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FAQ - Educational Resources

Below are topics that will answer some basic questions that are frequently asked about oral health. For more information or if you have additional questions, please feel free to ask.

Diabetes and Gum Disease

What is Diabetes?

Diabetes is an immune deficiency disease associated with six health complications including periodontal disease as well as effecting areas such as eyes, kidneys, heart, nerves and poor wound healing.

Type II diabetes or non-insulin dependent diabetes was once thought to be a middle age disease but could present at any age! Diet, exercise and medications can control type II.

Type I or insulin-dependent diabetes affects primarily young people and is caused by the total absence of beta cells. Beta cells secrete insulin; a hormone that is essential in the breakdown of sugars (glucose). The body must be assisted with injections of insulin.

How is Diabetes and Gum disease Related?

Both diseases are controlled NOT cured. Cells require sugar for energy, and in diabetes, insulin is defective and does not allow glucose to enter cells efficiently thus slowing down the healing process or causes cell death if no insulin is provided.

Uncontrolled diabetes can lead to bone loss, tissue break down and tooth loss even when there is little plaque and calculus (tartar). There is a greater risk of more aggressive bacteria causing abscesses and increased periodontal disease. Periodontal disease is associated with heart and circulatory disease. Uncontrolled diabetes is 3 times at risk for heart and circulatory disease, making the patient high risk for periodontal disease.

Controlled diabetes results in a decrease of oral inflammation. Diabetes should be controlled through proper diet and stable insulin levels. Well-controlled diabetics can have healthier gum tissues than non-diabetic patients due to lower sugar consumption.

Other complications in the mouth with poor sugar control. (Too much sugar in saliva):

  • ~ Dry mouth - relieved by chewing sugarless gum and lozenges
  • ~ Burning mouth or tongue
  • ~ Yeast infections/Thrush
  • ~ Canker sores/Oral Ulcers
  • ~ Poor taste/smell
  • ~ Pain orally and facially
  • ~ Lichen Planus

What can You Do?

Control your diabetes. Check your blood sugar levels regularly. Wear a medi-alert bracelet. Let us know of any changes in medication and condition. Avoid smoking as it affects the immune response. Brush, floss, tongue debridement, interproximal aids and fluoride treatment for root exposure and visit a dental office frequently, every 3-6 months depending on your needs.

What can we do?

We will assess your periodontal condition and advise you of treatment that suits your individual needs. We will gladly educate you on the appropriate tools for your plaque and bacterial control with our informative self-care program.

Overall Health and Gum Disease

Recent studies have linked periodontal disease (gum and bone disease) with several serious health conditions: heart and stroke, respiratory diseases, diabetes, and premature and low birth weight babies. As with smoking, high cholesterol and obesity, gum disease may be a risk factor for these conditions. It is thought that the disease causing bacteria in periodontal disease travels through the blood stream contributing to or possibly causing health problems.

Most adults have some form of gum disease. A bacterial infection which usually starts in the gums (gingivitis) and if untreated, spreads to the bone (periodontitis). Eventual tooth loss will occur if this disease process is not treated.

The Heart and Gum Disease:

Studies suggest that the gum disease causing bacteria may travel through the bloodstream and add to the formation of plaque that clog the arteries. One U.S. study found a higher incidence of heart and stroke disease in patients with moderate to severe gum disease than those with healthy mouths.

The Lungs and Gum Disease:

Scientists believe that gum disease may increase the risk of lung infections and worsen existing conditions such as emphysema and bronchitis. This can result when the disease causing bacteria from the oral cavity is inhaled into the lungs.

Sensitivity of Teeth

Do you get a pain from hot, cold, eating, sweet, or sour foods, or maybe just by touching your teeth with a toothbrush? Does the pain come and go? It could be due to sensitive teeth. Make sure to tell us if you have this problem.

Cause:

Studies show the cause of sensitivity is when the dentin of the tooth is exposed. Dentin is in the porous part of the tooth under the enamel. Exposure can happen because:

  • ~ Brushing too hard at the gum line
  • ~ Recession of gums
  • ~ Gum disease
  • ~ Periodontal treatment
  • ~ Fractured or chipped teeth
  • ~ Tooth wear at the gum line
  • ~ Clenching or grinding

Once the dentin has become exposed, tiny fluid filled tubes that make the dentin porous become exposed too. The tubes are now exposed to the moth, and connect back to the center of the tooth where the nerve is. Then, hot, cold, touch, sweets, or drinking can cause a pain.

Treatment:

We can show you a better brushing technique, and eating habits to help avoid triggering the sensitive spot. We may also suggest an in office treatment that can take some pain away. We may also recommend a sensitivity toothpaste. And in very severe cases, periodontal surgery can be effective.

Sensitivity toothpaste can block the pain signal from the nerve to the brain or reduce the fluid in the tubes that trigger the nerve. Sensitivity toothpaste works over time - it is not fast acting relief. Once you stop brushing with this, the pain may return.

Always tell us of any pain or sensitivity you are having. If it is sensitivity, we can help you in many ways so you are able to enjoy any type of foods and drinks.

Pregnancy and Oral Health

Many hormonal changes occur throughout pregnancy. Estrogen sites are found throughout the tissues and constant hormonal changes combined with increased levels of bacteria and plaque contribute to inflammation, and bleeding known as pregnancy gingivitis.

Women with moderate to severe periodontal disease are at risk of having pre-term low birth weight babies. Low birth weight babies compared to normal birth weight babies are at greater risk of neurodevelopment, respiratory problems and demonstrate behavioral problems including attention deficient disorder. So controlling your periodontal condition is extremely important to a healthy baby.

If you Plan to become Pregnant:

If you plan to become pregnant be sure to visit our dental office for a check-up and treat any existing oral problems prior to becoming pregnant. Have frequent dental cleanings to help control plaque and bacteria. A healthy diet during pregnancy will help to eliminate any dental problems, substituting healthy food such as fruits, vegetables and dairy for sweets.

If you are pregnant:

First and foremost, advise the office prior to any treatment that you are pregnant, and of any history of complications during pregnancy. Avoid dental X-rays, antibiotics (especially tetracycline) and pain medications during the first trimester unless it is absolutely necessary!

Schedule your dental visit during the fourth to sixth month of pregnancy. The first three months is a critical time for fetal development. During your last trimester, dental stress can induce labor and increase the incidence of prenatal complications.

Teeth and gums need extra attention during pregnancy so brushing and flossing, balanced diet and frequent dental visits will help reduce any dental problems associated with pregnancy.

Reducing the Risk:

Gum disease can be controlled. Regular hygiene appointments based on your periodontal assessment and customized oral hygiene programs appropriate for your needs are recommended to reduce systematic risks associated with gum disease.

Denture Process

Dentures are false teeth that are made to replace teeth for a patient who has lost all of their teeth. If a patient goes without any teeth in their mouth, their face can look shorter and their facial muscles begin to sag. Speech and mastication (chewing) can also become a challenge for a patient with no teeth.

We make "Premium" quality dentures here at Cooney Family Dentistry, which means they are made of the strongest and most esthetic materials available for denture fabrication. We do not offer "Economy" quality dentures.

A denture can be made one of two ways. The traditional method is preferable. This is when the patient has had their teeth extracted and has healed for 4-6 weeks before the impressions are taken for the construction of the denture. This method involves having several "try-in" appointments. At these appointments, we take measurements, try in the teeth, and make as many changes necessary, until the patient is satisfied. We will make these changes, as many times as necessary for the patient to be happy before the denture is processed and delivered. With this method, anything can be changed before processing, including the shape, size, color, and placement of the teeth. The only negative aspect to this method is that the patient has to go without teeth for anywhere from 8 to 12 weeks (4 to 6 weeks of healing and 4 to 6 weeks to make the denture).

Since most people are unable to go without teeth for the amount of time that it takes to make a traditional denture, we also offer "Immediate" dentures. With this method, impressions are made of the mouth, a few weeks before the teeth are extracted. The denture is processed at the lab and sent back to us to be delivered on the same day as the patient’s extractions. The negative aspect to this method is that we are unable to perform any "try-ins", which means we cannot make any changes to the esthetics of the denture. The shape, size, color and placement of the teeth can not be changed, once the denture has been made. A reline is included in the price of an immediate denture, which we typically do six months to one year after it’s been delivered to the patient. When you have an immediate denture, your gums and bone will shrink over about 6 months to a year. As this happens, the fitting of the denture will become less and less ideal, possibly causing the denture to "rock" or become "loose" in the patient’s mouth. A soft reline is also included in the price of the immediate denture, to help get you through the transition time, while you are healing. The soft reline is rubbery and can tear easily and eventually will deteriorate and can be difficult to clean. It is not durable enough to be used long term

TMJ Disease

Temporomandibular disorders (TMD) occur as a result of problems with the jaw, jaw joint and surrounding facial muscles that control chewing and moving the jaw.

What Is the Temporomandibular Joint?

The temporomandibular joint is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull, which is immediately in front of the ear on each side of your head. The joints are flexible, allowing the jaw to move smoothly up and down and side to side and enabling you to talk, chew, and yawn. Muscles attached to and surrounding the jaw joint control the position and movement of the jaw.

What Causes TMD?

The cause of TMD is not clear, but dentists believe that symptoms arise from problems with the muscles of the jaw or with the parts of the joint itself.

Injury to the jaw, temporomandibular joint, or muscles of the head and neck – such as from a heavy blow or whiplash – can cause TMD. Other possible causes include:

  • ~ Grinding or clenching the teeth, which puts a lot of pressure on the TMJ
  • ~ Dislocation of the soft cushion or disc between the ball and socket
  • ~ Presence of osteoarthritis or rheumatoid arthritis in the TMJ
  • ~ Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth

What Are the Symptoms of TMD?

People with TMD can experience severe pain and discomfort that can be temporary or last for many years. More women than men experience TMD and TMD is seen most commonly in people between the ages of 20 and 40.

Common symptoms of TMD include:

  • ~ Pain or tenderness in the face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak or open your mouth wide
  • ~ Limited ability to open the mouth very wide
  • ~ Jaws that get "stuck" or "lock" in the open- or closed-mouth position
  • ~ Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth (which may or may not be accompanied by pain)
  • ~ A tired feeling in the face
  • ~ Difficulty chewing or a sudden uncomfortable bite – as if the upper and lower teeth are not fitting together properly
  • ~ Swelling on the side of the face

Other common symptoms include toothaches, headaches, neckaches, dizziness, and earaches and hearing problems.

How Is TMD Diagnosed?

Because many other conditions can cause similar symptoms – including a toothache, sinus problems, arthritis, or gum disease – your dentist will conduct a careful patient history and clinical examination to determine the cause of your symptoms.

He or she will examine your temporomandibular joints for pain or tenderness; listen for clicking, popping or grating sounds during jaw movement; look for limited motion or locking of the jaw while opening or closing the mouth; and examine bite and facial muscle function. Sometimes panoramic X-rays will be taken. These full face X-rays allow your dentist to view the entire jaws, TMJ, and teeth to make sure other problems aren't causing the symptoms. Sometimes other imaging tests, such as magnetic resonance imaging (MRI) or a computer tomography (CT), are needed. The MRI views the soft tissue such as the TMJ disc to see if it is in the proper position as the jaw moves. A CT scan helps view the bony detail of the joint.

Your dentist may decide to send you to an oral surgeon (also called an oral and maxillofacial surgeon) for further care and treatment. This oral healthcare professional specializes in surgical procedures in and about the entire face, mouth and jaw area.

What Treatments Are Available for TMD?

Treatments range from simple self-care practices and conservative treatments to injections and surgery. Most experts agree that treatment should begin with conservative, nonsurgical therapies first, with surgery left as the last resort. Many of the treatments listed below often work best when used in combination.

Basic Treatments

  • ~ Apply moist heat or cold packs. Apply an ice pack to the side of your face and temple area for about 10 minutes.
  • ~ Eat soft foods. Eat soft foods such as yogurt, mashed potatoes, cottage cheese, soup, scrambled eggs, fish, cooked fruits and vegetables, beans and grains. In addition, cut foods into small pieces to decrease the amount of chewing required. Avoid hard and crunchy foods (like hard rolls, pretzels, raw carrots), chewy foods (like caramels and taffy) and thick and large foods that require your mouth to open wide to fit.
  • ~ Take medications. To relieve muscle pain and swelling, try nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen (Advil, Motrin, Aleve), which can be bought over-the-counter. Your dentist can prescribe higher doses of these or other NSAIDs or other drugs for pain such as narcotic pain relievers. Muscle relaxants, especially for people who grind or clench their teeth, can help relax tight jaw muscles. Anti-anxiety medications can help relieve stress that is sometimes thought to aggravate TMD. Antidepressants, when used in low doses, can also help reduce or control pain. Muscle relaxants, anti-anxiety drugs and antidepressants are available by prescription only.
  • ~ Wear a splint or night guard. Splints and night guards are plastic mouthpieces that fit over the upper and lower teeth. They prevent the upper and lower teeth from coming together, lessening the effects of clenching or grinding the teeth. They also correct the bite by positioning the teeth in their most correct and least traumatic position. The main difference between splints and night guards is that night guards are only worn at night and splints are worn full time (24 hours a day for 7 days). Your dentist will discuss with you what type of mouth guard appliance you may need.
  • ~ Undergo corrective dental treatments. Replace missing teeth; use crowns, bridges or braces to balance the biting surfaces of your teeth or to correct a bite problem.
  • ~ Avoid extreme jaw movements. Keep yawning and chewing (especially gum or ice) to a minimum and avoid extreme jaw movements such as yelling or singing.
  • ~ Don't rest your chin on your hand or hold the telephone between your shoulder and ear. Practice good posture to reduce neck and facial pain.
  • ~ Keep your teeth slightly apart as often as you can to relieve pressure on the jaw. To control clenching or grinding during the day, place your tongue between your teeth.
  • ~ Learning relaxation techniques to help control muscle tension in the jaw. Ask your dentist about the need for physical therapy or massage. Consider stress reduction therapy, including biofeedback.

Surgery

Surgery should only be considered after all other treatment options have been tried and you are still experiencing severe, persistent pain. Because surgery is irreversible, it is wise to get a second or even third opinion from other dentists.

There are three types of surgery for TMD: arthrocentesis, arthroscopy and open-joint surgery. The type of surgery needed depends on the TMD problem.