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.

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.

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!

Thumb Sucking and Pacifiers

Thumb sucking and Pacifiers

Parents of our littlest patients frequently ask us about oral habits such as thumb sucking and pacifiers.  These perfectly normal behaviors in an infant can become damaging to an older child’s facial growth and development.  There are many different opinions and treatment options, and this blog will give you a general overview as to the most widely accepted philosophies and treatments for prolonged habits.

Non-Nutritive Sucking Behaviors

Both thumb sucking and pacifier use are classified as “Non-Nutritive Sucking Behaviors” or NNSB.  All infants exhibit sucking behaviors because it is necessary for their nutrition, through either breastfeeding or a bottle.  Non-nutritive sucking behavior is performed with the same sucking motion, but no nutrition is received.  Its purpose is solely comforting or soothing.

What is “normal”?

Any non-nutritive sucking behavior in infancy is considered normal.  There are ultrasounds showing babies sucking thumbs or fingers in the womb.  Over 90% of children exhibit NNSB at some point during the first 2 years of life.  Researchers differ on what age at which NNSB is considered “prolonged”.  Most agree that by age 4 years, any NNSB should have naturally stopped.  On average, most children will discontinue thumb-sucking or pacifier use on their own at some point from ages 2 to 4 years.  Prolonged thumb-sucking or pacifier use is anything past 4 years of age. 

Why is prolonged thumb sucking or pacifier use bad?

Short explanation: It causes improper development of the jaws and positioning of the teeth that can only be corrected with orthodontics.

Long explanation: During growth, the jaws are very susceptible to outside influences.  The suction forces can distort the shape of the upper jaw and the position of the teeth causing an incorrect bite (malocclusion).  The pressure of a thumb or pacifier on the roof of the mouth can increase the height or vault and narrow the dental arch, which reverses the proper bite relationship between the upper and lower teeth (a posterior crossbite).  The constant presence of a thumb or pacifier in between the upper and lower teeth pushes them into a position that accommodates the habit and leaves an opening (called an anterior open bite) rather than allowing the upper and lower front teeth to contact in the appropriate way.  This open bite can lead to tongue thrusting and lisping, as well as not being able to bite into foods with the front teeth. 

What should a parent do about prolonged NNSB?

The first step to take in aiding your child to discontinue sucking thumbs or using pacifiers is talking to him or her about the negative effects of the habit.  Your child thinks the habit is a good thing because it makes him feel good, and he may not be able to understand the cause and effect relationship between the habit and the consequences to their teeth, jaws and face.  Children who verbalize that they are ready to stop the habit will have the quickest success.

  • Gently discourage the habit and use positive reinforcement when he or she is successful.

  • Start small with goals that are easier for him to meet, such as watching a movie without sucking his thumb.

  • Do not punish the child for continuing the habit. Negative reinforcement is not recommended as a technique because the habit is something that comforts or soothes him. Shaming or scaring him will only cause him to feel a greater need to suck his thumb or use his pacifier.

  • Because stress or anxiety can increase the child’s need to self-soothe by thumb sucking or pacifier use, try to identify situations that make him feel anxious and address them as needed.

  • If possible, gently and quietly remove the thumb or pacifier from his mouth after he has fallen asleep.

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Pacifiers have one benefit over thumbs: they can be taken away or made dysfunctional (cutting the tip off a pacifier renders it useless).  If the child claims he is ready to stop, simply remove any pacifiers from his possession and go “cold turkey”. 

Thumb sucking is a bit more difficult because the thumb is always available.  Because of this, thumb sucking typically persists longer than pacifier use.  Some try applying bitter-tasting nail polish or wrapping the thumb in a Band-Aid or covering the entire hand with a sock. 

Ask your dentist and pediatrician for their input on the habit.  There are many different techniques used to help in stopping the habit before it causes long-term damage.

As a last resort, a dentist, pediatric dentist or orthodontist can fabricate a dental appliance that prevents the habit by removing the ability to create a suction and impeding the insertion of the thumb or pacifier.  The appliance does not contain sharp spikes or anything that would harm the child’s tongue or fingers; it simply prevents them from being able to enjoy the sensation of the habit.

Concerned about your child’s thumb-sucking or pacifier 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!