All posts by AllSmiles

Teeth whitening

Why Aren’t Teeth Whitening Strips Working for My Tetracycline Stains?

Hi. Why aren’t whitening strips working for tetracycline stains on my teeth? I have been using teeth whitening strips for 6 months, and they have done nothing for my teeth. I have tetracycline stains on my teeth, so I expected it would take a little longer, but the strips have made no difference. Does it matter which brand I use, or must I buy whitening from a dentist? I feel like I’ve wasted so much time and money without improvement. Thanks. Kyndal

Kyndal– Tetracycline stains are intrinsic to the teeth and are very difficult, and sometimes impossible, to remove. Over-the-counter whitening strips won’t budge the stains.

Even professional teeth whitening from a dentist will result in limited improvement—if any–for tetracycline stains. However, a skilled cosmetic dentist can use porcelain veneers to hide the stains without making your teeth look pasty or opaque. Veneers are custom-crafted porcelain shells that fit over the fronts of your teeth. Veneers restore the teeth that show when you smile, but they are unsuitable for back teeth.

A cosmetic dentist can manipulate the porcelain to hide tetracycline stains, making the veneers look completely natural. The dentist will bond the veneers to your teeth for a solution lasting eight to ten years—even longer.

Schedule consultations with at least two cosmetic dentists to discuss your options for concealing the stains in your teeth.

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

Affordable Dentistry

How Can I Get a Cheap Smile Makeover that Looks Good?

How can I get a cheap smile makeover for chipped and blotchy teeth that looks good? I am deciding between online veneers for my teeth or dental bonding veneers. I wanted porcelain veneers from a dentist, but I had two consultations and got quotes of almost $2,000 per veneer. My dentist also gave me the alternative of bonding on my eight front teeth for $750. I don’t want to pick the cheapest option and have it fall off my teeth, but how do I decide if I’m on a budget? – Thanks. Miguel

Miguel,

We will explain the differences between dental bonding, porcelain veneers, and online veneers.

How Can You Get a Cheap Smile Makeover That Looks Good?

A smile makeover that looks good and is healthy for your teeth will not be not cheap. However, if you focus on cost, you can find a dentist for dental bonding or porcelain veneers, but you increase the chances of the work looking fake and not lasting. You will need to have the cosmetic dentistry work redone, costing you even more money.

Composite Veneers vs. Porcelain Veneers

An advanced dentist can rejuvenate chipped, blotchy teeth with dental bonding or porcelain veneers. We explain the differences. The costs depend on several factors, including the condition of your teeth, where you live in the U.S., and the cosmetic dentist’s experience and fees.

Composite veneers

You can expect the following with dental

  • Materials: Dental resin (plastic) and glass
  • Process: Layering selected composite by hand on each tooth, and then sharpening, hardening, and polishing it
  • Longevity: Five to ten years, depending on the quality and how well you take care of it
  • Stain resistance: It is porous and absorbs stains with time
  • Tooth preparation: Lightly etching the tooth enamel
  • Cost per tooth: $400 to $700 or more

Porcelain veneers

  • Materials: Dental porcelain
  • Process: Taking impressions of your teeth to make custom veneers and bond them to the fronts of the affected teeth
  • Longevity: Eight to 15 years or more for high-quality veneers
  • Stain resistance: Resists stains
  • Tooth preparation: May require removing tiny amounts of tooth enamel for a precise fit
  • Cost per tooth: $1,500 to $4,500

What About Online Veneers?

When you buy veneers online, they are one tray that fits over your teeth. Although you will take impressions of your teeth and send them to a lab to process the veneers, they are not a long-term solution. Online veneers cover your teeth and wear out quickly if you wear them daily. They will not improve the flaws in your teeth or restore your oral health.

Schedule a consultation with at least two cosmetic dentists to discuss your options. Be prepared to invest in quality cosmetic dentistry that lasts. You can ask the dentists about payment plan options to make care more affordable.

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

Sedation Dentistry

Root Canal Issue Seems Like It Will Never End

I am concerned about a root canal issue that seems will never end. Last November, my dentist filled a small cavity. But the tooth became sensitive to cold on and off. My dentist said I needed a root canal and a crown. He completed treatment, but my dentist had problems getting the bite correct. I was beginning to get jaw pain and earaches. The tooth settled down a bit but was still a little sensitive.

Within the past two weeks, the sensitivity increased. When I visited the dentist last week, he said he might need to repeat the root canal. But I am five months pregnant now and need another X-ray. And I am a little frustrated because it delayed my teeth whitening appointment. How do I know if I need repeat root canal treatment? I don’t know if I can get through the work without sedation. It’s so frustrating. Thanks – Nakia

Nakia,

Although Dr. Lacy would need to examine your tooth and crown, we are concerned about your dentist. It is unusual for a small cavity to end with an infection and root canal treatment. And your dentist has been unable to resolve tooth sensitivity completely.

From Small Cavity to Root Canal Treatment?

When a dentist tells you that they filled a small cavity, but the tooth soon needs root canal treatment, the dentist’s diagnosis is incorrect. The cavity must have been large, or your dentist missed signs of infection.

Tooth Sensitivity After a Filling and Crown

A tooth infection may be causing the sensitivity. But your dentist may have made a mistake while placing the filling or during your root canal treatment.

Dental X-rays During Pregnancy

We understand your concerns about exposing your baby to X-ray radiation or chemicals during pregnancy. But dental X-rays emit low radiation. So, you can review the American Dental Association’s recommendations about dental care during pregnancy. But if you have a tooth infection, it can potentially spread into your bloodstream and become more serious.

If you are skeptical about your dentist’s care, we recommend finding an advanced cosmetic dentist. The dentist will examine your tooth to identify the cause of sensitivity, jaw pain, and earaches. The dentist will also determine if you have a tooth infection and need to repeat root canal treatment. Although the process delays teeth whitening treatment, it is best to resolve it now than have the issue recur or worsen during pregnancy.

Based on your medical history, talk to your obstetrician and dentist about safe sedation options during pregnancy.

Best wishes for a quick resolution.

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

Teeth whitening

Is Peroxide Good for a Mouthwash Against Dental Office Germs?

I read online that hydrogen peroxide can disinfect dental office germs like coronavirus. I have a teeth whitening appointment before I get veneers in August. So, I looked online and found a do-it-yourself mouth rinse recipe that includes hydrogen peroxide. My only concern about rinsing my mouth with it is that it will only be helpful until I get veneers. I know alcohol-based mouthwash can loosen the bonding on veneers, but what about peroxide? Thank you. Cassie

Cassie,

It’s good that you have a dentist who understands you must whiten your teeth before getting porcelain veneers to ensure they match your whitened teeth. Whitening teeth after getting veneers can make them look darker than your teeth.

While the American Dental Association recommends at least a one-and-a-half percent concentration, some dental offices use about four or five percent rinses. Alcohol-based mouthwash can weaken the bonding behind porcelain veneers and cause stains. Still, weakening porcelain veneers’ bonding is not the only concern when choosing a mouthwash.

A Rutger’s School of Dental Medicine study published results on mouthwash and its effect on coronavirus. Additionally, the Environmental Protection Agency lists hydrogen peroxide as a disinfectant for COVID-19.

Still, if you get porcelain veneers, you must be cautious about which toothpaste and mouthwash you use. But even if you do not have porcelain veneers, regularly using hydrogen peroxide as a mouthwash can cause other problems.

What Are the Effects of Hydrogen Peroxide Mouthwash?

The effects of hydrogen peroxide mouthwash include:

  • It kills many harmful microorganisms
  • Long-term use kills healthy bacteria, too
  • Long-term use causes yeast (candida albicans) to thrive

Regular use of peroxide as mouthwash can result in an oral yeast infection. Your oral issue will turn white, peel, red, and become painful.

If you get an oral yeast infection, your dentist will recommend taking oral antifungal tablets, lozenges, or using a liquid for seven to fourteen days to eliminate the infection. You must complete treatment to prevent the infection from recurring.

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.