All posts by AllSmiles

My New Porcelain Veneers Inflamed My Gums

I received porcelain veneers in September, and my gums are still tender and slightly inflamed. I’ve seen my dentist about this issue three times, and his consistent answer is that I don’t floss between my teeth. But I floss between my teeth twice daily. I am partially blaming myself for this problem because I chose the dentist with the lowest cost for porcelain veneers after consultations with five dentists. My teeth were so damaged that I thought veneers were the right solution. Last week, my dentist told me that one of my incisors is infected and might need a root canal. I feel like he is taking advantage of me. Why discuss a root canal when the problems with my gums are not resolved? I want to cry, but I need to keep calm and think about what I should do next. What is your opinion? Thank you – Anika from Dallas


Thank you for your inquiry. We are sorry that your porcelain veneers are a new source of anxiety. Gum inflammation after you receive porcelain veneers is a clear sign that your dentist did something wrong. Gum tissue after veneers should be as healthy—or healthier—than before treatment. Although choosing a dentist with the lowest fees often comes with low-quality results, your dentist is responsible for your care.

What Causes Gum Inflammation After Porcelain Veneers?

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
Healthy veneers do not cause gum inflammation

After getting porcelain veneers, a common cause of gum inflammation is excess bonding cement that your dentist did not remove. The cement irritates your gum tissue and causes inflammation and infection. And the infection can spread and affect your teeth, which is likely why you need root canal treatment.

How to Get a Refund from Your Dentist

Cosmetic dentistry is not a recognized specialty, so it will be challenging to get a refund from your dentist based on your veneers and gums’ appearance.

Schedule an appointment with an advanced cosmetic dentist for an exam and second opinion. After the dentist gives you a diagnosis and explains your treatment options for veneers, talk to your current dentist about your complaints:

  • After receiving porcelain veneers, your gum inflammation is persistent.
  • Your dentist has not treated the issue.
  • Mention excess cement left behind—or whatever cause your second-opinion dentist finds.
  • Explain that the issues with your gums are causing discomfort and anxiety.
  • Request a refund and mention that you will consider filing a complaint with the state dental board.

If your current dentist does not promptly offer a refund, ask your new cosmetic dentist if they are willing to help you negotiate. Consider hiring an attorney if your dentist continues to be uncooperative.

Please try not to be overly concerned about the cost of regaining your oral health. Talk with your dentist about financing, payment plans, and how to make dental treatment affordable for you.

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

Is the screw post in my tooth causing this weird sensation?

My dentist did a root canal on my left front tooth, but the tooth broke at the gumline. I returned to my dentist, and she used a metal screw to attach the temporary crown.  After getting the screw, I feel a weird pressure-like sensation in my nose, but it is not painful. Is this screw going to cause more problems? I am afraid that I will lose the tooth and need a bridge. I’ve needed nitrous oxide for minor dental appointments and stronger sedation for anything more serious. I am concerned about how much this will cost because I lost my full-time job and insurance in April. I have two part-time jobs and no dental insurance. Ezra from FL


You probably would have more success with the tooth if your dentist inserted the metal post right after root canal treatment. The tooth might not have broken if your dentist had stabilized it. But we will focus on the post and possible treatment options. Keep in mind that Dr. Lacy would need to examine and x-ray your tooth for an accurate diagnosis.

What Is a Dental Post for a Crown?

A dental post for a crown is a small metal shaft or screw. A dentist places the metal post inside the tooth after root canal treatment. A post helps support a crown if you do not have enough healthy tooth structure left. A dental lab makes a custom crown that your dentist will cement to the post.

What Are the Risks of a Post?

Although screw posts are generally stable and stay in the tooth, they can exert pressure on the tooth root. The root can split with the stress and cause sensitivity or pain. A dentist needs to examine your tooth and post to determine if the post is causing your symptoms.

Treatment for Front Tooth Broken at the Gumline

When a front tooth breaks at the gumline, many dentists agree that it cannot be saved. Rotational forces on front teeth can cause a crown or post to loosen. You can accept your dentist’s recommendation for the crown and post or get a second option.

Alternative treatment if you lose the tooth

Diagram of a dental bridge
Dental bridge

If you lose your tooth, the most effective way to replace it is with a dental implant. But you explained your employment situation and lack of dental insurance. And implants are the most expensive treatment for replacing missing teeth. A dental bridge or a dental flipper is a more affordable option.

  • Dental bridgeThree crowns are connected at the sides to replace a missing tooth. Your dentist must taper the tooth on either side of the missing one because the crown on each end of the bridge must fit over those teeth to anchor the bridge.
  • Flipper partial – A replacement tooth is embedded in an acrylic base. A clasp on each end of the appliance hooks around a tooth to keep the partial in place.
Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Ask your dentist about sedation options

Depending on which treatment you use, you might need stronger sedation than nitrous oxide to help you relax. Talk to your dentist about your anxiety. Also, speak with her about financing or a payment plan to help you pay for care over time.

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

Which Toothpaste Will Brighten My Dental Crowns?


I don’t think that teeth whitening will whiten my crowns, but I read online that some toothpaste brands will help brighten veneers. Will you tell me if Supersmile toothpaste works for veneers and porcelain crowns? Thanks. Terri


Your question has two parts: whitening cosmetic dental work and toothpaste that is safe to use on it.

Can You Whiten Cosmetic Dental Work?

Photo of upper and lower teeth whitening trays in a blue case; for information on free teeth whitening from the office Plano dentist Dr. Miranda Lacy.
Ask for teeth whitening before you get cosmetic dental work

Cosmetic dental work, including ceramic crowns and porcelain veneers, cannot be whitened. The dental materials are colorfast. The same is true with dental composites. You cannot whiten it. Although you can use teeth whitening products if you have cosmetic dental work, only your natural teeth will get brighter. The cosmetic work will stay the same shade.

If you need new cosmetic work and want to whiten your natural teeth, ask your dentist for teeth whitening first. Your dentist will ensure your new crowns or veneers will match the shade of your natural teeth.

What Kind of Toothpaste Is Safe for Cosmetic Dental Work?

Supersmile toothpaste is safe for cosmetic dental work. Most toothpaste is abrasive and can scratch the surface of porcelain veneers or ceramic crowns—but not Supersmile. It will help keep your dental restorations white.

Will Supersmile Toothpaste Whiten Crowns or Veneers?

Supersmile toothpaste will keep your crown or veneers white, but it won’t make them a lighter shade. But your question seems to be about whitening your dental crowns. Toothpaste will not whiten crowns that are already dark. Depending on the cause of stains in your crowns or veneers, a cosmetic dentist can polish them. But if your dental crowns are old, worn, or have a metal foundation, polishing won’t work.

We recommend scheduling an appointment with an advanced cosmetic dentist to examine your crowns. It might be time to replace them, but the dentist will explain your options.

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

If I don’t like my porcelain veneers, can they be reversed?

I think that I want porcelain veneers. I found a dentist who is offering them about 25% cheaper than two other dentists that I met for consultations. My husband is warning me not to go cheap on something as important as my smile. I do love a bargain, and if this dentist can get it right, I am all for it. But what if I change my mind. Can porcelain veneers be reversed if I decide I don’t want them? Thank you. Claire from Houston

Claire –

Our first concern is shopping around for the lowest cost for dental care. Quality care and a beautiful smile are not cheap. It’s okay to look for a dentist with reasonable fees, but that should not be your basis for choosing a provider.

Results of Cheap Porcelain Veneers

If a dentist takes shortcuts just to give you a lower price, problems with your porcelain veneers can result, including:

  • Low-quality veneers that don’t look natural or don’t last
  • Poor bonding techniques that cause veneers to fall off
  • Leakage behind your veneers that promotes decay

Are Porcelain Veneers Reversible?

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
Don’t choose the cheapest dentist for porcelain veneers

Generally, after you receive porcelain veneers, they cannot be reversed. But some dentists might place veneers without preparing your teeth at all—or with very minimal preparation. In those cases, a skilled cosmetic dentist might be able to smooth and polish your enamel or use dental composite to restore the shape and gloss of your teeth.

But if a dentist aggressively prepares your teeth, if you decide you don’t want porcelain veneers, your teeth will have an unnatural shape and appearance. And you won’t like your smile.

Porcelain veneers are not meant to be removed. Weigh the pros and cons carefully before you ask a dentist for veneers.

Select a Skilled Cosmetic Dentist

Select a cosmetic dentist with advanced training in dental aesthetics. The dentist will be concerned about the function and appearance of your smile. Even at a 25% discount, you can expect to pay almost $1000 per veneer. That’s an investment. Why not choose a dentist who will enhance your smile?

True cosmetic dentists involve you in the process of designing your smile. You should expect the following from the dentist:

  • Show you a wax model of your new smile
  • Allow you to wear temporary veneers for about two weeks to see if you like how they look and feel
  • Use a try-in paste to secure your porcelain veneers to your teeth and ensure you love them before bonding them on

The process takes time, and you should not rush it. It helps a cosmetic dentist ensure you love your new smile and don’t want to reverse it.

 If you need to make the cost of porcelain veneers more affordable, speak with a cosmetic dentist about financing or payment plans. But don’t choose a dentist just because his or her fees are the lowest.

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

How Often Do Porcelain Veneers Fall Off?

For the past two years, I’ve been talking with my dentist about the possibility of getting porcelain veneers. I finally decided to move forward with my plans, so I had a long discussion with my dentist last week. One of my questions was about how long veneers last and if they ever need to be replaced. My dentist said that I could plan on returning to the office every three to four months because veneers fall off, and she will bond them back on. She said if I am careful about not eating crunchy foods, my veneers should last longer. I researched online over the weekend and didn’t see anything about veneers consistently popping off unless the dentist did something wrong.

My dentist’s estimate of how long veneers last is making me nervous. I already have a little dental anxiety. Sometimes I need nitrous oxide, but if I return to her office every few months because veneers pop off, I’ll end up a nitrous junkie. How frequently do veneers pop off? Thanks, Audriana


Shame on your dentist for telling you to expect your new veneers to pop off every few months.

It seems that your dentist is speaking from experience, which can mean several things:

  • Your dentist uses cheap veneers
  • She prepares teeth so aggressively that veneers won’t stay on
  • Bonding techniques are not in your dentist’s skill set

The dental profession has a principle—the standard of care. Although cosmetic dentistry isn’t a recognized specialty, porcelain veneers must stay on—even if they look bad.

How Often Do Porcelain Veneers Fall Off?

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
True cosmetic dentists prepare teeth conservatively and bond porcelain veneers so well they don’t come off

Veneers should never fall off, and they should last at least ten years. Your dentist’s prediction about porcelain veneers’ longevity is a warning to find a cosmetic dentist who is skilled with veneers.

And you can eat whatever you want with veneers. But don’t use your veneers—or even your natural teeth—to bite pins, bottle caps, or other hard objects.

We encourage you to search online for cosmetic dentists, look at their patient reviews or smile gallery, and choose two dentists for a consultation. Ask about each dentist’s processes and how long you can expect your veneers to last. Get ready to switch to a new dentist for veneers. And you won’t have to worry about repeat appointments and needing sedation to get through them.

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

Effects of Tooth Roots Left Behind After Extraction

I have tooth roots left from previous extractions that a dentist did years ago. Now a need surgery around the area where the root was left. The tooth that will be extracted is above a root. Is this a risky surgery? My current dentist says it should be no problem, but his answer does not give me confidence. I sent an x-ray of the tooth and the root beneath it. I’m already anxious about another extraction, and the thought of nerve damage is really scary. – Danni from NM


Your lower premolar is near the mental foramen, an opening in your front lower jaw that transmits the mental nerve and artery. A skilled surgeon can extract your tooth without damaging the nerve. But your dentist doesn’t sound confident about extracting the tooth without damage.

Your x-ray shows that the dentist who completed your extractions left a large amount of root behind. The bone didn’t heal correctly and left a defect that can damage neighboring teeth. We also see a fragment on the right side that doesn’t appear to be threatening.

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Ask about sedation options to help you relax during tooth extraction

We’re sorry that your former dentist did sloppy extractions. If your current dentist isn’t confident about removing your tooth without damaging a nerve, please get a second opinion or ask your dentist to refer you to an oral surgeon.

During your second opinion or consultation with a surgeon or another dentist, ask about sedation options to calm your anxiety before and during treatment.

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

Why Do My New Composite fillings Hurt?

I’ve had to put off teeth whitening because I have four small composite fillings that are painful. I received the fillings in early September. I get a brief sharp pain when I chew hard or crunchy foods. The pain isn’t worse, but it’s consistent. Also, I’ve noticed that I don’t feel the pain when I clench my teeth tother.

After my online search about this issue, it seems that I need to find a dentist who uses self-etching primers or a glass ionomer base. I’ve called a few dental offices, but the receptionists don’t know what I’m talking about. How can I find the right dentist to replace the fillings? – Thanks. Eve from S. Carolina


The sensitivity you describe occurs more often with small fillings than large ones.

Why Do New Composite Fillings Hurt?

The reason that new composite fillings hurt seems to be related to a dentist bonding the filling to dentin of the tooth. Most dental office receptionists are not familiar with self-etching primers or glass ionomer bases. Maybe a dental assistant who helps the dentist with the procedure might be familiar with the terms.

Although Dr. Lacy would need to examine your teeth, two possible solutions include:

Schedule an appointment to make your request – Before allowing a dentist to work on your teeth, insist on a glass ionomer base beneath the filling to protect the dentin and keep composite away from it. If the dentist doesn’t agree with your request, find another dentist.

Find an advanced cosmetic dentist – You might have to travel to find a cosmetic dentist who is familiar with self-etching primers and glass ionomer base. A dentist with post-graduate training in cosmetic dentistry knows how to protect your teeth, and you don’t have to explain your position or tell the dentist what materials you want in your teeth.

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.
Teeth whitening can further irritate sensitive teeth

Although a cosmetic dentist would usually whiten your teeth first and place the fillings afterward to match them, your teeth are sensitive. The bleaching gel can increase sensitivity. Speak with the dentist about the best time to start teeth whitening treatment.

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

Her Dentist Used the Wrong Color Bonding – Can It Be Fixed?

I visited three dentists for consultations and quotes for composite filling on 15 teeth. I chose the most affordable dentist because the bonding cost more than I expected. The dentist did the bonding for sensitivity near the gumline, not for cosmetic reasons.

Immediately after the dentist finished the work, I could see that she chose the wrong color bonding. And the fillings look pasty and rough. I no longer get compliments on my white teeth.

Do I have the get the boning on all 15 teeth removed and reapplied? Or can new boning be added over the old? What are the risks? I should add that several of the teeth already had bonding on them that started to chip. So, for those teeth, this would be the third round of bonding. – Thanks. Kasey from Albany, GA

Kasey – We’re sorry that you’ve had a bad experience with bonding. The lack of technique isn’t necessarily because you chose a dentist with affordable fees. A good family dentist should be able to get the color, textures, and polish right for fillings at the gumline.

Do your composite fillings need to be replaced?

Your composite fillings might need to be replaced depending on the shade and the extent of correction required.

A few facts:

  • A dentist might need to replace your fillings if the color is significantly off.
  • A dentist can remove some of the surfaces and resurface them with another color.
  • It’s not difficult to tell where the composite ends and the tooth structure begins, so replacing the fillings is easy.
  • Dental burs will selectively remove composite without harming your tooth structure.

Sensitive areas at the gumlines of teeth

Front tooth showing a wide notch at the gumline
Tooth abfraction lesion

Sensitive areas at the gumlines of teeth are called abfraction lesions. In the photograph, tooth enamel near the gumline is worn and leaves a notch that is often sensitive to air or touch. Research reveals that the primary cause of abfraction lesions is clenching your teeth. Clenching causes the tooth to flex and weaken at the gumline. Eventually, the tooth in that area wears away.

An experienced dentist will determine the cause of sensitivity at your gumline and select durable and flexible materials for clenching. Stiff composite materials will pop out under the force of clenching. But flexible materials like Silux Puls and Renamel look natural and are strong enough to stay intact.

If your dentist cannot correct your composite fillings, you can find a dentist who is skilled in bonding techniques and has affordable fees.

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

How to get a refund after paying the dentist upfront

Two years ago, I found an affordable cosmetic dentist to do some extensive work for me. The treatment was going to take about 18 months. About seven months in, I realized that the dentist didn’t know how to make crowns or balance my bite, so I stopped treatment and asked for a refund. I paid for the service through Care Credit®. The dentist hasn’t refunded me yet. Does the dentist have the money, or does Care Credit, and what should I do to get a refund? Zaida from TX


After you sign the contract, Care Credit deducts fees from the total and pays the remainder to the dentist upfront. If the dentist didn’t complete your work, he must refund the balance from his funds.

How to Get a Refund from Your Dentist

You have several options to get a refund from your dentist, depending on the conversations you’ve already had with the dental office. You can also consider what you know about your dentist and his ethics.

  • Threaten to leave negative online reviews – If your dentist has mainly positive online reviews, he might be concerned about negative ones.
  • Complain to the state dental board – Contact the dentist’s office and let them know you will file a complaint. They might be willing to pay you promptly.
  • Contact a consumer rights attorney – A single phone call from a consumer rights attorney might be all that’s needed to get your dentist to see that you’re serious about a refund.

While you’re settling the issue with your dentist, find two advanced cosmetic dentists and schedule consultations with them. Let them examine your dental records and x-rays and examine your teeth. Don’t mention the difficulty you’re having with your current dentist.

During the consultation, you can get treatment options from each dentist and find out how much time and expense are needed to restore your smile completely. Payment plans are still an affordable way to get the dental care you need, and Care Credit is a reliable source.

Before-and-after photos of porcelain crowns, which are available from Plano, TX dentist Dr. Miranda Lacy.
An affordable crown should still look and feel natural

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

I Have a High Resistance to Lidocaine at the Dentist

I have a high tolerance for lidocaine, so my dental visits are horrifying and painful. Three years ago, I got discouraged and stopped going to the dentist. Now I have four teeth that need extraction. I want to take control of my oral health. I’ve delayed the extractions because I want dental implants right away. I’m concerned about finding a gentle dentist who can do this with minimal pain and keep the costs down of getting four dental implants. How can I manage both?

Thanks. Daphne


Your high tolerance for lidocaine reflects a high level of dental anxiety. Instead of more local anesthetic, you need a relaxant. Dentists who know the subject and are interested in treating anxious patients ask questions to determine if they can benefit from sedation. A dentist might ask, “How does novocaine or lidocaine work for you?” When a patient says they have a high resistance to the anesthetic, their dentist can give them nitrous oxide or an oral sedative before the appointment to relieve anxiety. And the local anesthetic works fine.

Often, dental phobia is related to past negative dental experiences in childhood or adulthood. Many dentists have had negative or stressful experiences in the dental chair as patients. They get anxious too, and the local anesthetic wears off quickly unless they receive some form of dental sedation.

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Ask your new dentist about sedation options

You can search online for a dentist who offers sedation. A dentist who makes it known that sedation is available is used to working with anxious patients and makes an effort to be gentle. It might be helpful to schedule a consultation first, speak with the dentist about your experience with lidocaine, and discuss your goals for dental implants and a new smile. Nitrous oxide might be enough to give you a sense of well-being, so your body accepts the lidocaine.

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