Treating Gum Recession With Connective Tissue Grafting
When recession of the gum tissue occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an excellent option.
“Tissue grafting is recommended when you have gum recession that has left the root of a tooth exposed, or you are at risk of root exposure due to recession. It is a common procedure that is intended to recreate your gum line and prevent further deterioration of the gums, enhancing the appearance of your smile.
Gum recession can be caused by:
Aggressive toothbrushing
Gum disease
Gum tissue that is naturally thin
Previous orthodontic treatment
Previous tooth loss
What are benefits of soft tissue grafting?
Prevention or reduction of sensitivity by covering exposed root
Protection from future cavities
Symmetry in your gum line, creating an improved smile
Creation of a suitable environment for implant placement
Why is thicker tissue better than thin?
Thick gum tissue is critical to maintaining a healthy gum line and mouth. It makes your gums more resistant to recession over time and is more comfortable to brush. Additionally, thick gum tissue is important for achieving aesthetic results.” -Zimmer Dental
Before (left) and after (right) following Connective Tissue Grafting by Dr. Todd Britten of a Patient’s Lower Left Molars
As a periodontist, Dr. Britten often sees and helps to 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:
Anti-seizure medications
Immunosuppressant medications (used in transplant patients),
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.
Before and After Treatment for Gingival Hyperplasia and Discontinuation of a Calcium Channel Blocker
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
Bruxism is a problem in which you unconsciously grind or clench your teeth. You may clench and grind your teeth during the day. Or, at night while you sleep (sleep bruxism).
This condition can affect adults and children. Some people don’t have any symptoms. Others may experience headaches, jaw pain, tooth pain, or dental problems.
Children with this condition will often improve on their own. For adults, dental guards may help protect the teeth from damage.
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.
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.
Did you know? Many serious illnesses may be associated with your oral health.
Taking good care of your oral health benefits so much more than just your mouth. That’s why building healthy habits—and sticking to them—is vital. Clinical studies have shown links between poor oral health and pregnancy, Type 2 diabetes and heart disease, so keeping gum disease in check is a key part of looking after your overall wellness.
Get to know the early signs of gum disease
-Bleeding gums when you floss or brush
-Red, swollen and tender gums
-Persistent bad breath or taste
Experiencing any of these symptoms? Give us a call to set up an appointment.
Small steps with a big impact:
BRUSH
The right tools and techniques make all the difference—talk with us about how to improve your brushing.
INTERDENTAL CLEANING
The spaces in between your teeth are home to harmful bacteria, so clean them thoroughly for healthy gums.
CHECK-UPS
Even with the best at-home care, you should see your dentist and dental hygienist at your personalized recommended intervals.
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 highly recommends the Sonicare® powerbrush, as it is shaped like a traditional toothbrush head, and aids in effective plaque removal and gum stimulation and massage.
Watch this quick video on why Sonicare is such a great brush!
Simple Oral Hygiene Tips:
Brush your teeth twice a day for two minutes.
Clean in between your teeth thoroughly to remove harmful bacteria.
Replace your brush head every three months for optimal results.
Visit the dental office regularly to monitor and address your periodontitis.
We work with excellent local orthodontists to help keep our patients’ gum health in great shape during orthodontic treatment. From patients who may need tissue grafting to patients with more complex oral health issues such as periodontal disease or dental implants, we work closely with our local specialists to keep our patients’ gums healthy at any age!
Tips for maintaining oral health during ortho treatment
1. Brush your teeth twice a day for two minutes. The right tool and technique make all the difference.
2. Clean aligners, removable or fixed appliances carefully with your Sonicare.
3. The spaces in between your teeth are home to harmful bacteria, so clean them thoroughly for healthy gums.
4. Break up tongue coating before using a therapeutic mouthwash that reduces bacteria responsible for gum disease and bad breath.
5. Replace your brush head every three months for optimal results.
In order to achieve successful treatment results we must work together. Oral health goals are best reached when you, the patient, is actively involved in treatment through excellent compliance!
MORNING
After eating breakfast, brush for at least 2 minutes with your Sonicare Powerbrush using a fluoride toothpaste. (If using Clinpro 5000 prescription Toothpaste: Do not rinse with water; no eating/drinking for 30 minutes)
Clean between your teeth using one or more of the following: Softpicks (original, advanced/curved, wide), proxabrushes (tight, moderate, wide, extra wide) or unwaxed floss. If you have bridges or implants, you should also use: Proxysoft Bridge & Implant Floss, GUM EasyThread Floss, or Floss Threaders. You may be instructed to dip your proxabrushes or floss in Peridex (prescription chlorhexidine mouthwash) , Clinpro Toothpaste (prescription fluoride toothpaste) or another over-the-counter antibacterial or fluoride rinse. *Talk to your dentist or dental hygienist about the ideal interdental aides, prescriptions, toothpaste, or over the counter rinses for you!
MID-DAY (and after meals)
Brush for at least 2 minutes with your Sonicare Powerbrush using a
Perform interproximal care using the above recommended tools
EVENING
After eating & before bedtime, again brush for at least 2 minutes with your Sonicare Powerbrush using a fluoride toothpaste. (If using Clinpro 5000 prescription Toothpaste: Do not rinse with water; Leave Clinpro on teeth all night!)
Clean between your teeth using one or more of the following: Softpicks (original, advanced/curved, wide), proxabrushes (tight, moderate, wide, extra wide) or unwaxed floss. If you have bridges or implants, you should also use: Proxysoft Bridge & Implant Floss, GUM EasyThread Floss, or Floss Threaders. You may be instructed to dip your proxabrushes or floss in Peridex (prescription chlorhexidine mouthwash) , Clinpro Toothpaste (prescription fluoride toothpaste) or another over-the-counter antibacterial or fluoride rinse. *Talk to your dentist or dental hygienist about the ideal interdental aides, prescriptions, toothpaste, or over the counter rinses for you!
OTHER COMMONLY RECOMMENDED SPECIAL TOOLS: TEPE Compact Tufted Brush: Great for around gumline of all teeth and dental implants, hard to reach surfaces
TEPE Universal Care Brush: Great for under fixed implant appliances, dental implants or hard-to-reach surfaces
Rubbertip stimulator: Use around gumline to remove plaque and tone tissue
We look forward to your visit! Please review the below information prior to your visit.
1. Please call us immediately 727-586-2681 or text us at 727-513-6786 if you have any concerns regarding an exposure you had to COVID 19, positive test or any COVID symptoms you have experienced within 2 weeks of your visit.
2. Please wear a mask for all common areas in the office. *Please note, CDC and local authorities are still recommending masks in common areas for medical/dental facilities at this time for both vaccinated and unvaccinated personnel and patients*
3. If you prefer to wait in your car, please call to let us know when you have arrived for your appointment 727-586-2681 or text 727-513-6786. Our reception area is now open, but again, masks are STILL required.
Clearwater Periodontist and Dental implant specialist Dr. Todd Britten says he wants to ensure his dental implant patients have the best care possible using the latest technology available. By using advanced 3-D technology, Dr. Britten explains that he is able to obtain and review high-quality images for dental implant planning and even create a 3-D printed surgical guide.
When a patient is ready for a dental implant, Dr. Britten explains the first step is often to take a 3-D CT scan. Dr. Britten said he invested in a scanner that is both comfortable for patients, but provides high quality images at the lowest radiation levels possible. “The PAX-i3D Green is a digital imaging system that provides multiple views of a patient’s jaw and mouth. A 3-D digital scan can now be taken at the same visit in place of a tradition dental impression.” Dr. Britten explains he has a Medit i-700 scanner, making the scanning experience for our patients comfortable and easy. This digital impression can be done at the same visit as the CT scan.
He goes onto explain the patient’s CT scan and Digital Impression are then uploaded to the Dental Laboratory’s sophisticated software program. Dr. Britten plans the implant surgery (deciding on any need for bone grafting, sinus grafting and appropriate implant size and type) as well as a surgical guide to be fabricated by his experienced laboratory clinician.
The Dental Lab then can fabricate the surgical guide with their state-of-the-art 3-D printer. The process usually takes a few weeks, and then the patient is ready for dental implant surgery. Dr. Britten says with 3-D technology and imaging, he can perform dental implant surgeries with confidence, using a precision-crafted 3-D printed Implant Surgical Guide.
