Category Archives: 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


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.

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


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.

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.

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.

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


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.

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


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.

Restore or Extract a Wisdom Tooth with a Cavity?

I think I understand why my new dentist’s fees are lower than most in the area. I’m 52 years old. After my second cleaning and exam appointment, my dentist told me that there is a large cavity in my lower left wisdom tooth. The tooth isn’t impacted, sensitive, or painful. My dentist says that the cavity is so large that she needs to extract it. She didn’t give me an alternative. Can I trust her diagnosis? Dana from Tulsa, OK


If your dentist didn’t show you a picture of the large cavity in your wisdom tooth, you should ask to see it.

Large Cavity in a Wisdom Tooth – Restore or Extract?

Consider a few facts about large cavities and wisdom teeth.

Wisdom teeth

  • Although it’s usually best to save a natural tooth, wisdom teeth are often the exception.
  • Sometimes it can be difficult for a dentist to access a wisdom tooth because it’s far back in the mouth.
  • If your dentist doesn’t have full access to a tooth, he or she won’t be able to the tooth well. If the tooth is impacted, complications increase.
  • It’s often difficult for dentists to access wisdom teeth because they are far back in the mouth.
  • If you wait until you feel pain, the tooth can crumble as your dentist removes it—making it more challenging to extract.

Large cavities

Photo of a woman in a dental chair with a dentist and hygienst on either side of her; for information on affordable dentistry from Plano TX female dentist Dr. Miranda Lacy.
Find an affordable dentist you can trust

A dentist can use a large filling or a crown to restore a tooth. If the decay is extensive, your dentist might recommend root canal treatment. It isn’t easy to restore a wisdom tooth with a crown. The crown might need to be replaced more frequently than a crown on a tooth that your dentist can easily access.

Trusting Your Dentist

If you don’t trust your dentist, you’ll be unlikely to be satisfied with any of her treatment recommendations. Affordable dentistry doesn’t mean that a dentist has questionable practices. Speak with your dentist to understand why the is recommending extraction and ask to see your x-rays. If you need further reassurance, you can get a second opinion.

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

Dentist Left the Tip of an Instrument in the Patient’s Tooth After a Root Canal

During my root canal in March, my dentist told me that the tip of his file broke off and fell into the canal. He said the file is sterile, so he wasn’t going to damage my tooth and try to remove it. He said he would put a post in the tooth and put a crown on it.

I asked him to place a temporary crown until I think about what I want to do with the tooth. I haven’t been able to return to the dentist yet. Is it okay to leave the tip of the file inside my tooth? Lots of people go to this dentist because his fees are lower than others, but I don’t want cheaper care if it means a dentist will be careless. Thanks. Jules


Metal files can break easily, and it’s happened to a lot of dentists—even those who don’t have lower fees for services. A broken piece of a file can be challenging to remove for many general dentists. If the tip of the file is left, a dentist would need to navigate around it and seal the apex or tip of the tooth root. If the broken piece is blocking the apex, it decreases the chances of successful root canal treatment.

If the tip of the instrument irritates your tooth, you might need root canal treatment later. Cementing a post could make it impossible to retreat the tooth.

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

Your safest option is to ask your dentist to refer you to an endodontist, or root canal specialist. Endodontists have special tools to extract the tip of the file and fill the canal of the tooth. Although your dentist might not want to refer you to a specialist, you can insist on it or find an endodontist on your own. It’s good that you asked for a temporary crown until you decide what to do about the tooth. Don’t risk losing your tooth. Visit an endodontist.

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

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


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.

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


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.