All posts by AllSmiles

Teeth whitening

Are Ceramic Crowns a Metal-Free Option for Me?

I have three porcelain on metal crowns, but I want to get ceramic crowns instead. After successful cancer surgery last month, I want to reduce as many risks as possible and treat myself to new crowns. I read online that crowns contain metal ions. Should I be concerned? Also, I want my teeth whitened before the crowns because they are yellow from 30 years of smoking. I quit smoking when I got a cancer diagnosis, so whitening my teeth will make me feel more confident. Are ceramic crowns the way to go to reduce my metal exposure? Joshua

Joshua,

Although all-ceramic crowns do not contain metal known to provoke reactions, they have metal ions.

Metal Ions

Metal ions are essential for human, animal, and plant life. These ions are in the human body:

  • Calcium
  • Cobalt
  • Copper
  • Magnesium
  • Manganese
  • Molybdenum
  • Potassium
  • Zinc

Lithium

Lithium is in the sodium family. The ceramic lithium disilicate is in strong ceramic dental crowns, including e.max crowns.

Zirconium

Zirconia crowns are of high strength. Dental ceramists use zirconia to build dental bridges that are so strong they do not need a metal framework.

Advanced cosmetic dentists understand the types of ceramics available for dental crowns and will work with you to find a ceramic that matches your needs.

The condition of your teeth and the location of your crowns affects the type of ceramic that will look natural and be durable. Look for an experienced cosmetic dentist who understands which ceramics are best for front and back teeth for aesthetics and durability.

Teeth Bleaching

Ask your cosmetic dentist which brands they use and research the contents. Your dentist will work with you to ensure your metal-free crowns match your whitened teeth.

Best wishes for your healthier smile with new crowns.

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

Affordable Dentistry

Why Does the Cost of Porcelain Veneers Vary So Much?

I don’t understand why the cost of porcelain veneers varies so much. I did my homework and had consultations with dentists for 8 porcelain veneers. One dentist quoted $1200 for each porcelain veneer, and another quoted $3000. Why the vast difference? I also saw a more affordable dental special for $800. How do I know which one to go with? Thanks, Becky

Becky,

Thank you for contacting Dr. Lacy’s office.

Why Does the Cost of Porcelain Veneers Vary?

The cost of porcelain veneers varies for several reasons, including the following:

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
Choose quality porcelain veneers
  • Where you live in the country – As the cost of living varies in different states and cities, so does the cost of goods and services, including dental fees.
  • Type of porcelain veneers – The porcelain veneer type and quality a dentist uses can affect the cost. High-quality veneers last 20 years or more if you and a skilled cosmetic dentist maintain them well. No-prep veneers may cost less than veneers with a custom fit and color that a master ceramist crafts.
  • The dentist’s skill and experience – A cosmetic dentist with advanced training and skills will have higher fees than a dentist with little experience. The costs will be higher if the dentist uses a laboratory specializing in beautiful, customized porcelain veneers instead of a discount laboratory. But the results will be superior to discount veneers.

A comparable illustration is a new car. The cost depends on your budget and the features you want. You can get an economy car, a mid-range car, or a luxury car. Your location, budget, wants, needs, and the manufacturer determine the cost of the vehicle.

How Can You Choose a Dentist for Porcelain Veneers?

A reasonably fair way to compare the cost of veneers is to compare dentists with similar skills and experience, who practice in the same state, and who provide the same types of veneers. Ask to see patients’ before-and-after cases of veneers. Even then, you must carefully research the results you can expect.

Many dentists offer affordable financing or payment plans to help you pay for quality care.

Sedation Dentistry

Will Dental Insurance Pay for IV Sedation?

I had two consultations with dentists, who agreed I needed two dental implants and three crowns. I am terrified of the dentist and will need sedation for the dental work. One dentist only uses nitrous oxide in the office but would refer me to a specialist for implant surgery. The other dentist uses nitrous oxide and sedation pills. I know more than nitrous oxide is needed regardless of the procedure. I read about IV sedation and that it is stronger than other options. I am willing to switch dentists for more sedation, but I need to schedule consultations after finding dentists who use IV sedation. – Thanks. Paul from Lakeland, FL

Paul,

Thank you for contacting Dr. Lacy’s office. Many anxious patients require sedation to get dental work. We commend you for caring for your oral health and researching your options.

Will Dental Insurance Pay for IV Sedation?

Whether dental insurance provides coverage for IV sedation depends on the plan level and your needs as a patient. Some insurance companies offer benefits toward IV sedation when it is medically necessary based on several factors, including:

  • Dental procedure type
  • Patient’s physical, intellectual, and medical needs
  • Patients for whom alternatives are ineffective
  • Extraordinarily fearful or anxious patients
  • Patients who have experienced dental trauma and require potent sedation options

We recommend contacting your insurance company to find out how much if any, sedation dentistry procedures they cover. Some insurance companies that provide coverage limit the number of hours of IV sedation dentistry for which they will provide benefits. For example, dental insurance may provide benefits for up to one or two hours of sedation, and you would be responsible for the remaining cost.

Your insurance company may ask you to provide a pre-treatment estimate from your dentist to estimate your out-of-pocket costs.

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

Sedation Dentistry

Do I Still Need to See a Dentist If I am Taking Antibiotics?

Do I still need to see a dentist if I am taking antibiotics? I might have a tooth abscess, but I am not sure. I went to urgent care over the weekend. They gave me an antibiotic prescription for a possible infection. They looked at my tooth but said the gum seemed slightly irritated. They gave me discharge papers saying I needed to see a dentist, but I didn’t understand. If the infection goes away, I will be satisfied.

Why pay more to have a dentist look at my tooth and tell me everything looks good? Last year I had an infection, but it wasn’t a tooth infection. Still, the antibiotics knocked it completely out in 2-3 weeks. So I am thinking about giving the tooth the same amount of time, and I should be good. My girlfriend told me I shouldn’t take that kind of chance. I think the antibiotic will work. Is this emergency, and do I still need to see a dentist? I tried to avoid them whenever I could. Sorry. Thanks for your help. Henry

Henry – Your girlfriend is correct. A dentist needs to examine your tooth. Even though you may not have a regular dentist, you can find a dentist who accepts urgent appointments. A dentist will likely ask you to come to the office right away.

If your tooth is infected, it will need a root canal treatment to remove the infection. The dentist will replace the infected tooth pulp with dental filler material. You will most likely need a dental crown to protect the tooth from further decay or damage.

An untreated infection can spread to other teeth, your jawbone, and in the worst case, into your bloodstream. Find an emergency dentist and get the tooth examined and treated right away. Don’t wait two or three weeks to see if the infection clears. You can ask about nitrous oxide or oral conscious sedation to relax you during treatment.

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

Sedation Dentistry

How Long Can a Cracked Crown Last?

My crown cracked this week, and I want to know how long it can last. The crack is on a lower molar tooth, and I can feel it if I glide my tongue along the side of the crown. I can barely see the crack when I look at the crown in the mirror. I haven’t been to the dentist since pre-Covid, and I cannot relax enough to go before my vacation next week. I prefer to wait until I return in February to look for a dentist and let them know that I can only get work done if I get oral sedation first. How much time do I have before the crown breaks? Thanks. Ella from Austin

Ella,

Dr. Lacy would need to examine your cracked crown to determine the extent of the damage. Although the crack may not be an emergency yet, pressure on your teeth as you bite and chew weakens the crown. It will eventually break.

How Long Can You Delay Fixing a Cracked Dental Crown?

A hairline crack in a dental crown may not be an immediate concern, but how long you can wait depends on the overall condition of the crown. Eventually, you will see the crack and need prompt care.

We recommend scheduling an appointment with a dentist this week to assess the damage. Depending on the condition of the crown, the dentist may recommend a temporary crown to prevent a dental emergency while you are on vacation.

Talk to the dentist about your travel plans and dental anxiety. It is better to get a well-made and bonded temporary crown than a weak one that may fall off and leave the tooth unprotected.

Look for a dentist with cosmetic dentistry training who can provide a temporary crown to match your natural teeth and ensure it is comfortable.

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

Teeth whitening

I Wanted BL4 Shade Crowns, But My Dentist Declined

My eight upper front teeth have old crowns that I got in 2004. I am happy that the crowns lasted so long, but they need an update. My previous dentist retired six years ago. My current dentist recommended a B1 shade, although I wanted lighter crowns. She made my temporary crowns in the B1 shade anyway because she thought I would like them when I saw them. The crowns do not look any whiter than my old ones.

My dentist said a brighter shade would make the post in my left front tooth show through. She also says that she will not be able to get my lower teeth as light as B1 crowns when she does teeth whitening. Would BL4 work without showing the post? My dentist wants me to decide, and I feel pressured. Thank you. Anastasia from IL

Anastasia,

Thank you for contacting Dr. Lacy’s office. We are concerned about your dentist’s approach to cosmetic dentistry and your preferences.

Are BL4 Crowns Too White for a Tooth with a Post?

Although your dentist says BL4 crowns are too white for a tooth with a post, she is confusing crown color with translucence. Making a crown whiter does not increase translucency. If the tooth post does not show through with B1, it will not show through with BL4 or super white crowns.

Why Is Your Dentist Insisting on Her Preferences?

When you get a smile makeover, an artistic cosmetic dentist will ask about your preferences for tooth shape, color, size, and other characteristics. If your dentist continues to insist on her preference, ask how much experience she has with crowns in bleached shades. Ask to see pictures of her patients who had a complete smile makeover with crowns in whiter shades.

After you see pictures of her work, if you feel confident that she can complete the dental crowns you describe, tell her the color you want, and ask if she agrees. When your crowns are ready, ask your dentist to use a try-in paste to ensure you are happy with the results. Only allow your dentist to cement or bond the crowns if you are happy and have no reservations about the results.

Getting a Second Opinion

If your dentist cannot meet your requests, we recommend scheduling consultations with at least two cosmetic dentists. Experienced cosmetic dentists will readily explain how they achieve the crown shade you want with natural-looking translucence. They will also explain why they would complete teeth whitening before ordering dental crowns from the lab.

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

Sedation Dentistry

I Think My Dental Implants Are Failing

I think my dental implants are failing. My 2021 full-mouth reconstruction included implants, crowns, and veneers. I think several of the implant teeth are infected, and two crowns have fallen off. My gums are swollen, and it hurts to chew. Unfortunately, the dentist relocated, and I cannot find a current listing for him. I am concerned that another dentist must replace my implants and that I will need a repeat full-mouth reconstruction. I do not know where to begin, and my anxiety level is increasing because I am afraid that I will need implant surgery again and who knows what else. – Thank you. Vadim from IL

Vadim,

We are sorry to hear about your horrible experience. You certainly do not want the dentist doing additional dental work for you.

Infection Around Dental Implants

Infection around dental implants is peri-implantitis, a form of gum disease that can lead to dental implant failure. Signs and symptoms of infection include:

  • Bad breath or a bad taste in your mouth
  • Bleeding around the implants
  • Difficulty chewing
  • Loose implants
  • Pain, aches, or discomfort around the implant
  • Pus around the implants
  • Red or puffy gums
  • Visible implant threads

Treatment for Infection Around Dental Implants

Depending on the extent of the infection around your dental implants, treatment options may include:

  • Antibiotics
  • Antimicrobial therapy
  • Laser therapy for your gums
  • Surgery

Find a Skilled Implant Dentist

Yes, you need to find a new dentist. But look for a dentist with advanced implant training or who partners with an oral surgeon or periodontist to complete implant surgery. A highly trained implant dentist or surgeon will explain your options. You can also discuss your anxiety level and ask about sedation options to keep you relaxed throughout the procedure.

Man on beach portraying sedation dentistry, available form Plano, TX female dentist Dr. Miranda Lacy
Sedation can help you relax throughout dental procedures

It is essential for your new implant dentist or surgeon to perform a 3-D x-ray (CT) for a detailed view of your jawbone and oral anatomy and identify the cause of the problems with your dental implants. Please only trust providers who are willing to perform a CT scan.

Best wishes for a smooth recovery.

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

Affordable Dentistry

Will I Need Another Root Canal?

Hi. Will you please let me know if it sounds like I need another root canal? In 2017, a dentist completed a root canal on my upper left molar. The tooth started occasionally hurting in the spring, but it has hurt daily since August. Last week it got worse, so I took ibuprofen. Do I need to see a dentist within the next week or two, or can it wait? I am supposed to travel at the end of next week. I don’t want this to interfere with my travel plans, but I am concerned about what can happen if the treatment extends beyond my departure date. Thank you. Jessica from Toledo, OH

Jessica,

Thank you for your question. Although Dr. Lacy would need to examine and x-ray your tooth for an accurate diagnosis, we can explain what may be happening.

What Should You Do If You Feel Pain in a Root Canal Tooth?

If you feel pain in a root canal tooth, it is likely a symptom of root canal failure. Infection is usually the source of most toothaches, including a tooth that had root canal treatment. Only a dentist can confirm the status of your tooth with an exam and x-rays.

What Causes Root Canal Failure?

Root canal failure can occur if any infected tissue remains in a tooth. Your tooth may feel better at first, but the infection will linger. Channels in a tooth can be curvy or challenging to see, so a dentist may miss them or fail to clean them out thoroughly. Unless a dentist has advanced training and instruments for challenging cases, they may miss some of the infection. Most dentists refer challenging issues to an endodontist (root canal specialist).

How Is Root Canal Failure Treated?

A dentist or endodontist treats root canal failure with repeat root canal treatment. After taking an x-ray of the tooth, the dentist or endodontist can do the following:

  • Identify the area of infection
  • Use specialized tools to remove it
  • Sanitize the tooth
  • Fill it with a root canal filler material

A dentist will take impressions of the tooth to create a custom crown to protect it because root canal therapy weakens a tooth. Endodontists may perform root canal surgery (apicoectomy). An apicoectomy accesses the root tip through your bone and removes the infection.

Schedule an Appointment for an Exam

If you are concerned about the timing of treatment and whether you can complete it before traveling, seeing a specialist will help you get an accurate diagnosis. An endodontist’s skill and instruments will reduce the risk of needing a third root canal procedure. Search online for a board-certified endodontist and schedule an appointment soon.

This post is sponsored by Plano, Texas, female dentist Dr. Miranda Lacy. Call her office to learn more about financial arrangements and how she makes dental care affordable.

 

Affordable Dentistry

My Snap-On Denture Teeth Are Too Big

Fran,

We understand your disappointment with trying to stabilize your denture and getting results that detract from your smile. Your dentist is responsible for correcting the issue or giving you a refund. You can start with a list of what you do and do not like about your snap-on denture and approach your dentist another time with your request. Some patients succeed by reporting the issue to the state dental board or consulting with an attorney.

Why Causes Denture Teeth to Be Too Large?

Your denture teeth can be too large if your dentist does not take impressions correctly or makes mistakes with the try-in of a wax model of your denture. During the try-in, your dentist should check how the denture affects these aspects:

  • Your facial appearance
  • The fullness of your lips
  • Your bite
  • Your speech

Will You Need a New Denture to Replace the Teeth?

Whether you need a new denture to replace the teeth that are too large depends on the condition and quality of your denture. If your dentist’s cost is 40% less than other dentists, he may have sacrificed quality for the price. A skilled cosmetic dentist may be able to drill out the denture teeth of a quality denture and make the corrections. Otherwise, you may need a new denture. Either way, your denture will look and feel better, and you will feel more confident about your appearance and smile.

Even if you decide to keep your current dentist and give him another chance, consider getting a second opinion from an advanced cosmetic dentist. You can take the second opinion dentist’s documentation to your dentist to support your concerns and the corrections needed. Speak with the advanced cosmetic dentist about how to make treatment affordable if you need a new snap-on denture.

Best wishes for your dentist’s cooperation and a reasonable resolution.

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

 

 

Sedation Dentistry

What Kind of Sedation Can I Expect for Wisdom Teeth Removal?

I delayed wisdom teeth removal for years because of dental anxiety. Now, at age 47, two of my wisdom teeth are infected. I have not been to a dentist yet, but my gums around the teeth are swollen. I am sure that a dentist will refer me to an oral surgeon. Will I get local or general anesthesia? Thank you. Tyler from Boulder, CO

Tyler,

Thank you for contacting Dr. Lacy’s office. Most wisdom teeth cases only require local anesthesia. Still, an oral surgeon can give you sedation to relax during the procedure.

IV Sedation for Wisdom Teeth Extraction

Intravenous sedation causes you to drift in an out of consciousness. Your state of relaxation will be deeper than with nitrous oxide (laughing gas), which relaxes you although you are fully awake.

Deep Sedation

Drug-induced sedation prevents you from awakening easily.

Wisdom Teeth Extractions for Adults

Wisdom teeth removal for adults is more challenging because tooth roots and bone fully develop as we age. Nevertheless, oral surgeons are highly skilled at removing wisdom teeth and complete the procedure in 30 to 45 minutes.

Characteristics of adult wisdom teeth:

  • Jawbone – Mature jawbone is dense and firm around tooth roots.
  • Cementum – Calcified bone-like tissue accumulates at tooth roots, making removal more challenging. Still, oral surgeons use tools and techniques for painless, successful tooth removal
  • Position – Teeth can grow sideways in the bone or gum tissue.

Schedule an Appointment for an Exam

A dentist can take x-rays of your wisdom teeth to identify their location and whether they are leaning on other teeth or otherwise affecting your oral health. Your dentist will refer you to an oral surgeon for a consultation. Talk to the oral surgeon about your anxiety, and the surgeon will prescribe sedation based on your anxiety level and the complexity of your surgery. You will have a comfortable, painless procedure.

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