Dentistry

Dentists are becoming more and more aware of the importance of screening patients for Obstructive Sleep Apnea.  

The AADSM (The American Academy of Dental Sleep Medicine) recommends dentists evaluate patients for the following conditions as possible indicators of Sleep Apnea:

• A thick neck (greater than 16 inches in a woman or 17 inches in a man)

• A short neck

• Lower-face abnormalities, which may include:

        * A large tongue

• A crowded posterior airway (such as caused by an enlarged, floppy uvula or enlarged tonsils)

• An enlarged soft palate that rests on the base of the tongue

• Obesity

• Complaints of being overly tired during the day, low on energy, depressed, or moody

• Falling asleep in dental chair

• Trouble opening mouth wide during dental examination

The most successful treatment for Obstructive Sleep Apnea is a CPA appliance, however, 60% to 83% percent of users cannot tolerate this device.

Your dental professional can help you identify if a sleep appliance may help you. If you have any questions about OSA or dental sleep medicine, contact our office today at 727-586-2681 or visit our website at www.brittenperio.com

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

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

Medications associated with gum enlargement fall into three main categories:

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

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

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

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

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

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

NON-SURGICAL THERAPY

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

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

SURGICAL REMOVAL

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

2. Strength and reliability of the bond between the abutment and the implant that provides support to the restoration or crown. This bond is so strong that they ultimately unite to form a single unit.
3.  They should be made from neutral titanium. It is accepted by the human body and therefore the chances of long-term success are increased.
4. The implants are completely sterile and are opened only just before the implant placement begins. Your highly trained dentist or implant specialist and his assistant maintain sterile procedures as the implant is placed
5. A great quality of the implants we prefer to place is a rough surface which means that it will fit perfectly and heals the new root easily. They are also designed to ensure a perfect fit after restoration and will bond with a patient’s jaw bone.
6. The implant screw is designed so that the biting forces do not traumatize the surrounding bone.
7. Implants can be customized for an individual patient’s needs and are selected by length and diameter especially for this patient.
8. Ideally, implants should be placed around 2mm below the bone crest to get maximum benefits.
9. The implants system we use in our office have tapered conical connectors to avoid a gap between the restoration and the implant.  This keeps bacteria from collecting where the implant and abutment meet and prevent microscopic movements which over time would put strain on the implant and surrounding bone.

Britten Periodontics & Implant Dentistry is a periodontal practice offering patients personalized dental care in implant dentistry in Clearwater, Florida. Dr. Todd Britten received his Bachelor of Science & Doctorate of Dental Surgery from University of Florida, a Master’s Degree and Certificate in Periodontology and Implant Dentistry; and completed extensive training at the Institute of Advanced Laser Dentistry. He is one of the only board-certified periodontists in Pinellas County. He is a member of the American Academy of Periodontology, American Dental, Association, Florida Association of Periodontists, Upper Pinellas County Dental Association, Hillsborough County Dental Association, Hillsborough County Dental Research Association andFlorida West Coast Dental Association.  Dr. Todd Britten also routinely uses a 3D GREEN Cone Beam CT Scanner in his office which offers fantastic imaging detail to assist in the digital planning of dental implants for precise accuracy, safety and optimal results.  For more information, call 727-586-2681 or email at .

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

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

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

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