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What treatment is best for a cracked tooth depends on the extent and the severity of the damage. If a small crack is detected early enough, it’s often possible to seal the fissure with restorative materials. For larger cracks that involve the pulp of the tooth, root canal treatment is generally required. Afterward, the visible structure of the tooth may be restored with a crown or “cap.” Sometimes, additional procedures may be recommended to try and save the tooth. In the most severe cases, however, the tooth will need to be extracted.

The preferred treatment for cracked teeth is — you guessed it — prevention! Wearing proper protective equipment (including a custom-fitted mouthguard) when playing sports, and staying alert to dangerous situations (like distracted or impaired driving) can help keep you safe. So can regular dental checkups, where your teeth are examined carefully for early signs of a problem. However, if you experience any symptoms that could indicate a cracked tooth, don’t wait: The sooner it’s treated, the better the chance that we can save it.

Watch this video from Spear Education

Great Video from Spear Education about Dental Implants!

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.

Click link for video!

https://spearedu.co/P4NxgRX

Careful management of extraction sockets after a tooth is removed prevents unsightly bone loss and provides a better cosmetic outcome for tooth replacement. To increase the possibility of future implant placement, and to prevent more bone resorption, a ridge preservation procedure may be recommended. Without the use of a bone graft and collagen barrier at the time of extraction, studies show that 30­-40% of the jaw bone is immediately lost. This is because your body perceives that once the root is removed, the bone is no longer needed and your body absorbs or removes it, creating a ridge deformity.

These ridge deformities leave you with inadequate bone and tissue thickness for either bridge or dental implant restoration. The defects may have been caused by trauma, developmental defects, periodontal disease, the wearing of dentures, or through previous tooth loss.

Ridge augmentation procedures have been shown to greatly enhance the cleansability and appearance of your restorations. They increase your chance for long ­term successful dental restoration, both esthetically and functionally. Ridge augmentation procedures may be performed with gum tissue and/or bone grafting materials.

www.brittenperio.com

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Just like natural teeth there is no guarantee a person’s dental implant(s) will last a lifetime. Although they may look bionic in pictures, a dental implant still needs careful monitoring and regular care. True, they cannot decay like natural teeth – but they are subject to the same complications of gum disease and bone loss. Once a dental implant is placed, treatment does not stop there. If it does, there’s a high chance of a infection of the gums, even around implants.

If you’ve undergone treatment for periodontal (gum) disease, you know how involved it can be. If you have lost teeth to periodontal disease and have had dental implants placed, you know the great investment in time and money it takes. Naturally, you would like to protect your investment and keep your dental implant(s) for many years, if not for life! Even if you have had an implant placed due to decay or a cracked root or badly broken tooth, you need to keep the gum support around the implant health, just as you do for natural teeth.

Periodontal maintenance (PM) is important for all patients after treatment, especially those with dental implants. Plaque, a thin film of bacteria and food particles responsible gum disease, continue to grow again on your tooth and/or implant surfaces as it did before. Diligent, daily brushing and flossing will help 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. Patients prone to gum disease are usually prescribed three or four but for some other gum disease patients, six times a year, especially just after treatment. Many patients alternate visits for periodontal maintenance between a periodontal or implant specialist 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 infection of the gums, especially around a dental implant. 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 homemade and a routine periodontal maintenance schedule will help ensure your gums, and your implants 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.

Dental implant placement: Implants are versatile. If you are missing only one tooth, one implant plus one replacement tooth will do the trick. If you are missing several teeth in a row, a few strategically placed implants can support a permanent bridge (a set of replacement teeth). Similarly, if you have lost all of your teeth, a full bridge or full denture can be permanently fixed in your mouth with a strategic number of implants.

Dry mouth (reduced saliva, also known as xerostomia) is a problems because it creates a:
 
-Higher risk of cavities, because saliva neutralizes and buffers acids in the mouth caused by foods and bacteria, as well as cleanses the teeth
-Increased risk of oral infections
-Decreased sense of taste and enjoyment of food
-Bad breath
Causes of dry mouth
 
Medications seem to account for a substantial portion of dry mouth cases, especially among the elderly. Over 400 agents in drugs affect salivary levels, with evidence that the risk of xerostomia rises with the number of medications.
 
o Commonly used medications include those for those for acne, allergies (antihistamines), anxiety, asthma, depression, diarrhea, high blood pressure, incontinence, nausea, obesity, Parkinson’s disease. Other contributors are muscle relaxants and sedatives.
o Damage to salivary glands (Due to chemotherapy, radiotherapy, neck surgery)
o Dehydration (may be due to fever, sweating, vomiting, diarrhea, loss of blood)
o Habits, such as consumption of tobacco or methamphetamines (“meth”), breathing with mouth open, snoring.
o Diabetes, anemia, hypertension
 
Treatment of dry mouth should target its causes. For example, if your dry mouth is caused by medication, then an alternative medication or dosage change may help.
If a medication change or a health condition cannot be addressed to help with dry mouth, you can help promote saliva in the following ways:
• Sipping water or sugarless drinks often and during meals
• Avoiding drinks with caffeine, such as coffee, tea, and some sodas
• Professional recommendation for oral care products that will assist in moisturizing the mouth
• Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow citrus, cinnamon or mint-flavored candies are good choices
• Avoid tobacco or alcohol, which dry out the mouth
• Minimize spicy or salty foods, which may cause pain in a dry mouth
• Avoid sugar and acidic foods
• Using a humidifier at night
 
It is important to perform daily and effective removal of plaque, which is the main preventable cause of cavities and gum disease.
 
We have also found in our practice that a combination of over the counter Biotene products (gels, rinses, sprays, lozenges), a product available via prescription called Neutrasal, and PerioSciences’ Anti-Oxidant Gel can also be helpful for our patients suffering from dry mouth. For more information, call us today at 727-586-2681 or visit our website at www.brittenperio.com

Toothbrush

For most patients, a power toothbrush is the best choice. Studies show power toothbrushes are much more effective at cleaning teeth by removing plaque and stain effectively, particularly for those who have a history of tooth decay, gum disease, difficulty brushing or who have limited manual dexterity. Dr. Britten often recommends the Sonicare® Platinum toothbrush, as it is shaped like a traditional toothbrush head, and aids in effective plaque removal and gum stimulation and massage.

If not using a power toothbrush, a soft-bristled brush is best for removing plaque and debris from your teeth and along the gum line. Small-headed soft bristled toothbrushes are also preferred, as they can reach areas way in the back of the mouth.  Dental professionals generally encourage their patients to pick whatever shape and size is most comfortable. The best toothbrush is one that fits your mouth and allows you to reach all teeth easily.

Replace your toothbrush (or power toothbrush head) when it begins to show wear, or every three months, whichever comes first, or after any illness.

Toothpaste

Unless your dentist recommends otherwise, it’s important to use toothpaste that contains fluoride, which helps to strengthen the outer tooth enamel of our teeth. However, if you are allergic to fluoride, you may want to choose a different toothpaste. Be sure to speak to your dentist or physician before making this switch.

Sometimes a higher, or prescription-level dosage of fluoride is necessary for patients with sensitive teeth, exposed roots, or at greater risk for tooth decay.  Dr. Britten often prescribes Clinpro 5000 toothpaste, which contains a therapeutic level of fluoride, in addition to calcium and phosphate, other minerals that help strengthen enamel and the roots of the teeth.

Dr. Britten prefers toothpastes without added harsh chemicals. Some tartar control, whitening, or flavorings burn or irritate the soft tissues of the mouth (inside of lips, cheeks, the tongue, or even the gum tissues). Some toothpastes, especially those with added whitening agents, are abrasive to the enamel and over time can wear it away slowly. Ask your dental professional which products they recommend for whitening or tartar control.

Rinses

Mouthwash and fluoride mouth rinse are two different products. Anti-bacterial mouthwashes (like Listerine) are more effective in controlling plaque than fluoride rinses, and also freshen breath. Fluoride rinses (like ACT brand) coat the teeth with fluoride to strengthen teeth to prevent tooth decay and cavities. They also freshen breath.

Many mouthwashes contain alcohol, so always read the label before giving mouth rinse to a child or someone with a history of substance abuse. Your dental professional may recommend an alcohol-free mouthwash, or to dilute with 1:2 or 2:3 parts’ water.

There are other antimicrobial (Chlorhexidine) or fluoride (Perio-Med) rinses that Dr. Britten recommends available by prescription as needed.

Clean between the teeth at least once per day to remove dental plaque from areas not reached by tooth brushing alone and where tooth decay and gum disease often occur!

Floss

Flossing is critical for healthy gums. Floss is available in many different sizes, coatings, flavors and forms. If you have trouble using the floss around your fingers, you can purchase floss holders in most drugstores and grocery stores. Dr. Britten recommends a floss with texture, rather than a slippery, waxy floss, which will leave a plaque residue behind.

Two of our favorites:  Listerine “Gentle Gum Care” , (formerly Reach brand) woven floss.  The soft cloth material protects your sensitive gums while effectively removing sticky plaque build up. This soft, springy and resilient dental floss removes plaque effectively and is easier on the gum line.

POH No Wax floss has many thin strands of nylon which enable our floss to disrupt and disorganize sticky bacterial plaque, which is the key to preventing tooth decay and gum disease. It won’t just slide over plaque. The multiple strands of tiny nylon slip easily between the closest teeth, able to get just under the gum line.

LISTERINE® ULTRACLEAN® Dental Floss has shred-resistant technology to stretch, flex and glide for an ultimate clean. Its MICRO-GROOVES® technology removes 2x more plaque than Glide® Mint Floss.

How to floss:  Place the floss around your index and middle fingers, make a C shape around each tooth and use a push-pull and up and down motion to remove plaque at and below the gum line and between the teeth. Try to be gentle when placing the floss below the gum line.

Children should floss once a day with the assistance of their parents. Many people floss just before bedtime. But if another time is more convenient for you, do it then.

Water Irrigation Devices (such as Sonicare Air Flosser or Waterpik)

Water irrigation devices can remove food from between teeth. Children or teenagers with braces or other orthodontic appliances may find these devices useful to remove food debris and plaque from the teeth and gum line. These devices have shown reductions in bleeding, gingivitis (inflammation of the gums) and plaque accumulation.

Water irrigation devices are most effective when used along with tooth brushing and manual removal of plaque between the teeth with dental floss or other interdental aids and should not ever replace your toothbrush or floss!  Also, proper angulation and power settings will avoid injuring thin gum tissues, which may lead to gum recession.

Interdental Brushes or Picks

Dr. Britten recommends using plaque between the teeth using interproximal brushes, go-betweens or soft-picks.  These are great tools which remove dental plaque from areas between the teeth most commonly missed by toothbrushing alone. As a popular and effective alternative or addition to dental floss, we recommend GUM® brand Proxabrushes®, Soft-Picks ® or Go-Betweens® are safe and easy to use for cleaning between natural teeth and around crowns, bridges, dental implants and orthodontic appliances.

Proxabrush (Interdental brushes)

Between-teeth cleaning with interdental brushes such as GUM® Proxabrush Go-Betweens® cleaners is as effective as dental floss in removing plaque but is perceived to be much easier and more convenient.

These products are available on long handles (size of a toothbrush handle) or travel-size making it easy to carry the Go-Betweens® cleaners in your pocket or purse for use outside of the home.

The soft nylon bristles have an antibacterial coating** to help keep the brush clean and hygienic between uses. Different sizes of brush heads are available to fit from the tightest to widest of between teeth spaces. Tight brush heads are designed to clean the tooth and gum surfaces adjacent to the tight spaces.

In four diameters: Ultra Tight, Tight, Moderate and Wide brush heads. Choose the diameter that easily fits into the spaces between the teeth, under the bridge, or around the wires and brackets of an orthodontic appliance.

HOW TO USE

Use gentle in-and-out motions in the spaces between teeth and implants and around crowns and bridges to remove dental plaque and food particles.

  1. Never force the brush into tight spaces.*** Do not bend or twist wires during use.
  2. Rinse the brush and handle after each use.

***If a space is too tight to accommodate the smallest Ultra Tight brush, consider using string floss of a Soft-Pick in that space.

GUM® Soft-Picks®: For healthy gums and a great-looking smile, GUM® Soft-Picks® are the convenient way to effectively remove food, plaque and massage gums.

GUM® Soft-Picks®: For healthy gums and a great-looking smile, GUM® Soft-Picks® are the convenient way to effectively remove food, plaque and massage gums.

Dr. Britten and his hygienists are trained to help you select the appropriate oral hygiene aids for your maximum oral health and plaque removal. For more information regarding other oral hygiene aids that Dr. Britten recommends, visit  https://brittenperio.com/oral-health/oral-hygiene/

“On Wednesday’s we wear pink!”

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

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

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

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

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

If you have dental implants, you’re expecting them to last a many years, or perhaps a lifetime. In most cases they do, giving patients a fully restored, beautiful, functional smile. Experts estimate between 3-20% of implants fail. This is often due to peri-implantitis – which is a threat to the lifespan of dental implants. Peri-implantitis is gum disease around an implant that is not reversible without intervention by a periodontist or dental implant specialist.

DISEASE AROUND IMPLANTS MIMICS PERIODONTAL DISEASE

There are two categories of complications with implants: Peri-Implant Mucositis and Peri-Implantitis.

Peri-Implant Mucositis:  This condition is similar to gingivitis around a natural tooth and does not include loss of attachment (bone or gum tissue) and is hopefully reversible at this stage.  Peri-Implant Mucositis is a reversible inflammatory reaction in the soft tissues surrounding a functioning implant.  Treating this condition as soon as possible will prevent peri-implantitis!

Peri-Implantitis:  This is a condition similar to periodontitis with loss of supporting structures (gum and/or bone) around a natural tooth.  Peri-Implantitis is a destructive inflammatory reaction affecting the soft (gingiva) and hard (bone).

Signs/Symptoms of moderate-advanced Peri-Implantitis

SWELLING IN THE GUMS

IMPLANT MOBILITY

BLEEDING GUMS

CHANGE IN GUM COLOR SURROUNDING IMPLANT

HIGH GUM SENSITIVITY

IMPLANT EXPOSURE (GUM RECESSION PREVENTS ADHERENCE TO THE IMPLANT OR CROWN SURFACE)

MILD TO SEVERE PAIN AROUND IMPLANT SITE

EXCRETION OF PUS FROM THE IMPLANTS SURROUNDING TISSUES

The good news is that peri-implantitis is treatable, especially if the infection is treated early. In order to help patients catch peri-implantitis, your Clearwater periodontist, Dr. Todd Britten is sharing what peri-implantitis is and how it can be treated with laser surgical therapy, or the LAPIP procedure.

Peri-implantitis is a bacterial infection of the gum and bone around the implant.

LAPIP® is a minimally-invasive method of laser gum disease treatment for implants that helps regenerate healthy tissue instead of destroying it. For most people who have dental implants, LAPIP® is simply the best solution for gum disease around implants, also known as “peri-implantitis”.

Peri-implantitis is an infection that has much in common with periodontitis, or advanced gum disease. With both diseases, the gums and supporting structures in your mouth are infected and become inflamed. As these diseases progress, pockets of bacteria form below the gum line, creating protected spaces which harbor bacteria and debris, exacerbating the infection. Severe cases of both peri-implantitis and periodontitis lead to bone loss, which can compromise the stability of your teeth or your implant.

If you think you have gum disease, you will need to seek treatment, since both periodontitis and peri-implantitis are progressive diseases which cannot be treated at home. The same daily hygiene used to avoid gum disease can be used to protect against peri-implantitis. You should brush and floss every day, and schedule regular checkups with your dentist, dental implant specialist and periodontist. Finally, certain lifestyle choices, like tobacco use, can increase the risk of gum infections.

Periodontal disease is common, peri-implantitis is less common, occurring in around 1 out of 10 implant recipients. Peri-implantitis is also different from periodontitis because it’s harder to diagnose early. Many patients don’t know they have an infection until serious symptoms develop. More often, peri-implantitis is detected through an x-ray during a regular checkup.

There are several treatment options for peri-implantitis. Surgery or laser procedures are the most common, and of the two, laser treatment is by far the least invasive. LAPIP is similar to LANAP, the procedure used to treat periodontitis. LAPIP, however, is designed to target infection around dental implants.

First, a laser is inserted beneath the gums at the base of the implant, where it targets and destroys bacteria and infected tissue. Ultrasonic tools are then used to remove any remaining bacteria and to make sure the implant is 100% free from dangerous debris. The laser is inserted below the gum line one more time to eliminate any surviving bacteria, and the gums are encouraged to heal around the implant again.

LAPIP treatment offers many important benefits. First, it is less invasive than surgery and does not destroy any healthy gum tissue. The laser is specifically designed to only target infected tissue. This treatment is also quick and effective. Finally, the laser works to stimulate gum and bone growth, allowing your natural bone to increase in both density and mass without a bone graft, protecting the security of your implant for years to come.

Sometimes, the gum tissue surrounding an implant can become thin, and expose the threads of the implant surface below. In this case, Dr. Britten has developed a state-of the-procedure which combines use of the PerioLase laser to destroy bacteria, decontaminate the implant surface and surrounding tissues, and reduce inflammation. Dr. Britten can then perform a procedure to graft tissue around the implant in such a way as to cover the exposed portion of the implant, however, the main objective is to re­establish the protective barrier or layer of the gum around the implant.

If you have implants and think you have peri-implantitis, please contact us immediately. We at Britten Periodontics are committed to providing our patients with the highest level of care available.

Dental implants are often used to replace teeth, but when there is not enough jaw bone to hold the implants, a dental bone grafting procedure may have to be done first.

“After the loss of a tooth, the jawbone recedes, or becomes indented. Bone grafting allows us to fill in this space to have enough bone to place a dental implant.”

For patients with missing teeth who need additional jaw bone support for the placement of dental implants, a periodontal regenerative procedure, or bone grafting must first be performed. Dr. Britten, an implant specialist and periodontist in Clearwater, Florida, also provides the latest technology and techniques in ridge augmentation, ridge preservation, sinus lift or sinus augmentation procedures for patients missing teeth to be able to have dental implants.

Dental bone grafts can come from multiple sources. Autogenous grafts come from the patient, allografts are taken from a bone bank where human bone from cadavers has been donated, and xenografts are taken from animal bone. Local anesthesia is all that is needed in most cases. The new bone is surgically placed in the jaw area where it is deficient in bone and transplanted where the dental implants will be located.

Sometimes Leukocyte Rich Platelet Rich Fibrin is used in addition to bone grafting. (L- PRF) is a by-product of a patient’s own blood that can help healing after dental procedures such as a tooth extraction, as well as promote healing around bone or tissue grafts and dental implants. L-PRF treatments are often used for greater success for necessary procedures for dental implant placement, including socket bone grafts, sinus lifts, ridge augmentation, correcting peri-implantitis, block bone grafts and extraction sites prior to implant placement. Dr. Britten provides both of these technologies in his Clearwater, Florida periodontal practice.

The dental bone graft, or periodontal regeneration procedure, must be allowed to heal completely prior to other procedures, such as the placement of dental implants. This will generally take about four to six months. Once the area has completely healed, the patient can be reevaluated for the placement of dental implants.

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.

Patients interested in these procedures can get additional information by calling 727-586-2681.

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