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

Is all dental floss created equal?

If you’re uncertain about which type of floss is best for you or a member of your family, ask your dentist or dental hygienist for advice. Here are some points that might be helpful:

Large gaps between your teeth? Try woven floss or Super Floss. We like Listerine Gentle gum care woven floss.…/listerine-gentle-floss

Not much space between your teeth? You may find that a waxed floss, dental tape, or a thinner string floss such as POH is easier to slide into those tight spaces. POH even comes in black floss if you are excited to see how much plaque you are removing!

We also like shred resistant Listerine Ultraclean floss (formerly Reach brand) since it gets into these tighter spaces but still has microgroove and a toothpaste coating to help remove stubborn plaque!…/listerine-ultraclean-floss

Braces, bridges or implants? A spongy floss is a good option, but any floss can be used if you wear dental appliances, especially if you have a floss threader. We like Proxysoft (formerly Thornton’s) Bridge and Implant Threaders for our bridge, implant and even in problem gum areas where extra TLC is needed.

When it comes to dental floss, flossing every day is the most important choice you can make!

If you have any questions about which type of floss may be most effective for you, contact our dental hygiene department at or call 7275862681. ‪#‎brittenperio‬‪#‎clearwaterperiodontist‬


Clearwater FL Periodontist Dr. Todd Britten Campaigns to Raise Money and Awareness for Red Nose Day 2016!

Are you Red Nose Ready?

!cid_8b2727d2-f27e-4d04-96c4-81b7507f48eaBritten Periodontics & Implant Dentistry

Campaigns to Raise Money and Awareness for Red Nose Day 2016!

Throughout the month of May, Britten Periodontics & Implant Dentistry, is campaigning to bring awareness about Red Nose Day and help raise funds for this extraordinary cause!

Red Nose Day is a philanthropic event that began 25 years ago to help children in poverty worldwide.  In the past 25 years the event has raised more than 1 billion globally.  Their slogan is, “Laugh. Give. Save a kid.”

Dr. Todd M. Britten, a board certified periodontist in Clearwater, FL, has challenged his staff members to get #rednoseready by donating to this global event and then showing off their red nose as they share a little about each of themselves with the online community.  During the month of May each staff member has been featured on the practice’s facebook page with a silly red nose and their bio, in hopes to engage the community and bring awareness to Red Nose Day 2016!  They are challenging the community to post pictures of themselves in their own red noses onto Britten Periodontics & Implant Dentistry’s facebook page.  For every person who posts a picture with a red nose on their facebook page, they will donate an additional $1 to the Red Nose Day cause!

Jennifer Daly, one of the surgical assistants at Britten Periodontics & Implant Dentistry expressed why this cause is so important to her, “Red Nose Day is important to her because as a mother, it breaks my heart knowing that there are still children in the world that can’t or don’t have food to eat.  These are things that I take for granted, but would love to see the end of childhood hunger.”

Half of the money distributed by Red Nose Day 2016 will be spent right here in the U.S. The other half will be spent in some of the poorest communities in Latin America, Asia, and Africa. All money raised supports projects that ensure kids are safe, healthy, and educated.Red Nose Day 2016 directly benefits these charity partners; Boys & Girls Club of America, Feeding America, charity: water, Children’s Health Fund, National Urban League, Gavi The Vaccine Alliance, Oxfam America, The Global Fund, Save the Children, Covenant House and National Counsil of La Raza.

To find out more about how you can participate in Red Nose Day, visit…

Or to post a picture of you with your red nose on Britten Periodontics Facebook Page, please follow this link!

Periodontal Disease Can Be Controlled and Treated

Periodontal Disease Can Be Controlled and Treated

Your dentist and/or dental hygienist routinely perform an examination of your gum tissue health which includes periodontal probing, or measuring of the depth of your gums.

Unhealthy gums pull away from the teeth and form “pockets” that are infected. The body’s immune system fights bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s own enzymes fighting the infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Periodontal disease – and the harmful affects to the gums and supporting structures of the teeth – can be controlled and treated. Improvement to our patients’ overall health is also often dramatically improved.

The health improvement is easy to appreciate when you consider living with an active bacterial infection, easily exposed to one’s bloodstream, can have a detrimental affect beyond the harm to the tooth and gums.

If you have symptoms of gum disease, contact us immediately. Gum disease addressed early can be reversed – and gum disease addressed later can be controlled. For more information, please contact our office at 727-586-2681 or

Clearwater FL Periodontist Offers LANAP Surgical Therapy

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Dr Todd Britten’s Clearwater Periodontal office offers a minimally-invasive periodontal surgery procedure called the LANAP protocol.
Gum disease is a chronic inflammatory disease that destroys the tissue and bone around the teeth.  If left untreated, the disease can lead to receding gums, loss of bone, and ultimately tooth loss.

The LANAP protocol is the only laser periodontitis treatment that is cleared by the U.S. FDA and is clinically and histologically proven to regenerate new gum, tissue, ligament and bone

Who is a candidate for LANAP laser surgery?

Patients with moderate-to-severe gum disease can especially benefit from the LANAP protocol.  The LANAP protocol is also an excellent treatment option for patients who are fearful of conventional scalpel surgery and patients taking certain medications, such as blood thinners.  It is important to state however, that not every patient is a candidate for laser surgery, it all depends on the individual.  Dr. Britten will thoroughly explore all options to help you keep your teeth and gums healthy.

Dr. Todd Britten has received intensive training in the LANAP protocol by the Institute for Advanced Laser Dentistry.  The LANAP protocol is the only laser periodontitis treatment scientifically and clinically proven to regenerate soft tissue and bone.  The surgery is performed here in our practice with the only laser specifically designed for the LANAP protocol — the PerioLase MVP-7.

For more information regarding LANAP Laser Gum Treatment offered by Dr. Todd Britten, contact our office at 727-586-2681 or visit our website at

Clearwater Periodontist Dr. Todd Britten: Periodontal Exam

DO YOU RECALL HEARING NUMBERS – like 3, 2, 2, 4 – being said aloud during your dental cleanings or dental exams?

These numbers are your periodontal pocket depth measurements and they are very important in determining the condition of your gum health.

Your gum tissue does not attach directly to your teeth. There is a space or pocket between the gum and the tooth before it attaches. The pocket gets deeper when bacteria or gum disease is present. To monitor and evaluate gum health, the pocket depth is measured, recorded, and monitored over time.

In a healthy mouth, a pocket can be generally from 1-3 millimeters deep.

To measure a pocket, your dental hygienists or dentist uses a periodontal probe. The probe allows them to measure in millimeters from the top of the pocket to the bottom of the pocket. The bottom of the pocket is where the tissue is connected through ligaments to the root. This measurement is taken very gently and causes no damage to the gum tissue.

When a tooth has signs of gum disease, the tissue begins to detach. Under 3 mm deep a pocket is considered healthy, while 4mm or deeper is generally considered unhealthy. The bacteria and infection causing the detachment needs to be addressed.

At your next dental hygiene visit, make sure to find out any problem areas found during your periodontal exam and how to treat it.

It is important to catch gum disease as early as possible. Regular dental checkups are vital, as is an awareness of the warning signs of gum disease. If gingivitis progresses to periodontitis, serious problems including tooth loss can occur.

For more information, please contact our office at 727-586-2681 or visit our website at

Why Choose A Dental Implant “Specialist”?


12804873_1146685658704782_8699860544634225653_nIt is important to remember that with any surgical procedure, there are inherent risks that could be alleviated with experience. Dental implants are becoming a more common and desired option for tooth replacement.

Dental implants have such a high success rate (95-97% for 30+ years). This high success rate is likely due to the fact that most implants have been placed by highly skilled specialists (oral surgeons and periodontists) who completed surgical residency programs. These surgical specialists have an in-depth knowledge of surgical techniques, as well as the diagnosis and treatment of potential complications.

The comprehensive training and experience of the surgical specialists (oral surgeons and periodontists) enable them to diagnose and manage the potential complications that can occur with surgical procedures.

Some general dentists, prosthodontists, and endodontists have attended specialized training courses on surgical implant placement and have achieved very successful results placing implants for their patients. However, they may not always feel comfortable managing and treating potential complications that are routine for surgical specialists. As a result, some patients have experienced serious implant failures and complications that could have been possibly avoided if they had been treated by surgical specialists.

If you are considering dental implants or any other surgical procedure, the following questions can help you make an informed decision about your treatment and your oral health.

1) What is your specialty?
Oral and maxillofacial surgeons and periodontists are the only ADA recognized surgical specialists.

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.

2) What is the extent of your training and experience in implant placement?

Oral surgeons and periodontists will be more than willing to share their extensive training and experience with you.
If you are considering implant treatment provided by a non-surgical dentist, ask specific questions about the implant training courses they attended, such as the name of the courses, dates, duration, and sponsorship. You should also ask how many courses they attended on the management of complications and may even want to ask how many implants they have placed.

3) Ask to speak to other patients. Their experiences can be invaluable in determining if you are in good hands.

4) Speak to the staff about dental implants. If they cannot answer your questions, the office probably does not provide implant procedures on a regular basis.

5) Ask to see before and after photos of cases. Surgicals specialists have likely performed hundreds, or even thousands, of implant procedures and are usually happy to share their successful case results with you.

Please contact our office if you have any questions about dental implants at 727-586-2681 or ‪#‎dentalimplants‬‪#‎dentalimplantsclearwater‬ ‪#‎periodonticsandimplantdentistry‬

Brush your tongue!

Do you know what this is?! That’s right, it’s a tongue under magnification! Don’t forget to brush it!

“All those bumps and grooves on your tongue are a haven for bacteria and could be contributing to your bad breath because of the gases they give off, says Dr. Matthew Messina, a consumer advisor for the American Dental Association. It’s important to take care of the tongue in addition to regular brushing and flossing.”-from

The front portion of the tongue is pretty self-cleansing, however, the back portion can often collect more bacteria. You can use a toothbrush or a special tongue scraper. Tongue scrapers come in various designs.

Some tips:

1-Clean any area where there is a coating. This is usually found on the back portion of your tongue.

2- Be gentle. Don’t go too far back and stick to the center of the tongue and not the sides which are more delicate and prone to injury. If you have a sensitive gag reflex a tongue scraper will probably work better for you.

3- Do it daily. Just like brushing and flossing, frequency is key. Oral bacteria are constantly reproducing. Once you start doing it daily, you may find that your mouth just doesn’t seem as clean without doing it!

#brittenperio #clearwaterperiodontist #dentaltips

Gum Disease is a Lifelong Condition

Gum disease is a chronic lifelong condition which can often be halted in its earliest, often reversible stage, gingivitis. “Untreated gingivitis can advance to periodontitis (gum disease). With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which
the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.” -from

Once you have been diagnosed with gum disease, it can be treated with surgical and non-surgical therapy and in most cases easily maintained for life with routine periodontal maintenance (dental hygiene visits and close monitoring) and a recommended home care schedule. Gum disease is a lifelong battle, however, we are committed to working with you and your dentist to keep your smile healthy for life. Please contact our office at or visit our website at for more information.