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What PFD Has Been Up To: Dr. Jill Lectures at the Southwest Dental Conference

September 19, 2017

At Prosper Family Dentistry, we are committed to lifelong learning and the continual furthering of our knowledge.  Because dentistry is an ever-changing profession and our most important goal is taking excellent care of our patients, we place a high priority on dental education. As in most professions, dentists, dental hygienists and dental assistants must meet a minimum requirement of hours of education in order to maintain an active license.  Our doctors exceed the required hours of continuing education by five times or more.

The Southwest Dental Conference is held each year at the Kay Bailey Hutchinson Convention Center in downtown Dallas.  It provides a wide range of classes on a myriad of subjects by well-known dentists and other lecturers.  What made this year extra special is that one of those dentist/lecturers was our very own Dr. Jill!  After presenting a short table clinic in February 2017 at the American Academy of Restorative Dentistry in Chicago on the subject of the upper cervical spine, she was invited by the organizers of the Southwest Dental Conference to give a one hour lecture on the same topic at this year’s meeting.

In her lecture, Dr. Jill explained the anatomy of the upper cervical spine and how it affects the teeth and jaws.  She discussed a dentist’s unique position to identify problems in the upper cervical spine through the use of 3D imaging.  She described how a misalignment of the upper cervical spine can masquerade as a toothache or TMJ pain.  Dr. Jill illustrated this phenomenon with several case studies of patients she has treated at Prosper Family Dentistry over the last few years.

The doctors at Prosper Family Dentistry strongly believe in an interdisciplinary approach to dentistry.  The teeth and jaws are not isolated from the rest of the body, and they should not be treated as if they are.  This belief has led Dr. Jill and Dr. Cara to work with many specialists to help each patient reach optimum health.  In the case of the upper cervical spine, they work closely with chiropractors, physical therapists and physicians who specialize in the manipulation of the upper cervical spine.  As with many other situation, like high blood pressure and sleep apnea, our dentists are in a unique position to identify a problem before a patient seeks medical attention.  This is just one of many ways Dr. Jill and Dr. Cara provide our patients with the most comprehensive care possible.

Hannah and Kadi attended Dr. Jill’s lecture

Ending the lecture on a funny note

Taking questions after the lecture

 

 

Pizza Burns, Popcorn Shrapnel, and Tortilla Chip Daggers: Soft Tissue Injuries in Your Mouth

September 13, 2017 

Have you ever been so excited for your pizza that you just could not wait for it to cool down?  You are starving.   You cannot wait one more second.   So you take a big bite of piping hot pizza, only to feel the searing pain of a tomato sauce burn on the roof of your mouth instead of the simple gustatory satisfaction of bread, tomatoes, cheese and {insert your favorite topping here}.

Maybe Mexican food is your weakness.  The chips and salsa start calling your name as soon as you walk in the door.  You toss the whole chip with its twists and turns into your mouth, but when you bite down, a shard stabs into your gums.

At the movie theater, you eat hot, buttery popcorn by the giant handful.  When one shell of a kernel finds its way between your teeth, you spend the entire movie contorting your tongue to try to work it out and curse yourself for not carrying floss with you at all times.

Most everyone can relate to these slightly over-dramatized examples.  In some cases, the damage is very minor and only bothers you for an hour or two.  In other cases, the injury leads to a painful ulceration or a localized gum infection if not handled correctly.  Here is what you need to know about reducing your risk for these types of injuries and how to handle them when they inevitably happen.

How to Reduce the Risk of Injury

Slow down!  Many of these injuries happen because someone is eating too quickly, not allowing food to cool properly, or taking bites that are too large.  In order to lower your risk of these types of injuries, always wait for your food to cool to a manageable temperature.  Only take bites that are appropriate for your mouth, and chew slowly.  When teeth are aligned properly and chewing is performed at a normal rate, the anatomy of the mouth provides protection for the gum tissues, lips, cheeks and tongue as you chew.

How to Handle a Soft Tissue Injury

Keep your mouth as clean as possible!  The initial injury, whether it is a burn, laceration, or impacted food, can quickly progress to an inflammation or infection if not cleaned properly.  Our mouths are full of bacteria, and it is imperative to keep sores clean until they heal.  Gentle swishing of warm salt water or over-the-counter Peroxyl® mouthrinse can keep the injured site clean and promote rapid healing.

Use mild oral care products.  The injured site can be very tender and overly sensitive.  If you find that your normal mouthrinse and toothpaste cause a stinging or burning sensation to the injured area, you should switch to mild, hypoallergenic products like those made by Biotene.

Alter your diet.  Areas of ulceration or inflammation are easily irritated by very hot temperatures, very spicy foods, and acidic foods and beverages.  In order to keep the injured site as soothed as possible, you should avoid drinking hot coffee or tea.  Do not eat food that is extremely hot; allow it to cool down before taking a bite.  During the healing period, eat a mild diet that is not spicy or acidic.  Steer clear of foods high in tomato or citrus content until the area has resolved.

Avoid toothpicks.  If you feel that a popcorn kernel or other food debris is lodged between your teeth and gums, do not use a traditional wooden toothpick to attempt retrieval.  Ironically, we have removed more fragments of wooden toothpicks from patient’s gum tissues than popcorn kernels.  Only use dental floss or small interdental brushes (like a Proxabrush) to remove the embedded food particles.

Be careful when flossing.  It is possible to floss too aggressively and cause damage to your gum tissue.  When you floss with the intent to remove a popcorn kernel or other food particle, it is important to be gentle and monitor your progress.  Ideally, you want the floss to reach under the foreign body and pull it out.  If you feel that your flossing is actually pushing the material further into the gum tissue, stop immediately!

Come see us.  If you are unable to remove a piece of food or debris, it is important to see your dentist sooner rather than later.  The longer the irritant stays in place, the more likely it is to cause inflammation and can lead to infection.  If you have a painful burn or ulceration, we can prescribe a prescription mouthrinse and/or topical ointment to alleviate the painful symptoms and promote healing.

Have You Injured Yourself?

Call Prosper Family Dentistry at 972-347-1145 to schedule an appointment with Dr. Jill or Dr. Cara as soon as possible.

Dental Implants: Restoration of a Missing Tooth

September 6, 2017 

A Missing Tooth

In dentistry, we use the term prognosis to describe how long a tooth will continue to function properly.  That term also encompasses any treatment done on a tooth as a predictor of how long the treatment itself will last and keep the tooth in proper function.  Giving a prognosis on a tooth or treatment is a little like predicting the future.  We are not giving an exact timeline; we are making an educated guess.  We want your teeth and the work we perform on them to last as long as you do!

When a tooth has a hopeless prognosis, the only treatment option is removal of the tooth by extraction.  When a tooth or the proposed treatment to save a tooth has a poor long-term prognosis, we will always give you the option to remove the tooth.  Once the tooth is removed, you will have several options for replacing it.  We believe that your time, effort and money are best invested in something that will last.  The treatment option with the highest success rate for replacing a missing tooth is a dental implant.

Anatomy of a Dental Implant

One of the reasons a dental implant has such a high success rate is that its anatomy mimics a natural tooth more closely than any other treatment option available in dentistry.  This configuration allows a dental implant to stand alone; it does not anchor or rest on any other teeth unlike a bridge or a removable partial.

A dental implant consists of three parts:

  1. Implant body – The implant body is the root replacement. It is made from titanium, like implants and prostheses used in other parts of the body.  This titanium root form comes in many different sizes, and using our 3D image of your jawbones, we will select the proper size for your specific missing tooth.  In some cases, the implant can be placed at the time of extraction, called an immediate implant.  In other situations, it is necessary to allow the jawbone to heal for several months between the extraction and the placement of the dental implant. Once the implant has been placed into the jawbone, it must heal for several months, allowing the bone to grow into the threads of the implant form, which is a process called osseointegration.  After a minimum of 3 months of healing, we are able to test the level of osseointegration of the implant using a tool called an Osstell to ensure that the implant is stable and ready to withstand chewing forces.
  2. Abutment – The abutment is the connector between the implant root and the dental crown. An abutment can be made from several different materials, as needed for esthetics.  The abutment is affixed to the implant root form with a small screw, and it protrudes from the gums, providing the core structure for a crown.
  3. Abutment-supported crown – An abutment-supported crown is very similar to a traditional dental crown. It covers the entire abutment form to the gumline and restores the natural anatomy of the tooth, enabling you to return to normal function in this area.

What Is the Process for Replacing a Missing Tooth with a Dental Implant?

Visit 1:  Implant Planning

At this visit, some images are taken of the proposed implant site, including photographs, dental x-rays and a 3D CBCT image.  We determine which size dental implant will best restore your missing tooth and discuss the following surgical visit.

Visit 2: Surgical Placement of the Implant

During the surgical visit, you have the option to be sedated, and if you desire this, please discuss it with Dr. Jill or Dr. Cara BEFORE this visit.  You can also elect to have the procedure done with local anesthetic only, meaning you are awake throughout.  Implant placement is a relatively quick procedure and usually causes less discomfort than a tooth extraction so many people choose to remain awake for this visit.  You should feel only vibration as the site in the bone is being prepared and the implant placed.  You will be given very strict post-operative instructions regarding your stitches, care of the surgical site, and oral hygiene to follow.

Visit 3: Removal of Stitches

Between one and two weeks later, you will return for the removal of your stitches and a post-operative evaluation of the surgical site.  This is typically a very quick visit, and most, if not all, post-operative pain or discomfort has subsided by this time.

Visit 4: Uncovering and Testing Implant

At three months post-op, the implant will be exposed to the mouth (if it is not already) by removing the gum tissue over it with a dental laser.  Once the implant is accessible, we are able to test its stability to determine whether or not it is ready to withstand chewing forces.  Using an instrument called the Osstell, we can quantitatively measure the stability of the implant in the jawbone.  If the implant shows the correct amount of stability, we can proceed with visit 5.

Visit 5: Scanning for Abutment and Crown

This visit may be done in combination with visit 4 if the Osstell measurements are appropriate.  Using our 3D intraoral scanner, we take an image of the implant site and the surround teeth.  This image is sent to the laboratory for selection of the proper abutment and fabrication of your dental crown.  A covering called a healing cap is placed over the implant at the end of this visit.

Visit 6: Final Placement of Abutment and Crown

When the abutment and crown are delivered to our office from the dental laboratory, the healing cap is removed from the implant, and the abutment and crown are placed.  The abutment is attached to the implant via a small screw, which is torqued to the appropriate tightness.  Dental x-rays confirm the fit of the crown.  Once the crown meets our standards and feels perfect to you, it will be cemented and cleaned.

Do You Have a Missing Tooth that You Would Like Restored with a Dental Implant?

Call our office at 972-347-1145 to set up a consultation with Dr. Jill or Dr. Cara.  They will discuss your treatment options in detail and help you choose what is right for you.

 

Activated Charcoal and other DIY Whitening Trends

August 30, 2017 

You have probably seen it as you scroll through your Facebook, Instagram or Pinterest feed: do-it-yourself teeth whitening. The trend of attempting to whiten your teeth with “all-natural” or over-the-counter ingredients and without the endorsement of a dentist has gained widespread popularity in recent years. It’s no surprise that everyone wants whiter teeth. Our goal at Prosper Family Dentistry is for you to achieve your cosmetic goals while maintaining the best possible health of your mouth.

There are dangers associated with some of the DIY whitening trends, and it is important to know these dangers before you attempt any of the techniques promoted as “teeth whitening hacks”.

The Two Biggest Dangers: Abrasion and Acid Erosion

  1. Abrasion – Abrasion is defined as a wearing away, grinding or scraping by friction. In dentistry, it is the wearing away of surface tooth structure by friction with another surface or material. This is one of the dangers of DIY whitening trends that use rough, coarse or abrasive materials to polish superficial stains off of enamel. Very mild abrasion is the mechanism of action of whitening toothpastes; they contain small, coarse particles that clean the surface stains from the outer layer of enamel. If the wrong material is used (something that is too coarse), or if an approved material is used in the wrong manner (using an ADA approved whitening toothpaste with a hard toothbrush in aggressive motions), rather than simply removing surface stains, you can actually remove enamel! Removing enamel will make the teeth thinner, weaker, more sensitive, and ironically, yellower over time.
  2. Acid erosion – Acid erosion is the gradual destruction of tooth structure by the chemical action of acid on enamel. Dentists see severe acid erosion on patients who have a habit of sucking on lemons or patients with bulimia. Acid erosion of teeth can also be a complication of acid reflux or GERD. Many of the DIY whitening techniques recommend using acidic fruit juices or fruit pieces, which over time, can cause acid erosion on the teeth.

Activated Charcoal Powder and Charcoal Toothpastes

Its rise in recent popularity might make you think this is a new use for charcoal, but charcoal has actually been used in oral hygiene for thousands of years. Hippocrates documented using it in ancient Greece. The American Dental Association has responded to the rising interest in charcoal as an oral hygiene product by publishing a literature review of all published scientific research studies regarding charcoal and charcoal toothpastes. The goal was to find evidence in scientific research for the safety and effectiveness of using this material on the teeth. The results of the literature review state that there is not enough support by scientific research to claim that charcoal is safe for enamel and is an effective tooth whitener. The literature reviewed showed some mixed results, and the majority concluded that there is a risk of enamel abrasion. The literature review also included a study of 50 charcoal powders and toothpastes available for purchase on the internet, and none of them has achieved the Seal of Approval by the American Dental Association.

In short, activated charcoal cannot be deemed safe by dentists for use on teeth.

DIY Teeth Whitening using Lemons or other Fruits

Many other home whitening trends advise you to mix lemon juice with baking soda for a homemade whitening toothpaste. Another technique recommends rubbing your teeth with the inside of a banana peel, and one site calls for a paste made from strawberries. All of these fruits are acidic (lemon juice = 2, strawberries = 3.0-3.9, and bananas = 4.5-5.2) and are not meant to stay in contact with your teeth for longer than it takes to eat them. You should never purposefully apply any acid to your teeth. The enamel is weakened, increasing your cavity risk, causing tooth sensitivity, and irreversibly damaging the teeth.

Still Interested in DIY Teeth Whitening?

Please discuss your ideas with Dr. Jill and Dr. Cara. They will be able to advise you on which specific techniques may be safe for you and which could be especially dangerous. They can also answer any questions about the safety and effectiveness of professional teeth whitening offered at Prosper Family Dentistry.

 

Oral Cancer

August 23, 2017 

Cancer is a disease caused by uncontrolled growth of abnormal cells in a part of the body.  Oral cancer is a type of cancer in which these abnormal cells originate in the mouth.  Cancer is classified by the original site of abnormal cells.  Oral cancer kills approximately one person every hour in the United States.  About 50,000 new cases of oral cancer are diagnosed each year.

What are the different types of oral cancer?

The most common type of oral cancer is squamous cell carcinoma, and it occurs in the tissues lining the inside of the mouth or on the lips.  Squamous cell carcinoma makes up over 90% of all oral cancer.  A much smaller percentage of oral cancers develop in other types of tissue in the mouth, like the salivary glands causing adenocarcinoma, the lymph nodes or lymph tissue like tonsils causing lymphoma, or in pigmented tissue causing melanoma.

What are the risk factors for oral cancer?

The risk factors most closely associated with oral cancer are:

  • Tobacco use of any kind
  • Alcohol consumption
  • Infection with human papilloma virus (HPV)
  • Chronic oral infections
  • Persistent trauma to oral tissues
  • Poor oral hygiene, lack of dental care
  • Poor nutrition

Who is most likely to get oral cancer?

  • People who work outdoors and have a large amount of sun exposure on their lips are at a high risk for developing cancer on their lips.
  • People who smoke, use smokeless tobacco and/or drink alcohol have a high risk for oral cancer inside the mouth. Tobacco use combined with alcohol consumption creates a risk level that is higher than either one alone because they act synergistically together.
  • People infected with the human papilloma virus (HPV) have a higher risk for developing oral cancers at the back of the throat and base of the tongue. Certain strains of the virus have a higher risk than others.  HPV is the newest known cause of oral cancers and accounts for the changing demographics of oral cancer.  Historically, oral cancer was a disease of old men who smoked and drank alcohol a lot.  The average age of oral cancer has dropped in the last two decades, and it now affects more women than in the past.
  • People with chronic infections and persistent trauma in their mouths have an increased risk for developing oral cancers.

What can I do to lower my risk for oral cancer?

  • Limit sun exposure and use SPF chapstick!
  • Stop ALL tobacco use, both smoking and smokeless tobacco!
  • Limit alcohol consumption.
  • Practice good oral hygiene. Treat any persistent infections in the oral cavity including cavities and periodontal disease.
  • If you have an area of your mouth that is prone to trauma (cheek biting, a sharp tooth cutting your tongue), see your dentist to discuss treatment options to reduce the occurrence of this trauma.
  • See your dentist for regular oral cancer screenings. At PFD, this is included in every comprehensive and periodic oral evaluation you have with Dr. Jill and Dr. Cara.  In its initial stages, oral cancer is typically painless and easily goes unnoticed without a visual evaluation.  This is why consistent oral cancer screenings are so important.  Early detection is key!
  • Perform a self-screening exam once every month.

What should I look for in my mouth?

Any ulcer, sore, blister, lump or abnormal tissue that does not heal within 14 days needs professional evaluation by a dentist.  A very common presentation for oral cancer is an overgrowth of white tissue on the sides of the tongue or the floor of the mouth.  Cancerous lesions can also be bright red in color.  As you are screening yourself, simply search for anything that does not blend in with the surrounding tissue both by look and by feel.  Because of some locations in your mouth being difficult to see, you may be able to feel something unusual without seeing it.  Remember, oral cancer rarely causes any discomfort or pain in its early stages, so you have to be looking on a consistent basis to catch it early.

What do I do when I find something in my mouth that could be oral cancer?

Monitor it closely, noting what date you first saw or noticed the lesion.  Take photos of it, if possible.  Any sore, ulcer, or bump that does not heal within 14 days needs professional evaluation by a dentist.  Make an appointment with Dr. Jill or Dr. Cara for an evaluation as soon as possible.

 

What is the treatment for oral cancer?

Treatment for oral cancer depends on the stage of cancer diagnosed.  Early detection is the most important factor in beating oral cancer!  The first step is always a biopsy of the abnormal tissue.  Depending on the location of the tissue, this will be done either by a periodontist (gum specialist), oral and maxillofacial surgeon, or an ENT (for lesions on the tonsils or throat).  Once biopsy results confirm a diagnosis of cancer, treatment will commence with the surgeon working in coordination with an oncologist and can include surgical removal of cancerous tissue, chemotherapy and radiation.  Dr. Jill and Dr. Cara will work in cooperation with your doctors to ensure that the rest of your mouth stays as healthy as possible throughout treatment.

More information on oral cancer can be found online at The Oral Cancer Foundation and the American Association of Oral and Maxillofacial Surgeons.

 

 

 

Teeth Whitening

August 9, 2017 

A 2013 survey of 5,500 unmarried adults asked them to rank the qualities by which they judge the opposite sex on first meeting someone new.  Teeth was the highest ranked characteristic by a long shot (58% of men and 71% of women ranked it the #1 feature by which they judge a member of the opposite sex for attractiveness).  Americans spend $1.4 billion on teeth whitening products.  (Click here to see this and other interesting statistics about teeth whitening from research conducted by the American Academy of Cosmetic Dentistry.)  Globally, teeth whitening is a $3.2 billion industry.  If you are on social media, you have probably seen at least one DIY whitening trend.  Teeth whitening is one of the quickest and easiest ways to improve a smile.

What is Teeth Whitening?

Teeth whitening is any process that causes the teeth to appear whiter in color.  This can involve two different processes: 1) the removal of surface stains and polishing of the teeth and 2) chemically bleaching the teeth with peroxide agents.  The removal of surface stains and polishing of the teeth is the mechanism of action used by whitening toothpastes and all of the DIY whitening trends you see on Instagram and Pinterest.  This is accomplished by the use of abrasive compounds to polish the outer surface of enamel and remove superficial stains like coffee, tea and red wine.

The risks associated with this type of teeth whitening is the removal of enamel or exposed root surfaces.  This risk is the main concern that dentists have with DIY whitening trends: they can cause irreversible loss of tooth structure.  Teeth will initially appear whiter, and as the abrasion continues and enamel becomes thinner, the underlying dentin will begin to show through, making the teeth look darker over time.

The best way to lessen this risk is to use whitening toothpastes with the American Dental Association’s seal of approval because their abrasivity has been tested and confirmed to be safe for tooth structure.  Also, make sure to follow the manufacturer’s instructions when using a whitening toothpaste.

Teeth whitening can also involve bleaching the enamel and underlying dentin tooth structure with chemical compounds containing peroxides.  Because bleaching the teeth does not remove any tooth structure, it can actually be safer for your teeth.  Many over-the-counter products contain peroxide chemicals for bleaching and are safe when used as instructed.  This blog will address the professional whitening options offered at Prosper Family Dentistry, all of which are bleaching agents containing peroxides.

Hydrogen Peroxide vs. Carbamide Peroxide

The two possible whitening ingredients in professional teeth bleaching agents are hydrogen peroxide and carbamide peroxide.  Because carbamide peroxide breaks down into hydrogen peroxide, they are virtually the same.  There are two minor differences that may factor into the decision on which product to use: 1) Hydrogen peroxide shows an initially quicker whitening effect, which then plateaus so that the final whitening result is the same for both hydrogen peroxide and carbamide peroxide.  2)  Carbamide peroxide has a slightly longer shelf life.  This is important for take-home whitening gels that you may use on a less frequent basis.

Option #1: Opalescence® GO

Opalescence® GO is a set of prefilled disposable whitening trays containing either a 10% or 15% hydrogen peroxide whitening gel.  GO is available in a 10-tray pack or a 4-tray maintenance pack.

Pros: Cons:
  • No dental appointment required. You can run by the office, grab a pack, and start whitening immediately!
  • The entire set is disposable.  Once you have completed a set, a new pack must be purchased if any further whitening is desired.
  • Easy to use – the unique tray material uses the temperature of your mouth to adapt to the shape of your teeth.
  • Results are not immediate; typically, whiter teeth are noticed after 3-4 days of whitening.
  • No impressions of your teeth and no lab time.
  • This system is unable to whiten individual teeth for customization.  All teeth are exposed to the same amount of whitening gel for the same amount of time.
  • Adapts to any smile – this makes it the perfect choice for anyone who is in the midst of completing dental treatment, or a pre-teen whose teeth are still coming in.
  • Hydrogen peroxide compound means shorter wear time.
  • Contains potassium nitrate (desensitizes the teeth) and fluoride (strengthens enamel).
  • Least expensive initial investment.

Option #2: Opalescence® PF Whitening Gel in Custom Trays

Teeth whitening using custom trays and a bleaching gel is considered the “gold standard” in teeth whitening.  It is the most customizable and controlled option available in teeth whitening.  Opalescence® PF Whitening Gel is available in many concentrations; we offer 10%, 20%, and 35% in our practice.

Pros: Cons:
  • Once made, the custom trays will last for years.  The only reason you would need new ones is a major change in the shape of your teeth (for example, significant dental work or orthodontics).  This allows you to purchase refill kits of bleaching gel for continued whitening at a much lower cost than the initial investment.
  • Impressions of your mouth are necessary to fabricate a mold of your teeth, on which the custom tray is made.
  • You choose which teeth to whiten and when.  Easily customized to get the best result with the least amount of gel.
  • About 1 week lab time before you can begin whitening.
  • Greater variety of concentrations of the gels = greater versatility of whitening (anywhere from 15 minutes to 9 hours/overnight).
  • Results are not immediate; typically, whiter teeth are noticed after 3-4 days of whitening.
  • Whitening can be done any time for maintenance of a bright, white smile.
  • Properly loading the gel into the trays requires some manual dexterity.
  • Carbamide peroxide is the main ingredient, which increases its shelf life.
  • Contains potassium nitrate (desensitizes the teeth) and fluoride (strengthens enamel).
  • Very inexpensive after the initial investment for the custom trays.

Option #3: Opalescence® BOOST In-Office Whitening

Opalescence® BOOST In-Office Whitening is the way to go for an instantly whiter and brighter smile.  This option gives you instant gratification and is perfect for an upcoming special event or for those people who just do not have time for at-home whitening.  In one session of BOOST, you will achieve the same results you would get with multiple days of whitening your teeth through the first two methods of at-home whitening.  Basically, we do all the work for you!  Opalescence® BOOST is 40% hydrogen peroxide, which means it is strong and works fast.

Pros: Cons:
  • Instant results!  Your teeth are visibly whiter in one hour.
  • Most expensive option.
  • Customizable: Your dentist or hygienist can apply different amounts of gel to different teeth, if they are not all the same color.  They can also protect sensitive areas of gum recession and avoid using the gel on dental work.
  • Requires a scheduled appointment with your dentist or hygienist.
  • Contains potassium nitrate (desensitizes the teeth) and fluoride (strengthens enamel).
  • Increased risk of irritation of the gums or tooth sensitivity due to its high concentration.
  • Chemically activated: no light needed.
  • Some maintenance may be required if you frequently drink beverages with a high probability of staining your teeth (coffee, tea, red wine).

Interested in whitening your teeth?

Call our office to set up a whitening consultation with Dr. Jill and Dr. Cara to discuss your options and choose the whitening option that is right for you!

 

 

Back to School

August 9, 2017 

For many people, this time of year is more than just back to school.  It is back to daily and weekly routines, back to bedtimes and alarm clocks, and back to good habits that may have gone by the wayside in the easygoing days of summer.  Add this to your list of daily activities as you get back into the swing of things: taking great care of your teeth!  There are many things involved in pursuing a healthy mouth.  Here are some tips to getting that oral hygiene routine back on track.

Brushing

  • In order to properly remove plaque (the soft, sticky substance that causes cavities and gum disease), it is necessary to brush your teeth twice a day with a soft or extra-soft bristled toothbrush.
  • The most commonly missed area in brushing is at the gumline, so make sure the bristles of your toothbrush are gently touching the gums as you brush. 
  • Check the bristles of your toothbrush often.  The American Dental Association recommends replacing toothbrushes every 3-4 months or sooner if bristles are splayed and worn (like the photo shows).  A worn toothbrush cannot do a thorough job of cleaning teeth.
  • Please remember: never share a toothbrush with anyone, especially your child.
  • If you or your child is sick with any type of infection, replace your toothbrush or run it through your dishwasher’s “Sanitize” cycle.
  • Supervise your children’s brushing.  They should only be brushing their own teeth if they can tie their shoelaces or write their name in cursive.  Otherwise, you should still be brushing their teeth for them.

Flossing

Brushing alone cannot quite get the job done when it comes to removing all of the plaque from your teeth.  The nooks and crannies between your teeth are havens for clumps of bacteria where even the best brusher is not able to reach.  Flossing removes this plaque and reduces your risk for cavities and gum disease.  When you skip flossing, you miss over 35% of the surface of a tooth.  Studies have shown that flossing every day can prolong your life by six years.

Because flossing is a more difficult skill to master, you should floss your children’s teeth until they show they can properly do it on their own.  The easiest way to floss your child’s teeth is to sit on a bed or the floor, and have the child lay down with his head in your lap.  Have the child tilt his head up so that you can look straight down into his mouth.  This gives you the simplest access for flossing (also good for brushing).  The earlier you start this process, the easier it is to accomplish.

Preventive Dental Care

  • Professional cleanings – So let’s say you’re not a perfect brusher and flosser; no one is.  We all have areas that we may miss with our toothbrush or floss.  What happens when sticky, soft plaque is not removed from our teeth?  In 24 hours, it begins to harden into tartar (also called calculus).  Once it has hardened, it cannot be cleaned off with a toothbrush or floss.  It has to be removed by your dentist or dental hygienist.  Tartar buildup that is not removed on a regular basis leads to painful, chronic conditions that require more extensive and more expensive dental treatment.
  • Dental evaluation and x-rays – A dental evaluation by your dentist can uncover problems that can be treated in the early stages, when damage is minimal and restorations may be small.  Dental x-rays show how the teeth are developing and hidden decay that develops between the teeth.  X-rays also allow us to monitor the jawbones for any changes, including cancer or abnormal growths.  These important steps, taken on a regular basis, can help prevent painful, chronic conditions and save money.  Untreated tooth decay is a serious infectious disease for which there is no immunization.
  • Fluoride application – Cavities used to be a fact of life.  Over the past few decades, one thing has been responsible for a dramatic reduction in the prevalence of cavities: fluoride.  The U.S. Centers for Disease Control says that water fluoridation is “one of 10 great public health achievements of the 20th century”.  Fluoride in your water supply is integrated into children’s teeth as they are forming, adding strength and cavity resistance to their enamel.  Teeth can also be strengthened and protected with topical fluoride.  Topical fluoride includes many products you may already use at home (toothpaste, mouthwash and gel), and it can be professionally applied in your dentist’s office.  Your need for professional fluoride treatment should be assessed by your dentist and is based on your cavity risk level.
  • Sealants – Another common area that toothbrush bristles miss is the deep pits and grooves on the biting surfaces of your back teeth.  These types of cavities can be prevented by applying dental sealants over the pits and grooves.  A dental sealant is a thin coating that goes on in a liquid form, flowing into the pits and grooves and then hardening to form a smooth, flat surface that prevents the accumulation of bacteria and food particles.  Sealants are most effective when applied as soon as a back tooth enters the mouth.

In Prosper, school starts a week earlier than usual this year.  If you missed getting in to our office this summer for your preventive care, take a look at your school calendar.  School holidays are busy in our office, and appointments go quickly. Pick the next school holiday for your dental visits and call us today to get on the books for the day you want!

Call our office at 972-347-1145 to set up a preventive visit with your hygienist Staci, Kenneth, or Carli and an evaluation with Dr. Jill or Dr. Cara.

 

 

Staff Highlight: Dr. Jill

August 2, 2017

by Lara T. Coseo, DDS, FAGD

Dr. Jill has called many places home throughout her life, and now she is happy to call Prosper home.  This is where she and her husband Pat decided to put down roots in the form of a dental practice in August of 2004.  Before graduating from dental school, they began planning the rest of their lives by searching for the right place to build a private dental practice.  They looked for a town in which they would enjoy raising a family and being part of the community.  Their search, and a conversation with Staci Rigsby, the staff member who has been with Dr. Jill for the longest (over 12 years), brought them to Prosper.  At that time, there was not a single dentist in the town of Prosper.  Dr. Jill became the first!

Dr. Jill spent most of her formative years in the Santa Clarita Valley of California, where she was involved as a sports trainer in high school and practiced piano with the dream of becoming a concert pianist.  While she remains an avid sports fan and a follower of a wide variety of music, she switched her focus to healthcare during college, for which all of her patients are grateful.  When Dr. Jill traveled from California to Baylor University in Waco, Texas, to visit a friend, she immediately fell in love.  She describes the Baylor campus as one of her favorite places on earth. One of the many reasons she loves it so dearly is because she met her husband Pat there.  You have probably never met two bigger Baylor Bear fans than Jill and Pat.

They were married in July of 1999, and Dr. Jill spent her first year of marriage working as a vet tech in Plano while trying to decide whether or not to go to veterinary school.  Thankfully, she instead settled on dentistry and entered Baylor College of Dentistry in the fall of 2000.  Dr. Jill not only succeeded in becoming #1 in her dental school class; she did it while commuting to downtown Dallas from Plano every day for four years.  She often states that she could never have accomplished either of those feats without the love, support, and stability she received from Pat during those four years.

Prosper Family Dentistry opened its doors for business in August of 2004 in a brand new medical complex on Preston Road.  At the time, Preston only had two lanes of traffic!  Dr. Jill opened the dental practice with two operatories (patient rooms) and one employee.  Now, Prosper Family Dentistry has nine operatories and eleven team members!  It has certainly grown with the town.

Dr. Jill is well known among her patients for her friendliness, empathy and compassion to all people.  Her great reputation as a dentist is based on those qualities plus a truly comprehensive view of dentistry.  When you become a patient of Dr. Jill’s, you are not getting just a tooth-fixer; you are getting  a doctor who cares about your overall health and how it is affected by the condition of your mouth and jaws.  She delves into the relationship between your oral health and other parts of your body including your upper cervical spine, hormones, any past trauma or injuries, among many others.  You can read our reviews to see how well-loved she is.

Dr. Jill also loves interacting with the community.  She has participated in countless events in both public and private schools, at the local library, and around the community.  She has sponsored more sports teams and school events than we can count, and she brings students of all ages into her practice to give them an inside look at dentistry.  She and her family are very active in Prosper United Methodist Church and the many service opportunities it provides to the surrounding area.  In short, she loves this community and all the people in it.

 

 

In her home hangs a sign that reads “Faith   Family   Friends“.  It would be easy to think that this is just another cute decorative piece that really doesn’t have much to do with her work.  That’s just not the case with Dr. Jill.  For her, in the same way her view of dentistry is comprehensive, this sign is a comprehensive view of life that encompasses her work.  Her faith is the foundation on which she builds the compassion and empathy she feels for each person she meets, especially those entrusting themselves to her care.  She is called to use the knowledge and expertise she possesses to improve the quality of life of those around her.  In her team, she has created a family that works together and takes care of one another.  As a business owner, she feels the weight of providing for this family as much as her own.  Lastly, her patients are her friends.  She genuinely cares about their families, their vacations, their struggles, their sorrows, in a way rarely seen among healthcare providers.  She’s been known to cancel a patient’s treatment and just listen to their story and pray with them because that is what was truly best for that person that day.

Dr. Jill is loved near and far for all of these reasons and many more.  If you see her this week, wish her a Happy Birthday!

 

Crowns

July 26, 2017 

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 Prosper Family Dentistry, 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.  The chart below details the pros and cons of various crown materials.  Please click the image to enlarge it for better viewing.

Dental Crown Materials – Pros and Cons

What can I expect at my dental appointment for a crown?

  • Traditional lab fabricated – If your crown is being made in a dental lab by a professional, certified dental lab technician, 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).  Click here to watch a video of our dental assistant answering the most frequently asked questions about temporary crowns.
    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.
  • Same-day in-house crowns – A new trend in dentistry is same-day crowns. This technology eliminates the need for two appointments, the 3 week waiting period, and a temporary crown.  The same-day crowns are made with a CAD/CAM milling machine that works with 3D technology to create a physical crown out of digital information.  One limitation to same-day crowns is that they can only be made out of one material, so they are unable to make crowns that contain two types of materials like the porcelain-fused-to-metal crowns.  They are also limited in the customization allowed to create the perfect match to your natural teeth.  For this reason, they may not be selected as the right type of crown for front teeth.
    The tooth is prepared by the dentist in the same way, and instead of having a provisional crown made, you simply wait in the office while the crown is being milled by the CAD/CAM machine.  Once it’s completed, the crown is fitted to your tooth in the same process as noted above, and the same instructions apply.

Still need more information about crowns?

Call our office at 972-347-1145 to set up a consultation with Dr. Jill or Dr. Cara so they can discuss your options with you.

 

 

What PFD Has Been Up To: Mouthguard Day!

July 19, 2017

It is probably not possible to quantify how much Dr. Jill Sentlingar loves our little town of Prosper.  Opening a dental practice here in 2004 fulfilled her dream of being an integral part of a thriving, close-knit community, and she has spent the last 13 years providing the highest quality of healthcare to this place she calls home.  As a sports fan herself and the mom of two athletic boys, she loves the way Prosper rallies around its young athletes, from Little League all the way up to Prosper High School varsity teams.

Over a decade ago, she decided that one awesome way to promote great dental health and give back to her community was to make sure every Prosper High School varsity football player had access to a professionally-made custom mouthguard.  In our blog about athletic mouthguards, we discuss the statistics of sports injuries, the importance of mouthguard use, and the different types available.  The role of athletic mouthguards in preventing serious dental injuries cannot be overemphasized.

Over the years, Prosper Family Dentistry has made countless mouthguards for hundreds of football players who have passed through Prosper High School.  One year, when getting the players to our office became difficult, we took our office to them, taking impressions of their teeth in the fieldhouse (complete with proper infection control protocol).  In recent years, our “Mouthguard Day” event has become known for the fabulous barbecue pulled pork sandwiches provided by Dr. Jill’s husband, Pat.  We know how hungry teenage boys can be and serve barbecue to the players while they wait for their turn for impressions.

After the impressions of their teeth have been taken and the players have all gone, our talented dental assistants work ‘round the clock to make stone models of each player’s teeth and then use those models for the fabrication of a mouthguard, custom fit to each individual player.  We deliver the mouthguards to the athletic director at PHS, with instructions for the use and care of them.

If you would like to have an athletic mouthguard made for your athlete, please call us at 972-347-1145 to set up an appointment for an impression.

 

 

Athletic Mouthguards

July 12, 2017

People say that having children involved in sports is expensive.  In dentistry, we commonly see one of the most expensive aspects of sports: injuries.  The bad news is that the injuries themselves are sometimes unavoidable.  The good news is that the damage to the teeth, gums, lips, cheeks and jaws associated with sports injuries is largely preventable by wearing an athletic mouthguard.

Sports injuries to the face are very common and very expensive.  A research study on the use of athletic mouthguards cited some interesting statistics.

“The U.S. surgeon general’s report on oral health identified sporting activities as one of the “principal causes of craniofacial injuries.” Studies have linked sporting activities to nearly one-third of all dental injuries, and approximately one in six sports-related injuries is to the craniofacial area.”

Who needs an athletic mouthguard?

Most people associate sports injuries to the teeth with contact sports like football and hockey.  Interestingly, even non-contact sports such as baseball, gymnastics and cycling have a high incidence of injuries to the mouth.  If there is any chance you could be hit in the mouth by another person, a ball, or the ground, then you need an athletic mouthguard.

How do athletic mouthguards work?

Mouthguards work to prevent or lessen the severity of many types of damage to the mouth that can occur during a sports injury to the face and jaws.  They function by covering the teeth, separating the lips and cheeks from the teeth, and separating the upper and lower teeth from each other.  These three mechanisms of action are listed below with which types of injuries they can prevent or lessen the severity.

  • Covering the teeth – This covering prevents or lessens the severity of various injuries to teeth. Examples of injuries to the teeth during sports include:
    • Chipping
    • Luxation (forced movement of the tooth out of its natural position)
    • Root fractures
    • Avulsion (a tooth is knocked completely out with the entire root)
    • Intrusion (a tooth being forced into its socket so that it looks shorter than normal)
    • Necrosis (death of the nerves and blood vessels inside a tooth from blunt force)
  • Separating the lips and cheeks from the teeth – This separation prevents or lessens the severity of various injuries to the soft tissues of the mouth.
    • Cuts or lacerations to gum tissue, lips, cheeks, and intraoral muscle attachments
  • Separating the upper and lower teeth from each other – This separation prevents or lessens the severity of various injuries to the teeth and jaw joints by preventing a harsh impact of upper and lower teeth and jaws.
    • Condylar fractures – The condyles are the “balls” of the ball-and-socket jaw joints. A sharp impact between the upper and lower jaws can cause a fracture of the jaw bone just underneath the condyle.
    • Dislocation of TMJ (jaw joint) disc – The jaw joints each contain a small cartilage disc that separates the ball from the socket. When the lower jaw is hit with an impact, it can force the condyle (ball) off its correct position on the disc.  This leads to TMJ dysfunction and may require surgical intervention to repair.
    • Broken back teeth – Any time the upper and lower teeth are forced together with high forces, the back teeth can crack and break. Sometimes, they can be repaired through dental restorations; in other cases, the tooth has a hopeless long-term prognosis and must be extracted.

An important thing to note is that these problems can have long-term consequences requiring dental treatment for decades after the injury.

What types of athletic mouthguards are available?

There are three main types of mouthguards: stock, boil-and-bite, and custom.  The stock and boil-and-bite type mouthguards are available over the counter, and a dentist makes the custom mouthguard.  Because a custom mouthguard is made from a model of a patient’s teeth, it will have a better fit and should be very comfortable.  There is typically a direct correlation between cost and comfort; i.e. a stock mouthguard will be very inexpensive and very uncomfortable.  The more comfortable a mouthguard is, the more likely the athlete will be to wear it regularly.

How do I take care of my athletic mouthguard?

  • Do not clench on the mouthguard or chew it while you are wearing it. This will speed up the normal wear and tear and cause you to need a replacement much sooner than average.
  • After every use, rinse it. The best thing to do is to clean it with a soft toothbrush and cold water.  You can use liquid hand soap if necessary.
  • When not in use, store it in its vented case in a cool, dry area.
  • Do not allow it to get hot because it will lose its shape. This includes leaving it in your car!

Think you or your child may need an athletic mouthguard?

Call our office at 972-347-1145 to set up a consultation with Dr. Jill or Dr. Cara so they can discuss your options with you.

 

 

Hormone-Induced Gingivitis

July 5, 2017

What is hormone-induced gingivitis?

Hormone-induced gingivitis is a type of gingivitis that occurs specifically during changes in hormonal levels .  It is a very common condition that we see frequently in our office.  Hormone-induced gingivitis causes a patient to have gums that are swollen, red, tender, and bleed easily.   The tenderness and bleeding often make oral hygiene routines uncomfortable, and patients sometimes avoid proper brushing and flossing techniques because it hurts.  Healthy, natural gum tissues are light pink, relatively flat and tightly adhered to the teeth.  The appearance of bright red, puffy gums is unsightly, giving a diseased look to the mouth, and may cause embarrassment.

What causes hormone-induced gingivitis?

The name says it all: it is induced by hormones.  Rapid swings in hormone levels (most notably estrogen, progesterone, and chorionic gonadotropin) can have a profound effect on gum tissues.  Research has shown that these hormone levels cause two important changes to occur:

  • Hormone changes affect the tiny blood vessels in the gum tissue, increasing the blood flow in this area (which can cause swelling) and changing the permeability of the blood vessels (which makes the tissue bleed more easily).
  • Hormone changes also affect the types of bacteria present in gum tissues. Research shows that gum tissues in patients with hormone changes such as pregnancy or taking birth control pills have more dangerous bacteria than patients without hormone changes.  By “more dangerous”, we mean stronger and more likely to cause gum disease.

Who is at risk for hormone-induced gingivitis?

Hormone-induced gingivitis is common in children going through puberty, both girls and boys.  It is also prevalent in women at various stages of hormone changes, including menstrual cycles, the use of birth control pills, pregnancy, and menopause.  This higher risk for gum disease makes oral hygiene even more important than it already is.  People with poor oral hygiene are more likely to experience hormone-induced gingivitis than those with good plaque control and consistent oral hygiene habits.  People who have infrequent and inconsistent dental cleanings are also at an increased risk.

 

What can you do about hormone-induced gingivitis?

  • Practice perfect oral hygiene. Do not miss a single day of flossing!  Use an electric toothbrush; they are shown to effectively remove more plaque than a manual toothbrush.
  • Add a mouthwash to your oral hygiene routine, and use it twice daily. In addition to an over-the-counter alcohol-free mouthwash, you can swish with warm salt water throughout the day.  Some patients require a prescription mouthwash to get the inflammation under control.
  • Stay on schedule with professional dental cleanings. Your dental hygienist is able to remove bacterial buildup from areas you might be missing, even with good oral hygiene.
  • Consider increasing the frequency of professional dental cleanings. Many of our patients with severe gingivitis during puberty or pregnancy have their teeth cleaned every 3 months, instead of every 6 months.  This reduces the severity of gingivitis by reducing the amount of bacterial buildup accumulated between cleanings.
  • Talk to Dr. Jill or Dr. Cara about other recommendations they may have to improve your gingivitis. There are many additional oral hygiene products available to help reduce gum inflammation.  They will determine which one will be most beneficial for your unique situation.

Think you or your child may have hormone-induced gingivitis?

Call our office at 972-347-1145 to set up a consultation with Dr. Jill or Dr. Cara so they can discuss your options with you.

 

 

Bad Breath

June 28, 2017

It would not be a stretch to say that every single person has experienced bad breath at some point in his or her life.  We are all susceptible to “morning breath” or “garlic breath”, which are neither surprising nor difficult to fix.  Many people suffer from persistent bad breath which seems difficult to cure.  As with most things, finding the cause of the problem will lead us much closer to a solution.  Let’s take a look at the most common causes of bad breath.

What causes bad breath?

When you get to the bottom of bad breath, most of it is caused by bacteria in the mouth.  Over ninety-percent of bad breath originates in the mouth.  The rest stems from problems in the nose, throat, lungs, or GI tract.  These problems include postnasal drip, sinus infections, tonsil stones, bronchitis and other lung infections, H. pylori infections and GERD (gastroesophageal reflux disease).  These possible causes of halitosis are greatly outnumbered by problems in the oral cavity.  While you should be aware of them and inform your doctor or dentist of the presence of any of these issues, it is important to have your dentist rule out a more likely intraoral issue first.

What happens in the mouth to cause bad breath?

  • Cavities – Cavities, especially big ones, harbor lots of bacteria. When a cavity has gotten big enough to create a hole in the tooth, it collects food particles and plaque in addition to the bacteria that caused the cavity.  Think of it like a tiny kitchen trashcan.  It stinks!  Having the cavity fixed is like emptying the trashcan.
  • Gum (periodontal) disease – Periodontal disease affects the gum and bone supporting the teeth. In most cases, a pocket is formed where the gum and bone detach from the tooth surface.  These pockets are also like the above-mentioned tiny trashcans, collecting plaque, bacteria, food particles, etc . . . Having the proper periodontal treatment to reduce the depth of these pockets will minimize the size of the trashcan.
  • Food impaction – Perfectly shaped and aligned teeth and gums do not provide spaces for food to get caught. But let’s face it: no one is perfect.  Food impaction is the term dentists use for an area in your mouth that is consistently embedded with food debris.  If not properly cleaned out, it leads to more than just bad breath.  It can cause cavities and gum disease in that area.  If you do not feel that you are able to adequately and consistently clean an area of food impaction, please ask Dr. Jill or Dr. Cara about your options to change the shape of the teeth so that food does not continue to be caught.
  • Tongue – Tongues are bumpy. The bumps are called papillae.  The papillae vary in size and purpose.  There are some located near the back of the tongue that can be large and create lots of nooks and crannies for bacteria to collect around.  This is where cleaning your tongue can reduce bad breath.  For some people, simply swishing a mouthrinse can effectively clean your tongue.  For others, it may be necessary to brush the surface of your tongue.  And for still others, a tongue scraper is useful in cleaning any bacterial havens on your tongue.
  • Surgical wounds – When you have surgery in your mouth, there is usually something that can allow for the accumulation of bacteria like an extraction socket or stitches. Because surgical sites usually hurt, it is difficult to keep them clean.  Your dentist will give you instructions on keeping the site clean, as well as some adjuncts for your post-surgical oral hygiene like a very soft bristled toothbrush or an antibiotic solution to apply to the site with a Q-tip.  Thankfully, this is a temporary problem.  Follow the post-op instructions closely so healing occurs as quickly as possible.
  • Dry mouth – Saliva plays a big role in fighting bacteria; therefore, it plays a big role in fighting bad breath. If you do not have enough saliva, your dry mouth puts you at risk for bad breath and various oral diseases.  It can cause bad breath by allowing an accumulation of bacteria.  You can read more about dry mouth here.

What can I do about bad breath?

  • See your dentist – It is important to rule out cavities & gum disease as the cause of bad breath because they can progress and lead to many long-term health concerns. If you do have any oral disease, proceed with treatment as soon as possible.
  • Practice great oral hygiene – Keeping your teeth clean means reducing the amount of bacteria in your mouth, and therefore reducing bad breath. Add an alcohol-free mouthwash to your daily regimen.  This helps remove bacteria from all areas of your mouth.  It’s important to use an alcohol-free mouthwash because alcohol has a drying effect.  Dry=bad.  Also add brushing your tongue or using a tongue scraper to your oral hygiene routine.
  • Take steps to improve dry mouth – Discuss the various options with your dentist. Treatment may include using a salivary supplement, an antioxidant mouth gel, or a prescription mouthwash.
  • Chew sugar-free gum, preferably containing xylitol – Chewing gum stimulates saliva, which fights bacteria. The flavor of the gum may provide a brief, minty odor to your breath, and the improved salivary flow will keep the bad breath at bay.
  • Avoid substances that have a drying effect on your mouth – Cigarettes and alcohol both reduce salivary flow and predispose you to dry mouth.

Think you may have bad breath?

Call our office at 972-347-1145 to schedule a consultation with Dr. Jill or Dr. Cara.

 

 

Thumb Sucking and Pacifiers

Juse 21, 2017

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

Non-Nutritive Sucking Behaviors

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

What is “normal”?

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

Why is prolonged thumb sucking or pacifier use bad?

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

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

What should a parent do about prolonged NNSB?

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

  • Gently discourage the habit and use positive reinforcement when he or she is successful.
  • Start small with goals that are easier for him to meet, such as watching a movie without sucking his thumb.
  • Do not punish the child for continuing the habit. Negative reinforcement is not recommended as a technique because the habit is something that comforts or soothes him.  Shaming or scaring him will only cause him to feel a greater need to suck his thumb or use his pacifier.
  • Because stress or anxiety can increase the child’s need to self-soothe by thumb sucking or pacifier use, try to identify situations that make him feel anxious and address them as needed.
  • If possible, gently and quietly remove the thumb or pacifier from his mouth after he has fallen asleep.

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

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

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

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

Need more information?

Call to schedule a consultation with Dr. Jill or Dr. Cara to discuss your child’s habits.  972-347-1145

 

 

Aphthous Ulcers (Canker Sores)

Juse 14, 2017

If you have never had a mouth ulcer, thank your lucky stars!  They are terribly painful and interfere with eating, speaking, and brushing your teeth.  The most prevalent type of mouth ulcer is called an aphthous ulcer, and it is commonly referred to as a canker sore.  Aphthous ulcers are unusual in that, even now in 2017, we still do not know exactly what causes them.  There are many studies showing correlation between certain diets, vitamin deficiencies, hormone changes, and stress levels with the occurrence of aphthous ulcers.  But correlation is not the same as causation.

What are aphthous ulcers?

There are three main types of aphthous ulcers: 1) minor, 2) major, and 3) herpetiform.  They all the share similar appearance of a round or oval-shaped ulcer with an inflamed red border around a yellowish-white film that covers the deeper ulceration.

  • Minor aphthous ulcers are the most common and least painful. They typically are less than 1 cm in diameter and last for 7-14 days.
  • Major aphthous ulcers are much larger, up to 3 cm, and can last over a month. Due to their increased size and duration, they are much more painful.
  • Herpetiform aphthous ulcers take their name from herpes lesions (also called cold sores) caused by a Herpes Simplex Virus, which occur in clusters. Herpetiform aphthous ulcers also occur in clusters and can easily be misdiagnosed as viral sores.  Herpes viral sores and aphthous ulcers differ in cause and location.  There is no virus associated with aphthous ulcers, and they only occur on freely movable mucosa.  This includes the inner lining of the lips, cheeks, tongue, floor of mouth and the soft palate.  Herpes lesions, or cold sores, occur on the outside of the lips or any attached gum tissue like the hard palate or gums covering the teeth.  When herpetiform aphthous ulcers form in a cluster, the ulcers often coalesce or blend together to form one very large, very painful ulcer.

What causes aphthous ulcers?

There is currently no scientific data identifying one specific cause of these ulcers.  The research studies have shown a correlation in the occurrence of aphthous ulcers with certain predisposing factors, listed here.

  • Genetics – Some studies suggest a genetic component because children are much more likely (90%) to experience aphthous ulcers if both of their parents have had them.
  • Certain GI problems – There is a high correlation between patients who experience aphthous ulcers and those with gastrointestinal issues like ulcerative colitis, Crohn’s disease and Celiac Disease.
  • Vitamin deficiencies – Some studies show a correlation between patients with aphthous ulcers and low levels of iron, vitamin B12, and folic acid.
  • Hormone levels – Many women experience aphthous ulcers at regular intervals correlating to their menstrual cycle.
  • Stress – Because stress cannot be quantitatively measured, this one is difficult to prove scientifically. But it’s no surprise to people who suffer with these ulcers that stress can make them more likely to appear.
  • Trauma – This is likely the most common cause of aphthous ulcers. Trauma can range from anything as simple as accidentally biting the inside of your lip or hitting your gums with the toothbrush to routine dental treatment or a complicated oral surgery procedure.

How are aphthous ulcers treated?

There are many ways to treat the painful symptoms of aphthous ulcers, but there is no cure to prevent them from recurring.  There are many options available, and it is best to discuss them with Dr. Jill and Dr. Cara to figure out which one is best for your specific ulcers.  Some of the possible treatment options are listed here.

  • A topical gel or paste – Usually a prescription product, this is applied to the ulcer with a Q-tip or clean fingertip multiple times a day. It typically contains a steroid, which reduces the severity and duration of the ulcer, but does not change the frequency of occurrence.
  • A prescription mouthwash – Also used to alleviate symptoms only, this can contain an antibiotic, antifungal, steroid anti-inflammatory, antihistamine (like Benadryl), and antacid (which creates a thick coating over the oral lining). When used 4-6 times per day, it can reduce the symptoms of the painful ulcers.
  • Laser treatments – A laser can be used to treat the ulcer, which reduces inflammation and speeds up the healing process by making changes to the surface of the ulcer.
  • Dietary changes – Patients who are afflicted with frequent or multiple aphthous ulcers and have celiac disease or a gluten intolerance show a marked reduction in ulcer occurrence when gluten is eliminated from their diet. A very recent study has also shown an improvement in occurrence of ulcers when a dairy-free diet is observed.  This is based on a new study showing a higher level of antibodies to cow’s milk proteins in patients who have aphthous ulcers.
  • Vitamin therapy – In patients who do show deficiencies in iron, vitamin B12, and folic acid and experienced frequent aphthous ulcers, the ulcer occurrence rate decreased after vitamin therapy to treat those deficiencies.

What can I do about aphthous ulcers?

The most important step you can take is contacting your dentist as soon as you notice the lesion.  All of the above treatment modalities are most effective when started early in the life of the ulcer.

Ulcers are aggravated by acidic foods, spicy foods, and hot temperatures, so avoid them in order to reduce your painful symptoms.  Use caution when eating and talking so that you do not reinjure the area and cause the ulcer to last longer.  Cold can temporarily alleviate symptoms, so we do recommend drinking ice water and holding a piece of ice against the ulcer until you see the dentist for other treatment options.

Do you think you have an aphthous ulcer?

Call us now to see Dr. Jill and Dr. Cara so you can get started on the best treatment to reduce the pain and length of your ulcer.  972-347-1145

 

 

 

Tooth Sensitivity

Juse 7, 2017

Many people experience sensitive teeth, and not everyone has the same symptoms. You can have one sensitive tooth, or a mouth where every single tooth feels sensitive. You can have sensitivity to cold and/or hot temperatures and sweet and/or sour flavors. However you experience it, it is not fun!

Teeth are not supposed to be sensitive, and if they are, it is a symptom you should share with your dentist. She will discuss your specific issues and try to isolate the cause of your sensitivity so that you can remedy the situation.

What Causes Tooth Sensitivity?

There are three main causes of tooth sensitivity. In order to understand these, let’s cover a little dental anatomy first. Teeth are hollow, and the hollow space inside teeth contains a nerve (also called the pulp) that sends signals to your brain telling you when something is not quite right. The part of the tooth you can see is called the crown. The crown is covered in enamel, which is the hardest substance in the body, even harder than bone. Enamel is made to be a solid coating over the crown of the tooth, protecting it from the sensations we expose our teeth to when we eat and drink. The part of the tooth you cannot see because it is hidden in the jawbone and gums is the root. The root of the tooth is not covered in enamel because it is meant to be encased in bone and gums.

1. The first possible cause of tooth sensitivity is when there is a problem with the enamel coating of the tooth. This includes cavities and cracks which disrupt the solidarity of the enamel and provide an opening for those sensations to reach the nerve inside the tooth.

2. The second most common cause of tooth sensitivity is exposure of the root caused by gum recession. When gums and bone recede, it exposes the root to the mouth and all the subsequent sensations associated with eating and drinking. Because the root does not have enamel, it does not have the same protection as the crown of the tooth. This means the nerve inside the tooth can feel temperatures and flavors more than it is supposed to. (Gum recession does not always cause tooth sensitivity. Dr. Jill and Dr. Cara will evaluate the area where you feel sensitivity to determine if this is the cause.)

3. The third most common cause of tooth sensitivity that we see in our office is bruxism (clenching or grinding your teeth). This can cause individual tooth sensitivity or an entire mouth full of sensitive teeth. The cause of bruxism-related tooth sensitivity is hypersensitivity of the nerve inside the tooth because it is being subjected to abnormally-strong biting forces.

These causes can become interrelated because bruxism often leads to tooth cracks and gum recession. But let’s say cavities, cracks and gum recession have all been ruled out, and your teeth are still sensitive. Now it’s time to evaluate your whole mouth for signs of bruxism. The hypersensitivity of the nerve caused by the heavy forces of bruxism can affect different teeth at different times or all the teeth at once and often is inconsistent.

What Can I Do About Tooth Sensitivity?

The very first thing to do is have a dental evaluation to rule out cavities and cracks. Either of those conditions will require dental treatment to fix the problem. Once the cause of the sensitivity is treated, it should subside. It’s not always an immediate cure; it can take a few weeks after treatment for the nerve to settle back to normal. If you experience sensitivity more than a few weeks after treatment, you should have the tooth evaluated again.

If cavities or cracks are ruled out, then the cause of tooth sensitivity is likely a gum recession problem. There are many ways to treat hypersensitivity from gum recession including (but not limited to) fluoride treatments, over-the-counter sensitivity toothpastes and strips, fillings to cover the exposed root surface, or gum grafting to return the gums to their proper position.

If bruxism is determined to be the cause of your sensitivity, the simplest way to treat it is by wearing a mouthpiece (night guard) while you sleep that keeps the teeth separated and reduces the biting forces put on the teeth.

Tooth sensitivity can be treated relatively easily. The most important factor in treating it is accurately diagnosing the cause, which is your dentist’s job.

Need more information?

Call our office at 972-347-1145 to set up an evaluation with Dr. Jill or Dr. Cara.

 

 

 

Staff Highlight

May 31, 2017

Hannah Becerra

If you follow us on Facebook, you will recognize this sweet face.  Hannah is simply the most cheerful, versatile, agreeable gal in the office.

Us:  “Hannah, can we take pictures of you while you do that intraoral scan?”

Hannah: “Sure!”

Us: “Hannah, can you answer some questions about temporary crowns for a Facebook video?”

Hannah: “Sure!”

Us: “Hannah, can you answer the phones and scan these files and seat the next patient and assist on that 3 year old and manipulate that iCAT and grab Starbuck’s . . . ?”

Hannah: “Sure!”

. . . and all with a smile on her face.  Simply put, Hannah is one of the easiest people we have ever worked with.  She’s quick to learn new tasks, willing to pick up loose ends when things get crazy, and calm and caring to all of our patients from age 2 to 100.

Hannah joined Prosper Family Dentistry in 2014 while she was still working on her RDA through Grayson County College.  Part of her licensing process included interning at various offices, and we were her last stop.  We were all so impressed at her skill level, the ease with which she learned our office flow, and the quick camaraderie she built with everyone on the team.  Hannah is an asset to our office when we introduce any new technology.  She quickly learns it and then proceeds to teach the rest of us.  Hannah got married shortly after she began working with us, and her wedding was happily celebrated by the whole team!

Hannah is a Bells native and is very close with her large family.  She and her husband Roy have one son, Ben, who will turn one year old in August.  He has the cutest, squishiest cheeks and is the office darling.  They are active in their church and avid fans of the Texas Rangers. 

 

 

Do I Really Grind My Teeth?

May 24, 2017

Some of our patients are surprised when we inform them that we see evidence in their mouths of teeth grinding, or bruxism.  Many people have no idea that they are grinding their teeth.  And what happens very frequently is they come back in six months and say, “You know . . . I think I might be grinding my teeth.  Ever since you told me that six months ago, I’ve been noticing {insert symptom here}.”

Signs vs. Symptoms

In order to explain this phenomenon of a dentist telling the patient about something they are doing which they are unaware of, it is important to understand signs vs. symptoms.  Signs are objective, observable facts.  This means they are not swayed by opinions or feelings, and they can be shown by a photograph, an x-ray or other type of image, a lab result, etc…  Signs are noted by the dentist during an evaluation of your mouth.  Signs can exist without any symptoms, so it is possible that a dentist can inform you of the signs of a condition without your being aware of any issues.

Symptoms are subjective evidences of a condition or disease of which the patient is aware.  For instance, pain is a symptom because it cannot be observed, and the patient must describe it to their doctor for it to be properly documented and used to aid in diagnosis.  Other examples of symptoms include anxiety, fatigue, or muscle tension.

Bruxism (Teeth Grinding)

Bruxism is a very common condition in which a person closes the upper and lower jaws, creating high pressure on the teeth, gums, supporting jaw bones, facial muscles and jaw joints.  It can include hard squeezing called clenching, or a side-to-side or back-and-forth movement called grinding.  When bruxism occurs, it will manifest in one or more clinical signs and possibly some symptoms.

Signs of Bruxism

  • Attrition – the flattening of the biting surfaces of teeth and loss of enamel caused by clenching or grinding
  • Potholes – a specific type of attrition where the enamel has been worn through, and the underlying dentin is exposed and worn down into a concavity
  • Gum Recession – movement of the gum attachment away from stressful biting forces on the tooth to a position further toward the root, can cause exposure of the root and tooth sensitivity
  • Tooth Abfraction – a loss of tooth structure at the gumline causing a notch or concavity
  • Facial Muscle Enlargement – as with any other muscle in the body, when exercised frequently, they will enlarge
  • Linea Alba – Latin for “white line”, this is a visible line on the inside of your cheeks caused by friction against the grinding teeth, like a callous

  • Scalloped Tongue – the sides of your tongue can be pressed against the inner surfaces of the teeth when clenching or grinding, causing it to conform to the shape of the teeth and have a scalloped appearance

Symptoms of Bruxism

  • Facial pain, including headaches – constant clenching of muscles can create muscle soreness in the cheeks, temples, forehead, and the neck
  • Muscle tightness – a tight or tense feeling in the muscles of the cheeks and temples
  • Joint pain or sounds – the jaw joints, located in front of your ears, can be tender to touch, have sharp shooting pains, or make popping, clicking, or crunching sounds
  • Generalized tooth pain or sensitivity – the pressure of clenching or grinding can cause all of the teeth to be sore or sensitive to temperature

Not everyone who clenches or grinds his or her teeth will exhibit all of these signs or symptoms.  It is important for the dentist to get the whole picture and put together each patient’s specific signs and/or symptoms in order to accurately diagnose the condition of bruxism.

What Can I Do About It?

The most common treatment for bruxism is a hard, custom-made nightguard to protect the teeth, gums, bone, muscles and joints at night.  People who clench during the day can follow some habit-breaking techniques to prevent daytime damage.  If extensive damage is present, you will probably need some dental work to repair it before moving on to the preventive phase.

Will an Over-the-Counter Nightguard Work?

OTC nightguards are typically made of a soft, thermoplastic material that you can heat and shape to fit your teeth.  This material is not great at preventing the damage from bruxism because the soft, squishiness actually increases muscle action and deteriorates very quickly.  The best protection for your teeth, gums, bone, muscles and joints is a hard nightguard that is custom-made for you by your dentist.  These will actually reduce muscle force and provide real protection.

Need More Information?

If you think you may exhibit one or more of the listed signs and symptoms, please don’t hesitate to discuss it with Dr. Jill or Dr. Cara.  You can also call the office at 972-347-1145 to set up a consultation.

 

 

Do I Really Need to Have My Wisdom Teeth Removed?

May 17, 2017

Summer is approaching, and for a lot of high school and college students, this may mean it’s time to have their wisdom teeth removed.  Does everyone need to have their wisdom teeth removed?  Not necessarily.  There are many criteria that dentists evaluate to determine whether or not a patient’s wisdom teeth need to be removed.  There are also different criteria that we use to determine when they should be removed.  As with any type of medical procedure, there are risks and benefits, and we always weigh the risks vs. benefits to determine if the procedure is right for each specific person.

What are wisdom teeth?

Wisdom teeth are the third set of permanent molars in an adult mouth.  The first molars come in, or erupt, at about age 6-7 years, so they are also referred to as 6 year molars.  The second molars erupt at about 12 years of age and are also called 12 year molars.  If third molars erupt at all (many do not; instead they stay hidden under the gums), it’s typically between ages 18-25, so they’ve earned the nickname “wisdom teeth”.

 

Who can keep their wisdom teeth?

Unfortunately, not many people fall into the category of those who can keep their wisdom teeth with minimal risk of future problems.  In order to keep wisdom teeth with the least risk of cavities and gum disease, people need to have:  1) very large jaws with enough room for the wisdom teeth to fully erupt (come through the gums into the mouth), 2) wisdom teeth that are erupting in the correct alignment with the rest of the teeth, and most importantly, 3) great oral hygiene.  The average adult jaw does not have enough space behind their second molars for another molar to naturally reach the correct position for chewing and proper cleaning.

What are the risks of keeping wisdom teeth?

Assuming wisdom teeth have enough space and do come into their correct position behind the second molars, they are located in an area that is very difficult to keep clean.  Even the best brushers and flossers have trouble reaching the back of a wisdom tooth.  This leads to an accumulation of plaque and bacteria and food debris, which in turn, leads to tooth decay and gum disease.    This accumulation of bacteria also predisposes the adjacent second molar to both cavities and gum disease.

When wisdom teeth do not have enough space to fully erupt into the appropriate location, several problems can occur.  If the location of the tooth causes it to be partially covered by gum tissue, there is a very high risk of pericoronitis, an inflammation of the gum tissue that surrounds and often lays over the top of the tooth.  Because this partial covering creates a pocket where plaque and food can collect, painful inflammation easily develops, and can even lead to an infection.

When wisdom teeth are positioned at an angle, they are unable to erupt into the mouth (this is referred to as “impacted”) and can damage the adjacent jaw structures, as well as any adjacent teeth.  When this occurs, often both the second and third molars have to be extracted.

Why take wisdom teeth out preventively?

If your dentist determines that you are at risk for any of the problems noted above, she will recommend preventive extraction of the wisdom teeth and refer you to an oral surgeon.  This prevents potential pain and suffering from problems with the wisdom teeth themselves, and also protects the second molars from the higher risk for cavities and gum disease associated with the presence of wisdom teeth.

Why so young?

Teeth form from the biting surface down toward the roots.  At age 18, a wisdom tooth is much smaller than it is at age 25.  Earlier extraction of wisdom teeth means the removal of a much smaller tooth.  This results in smaller surgical site, smaller extraction sockets, quicker healing, and lowest risk of future infections.  Later extraction, after the tooth has fully formed roots, leaves the patient with a larger surgical site, a larger socket, and longer healing time.

Need more information?

Call our office at 972-347-1145 to schedule a consultation with one of our doctors.

 

 

Dental X-rays and Radiation Safety

May 11, 2017

Radiation Safety

We are often asked by our patients about the safety of dental x-rays.  Many people are curious about the levels of radiation they are being exposed to when diagnostic x-rays are taken.  Since exact measurements are difficult to obtain, this article will use averages and comparisons to help you understand what levels of radiation you are receiving with dental x-rays.

Risk

There is risk associated with any type of x-ray because it involves the use of radiation.  The level of risk varies among the different types of x-rays and is typically measured in a unit of effective dose called a milliSievert (mSv).  What most people worry about when they hear “radiation” is whether or not it can cause cancer.  According to the World Health Organization’s publication, Communicating radiation risks in paediatric imaging: Information to support healthcare discussions about benefit and risk, the risk of cancer incidence that is increased by various types of diagnostic x-rays is compared with a baseline lifetime cancer risk.  This publication is focused on the risk to children because: “Stochastic risks are of special concern in pediatric imaging since children are more vulnerable than adults to the development of certain cancer types, and have longer lifespans to develop long-term radiation-induced health effects.” Their studies showed that the increase in cancer incidence for children aged 1-10 years from dental x-rays is negligible.  That risk would be even lower in an adult.

The risk can also be measured by comparing it to the naturally occurring radiation that all people are exposed to on a daily basis.  These measurements vary widely based on location (there is a black sand beach in Brazil with the highest level of natural radiation), so a worldwide average and national US average are shown in the chart on Background radiation from Wikipedia.

 

A set of 4 bitewing x-rays, which is typically taken once per year, has an average effective dose of 0.005mSv.  The average amount of radiation someone in the US receives from cosmic radiation is 0.33mSv, more than 66 times that of your yearly dental x-rays.  The graph above shows other levels of natural background radiation experienced annually.

Benefit

The benefit of these x-rays is the early detection of multiple types of oral disease, including cavities, gum and bone infections, and oral cancer.  As with any disease, the earlier it is detected, the less invasive treatment can be and the better the long-term prognosis.  The risk of these diseases going undetected is the progression of disease, spread of infection, loss of teeth, loss of bone in the jaws, and in severe cases even death.

Risk vs. Benefit

Due to the prevalence of oral diseases and the risks associated with those diseases, it is the policy of our practice, as well as that of the American Dental Association, that the benefits of early detection with diagnostic x-ray imaging outweigh the risks associated with the x-rays.  Patients are far more likely to experience the consequences of undetected dental and oral diseases than they are to experience an increased cancer incidence due to dental x-rays.

It is also the policy of our practice to reduce the radiation exposure of each patient by using lead aprons with thyroid collars, taking the fewest necessary number of radiographs, using digital x-ray sensors (which require far less radiation for imaging), and using the lowest settings possible to achieve the necessary diagnostic images.

X-rays and Pregnancy

The American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women reaffirmed its committee opinion in 2015: “Patients often need reassurance that prevention, diagnosis, and treatment of oral conditions, including dental X-rays (with shielding of the abdomen and thyroid) … [is] safe during pregnancy.”  At Prosper Family Dentistry, we typically postpone any dental x-rays during a patient’s pregnancy until after the baby is born unless the patient has a very high risk for disease, which could affect the patient’s overall health and that of the pregnancy.

Need more information?

Call our office at 972-347-1145 to schedule a consultation with one of our doctors.

 

 

 

 

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Prosper Family Dentistry

201 N. Preston Road, Suite A
Prosper, TX 75078

Phone: 972-347-1145

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