Back to Basics

Back to Basics:

As dentists, our job is to properly communicate various dental issues and recommendations with our patients.  To improve our communication, it helps you to know some of the terms we use in describing some of the anatomy of the oral cavity, the problems that candevelop, and the steps you need to take to fix them.

Dr. Aanenson

The Anatomy of a Tooth:

 

  • Enamel – Enamel is the hardest structure in the human body, and it covers the external surface of each tooth.

  • Dentin – Dentin is the structure that lies between the enamel and the pulp. It forms the core substance of the tooth. It is softer than enamel and darker yellow in color. Dentin is responsible for giving teeth their color, and every person’s is different.

  • Pulp – Pulp is the collection of blood vessels and nerves inside the hollow chamber of a tooth.

  • Crown – The crown is the portion of the tooth that protrudes out of the gums. You could also describe the crown by stating that it is the part of the tooth that you can see. Enamel is only found on the crown of a tooth.

  • RootThe root of the tooth is the portion anchored into the jawbone. Each tooth has a different shaped root. Molars have multiple roots, and the shape of the root is important in the tooth’s stability in the bone.

 

Dr. Aanenson

Other Dental Terms Defined:

What is a cavity?  A cavity, or tooth decay, is the destruction of enamel and dentin by bacteria in your mouth.  The bacteria in your mouth eat sugar and produce acid as a by-product.  When the acid is allowed to stay in contact with the tooth surface for an extended period of time, it begins to eat its way through the enamel.  Once it passes through the enamel layer, it begins to spread through the dentin.  If the decay isn’t stopped, it will extend all the way to the pulp.  Once it reaches the pulp, the nerves and blood vessels become infected.

What is a filling?  When a cavity is removed from a tooth, the dentist ensures that he has removed all unhealthy enamel and dentist, leaving only solid, healthy enamel and dentin.  This cavity removal process creates a hole in the tooth.  The dentist repairs this hole by filling it with a dental restorative material to restore the normal shape, size and contour of a tooth.  This allows you to use the tooth for normal function again.

What is a composite?  Composite is a type of dental filling material.  It is a resin polymer that forms a bond to the tooth structure.  Composite requires a blue light to “cure” it (harden it after it has been formed to the proper shape).

What is plaque?  Plaque is a soft material that accumulates on the teeth every single day.  Plaque is made up of food particles, bacteria, and minerals present in your saliva.  Plaque is easily removed with a SOFT toothbrush and floss, and it is attracted to rough surfaces.

What is tartar?  Tartar, also called calculus, is a hard material that forms on the teeth from plaque that is not adequately removed.  When plaque stays on a tooth surface for more than 24 hours, it begins to calcify or harden.  This hardened substance is impossible to remove with a toothbrush or floss.  It can only be removed by being scraped off by a dental hygienist or dentist.  Tartar that is not removed causes periodontal disease.

What is gingivitis?  Gingivitis, also called gum disease, is an inflammation of the gums, and it is almost always caused by plaque and/or tartar buildup at the gumline of the teeth.  Gingivitis is characterized by swollen, red, painful or bleeding gums. 

Dr. Aanenson

  What is periodontal disease?Periodontal disease, if left untreated, will cause you to lose your teeth.  When tartar accumulates on the teeth, it irritates the gum tissue and bone that help hold the tooth in place.  This irritation, over time, causes destruction of the bone, which results in a lack of stability for the tooth.  If periodontal disease is caught in its early stages, it can usually be easily treated in your dentist’s office.  More advanced stages may need to be treated by a specialist called a periodontist.  Periodontal disease can be “silent”, not causing any pain or discomfort, so it is important to see your dentist regularly. 

What is bruxism?  Bruxism is the term dentists use to describe the habit of clenching or grinding your teeth.  It can occur at night or during the daytime, and it leaves noticeable signs inside your mouth.  Your dentist can tell if you have this habit.

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!

Spring Cleaning

Spring Cleaning

Spring has sprung!  This time of year is a time for new beginnings and fresh starts.  Trees are budding, and flowers are in bloom.  Most people are familiar with the concept of spring-cleaning.  We clean out our closets and our flowerbeds.  We throw out things we do not use anymore. 

Obviously, spring-cleaning carries with it the idea of cleaning up the things to keep.  It also implies cleaning out things that are past their usefulness. 

When you spring-clean, you strive for a clean slate, bringing things back to a state that is more easily maintained so that they stay cleaner for longer.

As your dentists, of course we want you to apply this concept to your mouth!

Spring Cleaning for Your Mouth

Cleaning Up the Things to Keep

We want you to keep your teeth.  Forever.  We want your teeth to outlast you!  In order to keep your teeth for the rest of your life, they must have healthy gums and supporting bone.  They also need to stay cavity free.

The key to keeping teeth free of decay with healthy gums and bones is keeping them as clean as possible.  There are two essential steps you must take to keep your mouth clean.

Professional Teeth Cleanings – To achieve a perfectly healthy mouth, it is absolutely necessary for you to have professional teeth cleanings on a consistent basis.  Our wonderful dental hygienists are masters at removing every trace of bacteria from your teeth and gums.  No matter how diligent you are, you can never clean every bit of plaque and tartar on your own at home.  Professional teeth cleanings are a must for a clean mouth.

  • Interval of Teeth Cleanings – All men are not created equally when it comes to plaque and tartar buildup. We are all unique, with specific risks and needs. For this reason, some people need to have professional teeth cleanings at different intervals than the average of six months. Ask your dentist and dental hygienist which interval will give you the healthiest outcome!

Great Home Care – As amazing as our hygienists are, they cannot do all of the work for you.  Their job stops when you walk out of our doors, and the ball is then in your court.  They leave you with a clean slate and all the information you need to keep it clean.  If you have a particularly difficult area to clean on your own, ask your dental hygienist.  They each have customized ways of teaching you how to clean your teeth to the best of your ability.  Follow this regimen for great home care.

  • Brush twice daily with a fluoride toothpaste after breakfast and before bedtime. If possible, use an electric toothbrush, which is proven to remove more plaque buildup than a manual toothbrush.

  • Floss every night before bed. Brushing alone does not get the job done. Flossing is the only way to remove plaque and food debris from between the teeth.

  • Add a mouthwash to your daily routine. There are so many different types of mouthwash available today, and they have different purposes. Ask your hygienist which type is best for your specific needs.

 

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 Cleaning Out Useless or Obsolete Things

Okay, this may seem like a strange concept when applying it to your oral health.  We have two ways that you should “clean out” things related to your mouth.

  1. Throw Out Your Toothbrush – Toothbrushes are wonderful tools that have greatly improved dental healthcare. But they do not last forever. If yours is frayed or splayed or otherwise “worn out”, toss it. For electric toothbrush users, buy the replacement heads, and throw this one out. Old toothbrushes can harbor bacteria and even grow mold. Once the bristles are worn out, they may not even touch the tooth surface as they should.

  2. Take a Tip from Marie Kondo – The bestselling author of “The Life-Changing Magic of Tidying Up” has a unique tactic for cleaning out your closet. Hold up an item and think about how it makes you feel. If it does not bring you joy, get rid of it. If we were to apply that tactic to your mouth, what would you get rid of? Is there an old discolored filling that you hate? Do you have a tooth that you try to hide when you smile? If there is something in your smile that does not bring you joy, please schedule a consultation with Dr. Jason, Dr. Alex or Dr. Serena to discuss how we can change that for you.

 

Maintaining a Clean Mouth

Have you noticed the phenomenon that it is much easier to keep something clean once it is clean?  The fact that the countertops are free of clutter makes you want to keep any clutter from building up. 

The same is true for your teeth.  The feeling of a perfectly clean mouth just after your professional teeth cleaning is so good that you are more motivated to follow a great home care regimen.  Don’t let that momentum fizzle out.  Commit to keeping up that great home care routine so that your “spring clean” lasts all year!

Do You Need a “Spring Cleaning”?

It is time for a fresh start!  Call our offices at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) today to schedule your professional teeth cleaning with our fabulous hygienists or a consultation with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell.

Sparkling water

Sparkling Water: A Surprising Cause of Cavities

 

Most people know that foods and drinks high in sugar can cause cavities.  It is common knowledge that sodas and candy are bad for your teeth. What many people are unaware of is that sparkling water can also damage the teeth.

Due to an increase in its popularity in recent years, we are frequently asked about sparkling water (carbonated water) and whether it can damage your teeth.  Although most sparkling water contains nothing more than carbonated water (perhaps with a few minerals) and natural flavors, most people do not expect it to be as acidic as soda, which typically contains phosphoric acid. Unfortunately, sparkling water is very acidic due to the carbonation process, which forms carbonic acid.

Yes, Sparkling Water Can Harm Your Teeth!

A group of researchers at the University of Birmingham in the United Kingdom wanted to find out if sparkling water could cause enamel erosion.

First, they measured the pH of various sparkling waters and found a pH of around three (ranging from 2.7-3.4). This pH level is just as low as most sodas!

This research group took some extracted teeth and placed them in glasses filled with different types of flavored carbonated waters. They found that the sparkling water does erode away tooth enamel.  In fact, they found that flavored sparkling water has as much or more of an erosive effect on teeth as orange juice, which is known to be very damaging to teeth.

The following is what this group of researchers concluded:

"Flavored sparkling waters should be considered as potentially erosive, and preventive advice on their consumption should recognize them as potentially acidic drinks rather than water with flavoring."

In other words, sparkling water can erode your tooth enamel and should not be considered “water” at all. Rather, it is more appropriately classified as an “acidic drink”. 

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 What does this mean for your teeth?

Enamel is the hardest substance in the human body.  It is a protective coating over the core nerves and blood vessels in our teeth.  The purpose of our teeth is to chew food; the enamel serves to withstand the mechanical and chemical forces that teeth are subjected to as they do that job.  Anything that softens, erodes, or breaks enamel is bad because it weakens the tooth.  Enamel erosion makes it easier for the bacteria in our mouths to cause cavities and can cause major breakdown of your teeth, which causes the need for more dental work in your future.

A healthy mouth has a pH level slightly above neutral (7.0).  Anything below neutral is an acid.  Enamel begins to soften or demineralize at a pH of 5.5 or below.  Many of the things we eat and drink are lower than 5.5 pH.  In a normal, healthy mouth, saliva can act as a buffer and bring the pH back up to neutral once the acid is gone (i.e. once you have stopped eating or drinking).

What should you do?

 

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  • Be aware of the sparkling water that you consume. Some sparkling waters are flavored with citrus flavorings such as lemon, lime, orange, etc…, which add citric acid on top of the carbonic acid. 
  • Pay attention to the amount of sparkling water that you consume.  You should never be drinking more sparkling water than regular water.
  • Do not slowly sip on acidic drinks throughout the day. This makes it more difficult for your saliva to keep your mouth at a neutral pH.  Drink it quickly.
  • After drinking a sparkling water, rinse your mouth with water to help quickly return it to a neutral pH.
  • Chew sugar-free gum after drinking something acidic.  This helps to stimulate good saliva flow and return the pH to neutral.

 


Special Considerations:

If you have a high risk for cavities, you should stay away from all acidic drinks.  If you do not know your cavity risk, ask Dr. Aanenson at your next dental visit.

If you have a dry mouth, you do not have the proper amount of saliva to counteract the acid in these drinks, so you should stay away from all acidic drinks.

Would you like more information about how acidic drinks like sparkling water can affect 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! They will assess your cavity risk and describe how sparkling water could be specifically harming your teeth.

Dental Trauma

Dental Trauma: What to Do When Your Child Suffers an Injury to the Teeth

Spring is almost here, and children’s sports are going to be in full swing!  This means an increased risk for injuries to your child’s teeth.

As children grow and learn new things, the risk of injury is relatively high.  Toddlers fall down when they are learning to walk.  Children have accidents when learning to ride a bicycle.  Adolescents suffer trauma when learning to play sports.

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Accidents and injuries happen.  In children, often these accidents involve injuries to the mouth and teeth.  This blog highlights what you need to know about trauma to the teeth.

Different Types of Trauma to the Teeth

Baby Teeth vs. Permanent Teeth

All of these types of trauma can happen to both baby teeth and permanent teeth.  The consequences of trauma to baby teeth are usually less severe than those for permanent teeth, simply because baby teeth fall out. 

The only serious consequence of trauma to a baby tooth occurs when the trauma affects the underlying permanent tooth as it is developing.  The crown (or visible part) of the permanent tooth forms underneath the roots of the baby tooth.  If an injury occurs which forces the baby tooth or its roots into the developing permanent tooth during this formation stage, the permanent tooth can be deformed.

The majority of injuries to teeth occur on the front of the face and affect front teeth.  It is possible for a back tooth to be injured if a child is hit from the side, for instance with a baseball.  The recommendations below apply to both front teeth and back teeth.

Injuries that Move a Tooth

When force from an injury moves a tooth, it needs to be addressed quickly. 

What You Will See:

The tooth looks whole, but it is in a different position.  It could be pushed up into the gums, hanging down out of the gums, or protruding at an unusual angle.  It is very common to have bleeding in the gums around a tooth that has been moved.

Baby Teeth vs. Permanent Teeth

In general, the treatment for this type of injury is the same for baby teeth and permanent teeth.  In severe cases, the baby tooth may be extracted.

What You Should Do:

Call your dentist immediately and start heading toward the office.  Attempt to move the tooth back to its normal position using light finger pressure only.  Whether you are able to reposition it or not, go to the dentist for an x-ray of the tooth to evaluate the health of the root, and the bone around the tooth.

Follow-Up Care:

Your child will need a soft diet for a period of a few days up to two weeks.  The goal is no additional pressure on the injured tooth as it is healing.  You may need to give your child over-the-counter pain reliever such as Children’s Advil or Children’s Motrin as needed for pain.

Follow-up with your dentist in 3 months.  He will x-ray the tooth to confirm healing and the health of the tooth and its surrounding structures.

Possible Long-Term Consequences:

When a tooth moves, it is possible that the nerve supply to the tooth has been broken where it enters at the tip of the root.  In many cases, the nerve supply can reattach, and the tooth heals.  In other cases, the nerve does not reattach, and the tissue inside the tooth dies.  A dead nerve must be removed, and the tooth needs a root canal.

The injury to the surrounding structures may also damage the connection between the tooth and the jaw bone.  A condition called ankylosis often develops, in which the tooth becomes fused to the bone and is unable to move.  This is a major concern in orthodontic treatment, when you desire to move that tooth.

Injuries that Chip or Break a Tooth

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If an injury to a tooth causes a portion of the tooth to chip or break off, the consequences are usually a little milder than a tooth that is moved or knocked out.  In minor cases, the small chip can be filled in to return the tooth to its natural shape.  In severe cases, the chip extends into the nerve of the tooth, and a root canal is needed.

What You Will See:

The tooth looks broken or jagged on the edge.  Look specifically for any pink or red spots in the center of the tooth.  This is the nerve inside the tooth, and large breaks may extend this far. 

Baby Teeth vs. Permanent Teeth

In general, the treatment for this type of injury is the same for baby teeth and permanent teeth.  Minor cases will be restored with filling material. In severe cases, a permanent tooth will need a root canal, and the baby tooth may be extracted.

What You Should Do:

Call your dentist immediately and start heading toward the office.  Try to locate any fragments of the tooth, and bring them with you.  Whether you are able to find it or not, go to the dentist for an x-ray of the tooth to evaluate the health of the root, and the bone around the tooth.  The dentist will evaluate the depth of the chip and determine whether or not the nerve is affected. 

Follow-Up Care:

If you have the tooth fragment, your dentist can reattach it to the tooth.  If not, he can rebuild the tooth back to its normal shape and size. 

Your child will need a soft diet for a period of a few days.  You may need to give your child over-the-counter pain reliever such as Children’s Advil or Children’s Motrin as needed for pain.

Follow-up with your dentist in 3 months.  He will x-ray the tooth to confirm healing and the health of the tooth and its surrounding structures.

Possible Long-Term Consequences:

The force to the tooth, which chipped it, could also have disrupted the nerve supply, as noted above.  Your dentist will monitor the tooth closely for any signs of a dead nerve.  If a root canal become necessary, your dentist will guide you in the steps involved in treatment.  It is important to know that the nerve inside a tooth could die at any point in the future, even decades later.

The tooth could also become ankylosed

The dental treatment, which restores the broken tooth, may need replacement at any point in the future.  Be careful not to use that tooth for anything besides chewing and speaking (i.e. holding hair pins or cutting fishing line).

Injuries that Knock Out a Tooth

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A tooth that is completely knocked out needs immediate action!  The longer you wait, the less chance the tooth has of surviving.

What You Will See:

The tooth is completely gone from the mouth.  Evaluation of the tooth should show the crown (visible part) of the tooth, as well as the root.

Baby Teeth vs. Permanent Teeth

There is no treatment for knocked out baby teeth.  The child will have a space in that tooth’s site until the permanent tooth comes in.

For a permanent tooth, we make every attempt to save and reattach the natural tooth.

What You Should Do:

Call your dentist immediately and start heading toward the office.  Hold the tooth by the crown ONLY.  Do not touch the root.  If you can, put the tooth back into the socket after very gently rinsing off any dirt or debris.  If you are unable to put the tooth back into the child’s mouth, place it in a cup with milk or saliva.  That’s right: fill up a cup with enough spit to cover the tooth.  Saliva is the best thing to keep the cells and fibers on the knocked-out tooth alive until it can be reimplanted into the mouth.

Whether you are able to reinsert it or not, go immediately to the dentist.  The dentist will clean and reinsert the tooth, using anesthetic if the child is in pain.  The sooner the tooth is reimplanted, the better the chances of its full healing.

Follow-Up Care:

Follow the recommendations for a soft diet and OTC pain relievers noted above.  The dentist will follow-up with you more frequently to confirm healing and reattachment of the tooth.

Possible Long-Term Consequences:

The consequences noted above, a dead nerve and ankylosis, are both highly likely when a tooth is completely knocked out.  Another possible consequence is failure of the tooth to reattach.  In this case, it is necessary to extract the tooth and replace it with a dental implant. 

Adhering to your dentist’s prescribed follow-up schedule will keep you informed of any of these consequences as they occur.

Be Prepared for Injuries to Your Child’s Teeth

As you can see from the instructions listed above, getting in to see your dentist as soon as possible is very important!  Save our number in your phone, and call us at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) as soon as an injury happens.  Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell will treat your child’s emergency and give you all the information you need for the right follow-up care. 

Your Child's First Dental Visit

Your Child’s First Dental Visit

At our Dental Centers in Freeman and Parkston our goal is for every dental visit to be a good one.  We understand that setting the right expectations can help us meet that goal.

When it comes to kids, not knowing what to expect can generate fear, anxiety and/or misbehavior.  Here is what to expect from your child’s first dental visit.

When to Make the Appointment

The American Academy of Pediatric Dentistry recommends that children have a dental evaluation by their first birthday or within 6 months of getting their first tooth, whichever comes first.  The purpose of a dental visit this early in life is not to perform dental treatment.  Education is the main purpose. 

If your child is already past this recommended age, do not worry!  Simply make an appointment as soon as possible.  The visit will vary a little based on the child’s age.  The purpose remains the same.

Educating the Child

If your child is an infant or toddler, the education comes in the form of the experience.  The child learns from the senses of sight, sound, taste, smell and touch.  He will see the smiling face of the dentist and his staff and learn what the dental tools look like.  He will hear the normal sounds of a dental office.  He will taste and smell the toothpaste or dental cleaning paste used by the dental hygienist.  And he will feel the gentle touch of the dentist evaluating his mouth.

It is important for parents to know that it is normal and acceptable for a small child to cry.  The dentist or hygienist may use that as an opportunity to look inside the child’s mouth and see as many teeth as possible. 

Educating the Parent

Even more important than the child’s education is the parents’.  The cause of most preventable problems that arise with children’s teeth is a simple lack of information and education.

A Child’s Oral Hygiene

At this dental visit, every parent receives instruction on proper oral hygiene of the child’s teeth and tips on various ways to accomplish this.  Keep in mind that not every technique or trick works on every child.  You may have to try several different approaches before you find the one that works best for you and your child. 

An example of a unique approach to flossing a toddler’s teeth is this:  Sit on the floor cross-legged.  Have your child lay down with his head in your lap and look straight up at you.  When the child opens his mouth, you will be able to easily see and access the teeth for flossing. 

This technique also works well with brushing.  If you use this technique for brushing, use only a pea-sized dot of toothpaste and no water.

Oral hygiene for baby teeth is just as important as it is for permanent teeth.  Do not make it an optional part of the bedtime routine.  This link has some great songs to sing while brushing and flossing your child’s teeth.  We know it can be a chore; do your best to make it a fun one.

A Child’s Nutrition

At the first dental visit, parents are taught how to help prevent cavities with good nutritional choices.  Your dentist will ask questions about current nutritional habits and eating patterns.  The most common error parents make is sending their child to bed with a sippy cup full of juice or milk.  The only thing a child should have access to overnight is water.

A Child’s Habits

Your dentist will assess risk for damage to the teeth and developing jaws by any habits like thumb-sucking or pacifier use.  For more information on these habits, please read our previous blog.

A Child’s Growth and Development

At this visit, the dentist evaluates the teeth and jaws for proper growth and development.  There is a pretty wide range of “normal” when it comes to teeth coming into the mouth.  The dentist’s objective is to detect any abnormalities in a child’s development as early as possible so that you can plan for the future.

For example, your dentist would inform you if there appears to be a deficiency in the growth of the jaws that would require early orthodontic treatment.  We want you to be as prepared as possible for any future dental work.

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 Dental X-rays

Dental x-rays are only taken on children under the age of 5 if there is evidence of a problem.  An x-ray is necessary if a large cavity is present with the risk of spreading infection into the jawbone.  Any injury to the teeth also requires an x-ray.

Around age 5-6 years, we take dental x-rays to evaluate the proper development of permanent teeth underneath the baby tooth roots.

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Fluoride

Professional fluoride treatments are proven to reduce a child’s risk for developing cavities.  We recommend fluoride as a preventive treatment for most children because we strongly believe in prevention.

If you have questions about professional fluoride treatments, please ask Dr. Jason, Dr. Alex, Dr. Serena or your dental hygienist at your next visit.  We are more than happy to discuss the benefits of fluoride and the reasons we strongly recommend it for children.

Is it Time for Your Child’s First Dental Visit?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to set up a happy visit for your child with Dr. Jason Aanenson, Dr. Alex Whitesell or Dr. Serena Whitesell and our fabulous dental hygienists.  They will get you and your child started with a great dental experience.

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.

New Year, New Smile

New Year, New Smile

 

It is that time of year when people around the world are resolving to make changes for the better.  A common theme in many New Year’s resolutions is improved health.  One of the great perks of improving your health is that it usually involves improving your appearance, too!  If you are exercising to enhance your health, you may also be losing weight or toning muscles.  If you resolve to get more sleep, you will lose those dark circles under your eyes.

The same applies to taking care of your teeth.  The steps you take to make your mouth healthier will make your smile prettier.  Here are a few ways you can improve the health and appearance of your smile.

Brush Up on Your Oral Hygiene Regimen

 

Keeping your teeth free from plaque reduces your risk of unsightly cavities and gum disease.  Here is the most effective way to keep your pearly whites pearly and white.

Brush twice a day, preferably after breakfast and before bed.  Make sure you are using a soft-bristled toothbrush at a 45 degree angle to the edge of the gums.  Make sure you touch every surface of every tooth.  This should include the cheek side, tongue side, and biting surface.  The most commonly missed area is the inside (tongue side) of the lower teeth.  Do not go to bed without brushing!

Floss nightly!  Brushing alone is not enough to ensure proper plaque removal.  The toothbrush bristles cannot reach in between the teeth; therefore, they leave harmful plaque, bacteria, and food debris on the teeth.  Flossing is absolutely mandatory to keep your teeth and gums healthy and beautiful.

Use a mouthwash.  Swishing mouthwash is a great way to flush out unhealthy bacteria from the various nooks and crannies of the oral cavity.  If you are cavity prone, use a mouthwash containing fluoride to strengthen your enamel and fight cavities.  If you have a dry mouth, stay away from mouthrinses containing alcohol.  For someone with red, swollen gums, a whitening mouthwash containing hydrogen peroxide is a great tool for reducing gum inflammation.

Treat Yourself to Teeth Whitening

There are many ways to improving your smile.  Whitening your teeth is one of the quickest ways to give your smile a boost.  At the dental centers in Freeman, Viborg and Parkston, we are proud to offer KöR professional teeth whitening.  With both in-office and at-home whitening products, we can help you find the type of whitening that most easily and quickly meets your needs. 

Another way you can achieve a brighter smile is by using an electric toothbrush and whitening toothpaste.  This works to polish off surface stains accumulated by years of drinking coffee or tea and using tobacco products.  Ask our dental hygienists about the other benefits of an electric toothbrush.  Most patients find that once they begin using an electric toothbrush, they cannot return to a manual toothbrush.  Electric toothbrushes truly give a cleaner, smoother, shinier appearance to the teeth.

Straight Teeth are Healthy Teeth

Many people consider crooked teeth to be a cosmetic issue.  In addition to an improved appearance, straightening your teeth actually creates a healthier oral environment.  A research experiment was conducted in which plaque was collected from both patients with straight teeth and those with crowded teeth.  This study concluded that not only do crooked and crowded teeth harbor a greater quantity of plaque; they actually harbor more dangerous bacteria than straight teeth.

Closing gaps between the teeth helps prevent food impaction, which leads to cavities and periodontal disease.  Aligning crooked teeth makes brushing flossing easier to accomplish.  Ask us how Invisalign® can make your mouth healthier!

Full Smile Makeover

Perhaps you have always wanted a full smile makeover, and 2018 is your year.  Missing teeth can be replaced with dental implants.  Broken teeth can be restored crowns.  Cavities can be repaired with cosmetic tooth-colored fillings.  

You can even get a beautiful, straight, white smile with veneers.  A veneer is a covering of at least one full surface of the tooth.  Veneers are made from porcelain or composite (an in-office dental restoration).  They can be contact lens thin for minor corrections and refinements.  Or they can be several millimeters thick to correct misalignments and dark discolorations.

The possibilities are almost endless!  To get started on your full smile makeover, schedule a consultation with Dr. Jason, Dr. Alex and Dr. Serena.  They will evaluate your current situation and discuss the treatment options available to meet your cosmetic goals.

Happy New Year!

Whether 2018 is the year for minor improvements or major life changes for you, there are two things that will always be a great idea: 1) Make healthy choices.  2) Smile! 

If you’d like help improving that smile, we are here for you. 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!

Caring for Your Teeth While in Braces

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Caring for Your Teeth While in Braces

Best Day Ever

The day you get your braces off should be the best day ever. After months, maybe even years, of hiding your metal mouth and constantly digging food out of the brackets and wires, you will feel a newfound sense of freedom and won’t be able to pass a mirror without smiling at yourself. The end result of orthodontics is always worth the time, money, and effort you put into it. Not only are straight teeth beautiful; they are actually healthier than crooked teeth.

There are two reasons straight teeth are healthy teeth: 1) Many people understand that crowded and crooked teeth allow more plaque accumulation because of the various nooks and crannies created by overlapping and rotated teeth. 2) Research studies have shown that the types of bacteria collecting on crooked teeth are different than the bacteria typically found on straight teeth. They are more periodontopathogenic - more likely to cause periodontal disease!

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How the Best Day can become the Worst Day

If the braces come off, and instead of exposing a beautiful, straight smile, a mouth full of discolored and decayed teeth is revealed, the Best Day has now become the Worst Day. Braces create a dental hygiene challenge that many people, especially preteens and teenagers are not aware of or prepared for. The extra apparatuses on the teeth are havens for plaque, bacteria, and food debris, causing a person’s risk for gum disease and cavities to sky-rocket.  The most common problem we see after braces is a phenomenon called "white spot lesions" that outline where the bracket was.  The white spots are areas of demineralization or weakening of the surface enamel where plaque was allowed to linger for too long and damaged the tooth structure surrounding the bracket.

 

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How to Lower Your Risk for Cavities & Gingivitis

  • Don’t miss a single dental visit! While you are busy seeing your orthodontist every 4-6 weeks, it is easy to forget your need for dental cleanings and checkups while in braces. Dr. Jason, Dr. Alex and Dr. Serena will be able to reassess your risk for both gum disease and cavities and make recommendations to help you lower your risk. This may include more frequent dental cleanings, a prescription toothpaste, a professional fluoride application, and adjunctive oral hygiene tools for you to use at home.

  • Additional oral hygiene tools - Braces take cleaning your teeth to a whole new dimension. A manual toothbrush usually will not adequately do the job, and traditional floss is virtually impossible to use alone.

    • Brushing - An electric toothbrush is a must because it can remove more plaque and bacteria around the brackets more effectively than a manual toothbrush.

    • Flossing - Using traditional floss requires the addition of something called a floss-threader, which is like a large plastic needle that can be inserted underneath the wire in order to floss between the teeth. An alternative to this is using small pre-threaded floss picks that will fit underneath the wires, called Platypus flossers.

    • Waterpik - Some people choose to add a Waterpik tool to their oral hygiene regimen. It is an effective way to remove food debris from underneath the orthodontic wires.

  • Additional oral hygiene products - The specific type of oral hygiene products you use matters when you have orthodontic appliances. There are many products available that can strengthen enamel and make it more resistant to damage from plaque and bacteria.

  • A prescription fluoride toothpaste or gel - Dr. Jason, Dr. Alex and Dr. Serena will give you recommendations based on your specific risk levels. If they determine that you are high risk for cavities, you may be given a prescription for a special toothpaste or gel to use on your teeth. Make sure to carefully follow the instructions and store any of these products out of the reach of small children.

  • Mouthwash - A mouthwash is a great way to flush out food debris from around the brackets and wires before you begin the flossing and brushing process. Any alcohol-free mouthwash is appropriate for pre-brush rinsing. Before bed and after brushing and flossing, you should swish with a fluoride-containing mouthwash. Do not rinse your mouth after using this one because the fluoride should stay in contact with your teeth for as long as possible. Our favorite fluoride mouthwash for patients in braces is Phos-Flur.

Questions about Your Risk (or Your Child’s Risk) While in Braces?

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 assess your risk for gingivitis and cavities while in braces and make the appropriate recommendations for your specific risk.

Dental Insurance: Are You Throwing Away Money?

Dental Insurance: Are You Throwing Away Money?

Some of the most common questions we answer in our dental offices are about dental insurance.  Dental insurance plans and the benefits they provide can be very confusing.  There are thousands of different plans, and many of them even share the same name.   So just knowing that you have Blue Cross Blue Shield won’t get you very far when it comes to figuring out your dental benefits.

The front office staffs in each of our locations have been working with our patients for decades to help them get the most out of their dental insurance.  We have  noticed some trends in recent years that may affect your dental care.  While insurance premiums have stayed the same or increased, the provided benefits have actually decreased.  This means that even though you or your company may be paying the same amount or more, you are receiving a lower dollar amount of dental benefits. 

How Do Dental Insurance Benefits Work?

Dental insurance is not like medical insurance at all.  If required, dental insurance deductibles are usually under $100, and are collected at your first dental visit of the insurance plan year.  Most insurance plans follow a calendar year; some use a different fiscal year, like August-to-August, which is important to know.   This matters when it comes to maximizing your benefits.

Dental insurance plans always have a “maximum”.  These range from $1000-2500.  There are a few great plans that offer higher maximums, but they are rare.  Dental insurance benefits pay up to their stated maximum, and then the patient is responsible for 100% of any fees that accrue past that. 

The important thing to understand about a benefit maximum is that any benefits you do not use during the plan’s year are not carried over to the following year.  They are simply lost.

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How Can I Maximize My Benefits?

Do not wait until the end of the year!  Many people forget about their dental insurance until December and then attempt to get all of their dental work done in a short amount of time.  In order you get the most out of your insurance plan, we need to see you as soon as possible.  Our experts will help you with the following things:

Know your plan’s benefit calendar.  If your benefits renew in August instead of January, that may change the timing of your treatment. 
Know your maximum.  If your plan offers $2000 in dental benefits, and you are in need of treatment, you should proceed with treatment before the end of the plan’s calendar.  Otherwise, those benefits are lost.

 

Your care at our dental centers is always based on what is best for your health, and our doctors will treat you with excellence and compassion regardless of the presence or absence of dental insurance benefits.  In all cases, Dr. Jason, Dr. Alex and Dr. Serena create a customized treatment plan for each person’s specific dental needs.  Only then will our insurance experts help you prioritize the timing and financing of each prescribed procedure so you get the most out of your dental insurance. 

How Can I Find Out What Benefits I Have?

Call our office at 605-925-4999 (Freeman) or (605) 928-3363 (Parkston) to speak with one of our insurance experts about your specific plan.  They can answer all of your questions and set you up to see 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!

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!

Hormone-Induced Gingivitis

Hormone-Induced Gingivitis

What is hormone-induced gingivitis?

Hormone-induced gingivitis is a type of gingivitis that occurs specifically during changes in hormonal levels .  It is a very common condition that we see frequently in our office.  Hormone-induced gingivitis causes a patient to have gums that are swollen, red, tender, and bleed easily.   The tenderness and bleeding often make oral hygiene routines uncomfortable, and patients sometimes avoid proper brushing and flossing techniques because it hurts.  Healthy, natural gum tissues are light pink, relatively flat and tightly adhered to the teeth.  The appearance of bright red, puffy gums is unsightly, giving a diseased look to the mouth, and may cause embarrassment. 

What causes hormone-induced gingivitis?  

The name says it all: it is induced by hormones.  Rapid swings in hormone levels (most notably estrogen, progesterone, and chorionic gonadotropin) can have a profound effect on gum tissues.  Research has shown that these hormone levels cause two important changes to occur:

  1. Hormone changes affect the tiny blood vessels in the gum tissue, increasing the blood flow in this area (which can cause swelling) and changing the permeability of the blood vessels (which makes the tissue bleed more easily).

  2. Hormone changes also affect the types of bacteria present in gum tissues. Research shows that gum tissues in patients with hormone changes such as pregnancy or taking birth control pills have more dangerous bacteria than patients without hormone changes. By “more dangerous”, we mean stronger and more likely to cause gum disease.


Who is at risk for hormone-induced gingivitis?  

Hormone-induced gingivitis is common in children going through puberty, both girls and boys.  It is also prevalent in women at various stages of hormone changes, including menstrual cycles, the use of birth control pills, pregnancy, and menopause.  This higher risk for gum disease makes oral hygiene even more important than it already is.  People with poor oral hygiene are more likely to experience hormone-induced gingivitis than those with good plaque control and consistent oral hygiene habits.  People who have infrequent and inconsistent dental cleanings are also at an increased risk.

 

What can you do about hormone-induced gingivitis?

 

  • Practice perfect oral hygiene. Do not miss a single day of flossing! Use an electric toothbrush; they are shown to effectively remove more plaque than a manual toothbrush.

  • Add a mouthwash to your oral hygiene routine, and use it twice daily. In addition to an over-the-counter alcohol-free mouthwash, you can swish with warm salt water throughout the day. Some patients require a prescription mouthwash to get the inflammation under control.

  • Stay on schedule with professional dental cleanings. Your dental hygienist is able to remove bacterial buildup from areas you might be missing, even with good oral hygiene.

  • Consider increasing the frequency of professional dental cleanings. Many of our patients with severe gingivitis during puberty or pregnancy have their teeth cleaned every 3 months, instead of every 6 months. This reduces the severity of gingivitis by reducing the amount of bacterial buildup accumulated between cleanings.

  • Talk to Dr. Jason, Dr. Alex or Dr. Serena about other recommendations they may have to improve your gingivitis. There are many additional oral hygiene products available to help reduce gum inflammation. They will determine which one will be most beneficial for your unique situation.

 

Think you or your child may have hormone-induced gingivitis?

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!

Aphthous Ulcers (Canker Sores)

Aphthous Ulcers (Canker Sores)

If you have never had a mouth ulcer, thank your lucky stars!  They are terribly painful and interfere with eating, speaking, and brushing your teeth.  The most prevalent type of mouth ulcer is an aphthous ulcer, and it is commonly referred to as a canker sore.  Aphthous ulcers are unusual in that, even now in 2017, we still do not know exactly what causes them.  There are many studies showing correlation between certain diets, vitamin deficiencies, hormone changes, and stress levels with the occurrence of aphthous ulcers.  But correlation is not the same as causation. 

What are aphthous ulcers?

There are three main types of aphthous ulcers: 1) minor, 2) major, and 3) herpetiform.  They all the share similar appearance of a round or oval-shaped ulcer with an inflamed red border around a yellowish-white film that covers the deeper ulceration.

  1. Minor aphthous ulcers are the most common and least painful. They typically are less than 1 cm in diameter and last for 7-14 days.

  2. Major aphthous ulcers are much larger, up to 3 cm, and can last over a month. Due to their increased size and duration, they are much more painful.

  3. Herpetiform aphthous ulcers take their name from herpes lesions (also called cold sores) caused by a Herpes Simplex Virus, which occur in clusters. Herpetiform aphthous ulcers also occur in clusters and can easily be misdiagnosed as viral sores. Herpes viral sores and aphthous ulcers differ in cause and location. There is no virus associated with aphthous ulcers, and they only occur on freely movable mucosa. This includes the inner lining of the lips, cheeks, tongue, floor of mouth and the soft palate. Herpes lesions, or cold sores, occur on the outside of the lips or any attached gum tissue like the hard palate or gums covering the teeth. When herpetiform aphthous ulcers form in a cluster, the ulcers often coalesce or blend together to form one very large, very painful ulcer.

 

What causes aphthous ulcers?

There is currently no scientific data identifying one specific cause of these ulcers.  The research studies have shown a correlation in the occurrence of aphthous ulcers with certain predisposing factors, listed here.

  • Genetics – Some studies suggest a genetic component because children are much more likely (90%) to experience aphthous ulcers if both of their parents have had them.

  • Certain GI problems – There is a high correlation between patients who experience aphthous ulcers and those with gastrointestinal issues like ulcerative colitis, Crohn’s disease and Celiac Disease.

  • Vitamin deficiencies – Some studies show a correlation between patients with aphthous ulcers and low levels of iron, vitamin B12, and folic acid.

  • Hormone levels – Many women experience aphthous ulcers at regular intervals correlating to their menstrual cycle.

  • Stress – Because stress cannot be quantitatively measured, this one is difficult to prove scientifically. But it’s no surprise to people who suffer with these ulcers that stress can make them more likely to appear.

  • Trauma – This is likely the most common cause of aphthous ulcers. Trauma can range from anything as simple as accidentally biting the inside of your lip or hitting your gums with the toothbrush to routine dental treatment or a complicated oral surgery procedure.

 

How are aphthous ulcers treated?

There are many ways to treat the painful symptoms of aphthous ulcers, but there is no cure to prevent them from recurring.  There are many options available, and it is best to discuss them with Dr. Jason, Dr. Alex and Dr. Serena to figure out which one is best for your specific ulcers.  Some of the possible treatment options are listed here.

  • A topical gel or paste – Usually a prescription product, this is applied to the ulcer with a Q-tip or clean fingertip multiple times a day. It typically contains a steroid, which reduces the severity and duration of the ulcer, but does not change the frequency of occurrence.

  • A prescription mouthwash – Also used to alleviate symptoms only, this can contain an antibiotic, antifungal, steroid anti-inflammatory, antihistamine (like Benadryl), and antacid (which creates a thick coating over the oral lining). When used 4-6 times per day, it can reduce the symptoms of the painful ulcers.

  • Laser treatments – A laser can be used to treat the ulcer, which reduces inflammation and speeds up the healing process by making changes to the surface of the ulcer.

  • Dietary changes – Patients who are afflicted with frequent or multiple aphthous ulcers and have celiac disease or a

  • gluten intolerance show a marked reduction in ulcer occurrence when gluten is eliminated from their diet. A very recent study has also shown an improvement in occurrence of ulcers when a dairy-free diet is observed. This is based on a new study showing a higher level of antibodies to cow’s milk proteins in patients who have aphthous ulcers.

  • Vitamin therapy – In patients who do show deficiencies in iron, vitamin B12, and folic acid and experienced frequent aphthous ulcers, the ulcer occurrence rate decreased after vitamin therapy to treat those deficiencies.

 

What can I do about aphthous ulcers?

The most important step you can take is contacting your dentist as soon as you notice the lesion.  All of the above treatment modalities are most effective when started early in the life of the ulcer.

Ulcers are aggravated by acidic foods, spicy foods, and hot temperatures, so avoid them in order to reduce your painful symptoms.  Use caution when eating and talking so that you do not reinjure the area and cause the ulcer to last longer.  Cold can temporarily alleviate symptoms, so we do recommend drinking ice water and holding a piece of ice against the ulcer until you see the dentist for other treatment options.

Do you think you have an aphthous ulcer?

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 help you get started on the best treatment to reduce the pain and length of your ulcer.  

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!

FAQ's for New Moms

FAQ's for New Moms

 When do the teeth break through the gums (erupt)?

Normal eruption of the first tooth is generally around 6-7 months of age +/- 6 months.  This means that it is normal for a baby to be born with teeth (6 months old minus 6 months = birth) or to have no teeth until they are 1 yr old (6 months old plus 6 months = 1 yr old).  You can see that “normal” encompasses a pretty wide range.  If your baby’s first tooth is later than the average, you can expect them to also lose teeth later than most of their peers.  This is still considered normal. 

Teething: What can be done, and when will it end? 

Teething causes intermittent discomfort, irritability and excessive salivation as new teeth are erupting in your baby’s mouth.  It can be managed with over-the-counter analgesics, such as Tylenol Infants’ Drops, or allowing the baby to chew on a soft, chilled teething ring.  Use of teething gels containing topical anesthetics such as benzocaine is NOT recommended due to potential toxicity of these products in infants.  Teething happens intermittently as teeth are erupting, so you may notice that it is off-and-on until the child is around 2 years of age or until all the teeth have erupted.

When should I start cleaning my baby’s teeth? 

As soon as a tooth appears!  The American Association of Pediatric Dentistry recommends that you use a smear of fluoridated toothpaste on a soft, infant-sized toothbrush twice a day.

Wait a minute! I thought I wasn’t supposed to use fluoride until the child is old enough to not swallow it? 

Yes, that used to be the case.  However, the recommendations were changed due to research showing that the benefits of fluoride, preventing devastating dental disease, far outweigh the risks.  Fluoride has been deemed safe and effective by both the American Dental Association and the American Association of Pediatric Dentists.  It should always be stored out of the reach of young children and should be used under adult supervision for children under age 5.

What kind of toothbrush should I use? 

There are many products available to clean your baby’s teeth.  You may have to try out a few different types to see which you like the best.  As the teeth first erupt, a soft wet washcloth is adequate to remove the soft buildup that accumulates on the teeth and gums.  There is a type of “toothbrush” for infants that includes a sleeve that fits over the parent’s finger with small rubbery bristles to clean the teeth.  An infant toothbrush is simply much smaller in size with very soft bristles.  Do not ever use a medium or hard toothbrush on your baby!

What about baby bottles or sippy cups? 

Baby bottles are a great way to nourish your child.  Once your child has moved on to a sippy cup and is no longer receiving all of his or her nutrition via bottle, the sippy cup should contain only water.  Anything else that your child sips throughout the day and/or night can greatly increase his risk for tooth decay.  A common cause of cavities in very young children is having a bottle or sippy cup in bed with milk or juice.

What about pacifiers and thumb-sucking? 

These habits constitute a behavior known as non-nutritive sucking because it stems from the sucking reflex babies have and does not provide any nutrition.  Pacifiers and thumb-sucking are a common method very young children use to self-soothe.  Please read our earlier blog on pacifiers and thumb-sucking below to learn more about these habits.

When should my baby visit a dentist?

The American Association of Pediatric Dentists recommends that every child should see a dentist by his or her first birthday or when the first tooth comes into the mouth.  This will enable the dentist to give you, the parent, valuable information and education regarding how best to care for your child’s teeth.  It will also familiarize your child with the dental office.  You will be shown how to properly clean your child’s teeth and given tips on how to best accomplish this as your child grows and becomes more mobile.

 Do you have other questions about your baby’s 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!

Back To School

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Back to School

For many people, this time of year is more than just back to school.  It is back to daily and weekly routines, back to bedtimes and alarm clocks, and back to good habits that may have gone by the wayside in the easygoing days of summer.  Add this to your list of daily activities as you get back into the swing of things: taking great care of your teeth!  There are many things involved in pursuing a healthy mouth.  Here are some tips to getting that oral hygiene routine back on track.

 Brushing

  • In order to properly remove plaque (the soft, sticky substance that causes cavities and gum disease), it is necessary to brush your teeth twice a day with a soft or extra-soft bristled toothbrush.

  • The most commonly missed area in brushing is at the gumline, so make sure the bristles of your toothbrush are gently touching the gums as you brush.

  • Check the bristles of your toothbrush often. The American Dental Association recommends replacing toothbrushes every 3-4 months or sooner if bristles are splayed and worn (like the photo shows). A worn toothbrush cannot do a thorough job of cleaning teeth.

  • Please remember: never share a toothbrush with anyone, especially your child.

  • If you or your child is sick with any type of infection, replace your toothbrush or run it through your dishwasher’s “Sanitize” cycle.

  • Supervise your children’s brushing. They should only be brushing their own teeth if they can tie their shoelaces or write their name in cursive. Otherwise, you should still be brushing their teeth for them.

 Flossing

Brushing alone cannot quite get the job done when it comes to removing all of the plaque from your teeth.  The nooks and crannies between your teeth are havens for clumps of bacteria where even the best brusher is not able to reach.  Flossing removes this plaque and reduces your risk for cavities and gum disease.  When you skip flossing, you miss over 35% of the surface of a tooth.  Studies have shown that flossing every day can prolong your life by six years.  

Because flossing is a more difficult skill to master, you should floss your children’s teeth until they show they can properly do it on their own.  The easiest way to floss your child’s teeth is to sit on a bed or the floor, and have the child lay down with his head in your lap.  Have the child tilt his head up so that you can look straight down into his mouth.  This gives you the simplest access for flossing (also good for brushing).  The earlier you start this process, the easier it is to accomplish. 

 Preventive Dental Care

  • Professional cleanings – So let’s say you’re not a perfect brusher and flosser; no one is. We all have areas that we may miss with our toothbrush or floss. What happens when sticky, soft plaque is not removed from our teeth? In 24 hours, it begins to harden into tartar (also called calculus). Once it has hardened, it cannot be cleaned off with a toothbrush or floss. It has to be removed by your dentist or dental hygienist. Tartar buildup that is not removed on a regular basis leads to painful, chronic conditions that require more extensive and more expensive dental treatment.

  • Dental evaluation and x-rays – A dental evaluation by your dentist can uncover problems that can be treated in the early stages, when damage is minimal and restorations may be small. Dental x-rays show how the teeth are developing and hidden decay that develops between the teeth. X-rays also allow us to monitor the jawbones for any changes, including cancer or abnormal growths. These important steps, taken on a regular basis, can help prevent painful, chronic conditions and save money. Untreated tooth decay is a serious infectious disease for which there is no immunization.

  • Fluoride application – Cavities used to be a fact of life. Over the past few decades, one thing has been responsible for a dramatic reduction in the prevalence of cavities: fluoride. The U.S. Centers for Disease Control says that water fluoridation is “one of 10 great public health achievements of the 20th century”. Fluoride in your water supply is integrated into children’s teeth as they are forming, adding strength and cavity resistance to their enamel. Teeth can also be strengthened and protected with topical fluoride. Topical fluoride includes many products you may already use at home (toothpaste, mouthwash and gel), and it can be professionally applied in your dentist’s office. Your need for professional fluoride treatment should be assessed by your dentist and is based on your cavity risk level.

  • Sealants – Another common area that toothbrush bristles miss is the deep pits and grooves on the biting surfaces of your back teeth. These types of cavities can be prevented by applying dental sealants over the pits and grooves. A dental sealant is a thin coating that goes on in a liquid form, flowing into the pits and grooves and then hardening to form a smooth, flat surface that prevents the accumulation of bacteria and food particles. Sealants are most effective when applied as soon as a back tooth enters the mouth.

 

If you missed getting in to our office this summer for your preventive care, take a look at your school calendar.  School holidays are busy in our office, and appointments go quickly! Pick the next school holiday for your dental visits and call us today to get on the books for the day you want!  

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!

Radiation Safety

Radiation Safety

We are often asked by our patients about the safety of dental x-rays.  Many people are concerned about the radiation they are exposed to when diagnostic x-rays are taken.  Since exact measurements are difficult to obtain, this article will use averages and comparisons to help you understand the radiation dose you receive from dental x-rays.

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Understanding Dose from X-rays

A set of four bitewing x-rays, which is typically taken once per year, delivers an average effective dose of 0.005 milliSievert (mSv). Effective dose is not measured. Effective dose is calculated by taking the dose delivered to the specific organs exposed during an x-ray and accounting for the sensitivity of the tissues exposed. Those values are then summed over all of the tissues in the human body to calculate an effective dose, which allows us to compare doses delivered in different ways to one another.

Comparing the dose from a set of four bite-wings to other doses we are exposed to daily is a useful way to understand dental x-ray doses in context. In the graphic below, dental bitewing x-ray dose is shown in comparison to other medical exposures and different sources of naturally occurring background radiation. Naturally occurring background radiation is exposure that each of us gets every day, and some of us more than others depending on the location in the world in which we live. In the chart below, the average US doses are shown. The total US average natural background dose from all sources per year is right around 3 mSv, or 600 times greater than the dose from one set of four dental bitewing x-rays, so you would nearly need to have bitewing x-rays twice a day for a year to equal the dose you receive annually just from living on the planet.

Risk from Dental Exposures

What most people worry about when they hear the word “radiation” is whether or not it can cause cancer.  The likelihood of an adverse effect (cancer) given an exposure to radioactivity is also known as risk. The delivery of radiation dose to the head and neck area during a dental x-ray does come with some associated risk.  According to the World Health Organization (WHO)’s publication, Communicating radiation risks in paediatric imaging: Information to support healthcare discussions about benefit and risk, the increased risk of cancer incidence from various types of diagnostic x-rays can be compared with baseline lifetime cancer risk.  This publication focused on risk to children because: “children are more vulnerable than adults to the development of certain cancer types, and have longer lifespans to develop long-term radiation-induced health effects.” Basically, kids are more susceptible than adults to cancer from radiation because they will live longer from time at exposure than their adult counterparts and their bodies are still growing and developing, so their organs are more vulnerable to exposure.  WHO’s studies showed that the increase in cancer incidence, or risk, for children aged 1-10 years from dental x-rays is <1 in 500,000.  That risk would be even lower in an adult. Levels of risk are generally considered to be “acceptable” among agencies that regulate radiation exposures to the public if they are in the range of 1 in 10,000 to 1 in 1,000,000. The cancer incidence risk from dental x-rays to children reported by WHO falls directly in this range of acceptable risk.

Benefit

The benefit of dental bitewing x-rays is the early detection of multiple types of oral disease, including cavities, gum and bone infections, and oral cancer.  As with any disease, the earlier it is detected, the less invasive treatment can be and the better the long-term prognosis.  The risk of these diseases going undetected is the progression of disease, spread of infection, loss of teeth, loss of bone in the jaws, and in severe cases even death.

Risk vs. Benefit

Due to the prevalence of oral diseases and the risks associated with those diseases, it is the opinion of our practice, as well as that of the American Dental Association, that the benefits of early detection with diagnostic x-ray imaging far outweigh the risks associated with the x-rays.  The risk of adverse consequences from undetected dental and oral diseases is significantly greater than the risk of increased cancer incidence due to dental x-rays.  Because each patient has different risk factors, the number of x-rays and the frequency at which they are taken can vary widely and is always determined on a case-by-case basis with the utmost respect for balancing patient concerns with positive outcomes.  For example, a patient with a higher risk for cavities or periodontal disease would benefit from more frequent dental x-rays than a patient who has a very low risk for either cavities or periodontal disease.  The more aggressive a dental condition is, the more frequently dental x-rays are needed to provide the best preventive and interceptive dental care.

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X-rays and Pregnancy

The American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women reaffirmed its committee opinion in 2015: “Patients often need reassurance that prevention, diagnosis, and treatment of oral conditions, including dental X-rays (with shielding of the abdomen and thyroid) … [is] safe during pregnancy.”  Dr. Jason, Dr. Alex and Dr. Serena typically postpone any dental x-rays during a patient’s pregnancy until after the baby is born unless the patient has a very high risk for disease, which could affect the patient’s overall health and that of the pregnancy.

 

Concerned about Radiation from Dental X-rays?

The number and type of dental x-rays taken on every patient is customized for his or her specific needs.  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!