All posts by AllSmiles

Affordable Dentistry

Three Causes of Tooth Pulp Sensitivity and Irritation

In early February, one of my bottom molar teeth cracked. The tooth had an old filling in it, and I felt it crack while I was at dinner with friends. At the time, I had only been in AZ for about two months. I relocated and still don’t have a job yet, so I found a dentist with reasonable fees. She said I needed a crown. She prepared the tooth and put on a temporary crown. The crown made my gums sore, and it hurt to chew on that side of my mouth. I also told my dentist that I felt some sensitivity in the tooth whenever I drink anything cold.

That issue wasn’t resolved before she placed my permanent crown later in January. The pain got worse, so I returned to the dentist she took x-rays and poked around the crown to see if I felt any pain or pressure. Of course, my tooth didn’t respond to any of her tricks, so she told me to wait two or three months for it to settle down. My tooth hurts daily. It’s not constant pain, but it hurts and is now sensitive to hot food. I’ve entered my symptoms in Google, and everything I read sounds like I need root canal treatment. Is my tooth dying? Thank you. Eun-ae M. from Flagstaff

Eun-ae,

Thank you for describing your symptoms and the history of your tooth pain. We recommend that you call an endodontist, or root canal specialist.

Side-by-side diagram of an infected tooth being cleaned out with root canal treatment (left) and a healthy tooth to the right.
Root canal treatment can save your cracked tooth

But without criticizing your dentist, we want to clarify a few facts.

Causes of Tooth Pulp Irritation and Sensitivity

  • Cracked tooth – A crack can easily affect the tooth pulp (living tissue, nerves, and blood vessels) inside your tooth. An infection can cause inflammation that chokes the pulp and makes it die.
  • Aggressive preparation for a crown – Significant sensitivity after your dentist prepares a tooth for a crown can result from improperly sealing the temporary crown or aggressive tooth preparation. But a tooth can be coated with a desensitizing product to limit the discomfort.
  • Cementing the crown – A temporary crown on a molar tooth should be made of durable material and bonded with soothing cement to help the tooth nerves calm down. Permanently cementing an already irritated tooth can cause further complications and the need for root canal treatment. The increased sensitivity you’re feeling might be due to changes in the tooth ligament near the root. An endodontist can see that, but most general dentists won’t recognize it as an issue.

Instead of allowing your general dentist to do any more work on your teeth, we recommend that you see a specialist.

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

Teeth whitening

9 Causes of Bad Breath and Why Hiding the Odor Isn’t Good Enough

I have a bad smell in my mouth. I brush daily but it still smells. I chew gum all day long and suck on mints, but I don’t want to get cavities from all the sugar. Any suggestions? Will teeth whitening help? – Thanks. Luca from San Antonio

Luca – Many factors can affect the way your breath smells. Although teeth whitening products can brighten your smile, they won’t help your breath smell fresh.

What Causes Bad Breath?

Several factors are reviewed below.

1. Bacteria

Bacteria in your mouth is the most common cause of bad breath. In addition to brushing your teeth daily, floss between them. Flossing removes food debris that promotes bacteria. If bacteria get stuck between your teeth, it will begin to smell bad. Some people benefit from a tongue cleaner to remove bacteria. Others gently brush their tongue.

2. Gum Disease

Infected gum tissue breeds bacteria. Gums can get inflamed and pus-filled and cause a foul odor on your breath.

3. Dry Mouth

Saliva cleanses your mouth. Lack of saliva production causes bacteria to breed and make your breath smell bad. Breathing through your mouth, instead of your nose, will also decrease saliva production.

4. GERD

When stomach acid flows up your esophagus, gastroesophageal reflux disease (GERD) occurs. The backup of regurgitated food can cause your breath to smell bad.

5. Liver Disease

Your liver removes toxins from your body. If your liver isn’t functioning properly, toxins can build up in your bloodstream and cause a sweet, musty odor on your breath.

6. Kidney Disease

Malfunctioning kidneys cause minerals to collect in your bloodstream. The result is often a metallic taste in your mouth and breath that smells like ammonia.

7. Extreme Low-Carb Diet

If you’re on an extremely low-carb diet, your body will burn fat, instead of sugar. Fat burning releases ketones in your body, including acetone, which can make your breath smell like nail polish.

8. Pneumonia

Phlegm from the bacterial or viral infection in your lung has a bad odor. As you cough it up, it will affect the smell of your breath.

9. Bronchitis

As you cough, foul-smelling mucus from your lungs will make your breath smell bad, too.

There are powerful products to help you treat bad breath, including BreathRx. But don’t neglect an appointment with your dentist or medical doctor to identify the cause of the problem. You might have an underlying medical condition that needs to be treated. The odor of your breath can be a lifesaving sign of something more serious. Don’t ignore it.

Plano, TX dentist Miranda Lacy sponsors this post.

Sedation Dentistry

What to Do If Root Canal Filler Material Falls Out of Your Tooth

In 2016, I had a root canal on an upper right molar tooth. I have only been to a dentist twice since that time and the last time was early last year. The cap fell off almost 2 months ago and there is a rod in my tooth that wiggles back and forth. Can I pull the post out? It’s uncomfortable when I chew, and I’m afraid it might come out when I’m eating. I don’t want to swallow it. Thanks. Clinton from Georgia

Clinton,

In addition to your lost dental crown, the root canal filling material is falling out. If your dental crown came off two months ago, you’re at risk for infection and needing another root canal treatment.

What Happens When Root Canal Filling Material Is Unprotected?

If you had root canal treatment on a tooth, problems with the tooth will increase if it isn’t sealed off and protected.

  • The material is exposed to oral fluids and saliva can loosen the filling
  • Your tooth can be infected again
  • You’ll need another root canal treatment
  • Your dentist will protect the tooth with a dental crown.

The metal crown in your tooth is likely a post that was used to fill your tooth. Although the post can last for years, if your crown if off, it won’t last. You shouldn’t remove it yourself. A dentist will examine your tooth to determine if root canal treatment needs to be repeated or if the tooth can simply be sealed and protected with a crown.

Do You Have Dental Anxiety?

Many patients who delay dental care have anxiety about dental visits. If you suffer from anxiety, Clinton, don’t let it prevent you from getting the care you need. Tell your dentist about your nervousness. Any dental procedure can be performed with sedation to help you relax and have a productive appointment. Depending on your level of anxiety, you can receive nitrous oxide or oral conscious sedation in pill form.

This post is sponsored by Miranda Lacy, DDS, a Plano, TX female dentist.

Sedation Dentistry

Her Sinus Peforation Still Hasn’t Healed

In late November when I had an upper right molar tooth extracted, my dentist sedated me. I don’t know why he was talking to me when I was half out of it. Anyway, my dentist told me he could see into my sinuses. I don’t remember much other than that. I took all the prescribed antibiotics, but the sinus perforation is only partially closed. When I sneeze or blow my nose, I can feel that it’s still open and I think that my sinuses are infected.

I get a low fever almost every day, and I have frequent headaches. My dentist keeps telling me to give it more time, but I wonder if it’s time to see an oral surgeon. I hate the thought of being sedated and something going wrong again. Is it normal to have a prolonged healing period? Thanks, Tyler

Tyler,

We are sorry to hear about your ongoing discomfort after your molar tooth was extracted. The prolonged healing period is not normal.

What’s happening?

  • It’s likely that you’ve had an infection ever since your tooth was extracted.
  • If the perforation hasn’t healed yet, the tip of the tooth root or a bone fragment might remain in your sinus.
  • Your dentist should have x-ray your sinus to see if an object is preventing the perforation from healing
  • You can ask for a referral to an otolaryngologist to determine if there is something preventing proper healing and to get the right treatment.
  • The hole needs to be closed. You’ll need another course of antibiotics to clear the infection.
  • If a bone graft is needed, the gum tissue over it will close in four to six weeks. The bone graft will heal in four to six months. You’ll have follow-up appointments to check the progress.

Will you need to be sedated?

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Sedation will help you relax as the sinus perforation is corrected

Although you are hesitant about being sedated again, it will ensure your comfort throughout the procedure. Otherwise, your discomfort can prevent the oral surgeon from completing the procedure. You will have a consultation before the perforation is closed, and you can talk with the surgeon about your concerns.

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

Teeth whitening

Is This Hydrogen Peroxide Solution Good for Whitening Porcelain Veneers?

I found a mouthwash and teeth whitening recipe online that I can make that won’t harm my porcelain veneers. I just want to double-check the ingredients to make sure it will work. It contains 8 oz filtered water, boiled; 8 oz of 3% hydrogen peroxide; and 2 tablespoons of sea salt. Is this mixture okay to use on porcelain veneers, or are the measurements off? Thanks. Gloria from Little Elm

Gloria,

If your veneers are stained, avoid any at-home methods to brighten them.

How to whitening teeth that have been restored with porcelain veneers

Mouthwash – Mouthwash that contains alcohol will soften the bonding that adheres the porcelain veneers to your teeth. It will create a reservoir around the edge of your veneers that attracts stains. Your veneers can loosen, too. Avoid alcohol-based mouthwash.

Hydrogen peroxide – Although hydrogen peroxide kills bacteria, including harmful bacteria that promote gum disease, it also kills beneficial microbes. The result is an overgrowth of yeast, or candida albicans.

Although short-term use of hydrogen peroxide is helpful as a mouthwash, prolonged use can develop into unwanted symptoms, including:

  • Oral yeast infection
  • White and peeling oral tissue
  • Raw, red, and painful patches

What if your veneers are stained?

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
Ensure your veneers are maintained by a cosmetic dentist

If your porcelain veneers appear to be stained—or if you want to ensure they remain sparkling white— what can you do?

  • Continue to maintain good oral hygiene. Floss between your teeth daily and brush them with non-abrasive toothpaste.
  • Speak with your dentist if you have concerns about discoloration or stains. He or she has in-office equipment to polish your veneers without harmful whitening chemicals.
  • Avoid using tooth whitening solutions on your porcelain veneers. The chemicals can scratch the surface of your veneers and attract stains.
  • Only have your veneers cleaned by a dental hygienist who is trained to use the correct tools to avoid damaging them.

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

Teeth whitening

Teeth Sensitive at the Gumline? What’s Causing It and How It’s Treated

For about 3 months, I’ve had periodic tooth sensitivity at the gumline on my top right front tooth and the one to the right of it. The teeth aren’t sensitive to heat or cold, but if I run my fingernail or a toothpick along the gums, it’s sensitive. Flossing or brushing my teeth doesn’t hurt. The sensitivity has increased over the past 3 weeks. The only thing different is that I’ve started whitening my teeth at home. The sensitivity isn’t during or after whitening, but if I put pressure on the teeth, it feels like the nerves in the area are more irritated than ever. What’s causing this? – Luke

Luke,

Thanks for submitting your question. Persistent tooth sensitivity should not be ignored because it can lead to internal damage and root canal treatment. Until the issue is diagnosed and treated, you should discontinue whitening your teeth, because bleaching gel can cause further irritation.

The good news is that your teeth aren’t sensitive to heat or cold, so it is unlikely that the pulp (living tissue in the tooth) is damaged.

How Are Sensitive Spots on Teeth Treated?

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.
Discontinue whitening until your dentist says it’s safe

Although many dentists aren’t aware of it, teeth slightly flex where the crown and root meet. These tiny movements can occur when we bite, chew, or clench or grind our teeth. Flexure causes small amounts of tooth structure to break. Over time, flexing sends impulses to a tooth and creates sensitivity. The tooth can develop a significant groove, referred to as an abfracted lesion.

It’s relatively easy for your dentist to treat teeth that are sensitive in specific locations.

  • Your dentist must examine your teeth to determine the size of the spots.
  • If the spots are small enough, your dentist will seal them.
  • Larger grooves must be filled. An ordinary filling often won’t stay in the grooves, so your dentist can use a microfill composite or another flexible filling material. Microfill composite will eliminate or reduce sensitivity in the teeth.

After treatment, your dentist will let you know when it’s safe to resume whitening your teeth.

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

Affordable Dentistry

Chipped Your Tooth? A Natural Looking—and Cheaper—Alternative to a Porcelain Veneer

Yesterday I fell and chipped the outer corner of my front left tooth, and I’m afraid that I cannot afford to have a dentist correct it. The chip is so large that there is a dark space, like a sideways triangle, in my smile.

I’ve been frantically looking online to find what type of treatment a dentist might recommend. Most of the search results come up with porcelain veneers. Based on what I read, my concerns are that I cannot afford to spend $1000 + on a porcelain veneer. I’m paying my way through medical school, so fixing my smile is essential. But I am afraid that anything cheaper than a veneer won’t look natural. – Thanks. Anika

Anika,

A cosmetic dentist can affordably repair a chipped tooth with chairside dental bonding—made with silica or quartz that is bound with dental resin. Experienced cosmetic dentists stock a variety of composites to replicate the variations in shade and translucence of your natural teeth.

But a general or family dentist who doesn’t have an artistic eye or advanced training in aesthetics won’t be able to produce lifelike results. That’s why most general dentists recommend a porcelain veneer or a crown to restore a chipped tooth.

Before-and-after photos of a chipped tooth repaired with dental bonding.
Dental bonding can repair a chipped tooth more affordably than a porcelain veneer

Although Dental Bonding Is Affordable, It Requires Skill

Dentists apply composite freehand, while you’re sitting in the dental chair.  What’s the process? What will your cosmetic dentist do to restore your tooth?

  • Select shades of dental composite to replicate the characteristics of your tooth enamel
  • Roughen your chipped tooth
  • Apply, shape, and sculpt the composite
  • Polish it to match the gloss of your natural teeth

Carefully a select cosmetic dentist. You can look at several dentists’ websites to find information about their advanced training and experience in cosmetic dentistry.

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

Sedation Dentistry

3 Facts You Need to Know About Pain and Sedation Dentistry

For some people, being able to relax with sedation dentistry isn’t enough. They also want a pain-free experience. After all, the anticipation of pain is one of the top causes of dental anxiety and a common reason that millions of Americans delay or cancel appointments. So, what can you expect from sedation dentistry in terms of pain relief?

What Is In-Office Sedation Dentistry?

When you receive sedation dentistry, it is not general anesthesia, which is administered in a hospital or surgical center. You will receive medication to help you relax. But you will be conscious and able to respond to questions and instructions.

Sedation dentistry can be used for any dental procedure—dental cleanings and exams, root canal treatment, or restorative work.

What About the Pain?

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

The purpose of sedation is to help you feel calm and relaxed. Sometimes, you will fall asleep.

  • Your sedation dentist will use a local anesthetic as the first step in pain control. Even before minimally invasive procedures, your dentist will numb your gums to ensure you receive a painless injection of a local anesthetic to block pain during your procedure.
  • Sedation dentistry decreases your sensitivity to pain.
  • Treatment is painless for most patients, and pain is limited or nonexistent afterward.
  • Your increased comfort and decreased sensitivity help your dentist accomplish more work in less time. Even if you don’t have dental anxiety, you can save time with sedation by being able to sit comfortably as your dentist accomplishes more work than usual.

Levels of Dental Sedation

Most state regulations require dentists to receive training and a permit to administer sedation. Staff members are trained to monitor your vital signs and handle any rare emergencies. Don’t hesitate to ask your dentist about training, experience, and the number of sedation cases he or she has completed.

Dentists offer varying levels of sedation based on their training, experience, licensure, and the patient’s needs. After discussing the causes and extent of your anxiety, your dentist will choose a level of sedation that is adequate for your procedure.

Mild

Nitrous oxide—or laughing gas—is the lowest level of sedation. It gives you tingling sensations or a sense of well-being. It’s useful in managing pain and dental anxiety. After you stop breathing it in, the effects quickly reverse.

Moderate

You will receive oral conscious sedation in pill form. Your dentist will tell you what time to take it before you arrive at the dental office. Your anxiety about—and hypersensitivity to—the pain will fade. You’ll be drowsy, unable to drive, and relaxed before and after your dental procedure. You might not remember anything about your appointment.

Deep

I.V. sedation is administered through your veins. Not all dentists offer it, though. You’ll be drowsy and need transportation before and after your appointment.

Talk to Your Dentist About Sedation and Pain

Regardless of which type of sedation your dentist offers, it will decrease your sensitivity to pain. Speak with your dentist about cases like yours that he or she has handled and what you can expect.

Miranda Lacy, DDS sponsors this post. She is a Plano, TX female dentist who offers sedation. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.

Teeth whitening

3 Reasons Why Whitening Might Be Bad for Your Teeth

Whiter teeth can make your smile look more youthful and enhance your facial appearance. But in some cases, teeth whitening attempts can do more harm than good.

1. Gum Disease and Cavities

If your gums bleed or are inflamed or irritated, teeth whitening will make matters worse. The bleaching agent will further irritate your gums and cause pain. Gum disease needs to be treated and controlled before bleaching your teeth. Also, bleaching gel will penetrate through cavities and increase sensitivity in your teeth.

2. Challenges of Charcoal for Whitening Teeth

Researchers at the Creighton University School of Dentistry concluded that charcoal toothpaste is harsh on tooth enamel and can cause premature wearing and tooth decay. Laboratory students observed that charcoal toothpaste caused discoloration and made teeth look yellow or gray.

3. Hydrogen Peroxide Hype

Hydrogen peroxide can whiten teeth, but it can be harmful to your oral health. Some people are tempted to purchase the most potent solution available to brighten their teeth. Studies show that high concentrations of hydrogen peroxide can burn your gums and oral tissue and break down tooth enamel. And if you ingest high-powered peroxide, it releases dangerous levels of oxygen in your bloodstream.

Long-term use of 3 percent hydrogen peroxide (low strength) can kill beneficial microbes in your mouth and cause microorganisms, including candida albicans (yeast), to thrive.

What Are the Alternatives?

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.
Dentist-supervised whitening is safe

If in-office whitening from your dentist isn’t within your budget, consider the following alternatives:

  • Take-home whitening from your dentist is effective.
  • Keep your dental exam and cleaning appointments. Often, your dental hygienist can get tough surface stains off your teeth.
  • Limit things that cause tooth stains, including smoking and drinking coffee, soda, wine, and dark juices.
  • Ask your dentist how whitening treatment can be made affordable for you. Some dentists offer free whitening for patients who keep their exam and cleaning appointments.

This post is sponsored by Miranda Lacy, DDS of Plano, TX.

Teeth whitening

Teeth Whitening Gel or Baking Soda to Brighten Your Dull Veneers?

Are you thinking about using teeth whitening or baking soda to brighten your porcelain veneers? What you use to clean your veneers can maximize—or minimize—their lifespan.

The Properties of Porcelain Veneers

Well-made porcelain veneers replicate tooth enamel. Although porcelain beautifully mimics enamel, the properties of porcelain are different. The dental ceramics used to make veneers are harder than tooth enamel. And veneers are stain resistant. So how can you whiten them?

Teeth Whitening

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 treatments won’t brighten porcelain veneers

Professional bleaching gel is made of carbamide peroxide, which penetrates through tooth enamel into the dentin in teeth. The gel lightens the natural pigmentation in your teeth. But porcelain veneers are colorfast—teeth whitening won’t change their color.

Baking Soda or Teeth-Whitening Toothpaste?

Powdered baking soda is abrasive. If used for an extended period, it can scratch tooth enamel or the surface of porcelain veneers. Additionally, most types of toothpaste—including those with teeth whitening properties—are too abrasive to use for an extended period on cosmetic dental work. At the margin of your gumline and the veneers, abrasive pastes can wear away the composite bonding that secures the veneers to your teeth.

Many advanced cosmetic dentists recommend low-abrasion toothpaste for any cosmetic work, including porcelain veneers. Supersmile® toothpaste is gentle on teeth and cosmetic work.

Bottom line: Don’t use powdered baking soda or teeth-whitening gels or pastes on your porcelain veneers. Long-term use will create scratches that attract stains. Use a low-abrasion brand of toothpaste that is recommended by your cosmetic dentist.

If Your Porcelain Veneers Are Dull or Stained

If porcelain veneers are stain resistant, why do yours look dull? Several factors can cause veneers to look dark and detract from your smile, including:

  • Bacteria leaking behind the cosmetic work
  • Excess dental cement that your dentist didn’t thoroughly remove when bonding the veneers to your teeth
  • Damage that results when a hygienist uses dental instruments or chemicals that work well on tooth enamel but not on veneers

It’s best to determine the cause of your dull or stained veneers. Teeth whitening gels or pastes won’t help. You can schedule an appointment for an exam with an advanced cosmetic dentist. Your cosmetic dentist might be able to polish your veneers and enhance their gloss. He or she will explain your options.

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