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What You Need to Know About Immediate Dental Implant Placement

Immediate dental implants are often necessary due to a non-restorable fracture of a tooth. In some cases, there may be infection associated with the cracked or fractured tooth. The procedure begins with an exam, 2-D and 3-D x-rays. A diagnosis is made and treatment options are discussed. An immediate dental implant is the treatment of choice. Any pre-operative study models that are needed are taken.

Surgical Procedure:  The patient is generally well sedated with either oral or IV sedation. Just like any other procedure, topical anesthetic is applied prior to local anesthesia administration. Impressions of the teeth are taken if necessary prior to the tooth extraction. The fractured tooth is removed very carefully to minimize any damage to any surrounding bone. At the time of surgery, Dr. Britten can determine if immediate implant placement is possible. This is the part you don’t always know until you get there. Additional bone grafting is often necessary to fill the voids between the dental implant and the remainder of the extraction socket. In addition, a membrane, soft-tissue graft or platelet graft (L-PRF) may be used to protect the bone graft.

As an implant specialist, Dr. Britten is highly trained and experienced in the most advanced and current technologies used for long-term implant health and success. He believes in using the best diagnostic tools as well as the highest quality implants in his practice. Dr. Britten works closely with the best restorative dentists in the Tampa Bay area to obtain the best possible outcome for his patients’ implants.  For more information, contact us at 727-586-2681

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The reason many patients have to take antibiotics before their dental visit

What is antibiotic prophylaxis or “premedication” for a dental procedure? How do I know if it applies to me?

Antibiotic prophylaxis, or premedication, refers to giving a patient a loading dose of antibiotics in preparation for a dental surgical procedure, dental hygiene visit or other dental treatment dealing with the teeth or gums. During some dental treatments, bacteria your mouth can enter your bloodstream. In most people, the immune system kills these bacteria. But in some patients, bacteria from the mouth can travel through the bloodstream and cause an infection somewhere else in the body. Antibiotic prophylaxis, or dental premedication may offer these patients extra protection. Patients that normally require antibiotic prophylaxis have fallen under 2 categories: those with joint replacements or certain heart conditions. Some other health issues such as breast implants, brittle diabetics or organ transplant patients may require dental premedication, based on a physician’s recommendations.

Up until 2012, antibiotics were recommended for two years after joint replacement surgery or for a lifetime. Since that time, physicians and dentists have become more concerned about the potential harm of antibiotics including risk for anaphylaxis (allergic reaction), antibiotic resistance, and opportunistic infections such as Clostridium difficile (C-diff) were included in creating the new recommendation.

The 2015 American Dental Association stated that “In general, for patients with prosthetic joint implants, prophylactic antibiotics are NOT recommended prior to dental procedures to prevent prosthetic joint infection.” However, many orthopedic surgeons are still recommended premedication with antibiotics for their patients for 2 years or a lifetime.  In patients with a history of complications associated with their joint replacement surgery, prophylactic antibiotics or premedication with antibiotics should be considered after consultation with the patient and orthopedic surgeon.

If you have a joint replacement and are unsure whether you should premedicate for your dental appointments or not, it is best to contact your orthopedic surgeon to determine what is best for you.

In patients with certain heart conditions, dental premedication is recommended to avoid infective endocarditis.  Infective endocarditis (IE), also called bacterial endocarditis (BE), is defined as an inflammation of the endocardial surface of the heart. Endocarditis generally occurs when bacteria or other germs from another part of the body enter and spread through the bloodstream and attach to damaged areas in the heart. If left untreated, endocarditis can damage or destroy the heart valves and can lead to life-threatening complications.

The American Heart Association says that premedication for dental procedures is required for the following conditions:

  • “A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.
  • A history of endocarditis.
  • A heart transplant with abnormal heart valve function.
  • Certain congenital heart defects including:
    • Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal) that has not been fully repaired, including children who have had a surgical shunt and conduits.
    • A congenital heart defect that’s been completely repaired with prosthetic material or a device for the first six months after the repair procedure.
    • Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.”

Patients that have had stents placed in their hearts or a history of coronary artery bypass surgery no longer require to premedicate with antibiotics prior to dental procedures under the American Heart Association’s guidelines. Numerous scientific evidence concluded that the risk of adverse reactions to antibiotics generally outweighs the benefits of prophylaxis for many patients who would have been considered eligible for prophylaxis in previous guidelines. Concern about the development of drug-resistant bacteria also was a factor for the simplified guidelines.

The 2014 American Dental Association & American College of Cardiology guidelines add that optimal oral health is maintained through regular professional dental care and the use of appropriate dental products, such as manual, powered, and ultrasonic toothbrushes; dental floss; and other plaque-removal devices.

Antibiotic dosage and schedule

  • 1 hour before the procedure to allows the antibiotic to reach adequate blood levels. However, if the dosage of antibiotic is inadvertently not administered before the procedure, the dosage may be administered up to 2 hours after the procedure.
  • Patients not allergic to penicillin: oral amoxicillin 2g (50 mg/kg for children)
  • Patients allergic to penicillin or ampicillin: oral cephalexin 2g (50 mg/kg for children) or clindamycin 600 mg (20 mg/kg for children)

If you have questions about whether you need to premedicate for your dental procedures, we will be happy to answer any questions you may have. It is best to carefully consider this matter with both you and your physician or surgeon and we are always happy to communicate with both.  Contact us today 727-586-2681 with any questions.

Why Dental Sleep Medicine is Changing Treatment for Snoring and Sleep Apnea

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

With the high rejection rate of the CPAP, the American Academy of Sleep Medicine designated dental sleep oral appliances as the No. 1 nonsurgical alternative for the CPAP intolerant. Numerous sleep appliances are available to the public and distributed through dentists.

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

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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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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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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.”

727-586-2681

What We’ve Been Up To: Breast Cancer Awareness Month!

“On Wednesday’s we wear pink!”

(Dr. Britten and his surgical assistants in their pink surgical gowns!)

It is Breast Cancer Awareness month and in honor of those fighting or who have fought this disease as a patient or a support system we will wear pink.

We will also be donating $5 for every patient we see on Wednesday’s to The American Cancer Society.

Our office is participating in the Making Strides Against Breast Cancer Walk in St. Pete on Saturday, October 14th. To Donate our join our team, contact us!

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This week we also gave our patient chocolate whoopie pies in honor of Breast Cancer Awareness month! These were made by our friend Stacey at The Sweet Life Bakery http://www.thesweetlife-bakery.com/

Now Collecting Donations for Puerto Rico

There are so many incredible organizations banding together to send relief to all those affected by Hurricanes Harvey, Irma and Maria. America is such a generous nation and we want to be part of the movement to help those in need.

Our office is gathering supplies to send to Puerto Rico via Course of Action PR, UpwindFly Club & Device Savers of Tampa to help some of our fellow Americans who are in crisis. These organizations will be delivering over 100,000 lbs of supplies to Puerto Rico in the next few weeks.

Dr. Britten’s father-in-law grew up in Fajardo, Puerto Rico. “We have many family members who live in Puerto Rico, so this is a cause that is very personal to my family and me. If you are able to help we will be having a drive at our office. Thank you!”

Most Needed Items:
Water
MRE’s
Battery powered lanterns
Manual can openers
First aid kits
Plenty of batteries and flashlights
Matches
Candles
Duct tape
Battery operated radios
Insect repellent
Soap and hygiene products
Cell phone portable chargers

Non perishable foods:
Diapers

Bring your supplies between now and October 31st to

1472 Jordan Hills Court

Clearwater, FL 33756

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