From your Clearwater FL Periodontist: November is National Diabetes Month

About 30 million people suffer from Type 1 or 2 diabetes in the United States. You may have a friend, family member or even you may be affected yourself by this condition. Most people are familiar with the basics of diabetes: your body either doesn't make enough insulin or responds to insulin improperly, leading to high amounts of sugar in the blood (known as high blood glucose). Diabetes effects all parts of the body: the heart, muscles, limbs and even the mouth.

Diabetes also has a significant effect on the health of the gums and bones. Poorly controlled diabetes has a particularly negative effect on your teeth and gums. Periodontal disease is typically worse in patients with diabetes. Additionally, all types of dental surgeries (tissue grafts, implants, sinus lifts, etc.) may take longer to heal and have a higher chance of failure in diabetic patients. The high concentration of blood glucose decreases your body's ability to heal, and may even interfere with a procedure's success, particularly in poorly controlled Diabetes. 

Controlling periodontal disease has a positive effect on managing blood glucose in diabetics. By removing and controlling chronic inflammation and active infection in the gum tissues, your body may likely better regulate its response to insulin. This will have a positive effect on the management of diabetes due to the connection between the health of your mouth and your overall health. Some health insurance companies are beginning to offer coverage for a yearly hygiene visit to their patients with diabetes, due to better gum health results in better diabetes control and lower medical costs.

Of course, diabetes is only one of many conditions that can affect your oral health. Many health conditions, medications, habits, and even stress can effect your oral health and how your body responds to dental treatment. Therefore, please keep us updated on all aspects of your health history- even the parts that may seem irrelevant.

If you would like to know more about the importance of oral health to overall health, please contact our office today at 727-586-2681 or visit our website at www.brittenperio.com

Clearwater FL Periodontist Dr. Todd Britten Discusses, Can My Medication Cause A Problem With My Gums?

Can My Medication Be Enlarging My Gums?

As a gum specialist, we often see and help treat changes in patient’s gum tissues related to certain medications they are taking.  One of the main issues we come across is gingival overgrowth, or hyperplasia. 

Gingival hyperplasia is an overgrowth of the gum tissue around your teeth.  In our practice, we sometimes see that certain medications our patients are taking contribute to gingival hyperplasia.  Other factors can include orthodontic treatment or certain medical issues, such as hormonal imbalances, leukemia, a genetic condition or the growth can sometimes be due to a benign or malignant lesion.  Inflammation of the gums and poor plaque control are often a main contributor for gum overgrowth.  Poor oral hygiene also can increase inflammation which may also play a role.

Medications associated with gum enlargement fall into three main categories:

1.         Anti-seizure medications

2.         Immunosuppressant medications (used in transplant patients),

3.         Calcium channel blockers used to treat certain heart conditions, most commonly high blood pressure.

It is important to notify your dentist or dental hygienist if you take any of these medications so they can watch for changes in your gum tissues.  Many of our patients are on some form of calcium channel blocker such as Amlodopine (Norvasc) or Diltiazem for high blood pressure. 

A more severe case of gingival overgrowth could effect a person’s appearance when they smile or talk.  Enlarged gum tissue will complicate and sometimes completely prevent patients from being able to remove harmful plaque bacteria at and below the gum line and in between their teeth.  The tissues become enlarged, grow over the surface of the teeth and can become fibrotic, or tough.  Once overgrowth has started, it becomes more difficult to maintain good oral hygiene.  This will lead to retaining more damaging periodontal bacteria under the gum line, which can in turn worsen the gingival hyperplasia. 

If a big factor of the gum overgrowth is a medication, your physician may need to be consulted. Stopping or changing the medication can help limit the overgrowth, but do NOT stop the medication on your own.  Your dentist or periodontist can communicate with your medical doctor to see if your medication can be altered.  In some cases, a person’s medical professional will advise against altering a medication, most often in seizure disorders, immunosuppressed patients, and certain heart conditions or difficult to manage blood pressure.  If this is the case, we have to handle the gingival overgrowth as best we can.  Options include increased oral hygiene, non-surgical, or surgical periodontal therapy. 

Even if the medication causing this condition can be altered or discontinued, this will not necessarily reverse the overgrowth.  Additional treatment is sometimes required and often includes:

AT-HOME CARE
Good oral hygiene, especially the effective removal of plaque between the teeth and at the gum line, can alleviate the condition in early or very mild cases.

NON-SURGICAL THERAPY

In a mild to slightly moderate condition, a series of scaling and root planing procedures (commonly known as a “deep cleaning”) can be performed, often by a dental hygienist using local anesthesia.

Your dentist or periodontist may have you return every three months for dental hygiene visits to limit the effects of inflammation on the soft tissues.

SURGICAL REMOVAL

In severe cases, the enlarged or hyperplastic gum tissue may need to be removed surgically. In the case of drug-induced overgrowths, if patients are not able to discontinue the medication, surgical removal may be the only effective treatment. This can be done with a scalpel or laser.

If you think you have an area of overgrowth, visit your dentist for an evaluation of your condition. If you are now taking medications that can cause gingival overgrowth, consult with your dental professional and physician.  If you have questions about gingival hyperplasia you can contact Dr. Todd Britten in his Clearwater, Florida periodontal practice at 727-586-2681 or http://www.brittenperio.com

Moderate gingival hyperplasia

Severe gingival hyperplasia of the lower front teeth

A more mild form of gingival hyperlasia

A very severe case of gingival hyperplasia

Clearwater FL Periodontist & Implant Specialist Dr. Todd Britten Shares Advancements in Dental Implants

Dental implants today are not only considered the gold standard of care for tooth replacement, but they are usually now considered to be the superior or ideal treatment option for damaged or lost teeth.  We are excited about the many advancements in implant planning, placement and technology. 

A major advancement has come in the form of improved imaging and planning of dental implants.  ConeBeam CT scans give an efficient, ultra-low radiation image that allows the surgeon excellent information about the surgical site.  This is often combined with computer software to plan the exact location of the dental implants, which is then used to make a surgical guide.  “This amazing technology takes virtually all human error out of the process.  We can practice planning the dental implants on the computer model before the patient comes in.  We can even plan for the location and shape of the final tooth,” says Dr. Todd Britten.

Implant sizes, materials and systems continue to improve. The titanium ally used in dental implants now allows for more compact and bio-compatible implants while still providing the needed strength to resist the strong bite forces of the mouth. Implant-supported dentures have also come a long way, and many times four implants can be used to retain a complete upper or lower denture. 

Materials to provide bone support are also continuously improving.  After the loss of one or more teeth, the jawbone will deteriorate or lose support where the tooth or teeth used to be.  Ridge augmentation uses bone and tissue-grafting procedures to fill in the area where jaw bone has been lost, leaving more bone and better support for dental implant placement.

Guided bone regeneration for ridge augmentation has been found to be very predictable. Synthetic growth factors have used for this procedure have improved and we can also use our patient’s own blood to produce materials rich in growth factors, such as L-PRF.

In summary, the advances in implant dentistry allowing us to plan our implant placements better, regenerate lost bone more predictably, and place implants with more accuracy and into more sites than ever before. It is exciting to think of what is coming in the future of dental implant placement, all with less patient discomfort and risk.

As an implant specialist, Dr. Britten is highly trained and experienced in the most advanced and current technologies used for long-term implant health and success. He believes in using the best diagnostic tools as well as the highest quality implants in his practice. Dr. Britten works closely with the best restorative dentists in the Tampa Bay area to obtain the best possible outcome for his patients' implants. For more information, contact us at 727-586-2681 or visit our website www.brittenperio.com