Whitening Options

Whitening Options

A 2013 survey of 5,500 unmarried adults asked them to rank the qualities by which they judge the opposite sex on first meeting someone new.  Teeth was the highest ranked characteristic by a long shot (58% of men and 71% of women ranked it the #1 feature by which they judge a member of the opposite sex for attractiveness).  Americans spend $1.4 billion on teeth whitening products.  (Click here to see this and other interesting statistics about teeth whitening from research conducted by the American Academy of Cosmetic Dentistry.)  Globally, teeth whitening is a $3.2 billion industry.  If you are on social media, you have probably seen at least one DIY whitening trend.  Teeth whitening is one of the quickest and easiest ways to improve a smile.

What is Teeth Whitening?

Teeth whitening is any process that causes the teeth to appear whiter in color.  This can involve two different processes: 1) the removal of surface stains and polishing of the teeth and 2) chemically bleaching the teeth with peroxide agents.  The removal of surface stains and polishing of the teeth is the mechanism of action used by whitening toothpastes and all of the DIY whitening trends you see on Instagram and Pinterest.  This is accomplished by the use of abrasive compounds to polish the outer surface of enamel and remove superficial stains like coffee, tea and red wine. 

The risks associated with this type of teeth whitening is the removal of enamel or exposed root surfaces.  This risk is the main concern that dentists have with DIY whitening trends: they can cause irreversible loss of tooth structure.  Teeth will initially appear whiter, and as the abrasion continues and enamel becomes thinner, the underlying dentin will begin to show through, making the teeth look darker over time. 

The best way to lessen this risk is to use whitening toothpastes with the American Dental Association’s seal of approval because their abrasivity has been tested and confirmed to be safe for tooth structure.  Also, make sure to follow the manufacturer’s instructions when using a whitening toothpaste.  

Teeth whitening can also involve bleaching the enamel and underlying dentin tooth structure with chemical compounds containing peroxides.  Because bleaching the teeth does not remove any tooth structure, it can actually be safer for your teeth.  Many over-the-counter products contain peroxide chemicals for bleaching and are safe when used as instructed.  This blog will address the professional whitening options offered at Prosper Family Dentistry, all of which are bleaching agents containing peroxides.

Hydrogen Peroxide vs. Carbamide Peroxide

The two possible whitening ingredients in professional teeth bleaching agents are hydrogen peroxide and carbamide peroxide.  Because carbamide peroxide breaks down into hydrogen peroxide, they are virtually the same.  There are two minor differences that may factor into the decision on which product to use: 1) Hydrogen peroxide shows an initially quicker whitening effect, which then plateaus so that the final whitening result is the same for both hydrogen peroxide and carbamide peroxide.  2)  Carbamide peroxide has a slightly longer shelf life.  This is important for take-home whitening gels that you may use on a less frequent basis.

 

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Option #1: Professional Whitening Gel in Custom Trays

Teeth whitening using custom trays and a bleaching gel is considered the “gold standard” in teeth whitening.  It is the most customizable and controlled option available in teeth whitening.  Professional Teeth Whitening Gel is available in many concentrations; we offer various concentrations in our practice.

Pros:

  • Once made, the custom trays will last for years.  The only reason you would need new ones is a major change in the shape of your teeth (for example, significant dental work or orthodontics).  This allows you to purchase refill kits of bleaching gel for continued whitening at a much lower cost than the initial investment.
  • You choose which teeth to whiten and when.  Easily customized to get the best result with the least amount of gel.
  • Greater variety of concentrations of the gels = greater versatility of whitening (anywhere from 15 minutes to 9 hours/overnight).
  • Whitening can be done any time for maintenance of a bright, white smile.
  • Carbamide peroxide is the main ingredient, which increases its shelf life.
  • Contains potassium nitrate (desensitizes the teeth) and fluoride (strengthens enamel).
  • Very inexpensive after the initial investment for the custom trays.

Cons:

  • Impressions of your mouth are necessary to fabricate a mold of your teeth, on which the custom tray is made.
  • About 1 week lab time before you can begin whitening.
  • Results are not immediate; typically, whiter teeth are noticed after 3-4 days of whitening.
  • Properly loading the gel into the trays requires some manual dexterity.

Option #2: In-Office Whitening

In-Office Whitening is the way to go for an instantly whiter and brighter smile.  This option gives you instant gratification and is perfect for an upcoming special event or for those people who just do not have time for at-home whitening.  In one session of in-office whitening, you will achieve the same results you would get with multiple days of whitening your teeth through the first two methods of at-home whitening.  Basically, we do all the work for you!  Most in-office whitening treatments are a high concentration of hydrogen peroxide gel, which means it is strong and works fast.

Pros:

  • Instant results!  Your teeth are visibly whiter in one hour.
  • Customizable: Your dentist or hygienist can apply different amounts of gel to different teeth, if they are not all the same color.  They can also protect sensitive areas of gum recession and avoid using the gel on dental work.
  • Chemically activated: no light needed.

Cons:

  • Most expensive option.
  • Requires a scheduled appointment with your dentist or hygienist.
  • Increased risk of irritation of the gums or tooth sensitivity due to its high concentration.
  • Some maintenance may be required if you frequently drink beverages with a high probability of staining your teeth (coffee, tea, red wine).

Interested in whitening your teeth?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell to set up a teeth whitening consultation.  They will discuss the various options available and help you decide which is right for you!

Interdisciplinary Dentistry

Interdisciplinary Dentistry

You’ve probably heard the saying, “Jack of all trades”; maybe you didn’t know that the rest of that phrase is “ . . . master of none”.  The theory behind this phrase is that a person can be competent in many tasks, but is usually limited to excellence in just a few.  At our dental centers in Freeman, Parkston, and Viborg, we believe that this phrase applies to dentistry.  Because our goal is for each patient to receive excellent care in every realm, we cooperate with medical and dental specialists to accomplish interdisciplinary dentistry. 

We understand that, as a patient, it is more convenient to have all of your dental care performed in one location.  However, when it comes to a choice between convenience and excellence, we will always choose excellence.  When Dr. Jason, Dr. Alex and Dr. Serena create a customized treatment plan for their patients, they considers what type of practitioner will best perform each individual procedure.  These decisions are made on a case-by-case basis, much like a primary care physician may treat a case of high blood pressure in his or her office, but refer out a complicated cardiovascular issue to a cardiologist.

Dental Specialties

The American Dental Association recognizes nine dental specialties in dentistry.  These specialties are characterized by residency programs, which add several years to their education, and certifying boards, which recognize their limitation of practice to a specific specialty.  The nine recognized dental specialties are:

  1. Dental Public Health – promotion of oral health and disease prevention

  2. Endodontics – root canals and surgeries related to infections originating within the tooth

  3. Oral & Maxillofacial Pathology – diagnosis of abnormal lesions and diseases of the oral cavity

  4. Oral & Maxillofacial Radiology – interpretation of images of the head & neck complex, including x-rays and cone beam computed tomography

  5. Oral & Maxillofacial Surgery – surgical intervention ranging from simple extraction of teeth to complex realignment of the upper and lower jaws

  6. Orthodontics – realignment of teeth and bite relationships

  7. Pediatric Dentistry – dentistry for children

  8. Periodontics – treatment of diseases and conditions of the supporting structures of the teeth: bones, ligaments, and gum tissue

  9. Prosthodontics – restoration of missing tooth and jaw structures

Many people are surprised to learn that there are currently no recognized specialties for TMJ, cosmetic dentistry, and dental implants.  Advertising claims can be misleading in these areas. 

Why Do Some Dentists Pull Wisdom Teeth, Place Implants or Do Root Canals?

Many general dentists have practiced long enough to determine which procedures they are able to perform with excellence, rather than just being competent.  They will spend more time in continuing education learning the procedures that they love, and will consistently improve their skill in specific techniques.  This is why some general dentists are able to provide excellent treatment in areas another general dentist would refer to a specialist.

On the other hand, you may find that a dentist who used to do root canals in his office no longer does.  It is likely that this dentist has found he is not able to efficiently provide the very best root canal for his patients, and they will receive a more positive long-term success rate by seeing an endodontist for that specific procedure. 

Medical Specialists

As we discussed in a previous blog on how oral health affects your overall health, there are many connections between the mouth and the rest of the body.  As we continue to gather more information about your head & neck with the 3D imaging and continued learning in dentistry, we are better able to recognize these connections and advise you to see the appropriate medical specialist.

The Importance of the General Dentist

In cases where interdisciplinary dentistry is necessary, the general dentist plays an important role.  In addition to performing certain procedures in the care of the patient, the general dentist is instrumental in organizing and coordinating the flow of communication and treatment among the various specialists.  

If you have a complicated dental history and think you need interdisciplinary dentistry, call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell! Their commitment to excellent care will ensure you see the proper doctor for each individual procedure your treatment requires.

Silver Diamine Fluoride

Silver Diamine Fluoride

What is SDF?

Last June, the New York Times published an article on a new dental material called Silver Diamine Fluoride (SDF) that excited all of its readers and everyone who saw it shared on Facebook!  (New York Times article) Correction: it is not new.  SDF has been used in Japan for decades (approved by their ministry of health in the 1960's), but it is new to the United States. 

This material, which is a clear liquid that looks like water, can stop tooth decay in its tracks.  That is an exciting material!

The Food & Drug Administration has classified SDF as a fluoride treatment and has only cleared it for use as a desensitizing agent.  This means that when dentists use it to stop cavities, it is being used "off-label".  The evidence is compelling enough that Dr. Jason, Dr. Alex and Dr. Serena have begun offering this "caries arrest" treatment to its applicable patients. 

Caries arrest, simply put, means stopping a cavity.  Caries is the scientific word for tooth decay or cavities.

Who is a candidate for SDF? 

The most common application of SDF is in young children because it prevents them from having a dental appointment involving local anesthetic, drilling and filling.  It takes about 5 minutes to isolate the affected tooth and apply the colorless liquid SDF to the site.  It is also a great option for treating cavities on elderly patients with a very high risk for decay, patients with dementia or Alzheimer's disease, and patients with special needs.  It can be used to stop the progression of decay for a patient who has need of extensive dental treatment and is unable to proceed for financial or medical reasons. 

Basically, SDF can be used to buy some time when it comes to "fixing" your teeth.

What are the pros?

  • No local anesthetic = no injections

  • No drilling

  • No filling

  • Much shorter treatment (about 5 minutes compared to 30+ minutes)

  • Decreased cost (about 10% of the cost of a filling)

 

 What are the cons?

  • The biggest con is that the silver particles in SDF stain the tooth black in areas of decay. The amount of staining depends on the amount of decay in the affected tooth. There will be some temporary staining of the gums near the treatment area, which will resolve over a few days. The gum staining is similar to a henna tattoo, reddish brown in color and lasting for several days.

  • It tastes awful. We do our best to keep it away from your tongue, but we cannot guarantee you won't taste it.

  • SDF is not 100% effective. There are some cavities SDF will not stop. So it requires follow-up x-rays to confirm that the SDF did its job and that the cavities have not grown since being treated with SDF.

  • It must be reapplied at your next cleaning appointment for maximum efficacy.

  • It does not fill in any holes created by the cavity, so you still get food impaction in the treated area, which can lead to gum disease or decay on other teeth. This means it is not a good option for normal permanent teeth on a healthy adult.

 

Is SDF Right for You or Your Loved One?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!  They can discuss the treatment options for each tooth, including which ones could benefit from SDF. 

How Implants Make Dentures Better

How Implants Make Dentures Better

The History of Dentures

More than 36 million Americans do not have any teeth.  Unfortunately, this state, called edentulism, is nothing new.  Teeth have been removed due to decay and gum disease for thousands of years.  People have also been attempting to replace those missing teeth for thousands of years.  There is historical evidence that dentures were made as far back as 700 BC!  Contrary to popular belief, President George Washington’s dentures were not made from wood, but from a combination of carved ivory, human teeth and animal teeth.

The history of dentures has been a long, ever-changing one.  Man has been attempting to improve “false teeth” for thousands of years.  Most of these changes have been in the materials and techniques by which the dentures are made.  In general, dentures have relied on the remaining jawbone for their only structural support.  And as the jawbone continually changes in response to the absence of teeth, maintaining a proper fit with full dentures is a constant battle.  Only in recent decades have we been able to give a full set of dentures something to anchor onto: Dental implants!

The Trouble With Dentures

A traditional full set of dentures has a large acrylic base that holds the false teeth.  This base simply rests on the gums and jawbone remaining in the mouth after all of the teeth have been extracted.  The gum and jawbone remaining after the teeth are pulled are called the alveolar ridge.  The upper and lower jawbones are unique in that their only purpose is to support teeth.  Once teeth are removed, the bone shrinks and recedes because it no longer has anything to hold onto.  This process happens slowly over a period of years.  As the ridge shrinks, there is less and less for the denture to sit on, so dentures become increasingly loose and difficult to wear.  Some people are able to adapt to full dentures and use the muscles in their cheeks, lips and tongue to hold them in place while eating and talking.  However, many people are not able to achieve that level of muscle control and struggle to keep their dentures in place, often suffering difficulty chewing, and embarrassment when talking or laughing.

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Better Dentures 

The solution for this worsening problem with ill-fitting dentures is dental implants.  Dental implants improve dentures in two different ways.
The root form: Dental implants are placed into the jawbone and function similarly to a natural tooth root.  The jawbone responds to an implant the way it would to a tooth root and does not shrink in height or width.  The dental implant acts to maintain the jawbone, giving the denture more surface area of the alveolar ridge to rest on, which is less likely to shrink and change over time.
The abutment: The abutment is the portion of the dental implant system that projects out of the gum tissue.  Abutments come in many shapes in sizes, depending on their purpose.  For the purpose of denture retention, a locator abutment is placed into the implant root form.  The denture contains a cap set into the denture acrylic base for each locator abutment in the jawbone.  There is a range of caps available, giving you and your dentist flexibility in how tightly your denture locks onto the locator abutment.  Because of this locking action, the dentures do not move when you chew or talk! 

 

This is a vast improvement from traditional dentures, which depend on a person’s muscles to hold them in place.  In this scenario, rather than having an acrylic denture base which simply fits over the gums, there are interlocking pieces on both the implant and the denture, creating a secure connection.  This connection eliminates the embarrassment and fear that plagues traditional denture wearers.

Implant-Supported Dentures 

Dental implants, used to support dentures, employ the same technology used for a single-tooth replacement implant.  It begins with 3D imaging for preoperative planning.  Dr. Jason, Dr. Alex and Dr. Serena will work in close collaboration with your oral surgeon to plan the position of the implants for the most optimal support of dentures.  Once the surgical phase is complete, and the implants have achieved adequate stability to withstand chewing forces, Dr. Jason, Dr. Alex and Dr. Serena will fabricate dentures with appropriate attachments to connect securely with your implants.  With implant-supported dentures, any adjustment period is much shorter due to the security and stability of the implant-denture connection.  This creates a level of function far superior to any achieved by traditional dentures.  Patients are more comfortable and more confident with implant-supported dentures.

Do You Have Poorly Fitting Dentures? 

If you are interested in implant-supported dentures, Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Dental Implants: Restoration of a Missing Tooth

Dental Implants: Restoration of a Missing Tooth

A Missing Tooth 

In dentistry, we use the term prognosis to describe how long a tooth will continue to function properly.  That term also encompasses any treatment done on a tooth as a predictor of how long the treatment itself will last and keep the tooth in proper function.  Giving a prognosis of a tooth or treatment is a little like predicting the future.  We are not giving an exact timeline; we are making an educated guess.  We want your teeth and the work we perform on them to last as long as you do!

When a tooth has a hopeless prognosis, the only treatment option is removal of the tooth by extraction.  When a tooth or the proposed treatment to save a tooth has a poor long-term prognosis, we will always give you the option to remove the tooth.  Once the tooth is removed, you will have several options for replacing it.  We believe that your time, effort and money are best invested in something that will last.  The treatment option with the highest success rate for replacing a missing tooth is a dental implant.

Anatomy of a Dental Implant 

One of the reasons a dental implant has such a high success rate is that its anatomy mimics a natural tooth more closely than any other treatment option available in dentistry.  This configuration allows a dental implant to stand alone; it does not anchor or rest on any other teeth the way a bridge or a removable partial does.

A dental implant consists of three parts:

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  1. Implant body - The implant body is the root replacement. It is made from titanium, like implants and prostheses used in other parts of the body. This titanium root form comes in many different sizes, and using our 3D image of your jawbones, we will select the proper size for your specific missing tooth. In some cases, the implant can be placed at the time of extraction, called an immediate implant. In other situations, it is necessary to allow the jawbone to heal for several months between the extraction and the placement of the dental implant. Once the implant has been placed into the jawbone, it must heal for several months, allowing the bone to grow into the threads of the implant form, which is a process called osseointegration. After a minimum of 3 months of healing, we assess the level of osseointegration of the implant to ensure that the implant is stable and ready to withstand chewing forces.

  2. Abutment - The abutment is the connector between the implant root and the dental crown. An abutment can be made from several different materials, as needed for appearance. The abutment is affixed to the implant root with a small screw, and it protrudes from the gums, providing the core structure for a crown.

  3. Abutment-supported crown - An abutment-supported crown is very similar to a traditional dental crown. It covers the entire abutment form to the gumline and restores the natural anatomy of the tooth, enabling you to return to normal function in this area.

 

What Is the Process for Replacing a Missing Tooth with a Dental Implant? 

Visit 1:  Implant Planning

At this visit, images are taken of the proposed implant site, including photographs, dental x-rays, and a 3D CBCT image.  Dr. Jason, Dr. Alex or Dr. Serena will determine the best treatment to restore your missing tooth and discuss the details of the upcoming surgical visit.  They will refer you to a skilled oral surgeon for the surgical placement of the dental implant.

Visit 2: Surgical Placement of the Implant

During the surgical visit, you have the option to be sedated, and if you desire this, please discuss it with your surgeon BEFORE this visit.  You can also elect to have the procedure done with local anesthetic only, meaning you are awake throughout.  Implant placement is a relatively quick procedure and usually causes less discomfort than a tooth extraction, so many people choose to remain awake for this visit.  You should feel only vibration as the site in the bone is being prepared and the implant placed.  You will be given very strict post-operative instructions regarding your stitches, care of the surgical site, and oral hygiene to follow.

Visit 3: Post-operative evaluation

Between one and two weeks later, you will return to the oral surgeon for the removal of any stitches and a post-operative evaluation of the surgical site.  This is typically a very quick visit, and most, if not all, post-operative pain or discomfort has subsided by this time.

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Visit 4: Uncovering and Testing Implant

At three months post-op, the implant will be exposed to the mouth (if it is not already) by removing the gum tissue over it with a dental laser.  If the implant shows the correct amount of stability, we can proceed with visit 5.

Visit 5: Impression for Abutment and Crown 

This visit may be done in combination with visit 4 if the implant has osseointegrated.  An impression is taken of the implant site and the surrounding teeth. The abutment and crown are designed and fabricated by a dental laboratory.  A healing cap may be placed to maintain the position of the gum tissue while the abutment and crown are being made.

Visit 6: Final Placement of Abutment and Crown

When the abutment and crown are completed, the healing cap is removed from the implant, and the abutment and crown are placed.  The abutment is attached to the implant via a small screw, which is torqued to the appropriate tightness.  Dental x-rays confirm the fit of the crown.  Once the crown meets our standards and feels perfect to you, it will be cemented and cleaned.

Do You Have a Missing Tooth that You Would Like Restored with a Dental Implant?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell! They will discuss your treatment options in detail and help you decide if a dental implant is right for you.

Crowns

Crowns

Most people have heard of the terms “crown” and “cap” in regard to dentistry (they are interchangeable, and dentists prefer the term crown), but few actually understand what a crown is.  This blog will explain this, along with why they are necessary, what types of crowns are available in modern dentistry, and what to expect if you are in need of one.

What is a crown?

There are actually two meanings of the word “crown” in dentistry, which can sometimes make things confusing.  We will define both here, and the rest of the blog will pertain only to the second definition.

  1. Crown – the portion of a tooth exposed to the mouth, which excludes the roots (even any root structure that is visible through gum recession). This definition describes an anatomical portion of a tooth. The crown is covered in enamel. Under this definition, every tooth has a crown.

  2. Crown – a dental restoration of a tooth in which all of the enamel has been removed and replaced with a new material. Crowns can be made out of metals, ceramics, or temporary materials. A crown should completely cover the entire exposed portion of the tooth, and the edge (margin) of the crown typically rests near the gum line of the tooth.

 

Why do certain teeth need crowns?

  • Very large cavities – In some cases, the integrity of the tooth is undermined by a very large cavity. Once all of the decay has been removed from the tooth, there must be an adequate amount of solid, healthy tooth structure to support a filling. If there is not enough tooth structure remaining to hold a filling, then the entire tooth must be covered by a crown in order to restore it to its proper shape for chewing. In this situation, if a filling were placed instead of a crown, it could only be considered a short-term solution at best.

  • Fracture – The enamel covering a tooth is one solid, continuous layer. A visible fracture or crack means that the enamel is no longer able to do its job of protecting the tooth from bacteria, food, and chewing forces. Interestingly, cracked teeth do not always cause pain. A crown’s role in “fixing” a cracked tooth is the total replacement of the enamel layer with a new solid, continuous material, which splints the underlying tooth structure together.

  • Lack of adequate coronal tooth structure – Just as a very large cavity can deprive a tooth of the necessary amount of tooth structure, a large filling or even missing tooth structure can do the same. The crown restores the tooth to its original shape, size and strength to provide proper function.

  • Root Canal Treatment – When a tooth has had a root canal, the nerves and blood vessels have been removed from the inner, hollow chamber of the tooth. They are replaced with a filling material called gutta percha. Because the tooth no longer has a blood supply, it no longer has a source of hydration and becomes dried out and brittle. This brittleness makes the tooth high risk for cracking. A crown is placed over a tooth that has had a root canal in order to prevent such cracking so that you can keep the tooth for a long time. A root canal is a significant investment in the life of a tooth. If the tooth is not properly covered and protected with a crown, that investment could be wasted.

What are the different types of crowns?

There are many different materials available for crowns today. Each material has pros and cons, listed below. What is most important is that your dentist select the proper material for each individual tooth. At our Dental Centers in Freeman, Parkston, and Viborg, we prioritize each patient as an individual with distinct and specific needs. You will never get a “one size fits all” recommendation. Our doctors take all of the pros and cons of each material into consideration when selecting the right crown for your particular needs.

Material

Pros

  • Gold

-Requires minimal removal of tooth structure

-Least damage to the opposing tooth

-Studies show best longevity and lowest chance of developing new cavities underneath

  • Porcelain-fused-to-metal

    -Better cosmetic appearance

    -Very durable and strong to withstand chewing forces

  • Zirconia

-Good cosmetic appearance with no dark metal

-Strongest material available, almost impossible to break

-Can withstand heavy clenching or grinding forces

  • All Porcelain

    -Best cosmetic appearance, most like a natural tooth with translucence and shading

    -Can achieve micromechanical bond with tooth structure

Cons

  • Gold

-Metallic appearance, not cosmetic

-Can wear down over time and can develop holes in its surface when worn too thin

-Can cause a reaction in patients with metal sensitivities or allergies

  • Porcelain-fused-to-metal

-Not cosmetic enough for front teeth due to opaque appearance and possible gray line at the gums

-Porcelain can fracture away from the metal

-Porcelain biting surface can damage the opposing tooth

  • Zirconia

-Can sometimes appear opaque

-Require more removal of tooth structure

-Very abrasive and damaging to opposing teeth

-Higher incidence of long-term post-operative discomfort

  • All Porcelain

-Requires most removal of tooth structure

-Most likely to crack or chip

-Porcelain biting surface can damage the opposing tooth

What can I expect at my dental appointment for a crown?

At our Dental Centers in Freeman, Parkston, and Viborg, crowns are made in a dental lab by a professional, certified dental lab technician. In order for a crown to be properly fabricated for your specific needs, you will experience a two-appointment process. At the first appointment, the tooth is prepared for the crown under local anesthetic. You should be numb and experience no discomfort during the preparation process. Once the doctor has achieved the proper preparation for your tooth based on the crown selected, either an impression or a 3D scan is taken. Both of these serve to communicate the exact shape of the prepared tooth from the doctor to the lab. The lab uses this to fabricate the prescribed crown. The process typically takes 2-3 weeks. During that time, you will wear a provisional or temporary crown to replace the enamel and cover the tooth. The temporary crown and your bite should feel comfortable after the initial post-operative sensitivity has worn off (on average, a few days). You will return for your second appointment after we have received your crown from the dental lab. At this visit, the temporary crown is removed, the underlying tooth structure cleaned, and the new crown fitted to your tooth. An x-ray is taken to confirm that the crown fits properly and allows no leaking of saliva or bacteria under the crown. The bite is adjusted, if necessary, and then the crown is cemented onto the tooth. You need to have a little caution when eating and cleaning the new crown for the first 24 hours. Afterward, you return to business as usual, eating and cleaning it like you would a natural tooth.

Want more information about crowns?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Do I Really Need to Have My Wisdom Teeth Removed?

Do I Really Need to Have My Wisdom Teeth Removed?

Tuesday, September 12, 2017

Does everyone need to have their wisdom teeth removed?  Not necessarily.  There are many criteria that dentists evaluate to determine whether or not a patient’s wisdom teeth need to be removed.  There are also different criteria that we use to determine when they should be removed.  As with any type of medical procedure, there are risks and benefits, and we always weigh the risks vs. benefits to determine if the procedure is right for each specific person.

What are wisdom teeth?

Wisdom teeth are the third set of permanent molars in an adult mouth.  The first molars come in, or erupt, at about age 6-7 years, so they are also referred to as 6 year molars.  The second molars erupt at about 12 years of age and are also called 12 year molars.  If third molars erupt at all (many do not; instead they stay hidden under the gums), it’s typically between ages 18-25, so they’ve earned the nickname “wisdom teeth”.

Who can keep their wisdom teeth?

Unfortunately, not many people fall into the category of those who can keep their wisdom teeth with minimal risk of future problems.  In order to keep wisdom teeth with the least risk of cavities and gum disease, people need to have:  1) very large jaws with enough room for the wisdom teeth to fully erupt (come through the gums into the mouth), 2) wisdom teeth that are erupting in the correct alignment with the rest of the teeth, and most importantly, 3) great oral hygiene.  The average adult jaw does not have enough space behind their second molars for another molar to naturally reach the correct position for chewing and proper cleaning.

What are the risks of keeping wisdom teeth?

Assuming wisdom teeth have enough space and do come into their correct position behind the second molars, they are located in an area that is very difficult to keep clean.  Even the best brushers and flossers have trouble reaching the back of a wisdom tooth.  This leads to an accumulation of plaque and bacteria and food debris, which in turn, leads to tooth decay and gum disease.    This accumulation of bacteria also predisposes the adjacent second molar to both cavities and gum disease. 

When wisdom teeth do not have enough space to fully erupt into the appropriate location, several problems can occur.  If the location of the tooth causes it to be partially covered by gum tissue, there is a very high risk of pericoronitis, an inflammation of the gum tissue that surrounds and often lays over the top of the tooth.  Because this partial covering creates a pocket where plaque and food can collect, painful inflammation easily develops, and can even lead to an infection.

When wisdom teeth are positioned at an angle, they are unable to erupt into the mouth (this is referred to as “impacted”) and can damage the adjacent jaw structures, as well as any adjacent teeth.  When this occurs, often both the second and third molars have to be extracted. 

Why take wisdom teeth out preventively?

If your dentist determines that you are at risk for any of the problems noted above, she will recommend preventive extraction of the wisdom teeth and refer you to an oral surgeon.  This prevents potential pain and suffering from problems with the wisdom teeth themselves, and also protects the second molars from the higher risk for cavities and gum disease associated with the presence of wisdom teeth.

Why so young?

Teeth form from the biting surface down toward the roots.  At age 18, a wisdom tooth is much smaller than it is at age 25.  Earlier extraction of wisdom teeth means the removal of a much smaller tooth.  This results in smaller surgical site, smaller extraction sockets, quicker healing, and lowest risk of future infections.  Later extraction, after the tooth has fully formed roots, leaves the patient with a larger surgical site, a larger socket, and longer healing time.

Still have questions about your wisdom teeth?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Invisalign

What is Invisalign®? 

Invisalign® is a method of straightening teeth that does not require metal brackets or wires.  It consists of a series of removable clear plastic aligners (or trays) that are custom made for each individual’s teeth.  When a patient decides to straighten their teeth with Invisalign®, Dr. Aanenson makes a personalized treatment plan for his or her orthodontic needs.  This unique plan is communicated to the AlignTech® laboratory, where each aligner is fabricated via CAD/CAM technology.  The aligners are virtually invisible, and it is one of the most esthetic ways to straighten your teeth.

What are the advantages of using Invisalign® to straighten teeth?

Aside from the obvious cosmetic advantages, Invisalign® provides the patient with the ability to clean the teeth much more easily than in traditional braces.  Because the aligners are removable, they are simply removed for a normal, good oral hygiene routine that includes mouthwash, brushing and flossing.  With traditional braces, adjunctive products such as special flossers, interdental brushes or picks or Waterpik tools are often needed to keep the teeth free of food debris and bacterial plaque.  The Invisalign® aligners make perfect custom whitening trays, so you can whiten your teeth while you straighten them.  The aligners can also be removed for special occasions like weddings, photo sessions, speeches, etc…

What are the disadvantages of using Invisalign® to straighten teeth?

Like the advantages, the disadvantages also stem from the fact that the aligners are removable.  Unlike braces and wires, which cannot be removed by the patient, Invisalign® aligners can be taken out at any time.  This means that the success of treatment depends on patient compliance.  If the aligners are not worn for at least 22 hours per day, the teeth will not move as prescribed by your dentist.  There are times when the orthodontic movement of teeth can cause discomfort or tooth pain.  This makes it very tempting to remove the aligners for relief from the pressure being put on the teeth.  There are many people who do not achieve a successful result with their Invisalign® treatment because they do not wear the aligners as prescribed.

How does it work? 

Through the use of its patented design, Invisalign® aligners move your teeth through the appropriate placement of controlled force.  To put it simply, Invisalign® moves teeth by pushing them into the desired position.  Invisalign® not only controls the amount and direction of force, but also the timing of the force application.  This means that your dentist can prescribe exact movements for each individual tooth, including which teeth not to move, like implants or teeth that are part of a cemented bridge.  Certain teeth can be held in place while others are being moved.

Why do some people get Invisalign® and others get braces? 

There are some limitations to the type of tooth movements Invisalign® can accomplish, and not every patient is a candidate for straightening their teeth with Invisalign®.  An orthodontic evaluation of your teeth is necessary to determine if your goals will be met by using Invisalign®.   

What is the cost?

For Invisalign® treatment, the cost varies depending on the length of treatment and is similar to the cost of traditional orthodontics.  Once Dr. Aanenson has done a thorough orthodontic evaluation, he will estimate the length of treatment and number of aligners required to meet your goals. 

Does my dental insurance cover Invisalign®? 

Many dental insurance companies do provide coverage for Invisalign®.  It is claimed as a benefit for Adult Orthodontics and typically ranges from $1500-2500.  To find out if you are covered, you can call your dental insurance company and ask if you have adult orthodontic coverage.  Teenagers are often covered under their insurance plan’s orthodontic benefits, up to a certain age limit, which varies depending on your specific insurance plan.

How long will it take to straighten my teeth?

Treatment time varies based on how much movement is required to achieve your goals and how compliant you are with wearing the aligners for at least 22 hours per day.  New studies suggest that each aligner may be worn from 7-14 days.  This range means that some patients may achieve quicker results than others.  Average treatment time for an adult is about 12-18 months. 

How often do I have to see the dentist during treatment?

After treatment has begun, your dentist will typically see you every 6 weeks, which means you will wear three sets of aligners between each visit.  Sometimes more frequent appointments are required to monitor the progress of the teeth.

What are the eating and drinking restrictions during Invisalign® treatment?

Because aligners can be removed for eating and drinking, there are no restrictions to what you can eat or drink when the aligners are not in your mouth.  You can eat with the aligners in, and the chewing force actually contributes to tooth movement.  It is important that you do not drink anything besides water with the aligners in.  Because the aligners keep your saliva from properly bathing the teeth, any acid or sugar from a beverage could be trapped under the aligners and increase the likelihood of cavities. 

Why now?

 There is no better time to straighten your teeth than now!  Over time, teeth continue to shift and move, and most problems are aggravated as we age.  Spacing between teeth continues to increase so gaps get noticeably larger.  Crowding on upper and lower front teeth typically gets worse so teeth appear more and more crooked.  Straightening teeth earlier, rather than later, allows for shorter treatment time and more time to enjoy your new, beautiful smile. 

Interested in learning more about Invisalign®?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your Invisalign consultation today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

TMJ Disorder and Dysfunction

TMJ Disorder and Dysfunction

What is TMD?

TMD stands for TemporoMandibular Disorder or Dysfunction. People commonly refer to this as "TMJ". TMJ actually means TemporoMandibular Joint, and we all have two TMJ’s. TMD is what dentists refer to when the joint has a problem. There are many different types of problems and different levels of severity of these problems.

What is TMJ?

TMJ is the TemporoMandibular Joint, which connects your lower jaw to your upper jaw. It is a ball and socket joint, and it is the most complex joint in the body because it is the only joint in which the ball comes out of the socket during normal function. Anytime you open to speak, yawn, chew or laugh the joint must move within the socket and many times out of the socket. The joint involves two bones (the ball and the socket, anatomically named the condyle and the fossa) separated by a cartilage disc. The disc is held in place by ligaments and muscles.

 How does TMD happen?

There are many reasons for TMD to happen. One of the most common reasons is damage to the muscles and ligaments that hold the disc in position. The muscles and ligaments work to maintain the disc’s position within the joint space during function. If the muscles or ligaments are put under pressure or torqueing forces, damage to the joint can occur. These pressures can develop from many causes; some of these include trauma to the head and/or neck, functional habits like clenching or grinding of the teeth, or posturing the jaw into abnormal positions.

What does it mean to be high risk?

If you are high risk, you show signs that the muscles, ligaments, or disc may be in a vulnerable state or have suffered damage in the past. When there is vulnerability and/or damage, it is necessary to diagnose and stabilize or treat the joint and supporting structures, including the teeth. Some of the risk signs include, but are not limited to:

  • Flat spots on the teeth (wear facets)

  • Enlarged jaw muscle size

  • Presence of a line on the inside of the cheek (linea alba)

  • Joint sounds, including popping or crunching/gravel-like noise with or without pain

  • Asymmetry of the face structures or asymmetry during opening or closing

  • Scalloping of the tongue

  • Tenderness of the jaw muscles

  • Headaches in the temples

  • Tenderness in the ear, ringing of the ear

  • Gum recession or tooth notching at the gum line

  • Anterior open bite; the front upper six teeth do not overlap the lower front six teeth

What can I do about it?

Diagnosis for TMD is similar to diagnosis for any other joint problem. It is essential to acquire radiographic images of the bones and MRI images of the soft tissue and disc in order to determine the condition of the joint. These images need to be interpreted by a radiologist trained in TMD. In addition to 3D imaging, we use models and photographs of the teeth to aid in the diagnosis of the joint condition and how it has affected your bite. This allows us to correlate the 3D images with the evidence in your mouth.

What treatment will I need?

Treatment for TMD varies greatly. Like damage to the knee, some injuries require surgery. More moderate injuries and concerns can sometimes be treated with oral appliances, orthodontics, physical therapy and/or medication. In order to determine what treatment best suits you, a proper diagnosis with radiographs, MRI, models and photographs is the key.  Without the correct diagnosis, it is impossible to determine what treatment is right for your joint condition.

How do I get started?

If you would like to get a complete diagnosis of your TMJ condition, you will need to complete three steps:

  1. Photos, dental models and MRI bite registrations completed.

  2. CBCT radiographic image taken in our office and interpreted by our doctors.

  3. MRI imaging with bite registration. Referral to an imaging center and interpreted by a medical radiologist.

What if I don’t do anything?

Without treatment, a very high percentage of high-risk joints progress to a degenerative state over time. This can include loss of the disc (similar to a slipped disc in the back), arthritis, and changes in the occlusion of the teeth (bite). Many people without treatment develop chronic neck and jaw pain.  Other patients will adapt to the dysfunctional joint.  It is impossible to predict how TMJ dysfunction will affect a person over the course of his or her life. 

Need more information?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your TMJ consultation today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

 

Athletic Mouthguards

Athletic Mouthguards

People say that having children involved in sports is expensive.  In dentistry, we commonly see one of  the most expensive aspects of sports: injuries.  The bad news is that the injuries themselves are sometimes unavoidable.  The good news is that the damage to the teeth, gums, lips, cheeks and jaws associated with sports injuries is largely preventable by wearing an athletic mouthguard.

Sports injuries to the face are very common and very expensive.  A research study on the use of athletic mouthguards cited some interesting statistics.

“The U.S. surgeon general’s report on oral health identified sporting activities as one of the “principal causes of craniofacial injuries.” Studies have linked sporting activities to nearly one-third of all dental injuries, and approximately one in six sports-related injuries is to the craniofacial area.”

Who needs an athletic mouthguard?

Most people associate sports injuries to the teeth with contact sports like football and hockey.  Interestingly, even non-contact sports such as baseball, gymnastics and cycling have a high incidence of injuries to the mouth.  If there is any chance you could be hit in the mouth by another person, a ball, or the ground, then you need an athletic mouthguard.

How do athletic mouthguards work?

Mouthguards work to prevent or lessen the severity of many types of damage to the mouth that can occur during a sports injury to the face and jaws.  They function by covering the teeth, separating the lips and cheeks from the teeth, and separating the upper and lower teeth from each other.  These three mechanisms of action are listed below with which types of injuries they can prevent or lessen the severity.

1.  Covering the teeth - This covering prevents or lessens the severity of various injuries to teeth.  Examples of injuries to the teeth during sports include:

  • Chipping

  • Luxation (forced movement of the tooth out of its natural position)

  • Root fractures

  • Avulsion (a tooth is knocked completely out with the entire root)

  • Intrusion (a tooth being forced into its socket so that it looks shorter than normal)

  • Necrosis (death of the nerves and blood vessels inside a tooth from blunt force)

2.  Separating the lips and cheeks from the teeth – This separation prevents or lessens the severity of various injuries to the soft tissues of the mouth. 

  • Cuts or lacerations to gum tissue, lips, cheeks, and intraoral muscle attachments

3.  Separating the upper and lower teeth from each other - This separation prevents or lessens the severity of various injuries to the teeth and jaw joints by preventing a harsh impact of upper and lower teeth and jaws.

  • Condylar fractures – The condyles are the “balls” of the ball-and-socket jaw joints. A sharp impact between the upper and lower jaws can cause a fracture of the jaw bone just underneath the condyle.

  • Dislocation of TMJ (jaw joint) disc – The jaw joints each contain a small cartilage disc that separates the ball from the socket. When the lower jaw is hit with an impact, it can force the condyle (ball) off its correct position on the disc. This leads to TMJ dysfunction and may require surgical intervention to repair.

  • Broken back teeth – Any time the upper and lower teeth are forced together with high forces, the back teeth can crack and break. Sometimes, they can be repaired through dental restorations; in other cases, the tooth has a hopeless long-term prognosis and must be extracted.

An important thing to note is that these problems can have long-term consequences requiring dental treatment for decades after the injury. 

What types of athletic mouthguards are available?

There are three main types of mouthguards: stock, boil-and-bite, and custom.  The stock and boil-and-bite type mouthguards are available over the counter, and a dentist makes the custom mouthguard.  Because a custom mouthguard is made from a model of a patient’s teeth, it will have a better fit and should be very comfortable.  There is typically a direct correlation between cost and comfort; i.e. a stock mouthguard will be very inexpensive and very uncomfortable.  The more comfortable a mouthguard is, the more likely the athlete will be to wear it regularly. 

How do I take care of my athletic mouthguard?

Do not clench on the mouthguard or chew it while you are wearing it.  This will speed up the normal wear and tear and cause you to need a replacement much sooner than average.

After every use, rinse it.  The best thing to do is to clean it with a soft toothbrush and cold water.  You can use liquid hand soap if necessary. 

When not in use, store it in its vented case in a cool, dry area.

Do not allow it to get hot because it will lose its shape.  This includes leaving it in your car!  

Do you or your child need an athletic mouthguard?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Crest Sensi-Stop Strips

Crest Sensi-Stop Strips

Who needs Crest Sensi-Stop Strips?

Sensitive teeth can be annoying, causing you to avoid certain foods or drinks, changing the way you chew or swallow, and even interrupting a conversation because you are in discomfort.  This blog highlights one of our favorite over-the-counter products that can help alleviate this common problem.

 {Disclaimer: Sensitivity to hot and cold temperatures or sweets can sometimes indicate that a tooth has a cavity or a crack.  It is important to see Dr. Aanenson and Dr. Kuiper to confirm that this is NOT the case before proceeding to over-the-counter relief products.  Please scroll down to read our previous blog about Sensitive Teeth.}

 

How are Crest Sensi-Stop Strips different from other products?

There are many over-the-counter products available, mostly toothpastes like Sensodyne, which contain the ingredient potassium nitrate. Potassium nitrate is an effective desensitizer in some cases and must be applied to the teeth regularly to achieve the desired desensitizing effect.  In most cases, you need to use the sensitivity toothpaste twice daily for at least two weeks before you will notice any relief in sensitivity.  Crest Sensi-Stop Strips are unique in their active ingredient, the method of application, and the length of sensitivity relief they provide.

 

How do Crest Sensi-Stop Strips work?

Most tooth sensitivity is caused by gum recession, which exposes the roots of teeth. Tooth roots should be covered by gum tissue and insulated against the hot and cold temperatures of food and drinks that we consume.  When gums recede, the root structure is exposed to those temperatures, and in some cases become very sensitive.  The active ingredient in Sensi-Stop strips is oxalate, a chemical that has been proven to fill in the open tubules (pores) on exposed root surfaces, thus eliminating the transmission of hot or cold temperatures to the nerve inside the tooth.

They also use a unique delivery method: the same type of strip everyone knows as Crest Whitestrips. Instead of a whitening gel, the strips are coated in an oxalate-containing gel.  This allows them to be effectively applied directly to the area of sensitivity.  They cover about three teeth and should be left in place for 10 minutes.  For the best results, they are applied to the sensitive teeth for 10 minutes per day, 3 days in a row.  This technique has been shown in clinical studies to provide at least a month of relief from sensitivity to hot and cold temperatures, sometimes even longer!  When you notice the sensitivity returning, simply use the strips again.

 

When should I use Crest Sensi-Stop Strips?

You can use them anytime you feel sensitivity on your teeth.  Make sure to follow the instructions.  You should not use them more than 3 times on the same site in less than 1 month.  If you did not experience any relief of the sensitivity in that area, you should contact Dr. Jason, Dr. Alex or Dr. Serena to discuss the issue.

These can be especially useful for people who dread getting their teeth cleaned because of the sharp pain caused by cold air or water used by your dental hygienist. If you have experienced this, try using a Sensi-Stop strip over the sensitive area 1-3 days prior to your dental cleaning.  Let your dental hygienist know that you have tried them and whether or not you notice a difference.

 

Need more information?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Dental Sealants

Dental Sealants

What are dental sealants? 

Dental sealants are a protective barrier, covering the most vulnerable surface of the teeth and shielding them from cavity-causing bacteria. The sealants are most commonly applied to the chewing surfaces of the back teeth (premolars and molars) where decay occurs most frequently.  They can also be applied to any deep pit or groove that is high risk for decay, including the back of upper front teeth.

How does a sealant help prevent decay?

A sealant is a dental material that is applied to the chewing surfaces of the back teeth—premolars and molars. This material has a micromechanical bond to enamel in the deep pits and grooves of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque, bacteria and acids.

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But in some cases, toothbrush bristles cannot reach the depth of pits and grooves to extract food and plaque. Sealants protect these vulnerable areas by filling in the grooves to prevent any accumulation of bacteria, plaque or food, and by creating a shallower, more cleansable surface for the toothbrush.

Is sealant application a complicated procedure?

Sealants are easy for your dentist or dental hygienist to apply, and it takes only a few minutes to seal each tooth. The teeth that will be sealed are cleaned. Then the chewing surfaces are roughened with an etching solution to help the sealant adhere to the tooth. The sealant is then “painted” onto the tooth enamel, where it bonds directly to the tooth and hardens. Sometimes a special curing light is used to help the sealant harden.

The only difficult aspects of sealant application are the bad taste of the materials used and the need to keep the tooth dry.  If a child is very cooperative, the sealant can be applied without his or her ever tasting the materials.  There is no pain associated with the application of a sealant.  

Sealants are just for kids, right? 

The likelihood of developing pit and fissure decay begins early in life, so children and teenagers are obvious candidates. Children typically do not have the manual dexterity necessary to adequately clean their teeth, so they are at a higher risk of developing cavities.  Adults can benefit from sealants as well.  An easy way to determine where a sealant would be most beneficial for an adult is to look for dark stains in the pits and grooves of the teeth.  A deep crevice that is accumulating stain which cannot be removed by brushing is a high-risk area for a cavity to start.  If it is collecting stain, it is also collecting bacteria.  Over a period of time, the bacteria is very likely to start damaging the enamel surface, leading to a cavity. 

“CDC Promotes Dental Sealants in New Report

According to a new U.S. Centers for Disease Control and Prevention (CDC) Vital Signs report, dental sealants are an extremely effective intervention for preventing most of the cavities children get in their permanent back teeth, but the majority of children still don’t have them. The report also found that children from low-income families, who are at increased risk for cavities, are less likely than children from higher-income families to have dental sealants. Increasing sealant use prevalence could substantially reduce untreated decay, associated problems, and dental treatment costs, the CDC report concludes.

Additional findings of the report include:

  • School-age children (ages 6-11) without sealants have almost three times more first molar cavities than those with sealants.

  • Although the overall number of children with sealants has increased over time, low-income children are 20 percent less likely to have them and two times more likely to have untreated cavities than higher-income children.”

Sounds great! Can I have dental sealants on all of my teeth?

Once a tooth already has decay, it cannot be sealed.  The decay must be removed and restored with a filling.  A one surface filling to fix this type of cavity costs over $200.  Placing sealants can prevent this type of decay, decreasing your costs for dental care in the long run.  A thorough evaluation of all of your teeth should be performed by your dentist to determine which teeth could benefit from sealants. 

Do sealants last forever?

As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. They can be damaged by habits such as teeth grinding and chewing ice.  During your dental evaluations, Dr. Jason, Dr. Alex and Dr. Serena will confirm the effectiveness of the sealants and reapply them when necessary.

Need more information?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Periodontal Disease: What Does it Mean to be High Risk?

Periodontal disease: What does it mean to be high risk?

What is periodontal disease? 

Periodontal disease is a disease that affects the structures supporting the teeth, including both the gums and the jawbone.  Its primary cause is bacterial buildup on the teeth, and some people have a higher risk due to genetic factors, systemic disorders (such as diabetes), and habits (such as smoking or oral tobacco use). 

What are the stages of periodontal disease?

The earliest stage of periodontal disease is called gingivitis, which means inflammation of the gums.  Inflammation can involve one or more of the following:

  • A bright red color to the gums

  • Swollen or puffy gums

  • Gums that bleed easily when brushing, flossing or having teeth professionally cleaned

 How does periodontal disease happen?

Periodontal disease begins with the accumulation of bacteria and plaque on the teeth.  This can be due to poor oral hygiene, and it can also be due to the presence of very difficult-to-clean areas on your teeth.  When teeth are crooked or rotated, they collect more bacteria.  We all have different types of bacteria in our mouths, and some types are more destructive than others, meaning they are more likely to cause disease.  Research studies show that the types of bacteria that gather on crooked teeth are more likely to cause periodontal disease than the types of bacteria that collect on straight teeth.  Periodontal disease progresses as the bacteria and plaque harden on the teeth into tartar, which can only be removed with a professional cleaning.  If no professional dental care is completed, the tartar accumulation will grow, causing more inflammation and more serious damage to the gum and bone.  In severe periodontal disease, the supporting structures have become so damaged that they can no longer hold the teeth, which become loose and have to be extracted.

What does it mean if I am high risk?

If, during your evaluation, you presented with some signs of gingivitis, you would be classified as high risk for periodontal disease.  As stated earlier, gingivitis is the first step to periodontal disease, and if left untreated, it can lead to a progression of disease.  The good news is that in the early stages, periodontal disease is completely reversible!

Risk factors noted during a clinical evaluation:

  • Pockets measuring ›3mm

  • Poor oral hygiene

  • Crowded teeth

  • Prior periodontal disease

  • Bone loss

  • Mobility (loose teeth)

  • Gum recession

  • Mucogingival defect (gum tissue that is not attached to the bone underneath it)

  • Abnormal frenum attachments

What can I do about it?

  1. Have a professional dental cleaning. This removes the bacterial accumulation from the teeth, essentially giving you a “clean slate”.

  2. Change your oral hygiene routine as directed by your dentist or hygienist. This may involve different toothbrushing techniques, an electric toothbrush, consistent flossing, interdental brushes, etc . . .

  3. If prescribed by your dentist, begin an antibiotic mouthrinse daily. The more bacteria you kill, the less there are to accumulate on your teeth.

  4. Return for a follow-up professional cleaning in 6-8 weeks. This allows us to assess the home care, suggest any positive changes to be made, and again remove bacteria that have accumulated.

What if I don’t do anything?

Without treatment, bacterial levels will increase, causing more accumulation of plaque and tartar.  More plaque and tartar causes more inflammation and response from the gums and bone.  As the bone migrates away from the tartar buildup, which it considers a foreign substance, the support for the teeth is slowly lost.  In a worst case scenario, untreated periodontal disease eventually leads to loss of all teeth and loss of the underlying jawbone, which makes future treatment with either dentures or dental implants less predictable.

Need more information?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!

Root Canal Treatment

Root Canal Treatment

What is a root canal? Teeth are hollow, and the hollow space contains the nerves and blood vessels of the teeth, also called the pulp.  The internal chamber or hollow space containing these nerves and blood vessels inside the tooth is the root canal. 

 

What is root canal treatment?  Root canal treatment is a dental procedure that involves removing the nerve tissue and blood vessels from the root canal inside the tooth and sealing the cleaned space with a root canal filling material. 

 

Why is it necessary?  A root canal is necessary when the pulp becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep cavities, repeated dental procedures on the tooth, faulty crowns, or a crack or chip in the tooth. In addition, trauma to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.   

Why might I be referred to a specialist? 

 Dr. Jason, Dr. Alex and Dr. Serena will closely evaluate the affected tooth to determine which treatment will give the best long-term prognosis.  In some cases, root canals should be performed by an endodontist (root canal specialist) with the aid of an operating microscope, which allows them to visualize the internal surfaces of the roots.  These are especially important in the diagnosis of root fractures, which can cause root canals to fail in the future.  Left undiagnosed, a root fracture can lead to repeated treatment on a tooth that has a poor or hopeless long-term prognosis.

 Is a crown necessary to cover the tooth after root canal treatment?  

Yes.  A root canal treatment removes the nerves and blood supply from the internal chamber of the tooth.  With no blood supply, teeth become brittle and can easily fracture.  A crown is necessary to protect the tooth.  If the tooth is not adequately covered, it could crack and need extraction despite having the root canal treatment.  Ideally, the crown should be placed within 30 days of the root canal treatment.

 What is an alternative to root canal treatment?  If the nerve inside a tooth is irreversibly inflamed, infected, or dead, the only alternative to a root canal treatment is extracting the tooth.  Most teeth can be restored with a dental implant after extraction if the proper planning is done before the tooth is extracted.  Please ask Dr. Jason, Dr. Alex or Dr. Serena for more information if you do not wish to save the tooth with a root canal treatment.

 

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to schedule your appointment today with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell!