Gum recession refers to the loss of gum tissue along the gumline. This can occur as a result of periodontal disease (gingivitis, periodontitis, advanced periodontitis), the natural aging process, or abrasive habits when it comes to brushing the teeth.
Why should gum recession be taken seriously?
When gum recession occurs, the root structure of the tooth becomes exposed. This means that tooth decay and other problems can affect the teeth along the gumline and beneath it. Since healthy gums are essential for a healthy mouth, getting gum recession treated is important for lasting dental wellness. When recession occurs to the point that no firm gum tissue remains, this leaves the roots of the teeth and the underlying bone relatively unprotected, which could result in root sensitivity, bacterial penetration, decay and even loss of teeth.
A gingival graft is designed to address these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gum tissue around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root, however, the main objective is to reestablish the protective barrier or layer of the gum around the tooth. Occasionally, the patient may need multiple procedures to achieve the ideal amount of root coverage.
Dr. Britten has trained in the latest minimally invasive techniques of gum grafting and can often perform the entire procedure through a pinhole incision.
Laser therapy uses intense beams of light projected by a dental laser. Dental lasers can be used to perform a wide variety of treatments.
Minimally Invasive gum disease treatment for moderate to severe cases
Laser Assisted Periodontal Therapy, is an advancement in periodontal infection removal. ™ laser uses a specific wavelength that targets and destroys diseased tissue and bacteria from periodontal pockets.
In Laser Assisted Periodontal Therapy there is no cutting away of the gums or bone as in traditional treatment. The PerioLase MVP-7 laser is used in our office for periodontal disease treatment. This procedure kills harmful bacteria and removes unhealthy gum tissue without harming bone or healthy tissue. In ideal candidates, LANAP Periodontal Therapy can be a gentler, more precise treatment that conserves healthy tissue and minimizes pain and discomfort.
Laser Assisted Periodontal Therapy is:
More Comfortable
Minimally Invasive
Less Damaging
Safe
Biologically Healthy
The beauty of dental lasers is that they damage far less of the surrounding tissue than traditional techniques – which means less discomfort and pain.
A small laser fiber is inserted into the diseased gum pocket. This precise laser disintegrates the bacteria and diseased tissue without harming any of your healthy tissues. The disease is removed and healthy gums and bone are given a good chance to regenerate.
In addition, the laser sterilizes as it removes diseased tissue and provides a sealing clot that inhibits reinfection.
is safe for patients with health concerns. In addition, patients taking blood thinning medications (e.g. Coumadin, aspirin, Plavix) need not go off of these medications to receive treatment. It is also more indicated for smokers as gum recession is less prevalent in laser dentistry.
Healthy gums are an important part of a person’s general oral hygiene and appearance. Sometimes in certain people the gums can grow and build up over the front surface of a tooth. This can often occur when patients have braces on their teeth. This formation of extra gum can change the balance between the length of the teeth and the height of the gum line, leading in some cases to a person having an uneven smile.
Before and After Ginigvectomy by Dr. Todd Britten
Gingivectomy is best described as the surgical removal of excess gum tissue.
Your orthodontist or family dentist may recommend gingivectomy for several reasons:
Prevent teeth from shifting after orthodontic appliances have been removed. Excess tissue can cause the teeth to separate even though braces have brought the teeth together.
There are gaps or pockets that have formed between your teeth and your gums. These pockets will trap food particles, harbour colonies of bacteria, and make it difficult for you to clean. If the pockets only involve soft tissues then these gaps may be removed by simply trimming the gums through gingivectomy.
There is too much gum tissue for your teeth. Aside from cosmetic reasons, too much gum tissue for your teeth will make it hard for you to keep your mouth clean. In severe situations, this condition can interfere with the way you eat and the way you talk.
A gum graft (also known as a gingival graft or periodontal plastic surgery), is a collective name for surgical periodontal procedures that aim to cover an exposed tooth root surface with grafted oral tissue.
Exposed tooth roots are usually the result of gingival recession due to periodontal disease. There are other common causes, including overly aggressive brushing and trauma.
Here are some of the most common types of gum grafting:
Free gingival graft – This procedure is often used to thicken gum tissue. A layer of tissue is removed from the palate and relocated to the area affected by gum recession. Both sites will quickly heal without permanent damage.
Subepithelial connective tissue graft – This procedure is commonly used to cover exposed roots. Tissue is removed fairly painlessly from the outer layer of the palate and relocated to the site of gum recession.
Acellular dermal matrix allograft – This procedure uses medically processed, donated human tissue as a tissue source for the graft. The advantage of this is procedure is that there is no need for a donor site from the patient’s palate (and thus, less pain).
Reasons for gum grafting
Gum grafting is a common periodontal procedure. Though the name might sound frightening, the procedure is commonly performed with excellent results.
Here are some of the major benefits associated with gum grafting:
Reduced sensitivity – When the tooth root becomes exposed, eating or drinking hot or cold foods can cause extreme sensitivity to the teeth. Gum grafting surgery permanently covers the exposed root, helps reduce discomfort, and restores the good health of the gums.
Improved appearance – Periodontal disease is characterized by gum recession and inflammation. Gum recession and root exposure can make the teeth look longer than normal and the smile to appear “toothy.” Gum grafting can make the teeth look shorter, more symmetrical and generally more pleasing to look at. In addition, adjacent tissue can be enhanced and augmented during the procedure for aesthetic purposes.
Improved gum health – Periodontal disease can progress and destroy gum tissue very rapidly. If left untreated, a large amount of gum tissue can be lost in a short period of time. Gum grafting can help halt tissue and bone loss; preventing further problems and protecting exposed roots from further decay.
Before and After – Free Gingival Graft by Dr. Todd BrittenBefore and After – Connective Tissue Grafting by Dr. Todd Britten
Britten Periodontics is excited to host another Holiday Food Drive with Metropolitan Ministries!
Thanks to Metropolitan families will find HOPE through receiving much-needed commodities!
Metropolitan Ministries’ greatest holiday food needs: Frozen protein (turkey, ham, chicken), yams, cereal, stuffing, and cranberry sauce.
Additional food needs: Canned beans, soup, bags or boxed rice, boxed/canned potatoes, packets of gravy, and dessert mixes
The greatest toy needs are “teen” toys with a focus on Ages 10 – 12 (boys and girls), and our additional age group needs: 0-2, 3-9, and 13-17 (boys and girls).
Please drop off your donations from October 24th -November 17th at our office at:
“Tooth erosion is a common dental concern. The American Dental Association (ADA) reports that more than one third of children and adults worldwide may exhibit dental erosion. Tooth wear can take a number of forms, all of which may cause sensitivity and discomfort. Knowing how to prevent tooth erosion can help your teeth stay strong and healthy!
Why Is Your Tooth Wearing Away?
Dental erosion is the irreversible loss of tooth enamel caused by acids in the mouth. It occurs in populations across the globe and affects people of all ages. Dietary habits, conditions such as bulimia and poor oral care can all lead to tooth erosion.
Erosion caused by diet often appears as a hollowed-out area on the chewing surface of the tooth. Drinking sodas, alcohol or energy drinks increases the likelihood of eroding your teeth, especially if you swish the liquids prior to swallowing. This causes the acid to wash across the surface of the teeth and wear away the enamel. While consuming these drinks does not always lead to erosion, it affects the pH of the mouth and contributes to an acidic environment.
Having these drinks with a meal may help balance the amount of acid in the mouth. It is also possible to reduce the acidity level by consuming the drink in a short period of time, as opposed to sipping it. This allows the oral cavity to restore a normal pH balance.
Those who are regularly exposed to environments with higher levels of acid, such as factory workers or swimmers, may have increased dental erosion, reports the ADA. Patients who have bulimia, reflux or digestive disorders may notice erosion on the tongue and interior palate side of the tooth, as opposed to the side of the tooth that sits against the cheeks and lips.
3 Types of Tooth Wear
Dental erosion occurs when acid comes in contact with the teeth. Three other kinds of tooth wear include attrition, abfraction and abrasion.
Attrition involves tooth-to-tooth contact, most often teeth grinding or improper biting. This type of tooth wear breaks down and flattens the chewing surfaces of the teeth.
Abfraction occurs when regular grinding or a misaligned bite create an abnormal load on the tooth. This results in a notch on the side of the tooth near the gumline. A dentist or dental hygienist will often recommend a night guard for patients exhibiting abfraction. Orthodontic treatment can help align the teeth to ensure they come together properly.
Abrasion can appear similar to abfraction, but it is caused by an external mechanical force, such as a toothbrush. If a patient is brushing too hard against the surface of the tooth or using a toothbrush with hard bristles, the constant wear can cause a notch-like surface at the gumline. Your dental hygienist can give you instructions on proper brushing techniques to avoid continued wear on the tooth surface.
Treatment for Tooth Wear
Those with abfraction or abrasion can have a filling placed on the side of the tooth over the damaged surface to help protect against continued wear, although it may not be medically necessary. Alternatively, a patient may choose to have fluoride applied at their six-month preventive care appointments or use a toothpaste that contains fluoride to help with sensitivity. Your dentist or dental hygienist may also continue monitoring the site of the tooth wear to ensure it doesn’t worsen.
Your enamel won’t grow back, but not all is lost! You can take measures to prevent further erosion and preserve your smile. Knowing how to take care of your teeth and practicing good habits recommended by your dental professionals can help your smile last a lifetime!”
Normal Teeth vs Wear from grindingNormal teeth vs acid attackNormal teeth vs soda destruction
Tori are excess bone that develops either in the upper or lower jaw. When present in the roof of the mouth (palate), the condition is referred to as torus palatinus. When present in the lower jaw, it is called torus mandibularis. Tori may develop due to genetic or environmental influences such as local irritation, grinding your teeth (bruxism), or misaligned teeth causing an uneven bite (malocclusion).
In most cases tori are benign and do not require treatment. However, tori will need to be surgically removed to accommodate upper or lower dentures and upper or lower partial dentures (flippers). Tori may also be removed to aid in minimizing food impaction under the excess bone, which will promote improved home care. In certain cases tori may contribute to plaque accumulation and periodontal pockets, and therefore will require removal to improve oral hygiene by allowing better angulation of the toothbrush. Once tori are removed, recurrence is rare. In situations where tori do reappear, regrowth is typically very slow.
Tori Removal On One Side performed by Dr. Todd Britten
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. As we continue to adapt to the changing nature of COVID-19, our office continues to monitor the COVID-19 Community Level. Masks welcome but at the current time are not required in our
waiting area, per CDC public indoor guidance. We frequently monitor our local levels and will require indoor masking in our waiting area if our local level is upgraded to HIGH. One thing that will not change at your upcoming visit is the adherence to strict COVID-19 safety protocols during your exam or procedure. Your health and safety are our top priorities, and the dental team will continue wearing all proper personal protective equipment (including masks), following enhanced cleaning protocols and more.
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.
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
