All posts by AllSmiles

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


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.

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


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.

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


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.

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


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.


My Snap-On Denture Teeth Are Too Big


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.



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


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.

Can I Trust Ads for Discounted Teeth Whitening?

I’ve been getting Groupon e-mails weekly for at-home teeth whitening products and teeth whitening specials with dentists. Do these really work? I’ve always wanted to have a really white smile, and now it looks like I can do it affordably. How do I know if it’s not a waste of money? – Karla R. from San Antonio


Thank you for your question.

At-home teeth whitening products are becoming increasingly popular. Some of the products contain 35% carbamide peroxide, which will whiten your teeth.

Still, be careful. Getting teeth whitening from your dentist has many advantages, even if you decide to get a take-home kit from your dentist. Factors to consider:

  • Types of stains – The American Dental Association confirms that teeth whitening does not work with all types of stains. Depending on the cause of the stains, the bleaching gel may not correct them and can even can make the stains more noticeable.
  • Whether you have dental restorations – A dentist needs to check existing dental work on your teeth, including crowns, veneers, and bonding, before starting the teeth whitening process. Bleaching your teeth can make them whiter than the restorations, and you will have mismatched results.
  • Custom bleaching trays – Your dentist will provide you with customized trays for your teeth. The trays help you avoid wasting the gel or irritating your gums from bleaching gel that oozes out of the trays.
  • Progress checks – Your dentist can monitor the progress of the teeth whitening and adjust your treatment as needed.

Be cautious about the products that you use. Talk with your dentist about the coupons you have seen and discuss the cost. Your dentist might be willing to work with your budget so that you can get your teeth safely whitened.

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

Can I Trade in My Partial Denture to Save Money on Dental Implants?

My partial denture annoys me, and I wonder if there is somewhere I could trade it in for dental implants and save money. I knew the partial would be uncomfortable, but it’s almost unbearable. It is nearly three years old, but it is almost like new. It is so painful that I only wear it when I leave home. The metal clasps on them keep digging into my gums.

I’ve returned to my dentist three times for adjustments, but the denture still hurts in the same place. I wear the partial for two missing teeth. I wonder if the metal part of the partial denture can be saved or if it has value as a trade-in. What are my options? Also, is there anything I can do to adjust the partial myself without breaking it? Thanks. – Ken from Nashville


Dental implants are the most effective way to replace missing teeth, but unfortunately, a three-year-old partial denture would not have trade-in value. You will not find a dentist who will discount dental implants because you have turned in your uncomfortable partial denture. Still, your situation is not hopeless. You have several options:

  • Schedule an appointment for a second opinion to see if a dentist can adjust your partial denture to increase comfort until you can get dental implants.
  • Schedule a consultation with an implant dentist and ask about the dentist’s financial arrangements for making implants affordable for you.
  • Consider a dental bridge as an alternative if dental implants are not within your budget.

Do not try to adjust your partial denture. You can damage it and cause more harm than good. If you alter a partial denture too much, you will not be able to wear it. You will need a new one or be obligated to choose an alternative.

We suggest finding two experienced implant dentists and scheduling consultations with them. You will get more information on how implants can benefit your case, the cost, and how to get them affordably without sacrificing quality and getting cheap implants that do not last.

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

Crowns on My Front Teeth Are the Wrong Shape

A dentist placed four zirconia crowns on my left central incisor back and the three teeth behind it. I got the crowns from the dentist because his price was $200 cheaper per crown than the other estimates. The crowns do not match the shape of my natural teeth, and they do not look natural at all. I am anxious about dental appointments anyway, and the thought of getting this work redone scares me. Could another dentist reshape these crowns to match my teeth? Thank you. Andra from GA


Thank you for your question. We are sorry to hear about your experience. Getting natural-looking results on crowns for front teeth is challenging, and zirconia crowns are even more difficult.

Challenges with Zirconia Crowns for Front Teeth

Some dentists with advanced cosmetic dentistry training understand how to make zirconia crowns look natural on front teeth. A cosmetic dentist can produce impressive results knowing these principles:

  • Dental labs make zirconia crowns from ceramic blocks – Dental labs mill mono-color zirconia blocks to shape them to fit over damaged natural teeth. The challenges are that a natural tooth varies in shade and translucence and achieving the right tooth shape with crowns takes a skilled dental ceramist.
  • Porcelain layers can make zirconia look natural – A ceramist must bake porcelain onto the surface and manipulate the color to match your natural teeth.

Can a Dentist Reshape Your Crowns?

Unfortunately, you will need new crowns because a dentist cannot reshape the existing ones. Ask your dentist for copies of your dental records and x-rays. Find an advanced cosmetic dentist for a consultation and exam to discuss how to correct your teeth.

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

After taking pictures and a mold of your teeth, a cosmetic dentist can create temporary crowns that match the characteristics of your natural teeth. If you approve the temporary crowns, your dentist will collaborate with a dental ceramist to duplicate them in high-quality ceramic. Speak with the dentist about your anxiety and sedation options to help you relax.

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

Should You Choose Ultra-thin or Traditional Veneers?

Porcelain veneers transform smiles. A skilled cosmetic dentist and ceramist can manipulate porcelain to mimic the color and translucence of natural teeth. Advanced dental technology has introduced ultra-thin veneers. Which type of veneers should you choose?

Should You Choose Ultra-thin or Traditional Veneers?

Whether you choose ultra-thin or traditional veneers depends on your case, the condition of your teeth, and your dentist’s recommendations. We explain some factors that may influence your and your dentist’s decision.

Traditional Porcelain Veneers

Traditional veneers have the following characteristics:

  • About .5 millimeter thick
  • Require preparation of your natural teeth so they fit correctly and will not look bulky
  • 0.3 to 0.5 millimeters of the front surface of a tooth is removed to prepare it for a veneer

Ultra-Thin Veneers

Ultra-thin veneers have the following characteristics:

  • About .3 millimeter thick
  • Can be bonded to your teeth without preparation
  • Cosmetic dentists strive to remove a minimal amount of a tooth’s front surface

What Do Ultra-thin and Traditional Veneers Have in Common?

Ultra-thin and traditional veneers have several things in common:

Teeth whitening application
Your cosmetic dentist can whiten your teeth before placing veneers
  • Custom-made in a dental lab
  • Match the characteristics of your natural teeth, so in the hands of a skilled cosmetic dentist, people will think your veneers are your natural teeth
  • Stain-resistant
  • Can last 15-20 years if you take diligent care of them and have them maintained by a trained cosmetic dentist

Which Should You Choose?

Schedule an appointment with a skilled cosmetic dentist. They can determine which type of veneers will give you the best results based on the condition of your teeth, the shape, position, and size of your teeth, and the results you want to achieve. You should not insist on either traditional or ultra-thin veneers. A cosmetic dentist will also preserve as much tooth structure as possible yet produce natural-looking results. The dentist will bond your veneers to ensure they look natural and are durable.

Many patients find it helpful to schedule at least two consultations before making decisions about porcelain veneers. Below are a few tips for scheduling your consultation:

  • Select experienced cosmetic dentists, preferably accredited, who have advanced, post-graduate training.
  • Look for a smile gallery on each dentist’s website and find photos of patients who received porcelain veneers.
  • Ask the dentist how many porcelain veneer cases they have completed.
  • Compare the recommendations, treatment plan, and costs of each dentist.
  • Look for patient reviews on the dentist’s work.

What Can You Expect?

After the consultation, if you are interested in porcelain veneers, you can expect the following:

  • An exam
  • Digital x-rays
  • A smile design that includes your preferences and considers your facial features to ensure natural-looking results

If you want a bright smile with porcelain veneers, your cosmetic dentist must whiten your natural teeth first. It will ensure that your veneers match the color of your teeth.

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