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What is dental anxiety? What can we do to help?

Dental anxiety affects many patients and can hinder them from taking the next step to achieve their oral health care goals.

Dental anxiety and dental phobia are extremely common. Many people have at least some anxiety about visiting the dentist.  But for a patient with a dental phobia, a dental visit can be terrifying. Up to 15 percent of Americans report they avoid seeing the dentist due to severe dental anxiety or dental phobia.  Some people will put off dental care for years or sometimes even decades! This can lead to advanced gum infections (periodontal disease), pain, or even broken or decayed teeth.  The price of dental phobia can include a higher risk of gum disease and can lead to tooth loss. Other people have to live with a loss of self-esteem or reduced quality of life due to embarrassment over how their smile looks, inability to eat well, or discomfort.

There are many different degrees of dental anxiety or phobia. In the case of a dental phobia, there can be a complete avoidance of the dentist – sometimes for years! Some will go to their appointment, but they may not sleep the night before or feel sick before or during their dental appointment.

When people are feeling tense, they may have a lower threshold for pain and may need extra anesthetic or other pain treatments. They may also suffer from headaches or muscle tension in their back, neck, arms or legs while in the dental chair.

Symptoms of dental phobia or anxiety

  • Tense muscles or trouble sleeping the night before a dental appointment
  • Increasing nervousness or feeling ill while in the waiting room.
  • Feeling like crying or getting overly emotional when you think of going to the dentist.
  • You panic, gag excessively, or have trouble breathing during a dental appointment.

What are the causes?

Those suffering from dental anxiety or phobia report the main triggers as:  pain, a feeling of helplessness and loss of control, embarrassment, or negative past experiences as the cause for their fear of the dental office.

The major triggers of dental anxiety or phobia, and how they may be handled:

Pain – Some people have had a previous dental experience that may have been uncomfortable, had trouble getting numb or have very sensitive teeth or gums.  Some of these experiences may have happened before many of the advances in “pain-free” dentistry.  These days, we have many pain control techniques, analgesics and anesthetics available.

  • Before and during the appointment: different comfort choices can be offered including headphones, music, blanket, a relaxed environment, distraction, mental imaging, sleep mask, breathing techniques, a bite block, or other comfort measures. Dental professionals have different local anesthetic and topical rinses, liquids, sprays or subgingivally applied gels that can be used.  Tooth desensitizing agents are also available.  Your dental professional will be very knowledgeable about what is available and can select the appropriate method based on the type of procedure, length of procedure as well as your individual needs and preferences.
  • For surgical or more intensive procedures, IV conscious sedation or oral sedation is often an option. Sedation dentistry can provide a calming experience for patients who have experienced high levels of anxiety related to dental treatment.  Some dentists are highly trained and certified in IV conscious sedation or oral sedation.

IV CONSCIOUS SEDATION

Intravenous (IV) Sedation helps even our most anxious patients remain relaxed and comfortable during procedures. Many patients feel as though they, “went to sleep” during the sedation. The goal of IV conscious sedation is not to provide general anesthesia but instead to allow patients to remain conscious and relaxed with minimal risk during the procedure.

ORAL SEDATION

A prescription medication can be given that can relieve anxiety patients feel before and during their dental procedure. It allows patients to respond verbally and physically to directions all while in a very “restful” state. Patients using oral sedation will need to be driven to and from the procedure.

  • After the appointment: Warm saltwater rinses, over the counter or prescription pain medications are available to assist in a person’s recovery after the procedure. Having post-appointment care information in writing as well as given verbally is also helpful.

Helplessness or loss of control — in the dental chair, a patient has to stay still, they can’t see what’s going on or predict any potential discomfort.  It’s common for people to feel helpless and out of control, which may trigger anxiety.  A patient’s state of mind is very important especially when one has dental anxiety or phobia.  For some patients, a clear explanation of what procedures will be done, what to expect, and how to indicate if they need the operator to stop or give them a rest can help immensely.

Embarrassment — People may feel ashamed or embarrassed to have a stranger looking in their mouth.  Some people lack self-confidence or are ashamed of how their teeth look, and may be afraid they’ll be judged or ridiculed. Dental care also involves an invasion of a person’s personal space as dental treatments require physical closeness. During a treatment, the hygienist’s or dentist’s face may be just a few inches away. This can make people anxious and uncomfortable.

Negative past experiences — many that have had pain or discomfort during a previous dental procedures, often in childhood, but it could be any other time, are likely to be more anxious.

To cope with dental fear, it is best to tell your dentist about your feelings, concerns and fears so they can help you overcome these feelings by adjusting your comfort and care in the dental office.

Through the specialty of periodontics & implant dentistry, we at Britten Periodontics strive to deliver comfortable care and ethical treatment in a welcoming environment.  Our goal is to deliver exceptional dental care with compassion, using the latest research based techniques. With education and encouragement, our goal create a strong relationship with our patients and a comfortable experience.

Our team members understand that the treatment provided is not always pleasant or comfortable but they possess the personality to make the patient feel at ease in spite of this.   As a team, we partner with other caring healthcare providers to deliver patient treatment with honor and dignity. A healthy, satisfied patient is our ultimate reward!  For our surgical procedures, Dr. Britten is highly trained and certified in both IV conscious sedation and oral sedation. He is one of the few Periodontists in the Tampa Bay area who offers IV sedation.

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 visit his website at https://brittenperio.com or call (727) 586-2681.

Cone Beam Imaging Improves the Dental Implant Process in Clearwater, FL

Successful placement of dental implants depends on precise placement of the implants in the jaw bone. Cone Beam imaging to assist in the replacement of missing teeth with implants.

Dr. Todd Britten has been using Cone Beam technology in his Clearwater, Florida Dental Implant Specialty Practice since 2014 for a better understanding of his patients’ anatomy. He states that this technology has allowed him to place dental implants in exactly the right place and more effectively replace missing teeth. “This is a very powerful treatment tool in our practice,” says Dr. Britten. “With it, we can work together with our referring dentists to more confidently map our surgical and restorative treatment plans and place and restore implants with accuracy.” Britten says he looked long and hard for the right machine for his specialty dental implant practice. That is why he chose The Green CBCT scanner by VA Tech America. This unit, he says, provides innovative technology for ultra-low-dose x-rays in 5.9 seconds and minimizes radiation to both patient and operator. Dr. Britten says the Green CBCT scanner protects both his patient and the x-ray technician while delivering a high quality 3-D imaging. “I am excited about not only the excellent image quality for diagnostic purposes, but also the increased protection for the health and safety of our patients. The VA Tech Cone Beam CT scanner is perfect for claustrophobic patients, as it is an ‘open air’ scanner. Patients are positioned and stand very still, and in less than six seconds, the scan is done.”

Traditionally, dental professionals used dental x-rays to determine what a patient’s dental structure was like. These x-rays only provide a limited picture of the patient’s mouth and jaw. Recent developments in technology have led to Cone Beam imaging, which produces 3D, high-resolution images of the mouth.
Cone beam imaging is different than a traditional dental x-ray because it uses an x-ray beam that is shaped like a cone rather than using a fan shape. Dr. Britten is highly experienced at reading and interpreting these generated images.
Dental professionals often use this type of imaging to determine the precise placement of dental implants. Dr. Britten recommends implants as the leading permanent tooth replacement solution for patients with missing teeth. After evaluating images generated by cone beam imaging, Dr. Britten determines whether or not implants are a good option for each patient, based on factors like jaw bone density. The images will reveal if the patients’ jaw bone is at a healthy enough degree of density to support implants. If the bone looks healthy enough, Dr. Britten will place the implants by first placing a titanium base in the bone of the jaw. An abutment piece and natural-looking crown will then be attached to the base. Patients will then care for the implants as they would their natural teeth.

Cone beam imaging can make for easier and more effective implant placement. Dr. Britten, also a board certified periodontist, can also use the same CT scan technology to see fine detailed tooth and jaw anatomy to diagnose conditions that may have been previously hard to detect. To learn more about cone beam technology and tooth replacement, interested parties can visit www.brittenperio.com

About The Doctor
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

What are teeth made of by Spear Education

As a periodontist, Dr. Todd Britten enjoys making a positive impact on his patient’s lives by improving their smiles as well as their comfort and health. He has patients that were once told they would lose all of their teeth, but through periodontal care, even after many years still have every one of them!

Sometimes, a basic understanding of what are teeth are made of, and how they are held in our mouths is the first step in understanding why they are so important, and how to properly care for them.

Please watch this great video about teeth from Spear Education

https://spearedu.co/QmKFtsg

5 Ways to Replace a Missing Tooth

It is unfortunate when someone loses a tooth, but there are usually several options to replace it.

  1. Removable Partial Denture
  • Worn during the day, can replace one or many missing. We recommend taking them out at night and soaking them in a cleaning solution.  teeth.  Sometimes a partial denture may need metal clasps to help it stay in the mouth.
  • Unfortunately, these metal clasps may be visible when speaking or smiling.
  • They can move a little when speaking or eating, which can be uncomfortable.
  • No need to file down any teeth.
  • This option is often the most economical.

2.  Temporary Partial Denture

  • A short term solution for a missing tooth.
  • We call it a “flipper” because it flips in and out easily.
  • This is used when the tooth will be restored in the future with a bridge or an implant, but is worn during the healing phase.
  • Much like a removable partial denture, but usually less sturdy, less bulky, and less expensive.
  • No alteration to adjacent teeth

3. Bridge

  • A bridge is a fixed solution that stays cemented in the mouth and does not come out.
  • This method involves cutting down the teeth on either side of the missing tooth to be able to connect them together.
  • We recommend floss threaders, which slide under the bridge, to keep it clean.
  • The disadvantages for bridges are cutting down teeth that might be perfectly healthy, and sometimes bridges in the lower jaw do not last as long since the jaw flexes and the unbendable bridge can spring a leak on one side or the other that allows for decay or bacteria to seep in.
  • A bridge can replace one or two missing teeth easily, and sometimes more if there is enough support.

4. Dental Implant

  • A great way to replace a missing tooth.
  • This solution feels and acts the most like a natural tooth when chewing, brushing or smiling.
  • The implant replaces the actual root of the missing tooth and heals in the bone for several months.
  • We then place an abutment, to which a crown will be cemented.
  • A major advantage is no need to alter any other teeth when placing an implant.
  • An implant is a great solution for a single missing tooth, and even more implants can replace many missing teeth.
  • When smiling or talking there is no way to tell the difference between an implant and a natural tooth

5. Do Nothing. There is always the option to do nothing.

  • When a tooth is removed, the bone melts away and the other teeth in the area will shift to fill the gap.
  • This can sometimes create a difficult place to clean and lead to other problems like bone loss or decay around the existing teeth.

Why Orthodontics is not just about a pretty smile

“Orthodontic treatment is used to correct a “bad bite,” a condition known as a malocclusion that involves teeth that are crowded or crooked. Correcting the problem can create a nice-looking smile, but more important, orthodontic treatment results in a healthier mouth. That’s because crooked and crowded teeth make cleaning the mouth difficult, which can lead to tooth decay, periodontal disease and possibly tooth loss.”

-colgate.com

Here is a great video about Orthodontics! from Spear Education

Britten Perio 5th Annual Veteran’s Day Event is Fast-Approaching

Dr. Todd M. Britten and the team at Britten Periodontics & Implant Dentistry is gearing up for their 5th annual Free Dental Day for Veterans. The event is scheduled for November 1, 2019.

“Veterans make the ultimate sacrifice for our country,” said Dr. Todd Britten. “Many of us ask ourselves, ‘What can we do?’, ‘How can we make a difference?’” Dr. Britten said that is exactly what he asked himself in 2015. “I am aware that dental coverage for veterans was very hard to attain, so we hit the ground running trying to deliver periodontal care to as many veterans as we could.”

The inaugural year of this event was 2014 for the the Clearwater, Florida based periodontal practice. Many others in the community have helped out each year since then. Dr. Britten stated, “Having local dentists involved 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 restorative specialists involved helps us to treat the whole mouth and really deliver comprehensive care to these veterans.”

Britten Periodontics and Implant Dentistry is currently doing initial exams on veterans to get them scheduled for treatment. “If you know of any veteran in serious need of dental care, please get in touch with their office right away, as these spaces are filling up quickly,” says Ellen Byrd, a dental hygienist in the practice who helps plan the event each year.

Britten Periodontics & Implant Dentistry is a periodontal practice offering patients personalized dental care in implant dentistry in Clearwater, Florida. Dr. Todd Britten offers sedation dentistry. For more information, visit https://brittenperio.com

Lack of Posterior (Back Teeth) and Splaying of the Front Teeth

When a patient has lost too many back teeth and not replaced them, excess pressure and trauma from increased forces of a person’s bite are placed on their front teeth. These forces are meant to be distributed on the stronger, wider and larger back teeth and can cause the forward shifting, or splaying of front teeth. This can cause periodontal, orthodontic and sometimes even restorative issues for these teeth.

For any questions about your periodontal issues or regarding replacing missing teeth, contact us:

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Oral Cancer: Early Detection is Key

Many patients with oral cancer have had their mouths reconstructed, palates removed, portions of their tongue removed or even teeth removed.  Your dental professionals can help regularly screen for oral cancer during your visits.

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.

The key is early detection.

If you are able to identify and obtain timely treatment, your chance of death from oral cancer will be greatly reduced.

As part of your routine dental exam, the dentist will conduct an oral cancer screening exam. When he or she does this, they will feel for any irregular lumps or tissue changes in your neck and head. When examining your mouth, your dentist will check for any discolored tissue, sores, or the symptoms listed below:

The most common symptoms are:

  • Lumps, rough spots, eroded areas, or swellings in any part of the mouth
  • Development of white and/or red splotches in the mouth
  • Persistent sores around the mouth area that bleed easily and do not heal within a couple of weeks
  • Unexpected bleeding or numbness
  • Pain in the throat–a feeling that something may be stuck back there
  • Difficulty eating and swallowing
  • Hoarseness in voice
  • Ear pain
  • Dramatic weight loss

It is important to realize that while these changes could potentially be a sign of oral cancer, that is not always the case! Oftentimes soreness in the mouth is caused by toothaches, cavities, cold sores or strep throat. The ear ache might only be an ear ache. The weight loss might be due to a different eating style. So while you shouldn’t jump to conclusions, if any of the above listed changes do not have a reasonable explanation due to your lifestyle, it would be wise to  get it checked out by a professional. Especially if cancer runs in your family.

 What can I do to prevent Oral Cancer in the first place?

This is a fantastic question. If you follow the below tips, you can drastically reduce your risk!

  • First, DON’T SMOKE or use any other tobacco products. Refrain from alcohol if possible. If not, only use in moderation.
  • EAT A WELL BALANCED DIET! Healthy nutrition leads to healthy bodies. Healthy bodies are better able to defend themselves against bad cells and cancerous growth.
  • LIMIT YOUR EXPOSURE TO THE SUN. I understand that we all like to have a nice tan once in a while–but consistent exposure to the sun causes an increases risk of cancer on the lips. When in the sun, make sure to use protective sun screen/lotions on your skin and lips to minimize UV rays from the sun.
  • CONDUCT A SELF EXAM AT LEAST ONCE A MONTH. Using a mirror and a bright light, look inside of your mouth for any of the above listed symptoms. Examine all surfaces. Feel for any bumps or enlarged lymph nodes. If you notice any drastic changes in the appearance of your mouth, call your dentist. Keep in mind that well over 90% of Oral Cancer is found on the side of the tongue or floor of the mouth.
  • SEE YOUR DENTIST ON A REGULAR BASIS. Conducting self examinations will help, but your dentist has been trained to spot those dangerous spots in your mouth, even when they are too small for you to see. If he or she isn’t already, don’t be afraid to ask your dentist to perform an oral exam.
  • MAINTAIN GOOD ORAL HYGIENE. The basics–brushing your teeth & flossing–will help keep away unwanted growth that could potentially become cancerous.

If you have any questions about Oral Cancer, please feel free to contact us today!

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Why choose a Board-Certified Periodontist

A few years ago, Dr. Todd Britten successfully passed the rigorous requirements to become a Board-Certified Diplomate of The American Board of Periodontology. Board-Certified periodontists are held to a higher level of care and skill by the American Board of Periodontology and we know he is so proud to be a Diplomate of this professional organization.

“The Mission of the American Board of Periodontology is to Advance the Art and Science of Periodontics and Elevate the Quality of Periodontal care through the Examination, Certification, and Recertification of Periodontists and by Encouraging the Achievement and Maintenance of Diplomate status.”

Dr. Britten is committed to excellent patient care by continually updating his skills and knowledge of new procedures and technology so that he can provide the highest quality, least invasive care available in our industry.

A Diplomate is a periodontist who has made significant achievements beyond the mandatory educational requirements of the specialty and who is certified by the American Board of Periodontology.

To be educationally qualified for Board certification requires:

  • Certification as a dentist, including basic college education and completion of dental school to earn the D.D.S. or D.M.D. degree and;
  • Certification as a periodontist after successful completion of an educational program in Periodontology, which is accredited by Commission on Dental Accrediation of the American Dental Association.
  • Comprehensive qualifying and oral examination covering all phases of periodontal disease and its treatment, including dental implants.
  • Recertification every six years.
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How dentists can help those that snore!

You know it instinctively: A good night’s sleep is essential for good health. It makes you feel rested and ready to take on the world. Yet many people don’t get the sleep they need. Sometimes this is related to sleep-related breathing disorders (SRBD) — their own, or those experienced by their sleeping partners.

SRBD is characterized by recurrent episodes of reduced or interrupted respiratory airflow. This is caused by soft tissues near the back of the throat collapsing during sleep so that they partially close off the windpipe. These tissues — the tongue, for example — can vibrate as air passes by, causing snoring. Snoring is often worsened sleeping on one’s back because this encourages the lower jaw to slip back, which in turn pushes the tongue in front of the airway.

Loud snoring often disturbs the person in the bed who isn’t the one doing it, robbing him or her of vital sleep. The snorer, on the other hand, may seem to be slumbering peacefully, but this might not actually be the case. Chronic loud snoring is a common symptom of Obstructive Sleep Apnea (OSA; “a” – without; “pnea” – breath), which occurs when the upper airway is blocked to the point of causing significant airflow disruption, or even no airflow whatsoever for 10 seconds or more. This can be dangerous as reduced airflow into the lungs lowers blood-oxygen levels.

A person with sleep apnea may wake 50 or more times per hour — that’s almost once a minute! — without having any memory of it. These awakenings, called micro-arousals, last just long enough to restore muscle tone to the airway so the individual can breathe. Unfortunately, all those micro-arousals preclude deep and restful sleep.

What to Look Out For
Sleep Related Breathing Disorders.

Obstructive Sleep Apnea is a serious matter as it can lead to heart problems and other health issues. It’s possible you may have OSA if you snore and also suffer from any of the following:

Excessive daytime sleepiness
Irritability
Poor memory/confusion
Accident proneness
Night sweats
Morning headaches
High blood pressure
Obesity
How Dentistry Can Help
Oral Appliance Therapy.By now you’re probably wondering: What does my dentist have to do with all this? Here’s the connection: Snoring or sleep apnea can sometimes be treated with an oral appliance available at the dental office that’s designed to hold the lower jaw forward during sleep. This repositioning of the jaw moves the tongue away from the back of the throat, reducing the potential for obstruction. This treatment is backed by a great deal of scientific evidence; it’s a good remedy to try before moving on to more complicated breathing devices or surgery to remove excess tissues in the throat.

Only a dentist can fabricate, fit, adjust, monitor, and treat complications associated with Oral Appliance Therapy used in managing SRBD. So if you or a loved one is experiencing any combination of the signs and symptoms mentioned above, a consultation with a dental professional is a good idea.

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