthy to last for a lifetime of chewing and tooth brushing. In some circumstances, especially those where the tooth had to be moved a long distance, there may be some minor gum surgery required to add bulk to the gum tissue over the relocated tooth so it remains healthy during normal function. Your dentist or orthodontist will explain this situation to you if it applies to your specific situation.

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.

While regular brushing, flossing, and checkups allow many of us to maintain our natural smiles for a lifetime, sometimes our teeth just can’t keep up. If you’ve lost a tooth (or a few teeth) due to injury or disease, dental implants can rejuvenate both your smile and your oral health.

An implant is a synthetic tooth root in the shape of a post that is surgically placed into the jawbone. The “root” is usually made of titanium (the same material used in many replacement hips and knees), a metal that is well suited to pairing with human bone. A replacement tooth is then fixed to the post. The tooth can be either permanently attached or removable. Permanent teeth are more stable and feel more like natural teeth.

The ideal candidate for implants is a non­-smoker who has good oral health, including a sufficient amount of bone in the jaw and healthy gums with no sign of gum disease.

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, call (727) 586-2681.[iphorm id=”3″ name=”Contact form”]

“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 2nd 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

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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

We are seeing more and more advertisements for “affordable” dentures. What does “affordable” or “discount denture” mean? Are these dentures the same thing that for a lower, fairer price? Unfortunately, the answer is NO!

There is a big difference in the outcome of customized dentures and “discount” dentures. Here are some of the main differences:

1) Quality dentures take TIME. Multiple visits are necessary to create a totally customized, well-fitting dentures. Beware of advertisements for dentures which can be made in a day. Discount denture centers often tell patients they can get their dentures the “same-day”, but most likely the result will be poor due to a lack of customization. Quality dentures must be tried in to check the bite, fit, and appearance of the teeth (and approved by the patient) before they are finalized. Customized dentures may take more time, but this time in the creation process results in less adjustments, a better looking denture, AND a happier patient.

2) It is wise to use the very best materials from start to finish when creating a denture. Quality dentures cannot be made with cheap materials or by cutting corners. Expert dental lab technicians should be involved in fabricating dentures along with the use of quality materials. This can mean the difference between a denture that looks natural versus one that looks fake, as well as how they fit and how long they last. Many “affordable” or discount dentures broken after just a few months due to the use of cheaper and less durable materials. As the saying goes: You get what you pay for.

3) Also beware, most discount denture centers do not back up their product with quality service and will charge for each and every adjustment, which quickly brings their cost up. Many patients are forced to choose not to have adjustments to their discount dentures because of the price, and they must put up with horrible pain or just leave their dentures in a drawer and go without teeth.

4) Lower dentures can be very difficult to wear. Lower denture treatment discussions, when possible, should include the option of at least two lower dental implants. Not everyone will choose implants due to cost, but everyone deserves to have this option presented. Often in an “affordable denture” situation this is not even offered and the difficulties of wearing a lower denture are not fully explained.

5) Dentures need regular maintenance such as relines from time to time. Customized dentures are easier to maintain, reline, repair and adjust due to the better quality of their material.

While our main goal is to save teeth and avoid dentures, our office is fortunate to work with many restorative dentists who are extensively trained and talented in the creation quality dentures. Dr. Britten is also an implant specialist trained in placing implants to retain dentures. For more questions about dentures, implant – supported dentures, or avoiding dentures, contact us today at or 727-586-2681.

On February 16th, we had the pleasure of hosting a seminar “Periodontal Maintenance of Dental Implants” with many local dental professionals. Dental implants have become the standard of excellence in tooth replacement. As is the case with natural teeth, patients and their dental professionals must work as a team to ensure the longevity of their dental implant.

Our educational seminar discussed the latest techniques and technologies available to help dental professionals monitor maintain the health of their patients’ dental implants. The seminar reviewed how dental professionals can help their patients achieve long-term implant health through state of the art monitoring techniques, regular professional dental hygiene care and patient oral hygiene education. It also reviewed fixtures of the many different implant systems (old and new) that exist as well as the most accepted and current methods of patient and professional maintenance.

Dental professionals realize that there are many variations of dental implant designs available, and an ever-increasing population of patients living with dental implants. As an expert in dental implant placement and dental implant health, Dr. Britten felt was important to share with his colleagues and their teams a continuing education course specific to dental implant care. “Dental implants are complex, sophisticated dental devices, and it is important that we as implant experts continuously stay educated on modern monitoring methods.” – Dr. Todd Britten

Dr. Gregory Oxford, a periodontist of 34 years and one of Dr. Britten’s professors at University of Florida and Dentsply-Sirona, a leader in dental products and the dental implant system Ankylos, partnered with Britten Periodontics & Implant Dentistry to provide a great continuing education course. The event was catered by Stephanie and Allie with Empamamas Food Truck. The food and service were spectacular! The Sweet Life Bakery even provided dental themed cookies for the event. So as always, we partnered learning with some food and some good food!

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Teeth are important! They are the first stage in eating and digestion AND a healthy set of teeth will help keep you looking your best. How can you show your teeth some love?

Sing to your teeth while you brush.

Or at least, listening to a song while you brush may help you brush your teeth better. Playing a song that lasts at least two minutes (with a power toothbrush) or four minutes (with a manual brush) can help you brush for a longer period than you’re used to.

Be gentle with your teeth.

Don’t brush too hard. If your toothbrush shows signs of early wear and bending bristles, then it’s likely that you’re brushing too hard. Be nice to your teeth and gums by brushing gently with a soft bristled toothbrush, or use a power toothbrush with the correct technique.

Give your teeth a drink of water.

Staying hydrated helps your overall health, and water can wash away food trapped in your teeth after meals. This can help balance the acidity of your mouth and reduce the amount of plaque on your teeth. Since bad breath is often caused by having a dry mouth, drinking plenty of water can help freshen your breath!

Take your teeth to the dentist.

Even if you take excellent care of your teeth at home, a regular visit to the dentist will help you avoid potential problems and clean areas that are difficult or impossible to get yourself. Preventative care is always the best way to say “Thanks!” to your teeth

If you are due for your regular check up or have any areas of concern, contact us today at or 727-586-2681 to make an appointment with Dr. Britten!

1. Of course, brushing in the morning protects your teeth against the bacteria that active all night while you were asleep! Your coworkers and friends will appreciate it! Brushing at night removes the plaque that has accumulated all day long so that bacteria cannot play on your teeth at night when your saliva decreases, causing less damage and decay.

2. The primary cause of gum disease is plaque accumulation at the gumline. Brushing before and after sleep will remove this plaque, avoiding the potential for swollen and bleeding gums.

3. Brushing twice a day reduces bad breath considerably. Try brushing tonight if you haven’t been. The next morning you will notice an improvement in any bad breath you have been experiencing.

4. The fluoride in toothpaste helps form a protective layer on your teeth to prevent them from the process of destruction. So, a 12 hour protection is always better than 24 hour.

5. Preventing dental problems decreases the extent of dental work you will need. Brush twice a day and save money.

6. Set an example for your kids! They are watching! If you do not brush yourselves your child will never ever brush twice a day.

Oh, and don’t forget about your daily interdental (in between the teeth) care!

The human mouth is filled with bacteria.  These bacteria, along with mucous and other particles form a sticky film called plaque is constantly forming and which adheres to the teeth.  This plaque can be removed by brushing and flossing.  When the plaque is allowed to remain on the teeth, the bacteria involved become more harmful, and more difficult to remove, creating an environment that is more toxic to the tissue.  The plaque itself can harden creating a cement like substance (calculus) that cannot be removed with brushing and flossing alone.

This leads to inflammation and gum disease.

The first stage of periodontal disease is gingivitis.  It is an inflammation of the gingiva or gums and  is characterized by red, tender, swollen gums, and halitosis or bad breath.  It  is a mild form of gum disease that can usually be reversed with daily brushing and flossing, cleaning by a dentist or dental hygienist, healthy nutrition and the cessation of smoking.  This form of gum disease does not involve any loss of bone and tissue that hold the teeth in place.  Untreated gingivitis can lead to periodontitis.

 Periodontitis

The next stage of periodontal disease is  periodontitis. It causes irreversible  damage to  the bone  and connective tissue that support the teeth in the mouth. As it  progresses the pockets deepen and the body’s immune system initiates an inflammatory response in which the body in essence turns on itself and the bone and connective tissue that hold the teeth in place are broken down and destroyed. If not treated the teeth may eventually become loose and need to be removed.

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 call (727) 586-2681.

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