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Health Daily Journal media
MARCH 2018 | In this issue:
RIVERFRONT DENTAL WEIGHS IN ON ORAL Caring for braces at any age LINX: Permanent solution for acid reflux
PAGE 2 | FERGUSFALLSJOURNAL.COM
Oral health: A window to your overall health Did you know that your oral health offers clues about your overall health — or that problems in your mouth can affect the rest of your body? Protect yourself by learning more about the connection between your oral health and overall health.
resistance to infection — putting the gums at risk. Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels, and that regular periodontal care can improve diabetes control.
What's the connection between oral health and overall health?
Like many areas of the body, your mouth is teeming with bacteria — most of them harmless. Normally the body's natural defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria under control. However, without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease. In addition, certain medications — such as decongestants, antihistamines, painkillers, diuretics and antidepressants — can reduce saliva flow. Saliva washes away food and neutralizes acids produced by bacteria in the mouth, helping to protect you from microbial invasion
HIV/AIDS Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.
Oral health can offer you clues about your overall health and can contribute to other issues in the body if not taken care of. PROVIDED. or overgrowth that might lead to bacteria and the inflammation assodisease. ciated with periodontitis — a severe Studies also suggest that oral form of gum disease — might play a role in some diseases. In addition, certain diseases, such as diabetes and HIV/AIDS, can lower the body's resistance to infection, making oral health problems more severe.
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Osteoporosis Osteoporosis — which causes bones to become weak and brittle — might be linked with periodontal bone loss and tooth loss. Drugs used to treat osteoporosis carry a small risk of damage to the bones of the jaw. Alzheimer’s disease Worsening oral health is seen as Alzheimer’s disease progresses.
Other conditions that might be linked to oral health include eating disorders, rheumatoid arthritis, head and neck cancers, and Sjogren’s syndrome — an immune system disorder that causes dry mouth. Because of these potential What conditions may be links, tell your dentist if you’re linked to oral health? taking any medications or have Your oral health might contrib- had any changes in your overute to various diseases and condi- all health — especially if you’ve tions, including: had any recent illnesses or you have a chronic condition, such as Endocarditis diabetes. Endocarditis is an infection of the inner lining of your heart (enHow can I protect docardium). Endocarditis typically occurs when bacteria or other my oral health? To protect your oral health, germs from another part of your body, such as your mouth, spread practice good oral hygiene every through your bloodstream and day. For example: • Brush your teeth at least twice attach to damaged areas in your a day with fluoride toothpaste. heart. • Floss daily. • Eat a healthy diet and limit Cardiovascular disease Some research suggests that between-meal snacks. • Replace your toothbrush heart disease, clogged arteries and stroke might be linked to the every three to four months or inflammation and infections that sooner if bristles are frayed. • Schedule regular dental oral bacteria can cause. Pregnancy and birth. Periodon- checkups and cleanings. • Avoid tobacco use. titis has been linked to premature birth and low birth weight. Also, contact your dentist as Certain conditions also might affect your oral health, including: soon as an oral health problem arises. Taking care of your oral Diabetes health is an investment in your Diabetes reduces the body’s overall health.
FERGUSFALLSJOURNAL.COM | PAGE 3
Caring for braces at any age Braces are often necessary for children and adults to develop straight, healthy teeth. According to the American Association of Orthodontists, braces help fix teeth that are crooked, too close together and too far apart. Braces also can be employed to address under- or overbites. Fortunately, braces no longer carry the stigma they once did, and many children are eager to embrace this orthodontic gear if it means achieving a more attractive smile and a properly aligned bite. One thing that kids (and adults) who wear braces need to consider is that oral hygiene is imperative while wearing braces. Taking good care of braces and teeth is essential to avoiding problems now and when the braces are eventually removed.
Compliance
The rules orthodontists give their patients are intended to make the duration of time wearing braces as short as possible. Therefore, avoiding hard or sticky candies and resisting any urges to open items or bite on inflexible items, such as pencils, is crucial. Broken hardware
or snapped wires will only prolong the length of treatment if they have to be replaced frequently.
Brushing
Braces will collect more food particles and bacteria than teeth without brackets and wires. Those with braces may have to change the way they brush their teeth and the frequency with which they brush their teeth. Orthodontists may recommend brushing after each meal to keep food particles from being lodged and plaque from building up. More time should be spent brushing to ensure all crevices and surface areas are addressed. Consult with the orthodontist about the products that may help keep teeth clean. Toothbrushes may need to be replaced more often if braces cause the bristles to wear down quickly.
Braces require more detailed care to help keep teeth healthy and strong.
type of floss has a stiff end that permits flossing between brackets. Reusable plastic floss threaders in combination with regular floss also can be used. Children should be careful not to put too much pressure Threader floss Flossing should continue while on wires or brackets when flossing wearing braces, even though floss- so they don’t accidentally dislodge ing with braces can be difficult. any hardware. Many orthodontists recommend “threader floss” that allows patients Keep appointments Visiting the orthodontist routinely to floss properly around wires. This
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for adjustments is a necessary part of wearing braces. Those who skip appointments or do not follow the advice of a skilled doctor may need to spend more time wearing braces. If something becomes loose or dislodged, visit the orthodontist right away. The benefits of wearing braces are numerous. Proper care can make braces even more effective and a lot more comfortable.
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LINX: A permanent solution to acid reflux By Jessica Sly
Eric Wallace, 47, of Staples suffered from acid reflux since he was a teenager, and it worsened as he aged. His wife, Wendy, noted that he was constantly in pain and would often get up at night to vomit. Then they discovered the LINX Reflux Management System at Tri-County Health Care in Wadena. About 20 percent of the U.S. population, or more than 60 million people, suffer from acid reflux. Common symptoms of reflux include heartburn, regurgitation, sore throat, coughing and chest pain. Symptoms can become so severe that they interfere with everyday life. Reflux is caused by weak muscles in the esophagus, or food pipe. The esophagus has small valves called sphincters that open and close to let food and liquid pass through. Weak sphincters can’t close all the way and allow acid and other stomach contents to splash into the esophagus. While
Dr. David Kloss, FACS, and Eric Wallace, a LINX patient, discuss acid reflux and how the LINX surgery is an outpatient procedure that will help eliminate acid reflux. PROVIDED. reflux medications decrease acid don’t solve the root of the problem. all that. production in the stomach, they The LINX procedure changes Dr. David Kloss, FACS, is a
Solve acid reflux, for good. Ask your doctor about LINX, a permanent solution to acid reflux offered at Tri-County Health Care in Wadena.
For more information call:
218-631-7581
David Kloss, M.D., FACS LINX Surgeon
Cutline TCHC.org
FERGUSFALLSJOURNAL.COM | PAGE 5
Brush up on dental care basics Your smile depends on simple dental care habits, such as brushing and flossing. But are you using the right techniques? Follow these steps to protect your oral health.
Brushing for oral health
Oral health begins with clean teeth. Keeping the area where your teeth meet your gums clean can prevent gum disease, while keeping your tooth surfaces clean can help you stave off cavities. Consider these brushing basics from the American Dental Association: Brush your teeth twice a day When you brush, don't rush. Take time to do a thorough job. Use the proper equipment Use a fluoride toothpaste and a soft-bristled toothbrush that fits your mouth comfortably. Consider using an electric or battery-operated toothbrush, which can reduce plaque and a mild form of gum disease (gingivitis) more than does manual brushing. These devices are also helpful if you have arthritis or other problems that make it difficult to brush effectively. Practice good technique Hold your toothbrush at a slight angle — aiming the bristles toward the area where your tooth meets your gum. Gently brush with short backand-forth motions. Remember to brush the outside, inside and chewing surfaces of your teeth, as well as your tongue. Keep your equipment clean Always rinse your toothbrush with water after brushing. Store your toothbrush in an upright position and allow it to air-dry until using it again. Try to keep it separate from other toothbrushes in the same holder to prevent cross-contamination. Don't routinely cover toothbrushes or store them in closed containers, which can encourage the growth of bacteria, mold and yeast. Know when to replace your toothbrush Invest in a new toothbrush or a replacement head for your electric or battery-operated toothbrush every three to four months — or sooner if the bristles become irregular or frayed.
Flossing for oral health
You can't reach the tight spaces between your teeth and under the gumline with a toothbrush. That's why daily flossing is important. When you floss: Don't skimp Break off about 18 inches (46 centimeters) of dental floss. Wind most of the floss around the middle finger on one hand, and the rest around the middle finger on the other hand. Grip the floss tightly between your thumbs and forefingers. Be gentle Guide the floss between your teeth using a rubbing motion. Don't snap the floss into your gums. When the floss reaches your gumline, curve it against one tooth. Take it one tooth at a time Slide the floss into the space between your gum and tooth. Use the floss to gently rub the side of the tooth in an up-and-down motion. Unwind fresh
To keep those pearly whites, brush up on a few of the basics of oral hygiene. PROVIDED. • Mouth ulcers or sores that don’t heal. floss as you progress to the rest of your teeth. Keep it up If you find it hard to handle floss, use an interRemember, early detection and treatment of dental cleaner — such as a dental pick, pre-thread- problems with your gums, teeth and mouth can ed flosser, tiny brushes that reach between teeth, help ensure a lifetime of good oral health. a water flosser or wooden or silicone plaque remover. As long as you do a thorough job, it doesn't matter if you brush or floss first.
Other oral health care tips
In addition to daily brushing and flossing, consider using mouthwash containing fluoride to promote oral health. Also, resist the temptation to use toothpicks or other objects that could injure your gums and let in bacteria.
When to see the dentist
To prevent gum disease and other oral health problems, schedule regular dental cleanings and exams. In the meantime, contact your dentist if you notice any signs or symptoms that could suggest oral health problems, such as: • Red, tender or swollen gums. • Gums that bleed when you brush or floss. • Gums that begin pulling away from your teeth. • Loose permanent teeth. • Changes in the way your top and bottom teeth align with each other. • Unusual sensitivity to hot and cold. • Persistent bad breath or an unusual taste in your mouth. • Changes in the way your dentures or partial dentures fit. • Difficulty swallowing.
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PAGE 6 | FERGUSFALLSJOURNAL.COM
Pain in the...knee: What to do about it It appears some people are more susceptible to knee pain than others and at times it runs in the family. Knee pain can be caused by an overuse or an underuse of the knee joint and muscles. Being active is important for good muscle and joint health, for lubrication and for muscle strength to keep alignment — especially of the patella (knee cap). Many people will have pain and/or clicking of the knee due to a gliding usually lateral of the kneecap on the knee. Jumping or landing from a height repetitively can also cause swelling and irritation to the knee. Standing on hard surfaces such as cement, doing increased kneeling or standing with your knees locked can all produce tightness at some area and weakness at another knee area, as well as wear on your joints. Once knee pain starts it is important to decrease the stress onto the knee and to keep it limber and flexible. However, it is also important to avoid the end range motion of being too straight (hyperextension) and bending too far into pain, as this will just aggravate the knee more. What you do want to do is the following: • Stand in good posture with your knees relaxed and more weight on your heels than on your toes. Doing this will shift weight from your knee to the hip/butt muscles where it should be. Wiggle your knees from time to
time to make sure they are relaxed and do not lean your waist onto a counter, as this tends to lock out your knees • Keep your gluteal (hip and butt) muscles strong. Making sure you can stand and sit from a chair without use of your arms safely ensures that these muscles are strong, try to slide to the front of your chair and position your feet and try to stand up and sit down with using only the leg muscles as long as you are balanced and do not have any pain, then work on this each time you sit or stand • If any of the above are difficult, working with physical therapy can help manage knee pain and improve strength. • If you are in need of knee surgery such as a total knee replacement, then it may be beneficial for you to see physical therapy prior to surgery to assist with gaining a range of motion, and decreasing swelling as this will enhance and hopefully speed up your recovery. Learning the exercises and trying to build a little muscle in the arthritic knee as well as the good knee that will be assisting you as you are using a walker is very important as well prior to surgery. Physical therapy can help ease knee pain and improve your functional activity limited by it.
Once knee pain starts, it is important to decrease the stress onto the knee and to keep it limber and flexible. PROVIDED. Shawn Krause Roberts is a PT, MPT, ATC and CEO of Orthopedic & Sports Phyical Therapy Inc.
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Fifty thousand first-grade students across Minnesota received oral health education in their classrooms this fall as part of Delta Dental of Minnesota Foundation’s Smiles@School program. In partnership with more than 600 schools, the program included presentations on oral health from dental care providers. Each student received backpacks filled with tools to help them care for their teeth, including toothbrushes, toothpaste, water bottles, educational booklets and other fun items. Additionally, an estimated 4,000 at-risk students received inschool dental sealants and fluoride, which have been shown to prevent tooth decay. “Despite easy prevention, tooth decay is the most common childhood disease – even more common than asthma or allergies,” said Joe Lally, executive director of Delta Dental of Minnesota Foundation. “School-based
programs are a proven method of delivering important information during critical habit-forming years. We’re grateful to our community partners and local teachers who help instill these healthy habits early.” Half of Minnesota’s third-graders have experienced tooth decay, which disproportionately affects children from low-income families and makes concentrating on learning difficult. Nationally, more than 51 million school hours are lost each year due to dental disease. The Smiles@School program offers oral health education to Minnesota first-graders, prevention education to second-graders, and measures oral health improvements for third-graders. The goal of the program is to eliminate tooth decay in school-age children. For a full list of participating schools, visit Delta Dental of Minnesota Foundation’s website.
FERGUSFALLSJOURNAL.COM | PAGE 7
Caring for dentures improves oral health Proper dental care and oral hygiene is essential at all stages in life, even for people who have dentures, partials or implants. People with dentures must recognize that oral hygiene protects their dentures as well as their mouths. According to the American College of Prosthodontists, 35 million Americans do not have any teeth, while 11 percent of the population requires the use of a complete denture. In addition, 5 percent of the U.S. population wears a partial denture. The Canadian Denture & Implant Centres says that 16 percent of the population wear dentures. Removable dentures require care to keep them clean and in good repair. Servicing dentures also helps ensure wearers’ mouths stay healthy. Follow these guidelines to keep dentures clean. Taking proper care of dentures is not only essential to keep long lasting artificial teeth, it will also improve your mouth’s overall health. PROVIDED. Handle with care Dentures are strong, but they are not impervious to damage. use gauze or a soft toothbrush Treat them with care while han- to clean the tongue, palate and dling, being sure not to bend or cheeks. If you still have any damage any clasps when clean- natural teeth, use a soft-bristled ing, and try not to drop the den- brush to cleanse. Always rinse Since 1928, we’ve blended attractive living settings tures. When handling dentures, dentures before returning them Colgate recommends standing to your mouth. with holistic, person centered care to fit individual over a folded towel or basin of needs of those we serve. An exceptional group of Schedule regular dental visits water for added protection. caregivers and health professionals has found it Dentists can advise how their calling to provide that care. frequently to have dentures Brush daily False teeth need to be brushed, checked for fit and professionPioneerCare Center so don’t trade in your toothbrush al cleaning. Loose dentures can Innovative short term therapy and just yet. Brushing will help cause sores and infection, so long term care remove food deposits and pre- it’s best to address any issues vent staining. regarding fitting promptly. DenPioneer Cottages tists also will inspect the inside Exceptional memory care of the mouth for signs of disease Take a break Pioneer Pointe Remove dentures before going or irritation. to bed and soak the dentures in Apartment living for seniors warm water or special denture Eat healthy foods PioneerLink cleansers. Removing dentures Make sure to eat a well-balAt-home technology solutions for six to eight hours allows anced diet to keep the body and tissue inside the mouth to re- mouth healthy. Cut up hard foods You have a choice. cover. Soaking helps to remove like fresh fruits and vegetables Make it PioneerCare. stains, bacteria and tartar. The if dentures are impacting your Mayo Clinic notes that most den- ability to eat these foods. tures need to remain moist to People of all ages rely on keep their shape, so do not allow partial or complete dentures them to dry out. to maintain their smiles. Rou218.998.1500 | www.pioneercare.org tine care is necessary to keep An equal opportunity provider and employer the dentures intact and mouths Clean your mouth While dentures are removed, healthy.
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PAGE 8 | FERGUSFALLSJOURNAL.COM
GRANT R. COLLING, D.D.S.
Dentists Need
Patience. patients Need Dentists.
RIVERFRONT DENTAL 218.736.5627 • 888.537.1653 124 E. Lincoln Ave. Fergus Falls, MN www.riverfrontdental.NET
Dr. Grant Colling has worked at Riverfront Dental for 37 years, and dental hygienist Jacki Rubish has been with Riverfront Dental for almost 30 years. KALEY SIEVERT/DAILY JOURNAL.
Say aaahhh: Local dental clinic gives tips on oral hygiene By Kaley Sievert
ksievert@fergusfallsjournal.com
Teeth are important. They help people articulate words and improve speech and eat healthier foods to get much-needed nutrients. Healthy mouths can lead to healthier lifestyles according to Riverfront Dental, and so, it is important to visit a dentist regularly. Jacki Rubish is a registered dental hygienist and has been working at Riverfront Dental with owner, Dr. Grant Colling, for almost 30 years. She said based on individual needs, it’s recommended that people visit the dentist more than once a year. “The minimum visits would be once a year,” Rubish said. “But, I would say more often than not, come in twice a year.” Visiting the dentist regularly can help prevent future emergency visits. For those who skip their regular checkup, could be risking the health of their mouth and potentially, their overall well-being. Colling opened Riverfront Dental 37 years ago. When it comes to dealing with dental emergencies, he said people typically come in with a toothache. “A toothache could mean a number of issues,” Colling said. “It could be tooth decay,
an abscess, a broken tooth etc.” A person could have a developing problem and not know it as well. That is why Colling recommends regular visits to the dentist to prevent a small problem from becoming a health emergency. “A lot of times, we might see teeth that are broken or see something wrong, but a patient doesn’t feel anything,” Colling said. In addition to tooth breaks and decay, Rubish said another side effect of poor mouth care can be a heart attack or stroke. Some people may have a history of a gum disease called periodontal disease. Patients with periodontal disease are twice as likely to die from a heart attack and three times as likely to die from a stroke. Rubish recommends that patients with this disease, come in three to four times a year to maintain their health and control the gum infection. “This gum disease is similar to diabetes in that you don’t cure it, you control it,” Rubish said. “There is no magic pill or injection that can control it, it’s more about how to care for your mouth.” Research has confirmed that the health of the mouth impacts the health of the rest of the body. Rubish said untreated periodontal disease can also be associated with premature
FERGUSFALLSJOURNAL.COM | PAGE 9 births, diabetes, pancreatic cancer, lupus, rheumatoid arthritis and alzheimer’s disease. It can also be associated with lung cancer and impotence. “Thirty years ago, when I started in this position we cleaned teeth and talked to people about brushing and flossing because we didn’t want people to lose their teeth and we still don’t,” Rubish said. “But it has become more than that. Keeping your mouth healthy is also a quality of life issue and potentially a longevity issue as well.” In between visits to the dentist, Rubish recommended a variety of healthy habits patients could adopt to take care of their teeth. One tip was to floss every time one brushes their teeth. “Even if people do a perfect job of brushing their teeth, they can only remove about 60 percent of plaque,” Rubish said. “So to get rid of the other 40 percent of plaque, you need to floss to clean between your teeth. The gum tissue in between our teeth is a mode of transportation for bacteria that enters into our bloodstream and that can cause other health issues.” To ensure people are cleaning their mouths efficiently, Rubish has a few recommendations on toothbrushes and floss. Powered toothbrushes, such as Sonic, are a great tool to use and can help remove more plaque than a manual toothbrush. She recommends, whether a person uses a manual or powered toothbrush, they use one with soft bristles. “With medium or hard bristled toothbrushes, you can actually brush the enamel off your teeth and can cause gum tissue to recede from brushing too aggressively,” Rubish said. When it comes to floss, Rubish said there is no specific brand or type she recommends to be best. However, a fine, unwaxed floss will cut through plaque better than waxed floss. To prevent tooth decay, grab a toothpaste with fluoride in it. There are also a variety of toothpastes out there to help prevent gingivitis, cavities and sensitivity. “We try to make recommendations for each person based on their individual needs,” Rubish said.
Top: Riverfront Dental is located at 124 E. Lincoln Ave., Fergus Falls. The office is open 8 a.m. to 5 p.m. Monday through Thursday. Bottom: Both, Dr. Grant Colling and dental hygienist, Jacki Rubish recommend people visit the dentist a couple times a year.
How to encourage kids to take care of their teeth Parents of young children know that getting kids to brush their teeth can sometimes feel like pulling teeth. Kids have a long history of disliking dental care, which can frustrate parents who know the importance and long-lasting benefits of proper dental hygiene. While many youngsters may never excitedly run to the bathroom to brush their teeth, parents can try various approaches to get kids to embrace proper dental care. • Start early. Parents should not hesitate to begin cleaning kids’ teeth once the first tooth appears.
The earlier dental care is part of a child’s routine, the more likely he or she is to accept it as part of everyday life. The American Academy of Pediatric Dentistry recommends using a soft-bristled brush with a small head. Ideally, use a toothbrush designed for infants, brushing teeth once per day at bedtime. The AAPD advises taking kids to visit a pediatric dentist when the first tooth appears, or no later than the child’s first birthday. • Make it a group effort. Young children love to imitate their parents’ actions and behaviors, and
moms and dads can use that adoration to their advantage when trying to get kids to brush their teeth. Brush teeth together as a family, making it seem like an enjoyable twice-daily activity. Get down on kids’ level and show them how to brush. If kids are resistant, engage them in conversation while brushing so they don’t even realize they’re cleaning away. • Involve kids in choosing their dental care products. While parents should be mindful of the type of toothbrush their children use, always sticking with products
recommended by their child’s pediatric dentist, let youngsters choose their toothbrush and toothpaste. Kids might prefer a particular flavor of toothpaste, and a colorful toothbrush with a favorite film or television character might make kids more enthusiastic and less fussy about brushing. • Compliment kids after positive dental appointments. When pediatric dentist appointments go well, compliment children and express your pride in them for taking dental hygiene as seriously as they do.
PAGE 10 | FERGUSFALLSJOURNAL.COM
Omissions on death certificates lead to undercounting of opioid overdoses In a refrigerator in the coroner's office in Marion County, Indiana, rows of vials await testing. They contain blood, urine and vitreous, the fluid collected from inside a human eye. In overdose cases, the fluids may contain clues for investigators. "We send that off to a toxicology lab to be tested for what we call drugs of abuse," said Alfie Ballew, deputy coroner. The results often include drugs such as cocaine, heroin, fentanyl or prescription pharmaceuticals. After testing, coroners typically write the drugs involved in an overdose on the death certificate — but not always. Standards for how to investigate and report on overdoses vary widely across states and counties. As a result, opioid overdose deaths aren't always captured in the data reported to the federal government. The country is undercounting opioid-related overdoses by 20 to 35 percent, according to a study published in February in the journal Addiction. "We have a real crisis, and one of the things we need to invest in, if we're going to make progress, is getting better information," said Christopher Ruhm, the author of the paper and a health economist at the University of Virginia. Data from death certificates move from coroners and medical examiners to states and eventually the Centers for Disease Control and Prevention, which
Samples of blood and other bodily fluids at the coroner’s office in Marion County, Indiana , are tested for controlled substances. publishes reports on overdose counts across the U.S. According to the CDC, more than 42,000 people died from opioid-related overdoses in 2016, a 30 percent increase from the year before. But that number is only as good as the data states submit to the CDC. Ruhm said the real number of opioid overdose deaths is closer to 50,000. He came to the higher estimate through an analysis of overdoses that weren't linked to specific drugs. On a death certificate, coroners and medical examiners often leave out exactly which drug or drugs contributed to a death. "In
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some cases, they're classifying it as a drug death, but they don't list the kind of drug that was involved," said Ruhm. In the years he reviewed in his paper, 1999 to 2015, investigators didn't specify a drug in one-sixth to one-quarter of overdose deaths. Some states do worse than others. In 14 states, between 20 and 48 percent of all overdose deaths weren't attributed to specific drugs in 2016, according to a breakdown from FiveThirtyEight. Many overdoses not linked to a specific drug were likely opioid-related, Ruhm says, so the lack of specificity leads to undercounting. According to Ruhm's earlier research published in 2017, Indiana's opioid overdose fatality rate is especially far off. He estimated the state's rate in 2014 was 14.3 overdose deaths per 100,000 people, twice as high as the rate reported that year. In some states such as Indiana, independent county coroners investigate deaths. Coroners are usually elected, and they aren't necessarily medical professionals. Other states, though, have medical examiners, who are doctors. Some even have a chief medical examiner who
oversees death investigations for the whole state. "States that have centralized oversight with medical examiners tend to do better than those with coroners," said Ruhm. In some places, death investigators don't list substances on a death certificate because they haven't tested for them. Brad Ray, a policy researcher at Indiana University's School of Public and Environmental Affairs, said toxicology reports cost hundreds of dollars each, which could strain county budgets. Additionally, toxicology reports are currently optional for Indiana coroners. "So if you're not required to pay for it, and you're not required to report it, why would you?" said Ray. Indiana's legislature recently passed a bill to standardize how coroners handle suspected overdoses, and Gov. Eric Holcomb is expected to sign it. Starting in July, coroners will have to run toxicology screens and report the results to the state health department. The state will also help cover the added costs. More accurate data will likely make the opioid problem look worse as the numbers go up. But Ray said realistic data could help the state access federal funds to tackle the opioid epidemic and keep better track of drug problems. "So we can see when trends are happening. We can see when there tend to be increases in cocaine and meth and decreases in opioids, if that happens," said Ray. Marion County's Ballew learned at a conference last year that she could help improve the state's data. Her office was already getting toxicology reports for all suspected overdoses, and now her team will list the drugs involved in an overdose on the death certificate. "We'll say 'drug overdose' or 'drug intoxication,' and then we identify the drugs," she said. "So if it's five drugs that have caused or contributed to the death, then we put those five drugs down." Ballew plans to travel the state and train other coroners to do it the same way.
FERGUSFALLSJOURNAL.COM | PAGE 11
Exploring proper care: Dental crowns Many people visit their dentists and learn they have a tooth that requires a crown. In many instances, dental crowns are necessary for proper tooth care. Crowns were once widely referred to as “caps.” A crown is a permanent cover for a tooth that would otherwise require a very large filling after dental decay has been removed. Crowns also may be used to repair cracked or broken teeth so that extraction is not necessary. Sometimes crowns are used for cosmetic modifications or to hold a dental bridge in place. The crown itself can be made from different materials, like stainless steel, gold or metallic alloy, porcelain, porcelain fused to metal, and resin. A dentist will determine which material will work best depending on the application and tooth location.
Understanding your appointment(s)
Crowns are typically installed in two appointments. The first appointment requires prep work so the tooth can hold the crown. This is typically a painless procedure, and one in which the dentist will anesthetize the tooth and gum tissue and then file down the tooth along the chewing surface and sides to make room for the crown covering. If the tooth was decayed or insubstantial, the dentist may have to “build up” the tooth instead of filing it down. Again, these determinations are made by the dentist who has the expertise to gauge how much workable tooth is left. Once the tooth has been prepared, an impression will be made of the bite area. That’s Employee Owned ®
Dental crowns, in many instances, are necessary for proper tooth care. PROVIDED. because the permanent crown will be fabricated in a laboratory and the fit/color will need to be exact for comfort — and also to ensure that bacteria and food debris do not get caught between the crown and tooth. The final component is a temporary cap that will keep the prepared tooth clean. This is molded in the office and will be worn only until the custom-made crown is ready. When the permanent crown is delivered, the patient will return to the office to have it checked for
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fit and then cemented into place. cover a predetermined percentage of the cost when the crown is medically necessary, but insurFull and partial crowns A partial crown may be used if ance may not cover anything if only a portion of the tooth needs the procedure is only cosmetic. It’s always a good idea for pato be covered. Dentists will often rely on full crowns to get maxi- tients to express their concerns and ask questions about crowns mum coverage and strength. prior to starting the procedure. Understanding the potential outCost factor Crowns can be expensive. Ac- of-pocket costs is essential as cording to the resource CostHelp- well. Dental crowns can last several er, crowns can range from $500 to $3,000 depending on the material years and represent the best way used and the patient’s insurance to salvage a tooth that is cracked coverage. Dental insurance may or damaged.
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Dr. Wallace R. Cole At 218-736-5353 Or 757-777-6022 (cell phone) For an appointment 109 N. Mill St. Fergus Falls, MN 56537
PAGE 12 | FERGUSFALLSJOURNAL.COM
New peer hotline seeks to help firefighters facing mental health crises By MPR News
The Minnesota Firefighter Initiative recently launched a peer support help line for firefighters who are thinking about suicide. Any Minnesota Firefighter can call if they're thinking about or planning to take their own life. Just three months in, they are already surprised by the number of calls they've gotten. It's not often talked about but firefighters and emergency workers are more likely to take their own lives than the general public. Chris Culkins, the paramedic program director at Century College and a former firefighter, studies suicide among emergency workers and says just about everyone knows a collegue who has died by suicide. "I was sitting around a table with a few other paramedics several years ago and we started throwing out names of people we knew who died by suicide and we came up with all these names and it was kind of an epiphany," Caulkins says. "We looked around and said, 'Wow, carpenters can't do this.'" Caulkins says 10 of his colleagues and former students have died by suicide. He thinks the prevalence of suicide among emergency workers is in large part due to the nature of the job. "We get a front row seat to all the bad stuff-the murders, the sexual assaults, the elder abuse, the child abuse-and then the just the horrible injuries and illnesses that aren't necessarily from something nefarious but they're bad," Caulkins said. "And that I think is the crux of the problem that interacts with all the other things that are going on." Despite the prevalence of mental illness and suicide in their ranks,
Firefighters stand by after police evacuate the area after a construction equipment struck a gas main in Minneapolis in 2017. MPR NEWS Caulkins says first responders don't often talk about it. In his research, Caulkins has found many firefighters fear that seeking help for mental illness will hurt their career opportunities. And he says emergency workers don't want to appear weak. "[It's] the cowboy culture. And by cowboy I mean women, too. It's like military culture. That's like public safety culture. Suck it up. Pull yourself up by the bootstraps. Help others before you help yourself," Caulkins said. Caulkins is in England today presenting on the issue of mental illness among emergency responders. Later he'll travel to New Zealand. He says the issue is finally getting more attention but there's still much to be done to help those who help others.
Think
Synstelien Community Services provides therapeutic treatment and daily living support for people with physical and developmental disabilities, brain injuries, and mental illness in the community of Fergus Falls.
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The Daily Journal 218.736.7511 800.726.1781
FERGUSFALLSJOURNAL.COM | PAGE 13
RIGHT AFTER SHOES AND HANDBAGS, WE’RE THE ACCESSORY SMART WOMEN CAN’T DO WITHOUT.
The LINX surgery uses a tiny, titanium ring of magnetic beads, left, around the esophagus to prevent stomach contents from splashing into the esophagus. board-certified general surgeon specially trained to perform the LINX surgery, and Tri-County is one of only nine facilities in Minnesota certified to offer it. The procedure involves implanting a tiny ring of titanium magnetic beads around the esophagus near the stomach. The magnets are weak enough so that food can still pass through, but they close immediately after swallowing to prevent the stomach contents from splashing into the esophagus. Typically performed as an
outpatient procedure, LINX only requires a small incision, resulting in less pain, minimal scarring and the ability to return to work quickly. Following his surgery, Eric returned to work within two weeks and didn’t experience any episodes of reflux, a result he described it as life-changing. “It has been a miracle for our family,” Wendy added. To learn if you are a candidate for LINX or for more information, call 218-631-7581 or visit TCHC. org/LINX.
The Daily Journal TO SUBSCRIBE, CALL
800.726.1781 OR 736.7511 www.fergusfallsjournal.com
Ask Your Neighbor Ask Your Friends Ask Your Doctor
LEADERS IN PRACTICE, PRIVILEGED IN MISSION
“Dad was at Mill Street only a month when he realized what a special place it is. He is enjoying the food and the wide variety of activities planned by the excellent staff. Dad enjoys visiting and has made many new friendships in his move to this special place.” ~ The Family of
SOLUTIONS Behavioral Healthcare Professionals is a licensed mental health clinic. With a warm office environment and a friendly staff, our team works with individuals and families to treat the following problem areas: • Depression • Anxiety Disorders • Bipolar/Mood Disorders • Adjustment Problems • ADHD • Behavior Problems • Autism-Spectrum Disorders • PTSD • Serious Mental Illness • Marital and Co-Parenting Difficulty
Russell Anderson
behavior al healthcare professionals
Apartments Now Available! 802 South Mill Street Fergus Falls, MN 218.739.2900
Mill Street
RESIDENCE A LAKE REGION HEALTHCARE ASSISTED LIVING COMMUNITY
www.millstreet.org
Angie Renner, MS
Julie Starkey, LICSW
Dr. Tessie Blake, Psy.D., L.P.
Luke Voorhees, MHP, Clinic Manager
1806 E. Fir Ave., Suite 200 • Fergus Falls, MN • SolutionsInPractice.org • 218-998-2992
PAGE 14 | FERGUSFALLSJOURNAL.COM
ADVOCACY SERVICES Freedom Resource Center 125 W Lincoln Ave #17, Fergus Falls 218-998-1799 Health Resources 126 E Lincoln Ave, Fergus Falls 218-736-6050 Someplace Safe 106 S Union St, Fergus Falls 218-739-2853 BEAUTY 715 Hotheads 133 S Mill St Suite 2, Fergus Falls 218-998-2559
Anthony Gettel, Chiropractor 255 Wildwood Trl, Fergus Falls 218-205-6588 Carlson Chiropractic 301 Lincoln Ave E, Fergus Falls 218-736-3972 Fergus Chiropractic 1304 W Lincoln Ave, Fergus Falls 218-998-2881 Fergus Falls Spine & Injury Center 1515 W Lincoln Ave, Fergus Falls 218-739-3216
Prairie’s Edge Dental Associates 106 E Washington Ave, Fergus Falls 218-739-9634 Jayme Mace DMD 323 S Cascade St, Fergus Falls 218-736-3179 Lifesmiles 321 Western Ave, Fergus Falls 218-739-2481 Northern Lakes Dental 1108 Western Ave, Fergus Falls 218-736-4000
Wales Hearing Center 1304 W Lincoln Ave, Fergus Falls 218-998-2757 • 218-998-3750 HOME HEALTH CARE Accra 119 E Lincoln Ave #103, Fergus Falls 218-736-0246 CK Home Health 106 N 4th Ave, Fergus Falls 218-998-3778 Harmony Home Health 22279 River Oaks Dr, Fergus Falls 218-739-2320
Smith Family Chiropractic 104 W Lincoln Ave, Fergus Falls 218-736-4113
Riverfront Dental 124 E Lincoln Ave, Fergus Falls 218-736-5627
Tysdal Chiropractic 402 W Lincoln Ave, Fergus Falls 218-998-1099
Stephen Whoolery DDS 219 E Lincoln Ave, Fergus Falls 218-739-2217
Vistad Chiropractic 301 N Union, Fergus Falls 218-736-5676
Swelstad Orthodontics 221 E Lincoln Ave, Fergus Falls 218-998-5000
ExSalonce 1411 College Way, Fergus Falls 218-736-2434
CLINICS LRHC Cancer Care Center 908 Cascade St S, Fergus Falls 218-736-8688
Terry Drake DDS 210 N Cascade St, Fergus Falls 218-736-3847
HOLISTIC HEALTH Fergus Falls Senior Citizens Program 115 Lincoln Ave W, Fergus Falls 218-736-6842
Hair Studio 123 W Cavour Ave, Fergus Falls 218-998-5990
LRHC Clinic 111 West Vernon Ave, Fergus Falls 218-739-2221
FITNESS Anytime Fitness 120 W Cavour Ave, Fergus Falls 218-998-4424
HOSPICE CARE LB Hospice 805 Channing Ave. E, Fergus Falls 218-998-1400
Hair N Beyond 105 N Cascade St, Fergus Falls 218-998-2745
LRHC Walk-in Clinic 2311 W Lincoln Ave, Fergus Falls 218-739-6800
New Beginnings 216 W. Cavour Ave, Fergus Falls 218-736-0044
HOSPITALS Lake Region Healthcare 712 S Cascade St, Fergus Falls 218-736-8000
Primp 112 S Mill St, Fergus Falls 218-998-2250
Tri-County Health Care Henning Clinic 401 Douglas Avenue Henning, MN 56551 218-583-2953
Phatty Natty’s 712 S Cascade St, Fergus Falls 218-205-6969
Attitudes for Hair 2007 Tower View Rd, Fergus Falls 218-739-9642 Family Hair Clinic 1205 W Lincoln Ave, Fergus Falls 218-736-4583 Glamour Beauty 427 W Lincoln Ave, Fergus Falls 218-736-3913
Salon & Company 309 S Mill St, Fergus Falls 218-736-7178 Salon Eclips 109 E Lincoln Ave, Fergus Falls 218-998-4247 Salon Tru 401 S Cascade St, Fergus Falls 218-739-6250 CHIROPRACTIC CARE Advanced Care ChiroCenter 801 Pebble Lake Rd, Fergus Falls 218-736-7547
Tri-County Health Care Ottertail Clinic 232 Minnesota Hwy 78 North Ottertail, MN 56571 218-367-6262 DENTAL/ORTHODONTIA Apple Tree Dental 2001 W Lincoln Ave, Fergus Falls 218-998-2218 Drs Hanley & Murphy Dentists 1409 College Way, Fergus Falls 218-739-3245
YMCA 1164 Friberg Ave, Fergus Falls 218-739-4489 FUNERAL PRE-PLANNING Glende-Nilson Funeral Home 301 E Washington Ave, Fergus Falls 218-736-7064 Olson Funeral Home 711 Pebble Lake Rd, Fergus Falls 218-736-7586 HEARING Beltone 125 W Lincoln Ave, Fergus Falls 800-669-3171
LB Home Care 805 Channing Ave E Fergus Falls 218-998-1400 New Dimensions 312 N Tower Rd, Fergus Falls 218-739-5856
Perham Health 1000 Coney St W, Perham 218-347-4500 Prairie Ridge Hospital 1411 St. Hwy 79 E Elbow Lake, MN 56531 218-685-7300 Tri-County Health Care 415 Jefferson St N Wadena, MN 218-631-3510 INVESTMENT Ameriprise Financial 111 E Lincoln Ave, Fergus Falls 218-998-3535 Dorn & Co, Inc. 216 E Washington, Fergus Falls 218-739-5236
FERGUSFALLSJOURNAL.COM | PAGE 15
FMS Financial PlanningPaul Mayer 121 E Lincoln Ave, Fergus Falls 218-393-0152 Security Insurance 225 W Cavour Ave, Fergus Falls 218-736-2222 Thrivent FinancialKurt Nygaard & Carol Juul 1401 College Way, Fergus Falls 218-998-2723 Thrivent FinancialSteven Gunderson Julius (JP) Stender 225 W Lincoln, Fergus Falls 218-739-4452 INSURANCE AFLAC-Sheri Meis 1008 Frontier Dr, Ste 205 Fergus Falls 218-205-5335 American Family InsuranceAnnabelle Lee 119 Friberg Ave, Ste A Fergus Falls 218-739-3977 AMP Insurance 920 Pebble Lake Rd, Fergus Falls 218-739-3316 Arneson AgencyRosanne Brisson 109 W Lincoln Ave, Fergus Falls 218-736-5693 Bakken Insurance 115 E Lincoln Ave, Fergus Falls 218-739-2244 Farmers Union-Grant Davenport 114 Lincoln Ste 2, Fergus Falls 218-735-5697 Larson Insurance 125 N Union Ave, Fergus Falls 218-739-2652 Eric Shelstad - BC&BS 225 W Lincoln Ave, #100 Fergus Falls 218-739-4451 Mullen Insurance 220 W Cavour Ave, Fergus Falls 218-739-4572 Rohde Insurance 1213 N Union Ave, Fergus Falls 218-739-3295 Scott Insurance 1403 College Way, Fergus Falls 218-739-2570 Solheim Agency, LLC 902 W Lincoln, Fergus Falls 218-736-5697
MASSAGE John Haugmo Massage 1164 Friberg Ave, Fergus Falls 218-739-2720 Poppy Seed Massage 214 E Cavour Ave, Fergus Falls 218-770-0096 Red River Massage 28943 290th Ave, Wendell 218-458-2229 Therapeutic Bodywork 301 Lincoln Ave E, Fergus Falls 218-998-3023
Thrifty White Drug 1484 W Lincoln Ave, Fergus Falls 218-736-5770
MENTAL HEALTH A Place To Belong 109 N Court, Fergus Falls 218-739-0797 Bridgeway Care 712 Cascade St S, Fergus Falls 218-736-8208 Lakeland Mental Health Center 980 S Tower Rd, Fergus Falls 218-736-6987 Productive Alternatives 1013 N Tower Rd, Fergus Falls 218-998-2525 Solutions Behavioral Healthcare Professionals 1220 N Tower Rd, Fergus Falls 218-998-2992
SENIOR HOUSING Alcott Manor 418 E Alcott Ave, Fergus Falls 218-998-7400
NUTRITION GNC 2500 Hwy 210, Westridge Mall, Fergus Falls 218-736-2486 Meadow Farm Foods 23064 Cty Hwy 1, Fergus Falls 218-739-4585 ORTHOPAEDIC SERVICES Matthys Orthopaedic 129 E Lincoln Ave, Fergus Falls 866-887-9300 MAINTENANCE Midwest Pest Control 800-818-2272 Knutson Lawn 218-731-5820 PHARMACIES Shopko Pharmacy 226 E Lincoln Ave, Fergus Falls 218-736-7531 Sun Mart Pharmacy 1205 W Lincoln Ave, Fergus Falls 218-739-3259
Thrifty White Drug 107 E Lincoln Ave, Fergus Falls 218-736-5565 Walgreens 326 W Lincoln Ave, Fergus Falls 218-736-1028 Walmart Pharmacy 3300 State Hwy 210, Fergus Falls 218-739-5559
Ashby Living Center 112 Iverson Ave, Ashby 218-747-2995 Broen Home 824 S Sheridan St, Fergus Falls 218-998-7300 Golden Living Center 907 Marshall Ave, Henning 218-583-2965 Good Samaritan Society 105 Glenhaven Drive, Battle Lake 218-864-5231 Mill Street Residence 802 S Mill St, Fergus Falls 218-739-2900 Park Gardens 215 Skogmo Blvd, Fergus Falls 218-998-4444 Pioneercare 1131 Mabelle Ave S, Fergus Falls 218-998-1500 PioneerCare Suites 1006 Sheridan St S, Fergus Falls 218-739-6399 Pioneer Pointe 411 Everett Ave, Fergus Falls 218-739-7772 Pioneer Senior Cottages 1317 Mabelle Ave, Fergus Falls 218-998-9677 Schuett Properties Park View Terrace 100 3rd St N # 1002, Moorhead, MN 56560 218-233-8548
Kaleva Apartments 205 N Walker Ave New York Mills, MN 56567 218-385-3273 Park Manor Estates 1035 Roosevelt Ave Detroit Lakes, MN 56501 218-847-2636 River Bend Apartments 222 N Whitford St Fergus Falls, MN 56537 218-736-2557 Mill Pond View Apartments 101 E Mill St Pelican Rapids, MN 56572 218-863-5085 CompassionCare 222 N Whitford St Fergus Falls, MN 56537 218-998-5307 Sheridan House 808 S Sheridan St, Fergus Falls 218-998-7400 LB Woodland Lodge 394 Woodland Dr, Fergus Falls 218-737-6100 SUPPORTIVE LIVING SERVICES Synstelien Community Services 128 E Meadowlark Ln, Fergus Falls 218-736-7322 WEIGHT LOSS Advanced Weight Loss Center 801 Pebble Lake Rd, Fergus Falls 218-736-7547 VISION 20/20 Optical 111 W Vernon Ave, Fergus Falls 218-998-2020 FF Optometic Center 117 E Lincoln Ave, Fergus Falls 218-736-7555 InVision 810 N Baird Ave, Fergus Falls 218-736-5609 Midwest Vision 2001 W Lincoln Ave #19 Westridge Mall, Fergus Falls 218-739-2236 Otter Tail Eye Care 603 Douglas Ave, Henning 218-583-4673
PAGE 16 | FERGUSFALLSJOURNAL.COM
THERE’S SO MUCH TO DO HERE. STAY HEALTHY FOR IT.
lrhc.org
Love where you live at Park Gardens! “My mother has been a resident at Park Gardens Assisted Living in Fergus Falls for several years, and I want the community to know how deeply grateful our family is for the excellent care provided her over that time. Mom always wanted to live out her days in her hometown. As a daughter who lives halfway across the country, it has been a blessing beyond measure to know that she is well cared for in her time of need. Park Gardens truly became her home and her extended family. The staff at Park Gardens get high praise from us. Time and time again, we see acts of kindness and patience as staff members at every level provide care and services for mom and other residents.” – Sue, tenant family member
Independent Plus • Assisted Living • Memory Care For more information, call 218.998.4444
215 E Skogmo Blvd, Fergus Falls, MN 56537 www.parkgardensfergusfalls.com