All posts by AllSmiles

Sedation Dentistry

How much does sedation dentistry cost?

Can you tell me how much sedation dentistry costs? I have put off dental work for some time, knowing that I have severe decay. I have delayed going to the dentist because I did not have dental insurance for years. And although I got dental insurance in September of last year, I did not make a dental appointment due to anxiety. I’ve had three dentists over my lifetime, and two of them had poor patient care and were unnecessarily rough. I always left appointments in pain regardless of the procedure. Last weekend I fell and cracked a tooth. The crack doesn’t look that bad, but my tooth hurts. The pain throbs on and off. I think that I can make a dental appointment if I get sedated, but I would like to know how much it costs. If sedation is expensive, I can save money from each paycheck over the next two months. Thank you. Amit

Amit,

Thank you for submitting your inquiry to our office. Your throbbing tooth pain is a symptom of internal tooth damage. See a dentist promptly for an examination.

Although sedation dentistry fees vary and you must speak with your provider for exacts costs, we can provide estimates.

How Much Does Sedation Dentistry Cost?

The cost of sedation dentistry depends on several factors, including the type of sedation you receive, the length of your dental appointment, and where you live in the U.S. because dental fees vary by location throughout the country.

Types of Sedation

Although dental offices vary with the sedation services offered, the types of sedation available include nitrous oxide, oral conscious sedation, and IV sedation. Many dental offices do not offer sedation at all, but others provide at least one option. The costs below are estimates. Call your dentist’s office to ask what type of sedation is available and how much it costs.

Sedation Dentistry with Nitrous Oxide

Nitrous oxide, also known as laughing gas, is the lowest level of sedation.  You breathe in nitrous oxide through a small nose mask during your dental procedure. After the procedure, your dentist will give you pure oxygen to breathe in and quickly reverse the effects.

How much does nitrous oxide cost?

The average cost of sedation dentistry with nitrous oxide in the U.S. is $80 to $150 for the first hour. Your dentist may charge an additional fee if you require nitrous oxide longer than an hour.

Oral Conscious Sedation

Oral conscious sedation is in pill form. Many dentists use the medication Halcion (Triazolam), while others may offer diazepam or lorazepam for sedation. You will take the medication before your dental appointment so that you can arrive relaxed.

How much does oral conscious sedation cost?

The average cost of oral conscious sedation in the U.S. is $250 to $500 per hour. If you need to remain sedated beyond an hour, you may incur an additional fee.

IV Sedation

Intravenous sedation works faster than nitrous oxide and sedation dentistry. The amount of sedation your dentist gives you can vary from making you drowsy to putting you in a deep sleep.

How much does IV sedation cost?

Although the depth of sedation affects the cost, on average, in the U.S., IV sedation costs $500 to $1000 per hour with an additional fee beyond an hour.

Will Insurance Cover the Cost of Sedation?

Woman's face with her eyes closed while she receives dental work
Ask your dentist’s office about sedation dentistry fees and contact your insurance provider about benefits

Each insurance plan differs. Contact your insurance provider and ask if they provide benefits for sedation dentistry. Most insurance plans that offer sedation benefits have restrictions on the length of time coverage is provided for a procedure. For example, an insurance plan may provide benefits toward the first hour of sedation only.

Your dentist’s office will explain sedation dentistry fees and how long you will need sedation during your dental procedure.

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

Teeth whitening

My dentist extracted my tooth and left two roots behind

I had not been to a dentist in years, so I decided to get an exam and cleaning and schedule teeth whitening later. A needed several fillings before I could get my teeth whitened, and the dentist said one tooth was severely decayed and required an extraction. The dentist extracted the tooth last Thursday, and this weekend when I looked at the extraction hole to clean it, I saw two roots of the tooth left. Will those roots interfere with a dental implant, and why would my dentist leave them? Thank you. Konnor

Thank you for your question. Molar teeth have multiple roots, and it is a challenge to see into an extraction site near the back of your mouth. Are you sure that you see tooth roots are left and not debris stuck in the socket?

If your dentist left two roots behind, there must be a reason for it—although your dentist should inform you when this happens. Sometimes the location of tooth root tips is so close to the sinus that removing them could puncture the sinus or damage or nerve. But the roots must be removed before getting a dental implant.

Not all dentists are comfortable retrieving tooth roots and tips, and some do not have the instruments required to do it. The process can be challenging and lengthy for a dentist who does not have much experience in this area. If you have roots left in the extraction site instead of debris and your dentist cannot remove them, an oral surgeon can. It is easier to remove the roots soon after extraction, so schedule an appointment promptly

Teeth Whitening After Extraction

After the extraction site heals, you can begin teeth whitening treatment. When your teeth are as white as you want, your implant dentist will begin the process. A lab will make your dental crowns to match your brightened smile.

Selecting Your Dental Implants Provider

Diagram of dental imlant components, including the root form, connector, and crown
Dental implant

Look for a skilled implant dentist or oral surgeon. If your dentist left roots and not debris behind, it might be challenging for him to resolve the issue with the roots before placing a dental implant. It might be best to ask for a referral to an oral surgeon for tooth root removal and implant placement.

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

Teeth whitening

Do I really need both wisdom teeth extracted?

My dentist is going to remove my lower right wisdom tooth because it aches. He says that if I don’t remove the upper right wisdom tooth, it will drop into the space of the lower one and eventually hit my gums or interfere with other teeth. Is that true. Do I need both wisdom teeth extracted? I am 54 years old and do not want unnecessary complications. I am anxious to begin teeth whitening treatment. Thank you. Regina

Regina,

Your dentist is right. It is wise to remove wisdom teeth in pairs for several reasons.

  • Drifting – Keeping the upper right wisdom tooth can cause it to drift into the lower space.
  • Bite disruption – The unevenness can disrupt your bite or contribute to tooth decay or gum disease.
  • Tooth decay or gum disease – Without a lower tooth to chew against, if the upper tooth disrupts your bite, tooth decay or gum disease can occur in other teeth.

What Can You Expect with Wisdom Teeth Removal?

You can expect painless surgery and progressive recovery with wisdom tooth removal. Impacted wisdom teeth can be challenging to extract. If your dentist is not experienced with a variety of cases and your teeth are impacted, he may refer you to an oral surgeon.

Comfort – Before surgery, the oral surgeon will sedate you.

Surgery length – Your time in surgery depends on how many teeth the surgeon will remove and if they are impacted. Average time for removing all four wisdom teeth is about 1.5 hours.

Progressive recovery – You will see some swelling and feel soreness, but post-operative instructions explain how to manage them both and keep comfortable. Each day, you will progressively feel better. Although complications are rare, your oral surgeon will explain the signs and symptoms of complications, including:

Photo of upper and lower teeth whitening trays in a blue case; for information on free teeth whitening from the office Plano dentist Dr. Miranda Lacy.
Teeth whitening can begin after wisdom tooth extracation
  • Dry socket
  • Infection
  • Sensory nerve damage
  • Sinus perforation

Follow-up visits – You may have one follow-up visit after extraction, but it is often not needed.

Your dentist will schedule an appointment to check the extractions sites and ensure your gums and remaining teeth are healthy before starting teeth whitening treatment.

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

Affordable Dentistry

Is tooth extraction my only choice?

Two of my left molar teeth are infected. Both teeth have old fillings in them. After over a month of pain that I managed with Advil, I went to the dentist. The dentist took an x-ray and said both teeth have an abscess, and he wants to extract them both. I asked him about my options, and he said there aren’t any. Is this a standard solution for molar teeth with abscesses? – Thank you. Noah from Austin

Noah,

A dentist is ethically and legally obligated to explain your options. Unless your dental insurance is government funded, your dentist must explain your options. Government programs will pay for the cheapest option, which is extraction.

Treatment Alternatives to Tooth Extraction

Side-by-side diagram of an infected tooth being cleaned out with root canal treatment (left) and a healthy tooth to the right.
An endodontist can resolve previous root canal issues

If your teeth are infected, root canal treatment is the best treatment option. An abscess at a tooth root is a sign that the tooth pulp—living tissue—is dead. Tooth nerves are in the pulp, so your root canal treatment will be painless and more comfortable than tooth extraction. When third molars, or wisdom teeth, are infected, tooth extraction is best because wisdom tooth anatomy is complex.

Faulty Fillings and Tooth Pain

Faulty fillings can cause tooth pain and lead to infection. If your dentist did shoddy work on your fillings and knows it, he may want to extract your teeth without explaining your option.

What Happens After Tooth Extraction?

If a dentist extracts a second or first molar, the upper tooth will probably drift into the space and hit the lower gum. You can lose the upper tooth also. If there are no teeth behind your second molar, you probably won’t have complications.

Keep in mind that Dr. Lacy has not examined your teeth, and we cannot provide an accurate diagnosis. We recommend that you get a second opinion from an experienced dentist who will explain your treatment options. It would be unusual, but if you require extractions and dental implants, you can speak with the dentist about financing or payment plans if needed.

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

Sedation Dentistry

Is it too late to save my fractured tooth?

I split my left incisor tooth, and after seeing three dentists, none of them want to save it. They all recommend extraction, but I want a dentist who will try to save it first. How can I find a dentist without schedule one consultation after another? I sweat when I think about what it will take to repair the tooth, but I can’t worry about the pain. I want to save it. – Thank you. Clarke

Clarke,

You have two challenges in finding a dentist who will try to save your fractured tooth.

Timing – It is essential to get treatment within a day or two. Although you didn’t mention when your tooth split, more than two days may have passed if you have seen three dentists.

Technique – Few dentists try to save a fractured tooth. But some have found success with this method:

  • Fit the tooth pieces perfectly back together
  • Hold the pieces with a dental crown
  • Follow-up on the tooth for the life of the patient

Documentation on this technique is limited, and there is insufficient research to declare it an acceptable method.

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

If a dentist is willing to save your tooth, perhaps an endodontist (root canal specialist) might be willing to do it. Visit the American Association of Endodontists website for information about traumatic tooth injuries, the risks associated with them, and where an endodontist can save a tooth or need to extract it. Regardless of which treatment you receive, an endodontist will numb the tooth. If you are anxious, you can request sedation.

But you must get an appointment right away. Look for a board-certified endodontist and schedule an appointment for an exam. You do not have any more time to schedule a consultation. The longer you wait, the higher the risk of requiring tooth extraction and a dental implant.

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

Teeth whitening

Is an extraction instead of a root canal necessary?

I scheduled an appointment for a dental exam and teeth whitening consultation. The exam included an x-ray, and the dentist said he isn’t comfortable doing teeth whitening yet because one of my top left molars that already has a crown on it no longer has a canal. The tooth has been uncomfortable for a few months, but I didn’t think it was that serious. My dentist prescribed antibiotics and said that since the tooth doesn’t have a canal, he can’t do root canal treatment. If the tooth doesn’t improve from antibiotics, he recommends extraction. I’ve read many times that it is always better to keep your natural teeth. My dentist didn’t give me any options. Are there alternatives to an extraction? – Thank you. Latha

Latha,

Although Dr. Lacy would need to examine your tooth and x-rays for an accurate diagnosis, we are not comfortable with your dentist’s evaluation.

Antibiotics for tooth discomfort

Your tooth cannot be treated with antibiotics alone. A dentist might use antibiotics as a diagnostic tool.

  • Tooth pain that improves with antibiotics – If tooth pain goes away with antibiotic treatment, you have a tooth infection. Treatment options can include root canal treatment or extraction. But if your dentist does not treat the tooth and remove the infection, after you stop taking the medication, the symptoms will return.
  • Tooth pain that does not improve with antibiotics – When antibiotics do not resolve tooth pain, it is an indication that a tooth infection is not the source. Your dentist would need to find the cause before recommending treatment.

A tooth without a canal?

If a dentist tells you that your tooth does not have a canal, two possible factors include:

  • Upper molar teeth have a lot of bone around them, making it difficult to see the root canal, so your dentist’s assessment might not be correct.
  • Tooth irritation causes a buildup of dentin (layer beneath tooth enamel) inside the tooth pulp and canals. The buildup narrows the canals and can make them more challenging to see on an x-ray.

Saving your natural tooth

If you want to save your tooth, we recommend getting a second opinion. Look for an endodontist (root canal specialist) or ask your dentist for a referral to an endodontist. Be aware that your dentist might refer you to a friend who will agree with your dentist’s assessment. You may want an independent opinion.

Photo of upper and lower teeth whitening trays in a blue case; for information on free teeth whitening from the office Plano dentist Dr. Miranda Lacy.
Only begin teeth whitening treatment if your teeth are healthy

After an examination and x-ray, an endodontist will explain if it’s possible to save your tooth and the results you can expect with root canal treatment. It is wise to postpone your plans for teeth whitening until your tooth is healthy. Otherwise, it may become further irritated.

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

Affordable Dentistry

My New Porcelain Veneers Inflamed My Gums

I received porcelain veneers in September, and my gums are still tender and slightly inflamed. I’ve seen my dentist about this issue three times, and his consistent answer is that I don’t floss between my teeth. But I floss between my teeth twice daily. I am partially blaming myself for this problem because I chose the dentist with the lowest cost for porcelain veneers after consultations with five dentists. My teeth were so damaged that I thought veneers were the right solution. Last week, my dentist told me that one of my incisors is infected and might need a root canal. I feel like he is taking advantage of me. Why discuss a root canal when the problems with my gums are not resolved? I want to cry, but I need to keep calm and think about what I should do next. What is your opinion? Thank you – Anika from Dallas

Anika,

Thank you for your inquiry. We are sorry that your porcelain veneers are a new source of anxiety. Gum inflammation after you receive porcelain veneers is a clear sign that your dentist did something wrong. Gum tissue after veneers should be as healthy—or healthier—than before treatment. Although choosing a dentist with the lowest fees often comes with low-quality results, your dentist is responsible for your care.

What Causes Gum Inflammation After Porcelain Veneers?

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
Healthy veneers do not cause gum inflammation

After getting porcelain veneers, a common cause of gum inflammation is excess bonding cement that your dentist did not remove. The cement irritates your gum tissue and causes inflammation and infection. And the infection can spread and affect your teeth, which is likely why you need root canal treatment.

How to Get a Refund from Your Dentist

Cosmetic dentistry is not a recognized specialty, so it will be challenging to get a refund from your dentist based on your veneers and gums’ appearance.

Schedule an appointment with an advanced cosmetic dentist for an exam and second opinion. After the dentist gives you a diagnosis and explains your treatment options for veneers, talk to your current dentist about your complaints:

  • After receiving porcelain veneers, your gum inflammation is persistent.
  • Your dentist has not treated the issue.
  • Mention excess cement left behind—or whatever cause your second-opinion dentist finds.
  • Explain that the issues with your gums are causing discomfort and anxiety.
  • Request a refund and mention that you will consider filing a complaint with the state dental board.

If your current dentist does not promptly offer a refund, ask your new cosmetic dentist if they are willing to help you negotiate. Consider hiring an attorney if your dentist continues to be uncooperative.

Please try not to be overly concerned about the cost of regaining your oral health. Talk with your dentist about financing, payment plans, and how to make dental treatment affordable for you.

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

Sedation Dentistry

Is the screw post in my tooth causing this weird sensation?

My dentist did a root canal on my left front tooth, but the tooth broke at the gumline. I returned to my dentist, and she used a metal screw to attach the temporary crown.  After getting the screw, I feel a weird pressure-like sensation in my nose, but it is not painful. Is this screw going to cause more problems? I am afraid that I will lose the tooth and need a bridge. I’ve needed nitrous oxide for minor dental appointments and stronger sedation for anything more serious. I am concerned about how much this will cost because I lost my full-time job and insurance in April. I have two part-time jobs and no dental insurance. Ezra from FL

Ezra,

You probably would have more success with the tooth if your dentist inserted the metal post right after root canal treatment. The tooth might not have broken if your dentist had stabilized it. But we will focus on the post and possible treatment options. Keep in mind that Dr. Lacy would need to examine and x-ray your tooth for an accurate diagnosis.

What Is a Dental Post for a Crown?

A dental post for a crown is a small metal shaft or screw. A dentist places the metal post inside the tooth after root canal treatment. A post helps support a crown if you do not have enough healthy tooth structure left. A dental lab makes a custom crown that your dentist will cement to the post.

What Are the Risks of a Post?

Although screw posts are generally stable and stay in the tooth, they can exert pressure on the tooth root. The root can split with the stress and cause sensitivity or pain. A dentist needs to examine your tooth and post to determine if the post is causing your symptoms.

Treatment for Front Tooth Broken at the Gumline

When a front tooth breaks at the gumline, many dentists agree that it cannot be saved. Rotational forces on front teeth can cause a crown or post to loosen. You can accept your dentist’s recommendation for the crown and post or get a second option.

Alternative treatment if you lose the tooth

Diagram of a dental bridge
Dental bridge

If you lose your tooth, the most effective way to replace it is with a dental implant. But you explained your employment situation and lack of dental insurance. And implants are the most expensive treatment for replacing missing teeth. A dental bridge or a dental flipper is a more affordable option.

  • Dental bridge – Three crowns are connected at the sides to replace a missing tooth. Your dentist must taper the tooth on either side of the missing one because the crown on each end of the bridge must fit over those teeth to anchor the bridge.
  • Flipper partial – A replacement tooth is embedded in an acrylic base. A clasp on each end of the appliance hooks around a tooth to keep the partial in place.
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

Depending on which treatment you use, you might need stronger sedation than nitrous oxide to help you relax. Talk to your dentist about your anxiety. Also, speak with her about financing or a payment plan to help you pay for care over time.

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

Teeth whitening

Which Toothpaste Will Brighten My Dental Crowns?

Hello,

I don’t think that teeth whitening will whiten my crowns, but I read online that some toothpaste brands will help brighten veneers. Will you tell me if Supersmile toothpaste works for veneers and porcelain crowns? Thanks. Terri

Terri,

Your question has two parts: whitening cosmetic dental work and toothpaste that is safe to use on it.

Can You Whiten Cosmetic Dental Work?

Photo of upper and lower teeth whitening trays in a blue case; for information on free teeth whitening from the office Plano dentist Dr. Miranda Lacy.
Ask for teeth whitening before you get cosmetic dental work

Cosmetic dental work, including ceramic crowns and porcelain veneers, cannot be whitened. The dental materials are colorfast. The same is true with dental composites. You cannot whiten it. Although you can use teeth whitening products if you have cosmetic dental work, only your natural teeth will get brighter. The cosmetic work will stay the same shade.

If you need new cosmetic work and want to whiten your natural teeth, ask your dentist for teeth whitening first. Your dentist will ensure your new crowns or veneers will match the shade of your natural teeth.

What Kind of Toothpaste Is Safe for Cosmetic Dental Work?

Supersmile toothpaste is safe for cosmetic dental work. Most toothpaste is abrasive and can scratch the surface of porcelain veneers or ceramic crowns—but not Supersmile. It will help keep your dental restorations white.

Will Supersmile Toothpaste Whiten Crowns or Veneers?

Supersmile toothpaste will keep your crown or veneers white, but it won’t make them a lighter shade. But your question seems to be about whitening your dental crowns. Toothpaste will not whiten crowns that are already dark. Depending on the cause of stains in your crowns or veneers, a cosmetic dentist can polish them. But if your dental crowns are old, worn, or have a metal foundation, polishing won’t work.

We recommend scheduling an appointment with an advanced cosmetic dentist to examine your crowns. It might be time to replace them, but the dentist will explain your options.

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

Affordable Dentistry

If I don’t like my porcelain veneers, can they be reversed?

I think that I want porcelain veneers. I found a dentist who is offering them about 25% cheaper than two other dentists that I met for consultations. My husband is warning me not to go cheap on something as important as my smile. I do love a bargain, and if this dentist can get it right, I am all for it. But what if I change my mind. Can porcelain veneers be reversed if I decide I don’t want them? Thank you. Claire from Houston

Claire –

Our first concern is shopping around for the lowest cost for dental care. Quality care and a beautiful smile are not cheap. It’s okay to look for a dentist with reasonable fees, but that should not be your basis for choosing a provider.

Results of Cheap Porcelain Veneers

If a dentist takes shortcuts just to give you a lower price, problems with your porcelain veneers can result, including:

  • Low-quality veneers that don’t look natural or don’t last
  • Poor bonding techniques that cause veneers to fall off
  • Leakage behind your veneers that promotes decay

Are Porcelain Veneers Reversible?

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
Don’t choose the cheapest dentist for porcelain veneers

Generally, after you receive porcelain veneers, they cannot be reversed. But some dentists might place veneers without preparing your teeth at all—or with very minimal preparation. In those cases, a skilled cosmetic dentist might be able to smooth and polish your enamel or use dental composite to restore the shape and gloss of your teeth.

But if a dentist aggressively prepares your teeth, if you decide you don’t want porcelain veneers, your teeth will have an unnatural shape and appearance. And you won’t like your smile.

Porcelain veneers are not meant to be removed. Weigh the pros and cons carefully before you ask a dentist for veneers.

Select a Skilled Cosmetic Dentist

Select a cosmetic dentist with advanced training in dental aesthetics. The dentist will be concerned about the function and appearance of your smile. Even at a 25% discount, you can expect to pay almost $1000 per veneer. That’s an investment. Why not choose a dentist who will enhance your smile?

True cosmetic dentists involve you in the process of designing your smile. You should expect the following from the dentist:

  • Show you a wax model of your new smile
  • Allow you to wear temporary veneers for about two weeks to see if you like how they look and feel
  • Use a try-in paste to secure your porcelain veneers to your teeth and ensure you love them before bonding them on

The process takes time, and you should not rush it. It helps a cosmetic dentist ensure you love your new smile and don’t want to reverse it.

 If you need to make the cost of porcelain veneers more affordable, speak with a cosmetic dentist about financing or payment plans. But don’t choose a dentist just because his or her fees are the lowest.

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