All posts by AllSmiles

What Causes Pain After New White Fillings? And How to Resolve It

I need to find a dentist who is skilled at restoring cavities and who is willing to sedate me while I’m getting the work done. Although cavities haven’t been a problem for me in the past, it started after I had my baby in February 2019. Last July, I went to the dentist in severe pain. I had six cavities that the dentist filled at a second appointment. When I returned to the dentist in February of this year, I had two more cavities. One of the two most recent white fillings on a molar tooth is painful when I chew on it. My dentist checked my bite and said it looks good. She offered to remove the filling and replace it. She said that the tooth might have a crack, and she can x-ray it. If it’s cracked, I need root canal treatment.

I decided to wait and do nothing because I don’t understand why I’m having so many problems with my teeth. Meanwhile, the tooth with the possible crack hurts when I floss around it, and it hurts to chew on that side of my mouth. Within the past two weeks, when I’m chewing, I sometimes feel a dull pain in two of the first six fillings that I received. They are molar teeth also. I’ve had some post-partum stress, and this situation is making it worse. I didn’t have dental anxiety before, but I’ve decided that I need to switch dentists and find one who is willing to sedate me to figure out what’s happening with my teeth. I’m not sure if I need a cosmetic dentist, but I would like some advice on finding a dentist who knows if I have more cavities and how to do white fillings correctly.  Thank you. Gabrielle


Sedation dentistry can make getting new fillings easier

We understand your concern about your dentist’s technique with composite fillings. You described pain when you chew. When and where you feel pain will help a second-opinion dentist determine what’s causing the problem. Look for a dentist with training in cosmetic and sedation dentistry. Ask friends or family members for a cosmetic dentist—not a general dentist. If you don’t get any recommendations, search online, and read each dentist’s bio to determine if they have post-graduate training.

How to Resolve Pain After Getting Composite Fillings on Back Teeth

Pain when chewing, not clenching – Usually, pain while chewing results form improperly bonding the filling to your tooth. A cosmetic dentist with advanced training in composite fillings will remove the filling and replace it using proper bonding techniques.

Composite fillings on front vs. back teeth – Some dentists who place composite fillings don’t have advanced training in the technique. They rely on what they learned in dental school for placing composite fillings on front teeth. But the method for back teeth is not the same. It’s essential to find a dentist who has training in composite filling techniques.

Plano, TX female dentist Dr. Miranda Lacy sponsors this post.

Dentist Left the Tip of an Instrument in the Patient’s Tooth After a Root Canal

During my root canal in March, my dentist told me that the tip of his file broke off and fell into the canal. He said the file is sterile, so he wasn’t going to damage my tooth and try to remove it. He said he would put a post in the tooth and put a crown on it.

I asked him to place a temporary crown until I think about what I want to do with the tooth. I haven’t been able to return to the dentist yet. Is it okay to leave the tip of the file inside my tooth? Lots of people go to this dentist because his fees are lower than others, but I don’t want cheaper care if it means a dentist will be careless. Thanks. Jules


Metal files can break easily, and it’s happened to a lot of dentists—even those who don’t have lower fees for services. A broken piece of a file can be challenging to remove for many general dentists. If the tip of the file is left, a dentist would need to navigate around it and seal the apex or tip of the tooth root. If the broken piece is blocking the apex, it decreases the chances of successful root canal treatment.

If the tip of the instrument irritates your tooth, you might need root canal treatment later. Cementing a post could make it impossible to retreat the tooth.

Side-by-side diagram of an infected tooth being cleaned out with root canal treatment (left) and a healthy tooth to the right.
An endodontist can resolve previous root canal issues

Your safest option is to ask your dentist to refer you to an endodontist, or root canal specialist. Endodontists have special tools to extract the tip of the file and fill the canal of the tooth. Although your dentist might not want to refer you to a specialist, you can insist on it or find an endodontist on your own. It’s good that you asked for a temporary crown until you decide what to do about the tooth. Don’t risk losing your tooth. Visit an endodontist.

This post is sponsored by Plano, TX female dentist Dr. Miranda Lacy.

How to Get a Whiter, More Even Smile Without Porcelain Veneers

I want my teeth to be whiter and to close the spaces between them, but I can’t afford porcelain veneers. I’m thinking about a snap-on smile because it will cover both of my concerns. I’m not sure how a snap-on smile compares to veneers, but I know it’s cheaper. Braces are out of the question for the spaces between my teeth. I’m not sure that my research has revealed all my options, though. How can I improve my smile without going into debt? Thanks. Yazi


Before you ask a dentist for a Snap-On Smile, we’ll explain what you can expect. It will help you decide if it’s the solution you’re seeking.

What to Expect from a Snap-On Smile

Cost – You can expect to pay about $1500 for a Snap-On smile. If you wear it all the time, it can last two years or more—depending on how well you take care of it.

Aesthetics – A Snap-On smile fits over your teeth, so it makes them look bulky. Unless you have small teeth, a Snap-On smile might draw more attention to your smile in a negative way.

Feel – It’s an appliance that fits over your teeth. Although you’ll get used to it, it won’t feel natural. And it takes time to learn to speak without lisping while you’re wearing it.

Alternatives for a Brighter, More Even Smile

Alternatives to a Snap-On Smile will give you better, longer-lasting results.

Brighter smile

If you want a brighter smile, teeth whitening is an option that will help your smile look younger. Some dentists offer free or discounted whitening to patients to keep their cleaning and exam appointment.

Teeth whitening will help your smile look younger

Closing gaps or spaces

Also, tooth-colored composite bonding will close small gaps or spaces between your teeth. But it takes an artistic cosmetic dentist to apply dental composite and mimic the characteristics of natural teeth.

If you ask for a specific treatment, some dentists will provide it even though alternatives might work best for the long-term health of your smile. We suggest that you schedule consultations with at least two cosmetic dentists. They will examine your teeth, explain your options, and let you know what to expect.

Miranda Lacy, DDS, a Plano, TX, female dentist, sponsors this post.

3 Reasons to Be Concerned about PTSD and Teeth Clenching and Grinding

I suffer from PTSD, and for the past 4 years, I clench my teeth during the day and grind them at night. I have some neck pain and headaches that I think are related to my habit. I’ve had the same dentist since 2011, and he says my teeth look okay. But I’m starting to feel short spurts of dull pain in my lower molar teeth. My last exam and cleaning appointment was in mid-February. I’m afraid of the dentist anyway and need sedation for all my appointments. Now with the COVID-19 restrictions, I’m not going to any dentist. Besides, the office is only open for emergencies. I’m wondering if the dull pain and pressure on my lower teeth might be due to cavities or from teeth grinding. Is there anything I can do about this at home? – Thanks. Quinn from San Antonio

Quinn – We’re not sure why your dentist though your checkup appointment was good if you’ve been clenching and grinding your teeth for about four years. And you’re feeling pain and pressure in your teeth. That’s a problem.

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Sedation will help you relax throughout dental procedures

Dr. Lacy would need to review your x-rays and check your teeth and mouth. We’re concerned that your dentist didn’t thoroughly examine your teeth.

When you clench and grind your teeth, more than cavities and fillings are involved. Other oral health issues can arise, including

  • TMJ disorder
  • Gum disease
  • Poor occlusion

We recommend that you seek a second opinion from a dentist who will be more thorough. The pain you’ve described could be from gum disease or the trauma of grinding your teeth. In either case, you need an examination. Without an exam, gum disease can progress and lead to jawbone loss. Grinding your teeth will wear them away.

Your new dentist may be able to resolve your pain and discomfort with a custom night guard. It’s worth it to contact a new dentist and at least have a video conference to describe your symptoms. You’ll receive recommendations on what you can now and how to handle the situation before you see a dentist.

Plano, TX female dentist Dr. Miranda Lacy sponsors this post.

Three Causes of Tooth Pulp Sensitivity and Irritation

In early February, one of my bottom molar teeth cracked. The tooth had an old filling in it, and I felt it crack while I was at dinner with friends. At the time, I had only been in AZ for about two months. I relocated and still don’t have a job yet, so I found a dentist with reasonable fees. She said I needed a crown. She prepared the tooth and put on a temporary crown. The crown made my gums sore, and it hurt to chew on that side of my mouth. I also told my dentist that I felt some sensitivity in the tooth whenever I drink anything cold.

That issue wasn’t resolved before she placed my permanent crown later in January. The pain got worse, so I returned to the dentist she took x-rays and poked around the crown to see if I felt any pain or pressure. Of course, my tooth didn’t respond to any of her tricks, so she told me to wait two or three months for it to settle down. My tooth hurts daily. It’s not constant pain, but it hurts and is now sensitive to hot food. I’ve entered my symptoms in Google, and everything I read sounds like I need root canal treatment. Is my tooth dying? Thank you. Eun-ae M. from Flagstaff


Thank you for describing your symptoms and the history of your tooth pain. We recommend that you call an endodontist, or root canal specialist.

Side-by-side diagram of an infected tooth being cleaned out with root canal treatment (left) and a healthy tooth to the right.
Root canal treatment can save your cracked tooth

But without criticizing your dentist, we want to clarify a few facts.

Causes of Tooth Pulp Irritation and Sensitivity

  • Cracked tooth – A crack can easily affect the tooth pulp (living tissue, nerves, and blood vessels) inside your tooth. An infection can cause inflammation that chokes the pulp and makes it die.
  • Aggressive preparation for a crown – Significant sensitivity after your dentist prepares a tooth for a crown can result from improperly sealing the temporary crown or aggressive tooth preparation. But a tooth can be coated with a desensitizing product to limit the discomfort.
  • Cementing the crown – A temporary crown on a molar tooth should be made of durable material and bonded with soothing cement to help the tooth nerves calm down. Permanently cementing an already irritated tooth can cause further complications and the need for root canal treatment. The increased sensitivity you’re feeling might be due to changes in the tooth ligament near the root. An endodontist can see that, but most general dentists won’t recognize it as an issue.

Instead of allowing your general dentist to do any more work on your teeth, we recommend that you see a specialist.

This post is sponsored by Plano, TX female dentist Dr. Miranda Lacy.

9 Causes of Bad Breath and Why Hiding the Odor Isn’t Good Enough

I have a bad smell in my mouth. I brush daily but it still smells. I chew gum all day long and suck on mints, but I don’t want to get cavities from all the sugar. Any suggestions? Will teeth whitening help? – Thanks. Luca from San Antonio

Luca – Many factors can affect the way your breath smells. Although teeth whitening products can brighten your smile, they won’t help your breath smell fresh.

What Causes Bad Breath?

Several factors are reviewed below.

1. Bacteria

Bacteria in your mouth is the most common cause of bad breath. In addition to brushing your teeth daily, floss between them. Flossing removes food debris that promotes bacteria. If bacteria get stuck between your teeth, it will begin to smell bad. Some people benefit from a tongue cleaner to remove bacteria. Others gently brush their tongue.

2. Gum Disease

Infected gum tissue breeds bacteria. Gums can get inflamed and pus-filled and cause a foul odor on your breath.

3. Dry Mouth

Saliva cleanses your mouth. Lack of saliva production causes bacteria to breed and make your breath smell bad. Breathing through your mouth, instead of your nose, will also decrease saliva production.


When stomach acid flows up your esophagus, gastroesophageal reflux disease (GERD) occurs. The backup of regurgitated food can cause your breath to smell bad.

5. Liver Disease

Your liver removes toxins from your body. If your liver isn’t functioning properly, toxins can build up in your bloodstream and cause a sweet, musty odor on your breath.

6. Kidney Disease

Malfunctioning kidneys cause minerals to collect in your bloodstream. The result is often a metallic taste in your mouth and breath that smells like ammonia.

7. Extreme Low-Carb Diet

If you’re on an extremely low-carb diet, your body will burn fat, instead of sugar. Fat burning releases ketones in your body, including acetone, which can make your breath smell like nail polish.

8. Pneumonia

Phlegm from the bacterial or viral infection in your lung has a bad odor. As you cough it up, it will affect the smell of your breath.

9. Bronchitis

As you cough, foul-smelling mucus from your lungs will make your breath smell bad, too.

There are powerful products to help you treat bad breath, including BreathRx. But don’t neglect an appointment with your dentist or medical doctor to identify the cause of the problem. You might have an underlying medical condition that needs to be treated. The odor of your breath can be a lifesaving sign of something more serious. Don’t ignore it.

Plano, TX dentist Miranda Lacy sponsors this post.

What to Do If Root Canal Filler Material Falls Out of Your Tooth

In 2016, I had a root canal on an upper right molar tooth. I have only been to a dentist twice since that time and the last time was early last year. The cap fell off almost 2 months ago and there is a rod in my tooth that wiggles back and forth. Can I pull the post out? It’s uncomfortable when I chew, and I’m afraid it might come out when I’m eating. I don’t want to swallow it. Thanks. Clinton from Georgia


In addition to your lost dental crown, the root canal filling material is falling out. If your dental crown came off two months ago, you’re at risk for infection and needing another root canal treatment.

What Happens When Root Canal Filling Material Is Unprotected?

If you had root canal treatment on a tooth, problems with the tooth will increase if it isn’t sealed off and protected.

  • The material is exposed to oral fluids and saliva can loosen the filling
  • Your tooth can be infected again
  • You’ll need another root canal treatment
  • Your dentist will protect the tooth with a dental crown.

The metal crown in your tooth is likely a post that was used to fill your tooth. Although the post can last for years, if your crown if off, it won’t last. You shouldn’t remove it yourself. A dentist will examine your tooth to determine if root canal treatment needs to be repeated or if the tooth can simply be sealed and protected with a crown.

Do You Have Dental Anxiety?

Many patients who delay dental care have anxiety about dental visits. If you suffer from anxiety, Clinton, don’t let it prevent you from getting the care you need. Tell your dentist about your nervousness. Any dental procedure can be performed with sedation to help you relax and have a productive appointment. Depending on your level of anxiety, you can receive nitrous oxide or oral conscious sedation in pill form.

This post is sponsored by Miranda Lacy, DDS, a Plano, TX female dentist.

Her Sinus Peforation Still Hasn’t Healed

In late November when I had an upper right molar tooth extracted, my dentist sedated me. I don’t know why he was talking to me when I was half out of it. Anyway, my dentist told me he could see into my sinuses. I don’t remember much other than that. I took all the prescribed antibiotics, but the sinus perforation is only partially closed. When I sneeze or blow my nose, I can feel that it’s still open and I think that my sinuses are infected.

I get a low fever almost every day, and I have frequent headaches. My dentist keeps telling me to give it more time, but I wonder if it’s time to see an oral surgeon. I hate the thought of being sedated and something going wrong again. Is it normal to have a prolonged healing period? Thanks, Tyler


We are sorry to hear about your ongoing discomfort after your molar tooth was extracted. The prolonged healing period is not normal.

What’s happening?

  • It’s likely that you’ve had an infection ever since your tooth was extracted.
  • If the perforation hasn’t healed yet, the tip of the tooth root or a bone fragment might remain in your sinus.
  • Your dentist should have x-ray your sinus to see if an object is preventing the perforation from healing
  • You can ask for a referral to an otolaryngologist to determine if there is something preventing proper healing and to get the right treatment.
  • The hole needs to be closed. You’ll need another course of antibiotics to clear the infection.
  • If a bone graft is needed, the gum tissue over it will close in four to six weeks. The bone graft will heal in four to six months. You’ll have follow-up appointments to check the progress.

Will you need to be sedated?

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Sedation will help you relax as the sinus perforation is corrected

Although you are hesitant about being sedated again, it will ensure your comfort throughout the procedure. Otherwise, your discomfort can prevent the oral surgeon from completing the procedure. You will have a consultation before the perforation is closed, and you can talk with the surgeon about your concerns.

This post is sponsored by Plano, TX dentist Dr. Miranda Lacy.

Is This Hydrogen Peroxide Solution Good for Whitening Porcelain Veneers?

I found a mouthwash and teeth whitening recipe online that I can make that won’t harm my porcelain veneers. I just want to double-check the ingredients to make sure it will work. It contains 8 oz filtered water, boiled; 8 oz of 3% hydrogen peroxide; and 2 tablespoons of sea salt. Is this mixture okay to use on porcelain veneers, or are the measurements off? Thanks. Gloria from Little Elm


If your veneers are stained, avoid any at-home methods to brighten them.

How to whitening teeth that have been restored with porcelain veneers

Mouthwash – Mouthwash that contains alcohol will soften the bonding that adheres the porcelain veneers to your teeth. It will create a reservoir around the edge of your veneers that attracts stains. Your veneers can loosen, too. Avoid alcohol-based mouthwash.

Hydrogen peroxide – Although hydrogen peroxide kills bacteria, including harmful bacteria that promote gum disease, it also kills beneficial microbes. The result is an overgrowth of yeast, or candida albicans.

Although short-term use of hydrogen peroxide is helpful as a mouthwash, prolonged use can develop into unwanted symptoms, including:

  • Oral yeast infection
  • White and peeling oral tissue
  • Raw, red, and painful patches

What if your veneers are stained?

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
Ensure your veneers are maintained by a cosmetic dentist

If your porcelain veneers appear to be stained—or if you want to ensure they remain sparkling white— what can you do?

  • Continue to maintain good oral hygiene. Floss between your teeth daily and brush them with non-abrasive toothpaste.
  • Speak with your dentist if you have concerns about discoloration or stains. He or she has in-office equipment to polish your veneers without harmful whitening chemicals.
  • Avoid using tooth whitening solutions on your porcelain veneers. The chemicals can scratch the surface of your veneers and attract stains.
  • Only have your veneers cleaned by a dental hygienist who is trained to use the correct tools to avoid damaging them.

Plano TX female dentist, Dr. Miranda Lacy, sponsors this post.

Teeth Sensitive at the Gumline? What’s Causing It and How It’s Treated

For about 3 months, I’ve had periodic tooth sensitivity at the gumline on my top right front tooth and the one to the right of it. The teeth aren’t sensitive to heat or cold, but if I run my fingernail or a toothpick along the gums, it’s sensitive. Flossing or brushing my teeth doesn’t hurt. The sensitivity has increased over the past 3 weeks. The only thing different is that I’ve started whitening my teeth at home. The sensitivity isn’t during or after whitening, but if I put pressure on the teeth, it feels like the nerves in the area are more irritated than ever. What’s causing this? – Luke


Thanks for submitting your question. Persistent tooth sensitivity should not be ignored because it can lead to internal damage and root canal treatment. Until the issue is diagnosed and treated, you should discontinue whitening your teeth, because bleaching gel can cause further irritation.

The good news is that your teeth aren’t sensitive to heat or cold, so it is unlikely that the pulp (living tissue in the tooth) is damaged.

How Are Sensitive Spots on Teeth Treated?

Photo of upper and lower teeth whitening trays in a blue case; for information on teeth alignment from the office Plano dentist Dr. Miranda Lacy.
Discontinue whitening until your dentist says it’s safe

Although many dentists aren’t aware of it, teeth slightly flex where the crown and root meet. These tiny movements can occur when we bite, chew, or clench or grind our teeth. Flexure causes small amounts of tooth structure to break. Over time, flexing sends impulses to a tooth and creates sensitivity. The tooth can develop a significant groove, referred to as an abfracted lesion.

It’s relatively easy for your dentist to treat teeth that are sensitive in specific locations.

  • Your dentist must examine your teeth to determine the size of the spots.
  • If the spots are small enough, your dentist will seal them.
  • Larger grooves must be filled. An ordinary filling often won’t stay in the grooves, so your dentist can use a microfill composite or another flexible filling material. Microfill composite will eliminate or reduce sensitivity in the teeth.

After treatment, your dentist will let you know when it’s safe to resume whitening your teeth.

Plano female dentist, Miranda Lacy DDS, sponsors this post.