All posts by AllSmiles

Ceramic Crowns

My Six New Crowns Cause My Gums to Burn

My gums have been burning since I got new temporary crowns. After I complained, my dentist took the first set of temps off. After removing the crowns, my dentist recommended a fluoride treatment and prescribed an antibiotic.

When I got the temporary crowns, my bite was off. My dentist did so much filing on the crowns that when I drank anything, I could feel the fluid rushing beneath the crown. I got new temporaries, but my teeth are sensitive, and my gums burn. My dentist made drastic changes to my teeth, making them uncomfortable with crowns. Can I expect major rework to resolve my concerns? I’m exhausted. Thanks. Joan from AZ

Joan,

We understand our exhaustion and frustration.

Before your dentist permanently cements your new crowns, please ensure you are entirely satisfied with their fit and feel.

Confirming the specific metal alloy used is crucial if these are porcelain-fused-to-metal crowns. A potential metal allergy, particularly to nickel, could be causing the burning sensation. Request a copy of the dental laboratory’s alloy certificate for detailed composition information. Even if they are all ceramic crowns, a dentist must determine the underlying cause of the discomfort.

Several aspects of your treatment raise concerns about the dentist’s experience and judgment. A smile reconstruction is a complex procedure that often requires specialized expertise in cosmetic dentistry. Bite discrepancies and the need for significant post-treatment adjustments are red flags. Additionally, fluoride treatment on prepared teeth seems inappropriate because it cannot address bacterial infection. A more suitable approach would involve an antibacterial agent like peroxide or chlorhexidine.

We recommend seeking a second opinion from a dentist with extensive cosmetic dentistry experience and training. This will allow you to ensure optimal comfort and quality of care. A well-placed crown should feel like a healthy, natural tooth.

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

Root Canal Treatment

Can I Get a Root Canal at Six Months Pregnant?

In early September, my dentist filled a small cavity in my top right first molar. The tooth began to hurt about three weeks later, and now my dentist says I need a root canal. However, I’m six months pregnant. Is it safe to get a root canal? – Thanks, Kaylynn from MS

Kaylynn,

While we cannot provide a definitive diagnosis without a physical examination and seeing your X-rays, based on your description, a root canal treatment may not be necessary. It is unlikely that a minor cavity would develop into deep decay in less than two months and need root canal treatment.

It’s wise to seek a second opinion from a qualified dentist to evaluate your tooth’s condition.

Regarding your pregnancy, avoiding major dental procedures during the last trimester is advisable. However, if the tooth is infected, prompt treatment is essential to protect your and your baby’s health.

If an X-ray is necessary for accurate diagnosis, wearing a lead apron can shield your abdomen from radiation exposure.

Ultimately, the decision to proceed with dental treatment during pregnancy should be made in consultation with your dentist and healthcare provider.

Dr. Miranda Lacy, a Plano, Texas dentist, sponsors this post. She makes dental care affordable.

Cosmetic Dentistry

Can an Onlay Save a Cracked Tooth?

 My dentist tried to mend my cracked tooth with bonding, but it didn’t work. Now she wants to try and onlay. Is it worth it, or should I get a crown? – Thanks. Evan

Evan

A cosmetic dentist will need to thoroughly examine your tooth and take an X-ray to accurately determine the extent of the crack.

What Is the Treatment for a Cracked Tooth?

Appropriate treatment for a cracked tooth depends on various factors, including the crack’s extent, location, and severity.

  • The extent of the crack: Cracks can range from superficial enamel cracks to deeper cracks extending into the dentin (the layer beneath the enamel) or even the pulp (the living tissue inside the tooth).
  • Location of the crack: Cracks can be either horizontal or vertical.
  • Crack or fracture: If any part of the tooth moves independently, it is considered a fracture. Prompt treatment is necessary to prevent further damage.

Can an Onlay Work Repair a Cracked Tooth?

Onlays come in various types, some suitable for most cracks while others have limitations. Gold and zirconia onlays are known for their strength and ability to withstand the biting forces of your teeth.

What Is an Onlay?

An onlay is a custom-made dental restoration, typically made from ceramic, gold, or hardened composite, that covers a significant portion or all the chewing surface of your tooth. Many advanced cosmetic dentists prefer onlays over dental crowns for specific applications. To create an onlay, your dentist will take impressions of your tooth, and a custom restoration will be fabricated to fit your tooth precisely. This procedure requires specialized skills and advanced cosmetic dentistry training.

  • Gold onlay: A gold onlay can cover the entire chewing surface of your tooth, effectively preventing the crack from spreading.
  • Porcelain or ceramic onlay: All-porcelain onlays are suitable for minor cracks that affect a tooth’s cusp or corner. However, porcelain may not be sufficiently strong to hold a molar tooth together. Zirconia, a high-strength dental ceramic, offers greater strength and durability than all-porcelain onlays. Advanced cosmetic dentists often utilize zirconia onlays to preserve teeth.
  • Hardened composite onlay: While less durable than porcelain, a hardened composite onlay may not be strong enough to protect a crack in a molar tooth.

We recommend getting a second opinion from a cosmetic dentist trained in occlusion and bite. They will explain your options for a restoration that fits well, protects your tooth, and prevents the crack from worsening.

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

Cosmetic Dentistry

How Can I Find a Good Cosmetic Dentist?

I live 80 miles from your office. I’m looking for a cosmetic dentist that is closer to home. I don’t want to have consultations and x-rays from each dentist. My time is limited, and I would like to narrow my choices at home before scheduling appointments. Please give me tips on what to look for in a cosmetic dentist. I need three new crowns. Thanks, Gina

Gina,

Thanks for your inquiry. Yes, we have some suggestions. There is a lot of information online about dentists and their practices.

1.    Check patient reviews

Look for online reviews about the dentist. You can check Google Business Profiles, Yelp, and Facebook reviews. You can type a dentist’s name and the word reviews to find other sources.

2.    Look at cosmetic dentists’ websites

An experienced cosmetic dentist has a website. Read the doctor’s bio to learn about their training, experience, continuing education, and experience. Look for a dentist’s post-graduate training in cosmetic dentistry.

3.    Schedule a complimentary visit

Most cosmetic dentists offer a complimentary consultation. Tell the scheduler you want to see the office, meet the dentist, and discuss treatment options. Many dental practices will schedule five or ten minutes with the dentist or staff to discuss your smile goals. You will have an opportunity to decide if you would feel comfortable at the dental practice. Visit at least two cosmetic dentists before you choose a provider. Ask each dentist for patients’ before-and-after dental crown procedures.

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

Tooth Infection

Do I Have a Tooth Abscess or a Cyst?

The gums around my upper left premolar have been swollen since the summer of 2022. The gum tissue is tender, but it doesn’t hurt. My dentist said I have a chronic abscess, and I would keep the tooth or get it extracted. During my last visit, I expressed concern about the lingering swelling, so my dentist referred me to an endodontist. The specialist said she could do a root canal with 70 percent success, but she is unsure whether I have a cyst. She took an x-ray, so I’m unsure why she couldn’t see a cyst. She showed me a dark shadow on the x-ray where my gums were sore.

My dentist and the specialist mentioned a procedure to access the tooth root through my gum tissue and bone. I could choose that procedure first and a root canal later if it doesn’t work. I understand how I went from my dentist saying that I could keep the tooth or get it extracted to cutting through my gums and bone to see if there is a cyst or an abscess. Are there questions that I need to ask my dentist? Thanks. Sarai

Sarai,

Although dental schools teach about cysts, they are rare, and the risks of having one are small. An infection causes swelling in the gum tissue around a tooth. Root canal treatment will remove the infection. Afterward, you will see and feel relief.

An apicoectomy is a dental procedure that involves cutting through your gums and bone to access a tooth’s root(s). The suggestion of an apicoectomy for your tooth sounds like over-treatment. Additionally, it concerns us that your dentist allowed the swelling to continue without investigation and treatment. An abscess can leak bacteria and affect neighboring teeth and your jawbone, even spreading into your bloodstream.

Like other infections, tooth infections can drain your energy and cause malaise. Root canal treatment has at least an 85 percent success rate. The skill of a root canal specialist (endodontist) decreases the risk of root canal failure. The specialist has the latest technology and understands which techniques work best, even in complex cases. Afterward, your dentist will protect your tooth with a custom dental crown.

We recommend treating the infection promptly. If you are uncomfortable with your dentist’s and endodontist’s recommendations, you can see another dentist or specialist for a third opinion.

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

Dental Crowns

Why Does My Dental Crown Still Hurt After Two Months?

Two months ago, I went to Costa Rica for 10 lower crowns and eight porcelain veneers in early May. Since returning home, I have felt severe pain in my lower jaw. One molar tooth hurts whenever I chew anything. I called the dentist, who advised me to take ibuprofen every 4-6 hours for two weeks. I know the health risks, so I don’t take it as often as she recommended. The dentist also mentioned that I might need a root canal. The tooth hurts when I chew but not when I touch or clench my teeth. Should I have pain two months after dental work? I’m embarrassed to see a local dentist about work I had done outside of the US. Thanks. Luca from Nashville

Luca.

Your symptoms and the dentist’s recommendation to take ibuprofen so frequently are alarming. Long-term ibuprofen use can damage your liver or kidneys. You are wise to minimize your use of it.

Lingering pain after dental crowns or veneers is not normal. Although tenderness may occur after a few weeks, symptoms should not last for months.

We understand your embarrassment, but you need care from a skilled cosmetic dentist. Look for dentists with post-graduate cosmetic dentistry experience and schedule consultations or exams. You may need root canal treatment, but please don’t return to Costa Rica for it.

Few dentists have the advanced cosmetic dentistry and training required to produce a beautiful smile makeover with crowns and porcelain veneers. Your chances of getting a beautiful smile out of the country are even lower. Please consult a cosmetic dentist to examine all your Costa Rica dental work and the molar tooth that hurts.

The precaution of examining your dental work can minimize future problems with your dental restorations.

This post is sponsored by Plano, Texas, female dentist Dr. Miranda Lacy. We cater to anxious dental patients.

Dentures

My Denture Still Irritates the Roof of My Mouth

I got a new denture last October, but it still hurts the roof of my mouth. My dentist says it takes some people longer to adjust, but the discomfort hasn’t improved. Can I get a soft palate in the denture because the hard one rubs the roof of my mouth? It’s so sore. I only wear my new denture if I must leave home and have social interactions. Thank you. Anita

Anita,

Removable complete dentures often have a hard surface that stays in place from suction between the denture and the roof of your mouth (palate). While this design adds stability during chewing, it can cause irritation or discomfort. However, a denture with a softer palate material wouldn’t withstand the constant pressure of chewing.

How Can You Get Relief from an Uncomfortable Denture in the Roof of Your Mouth?

If your removable denture is causing pain on the roof of your mouth, an implant denture offers a comfortable alternative. These dentures are designed without a palate, eliminating that source of irritation.

What Is a Palateless Denture?

Implant-supported dentures are palateless dentures. This approach utilizes four or more dental implants to support a full arch of replacement teeth.

An implant dentist or oral surgeon strategically places four to six implants in your jawbone. These implants then anchor a custom-made denture that securely clicks into place.

Implant-supported dentures effectively restore your chewing ability, allowing you to enjoy a wider variety of foods. Additionally, a palateless denture improves your taste perception. You can speak, eat, and live with confidence, free from the discomfort of a traditional denture.

Another advantage of implant-supported dentures is their positive impact on your jawbone health. The implants stimulate the jawbone, preventing bone resorption and facial sagging that can occur with traditional dentures and jawbone shrinkage.

Consider scheduling consultations with a cosmetic dentist who partners with an oral surgeon or periodontist for dental implants. Discussing your specific needs and preferences will help you decide how to restore your smile.

Porcelain Veneers

Will Root Canal Treatment Ruin a Porcelain Veneer?

I have eight porcelain veneers on my upper front teeth. After seeing an ENT for what I thought was a sinus infection, my dentist found the problem. I have a periapical abscess. My dentist referred me to an endodontist for a root canal, but I’m concerned because the abscess is between my right lateral incisor and the tooth behind it. Will I need a new veneer for the tooth with an abscess? Thanks. Abbie from Arlington, VA

Abbie,

Without root canal treatment, the infection can spread deep into your jawbone. However, it is uncommon to have an infection in a porcelain veneer tooth.

Will Root Canal Treatment Ruin a Porcelain Veneer?

If your dentist placed and bonded your porcelain veneers well, you should not lose them during root canal treatment. The endodontist can access the infection without damaging the veneer. You can ask the endodontist about the procedure and how he will avoid damaging your veneers.

Why Might a Porcelain Veneer Tooth Need a Root Canal?

Aggressively preparing a tooth for porcelain veneers increases the risk of stress and infection that requires root canal treatment. We hope that over-preparation of your teeth for veneers is not the cause of your tooth infection. However, we won’t linger on what may be the cause of the infection because you need root canal treatment.

A tooth turns dark after a root canal procedure because a dentist replaces the tooth pulp with root canal filler material after removing the infection. The material and cement left in the tooth make it look darker.

Ask your dentist to clean the filler material and cement from the portion of your tooth above the gumline. After removing the material, your dentist can place a fiberglass post into the tooth root and fill the space with a tooth-colored composite. This intervention can help your teeth retain its color for five to ten years.

Dr. Miranda Lacy, a Plano, Texas dentist, sponsors this post. Dr. Lacy makes treatment affordable through payment plans and offering treatment alternatives when appropriate.

Cosmetic Dentistry

What Can I Do If a Tooth Post Broke Beneath My Dental Bridge?

A post in one of my teeth broke, but the tooth is a lateral incisor and part of a dental bridge. I had a root canal on the tooth three years ago, and my dentist added the post because the tooth was broken. Now that the post has broken at the gumline, will I need a new post and a bridge? Or can my dentist take the bridge off, replace the post, and put the bridge back? – Thanks. Stefan from San Bernardino.

Stefan,

Dr. Lacy would need to examine your tooth and take X-rays for an accurate diagnosis and treatment. However, we have a few observations.

Our first concern is whether a new post in your tooth would work or if it would also break. A post broken at the gumline limits a dentist’s techniques to grab and remove it. Sometimes, an ultrasonic scaler can loosen the cement around the post so the dentist can remove it. However, when a post breaks at the gumline, a dentist may have to drill away tooth structure to retrieve it.

A lateral incisor is a small tooth; drilling it will further weaken it. The risk of losing a second post increases. Your dentist must remove the crown from the bridge to access the post. It would be easier to remove the entire bridge, access the tooth and post, and replace the bridge. This highlights one disadvantage of a dental bridge versus a dental implant: A dentist must replace the entire bridge if a problem occurs with a tooth in the bridge.

You cannot expect a new post to last longer than the old one on a weak incisor that will absorb lateral stress when you chew. The post will weaken and break if you have a heavy biting force.

We recommend consulting a cosmetic dentist for an exam and X-rays. The dentist can determine whether you can benefit from a dental implant for the missing tooth and the tooth with the broken post or if a new post and bridge will last.

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

Affordable Dentistry

Is it Too Late for a Palateless Denture?

I have worn dentures for seven years and am ready to remove the palate from my denture. I wouldn’t say I like the hard palate of the denture against the roof of my mouth. It feels like a mouth full of plastic. I am not ungrateful. My dentist reminds me that it is better to have dentures than no teeth at all. If I must wear dentures, maybe there is a way to make them more comfortable. My dentist needs to be more helpful, which leads to the question, why is he still my dentist? Long story. I would like to know if dentures exist with a soft palate and if it’s too late because I’ve worn dentures for so long. Thank you. Ethel from Decatur, GA

Ethel,

The palate of a complete denture is firm to fit well and remain stable when you chew. When “soft” refers to a denture, it means relining (reshaping) the denture with soft materials.

Facts about a soft denture reline:

  • As the shape of your ridge shrinks or changes shape due to missing teeth, a reline helps your denture fit more snugly
  • It resurfaces the upper portion of the denture that touches the roof of your mouth and gums
  • It prevents the denture from rubbing on your gums and making them sore

What Is a Palateless Denture?

A palateless denture is an implant denture that does not cover the roof of your mouth. Instead, dental implants support the arch of denture teeth.

Implant dentures can relieve the discomfort of a hard denture palate.

  • Placing dental implants for a denture – An implant dentist or an oral surgeon can place as few as two implants in your jawbone to support your denture, making them more affordable for many dental patients. However, four to six implants provide maximum stability.
  • Improving denture comfort – Although implant dentures cost more money than completely removable dentures, they restore your chewing efficiency and make you feel more like your own teeth.
  • Preserving jawbone – Dental implants stimulate your jawbone and help prevent facial collapse.

You can schedule an appointment with an implant dentist to discuss your options. It’s not too late, even if you need a bone graft in areas of low bone volume to stabilize dental implants.

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