All posts by AllSmiles

Sedation Dentistry

How Often Do Porcelain Veneers Fall Off?

For the past two years, I’ve been talking with my dentist about the possibility of getting porcelain veneers. I finally decided to move forward with my plans, so I had a long discussion with my dentist last week. One of my questions was about how long veneers last and if they ever need to be replaced. My dentist said that I could plan on returning to the office every three to four months because veneers fall off, and she will bond them back on. She said if I am careful about not eating crunchy foods, my veneers should last longer. I researched online over the weekend and didn’t see anything about veneers consistently popping off unless the dentist did something wrong.

My dentist’s estimate of how long veneers last is making me nervous. I already have a little dental anxiety. Sometimes I need nitrous oxide, but if I return to her office every few months because veneers pop off, I’ll end up a nitrous junkie. How frequently do veneers pop off? Thanks, Audriana

Audriana,

Shame on your dentist for telling you to expect your new veneers to pop off every few months.

It seems that your dentist is speaking from experience, which can mean several things:

  • Your dentist uses cheap veneers
  • She prepares teeth so aggressively that veneers won’t stay on
  • Bonding techniques are not in your dentist’s skill set

The dental profession has a principle—the standard of care. Although cosmetic dentistry isn’t a recognized specialty, porcelain veneers must stay on—even if they look bad.

How Often Do Porcelain Veneers Fall Off?

Photo of a single porcelain veneers, from affordable Plano TX dentist Dr. Miranda Lacy.
True cosmetic dentists prepare teeth conservatively and bond porcelain veneers so well they don’t come off

Veneers should never fall off, and they should last at least ten years. Your dentist’s prediction about porcelain veneers’ longevity is a warning to find a cosmetic dentist who is skilled with veneers.

And you can eat whatever you want with veneers. But don’t use your veneers—or even your natural teeth—to bite pins, bottle caps, or other hard objects.

We encourage you to search online for cosmetic dentists, look at their patient reviews or smile gallery, and choose two dentists for a consultation. Ask about each dentist’s processes and how long you can expect your veneers to last. Get ready to switch to a new dentist for veneers. And you won’t have to worry about repeat appointments and needing sedation to get through them.

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

Sedation Dentistry

Effects of Tooth Roots Left Behind After Extraction

I have tooth roots left from previous extractions that a dentist did years ago. Now a need surgery around the area where the root was left. The tooth that will be extracted is above a root. Is this a risky surgery? My current dentist says it should be no problem, but his answer does not give me confidence. I sent an x-ray of the tooth and the root beneath it. I’m already anxious about another extraction, and the thought of nerve damage is really scary. – Danni from NM

Danni

Your lower premolar is near the mental foramen, an opening in your front lower jaw that transmits the mental nerve and artery. A skilled surgeon can extract your tooth without damaging the nerve. But your dentist doesn’t sound confident about extracting the tooth without damage.

Your x-ray shows that the dentist who completed your extractions left a large amount of root behind. The bone didn’t heal correctly and left a defect that can damage neighboring teeth. We also see a fragment on the right side that doesn’t appear to be threatening.

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Ask about sedation options to help you relax during tooth extraction

We’re sorry that your former dentist did sloppy extractions. If your current dentist isn’t confident about removing your tooth without damaging a nerve, please get a second opinion or ask your dentist to refer you to an oral surgeon.

During your second opinion or consultation with a surgeon or another dentist, ask about sedation options to calm your anxiety before and during treatment.

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

Teeth whitening

Why Do My New Composite fillings Hurt?

I’ve had to put off teeth whitening because I have four small composite fillings that are painful. I received the fillings in early September. I get a brief sharp pain when I chew hard or crunchy foods. The pain isn’t worse, but it’s consistent. Also, I’ve noticed that I don’t feel the pain when I clench my teeth tother.

After my online search about this issue, it seems that I need to find a dentist who uses self-etching primers or a glass ionomer base. I’ve called a few dental offices, but the receptionists don’t know what I’m talking about. How can I find the right dentist to replace the fillings? – Thanks. Eve from S. Carolina

Eve,

The sensitivity you describe occurs more often with small fillings than large ones.

Why Do New Composite Fillings Hurt?

The reason that new composite fillings hurt seems to be related to a dentist bonding the filling to dentin of the tooth. Most dental office receptionists are not familiar with self-etching primers or glass ionomer bases. Maybe a dental assistant who helps the dentist with the procedure might be familiar with the terms.

Although Dr. Lacy would need to examine your teeth, two possible solutions include:

Schedule an appointment to make your request – Before allowing a dentist to work on your teeth, insist on a glass ionomer base beneath the filling to protect the dentin and keep composite away from it. If the dentist doesn’t agree with your request, find another dentist.

Find an advanced cosmetic dentist – You might have to travel to find a cosmetic dentist who is familiar with self-etching primers and glass ionomer base. A dentist with post-graduate training in cosmetic dentistry knows how to protect your teeth, and you don’t have to explain your position or tell the dentist what materials you want in your teeth.

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 can further irritate sensitive teeth

Although a cosmetic dentist would usually whiten your teeth first and place the fillings afterward to match them, your teeth are sensitive. The bleaching gel can increase sensitivity. Speak with the dentist about the best time to start teeth whitening treatment.

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

Affordable Dentistry

Her Dentist Used the Wrong Color Bonding – Can It Be Fixed?

I visited three dentists for consultations and quotes for composite filling on 15 teeth. I chose the most affordable dentist because the bonding cost more than I expected. The dentist did the bonding for sensitivity near the gumline, not for cosmetic reasons.

Immediately after the dentist finished the work, I could see that she chose the wrong color bonding. And the fillings look pasty and rough. I no longer get compliments on my white teeth.

Do I have the get the boning on all 15 teeth removed and reapplied? Or can new boning be added over the old? What are the risks? I should add that several of the teeth already had bonding on them that started to chip. So, for those teeth, this would be the third round of bonding. – Thanks. Kasey from Albany, GA

Kasey – We’re sorry that you’ve had a bad experience with bonding. The lack of technique isn’t necessarily because you chose a dentist with affordable fees. A good family dentist should be able to get the color, textures, and polish right for fillings at the gumline.

Do your composite fillings need to be replaced?

Your composite fillings might need to be replaced depending on the shade and the extent of correction required.

A few facts:

  • A dentist might need to replace your fillings if the color is significantly off.
  • A dentist can remove some of the surfaces and resurface them with another color.
  • It’s not difficult to tell where the composite ends and the tooth structure begins, so replacing the fillings is easy.
  • Dental burs will selectively remove composite without harming your tooth structure.

Sensitive areas at the gumlines of teeth

Front tooth showing a wide notch at the gumline
Tooth abfraction lesion

Sensitive areas at the gumlines of teeth are called abfraction lesions. In the photograph, tooth enamel near the gumline is worn and leaves a notch that is often sensitive to air or touch. Research reveals that the primary cause of abfraction lesions is clenching your teeth. Clenching causes the tooth to flex and weaken at the gumline. Eventually, the tooth in that area wears away.

An experienced dentist will determine the cause of sensitivity at your gumline and select durable and flexible materials for clenching. Stiff composite materials will pop out under the force of clenching. But flexible materials like Silux Puls and Renamel look natural and are strong enough to stay intact.

If your dentist cannot correct your composite fillings, you can find a dentist who is skilled in bonding techniques and has affordable fees.

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

Affordable Dentistry

How to get a refund after paying the dentist upfront

Two years ago, I found an affordable cosmetic dentist to do some extensive work for me. The treatment was going to take about 18 months. About seven months in, I realized that the dentist didn’t know how to make crowns or balance my bite, so I stopped treatment and asked for a refund. I paid for the service through Care Credit®. The dentist hasn’t refunded me yet. Does the dentist have the money, or does Care Credit, and what should I do to get a refund? Zaida from TX

Zaida,

After you sign the contract, Care Credit deducts fees from the total and pays the remainder to the dentist upfront. If the dentist didn’t complete your work, he must refund the balance from his funds.

How to Get a Refund from Your Dentist

You have several options to get a refund from your dentist, depending on the conversations you’ve already had with the dental office. You can also consider what you know about your dentist and his ethics.

  • Threaten to leave negative online reviews – If your dentist has mainly positive online reviews, he might be concerned about negative ones.
  • Complain to the state dental board – Contact the dentist’s office and let them know you will file a complaint. They might be willing to pay you promptly.
  • Contact a consumer rights attorney – A single phone call from a consumer rights attorney might be all that’s needed to get your dentist to see that you’re serious about a refund.

While you’re settling the issue with your dentist, find two advanced cosmetic dentists and schedule consultations with them. Let them examine your dental records and x-rays and examine your teeth. Don’t mention the difficulty you’re having with your current dentist.

During the consultation, you can get treatment options from each dentist and find out how much time and expense are needed to restore your smile completely. Payment plans are still an affordable way to get the dental care you need, and Care Credit is a reliable source.

Before-and-after photos of porcelain crowns, which are available from Plano, TX dentist Dr. Miranda Lacy.
An affordable crown should still look and feel natural

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

Sedation Dentistry

I Have a High Resistance to Lidocaine at the Dentist

I have a high tolerance for lidocaine, so my dental visits are horrifying and painful. Three years ago, I got discouraged and stopped going to the dentist. Now I have four teeth that need extraction. I want to take control of my oral health. I’ve delayed the extractions because I want dental implants right away. I’m concerned about finding a gentle dentist who can do this with minimal pain and keep the costs down of getting four dental implants. How can I manage both?

Thanks. Daphne

Daphne,

Your high tolerance for lidocaine reflects a high level of dental anxiety. Instead of more local anesthetic, you need a relaxant. Dentists who know the subject and are interested in treating anxious patients ask questions to determine if they can benefit from sedation. A dentist might ask, “How does novocaine or lidocaine work for you?” When a patient says they have a high resistance to the anesthetic, their dentist can give them nitrous oxide or an oral sedative before the appointment to relieve anxiety. And the local anesthetic works fine.

Often, dental phobia is related to past negative dental experiences in childhood or adulthood. Many dentists have had negative or stressful experiences in the dental chair as patients. They get anxious too, and the local anesthetic wears off quickly unless they receive some form of dental sedation.

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 new dentist about sedation options

You can search online for a dentist who offers sedation. A dentist who makes it known that sedation is available is used to working with anxious patients and makes an effort to be gentle. It might be helpful to schedule a consultation first, speak with the dentist about your experience with lidocaine, and discuss your goals for dental implants and a new smile. Nitrous oxide might be enough to give you a sense of well-being, so your body accepts the lidocaine.

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

Teeth whitening

Will Teeth Whitening Help White Spots or Make Them Worse?

When I was a child, solid white spots developed on the tips of my teeth. As a teenager, I had braces, and I think the braces cause white spots on my upper center front teeth. My family dentist says my teeth are healthy, and since I’m 30 years old with healthy teeth, I shouldn’t be overly concerned. The white spots because they are noticeable when I smile. Will Zoom whitening or whitestrips make the spots more prominent, or are porcelain veneers better? Thanks, Laney from AL

Laney,

So many dentists have the attitude that your teeth look okay, so leave them alone. But that’s not what you want. And they’re not genuinely concerned about how you feel about your smile. They just fix teeth to their satisfaction. Don’t ask your family dentist to do anything about the white spots on your teeth.

Zoom whitening, whitestrips, or any teeth bleaching will improve the spots on your teeth. It can make them worse. Although some dentists might prescribe whitening, find a dentist with advanced training in cosmetic dentistry.

Although Dr. Lacy would need to examine your teeth, dental bonding might conceal the white spots. If not, porcelain veneers will cover them. If you want a brighter smile overall, you can whiten your teeth and then use bonding or porcelain veneers for the white spots.

  • 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 bleaching isn’t for white spots on teeth

But don’t think that every dentist who claims to be a cosmetic dentist can do the work. Some claim to be a cosmetic dentist because the procedures are profitable. But the dentists don’t have artistic talent or training, color management, or translucence. If you choose a dentist based on their claims alone, you can still be disappointed with the results.

Take time to find a cosmetic dentist to conceal the white spots, and then you can return to your family dentist for general care.

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

Affordable Dentistry

Need a Tooth Extracted But Can’t Afford a Dentist? 3 Facts to Consider

Last September, one of my bottom right molars cracked. A corner of the tooth came off, but I didn’t go to the dentist because I don’t have dental insurance and can’t afford to pay for services upfront. Now the tooth is crumbling piece by piece. The backside of the tooth is intact, and the tooth is hyper-sensitive. Will my tooth fall out without me going to a dentist? – Thanks, Jen

Jen,

If your tooth is sensitive and decayed, it will eventually fall out. Although Dr. Lacy would need to examine your tooth for an exact diagnosis, the sensitivity in your tooth means that it’s irritated. And the pulp (living tissue) in the tooth can become infected. It’s best to have a dentist extract the tooth to prevent the infection from spreading into your jawbone or elsewhere in your body.

Three Factors to Consider If You Think You Need an Extraction

We’ll share a few scenarios with you to help you decide if you want to wait until the tooth falls out or find a dentist willing to work with your budget.

  1. Sensitivity in your tooth – You didn’t mention when or to what your tooth is sensitive. When tooth pulp is infected and dead, your tooth is sensitive when you bite. If it’s sensitive to cold or air, the pulp is still alive.
  2. Swelling – You didn’t mention swelling, but if your jaw area isn’t swollen, you can wait and hope the tooth decays away. Swelling indicates and infection that a dentist needs to treat right away.
  3. Tooth location – It’s easier for a dentist to access lower tooth nerves and treat the tooth without injected anesthetic into the tooth pulp. Upper teeth have more risk. You said the tooth is a molar, but you didn’t mention wisdom tooth. If it’s not a wisdom tooth, when the tooth is missing, the surrounding tooth will drift into the space and affect your bite. You can develop TMJ disorder, including jaw, neck, and ear pain, headaches.
Photo of woman holding the right side of her face, who might need Plano affordable dentistry from female dentist Dr. Miranda Lacy.
Although you don’t have insurance, you can find an affordable dentist

Although it can be challenging to receive quality dental care without insurance, we suggest that you look for a dental clinic or dentists who will let you pay for care over time. At least have a dentist examine your tooth and explain your options. The dentist might be able to save the tooth and protect it with a crown. At least you’ll know what to expect and how the tooth will affect your oral health in the future, even if you decline treatment.

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

Teeth whitening

Dentist Wants to Replace Bonding with Crowns? 3 Reasons to Run

About 7 years ago my dentist put bonding on my six center upper teeth to cover stains. The bonding chipped on several teeth. I live in TX now and my new dentist said that my teeth are stained on the inside. She recommended internal teeth bleaching or porcelain crowns. I was expecting more dental bonding but not crowns on six teeth. My anxiety is going off the charts with the thought of needing crowns. I need nitrous oxide to get dental bonding. Is there any way I can avoid crowns even if I have to switch dentists?   Thanks – Leanne

Leanne,

We’re glad that you mentioned switching dentists. It’s our suggestion that you find an experienced cosmetic dentist and ask for a second opinion.

Your description is stains on your teeth that were concealed with dental bonding. If you don’t have root canal treatments on your teeth, we are unsure of why our dentist would recommend internal bleaching or crowns.

Each tooth needs to be ground down for a crown to fit over it. A trained cosmetic dentist treats teeth conservatively with a focus on saving healthy tooth structure. It sounds as if your dentist doesn’t know much about cosmetic dentistry.

Three Alternatives to Dental Crowns

A skilled cosmetic dentist will examine your teeth, take some digital x-rays to ensure they are internally healthy, and recommend treatment. You can make a quick getaway from your current dentist because there are alternatives to grinding down your teeth to place crowns. Treatment recommendations might include one or more of the following:

  • Teeth bleaching – Before any cosmetic work is completed on your teeth, if you want to brighten your smile, bleaching will be completed first. The dentist will match the cosmetic bonding or other treatment to match your whitened natural teeth.
  • Dental bonding – A cosmetic dentist can skillfully remove the old dental bonding and replace it.
  • Porcelain veneers – If there is damage to teeth that bonding won’t conceal, your cosmetic dentist might recommend porcelain veneers for one or more 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 new cosmetic dentist about sedation options

Schedule consultations with at least two cosmetic dentists in your area. Don’t mention your current dentist’s recommendation. Just let the dentists examine your teeth and offer treatment recommendations. During your consultation, you can ask the dentist about his or her options for sedation and helping you relax throughout treatment.

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

Teeth whitening

How to Whiten a Single Tooth and Get a PERFECT Color Match

I love my smile and my teeth are as white as I want them except one that’s turning brown. In elementary school, I collided with a student, and his head hit my mouth. Although I’ve had a hairline fracture in the tooth and it sits back farther than the one on either side, now the tooth is getting dark. It doesn’t hurt, and it’s not sensitive. Is there a safe way to whiten it without it turning dark? Is it possible to get whitening for one tooth or will bonding work? If whitening will work, I’ll try it myself. Thanks. Chanele from Fort Wayne, IN

Chanele,

If your tooth is not painful or infected, you won’t need root canal treatment. A tooth that has light trauma can develop thicker dentin (layer beneath the enamel) and darken.

Is Teeth Whitening an Option for a Single Tooth?

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.
Don’t try to whiten a single dark tooth at home

Manipulating the color of a single tooth is a challenge for about 98% of dentists. But don’t ask a dentist to color match a single tooth with a bleaching agent. Sometimes bleaching gel makes discoloration in teeth even more noticeable. And it can be tricky to determine how long to leave the gel on a tooth to achieve the right color—especially after a few days when the color stabilizes. Don’t try to whiten your tooth at home.

Lighten a Single Tooth with Dental Bonding or a Veneer

An artistic cosmetic dentist will use dental bonding to achieve a perfect color match. A single, lab-made porcelain veneer will produce natural-looking results, but it’s more invasive than dental bonding.

An advanced cosmetic dentist will blend dental bonding to match the shade, translucency, and gloss of your natural teeth. The same can be achieved with a porcelain veneer and ceramic who will manipulate the color to match your surrounding teeth.

Consult with a cosmetic dentist to discuss your options and the cost of dental bonding vs. a single porcelain veneer.

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