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A Toothache Caused by Sinus Problems

November 15, 2017

Can a sinus infection make my teeth hurt?

It’s fall, y’all.  And unfortunately, with this lovely cool weather comes new allergens, sinus infections, head colds, and the flu.  It is very common for us to see an increase in “toothaches” during this season.  We put “toothaches” in quotes because while the tooth definitely aches, it’s not a tooth problem.  Many patients will call us with a toothache and come in for an evaluation, only to be told that the tooth is perfectly fine.

Why does sinus pressure make my teeth hurt?

The natural anatomy of our upper teeth, jawbones and sinus cavities predisposes us to this problem.  The maxillary sinus cavities are large, air-filled spaces located just inside our cheekbones.  They extend inward toward the nose and downward toward the upper teeth.  Often the jawbone separating our upper teeth from the above sinus cavity is extremely thin.

The sinus cavities are supposed to be empty.  These air-filled spaces allow for the passage of air as we breathe and lighten the weight of our skull so that we can hold our heads up.  Anyone who has ever experienced sinus congestion knows that it can be hard to breathe and make your head feel heavy.

When the sinuses are filled instead of empty, pressure is created in that bone-encased space.  Many people feel this pressure inside their cheekbones or under their eyes.  Many also feel this pressure on their upper molars and premolars.  The nerves that supply sensation and feeling to our teeth enter the tooth at the very tip of its root.  Many upper molars’ roots protrude up into the sinus cavity.  When there is an increase in pressure in the sinus, it can cause sensitivity, soreness or just a plain old toothache.

What symptoms are commonly associated with sinus pressure toothaches?

  • Because the toothaches associated with sinus cavities are caused by an increase in pressure, anything that changes the pressure would change the pain in the tooth. Things like the impact of running or jumping and tossing your head upside down to blow-dry your hair will affect the pain of a toothache caused by sinus pressure.
  • Because of the pressure on the tooth’s nerves, the teeth may be more sensitive to cold air or liquids.
  • The increase in pressure on the roots of the teeth also causes a soreness or tenderness when chewing, grinding, or tapping on the side of the tooth.

What can I do about it?

First of all, you should rule out any problems with your teeth.  If you haven’t seen a dentist in a while, you should schedule a visit to have the tooth or teeth evaluated.

If you have been seen regularly by your dentist and know that you have no cavities or other problems with your teeth, you may want to begin by treating your sinus pressure.  Take over-the-counter decongestants and antihistamines.  If these do not help, you should see your medical doctor to treat your sinus condition, allergies, cold or flu.

Many patients have experienced this multiple times and are able to recognize it as a sinus problem and not a tooth problem.  If you’re not sure, come see us anyway.  When in doubt, rule a real toothache out!

Have a toothache that could be from sinus pressure?

Call us today at 972-347-1145 to schedule an evaluation with Dr. Jill or Dr. Cara.  They will do a thorough evaluation of the area that is bothering you and distinguish between a tooth problem and a sinus problem.


Save $1000 on Invisalign®!

November 8, 2017

Click for details!

What is Invisalign®?

Invisalign® is an almost-invisible method of straightening teeth that does not require metal brackets or wires.  It consists of a series of clear plastic aligners (or trays) that are custom made for each individual’s teeth.  Dr. Jill and Dr. Carat make a personalized treatment plan for your orthodontic needs.  This plan is communicated to the AlignTech laboratory, where each aligner is fabricated via precise CAD/CAM technology.  The aligners are virtually invisible, so it is the most esthetic way to straighten your teeth.

How does it work?

Through the use of its patented design, Invisalign® aligners move your teeth through the appropriate placement of controlled force.  Invisalign® not only controls the force, but also the timing of the force application.  This means that Dr. Jill and Dr. Cara can prescribe exact movements for each individual tooth, including which teeth not to move, like implants or teeth that are part of a cemented bridge.  Certain teeth can be held in place while others are being moved.  This is an advantage that Invisalign® has over traditional brackets and wires.

Why do some people get Invisalign® and others get braces?

Invisalign® is limited in the exact tooth movements it can accomplish, and not every patient is a candidate for straightening their teeth with Invisalign®.  An orthodontic evaluation of your teeth is necessary to determine if your goals will be met by using Invisalign®.

What is the cost?

For full-length Invisalign® treatment, the cost ranges from $4500-6000 depending on the length of treatment.  There are some limited Invisalign® options that are used for correcting minor issues that range from $1500-3000.  During our special Invisalign® event on Wednesday, November 15, 2017, you can receive $1000 off full Invisalign® treatment, and 15% off any limited Invisalign® treatment.  This is the largest sale we have ever given on Invisalign®.  Don’t miss it!

Does my dental insurance cover Invisalign®?

Yes!  Many dental insurance companies do provide coverage for Invisalign®.  It is claimed as a benefit for Adult Orthodontics and typically ranges from $1500-2500.  To find out if you are covered, you can call your dental insurance company and ask if you have adult orthodontic coverage.  We can also verify any orthodontic benefits you may have when we have your dental insurance information.  Teenagers are often covered under their insurance plan’s orthodontic benefits, up to a certain age limit, which varies depending on your specific insurance plan.

How long will it take to straighten my teeth?

Treatment time varies based on how much movement is required to achieve your goals.  If more movement is required, then treatment will last longer.  Some minor tooth movements can be accomplished in as little as 2-3 months!  Average treatment time for full Invisalign® treatment for an adult is around 12-18 months.

How often do I have to see the dentist during treatment

After treatment has begun, Dr. Jill and Dr. Cara will typically see you every 6 weeks, which means you will wear 3 sets of aligners between each visit.  Certain patients are eligible to wear their aligners for only 7 days, instead of the average 2 weeks.  This will speed up tooth movement and decrease the length of time required for treatment.  Ask Dr. Jill and Dr. Cara if you can do accelerated tooth movement by wearing your aligners for 7 days!  Sometimes more frequent appointments are required to monitor the progress of the teeth.

What are the eating and drinking restrictions during Invisalign® treatment?

Because aligners can be removed for eating and drinking, there are no restrictions to what you can eat or drink when the aligners are not in your mouth.  You can eat with the aligners in, and the chewing force actually contributes to tooth movement by putting pressure on the teeth to move them into the position the aligner dictates.  It is important that you do not drink anything besides water with the aligners in.  Because the aligners keep your saliva from properly bathing the teeth, any acid or sugar from a beverage could be trapped under the aligners and increase the likelihood of cavities.

Why now?

There is no better time to straighten your teeth than now!  Over time, teeth continue to shift and move, and most problems are aggravated as we age.  Spacing between teeth continues to increase so gaps get noticeably larger.  Crowding on upper and lower front teeth typically gets worse so teeth appear more and more crooked.  Straightening teeth earlier, rather than later, allows for shorter treatment time and more time to enjoy your new, beautiful smile.

Another reason to start now: Our biggest Invisalign® special ever!  On Wednesday, November 15, 2017, we are hosting a special Invisalign® event, offering $1000 off full Invisalign® treatment and 15% off limited Invisalign® treatment!  Call the office at (972)347-1145 for details.

10th Annual Candy Graveyard

November 1, 2017

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A House Full of Candy . . . Now What?

Halloween is one of the most widely celebrated holidays in the USA.  Over 179 million Americans celebrated Halloween this year, with 70% handing out candy.  In 2015, our merry-makers spent over $2.1 billion on Halloween candy.  That is a lot of candy!

The average US trick-or-treater takes home 600 grams of sugar – the equivalent of 3 cups.  The recommended daily amount of sugar for a moderately active ten-year-old is 23 grams per day.  This means you would have to stretch that Halloween candy out in evenly divided doses over 26 days and eliminate any other sources of sugar in your child’s diet to stay healthy.

Or you could throw all that candy away and subject yourself to much weeping and gnashing of teeth by your maniacal, sugar-crazed kids.

How about another option?

At Prosper Family Dentistry, we were buying back Halloween candy before candy buy-backs were cool.  This year, we are celebrating our 10th annual Candy Graveyard.  In this event, hosted at our office each year in the days following Halloween, children are invited to bury their candy in our graveyard cauldron and receive cold hard cash for their healthy efforts.  We believe that Halloween should be fun, and that all candy is not created equal.  There are some candies that can be consumed in a healthier manner (read last week’s blog for tips on better candy choices).

In order to keep things fun, help your children come up with ways they can spend the money they earn by trading in their candy.  Maybe a trip to the dollar section at Target would make their day.  Add it to their allowance that they are saving up for a big purchase.  You could even use it as a teaching point about giving back and help them choose a worthy cause to which they can donate their Halloween money.

The point is that children can be rewarded for making healthy choices, and you can teach them that life is still fun without 600 grams of sugar.

How Can I Participate?

Drop by our office anytime today, November 1, or tomorrow, November 2, between 7:30am-2:30pm.  Bring all the candy you can.  We will help your child weigh it and pay $1 per pound.  We promise to ooh and ahh and gush over your sweet kiddos and their healthy choices!  Call us at 972-347-1145 if you have any questions.

Don’t Get Tricked by Halloween Treats

October 25, 2017

Halloween: Making Good Decisions for Your Teeth

Halloween is almost synonymous with candy, and most people know that candy can cause cavities.  What many people do not know is that some candy is worse and more likely to cause cavities than other types of candy.  As dentists, it is easy to be a killjoy on Halloween.  Since we know kids are going to load up on candy at Halloween, we are not going to tell you not to eat it.  We’re going to give you information that will help you make better decisions about Halloween candy.

All Candy is Not Created Equal

The cavity risk associated with candy is based on two factors: 1) the amount of sugar in the candy, and 2) the amount of time the sugar from the candy is exposed to the teeth.  This blog will give you tips to help address both of these factors so that your risk of a Halloween cavity is minimal.

Moderation and Timing are Key

In order the address the amount of sugar in Halloween candy, it is important to exercise moderation.  Try not to binge on Halloween candy, and don’t let your kids do it, either.  Eating large amounts of candy fuels the cavity-causing bacteria in our mouths with unlimited sugar.  Limiting your candy intake to “dessert” (with a meal) also reduces cavity risk by counteracting the high amount of sugar with a high volume of healthy, cavity-fighting saliva.

Make Good Choices

  • Sort through all your Halloween candy. Make three piles: 1) Sticky, gooey candy like caramels, Starburst, any kind of taffy, anything “gummy”.  2)  Hard candies or anything that is held in the mouth for a long period of time like a jawbreaker or any kind of sucker (lollipop).  Even mints fall into this category.  3) Chocolates or candy bars containing fat, anything that would be eaten quickly.
  • Now throw away piles 1 and 2. These sticky and hard candies have a high risk for causing cavities because they expose the teeth to sugar for a long period of time.  The sugar in sticky candies will adhere to the tooth, especially in deep grooves, and provide fuel for bacteria for as long as the candy is stuck to the tooth.  You also fuel those bacteria by sucking on a piece of candy for an extended length of time.
  • Eat your chocolates and candy bars in moderation as explained above.

Feel Bad Throwing Candy Away?

At Prosper Family Dentistry, we want to make Halloween as fun as possible while still encouraging good habits.  We offer a candy buy-back program called the Candy Graveyard.  Your child can bring in any amount of candy, and we will buy it for $1 per pound.  We also give a prize for the child who brings in the largest amount of candy!  Call us at 972-347-1145 to find out the details about our Candy Graveyard.

Caring for Teeth While in Braces

October 18, 2017

Best Day Ever

The day you get your braces off should be the best day ever. After months, maybe even years, of hiding your metal mouth and constantly digging food out of the brackets and wires, you will feel a newfound sense of freedom and won’t be able to pass a mirror without smiling at yourself. The end result of orthodontics is always worth the time, money, and effort you put into it. Not only are straight teeth beautiful; they are actually healthier than crooked teeth.

There are two reasons straight teeth are healthy teeth: 1) Many people understand that crowded and crooked teeth allow more plaque accumulation because of the various nooks and crannies created by overlapping and rotated teeth. 2) Research studies have shown that the types of bacteria collecting on crooked teeth are different than the bacteria typically found on straight teeth. They are more periodontopathogenic – more likely to cause periodontal disease!

How the Best Day can become the Worst Day

If the braces come off, and instead of exposing a beautiful, straight smile, a mouth full of discolored and decayed teeth is revealed, the Best Day has now become the Worst Day. Braces create a dental hygiene challenge that many people, especially preteens and teenagers are not aware of or prepared for. The extra apparatuses on the teeth are havens for plaque, bacteria, and food debris, causing a person’s risk for gum disease and cavities to sky-rocket.  The most common problem we see after braces is a phenomenon called “white spot lesions” that outline where the bracket was.  The white spots are areas of demineralization or weakening of the surface enamel where plaque was allowed to linger for too long and damaged the tooth structure surrounding the bracket.

How to Lower the Inherent Risk for Gingivitis and Cavities that comes with Braces

  • Don’t miss a single dental visit. While you’re busy seeing your orthodontist every 4-6 weeks, it is easy to forget your need for dental cleanings and checkups while in braces. Dr. Jill and Dr. Cara will be able to reassess your risk for both gum disease and cavities and make recommendations to help you lower your risk. This may include more frequent dental cleanings, a prescription toothpaste, a professional fluoride application, and adjunctive oral hygiene tools for you to use at home.
  • Adjunctive oral hygiene tools – Braces take cleaning your teeth to a whole new dimension. A manual toothbrush usually won’t do the job, and traditional floss is virtually impossible to use alone.
    • Brushing – An electric toothbrush is a must because it can remove more plaque and bacteria around the brackets more effectively than a manual toothbrush.
    • Flossing – Using traditional floss requires the addition of something called a floss-threader, which is like a large plastic needle that can be inserted underneath the wire in order to floss between the teeth. An alternative to this is using small pre-threaded floss picks that will fit underneath the wires, called Platypus flossers.
    • Waterpik – Some people choose to add a Waterpik tool to their oral hygiene regimen. It is an effective way to remove food debris from underneath the orthodontic wires.
  • Additional oral hygiene products – The specific type of oral hygiene products you use matters when you have orthodontic appliances. There are many products available that can strengthen enamel and make it more resistant to damage from plaque and bacteria.
    • A prescription fluoride toothpaste or gel – Dr. Jill and Dr. Cara will give you recommendations based on your specific risk levels. If they determine that you are high risk for cavities, you may be given a prescription for a special toothpaste or gel to use on your teeth. Make sure to carefully follow the instructions and store any of these products out of the reach of small children.
    • Mouthwash – A mouthwash is a great way to flush out food debris from around the brackets and wires before you begin the flossing and brushing process. Any alcohol-free mouthwash is appropriate for pre-brush rinsing. Before bed and after brushing and flossing, you should swish with a fluoride-containing mouthwash. Do not rinse this one because the fluoride should stay in contact with your teeth for as long as possible. Our favorite fluoride mouthwash for orthodontics is Phos-Flur. Click here to read more about Phos-Flur mouthwash.

Questions about Your Risk (or Your Child’s Risk) While in Braces?

Call our office at 972-347-1145 to schedule a consultation with Dr. Jill and Dr. Cara. They will assess your risk for gingivitis and cavities while in braces and make the appropriate recommendations for your specific risk.


Energy Drinks

October 11, 2017

Red Bull gives you wings, but it may also give you cavities.  Energy drinks are defined as “any of various types of beverage that are considered a source of energy, especially a soft drink containing a high percentage of sugar and/or caffeine or other stimulant”.  The most common brands of energy drinks sold in the U.S. are Red Bull, Monster, and RockStar.  In 2015, Red Bull had $4.55 billion in sales.  While the soda industry is noticing a slow, steady decline in sales, the energy drink industry is steadily climbing.

What is in an Energy Drink?

  • Caffeine – Energy drinks contain a varying amount of caffeine, some as high as 160mg, which is equivalent to a Starbucks coffee. If you would not let your child drinks a strong coffee at Starbucks, you should not let them drink energy drinks.
  • Taurine – Taurine is an amino acid, present in most energy drinks, that shows no actual evidence of providing any energy at all.
  • Guarana – A plant native to the Amazon region, guarana berries contain a very high concentration of caffeine. Guarana is an ingredient in both Monster and Rockstar energy drinks.  If you see both caffeine and guarana listed as ingredients in your energy drink, it’s a double whammy, and you should proceed with caution.
  • Lots and lots of sugar – An 8-oz serving of Monster energy drink contains 27g of sugar, which is the exact amount of sugar in an 8-oz serving of CocaCola.  The important thing to remember is that most people buy both energy drinks and sodas in 16-oz bottles or cans.  If you drink a 16-oz energy drink, the amount of sugar is doubled to 54g, which is far higher than anyone’s recommended daily allowance.

How Do Energy Drinks Cause Cavities?

Energy drinks cause cavities in the same way sodas cause cavities: high sugar content, and very acidic pH.  It is important for both parents and children to understand that energy drinks offer no health advantages over sodas; in fact, they are more harmful due to the high levels of caffeine they provide.

  1. Sugar – The bacteria which is naturally present in mouths ingests (eats) sugar, and the by-product is an acid. When this acid stays in contact with the enamel surface, it begins to etch or weaken the outer layer of enamel.  This process is the beginning of a cavity.  The more sugar you drink, the more you are feeding the bacteria in your mouth, enabling them to cause damage to your enamel.
  2. pH – All energy drinks, even the sugar-free versions, have a very low pH. Rockstar Sugar Free has a pH of 3.15, Red Bull Sugar Free is 3.39, and Monster Low Carb is 3.60.  These pH measurements are well below (more acidic than) the threshold of 5.5, at which enamel begins to soften and become susceptible to decay.  Consistently drinking very acidic drinks predisposes you to a high risk for cavities.

What if I Can’t Give Up My Energy Drink?

  • As with sodas and sparkling waters, you can minimize the damage to your teeth by high sugar, acidic drinks if you limit them to mealtime only.  Drink them quickly and while you are eating.  The saliva stimulated by your chewing and tasting food will counteract the acid in the energy drink.
  • If you have a dry mouth, you are at a much higher risk for developing cavities from energy drinks.  Please ask Dr. Jill and Dr. Cara how you can address your dry mouth issues and still enjoy an energy drink from time to time.
  • After having your energy drink, chew sugar-free, xylitol gum for 20 minutes.  Chewing gum stimulates saliva production and can bring the pH in your mouth back up to neutral more quickly than it can without chewing gum.
  • Know your cavity risk.  Unfortunately, some people are much more prone to cavities than others.  You should know your risk and take the necessary steps to lower that risk as much as possible.  If you do not know your level of cavity risk, call the office today at 972-347-1145 to schedule a consultation with Dr. Jill or Dr. Cara.


What is Gingivitis?

October 4, 2017

A lot of people hear this word from their dentist and are not really sure what it means.  Have you been told that you have gingivitis by your dentist or dental hygienist?  Do you sometimes see blood when you spit your toothpaste out in the sink?  This blog will describe what gingivitis is, what it is not, what causes it, and what you can do about it.

What Gingivitis Is

The word gingivitis is easy to break down into its two components: gingiva and the suffix “–itis”.  Gingiva is the scientific term for gum tissue.  The suffix “–itis” always indicates inflammation.  Appendicitis is inflammation of the appendix.  Dermatitis is inflammation of the skin.  Inflammation will always exhibit at least one of four characteristics: redness, swelling, heat, and pain.

In gingivitis, the most common characteristics of inflammation are redness and swelling.  Any bleeding of the gums without injury indicates the presence of gingivitis (and, no, brushing, flossing and professional teeth cleanings do not count as injuries).  Gingivitis can be localized or generalized.  Localized gingivitis is isolated to a small area of the mouth, perhaps 1-2 teeth.  Generalized gingivitis is inflammation of the gum tissue around all of the teeth.

What Gingivitis Is Not

While gingivitis is typically present at the same time as many of these other conditions, it is technically not the same thing.

Periodontal disease – Periodontal disease is the loss of gum and bone attachment to teeth.  The jawbone and gums are the foundation on which our teeth function.  They support the teeth and hold them in place.  When periodontal disease is present, that support is compromised.  In severe periodontal disease, the teeth will become loose and, in extreme cases, can even fall out.  Periodontal disease often occurs in conjunction with gingivitis.  Gingivitis, if untreated, will advance to periodontal disease.  However, periodontal disease is called a “silent” disease because the inflammation can be hidden underneath the gums, not visible to an untrained eye.

Gum recession – Gum recession is the process of gum tissue receding down the root surface of a tooth.  Recession exposes the root and also compromises the support for a tooth because it is a loss of attachment.  Gum recession is often accompanied by gingivitis, but recession can be present without any inflammation.

What Causes Gingivitis

  • Plaque – The #1 cause of gingivitis is the accumulation of plaque.  Plaque consists of bacteria, their by-products, and food debris.  Plaque is an irritant to gum tissue, so when it is not properly cleaned away, the gums respond with an inflammatory reaction.  Plaque is the easiest cause of gingivitis to treat.
  • Hormones – Many people experience changes in levels of inflammation due to changes in levels of hormones.  This can affect patients going through puberty, pregnancy, and menopause.  Read more about how hormones affect gingivitis here.
  • Mouth breathing – Constant mouth breathing has a drying effect on all the tissue inside the mouth.  Saliva is instrumental in maintaining the pH of a mouth, moistening the tissue, and fighting bacteria.  Mouth breathing allows a greater accumulation of bacteria on the gum tissue, leading to inflammation.  This can affect people who have nasal obstruction, severe allergies, or sleep-disordered breathing.
  • Braces – Orthodontic treatment creates beautiful smiles.  Sometimes it also contributes to gingivitis.  All of the additional fixtures in the mouth during orthodontic treatment provide countless hiding places for bacteria to accumulate.  More bacteria means more gingivitis.
  • Some prescription medications – There are a few prescription medications that cause gingivitis as a common side effect.  Dr. Jill and Dr. Cara are familiar with these drugs and their influence on gum tissue.  They will advise you in the event you are taking a medication that could cause changes in your gum tissue.

What You Can Do About Gingivitis

  1. Improve your oral hygiene routine at home! Your routine should include brushing twice daily and flossing before bedtime.  Adding a pre-brush mouthrinse that contains hydrogen peroxide (like an over-the-counter whitening mouthrinse) will help reduce inflammation in your gum tissue. 
  2. Have your teeth professionally cleaned! Patients who are prone to gingivitis should never miss a cleaning.  Many even need to have cleanings more frequently than ever 6 months.  The good news is that more frequent cleanings always mean more comfortable cleanings.  If you skip cleanings, the bacterial buildup that is causing the gingivitis will persist and can worsen into periodontal disease.
  3. Talk it over with your dentist. You may have more than one risk factor for gingivitis, like mouth breathing or hormones.  Jill and Dr. Cara will give you customized recommendations for your specific situation.

Worried about Gingivitis?

Call our office at 972-347-1145 to schedule a consultation to discuss your concerns with Dr. Jill and Dr. Cara and get a plan to resolve your gingivitis.


Is Morning Sickness Ruining Your Teeth?

September 26, 2017

What is Morning Sickness?

Morning sickness is a commonly used term to describe the nausea and vomiting that affects many women during pregnancy.  It’s a bit of a misnomer, as most women who experience this phenomenon say it actually happens throughout the entire day and not just in the mornings.  Morning sickness affects between 70-85 percent of pregnant women!  While most women experience morning sickness in the first 16-20 weeks of pregnancy, some of the unlucky ones have symptoms throughout the entire pregnancy.

Morning sickness affects a person’s ability to work, perform necessary tasks around the home, and/or care for children or other dependents in the household.  Many women state that morning sickness forced them to reveal their pregnancy earlier than they would have preferred.

How Does Morning Sickness Affect My Teeth?

The reason morning sickness is damaging to teeth is that the nausea and vomiting brings acid from the stomach up into the mouth.  Healthy stomachs are filled with acid, which breaks down food as an important part of the digestion process.  However, that acid is supposed to stay in the stomach.  Stomach acid has a pH of 1.5-3.5.

In contrast, a healthy mouth has a pH that is slightly above neutral, in the range of 7.1-7.5.  Teeth can stay strong at this pH.  The enamel covering our teeth begins to weaken when the pH drops to 5.5 or below.

When someone vomits, the acid in the stomach is pulled up the esophagus and into the mouth.  This stomach acid is far below the pH threshold for enamel damage.  When the mouth is subjected to this strong acid with such a low pH repeatedly, the enamel is weakened and may begin to erode.

Enamel erosion is the gradual degradation of the enamel surface of teeth caused by exposure to acids.  This includes any acid, like sodas, lemon juice, and any carbonated drink.  Because stomach acid is more acidic than these things, it can cause more damage in a shorter amount of time.  The photos below show examples of severe enamel erosion.  The enamel becomes thinner and is even missing in some areas.  On front teeth, this can cause the teeth to appear translucent or “see-through”.  On back teeth, the enamel can erode away from a filling, leaving the filling taller than the tooth surface.

Because enamel is a tooth’s defense against decay, anything that weakens enamel makes a tooth more likely to get a cavity.  Loss of enamel also causes tooth sensitivity.

How Do I Protect My Teeth From Morning Sickness?

There are several steps you can take to protect your teeth if you are suffering from morning sickness.

  1. After vomiting, do not immediately brush your teeth.  Rinse your mouth thoroughly with water, wait 30 minutes and then brush.
  2. Use an over-the-counter mouthrinse that contains fluoride before bed each night. Fluoride can strengthen the enamel and protect it against acid.
  3. Chew sugar-free gum throughout the day. This stimulates your natural saliva production, which raises the pH in your mouth.
  4. See your dentist. If you are suffering from morning sickness, let Dr. Jill and Dr. Cara know.  They can assess your risk for enamel erosion and make specific recommendations for you.

What Else Can Cause Acid Erosion of Teeth?

  • GERD – Severe acid reflux can keep the pH in the mouth much lower than normal.
  • Bulimia – As with morning sickness, consistent vomiting causes enamel erosion.
  • Lemon juice cleanses – Lemon juice is as acidic as stomach acid and should never touch the teeth.

Are You Suffering With Morning Sickness?

Call our office at 972-347-1145 to schedule a consultation with Dr. Jill or Dr. Cara.  They will determine your risk for enamel damage and give you customized recommendations to lower that risk.


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.


  • 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.


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!



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.






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Prosper Family Dentistry

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

Phone: 972-347-1145



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