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.

Is Your Mouth Making You Sick?

Is your mouth making you sick?

How Oral Health Impacts Systemic Health

At our Dental Centers in Freeman, Parkston and Viborg, we take healthcare seriously.  While we are specifically concerned with our patients’ oral health, we acknowledge its role in a person’s overall health.  Unfortunately, the mouth has always been treated by a realm of healthcare (dentistry), which has historically been kept separate from general medicine.  For this reason, some people are under the impression that the mouth is therefore independent and unrelated to the rest of the body. 

This is a dangerous myth!

What systemic issues are connected with the mouth?

In 2000, the surgeon general released a report called “Oral Health in America”.  The purpose of this report was to inform and educate the nation about oral health, its prevalence in our nation, and how it affects a person’s overall health.  This report was based on a review of published scientific literature and is still considered the authority on the link between oral health and systemic health.

There are many links between the mouth and the rest of the body.  In this article, we will limit the discussion to the most harmful health conditions that are affected by the health of your mouth.

  • Osteoporosis – Osteoporosis is a condition of decreased bone density and often brings to mind a picture of a frail old lady whose bones break easily.  Osteoporosis can affect any bone in the body, even the jawbones.  This is especially important in patients who have lost teeth and wear dentures.  The jawbones in a patient with osteoporosis will diminish much more rapidly than in a patient with healthy bones, causing the denture to become loose and uncomfortable.  
  • In a patient with all of their teeth, osteoporosis causes an increased risk for periodontal bone loss.  It has even been suggested that bone loss around the teeth could be a warning sign of osteoporosis.
  • Immunosuppression – There are many different diseases, disorders, and conditions that suppress the immune system, including HIV, autoimmune diseases, organ transplants and cancer treatments.  A suppressed immune system makes any type of infection worse because your body cannot fight it naturally.  This puts a person at higher risk for periodontal disease and dental abscesses.  Because these infections also affect other areas of the body, the impact on the overall health is much greater in an immunocompromised patient.  
  • Anyone who has a problem with their immune system should keep to a strict oral hygiene routine and continuing care schedule with their  dentist.
  • Some people with a weakened immune system will suffer from persistent mouth sores and ulcers that do not heal.  Often a dentist is the first  person to catch these signs of a suppressed immune system.
  • Pulmonary Disease – Because the bacteria in the mouth have a quick pathway to the lungs, there is a link between oral disease and pulmonary disease.  COPD (chronic obstructive pulmonary disease) is associated with poor oral health, and patients with periodontal disease are at a higher risk of developing bacterial pneumonia.
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  • Diabetes – The link between periodontal disease and diabetes is considered a two-way connection: meaning diabetes makes periodontal disease worse, and periodontal disease makes diabetes worse.  Diabetes worsens periodontal disease through its affect on blood flow, inflammation and healing ability.  Periodontal disease worsens diabetes by contributing to hyperglycemia and complicated metabolic controls.  This association is thought to be true of diabetes with any chronic infection in the body
  • Heart Disease – The bacteria present in the mouth of a patient with periodontal disease can contribute to heart disease through a few different mechanisms of action: 1) small localized infections of blood vessel walls, which leads to plaque formation, atherosclerosis, and in severe cases, a heart attack,  2) an influence on platelets causing them to aggregate and form clots in the bloodstream, which could block a coronary artery, leading to heart attack.  People with periodontal disease have a 25% higher risk of heart disease than people with healthy gums.

 

  • Stroke – The increased risk of a stroke in patients with periodontal disease is based on the same mechanism of action noted above: increased risk for clot formation, which can travel to the brain and occlude a cerebral artery, blocking blood flow to brain tissues.
  • Adverse Pregnancy Outcomes – There is a correlation between periodontal disease and low birth weight infants.  The mechanism is in need of more scientific research.  At this time, it is thought to arise from two possible consequences of periodontal disease:  1) The bacteria present in periodontal disease produce toxins that could enter the blood stream, cross the placenta, and cause damage to the fetus.  2) The maternal inflammatory response to these toxins could interfere with fetal growth.

 

How do I reduce my risk of health problems?

All people should be aware of the health risks associated with dental diseases.  Because most oral health problems are preventable, you can be instrumental in lowering your risk for systemic health problems.

 

  1. See your dentist and dental hygienist at their recommended intervals for cleanings and oral evaluations.
  2. Practice good oral home care with regular brushing, flossing, and rinsing with the proper mouthwash.
  3. Treat dental problems as they arise.  Do not wait until something hurts!  Periodontal disease is often called a “silent” disease because it rarely causes pain.
  4. See your medical doctor to be as preventive as possible with conditions like diabetes and cardiovascular diseases.

 

I am concerned that my mouth is affecting my overall health.  What now?

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 medical history with you and outline how it can affect your oral health and vice versa.  

High Risk for Teeth Grinding

High Risk for Teeth Grinding 

What is bruxism? 

Bruxism is the medical term for the grinding of teeth or the clenching of jaws. Bruxism often occurs during deep sleep or while under stress.  Clenching and/or grinding the teeth can be a subconscious act, meaning you are unaware that you are doing it.  Many people clench or grind their teeth when they are concentrating, driving or working out in addition to while they are sleeping.

What are the causes of bruxism?

Bruxism can have several different causes.  Some people have irregularities in the way the teeth come together (occlusion) that cause increased muscle activity.  Other people clench or grind their teeth when they are under stress.  Often, bruxism is a sign of a sleep-disordered breathing problem, like sleep apnea.  It can also be a side effect of certain medications, including some antidepressants and ADHD medications.

What does it mean that I am high risk? 

There are multiple factors that can show your dentist that you are at high risk for clenching or grinding your teeth.

  • Wear facets – damage to the biting surfaces of teeth that looks like flattened areas

  • Tightness or soreness in the muscles of the jaws

  • Excessive muscle force – evidenced by large facial muscles

  • Recession – loss of gum attachment, teeth appear longer

  • Abfractions – notching of enamel at the gumline

  • Potholes on the biting surfaces of back teeth – the enamel is completely worn away, and the underlying tooth structure becomes deep and concave, just like a pothole in the road

  • Linea alba – white callous line on inner cheeks

  • Scalloped tongue – the outer edges of the tongue become shaped like the inner edges of the teeth

What can I do about it? 

You can prevent some of the damage to your teeth and gums by having a dental nightguard custom made for your mouth.  When you sleep in a protective nightguard, you decrease the stressful forces applied to the teeth as you sleep and protect them from further breakdown.  If you find yourself clenching during the daytime, talk with Dr. Jason, Dr. Alex or Dr. Serena about techniques to help break that habit.

What if I don’t do anything?

Bruxism can lead to multiple complications of your oral health.  Inside the mouth, bruxism can cause cracked teeth, loss of tooth structure, shortened teeth, gum recession, abfraction or notching of the teeth at the gumline.  These complications can result in many different types of damage to the teeth and an increased cost of dental care over your lifetime.  Outside the oral cavity, bruxism can cause problems in the chewing muscles or in the jaw joint itself.  Muscle tension can lead to facial pain or headaches.  Problems in the joint can lead to arthritis and slipped disks within the jaw joint.  This all can lead to pain, limited function, and decreased overall quality of life.

How do I find out if I am grinding my 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!

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

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

What is periodontal disease? 

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

What are the stages of periodontal disease?

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

  • A bright red color to the gums

  • Swollen or puffy gums

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

 How does periodontal disease happen?

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

What does it mean if I am high risk?

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

Risk factors noted during a clinical evaluation:

  • Pockets measuring ›3mm

  • Poor oral hygiene

  • Crowded teeth

  • Prior periodontal disease

  • Bone loss

  • Mobility (loose teeth)

  • Gum recession

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

  • Abnormal frenum attachments

What can I do about it?

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

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

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

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

What if I don’t do anything?

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

Need more information?

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