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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 to do in a dental emergency?

A dental emergency is a frightening and often painful experience. Seeking treatment as soon as possible is is the best way to alleviate pain and to give the effected tooth or teeth the best possible chance of survival.

Teeth can become fractured by trauma, grinding, or biting on a hard object. Sometimes fillings, crowns, and other restorative devices can be damaged or fall out of the mouth completely. If there is severe pain, it is essential to contact your dentist immediately!

Pain from a dental emergency will almost always get worse without treatment, and dental issues, particularly infections can also cause other serious health issues!

Possible dental emergencies and how to deal with them

Tooth knocked out (avulsed)
It is essential to see a dentist immediately. Once out of the mouth, tissues, nerves, and blood vessels become damaged. If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Here are some steps to take:

Call your dentist immediately.
Pick up the tooth by the crown and rinse it under warm water. DO NOT touch the root.
If possible, place it back into its socket – if it can not, tuck it into the inside of your cheek pouch.
If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort. It is important to keep the tooth from drying out.
Get to your dentist, quickly and safely.
They will try to replace the tooth in its natural socket. In some cases, the tooth will reattach, however, root canal therapy might be necessary.

Dislodged/loose teeth
When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it. If the tooth remains in the mouth still attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.
It is important to call your dentist immediately to make an appointment. In the meantime, use a cold compress and over-the-counter medications to relieve pain. Your dentist will reposition the tooth and may be able to splints the tooth to stabilize it. If the tooth fails to heal, root canal therapy might be required.

Lost filling or crown
Usually, a crown or filling comes loose while eating. The tooth may be incredibly sensitive to temperature changes and pressure.

What to do: Make a dental appointment as soon as possible. Keep the crown in a cool, safe place because there is a possibility that may be recemented. If the crown is out of the mouth for a long period of time, other teeth may shift or sustain damage.
If your dentist is not immediately accessible, here are the steps to take:

Clean the crown, and affix it onto the tooth with dental cement. This can be purchased at a local pharmacy.
If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
DO NOT use any kind of glue to affix the crown.
Your dentist will check the crown to see if it still fits. If it does, it will be recemented to the tooth. If decay is noted (which often is the reason the crown became loose) this will be treated and a new crown will be made.

Cracked or broken teeth
Teeth are strong, but they may still fracture, crack or break. Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme. Fractures, cracks, and breaks can take several different forms, but are generally caused by trauma, grinding, and biting.

What to do:
Schedule an appointment as soon as possible!

If a portion of the tooth has been broken off, here are some steps that can be taken at home:

Call your dentist.
Rinse the tooth fragment and the mouth with lukewarm water.
Apply gauze to the area for ten minutes if there is bleeding.
Place a cold, damp dishtowel on your cheek if there is any swelling or pain.
Cover the affected area with over-the-counter dental cement if you cannot see us immediately.
Take a topical pain reliever.
The nature of the break or fracture will dictate what your dentist is able to do. If a fracture or crack extends into the root, root canal therapy is often the most effective way to retain the tooth. Some fractures may cause either eventual or immediate loss of a tooth. The extent of damage from a fracture can often be determined with radiographs or a CT scan.

If you have questions or concerns about dental emergencies, please contact our office or your restorative dentist.

For more information, go to http://www.brittenperio.com or call the office at (727) 586-2681.

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 Shares “Does Sugar Cause Cavities?”

Does Sugar Cause Cavities?

A diet high in sugar certainly promotes the formation of cavities, but sugar itself isn’t the only culprit behind tooth decay.

Cavities are formed when bacteria living in the mouth digest carbohydrates left on the teeth after you eat. This includes refined sugars found in cookies, candy or other treats, however they may also come from healthy foods like whole grains, vegetables and fruits.

When digesting carbohydrates, bacteria in your mouth produce an acid that combines with food debris and saliva and forms plaque.

It’s the plaque — not sugar — that directly leads to tooth decay. Plaque starts building up after every meal, and if it isn’t brushed away frequently, it can erode the hard, outer enamel of a tooth, resulting in tiny holes in the tooth’s surface. These holes mark the first stage of cavities and can do a lot of damage to a tooth if left untreated.

Eventually, acid and bacteria in plaque can eat through the other layers of your teeth, as well — from the softer layer of teeth under the enamel, known as dentin, to the third layer (the pulp), which contains your teeth’s blood vessels and nerves. Cavities affecting the pulp of a tooth, as well as the bone supporting the tooth, can cause severe toothaches, sensitivity, pain when eating and even abscesses in the mouth.

It is important to know that the kinds of foods and drinks you consume, and how you are consuming them is also important to oral health.

Sticky foods — like hard candy, breath mints, raisins and dry cereal — can get stuck in the grooves and crevices of your teeth, where they could cause decay. Fruit and yogurt, on the other hand, wash away easily with saliva and are, therefore, less likely to cause plaque buildup.

QUickly finishing a can of soda does less damage to your teeth than sipping on it throughout the day, because the acid created by mouth bacteria stays in the mouth around 20 minutes after eating or drinking. Every time you eat carbohydrates, sugary food, or take a sip of soda, you restart the plaque-production clock and increase your risk of developing cavities.

In addition to a high sugar content, soft drinks and sports drinks also contain phosphoric and citric acids that erode tooth enamel. Eating or drinking highly acidic foods — even healthy foods, like citrus fruits — can lead to tooth decay if oral hygiene is not properly maintained.

None of us can totally avoid eating all carbohydrates, sugars, or acidic foods all of the time but we can limit the amount and more importantly the frequency of consumption. And we can also work on effective and regular plaque control by using oral hygiene aids to remove the plaque colonies which are forming constantly on the teeth.

Dr. Britten recommends brushing at least twice a day with a power toothbrush for two minutes as well as cleaning between the teeth at least once a day using floss or other interdental aids. For more information on effective oral hygiene and plaque control visit our website atwww.brittenperio.com or call the office at 727-586-2681.#wednesdaywellness

2nd Annual Free Dental Day for Veterans at Britten Periodontics & Implant Dentistry in Clearwater, FL

On Friday, November 11th, 2016 the team of Britten Periodontics & Implant Dentistry in Clearwater, FL gathered together to provide compassionate, comprehensive dental care to deserving veterans.  “There was something really special about coming into work today.  It was just so rewarding knowing that the office is filled with veterans and we are doing something great for them,” one dental hygienist stated.  Dr. Britten reflected that one of the patients who made a lasting impression on him was a young lady that served in the Marine Corps in Afghanistan.  This veteran’s armored transport unit had been hit with an explosive that left her with a traumatic brain injury.  “She was so proud of her Marine’s tattoo and showed me a photo of herself in action before the accident.  I could tell she was a Marine for life, right down to the bone.  It made me proud that we have men and women serving us that are so dedicated.”

 

This is the 2nd annual Free Dental Day Dr. Todd M. Britten has organized in his Clearwater, Florida periodontal practice.  A little over two years ago, Britten and his team were brainstorming ways to give back to the community. Britten stated, “Our veterans and their families have made so many sacrifices for our freedoms and I wanted to find a way that we could give something back.  Offering a day of dental work is the least we could do.”

 

After Dr. Britten and his team decided to plan the event, it was full steam ahead.  One member of the Britten Periodontics staff, Ellen Byrd, helped find patients in need and organized the event.  Byrd, a dental hygienist, reached out to local dentists and organizations such as the Community Dental Clinic to find patients in need of periodontal care.  Dr. Britten stated, “Ellen really stepped up.  She got the word out about what we were doing and was able to find an incredible group of vets both last year and this year that were in need of periodontal treatment.  We wouldn’t be able to do what we are doing without all of her hard work.”

 

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.  The staff at Britten Periodontics expressed that if they could find Veterans in need of periodontal care they could improve their quality of life.  “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,” Dr. Britten expressed his concern. “Even though we had to remove some teeth I felt better knowing these veterans do not have to be in discomfort anymore.”

 

The majority of the surgical and non-surgical dental procedures were performed on November 11th, however there was significant pre-operative work involved.  This included new patient exams, dental x-rays, medical history reviews, even post-operative care.  Dr. Britten performed the same comprehensive exam that he would for anyone under his care.  He wanted it to be a very personal compassionate experience for these veterans.  Dr. Britten stated, “It was a priority to make sure they were comfortable with us.  Many of our veteran patients have dental phobias and are suffering from post-traumatic stress disorder so we needed to take the time, go the extra mile and treat them with the utmost respect.”

 

Veteran Chuck Pankow, one of the veterans referred by a local dentist said, “From the moment I walked in I have been treated so well.  This has been a really great experience.” Another Veteran, Chris Bode, referred by the Community Dental Clinic in Clearwater, was also pleased with his care, “Dr. Britten and his staff were amazing.  They put compassion over cost when it came to helping us out.  I am so grateful.”

 

imagejpeg_2Britten Periodontics & Implant dentistry has provided over $25,000 worth of dental treatment these past two years.  One of the best parts about this event is that it has already started to gain more participation in just its second year.  The team members and dentists (Dr. Matthew Burton, Dr. Nolan Allen, Dr. James Hayslett, and Dr. Keith Kiskaddon) of Clearwater Dental Associates were happy to partner with Britten Periodontics to provide general dentistry for as many veterans as they could.  Dr. Britten stated he and his staff were honored to hear that Clearwater Dental wanted to join in this cause.  Their hope is that with each year this event will grow and be able to help more veterans.  Nearly 95% of veterans are without dental coverage, making this a serious need in our community.

 

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 visit his website at http://www.brittenperio.com or call (727) 586-2681.

 

 

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

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 http://www.brittenperio.com

Clearwater Florida Periodontist Dr. Todd Britten using New Green Technology in Practice

Clearwater Florida Periodontist Dr. Todd Britten using New Green Technology in Practice

In the past, traditional dental x-rays were only able to provide limited information about the condition of a patient’s teeth and jaw bone. Advances in technology now allow Clearwater Florida Periodontist Dr. Britten to see fine detailed tooth and jaw anatomy to diagnose conditions that may have been previously hard to detect. Britten Periodontics & Implant Dentistry is now offering the only dental 3D CT Scan that is FDA approved for use on pediatric patients as it delivers the lowest dose of radiation possible on both children and adults. The VATECH PAX-i3D GREEN cone beam CT Scanner offers fantastic imaging detail and is the only cone beam system considered a “Green CT” due to its extremely low dose, equivalent to only a short time out in the sun. This technology also assists in the digital planning of dental implants for precise accuracy, safety and optimal results. It can also assist in planning for bone grafting, tooth extractions, particularly third molars (wisdom teeth) and suspected pathology such as infected cracked teeth or impacted teeth.

 

The Green CBCT scanner by VA Tech America provides innovative technology for ultra-low-dose x-rays in 5.9 seconds and minimizes radiation to both patient and operator.

“I am excited about not only the excellent image quality for diagnostic purposes, but also the increased protection for the health and safety of our patients. The VA Tech Cone Beam CT scanner is perfect for claustrophobic patients.

Periodontal and Implant Specialist Dr. Todd Britten recently began using the latest in Cone Beam CT technology, an open Green CBCT scanner, in his Clearwater office. He says the goal with this cutting-edge technology is obtaining a high quality 3-D image, using the lowest possible radiation dose. Dr. Britten states that this new technology allows him to not only take routine x-rays but also uses it for ConeBeam CT scan technology to take very accurate 3D images which typically require a higher dose of radiation.

The Green CBCT scanner by VA Tech America provides innovative technology for ultra-low-dose x-rays in 5.9 seconds and minimizes radiation to both patient and operator. Dr. Britten says the Green CBCT scanner protects both his patient and the x-ray technician while delivering a high quality 3-D imaging. “I am excited about not only the excellent image quality for diagnostic purposes, but also the increased protection for the health and safety of our patients. The VA Tech Cone Beam CT scanner is perfect for claustrophobic patients, as it is an ‘open air’ scanner. Patients are positioned and stand very still, and in less than six seconds, the scan is done.”

Dentists and dental specialists are using ConeBeam 3-D CT scans more and more frequently as a diagnostic tool for ultimate treatment efficiency and precision, particularly for dental implants, however, they can provide information for full mouth treatment when needed or localized to third molars or even the Temporomandibular Joint. New Green CBCT technology allows your dentist or x-ray technician to select specifically the desired scan while managing radiation dosage to their patients.

“This is a very powerful treatment tool in our practice,” says Dr. Britten. “With it, we can work together with our referring dentists to more confidently map our surgical and restorative treatment plans and place and restore implants with accuracy, while protecting our patients and our staff with lower radiation. I have read thousands of CT scans of the jaws but am still amazed at the fine details that I am now able to see in our VA Tech scans. We often see hairline cracks in people’s teeth that were previously unclear on traditional x-rays, yet causing them discomfort.”

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 visit his website at:http://www.clearwaterperiodontist.com or http://www.brittenperio.com or call (727) 586-2681.

Clearwater FL Periodontist Shares What is Peri-Implantitis

Dental implants are fantastic, but like anything biologic or placed in or on the human body can NOT always be completely predictable or guaranteed all the time. One of the long-term risks associated with dental implants is a condition called Peri-implantitis. Peri-implantitis is an infectious disease that causes inflammation of the surrounding gum and bone of a dental implant, and can lead to the loss of supporting bone. This condition is very difficult to treat. Fortunately, most patients receiving dental implants never develop this condition.
Sometimes, for a variety of reasons, bone can be lost around a dental implant. This will often occur without a patient ever being aware of it. Some dental implants will develop bone loss very early after having the implant crown is placed or it can happen many years down the road. Most patients are unaware that they have bone loss around the dental implant. Peri-implantitis generally begins painlessly and without symptoms. Once peri-implantitis becomes advanced, symptoms can develop and the patient will notice. There are several risk factors for peri-implantitis, especially smoking. Smoking definitely causes constriction of blood vessels which leads to bone loss. Medical issues such as Diabetes, Osteoporosis and a weakened immune system are more at risk for developing bone loss around dental implants. Those with a history of gum disease are more at risk. Good home care is critical. Brushing twice a day for 2 minutes or more with an electric toothbrush, flossing once a day and using adjuncts such as a rubber tip or implant floss every day!
Grinding your teeth is another risk factor for dental implant bone loss. Factors related to the surgical procedure can also cause peri-implantitis to later occur: Soft bone, lack of tightness when the dental implant is placed, bone that was grafted in a vertical fashion, implant size too big, overheated bone, and many others.
Signs of Peri-implantitis
• Deep periodontal pockets around the implant • Pus comes out from the implants and gums • Bleeding at the gumline • Appearance – Gum tissue may appear red, or slightly purplish bluish, and tartar/plaque build up is noted • Progressive loss of supporting bone on x-rays • Metal thread exposure • Long tooth
Again, peri-implantitis is not always symptomatic and typically there is no pain. Some patients will complain of a dull ache or tenderness when they brush or touch the area. A bad taste can develop if infection or pus has developed around the implant. If this infection around the implant becomes very severe, the glands in your neck may become swollen and the dental implants may begin to be noticeably loose. The first thing an implant specialist will usually check around the implant is to make sure the crown or bridge was made properly. An x-ray, or sometimes a 3-D Cone Beam CT scan is necessary to see the inside surface. Extra cement can often be the cause of peri-implantitis. The cement oozes beyond the abutment and gets down below the gum near the bone and becomes an irritant. There is often good reason to make crowns held in by screws rather than cement in some cases. The technique of cementation and choice of cement used is a big factor on implant success! This is why it is important to work with an experience implant specialist and restorative dentist in implant placement. Occasionally a loose abutment screw may be present which may not have been torqued properly or it has broken, sometimes due to a patient’s heavy bite. Patients with heavy bites need to have their crowns designed to protect the implants.
How an implant crown is made is critical for the longevity of the dental implant in the bone. Low-budget implants have poorly designed screws or may move (even microscopically) when you chew. Sometimes gum disease on nearby teeth can stimulate peri-implantitis to start on the implant. Generally some type of exploratory surgery needs to be done to find out the cause of peri-implantitis along with a simultaneous bone graft to save the implant. Not all implants that have developed peri-implantitis can be saved.
Treatment The long-term goals are to stop the progression of bone loss and maintain your dental implants! Generally speaking the area will need to be cleaned thoroughly using dental instruments. Sometimes antibiotics will be prescribed or special antibacterial agents will need to be applied to the implants itself such as iodine or tetracycline. Sometimes a laser procedure can be performed around the implant, called LAPIP, to sterilize the implant. Most peri-implantitis dental implants require surgery and bone grafting. This means that the dental implant surgeon has to open the gum tissue in order to detoxify the implant. All of the bacteria will be killed in order to have bone re-grafted onto the implants. The physiology and the type of bone that is used is critical. Sometimes your implant surgeon will recommend using your body’s own helpful blood products such as PRF/ PRP. The best way to prevent peri-impantitis is to have the implant properly placed by a specialist and restored by a highly experienced restorative dentist. Oral surgeons and periodontists have extensive training and have also developed more predictable implant placement technique.
When an implant has had too much bone loss, a success rate can be as low as 35 to 50%. Some severe cases of peri-implantitis are better off removing the implant and placing a new one if detoxifying and regrafting do not seem to have a good long-term prognosis. If one implant fails or develops bone loss, it doesn’t mean the second one will. Time will tell if the procedure works. There are no guarantees on grafting around implants that have pre-existing bone loss. It is far more successful if the bone missing is in the shape of a moat rather than an entire wall missing.
Correction of dental implants with problems should be performed by an implant specialist and highly trained restorative dentist who routinely performs this procedure. Dr. Todd Britten is a periodontist and implant specialist practicing in Clearwater, Florida. As periodontist, Dr. Britten specializes in the prevention, diagnosis, and treatment of periodontal disease, the placement of dental implants and bone grafts, and treatment of oral inflammation. Periodontists also perform cosmetic periodontal surgery. Dr. Britten has received an additional three years of specialty education and surgical training beyond dental school and has experience in treating this very difficult condition. If you have any questions regarding implant placement, contact us at 727-586-2681 or email us at healthysmiles@brittenperio.com.periimpalntitis