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Vaping and its effects on oral health explained by Dr. Todd Britten, periodontist in Clearwater, Florida.

Weighing in on Vaping and Oral Health

“Here in our Clearwater periodontal office, we have noticed that many young people and other patients feel that compared to traditional tobacco use, e-cigarettes are a safer and healthier option,” says Clearwater periodontist Dr. Todd Britten. “I see that companies selling these products are adding attractive and sweet flavoring products to attract young people. However, we are noticing in our dental practice that vaping may be as dangerous to oral health—if not more dangerous for the teeth and gums!”

Dr. Britten explained that E-cigarettes and vaporizers work by heating a liquid to generate aerosol, rather than smoke. The E-liquid in vaporizers and e-cigarettes are usually made up of propylene glycol, glycerin, flavorings, water, and in e-cigarettes, nicotine. One of the major ingredients used in vapes and e-cigarettes is a fluid called propylene glycol. “It is a like a thin sweet-tasting gel,” says Dr. Britten, “which when broken down becomes acetic acid, lactic acid, and propionaldehyde. We know in the dental community that acids are NEVER good for tooth enamel – that is what causes cavities!”  Dr. Britten also explained that it is believed that the water molecules in saliva and the tissues of the mouth will bond to the propylene glycol drying the mouth and its tissues out considerable. “We know well in the dental community how harmful dry mouth is in the development of both cavities and gum disease!”

Another ingredient in e-liquid is a combination of vegetable glycerin as well as flavorings which studies have shown  produces twice as much plaque on the teeth, which is also known as biofilm, and increased the stickiness of the bacteria to the teeth by about four times!  This, he explained, means more cavity-causing bacteria to stick to the teeth and roots and can lead to severe tooth decay as well as an increase of gum disease.

“Even for those who may be quitting smoking by switching to e-cigarettes or vapes, unfortunately, it is not a safer alternative for the teeth and soft tissues inside the mouth,” Dr. Britten says. “Nicotine users using an e-cigarette may have lower concentrations of nicotine in their blood, but we really haven’t seen what vaping and e-cigarettes do to the body long-term.”  But short-term, he says, dentists and dental hygienists are starting to see softer enamel, increased plaque and drier mouths with patients using these products.  Which is not good for patients, because as Dr. Britten says, the plaque bacteria in the mouth cause gum disease and the combination of these bacteria and acid in the mouth, cause dental cavities.

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, which can be very helpful for those needing advanced treatment, suffer from PTSD or have a fear of the dentist.

Questions? Contact us at:

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Tips for managing chronic dry mouth from Britten Periodontics to improve oral comfort and health.

What you need to know about chronic dry mouth

Have you ever noticed bad breath due to dry mouth?

Do you experience pain or discomfort from dry mouth?

Have you had changes in your oral health – like sudden decay or worsened gum disease?

Do you get sores in your mouth or on your tongue frequently?

Does your dry mouth interfere with your sleep?

Do you avoid certain foods because they are too difficult to eat with dry mouth?

Do you have trouble swallowing due to thick mucus?

If you answered “yes” to one or more of these questions, be sure to ask your dentist about dry mouth.  Chronic dry mouth is a condition that can be painful, or even unnoticed by a patient sometimes because they have gotten used to living with the discomfort or incovenience of choronic dry mouth.  It can occur due to medicine, medical conditions, or even lifestyle choices.  It can lead to significant oral health issues like cavities, gingivitis, periodontitis, or problems eating or wearing dentures.

 We have also found in our practice that different remedies help different patients combat chronic dry mouth. Here are some possible suggestions and options for patients with dry mouth:
1. Some patients find comfort from carrying water with them throughout the day and taking small sips.  Cold water may help soothe and calm fiery red tissues. For those without high blood pressure or an adversion to sodium, you can mix a pinch of baking soda in their water and swish and spit this mixture out throughout the day. Baking soda is alkalizing and can protect from decay.
2. A combination of over the counter Biotene products (gels, rinses, sprays, lozenges) used 5 times a day (A combination and routine of these products can usually be recommended by your dental health professional).  Many patients find Biotene Gel to be extremely comforting to their dry oral tissues, especially before bed time.  Patients using C-Pap appliances should use an oral gel as these devices often blow air which aggravates this condition greatly.
3. There is a product available via prescription called Neutrasal. Neutrasal works like saliva to help restore a healthy mouth. A powder pack is mixed and dissolved in one ounce of water, and swished for 1 minute before spitting.  It can be used 2 to 10 times a day, depending on what your dental health care provider recommends, and you should avoid eating or drinking for at least 15 minutes after use.
4. PerioSciences’ Anti-Oxidant Gel can also be helpful for our patients suffering from dry mouth.
5. Many patients with dry mouth should be on a strict caries prevention program, which can include prescription toothpaste, rinse, gel, trays, or in-office treatments.  Calcium and phosphate are often included in some of these products, which are minerals that help rebuild weakened enamel.
For more information, call us today at 727-586-2681 or visit our website at www.brittenperio.com
Dr. Britten, your dentist, or dental hygienist will review the cause of dry mouth, as well as your risks for periodontal disease or tooth decay.
Talk to your dentist about your dry mouth symptoms to see which dry mouth treatment is best for you!
Britten Periodontics team participating in community involvement and outreach events in Clearwater, Florida.
Informative graphic by Britten Periodontics illustrating the dangers of smoking on periodontal health.

The Dangers of Smoking and Periodontal Health

Advanced Periodontal Disease and Tooth Loss in Smokers

Quitting smoking can be very difficult to committing to, even if you know the health risks and potential benefits of giving up. Most people are all too well aware of  the links of smoking to lung cancer and advanced periodontal disease, but one of the major problems with smoking is that it tends to mask the damage being caused to teeth and gums. Reduced blood flow in the inflammatory lesions of smokers makes it harder for the body to fight infection by reducing the flow of essential nutrients to damaged tissues. At the same time the body is also less able to transport toxins away from the infection site. Smoking makes it harder to see the damage being caused to gums, so if you have any signs of active gum disease, then these will be far less visible.

Other chemicals contained within the smoke will combine with plaque bacteria and this is dangerous because x-rays taken of smoker’s teeth often shows that the jawbone has begun to shrink away from their teeth. This damage can be difficult to detect, producing very few early warning signs of advanced periodontal disease.

Additionally, nicotine affects saliva, causing it to become thicker so it is less able to wash away acid created after eating. As a result heavy smokers can be more likely to suffer from tooth decay than non-smokers, even though they may practice good oral hygiene.

Developing Advanced Periodontal Disease

This is a major problem and as a top periodontist in Clearwater, Florida, Dr. Todd Britten is highly concerned when seeing patients who smoke. The likelihood of developing advanced periodontal disease or gum disease is six times higher in smokers. Periodontal disease is an extremely serious condition affecting not only the gums, but also the membranes and ligaments and bone supporting the teeth.

Will You Lose Your Teeth If You Have Periodontal Disease?

In advanced cases, Britten may have little choice but to extract teeth that have already become loose. Smoking masks one of the major signs of gum disease which is bleeding gums and as a result periodontal disease can be very advanced before a smoker notices there is something wrong with their dental health. Although diligent brushing and flossing may slow down deteriorating gums, it’s often difficult for smokers to thoroughly remove all the plaque from the teeth due to smoking decreasing sensations in the mouth, making it difficult for them to detect areas that may not have been properly brushed.

As a periodontist, Dr. Britten is a specialist in treating advanced periodontal disease and is able to provide patients with the very latest techniques and treatments to help slow down this condition. Where teeth are lost then one option is to replace them with dental implants, but smoking is not advisable during this treatment because it does slow down healing.

If you do currently smoke and value your smile, it’s worth thinking about quitting.

Information about TMJ disorders from Britten Periodontics, explaining symptoms and treatment options.

TMD: A Painful Disorder of the Jaw

Headaches, neck pain, and frequent jaw tenderness or popping are signs you may be suffering from a TMJ condition.

What is the difference betweenTMJ and TMD?

The TMJ, or temporomandibular joints, are the two  joints on each side of the face that connect the jaw to the temporal bone of the skull. Each temporomandibular joint has a disc located between a ball and socket. The disc provides padding for chewing forces while enabling the jaw to open wide and glide and even rotate.  The TMJ work together during chewing, speaking and swallowing.  They control the lower jaw (mandible) as it moves forward, backward and side to side.  When the TMJ is not functioning properly, it is known as TMD. TMD is a disorder which includes any problem that prevents the joints, jaw muscles, ligaments or jaw bone that work to open and close your mouth from working properly.

A disruption in this complex system of muscles, ligaments, discs and bones from may result in a painful TMJ disorder.  TMJ disorders (or TMD) can be caused by arthritis,  jaw dislocation or injury, tooth and jaw alignment or can be complications due to muscle tension stress and tooth grinding. During a TMJ exam, your dentist will evaluate the joints and muscles for tenderness, clicking, popping, creaking and discomfort . Depending on the severity and cause of  any irregularities, the dentist may refer you to a physician or another dental specialist. There are many options for treatment of TMJ, ranging from very conservative treatments to more invasive surgeries. According to the American Dental Association, the “National Institute of Dental and Craniofacial Research recommends a “less is often best” approach in treating TMJ disorders”.

Treatments for TMD include:

– a soft diet (avoiding chewing gum or nail biting)

-simple pain care such as warm compresses, over the counter anti-inflammatory medications (Nsaids, ibuprofen)

– Relaxation techniques for jaw tension , such as help for stress reduction, meditation or biofeedback.

-physical therapy for jaw exercises or jaw massage. Physical therapy may also include  transcutaneous electrical nerve stimulator (TENS) to use low-level electrical currents to relax joint and facial muscles and provide relief or laser therapy.

-prescription medications for muscle relaxers, pain relief, or anti-anxiety medications,

– a night guard or bite splint to decrease clenching or grinding of teeth.

– sometimes an evaluation and adjustment of a person’s bite by their dentist can help.

-orthodontic treatment may be recommended to change jaw and teeth alignment for a more favorable position for TMJ health.

In extreme cases, surgical intervention may be advisable for TMD treatment. While other joints in our bodies can be treated by complete rest or isolation with a cast or splint… this is not easy with our jaw! Eating and speaking are so important in daily life! For those suffering from TMD, relief begins with a proper diagnosis, understanding of the underlying causes and often trying the more conservative methods first before considering surgical intervention.

If you feel you may be suffering from TMD, contact us today for more information. 727-586-2681

Informative graphic from Britten Periodontics explaining what patients need to know about Lichen Planus, including symptoms and treatment options.

What You Need to Know About Lichen Planus

If you’ve noticed sores or white ulcerations in your mouth, it’s possible you have a non-contagious disease known as Lichen Planus.  Many patients do not even realize they have it because it may cause no noticeable symptoms.  Many times, you may not even be aware you have the condition unless pointed out during a dental exam.  Although usually benign, it’s still a good idea to have it examined and monitored.  

The lesions of Lichen Planus are similar in appearance to lichen, the algae and fungi organism often found on rocks and trees. It’s believed to be an autoimmune disease, in which the body treats some of its own cells as foreign and reacts adversely to them. Certain medications and substances may also cause a lichenoid reaction. Besides the inner cheeks, gums or tongue, Lichen Planus may also appear on other skin or mucous surfaces on the wrists, legs or fingernails.

Inside the mouth it usually resembles a lacy pattern of white lines or ulceration. Gum tissues may become red and inflamed, with some soreness after brushing or eating. Sometimes it has ulcerations that come along with it.  Although there’s no known cure for Lichen Planus, it rarely causes serious problems.  It may even fade away on its own in time.  Chances are if you have a case of Lichen Planus it isn’t causing you any problems. If it does cause you discomfort, you can take steps to ease your symptoms.

If the lesions do become uncomfortable (painful, itchy or overly-sensitive), we recommend brushing with a soft toothbrush, flossing with soft woven floss (to avoid irritating or traumatizing the tissues).  Effective plaque control is important to keep the condition under control.  It may also be smart to avoid acidic or spicy foods and beverages which have been known to cause flare-ups. Managing stress is also helpful, and a topical steroid may be prescribed for more severe outbreaks.

Perhaps the greatest concern with Lichen Planus, though, is it may resemble more serious conditions, particularly oral cancer. The only way to be certain that it is a benign condition is to perform a biopsy on some of the affected tissue. If you notice a problem, be sure to visit us for a complete examination. And regardless of whether you have the condition or not, regular oral cancer screenings, as well as limits on alcohol consumption and stopping use of tobacco, will also reduce your risk of oral cancer.

 If you would like more information on Lichen Planus and similar oral conditions, please contact us or schedule an appointment for a consultation.

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Warning signs indicating the need for immediate consultation with a periodontist about dental implants, from Britten Periodontics

Signs You Should See a Periodontist Immediately About Your Dental Implants

Dental implants can dramatically improve the appearance and health of your smile.  If you have one or more dental implants in your mouth, it is important to be on the lookout for the signs of peri-implant disease. Bleeding gums, gingivitis, and other issues can be even more severe in dental implant patients. Read more for the signs that you should see a periodontist about your dental implants.

Swollen or Red Gums

Pay careful attention to the health and condition of the gums that surround the implant site. Swollen or red gums are among the first signs that you are developing peri-implant disease. If you notice bleeding when touching, flossing or brushing your implant, that is something to get checked. A periodontist will be able to help you care for your gums and make sure that your dental implant is in good condition.

Pain When Eating or Chewing

A healthy implant will not cause pain or discomfort when you are chewing, eating, or swallowing. You should see a periodontist if you start to experience any of these symptoms around your dental implant. Swollen and inflamed gums can cause pain and discomfort around the implant area. Treating your gums will help you restore comfort to your entire mouth.

Shifting or Crooked Teeth

Periodontal disease can cause your teeth around the implant to shift out of place over time. If you have started to notice that your implant has moved from its original position, it may be time to make a trip to the periodontist. Your periodontist can treat your gums and ensure that your implant has a healthy and properly placed position in your smile.

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Dr. Todd Britten at Britten Periodontics employs advanced technology for bone grafting to prepare for dental implants

Dr. Todd Britten Uses the Latest Technology for Bone Grafting to Prepare for Dental Implants

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.

Informational guide for patients on maintaining implant health and periodontal care.

A Patient’s Guide to Implant Health and Periodontal Maintenance

When teeth need to be replaced, dental implants are a wonderful option for many people. Just like natural teeth, however, 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.

There are two categories of peri-implant complications: 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).

Checking for implant health

Upon routine examination, Dr. Britten, your general dentist or dental hygienist will evaluate your implant for plaque or tartar build up around the implant, as well as gum tissue color, texture and type of gum tissue supporting the implant (attached to bone or unattached).

Next, probing measurements will be taken around the implant. Dr. Britten, the dentist or hygienist will use light pressure and a plastic probe. The tissues surrounding dental implants have a weaker attachment, bleed easier, and may be a bit more sensitive to probing. Heavy bleeding, pus, and increased probing measurements will require attention.
We will check both the implant body and its restorative parts, such as the implant abutment or crown for any loose parts. If the restorative parts are loose they can likely be repaired by your restorative dentist or implant specialist, Dr. Todd Britten. If the implant body itself is mobile, it’s an immediate failure and will require removal. Dr. Britten, or your dentist will also check your bite to make sure that the implant is not being hit with excessive pressure, as this could cause the bone surrounding the implant to weaken and the implant body to become loose.

Radiographs, or x-rays, should be taken at different times during the surgical and restorative phase of implant placement. Routine, annual “checkup” x-rays should be taken of the implant to compare to the original ones taken to carefully evaluate bone levels.

The dental hygiene visit includes removal of all soft and hard deposits on the implants, just as on the teeth themselves. Our hygienists often use instruments designed exclusively for implant care. We will then discuss the best daily oral hygiene care plan for your mouth and your dental implant(s). Listen closely to these oral hygiene instructions and customized daily oral hygiene strategies. Just like with natural teeth, biofilm or plaque must be removed skillfully every day because it can cause both infection and inflammation around a dental implant.

Studies show rinsing with Listerine (diluted with water if strong alcohol content is an issue) has its benefits because of its great antibacterial properties. Other great oral hygiene aids for implant care include a power toothbrush (love Sonicare by Phillips), Proxysoft Bridge and Implant Floss (www.proxysoft.com), double-bend end tufted brush for lingual of lower hybrids (Tepe brand). A Waterpik may also be used, but with careful instruction from your dental professional.

Our periodontist, Dr. Todd Britten, will determine a maintenance schedule that is appropriate for you. It is very common for patients with implants to be seen every 3 to 4 months for those with less-than-ideal oral health, advancing age, or systemic conditions.

When complications arise

Peri-Implant mucositis can be treated with non-surgical therapy and daily disease control (effective oral hygiene). This condition should be carefully reevaluated and reassessed. If the issue cannot be resolved in six months, it is advisable to see an implant specialist.

If Peri-Implantitis is diagnosed, non-surgical therapy is typically ineffective. At this stage, it is adviseable to see an implant specialist to see if there is a restorative issue that can be addressed, or if surgical (traditional or laser LAPIP therapy) or implant removal is needed.

Regular dental hygiene care and examination is just as important to dental implant health as it is to natural teeth. If you have any questions regarding the health of your dental implant, contact us today at 727-586-2681 or visit our website at www.brittenperio.com.

Dental implant specialist Dr. Todd Britten

Dental Implants 101

While regular brushing, flossing, and checkups allow many of us to maintain our natural smiles for a lifetime, sometimes our teeth just can’t keep up. If you’ve lost a tooth (or a few teeth) due to injury or disease, dental implants can rejuvenate both your smile and your oral health.

An implant is a synthetic tooth root in the shape of a post that is surgically placed into the jawbone. The “root” is usually made of titanium (the same material used in many replacement hips and knees), a metal that is well suited to pairing with human bone. A replacement tooth is then fixed to the post. The tooth can be either permanently attached or removable. Permanent teeth are more stable and feel more like natural teeth.

The ideal candidate for implants is a non­-smoker who has good oral health, including a sufficient amount of bone in the jaw and healthy gums with no sign of gum disease.

Britten Periodontics & Implant Dentistry is a periodontal practice offering patients personalized dental care in implant dentistry in Clearwater, Florida. Dr. Todd Britten received his Bachelor of Science & Doctorate of Dental Surgery from University of Florida, a Master’s Degree and Certificate in Periodontology and Implant Dentistry; and completed extensive training at the Institute of Advanced Laser Dentistry. He is one of the only board-certified periodontists in Pinellas County. He is a member of the American Academy of Periodontology, American Dental Association, Florida Association of Periodontists, Upper Pinellas County Dental Association, Hillsborough County Dental Association, Hillsborough County Dental Research Association and Florida West Coast Dental Association.

To learn more about Dr. Britten and his dental services, call (727) 586-2681.[iphorm id=”3″ name=”Contact form”]

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