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Valuable Information About the Different Types of Gum Disease

“TYPES OF GUM DISEASE (from Mouth Healthy.org)

Untreated gingivitis can advance to periodontitis and can eventually lead to tooth loss and other health problems.

GINGIVITIS
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.

PERIODONTITIS
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

There are many forms of periodontitis. The most common ones include the following.

Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.

Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.”

From Mouthhealthy.org (American Dental Association)

Investing in a power toothbrush: is it just a luxury?

Most of our patients can tell the difference in how their teeth and gums feel when they switch to a power toothbrush. Dr. Britten and his team can also typically tell when a patient uses an electric toothbrush versus a manual toothbrush – as there is usually a noticeable difference in the amount of plaque present as well as a patient’s gum tissue tone and color.

Improving oral health will improve overall health, a reason most patients will be happy to make the extra investment for a powerbrush. An electric toothbrush (our favorite professional-grade brands typically run from $150-200) is only a fraction of what it costs to complete most dental procedures. In the end, investing in a good power toothbrush, changing brush heads every 90 days, and using the proper technique will save you money!

Why choose a powerbrush?

Power toothbrushes usually have built in features with an advantage for better oral health.

Timer – Many brands feature a timer to ensure patients brush for a full two minutes, and may also have a pressure indicator to pause brushing or to let patients know if they’re brushing too hard and possibly damaging their gums. The Phillips Sonicare, one of our favorites, hesitates every 30 seconds, to help a patient distribute their brushing in all four sections of the mouth.

More effectively disrupts and removes harmful bacteria in the mouth.  The sonic vibrating or oscillating of bristles from an electric brush remove sticky plaque bacteria effectively and stimulate the gum tissue, reducing inflammation. Electrics brushes operate at 30,000 strokes per minute while a manual is only 200 strokes.

Simpler technique.  With a power toothbrush, all you have to do is move the brush from tooth to tooth, spending a few seconds at a time.   The professional line of powerbrushes from Phillips Sonicare are definitely our favorite because they can penetrate below the gum line to disrupt the bacterial environment formed by plaque.  Other brands, most notably the Oral B have brush heads that oscillate in a half-circle motion to remove biofilm (plaque) from the tooth surface.

Gentle and safe at the gumline.  Using a powerbrush with the correct technique will help prevent gum recession, enamel abrasion (wearing away) and tooth sensitivity from improper brushing as well as tooth decay and gum disease. Even with their phenomenal power, power toothbrushes such as the Sonicare are still very gentle on the teeth and gums. If patients have gum recession, they can just place the brush on the tooth without using a scrubbing action, which can traumatize and wear away more thin and delicate gum tissue.

Stain removal.  Electric toothbrushes help with stain removal, which is attractive to patients who really want a bright, white smile. Some Sonicare models come with a “whitening” setting or even special polishing brush heads.

Helps those with dexterity issues.  Elderly patients or others with dexterity issues can also benefit from electric toothbrushes.  Many patients can’t move their hands the way they need to, so if they use a manual brush, they’re likely leaving plaque behind. Powerbrushes help remove plaque from the teeth for them, so as long as they get it close to where it needs to be, it’s going to remove plaque and help prevent problems.

Great for kids.  Electric toothbrushes are also great options for children, especially if they have braces!

Less time brushing, with a better result! In two minutes, a power toothbrush will remove plaque and massage and stimulate gum tissue more effectively than the minimum of four minutes you would need to brush with a manual toothbrush.

Proper Technique for Effective Power Toothbrushing

Divide your mouth into four quadrants. This can help ensure that you brush each section of your teeth and mouth cavity.

Place toothbrush bristles along gum line. Hold your toothbrush at a 45 ­degree angle to your gum line with a Sonicare or 90 degrees with an oscillating brush such as the Oral B. Applying gentle pressure, keeping the bristles in contact with your tooth surface and gum line, which can help ensure you get the most effective result possible. Stay on each area for a few seconds, moving the brush only when it is time to go to the next area. Once you’ve completed this procedure for a quadrant, move to the inner surfaces of your teeth and repeat the same procedure.

To brush behind your front teeth, tilt the brush vertically using only the front half of your brush. Clean biting surfaces, your tongue, and soft palate. This can help remove debris and other odor ­causing bacteria.

This is How to Prevent Re-Infection of Your Gums After Periodontal Treatment

If you’ve undergone treatment for periodontal (gum) disease, you know how involved it can be, whether your treatment required nonsurgical therapy, surgical therapy or a combination of both.

Following gum surgery or scaling and root planing, a nonsurgical periodontal therapy, plaque and calculus (hardened plaque deposits) are removed and as they heal swollen, red gums finally begin to regain their healthy pink color.

Treatment does not stop there. If it does, there’s a high chance of a re-infection of the gums.

Periodontal maintenance (PM) is important for gum disease patients after treatment. Plaque, a thin film of bacteria and food particles responsible gum disease, continue to grow again on your tooth surfaces as it did before. Diligent, daily brushing and flossing to curb that development.

It is also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For patients with gum disease it is usually four but for some advanced gum disease patients, six times a year, especially just after treatment. Many of our patients alternate visits for periodontal maintenance between our office and their general dentist so that their periodontal condition is closely monitored, as well as the health of their teeth.

Our goal is to reduce the chances of re-infection. To do this, we’ll thoroughly examine your teeth, gums and any implants for signs of disease (as well as an oral cancer screening). This includes an assessment the health of your teeth and gums and to see how well you’re doing with plaque control and review your recommended customized daily oral hygiene instructions.

Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it relapses. Keeping up with homecare and a routine periodontal maintenance schedule will help ensure your gums continue to stay healthy.

If you would like more information on periodontal disease, please contact us or schedule an appointment for a consultation 727-586-2681.

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Ouch! Why does my wisdom tooth hurt?

How does a wisdom tooth become infected? What can happen? What can be done? Watch the video with sound for answers to these questions.

Dr. Britten normally refers to an oral surgeon for the extraction of wisdom teeth, unless gum surgery is being performed to treat other areas right next to a problematic wisdom tooth.

We work cohesively with the best dentists, prosthodontists, orthodontists, endodontists, oral surgeons, and pedodontists to provide you with the best care possible. We have a team of dentists that focuses on the area that they are trained and most skilled at and work together to provide the best care. The advantages? We strongly believe you will receive a higher quality of care and better end result.

If you have any questions about wisdom teeth or any aspect of dentistry, contact us today!

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727-586-2681

https://youtu.be/EjlOgvraEHU

How scaling and root planing procedures can help treat gum disease

How scaling and root planing procedures can help treat gum diseaseThe human mouth is filled with bacteria.  These bacteria, along with mucous and other particles form a sticky film called plaque is constantly forming and which adheres to the teeth.  This plaque can be removed by brushing and flossing.  When the plaque is allowed to remain on the teeth, the bacteria involved become more harmful, and more difficult to remove, creating an environment that is more toxic to the tissue.  The plaque itself can harden creating a cement like substance (calculus) that cannot be removed with brushing and flossing alone.

Your gum tissue does not attach directly to your teeth. There is a space or pocket between the gum and the tooth before it attaches. The pocket gets deeper when plaque, tartar and inflammation are present. This leads to inflammation and gum disease. The gums become irritated and begin to separate from the tooth, creating a periodontal pocket.

The bacteria and infection causing the detachment needs to be addressed.

Scaling and Root Planing

Non Surgical Periodontal Therapy includes a very important option known as scaling and root planing or “a deep cleaning” This is often recommended as the first step in periodontal therapy. Treatment is usually done by one of our hygienists using local anesthesia to provide comfort for the patient as the root surfaces in deep periodontal pockets are debrided to remove calculus or “tartar” and to smooth the root surfaces to remove bacterial toxins. This may take more than one visit with the hygienist and is followed up with a visit with Dr. Britten in four to six weeks to evaluate the periodontal tissues.

https://youtu.be/6-CKhC1_XTo

If you have any questions about gum disease or its treatments, please contact our team or make an appointment. Our incredible staff will give you the best dental care possible.

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www.brittenperio.com
727-586-2681

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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This is what happens when you need a root canal

What is a root canal?
When a cavity, or tooth decay, extends into the root, root canal therapy is often the most effective way to retain the tooth.
This video shows root canal therapy which can be performed by your general dentist, but in most cases referral to a root canal specialist, or endodontist, is recommended. A temporary filling is placed, and then a patient will see a general dentist for a permanent restoration, normally a crown.
At Britten Periodontics and Implant Dentistry, we do not perform root canals in our practice but work cohesively with the best endodontists and general dentists to provide you with the best care possible. This way, you can be seen by a team of dentists that focuses on the area that they are trained and most skilled at and work together to provide the best care.

If you have any questions about root canals (endodontic treatment), or any other aspect of dentistry that concerns you, contact our knowlegeable staff today at 727-586-2681.

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Gum recession

Gum recession is the process in which the gum tissue that which surrounds your teeth wears away, or pulls back, exposing the tooth’s root. If left untreated, gum recession may ultimately result in tooth loss.  Most people don’t notice their gums receding because it occurs very gradually. You may notice tooth sensitivity, or that your tooth looks longer than normal. Sometimes a notch can be felt near the gum line with your fingernail.  Gum recession is often caused by periodontal disease.

Causes:

Aggressive tooth brushing. If you brush your teeth too hard, it can cause the enamel on your teeth to wear away and your gums to recede.  Clenching and grinding of the teeth can also contribute to gum recession and defects in the tooth roots. Many people do not even realize they have this habit, and many do it in their sleep!

Insufficient dental care, Inadequate brushing, flossing, and rinsing with antibacterial mouthwash makes it easy for plaque to harden into tartar or calculus, a hard substance that builds on and between your teeth and can only be removed by a professional dental cleaning.

Gum recession is not something you want to ignore.  If untreated, gum disease leads to the destruction gum tissue and supporting bone that hold your teeth in place.  If you think your gums are receding, make an appointment. There are treatments that can repair the gum and prevent further damage.

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