Category Archives: Gum Treatment

Clearwater FL Periodontist Shares: Why Do I have to take Antibiotics to See the Dentist?

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 or visit our website at http://www.brittenperio.com.

Dental Implants Clearwater, Florida Dr. Todd Britten hosts seminar

Clearwater FL Dental Implants Periodontist Dr. Todd Britten
Periodontal Maintenance Dental Implants Clearwater

On February 16th, we had the pleasure of hosting a seminar “Periodontal Maintenance of Dental Implants” with many local dental professionals. Dental implants have become the standard of excellence in tooth replacement. As is the case with natural teeth, patients and their dental professionals must work as a team to ensure the longevity of their dental implant.

Our educational seminar discussed the latest techniques and technologies available to help dental professionals monitor maintain the health of their patients’ dental implants. The seminar reviewed how dental professionals can help their patients achieve long-term implant health through state of the art monitoring techniques, regular professional dental hygiene care and patient oral hygiene education. It also reviewed fixtures of the many different implant systems (old and new) that exist as well as the most accepted and current methods of patient and professional maintenance.

Dental professionals realize that there are many variations of dental implant designs available, and an ever-increasing population of patients living with dental implants. As an expert in dental implant placement and dental implant health, Dr. Britten felt was important to share with his colleagues and their teams a continuing education course specific to dental implant care. “Dental implants are complex, sophisticated dental devices, and it is important that we as implant experts continuously stay educated on modern monitoring methods.” – Dr. Todd Britten

Dr. Gregory Oxford, a periodontist of 34 years and one of Dr. Britten’s professors at University of Florida and Dentsply-Sirona, a leader in dental products and the dental implant system Ankylos, partnered with Britten Periodontics & Implant Dentistry to provide a great continuing education course. The event was catered by Stephanie and Allie with Empamamas Food Truck. The food and service were spectacular! The Sweet Life Bakery even provided dental themed cookies for the event. So as always, we partnered learning with some food and some good food!

http://www.brittenperio.com

 

 

Clearwater FL Periodontist Dr. Todd Britten Shares: What happens when a baby tooth does not erupt properly?

Most people have heard of wisdom teeth that become impacted, however the upper canines, or eye teeth are the second most common impacted adult teeth. If a canine tooth does not erupt spontaneously, your orthodontist and periodontist or oral surgeon will work together to get these unerupted canine to erupt. Each case must be evaluated on an individual basis but treatment will usually involve a combined effort. The most common scenario will call for the orthodontist to place braces on the teeth (at least the upper arch). A space will be opened to provide room for the impacted tooth to be moved into its proper position in the dental arch. If the baby canine has not fallen out already, it is usually left in place until the space for the adult canine is ready. Once the space is ready, the orthodontist will refer the patient to the oral surgeon to have the impacted canine exposed and bracketed.

In a simple surgical procedure performed in the surgeon’s office, the gum on top of the impacted tooth will be lifted up to expose the hidden tooth underneath. If there is a baby tooth present, it will be removed at the same time. Once the tooth is exposed, your oral surgeon or periodontist will bond an orthodontic bracket to the exposed tooth. The bracket will have a miniature gold chain attached to it. The surgeon will guide the chain back to the orthodontic arch wire where it will be temporarily attached. Sometimes the surgeon will leave the exposed impacted tooth completely uncovered by suturing the gum up high above the tooth or making a window in the gum covering the tooth (on selected cases located on the roof of the mouth). Most of the time, the gum will be returned to its original location and sutured back with only the chain remaining visible as it exits a small hole in the gum.

Shortly after surgery (1-14 days) the patient will return to the orthodontist. A rubber band will be attached to the chain to put a light eruptive pulling force on the impacted tooth. This will begin the process of moving the tooth into its proper place in the dental arch. This is a carefully controlled, slow process that may take up to a full year to complete. Remember, the goal is to erupt the impacted tooth and not to extract it! Once the tooth is moved into the arch in its final position, the gum around it will be evaluated to make sure it is sufficiently strong and healthy to last for a lifetime of chewing and tooth brushing. In some circumstances, especially those where the tooth had to be moved a long distance, there may be some minor gum surgery required to add bulk to the gum tissue over the relocated tooth so it remains healthy during normal function. Your dentist or orthodontist will explain this situation to you if it applies to your specific situation.

 

Dr. Britten works with excellent pediatric dentists, general dentists and orthodontists in our area to surgically intervene in case of an impacted tooth.  Call us today if you have any questions!  727-586-2681 or visit our website at http://www.brittenperio.com

Clearwater Periodontist Shares Information on Screening Patients for Obstructive Sleep Apnea

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Dentists are becoming more and more aware of the importance of screening patients for Obstructive Sleep Apnea.  

From the American Academy of Dental Sleep Medicine:

“Approximately 25 million adults in the U.S. have obstructive sleep apnea (OSA), which can cause them to stop breathing hundreds of times a night for anywhere from a few seconds to more than a minute.

Sleep apnea is a chronic condition that occurs when your muscles relax during sleep, allowing soft tissue to collapse and block the airway. As a result, repeated breathing pauses occur, which often reduce your oxygen levels. These breathing pauses are followed by brief awakenings that disturb your sleep.

Common signs of sleep apnea include snoring and gasping or choking sounds during sleep. Like snoring, sleep apnea is more common in men, but it can occur in women too, especially during and after menopause. Having excess body weight, a narrow airway or misaligned jaw all increase the risk of sleep apnea.”

The AADSM (The American Academy of Dental Sleep Medicine) recommends dentists evaluate patients for the following conditions as possible indicators of Sleep Apnea:

• A thick neck (greater than 16 inches in a woman or 17 inches in a man)

• A short neck

• Lower-face abnormalities, which may include:

        * A large tongue

• A crowded posterior airway (such as caused by an enlarged, floppy uvula or enlarged tonsils)

• An enlarged soft palate that rests on the base of the tongue

• Obesity

• Complaints of being overly tired during the day, low on energy, depressed, or moody

• Falling asleep in dental chair

• Trouble opening mouth wide during dental examination


The most successful treatment for Obstructive Sleep Apnea is a CPA appliance, however, 60% to 83% percent of users cannot tolerate this device.

With the high rejection rate of the CPAP, the American Academy of Sleep Medicine designated dental sleep oral appliances as the No. 1 nonsurgical alternative for the CPAP intolerant. Numerous sleep appliances are available to the public and distributed through dentists.

Your dental professional can help you identify if a sleep appliance may help you. If you have any questions about OSA or dental sleep medicine, contact our office today at 727-586-2681 or visit our website at http://www.brittenperio.com

 

Clearwater Periodontist Shares Information on Screening Patients for Obstructive Sleep Apnea

Clearwater FL Periodontist Dr. Todd Britten, Offers Laser Dental Surgery As a Successful Treatment for Periodontal Disease

Dr. Todd Britten is offering patients at Britten Periodontics & Implant Dentistry surgical treatment utilizing the PerioLase and LANAP® protocol for treatment of periodontal disease. LANAP, or the Laser Assisted New Attachment Procedure, is an alternative to traditional periodontal surgery for the treatment of gum disease. Dr. Britten also offers LAPIP®, the Laser Assisted Peri-Implantitis Procedure, to treat infected and/or save failing dental implants.

Dr. Todd Britten, DMD, M.S. , a board-certified periodontist, provides LANAP therapy as an option to traditional surgery for patients who suffer from gum or periodontal disease. Dr. Britten received special training on the procedure, which uses the PerioLase MVP-7 laser for periodontal disease treatment. This procedure kills harmful bacteria and removes unhealthy gum tissue without harming bone or healthy tissue.

At Britten Periodontics & Implant Dentistry, Dr. Todd Britten and his staff care about their patients’ total oral and systemic health and are concerned that nearly half of American adults have some form of gum disease and many don’t even know it.  Gum disease can cause serious oral health problems, and has been connected to a number of other major health issues, such as heart disease and Diabetes. The uses a laser instead of scalpel, so it is minimally invasive. Patients who have undergone this periodontal disease treatment have reported little, if any, discomfort or pain and a shorter recovery period.

The laser dental surgery procedure begins with Dr. Britten using a periodontal probe to determine the depth of the pockets between the teeth and gums that contain bacteria.  He then uses the PerioLase laser to eliminate those harmful bacteria, tartar and diseased gum tissue in the pockets.   The healthy tissue is compressed and stimulated to attach to the tooth and bone regeneration may also stimulated by the laser.

The LANAP procedure is fully cleared by the FDA for periodontal disease treatment and has been shown to be quite effective. Patients who suffer from gum disease can now be evaluated to determine whether they are candidates for this new treatment procedure. For additional information on the LANAP procedure, visit http://www.clearwaterperiodontist.com or www.brittenperio.com

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

Dr. Todd Britten is now offering this FDA-cleared laser procedure for gum disease and periodontal treatment. To learn more about Dr. Britten and his dental services visit his website at:http://www.clearwaterperiodontist.com or www.brittenperio.com or call (727) 586-2681.
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