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.

 

toothbrush_1856268_1280.jpg

 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”. 

pH_chart_of_drinks.jpg

 

 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?

 

Ice_Cubes.png
  • 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.

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.

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!

Root Canal Treatment

Root Canal Treatment

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

 

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

 

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

Why might I be referred to a specialist? 

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

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

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

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

 

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