In his Clearwater periodontal practice, Dr. Todd Britten sees veterans for periodontal screenings followed by a free day of surgical and non-surgical periodontal treatment. He works with local restorative dentists who help provide fillings, crowns and sometimes dentures.
Dr. Todd M. Britten and the team at Britten Periodontics & Implant Dentistry is gearing up for their 4th annual Free Dental Day for Veterans. The event is scheduled for November 9, 2018.
“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 the Clearwater, FL based periodontal practice provided over $35,000 in treatment over the last 3 years’ events. Stated Britten, “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
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. We are happy to host this annual event, and hope to do it for many years to come.
Dr. Todd Britten cites recent scientific studies when urging patients to seek gum disease treatment before periodontal disease begins affecting overall health.
Dr. Todd Britten, a periodontist in Clearwater, Florida, cites recent scientific studies to help educate people about the connection between unhealthy gums and different systemic health conditions. Citing the ever-increasing studies linking periodontal (gum) health to overall systemic health, Dr. Britten continues to educate his patients about the benefits of seeking gum disease treatment before it begins affecting overall health.
Dr. Britten states that recent research demonstrates that inflammation may be responsible for the association between periodontal disease and other diseases. Dr. Britten states, “There is strong evidence linking periodontal disease to several systemic diseases, such as diabetes and cardiovascular disease as well increasing the risk factors and complications of other diseases such as osteoporosis, respiratory disease, stroke and even cancer.”
A recent study in an October 2016 report in the Journal of Periodontology titled “Periodontal Disease and Incident Lung Cancer Risk: A Meta-Analysis of Cohort Studies,” (attached) found that individuals with periodontal disease have an increased risk of developing lung cancer. Study participants with other risk factors such as frequent alcohol use, smoking, and diabetics demonstrated even a slightly increase in lung cancer risk and that women with periodontal disease are more likely than men to develop lung cancer. A related cohort study stated that oral bacteria may be involved in the development of cancer cells in the lungs, while another study indicates successful treatment of periodontal disease may lead to a substantially reduced lung cancer risk. “This report can be added to the body of literature that associates periodontal disease with other conditions in the body, including diabetes and heart disease,” says president of the American Academy of Periodontology (AAP) Wayne A. Aldredge, DMD. “While additional research is needed on the possible links between lung cancer and periodontal disease, we know for sure that taking care of your teeth and gums can reduce periodontal disease risk and possibly the risk of other systemic conditions.”
A 2013 consensus report from the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) finds that periodontal health may play an important role in the management of diabetes. The report outlines clinical recommendations for dental professionals to use when treating people with diabetes and emphasizes the importance of annual comprehensive periodontal evaluations (CPE) as part of an effective diabetes management program. The consensus report is based on a large body of scientific evidence that suggests periodontal health may be helpful in controlling diabetes.
“There are many studies which provide evidence indicating a relationship between periodontal disease and several other systemic diseases, including chronic kidney disease, cognitive impairment, obesity, chronic kidney disease and metabolic syndrome. A new study has even revealed a relationship between chronic periodontitis and lacunar infarct, a type of cerebral small vessel disease that can lead to a stroke.” Dr. Britten wants patients to know that while additional research is required to gain a more thorough understanding of many of these relationships between systemic disease and periodontal health, patients should be aware that the associations do exist.
Periodontal disease affects one of every two Americans age 30 and older and is 2.5 times more prevalent than diabetes. Caused by an inflammatory reaction to a bacterial infection below the gum line, periodontal disease can lead to swelling, irritation, receding gums, and tooth loss if left untreated. Dr.Britten’s Clearwater, Florida practice offers many disease treatment options, including traditional or laser gum surgery, replacing missing or diseased teeth with implants, scaling and root planning, and periodontal regenerative procedures such as bone grafting and tissue grafting.
Britten Periodontics is a periodontal practice offering patients personalized dental care in periodontics, laser therapy and implant dentistry for Clearwater, Florida. Dr. Todd Britten received his Bachelor of Science and Doctorate of Dental Medicine and Master’s Degree and Certificate in Periodontology and Implant Dentistry at the University of Florida. He is a Diplomate of the American Board of Periodontology. He has completed extensive continuing education coursework, including training at the Pankey Institute, Pikos Institute for Advanced Bone Grafting, Misch International Implant Institute and LANAP Institute for advanced Laser Dentistry. His Professional Associations and Memberships include American Board of Periodontology, American Academy of Periodontology, American Dental Association, Florida Association of Periodontists, Academy of Osseointegration, Upper Pinellas County Dental Association, Pinellas County Dental Association, Top Dentist 2015, Florida West Coast Dental Association and he completed extensive training at the Institute of Advanced Laser Dentistry. Dr. Britten is part of the one percent of dental professionals offering the FDA cleared laser procedure for gum disease treatment.
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.
If you have any questions about Oral Cancer, please feel free to contact us via email at or call at 727-586-2681.
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.”
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.
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.
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!
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.
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.
On Friday, January 12th our team members that braved the cold rainy Friday and worked VERY hard breaking down old floors and hauling heavy debris to keep up a much loved tradition of volunteering with Habitat for Humanity! #brittenperio#clearwaterperiodontist#brush#floss#smile#habitatforhumanity
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.
