All posts by AllSmiles

How Can I Treat Gum Disease at Home?

Although I have not seen a dentist yet, I am sure that I have gum disease. All the signs point to gum disease. I have bleeding and swollen gums and two loose teeth where the gums shrank back a little. I do not have dental insurance right now but am looking for a job that offers it. I also have dental anxiety, so I know they need to give me nitrous or something to calm me down. I’m afraid of not having enough money to meet my home expenses if I must pay for it on my own. Meanwhile, is there anything that I can do at home to slow down the damage to my gums and teeth? Thank you.  Jan from Iowa


The signs and symptoms you described reflect advanced gum disease. When your teeth begin to loosen, you can do nothing at home to save them. And if two teeth are loose, more will probably follow.

What Happens If You Don’t Treat Gum Disease?

Untreated gum disease can threaten your long-term oral and overall health. According to the American Academy of Periodontology, as gum disease gets worse, the following issues result:

  • Chronic inflammation
  • Diseased bone that supports your teeth
  • Deep pockets between your gums and teeth
  • Teeth fall out

Preventing gum disease is not expensive. But the longer you delay, the more costly treatment will become. Your dentist will recommend deep cleanings to remove the buildup of plaque and tartar between your teeth. You may need a specialist to stop the disease from getting worse?

What If You Have Gum Disease But No Dental Insurance?

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Ask a dentist about making gum disease treatment and sedation affordable for you

If you have gum disease but no dental insurance, see a dentist anyway. Even if you need sedation during the treatment you need, it is worth it. Call a few dental offices in your area and ask about payment plans and how the practice can make treatment affordable for you.

Plano Texas dentist Dr. Miranda Lacy sponsors this post.

Is My New Dentist Overdoing It with X-Rays and Fluoride Treatment?

I have a new dentist and have some questions about their recommendations. Do I need x-rays every six months? Also, as an adult, do I need a yearly fluoride treatment? I want to limit treatment that I do not need frequently. Thank you. Susanna from San Francisco


Thank you for your questions.

How Often Do You Need Dental X-rays?

General guidelines for dental x-rays are as follows:

  • Bitewing x-rays – Yearly
  • Panographic x-ray – once every five years

However, the American Dental Association (ADA) states that your dentist may recommend x-rays more often depending on several factors, including:

  • Your age
  • Your oral health
  • Your risk for disease
  • Signs and symptoms of oral disease, including tooth decay, bone disease, or gum disease

Dental x-rays expose you to minimal radiation. Still, the ADA document, Dental Radiographs – Benefits and Safety, recommends providing a new dentist with your existing x-rays to avoid duplicating them.

How Often Do Adults Need Fluoride Treatment?

Although dentists usually give fluoride treatment to children, adults may receive treatment for aggressive decay. How often you receive fluoride depends on your condition and its severity.

Teeth whitening application
Fluoride treatment can calm lingering sensitivity from teeth whitening

Reasons that your dentist might recommend fluoride treatment

  • Advanced tooth decay
  • Lingering sensitivity from teeth bleaching
  • Minimize decay from reduced saliva flow from diseases, medications, or medical treatments.

Most dental offices use acidulated fluoride. If you have porcelain veneers or crowns, acidulated fluoride can etch the surface, roughen it, and increase the risk of our crowns or veneer staining. If the dental lab makes your porcelain restorations tinted the surface, acidulated fluoride can dissolve the tint.

And if you want your teeth whitened, ask your dentist to supervise it, help you minimize sensitivity, and avoid the need for fluoride treatment.

Will My Chipped Tooth Grow Back?

My girlfriend keeps nagging me about a chipped tooth that happened a few weeks ago. I hurt when it first happened but now only every now and then does it bother me. I think she is embarrassed by it, but it doesn’t bother me. Is this something that a dentist needs to fix, or can I leave it alone and save the money for something else?  Will a chipped tooth grow back? Thanks. Logan from SC

Logan – Thanks for choosing our office for your question.

Will a Chipped Tooth Grow Back?

A chipped tooth will not grow back. Although tooth enamel is the body’s most rigid tissue, it is not living. So, your tooth will not repair itself.

Do You Need to Have a Chipped Tooth Fixed?

Whether you need to have a chipped tooth fixed depends on the extent of the damage. A chipped tooth can worsen. Stress on the tooth from biting hard food can cause further damage. It is best to have your tooth examined by a dentist to determine if internal damage to the tooth needs treatment.

Chipped tooth before-and-after photos
Dental bonding repairs chipped teeth seamlessly

If there is no internal damage to the tooth and it is structurally sound, a dentist can repair it with dental bonding. Cosmetic dentists apply dental bonding by hand to fill in the missing space seamlessly. An experienced cosmetic dentist can manipulate bonding to match the color and translucence of your natural tooth. A dentist can complete the treatment in one visit—usually in less than an hour.

Although you are not concerned about the appearance of your tooth, at least have it examined to ensure that the damage is only cosmetic. You can find a cosmetic dentist willing to make treatment affordable for you.

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

Can I Trust My Dentist to Get My Crown Color Right This Time?

I fell in August and broke three upper teeth, including one front tooth. And I broke a lower front tooth. I did not like the dentist I had at the time, so I chose another dentist. I was so traumatized that they had to give me sedation even before an exam. The dentist did root canals and crowns on all my broken teeth. The crowns were the wrong color and tooth thick. Then he tried again with only slight improvement.

Now the crowns look light gray instead of almost medium gray. It is still unacceptable. The dentist said he could try again, but he does not sound confident. Also, my anxiety is increasing. Even though he sedates me, I am anxious about being sedated because I do not know how my crowns will look.  Is it worth giving my dentist another chance? Thank you. Cailia from Idaho


Dr. Lacy would need to examine your crowns to identify the issue. Although you have not told us what types of crowns you received, you say they look gray. We guess that you have pure ceramic crowns with metal posts and cores to reinforce the insides of your broken teeth. In that case, the metal is showing through the crowns and making them look gray.

The issue is that your dentist does not know enough about cosmetic dentistry to give you crowns that fit your mouth, are not bulky and match your natural teeth.

How to Prevent Dental Crowns from Looking Gray

A dentist with advanced cosmetic dentistry training understands how to prevent ceramic crowns from looking gray. Three approaches include these steps:

Composite core

  • Perform root canal treatment
  • Insert a fiberglass post in each tooth
  • Add a composite core close to the color of your natural teeth

Metal core

  • Bond composite over the metal to block the color
  • Bond the crown over the opaque layer

Opaque the crown enough

Another alternative is to give the laboratory technician instructions about metal core color and extent and ask the tech to opaque the crown enough to conceal the metal.

Get a Second Opinion

Woman's face with her eyes closed while she receives dental work
You can relax with sedation and dentist you trust

An expert cosmetic dentist understands color manipulation and how to give you crowns that look natural. After two attempts from your dentist, we recommend that you find another dentist to replace your crowns and get them right.

Schedule a consultation first to ensure you are comfortable with the dentist. Although you probably still need sedation during crown replacement, you can have confidence that a cosmetic dentist will resolve the problems with your crowns.

Miranda Lacy, DDS of Plano, Texas, sponsors this post.

Is My Toothpaste Scratching My Veneers?

I think I misunderstood something about whitening toothpaste and porcelain veneers. My dentist gave me free teeth whitening gel and trays. I wanted to get all my natural teeth whitening before she placed veneers. After I finished whitening my teeth, I used whitening toothpaste to keep them bright. And after I got veneers, I kept using the toothpaste. But last week, at my dental appointment, the hygienist said that I could damage the veneers with the whitening toothpaste. I thought that other whitening agents do not change the color or harm veneers. Could I really scratch them with the toothpaste that I’m using to keep my natural teeth bright? – Deynah from Long Island


Thank you for your question.

Whitening toothpaste cannot change the colors of your veneers. But if you use them long-term, their abrasiveness might scratch the glaze on your veneers. If you have not been using the toothpaste long, do not worry about it.

What Can Scratch Porcelain Veneers?

Certain toothpastes, dental materials, and dental chemicals can damage the glaze on porcelain veneers. Some of them include:

Photo of a yellow toothbrush with toothpaste being applied to it; for information on free teeth whitening in Plano, TX
Long-term use of abrasive toothpaste can scratch porcelain veneers
  • Abrasive toothpaste
  • Abrasive polishing pastes
  • Acidulated fluoride
  • Power polishing equipment at a dental office

We recommend toothpaste made for cosmetic dental work.  Supersmile is a toothpaste brand that will remove surface stains from veneers without damaging them. Be careful about types of toothpaste within a brand that claim to be low abrasion. Read the labels for specific instructions about using the brand of toothpaste on cosmetic dentistry work. Consistently rubbing your veneers can wear away the bonding between your teeth and veneers.

You can use bleaching gel from your dentist to touch up your natural teeth and keep them bright without harming your porcelain veneers.

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

I think my root canal filling is coming out

Man holding the side of his face - portraying need for an affordable dentist

In 2007, I had an injury that impacted my mouth. My dentist did root canals on two teeth. Above five years ago, the crown broke off one tooth and left a hole in the tooth, which the dentist patched with a filling. I haven’t seen a dentist in several years, but now the tooth hurts. When I eat, it is painful, and the pain travels up my cheek into my eye. The tooth doesn’t feel smooth anymore when I run my tongue over it. I think the cement is coming off. I cannot afford a new crown, but it seems that I need to see a dentist. Are antibiotics an option for delaying a new crown? Thank you. Manny T from Dallas


Thank you for your question.

 Dr. Lacy would need to examine your tooth and an x-ray for an accurate diagnosis. But your description sounds like the tooth is infected. So, yes, see a dentist right away.

Painful Tooth with a Root Canal Filling

An exposed root canal filling allows saliva to enter and wash out the dental cement, which keeps the filling material in place and seals out bacteria. Your tooth can become reinfected. Pain or swelling in your cheek or upper jaw can spread to your eye.

Although antibiotics can control the infection, they will not remove it. And taking antibiotics for an extended period can result in an antibiotic-resistant infection. Only repeat root canal treatment can remove the infection. The longer you wait, the more the infection will spread.

A dentist will examine your tooth to determine if a temporary filling is enough to preserve it or if getting a crown is the best protection.

What If You Cannot Afford a Dental Crown?

If you cannot afford a dental crown, talk with your dentist about ways to receive the treatment you need. Many dentists offer financing or payment plans. Keep in mind that if your dentist recommends a crown to protect your tooth and prevent further infection, delaying the crown can lead to more costly problems.

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

Acid reflux is making my teeth sensitive

Man holding his face with tooth pain - for sedation dentistry info from Miranda Lacy, DDS of Plano, TX

I’ve had acid reflux for years. Although I have used proton pump inhibitors for more than ten years, my new gastro specialist asked me to stop. We are exploring alternatives. Meanwhile, I am following a strict low acidic diet which seems to help. But my teeth are in horrible condition from years of stomach acid and vomit eating away at them. It hurts to chew a banana. I cannot image the pain of getting my teeth cleaned or treated for the sensitivity and pain. Will I need crowns on my teeth? Jamie


Thank you for contacting our office. Dr. Lacy would need to examine your teeth, but we hope your acid reflux is controlled soon.

As you mentioned, vomit is acidic—so acidic that it dissolves too enamel. Your teeth become sensitive and prone to decay. Acid reflux, or Gastroesophageal reflux disease (GERD), has the same effect on teeth as bulimia.

What Is the Best Treatment for Acid Reflux Damaged Teeth?

Prevention—controlling reflux disease—is the best treatment to protect your teeth. After doctor has the disease under control, your dentist can discuss treatment options.

  • Fluoride – Fluoride may strengthen your teeth with fluoride treatments. Fluoride will decrease tooth sensitivity.
  • Dental crowns – Your dentist can use ceramic crowns to cover and protect your teeth. But the acid can potentially get beneath the crown, attack the tooth, and loosen the crowns eventually.
  • Self-care – Meanwhile, rinse your mouth immediately after every snack or meal to neutralize the acid. Although rinsing your mouth is not a long-term solution. It will reduce the potency of stomach acid and vomit and limit the damage to your teeth. Limit brushing your teeth to twice daily. Too much brushing can further weaken your teeth.

Regardless of the treatment your dentist recommends, local anesthetic will prevent you from feeling pain. And sedation will calm your anxiety.

Best wishes for a swift resolution to your medical and dental health.

Miranda Lacy, DDS of Plano, Texas, sponsors this post.

Dentist won’t whiten my teeth without treating a broken tooth first

I have intense pain in a tooth that broke three years ago. I did not see a dentist about it until I decided to get my teeth cleaned and whitened. Last week, I saw a dentist who says that there is no way I can get my teeth whitened without treating this tooth that is hurting my chin and jaw. The dentist asked me to return for an x-ray because I was in the office for a teeth whitening consultation. Is it necessary to take care of an old broken tooth before whitening my teeth? – Brandon from Denver, CO


A tooth infection is causing your pain, and it needs treatment right away. If the pain is traveling into your jaw and chin, the infection is spreading.

Tooth Pain in Your Jaw and Chin

If you have tooth pain in your jaw and chin, schedule an appointment for an x-ray as the dentist you saw recommended. And ask her to x-ray your other teeth. Your broken tooth probably had a large cavity. Before pain spreads to your jawbone, other teeth can get infected along the way. Stopping the infection now is a wise decision.

When Can You Get Your Teeth Whitened?

Nose-to-chin photo of a man's white teeth - from Plano, TX dentist Dr. Miranda Lacy

You can get teeth whitened after the infection is clear. If the dentist can save your broken tooth, she will recommend root canal treatment and a crown. But if most of the healthy tooth structure is gone, or if the tooth is too damaged, you will need an extraction.

If root canal treatment is an option, you can wear a temporary crown until completing the whitening process. After your teeth are as white as you want them, your dentist can make a crown to match.

Check the Dentist’s Cosmetic Dentistry Training

The improvement you want for your smile can benefit from a cosmetic dentist, so check for the dentist’s advanced cosmetic dentistry training. A cosmetic dentist can perfectly match a crown to your newly whitened teeth. The results will look natural.

Miranda Lacy, DDS of Plano, TX, sponsors this post.

Why Would Dentists Recommend a Partial Denture When I Want Implants?

After years of neglect, my front teeth are stained and chipped. Two left teeth – incisor and canine are missing. I found a new dentist two months ago who would not listen to me and was disrespectful about the condition of my mouth. I asked about cosmetic treatment, and she recommended a partial denture. I do not want a partial denture, and I asked her to explain my options. The dentist said that a partial denture is the least expensive way to fix my teeth.

Neglecting my oral health over the years had nothing to do with money. I decided to switch dentists. My appointment was two weeks ago, and again, this dentist recommended a partial denture and told me that an implant is another option, but it is out of the ballpark for me. I am insulted. Although I am not wealthy, I work and can budget to pay for dental care. How can I find a dentist willing to save my teeth and respect me and my preferences? – Thank you. Toya from Dallas


Many dentists do not want to try to save teeth. It is easier to extract them and offer a partial denture. An implant is a better option than a partial denture. If you want dental implants, find a dentist with advanced implant training or who partners with an oral surgeon for implant surgery.

If you have a mixture of chipped and discolored teeth, a dentist with advanced cosmetic dentistry training can use a combination of treatments to restore them. But a dentist who is not comfortable with cosmetic dentistry might direct you to a quick solution—a partial denture.

Finding a Dentist to Restore Your Teeth

You can find a dentist to save and restore your teeth by researching two or three dentists and scheduling consultations with them. Look for these factors:

  • Advanced cosmetic dentistry training
  • Post-graduate dental implant training or partnership with an oral surgeon or periodontist for implant surgery
  • A website smile gallery or before-and-after photos to show you
Diagram of dental imlant components, including the root form, connector, and crown
Dental implants are much more effective than partial dentures

A skilled cosmetic dentist who regularly restores implants and provides other aesthetic treatments will readily recommend saving your teeth. After two or three consultations, you can choose a dentist that you think you can trust. And if you need extensive dental work and want to pay for your dental care over time, ask the dentist about financing or payment plans.

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

Oral Surgeon Refuses to Remove Both My Wisdom Teeth

Last May, I got two root canals, one repeat root canal, and three crowns. I am trying to catch up on dental work for my neglected teeth. I have two wisdom teeth left – both lower – one hurts and is impacted. The oral surgeon says the impacted wisdom tooth is causing neck and ear pain. She says that after she removed it, I will feel relief. For some reason, she does not want to remove both wisdom teeth while I am sedated. I told her that I do not want either of them removed if she does not take both teeth out. Neither of us is budging. Why wouldn’t she remove both teeth? Thank you. Jonah from TN


Dr. Lacy would need to examine your teeth or refer you to an oral surgeon for a second opinion. Without an exam, we cannot give you an accurate diagnosis. If your oral surgeon does not want to remove both wisdom teeth while you are sedated, she must have a good reason for it. Maybe there are no issues with the tooth.

But if you do not understand why the oral surgeon will not remove the tooth, it is best to speak with her. Ask for an explanation.

What Happens If You Do Not Remove and Impacted Wisdom Teeth

Woman's face with her eyes closed while she receives dental work
Get a second opinion on wisdom teeth removal

If you do not remove an impacted wisdom tooth, a tooth infection can spread. If you already have an earache and neck pain, they are symptoms that your body is trying to fight the infection. Lingering tooth infections can flare-up. In rare cases, they can even be life-threatening.

You and your oral surgeon disagree. So, you can schedule a second opinion with another oral surgeon. Have copies of your x-ray sent before your second-opinion appointment.

Miranda Lacy, DDS of Plano, Texas, sponsors this post.