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. 

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.

TMJ Disorder and Dysfunction

TMJ Disorder and Dysfunction

What is TMD?

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

What is TMJ?

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

 How does TMD happen?

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

What does it mean to be high risk?

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

  • Flat spots on the teeth (wear facets)

  • Enlarged jaw muscle size

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

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

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

  • Scalloping of the tongue

  • Tenderness of the jaw muscles

  • Headaches in the temples

  • Tenderness in the ear, ringing of the ear

  • Gum recession or tooth notching at the gum line

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

What can I do about it?

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

What treatment will I need?

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

How do I get started?

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

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

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

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

What if I don’t do anything?

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

Need more information?

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

 

Why is My Dentist Asking How I Sleep?

Why is my dentist asking how I sleep?

Patients at our offices in Freeman, Parkston and Viborg may be accustomed to the dentists, hygienists, and assistants asking about their quality of sleep, but this is usually something new or surprising for patients who are new to our practice.  There are a few reasons dentists are involved in the recognition and treatment of sleep-disordered breathing:

  • Dentists are in a unique position to recognize a potential problem with sleep-disordered breathing.

  • Sleep-disordered breathing often causes dental signs and symptoms that your dentist will notice during an evaluation.

  • One of the treatment options for a patient who has been diagnosed with mild or moderate obstructive sleep apnea is a dental appliance to position the lower jaw and open the airway.

Recognizing airway risk

Dr. Jason, Dr. Alex and Dr. Serena have been trained to recognize patients with high risk for a possible sleep-disordered breathing issue.  Obstructive sleep apnea happens when the upper airway is partially or completely obstructed (or blocked) during sleep, which causes a disruption in breathing.  There are two ways that our doctors evaluate the upper airway on our patients.  The first is through an intraoral evaluation, which allows them to visualize the opening into the upper airway at the back of the mouth.  The anatomy of this area (the oropharynx) varies widely among patients, and certain anatomical variants cause a very high risk of airway obstruction during sleep.  The second way the upper airway is evaluated during a dental visit is with 3D imaging.  At our practice, we have the ability to obtain a 3D image of the head and neck, which allows us to take a measurement of the airway and determine a patient's anatomical risk for sleep-disordered breathing.

 

The dental signs and symptoms

One of the body's responses to a reduction in oxygen levels is to grind the teeth in a protrusive motion, pushing the lower jaw forward to open the airway.  This can lead to noticeable attrition (surface wear) on the upper and lower front teeth.  An example of severe attrition is shown in the picture below.  This makes the teeth look like they are getting shorter.  Some dental symptoms patients may experience are facial muscle pain or tension, jaw discomfort, and sensitive teeth.  Patients with sleep apnea often also experience GERD (acid reflux), which brings the pH level of the mouth down and can lead to acid erosion of the teeth.

 

A dental treatment option

A dental appliance is an alternative to breathing machine treatment options.  Obstructive sleep apnea is a medical condition that must be diagnosed by a medical doctor, and it may be treated with a dental appliance, which must be fabricated and overseen by a dentist.  Our practice has been treating sleep-disordered breathing for over 13 years and understands this relationship well.  An oral appliance is not the best treatment for everyone, and it’s important to evaluate the severity of sleep-disordered breathing and whether or not a dental appliance would adequately treat it.  Your dentist needs to evaluate the health of your teeth, their supporting gums and bone, and your temporomandibular (TMJ or jaw) joint to make sure a dental appliance will be properly supported and do no harm.

 

How can I get started?

The first step in treating sleep apnea is having it diagnosed by your physician.  Our practices offer a home screening monitor that can be used to evaluate the quality of your sleep.  It gathers several types of data while you sleep, including whether or not you grind your teeth.  Our doctors will advise you based on the preliminary data reported by the home sleep screening monitor.  You may be referred to your physician for a more in-depth evaluation of your sleep prior to treatment.  If you have already been diagnosed with sleep apnea and have not had success with previous treatment options, we can help discuss options that might be available to you with oral appliances.

Some great resources for information on sleep-disordered breathing:

American Academy of Dental Sleep Medicine

Narval Oral Appliance

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!