Immediate Dental Implant Placement for a Fractured Tooth

Immediate dental implants are often necessary due to a non-restorable fracture of a tooth. In some cases, there may be infection associated with the cracked or fractured tooth. The procedure begins with an exam, 2-D and 3-D x-rays. A diagnosis is made and treatment options are discussed. An immediate dental implant is the treatment of choice. Any pre-operative study models that are needed are taken.

Surgical Procedure:  The patient is generally well sedated with either oral or IV sedation. Just like any other procedure, topical anesthetic is applied prior to local anesthesia administration. Impressions of the teeth are taken if necessary prior to the tooth extraction. The fractured tooth is removed very carefully to minimize any damage to any surrounding bone. At the time of surgery, Dr. Britten can determine if immediate implant placement is possible. This is the part you don’t always know until you get there. Additional bone grafting is often necessary to fill the voids between the dental implant and the remainder of the extraction socket. In addition, a membrane, soft-tissue graft or platelet graft (L-PRF) may be used to protect the bone graft.

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 www.brittenperio.com

https://youtu.be/PD6A88Yq8AU

4 Ways to Replace a Missing Tooth

Fixed Bridge

A bridge is an option when there are teeth on either side of the missing tooth.

Advantages
It stays cemented in the mouth and does not come out.

Disadvantages
This does involve cutting down the teeth on either side of the missing tooth to be able to connect them together. Floss threaders, which slide under the bridge, should be used daily, to keep it clean.
The disadvantages for bridges are cutting down teeth that might be perfectly healthy. If there is a leak under the anchor teeth of the bridge, decay can occur below. A bridge can replace one or two missing teeth easily, and sometimes more if there is enough support.

Removable partial denture

A removable partial denture is worn during the day. This is used to replace one or many missing teeth.

Disadvantages 
-Sometimes may need metal clasps to help it stay in the mouth which may be visible when speaking or smiling.
- They move a little when speaking or eating, which can be uncomfortable.
-We recommend taking them out at night and soaking them in a cleaning solution.

Advantages
There is no need to file down any teeth, and this option is usually the most economical. A full denture can replace all missing teeth.

Dental Implant

An implant is a great way to replace a missing tooth.

Advantages
This solution feels and acts the most like a natural tooth when chewing, brushing or smiling. A major advantage is no need to alter any other teeth when placing an implant. An implant is a great solution for a single missing tooth, and even more implants can replace many missing teeth. When smiling or talking there is no way to tell the difference between an implant and a natural tooth.

Disadvantages
The implant replaces the actual root of the missing tooth and heals in the bone for 3 to 7 months and we then begin the restorative phase. We or your dentist then place an abutment, to which a crown will be cemented. Dental implants are usually a more costly option, at least initially, but are often the best long-term investment.

Do Nothing

There is always the option to do nothing.
Advantages
Saves money, at least initially
Disadvantages
When a tooth is removed, the bone shrinks away and the other teeth in the area will shift to fill the gap. This can sometimes lead to other problems like shifting of other teeth, causing bone loss or decay around the existing teeth as they become more difficult to clean.
If you have questions about replacing teeth lost to fractures, decay or gum disease, contact us today at 727-586-2681.
www.brittenperio.com

Eat the foods you love again with Gum Grafting Procedures in Clearwater, Florida

Want to be able to eat ice cream again?

Tooth pain that you experience because of sensitivity to hot, cold, or acidic food or drink can be caused by decay, fractured teeth or worn fillings. But gum disease, causing exposed roots due to a receding gum line, along with with worn teeth or roots can also be the source of the problem.

Healthy teeth have a layer of enamel that protects the crowns of your teeth—the part you can see above the gum line. Below the gum line a layer called cementum protects the roots, and below the enamel and the cementum is dentin. Dentin contains microscopic tubules (small canals). If dentin loses its protective covering of enamel or cementum –or sometimes when gums recede — these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. The result can be hypersensitivity.

Sensitive teeth can be treated in a variety of ways. Dr. Britten will recommend the appropriate treatment based on the cause of your sensitivity. Those might include:

- A de-sensitizing or prescription toothpaste containing minerals or compounds that help block transmission of sensation from the tooth surface to the nerve. Repeated applications (4 to 6 weeks) are usually necessary before the sensitivity is reduced.

- Application of a fluoride varnish or Kuraray desensitizing mineral powder, an in-office treatment which strengthens tooth enamel and reduces the transmission of sensations.

- Sometimes gum grafting is needed. This is a surgical procedure to protect the root and reduce sensitivity by replacing gum tissue that has been lost from the root.

Proper oral hygiene can often prevent tooth pain not caused by trauma.  Contact us today if you have any questions about your daily oral hygiene routine or concerns about tooth sensitivity.

www.brittenperio.com

Clearwater Dental Implant Specialist LAPIP laser surgery for dental implants

Dental implants are a great way to give you a beautiful and functional smile, they are not without limitations. Some patients could experience swelling or infection around their implants, which is known as peri-implantitis.

If you noticed a change in your implants, Dr. Todd Britten can provide a breakthrough procedure following the LAPIP® protocol.

How the Procedure Works

This procedure is minimally invasive, due to the use of cutting-edge, gentle laser technology. This allows Dr. Britten to treat peri-implantitis without the need for incisions.

During the procedure, our state-of-the-art PerioLase laser targets the inflamed area of the gum tissue and eliminates harmful bacteria and infection that has developed. There is no need to worry about an extensive recovery period, sutures or any incisions.

The importance of eliminating unhealthy tissue

Even though dental implants are a great option for patients who have lost their teeth due to periodontal disease, the disease can still continue even around dental implants.

It is essential that diseased implants receive proper treatment as soon as possible to protect these implants, other teeth, bone structure and oral health.

If you think your gums might be inflamed around your dental implants, schedule an appointment with us today. Contact us today to learn more about the LAPIP® protocol and its many benefits to you and your oral health.

www.brittenperio.com

#lapip #lapipperiodontist #clearwaterperiodontist #lasersurgery #LANAP #LAPIP #dentalimplantsclearwater

Indirect Sinus Lift Clearwater, Florida

This procedure is less invasive than the direct sinus augmentation lift and is performed by preparing the bone for the dental implant as normal. Once the floor of the sinus has been reached, bone is gently packed in the preparation and pressed upward. This motion will tent the membrane of the sinus upward and create additional room for the full length of the implant.

As with the sinus augmentation graft or direct sinus lift, care will be taken not to damage the sinus and this procedure will have no effect on sinus pressure or affect people that suffer from seasonal allergies.

www.brittenperio.com

Clearwater Periodontist & Dental Implant Specialist Dr. Todd Britten

727-586-2681

Ridge Augmentation in Clearwater, Florida Dr. Todd Britten

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

727-586-2681

Clearwater Periodontist Holds Third Annual Veteran's Day Event

Dr. Todd M. Britten and the team at Britten Periodontics & Implant Dentistry had an early start on Veteran's Day which is Friday, November 11th. They held their 3rd annual Free Dental Day for Veterans on Friday, November 3rd, 2017. Britten Periodontics once again had overwhelming offers to help from many dental professionals in the community willing to donate their time and resources to provide free dental care. Patients were directed to the event this year from The Homeless Emergency Project in Clearwater, as well as local V.A. Branches from Pinellas, Pasco and Hillsborough counties.

“Once again, we have had an incredible response from the community and were able to get skilled and compassione local restorative dentists involved.” For the third year in a row, Clearwater Dental Associates, Dr. Jim Hayslett and Dr. Keith Kiskadden and their staff are on board to help out with our event, seeing patients for fillings, crowns and even dentures. New to this year’s event, Dr. Michael Podlusky in Seminole, Florida, also reached out to Dr. Britten to also help, making upper and lower dentures at no-cost for one of the patients. "Many thanks to Dr. Britten for organizing the Veteran's Day Event and graciously offering me the opportunity to help treat a patient. So glad to help at least one of our honored Vets. One person can't do everything, but all of us working together surely can!" Said Dr. Mike Podlusky.   

Dr. Britten’s dental specialty, periodontics, often involves managing and treating advanced gum disease. A periodontist is often able to help a patient in danger of losing teeth or with active oral infection to turn their health around. “Having Clearwater Dental Associates involved again this year, and the gracious help of Dr. Mike Podlusky and his team 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 the restorative specialists involved helps us to treat the whole mouth and really deliver comprehensive care to these veterans.” Dr. Britten sees most patients for a comprehensive evaluation, radiographs and treatment consult prior to the event in order to determine what services he as the gum specialist can provide in his office, and make appropriate referral for restorative care from local dentists who have volunteered to help with the event.

Britten says being able to offer two different forms of sedation to Veterans for this event in his Clearwater, FL practice has helped for patients who have PTSD, dental anxiety, or may require extensive surgical treatment.  Dr. Britten expressed his concern. “Most of the time, periodontal disease is not painful until it gets to be very advanced. Some of the veterans had been dealing with painful teeth for a long time.”

For Britten and his team this event is something they look forward to all year long. They keep in touch with veterans from previous events and this year they were able to provide follow up exams, x-rays and periodontal maintenance procedures, which help prevent reinfection of the gums following treatment. “This year we were able to invite Veterans from previous events to receive follow up maintenance care at this year’s event,” said one dental hygienist at Britten Periodontics who helped organize this year’s event. "It was great to see them again and the progress they have made in their oral health. It is touching to be a part of something that has changed someone's life in such a positive way."

One patient returning this year received treatment at the inaugural event was John Smith, who served in the US Navy in Vietnam from 1965-1969. Dr. Britten explained that he was honored to be able to help Mr. Smith and to continue in his care since the 2015 event. The VFW Post 2473 in Clearwater where Mr. Smith serves as canteen manager does much to help local veterans.

When asked what this event meant to him in 2015, Smith had stated, "I get to keep my teeth and I can't believe it's free." A patient new to this year's event, Yvette said, "This was the most amazing dental cleaning I have had in my whole life!"

Dr. Todd Britten explained how glad he is to be doing this the third year in a row and would like to do it annually for the entirety of his career. When asked why this is a cause so near and dear to his heart he stated that his grandfathers and uncles served in the military and giving back to veterans in need is a top priority for him. Dr. Britten said, “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.”

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.

www.brittenperio.com

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Clearwater FL Periodontist: American Diabetes Month

Oral health = overall health. November is known as American Diabetes Month. Dental professionals support the American Diabetes Association's efforts to focus our nation's attention on the disease and the tens of millions of people affected by it.

Most of us have been affected by Diabetes, having friends, families and neighbors managing the day-to-day triumphs and challenges of the disease. The American Diabetes Association uses this special month to raise awareness and create a sense of urgency about this growing public health crisis.

For more information on how Diabetes effects oral and periodontal health, visit our website at

http://brittenperio.com/oral-health/overall-health/

This is How to Prevent Re-Infection of Your Gums Around Dental Implants

Clearwater Periodontist Dr. Todd Britten Shares:

This is How to Prevent Re-Infection of Your Gums Around Dental Implants

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 re-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!

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 re-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 or visit www.brittenperio.com

Clearwater Periodontist Shares: 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!

Clearwater Periodontist serving those who have served our country!

Dr. Todd M. Britten and the team at Britten Periodontics & Implant Dentistry is gearing up for their 3^rd annual Free Dental Day for Veterans.  The event is scheduled for November 3^rd, 2017.

“We all know someone who has served or is currently serving in the military.  We have heard stories, we have seen families living apart during deployments, we have seen veterans with disabilities both physical and emotional, we have seen families devastated by the loss of loved ones.  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.  He and his team were brainstorming idea for how they could use their skill set to pay it forward to others in the Clearwater community.  “Both of my grandfathers served in World War II and I remember hearing stories both from them and my grandmothers about what life was like during those times.  The sacrifices made by veterans and their families are truly astounding.  I was 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.” 

Jennifer Daly, a surgical assistant at the practice served in the Airforce, “I am very proud of my service to my country and I am even more proud of this dental work that we are doing for my fellow veterans.”

The inaugural year the Clearwater, FL based periodontal practice provided over $10,000 worth of comprehensive dental treatment to a group of veterans, the following year over $15,000, “As word has gotten out, we have had an incredible response from the community and even were able to get the skilled and compassionate restorative dentists at Clearwater Dental Associates, Dr. Jim Hayslett, Dr. Keith Kiskadden and Dr. Matt Burton on board to help out with our event.” Stated Britten.  “Having the Dentists and staff at CDA 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 the restorative specialists at CDA involved helps us to treat the whole mouth and really deliver comprehensive care to these veterans.”

For Britten and his team this event is something they look forward to all year long.  They even keep in touch with many of the veterans.  “What I’ve enjoyed the most about this event over the past two years is the friends that we have made.  My respect for servicemen and women has simply increased.  Hearing their stories and getting to be a part of their health journey has been a very rewarding experience.” 

This sentiment was mirrored by everyone on Britten’s team, “This is such a feel good event.  I really enjoy getting to know all of the veterans. Their stories will bring tears to your eyes, and we are all so grateful to be able to pay it forward,” stated Ellen Byrd, a registered dental hygienist who has been in charge of scheduling and planning the event.  “We have been working closely with the Community Dental Clinic, the Homeless Emergency Project, and social workers from local V.A. Branches.

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,” Ellen Byrd said.

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.

Dental Implants Clearwater FL: Sinus Augmentation

A sinus augmentation graft procedure makes it possible for many patients to have dental implants when years ago there was no other option besides wearing loose dentures.

An indirect sinus lift is less invasive than a direct sinus augmentation lift and is performed by preparing the bone for the dental implant as normal. Once the floor of the sinus has been reached, bone is gently packed in the preparation and pressed upward. This motion will tent the membrane of the sinus upward and create additional room for the full length of the implant. Care will be taken not to damage the sinus and this procedure will have no effect on sinus pressure or affect people that suffer from seasonal allergies.

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 us (727) 586-2681 or visit our website www.brittenperio.com

Clearwater FL Periodontist Shares Why Do I have to Premedicate with Antibiotics for my 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.

Dental implant specialist Clearwater Dr. Todd Britten: Dental Implant Health, A review of definitions for the dental professional

Dental Implant Health: A review of definitions & recommendations for care

Peri-implant mucositis: A reversible inflammatory reaction in the soft tissues surrounding a 

functioning implant. Treating this condition will prevent peri-implantitis! Similar to gingivitis around a natural tooth. 

Peri-implantitis: A destructive inflammatory reaction affecting the soft (gingiva) and hard (bone). Similar to periodontal disease with loss of attachment in a natural tooth.

Different implant systems have different methods of placement.

Tissue level implant (Pictured below, 2 images to the left): The implant has a rough surface, which is placed down to the bone crest, and a polished collar (all one part of implant) extends to the gingival margin. Bone levels should maintain at the top of the rough surface.

Bone level implant (Pictured below, right image): The implant has a fully roughened surface and is placed equal to the bone crest. A separate restorative abutment is later connected that extends up to the gingival margin. Bone levels should maintain at the top of the rough surface.

Clinical assessments (visual, probing and radiographs) that will be performed by your dental professional to determine the health of  your dental implant.

 Visual: Evaluate for plaque, tartar or cement, gingival tissue color, texture and keratinized (attached) vs. non-keratinized tissue (unattached).

 Clinical assessment: Your dental professional will be able to identify different implant systems and whether it is a tissue level or bone level implant, check for movement, and check the bite. As with natural teeth, implant mobility should be assessed using the flat ends of hand instruments. True mobility of an implant is a lack of osseointegration (attachment to the bone) that will require removal of the implant. However, clinical evaluation should include a check for other prosthetic issues, such as a loose implant crown, abutment or screw. If the implant body is mobile, it’s a failure. 

 Probing: The tissues around dental implants have a weaker attachment, bleed easier, and are more sensitive to probing. Use light pressure and a plastic probe. Profuse bleeding, suppuration, and increasing pocket depth require attention/action.

 Radiographs (x-rays) will be taken to compare to baseline x-rays to evaluate for bone loss.

 Periodontal maintenance procedure (dental hygiene visits and cleanings are often performed 3 or 4 times a year for patients with dental implants)

 Evaluation and documentation

 Removal of all soft and hard deposits, often using specialized dental implant plastic or titanium instruments. If infection is present, use whatever necessary to debride and decontaminate the implants. A person's bite should be checked regularly.

 Reinforcing daily biofilm (plaque) removal with at home oral hygiene instructions and customized daily oral hygiene strategies. I do agree with using Listerine (diluted with water if strong alcohol content is an issue), power toothbrush, Proxysoft Bridge and Implant Floss (www.proxysoft.com), double-bend end tufted brush for lingual of lower hybrids (Tepe brand) Waterpik only if the patient has proven non-complaint to all other suggestions after multiple times (with instruction to keep on a low setting and 90 degree angle).


 Determination of hygiene maintenance schedule – Every 3 to 4 months if less than ideal periodontal health, advancing age, or systemic health conditions.

 Care for Peri-implant mucositis or Peri-Implantitis

Suspected Peri- Implant Mucositis: Your dental professional can attempt to treat this condition with non-surgical therapy and daily disease control (effective oral hygiene). Reevaluate and reassess. If the issue cannot be resolved in six months, refer to your implant specialist.

Suspected Periimplantitis: Non-surgical therapy is typically ineffective unless an obvious piece of cement or debris can be removed. This is because of the complex structure of the implant prosthesis, rough surface or implant threads. Your dentist will then refer you to an implant specialist to see if a restorative issue can be addressed, or if surgical (traditional or laser LAPIP therapy https://www.lanap.com/lanap/what-is-lapip), or implant removal is needed.

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 or visit our website at www.brittenperio.com

Clearwater, FL Dental Implant Specialist Dr. Todd Britten

Dental implants have become a vital and mandatory option for tooth replacement in recent years. While modern implant dentistry has seen major advancements in popularity and success, not all dental implants are created equal, and no dental implants are guaranteed to last forever.  However, using a high-quality implant as well as a highly trained implant surgeon and restorative dentist, can make a big difference as to whether the implant will last for many years (and preferably a lifetime), which is always our goal.

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 www.brittenperio.com

Clearwater Dental Implants: Why choose Dental Implants?

www.brittenperio.com

What is Gum Recession?

Clearwater FL Periodontist Dr. Todd Britten discusses 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. If untreated, gum disease leads to the destruction gum tissue and supporting bone that hold your teeth in place.

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 you think your gums are receding, make an appointment with your dentist. There are treatments that can repair the gum and prevent further damage.

Clearwater FL Periodontist discusses Dry Mouth

Dry Mouth

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

Clearwater FL Periodontist Dr. Todd Britten Shares Technology for better healing of dental implants, regenerative periodontal procedures, bone grafting, and extraction sites

Dr. Todd Britten is happy to announce that we are using Platelet Concentrates (L-PRF, or Leukocyte-Platelet Rich Fibrin) to promote healing in dental procedures.

Concentrated blood has been used in hospitals for a long time to accelerate healing.  Leukocyte Rich Platelet Rich Fibrin (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™ is a 3-D autogenous combination of Platelet Rich Fibrin derived from a patient’s blood.  First, it is determined if patient is a candidate for L-PRF treatment.  If so, blood is then drawn in our office from a patient’s arm. The blood is then immediately placed into a centrifuge to separate the blood into layers.  This thin, compressed layer of platelet rich fibrin is strong, pliable and even suitable for suturing. This natural fibrin network is rich in platelets, growth factors (PDGF, BMP, VEGF) and cytokines derived from the blood platelets and white blood cells called leukocytes. These proteins promote rapid healing, especially during the critical first seven days after they are placed.

Growth factors are triggered and released and clot formation is stimulated by blood platelets, fibrin and growth factors to help heal wounds.  Growth factors stimulate stem cells to produce new host tissue quickly, making L-PRF effective in the healing process.

Advantages of using L-PRF also include lower infection risk after surgical dental procedures by sealing a treatment wound from bacteria after treatment.  Saturation of the surgical area, bone graft material and/or dental implant helps increase tissue formation due to its growth factors such as BMP, VEGF and PDGF, and this, in turn, results in faster gum and bone regeneration. Speedier healing decreases the risk of later infections, complications, and discomfort.  The use of this technology has been shown to lower the chance of dry sockets after extraction, which can be very painful.

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.L-PRF technology is used to quicken the healing process and is completely safe. Disease transmission is not a factor since blood is drawn from a patient’s own body.  Most patients report a greater degree of comfort during healing even immediately after their procedure. The amount of blood needed is minimal and can be collected easily.

If you have any questions about treatment with platelet rich fibrin/plasma or would like to find out if you are a candidate and can benefit from this treatment, please contact us at 727-586-2681.

Healing From Within With L-PRF

·         Only requires a small blood sample – Virtually painless!

·         100% natural, 100% you -  Biocompatible.

·         No additives, chemicals, or foreign substances – Lowered risk for complications

·         Contains your unique healing properties – Promotes Recovery!

·         Simple procedure – FDA Cleared

Tooth loss and damage to the jaw bone and tissues are often challenging for your dentist during oral surgery or implant placement. Without enough support in the jawbone, dental implants cannot be immediately stabilized and tissue healing can be a long process. The solution to these and other difficult situations is a new Platelet Therapy created from your own blood. Leukocyte –Platelet Rich Fibrin (L-PRF) changes all the rules as it promotes healing and bone growth from within your own body. Unlike other treatments that use artificial components, Platelet Therapy with L-PRF uses only your own blood. With a simple blood draw and an advanced technology protocol, L-PRF is individually made for you – from you. The end results are improved healing response and significantly less recovery time.

L-PRF™ is basically a bioactive “band-aid” that is created from your own blood and then placed in your surgery sites to promote healing. A sample of your blood is collected in a tube, just as it would be for a blood test. The dentist then uses the unique IntraSpin™ System to separate and concentrate certain important cells and active proteins by spinning your own blood in a dedicated centrifuge. After a fast preparation the bioactive clot, created just from your own blood, is now ideal for your procedure.

 After your L-PRF is created, it can be placed directly in/on surgical sites to immediately promote healing. When placed in surgery sites, L-PRF releases your body’s own natural healing proteins, creating a more efficient network for cells to enhance the healing process. Depending on your situation, the doctor may supplement your L-PRF clot with different biomaterials customized for your needs. For patients with significant bone loss, a combination of L-PRF and bone growth material may also be used to promote natural bone regeneration.

The therapy is 100% natural and additive-free. Natural growth factors present in your body are concentrated using L-PRF. Your own concentrated platelets and other key blood cells and their unique healing abilities are simply re-introduced at the site of your surgical procedure. As a result, your own body releases powerful healing proteins, and creates a scaffold for healing.

If you are interested in finding out more about L-PRF, give our office a call and we will be happy to set up an appointment to discuss using L-PRF in your next procedure.

Heal Quicker Using L-PRF, Make An Appointment!  www.brittenperio.com