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