Category Archives: Oral Health

Will osteoporosis prevent me from getting sedation dentistry?

I have osteoporosis and I think sedation dentistry might help me get some issues with my teeth taken care of. I’m just concerned that sedation might make my condition worse. I have difficulty sitting for extended periods, so if sedation is going to keep me in the dental chair longer than I should be, that’s a concern too. The thought of falling from being drowsy also scares me. Do patients with osteoporosis get sedation dentistry? Is there anything I need to consider before I ask for it? Valeriya

Valeriya – As you know, osteoporosis decreases bone density and makes bones very fragile. It can affect your oral health.

Osteoporosis Affects Oral Health

The disease can affect any bone in your body, including your jawbone. It creates oral health risks including:

  • Decreased jawbone density and affecting the stability of your teeth.
  • Triggering periodontal (gum) disease
  • Increased risk of needing dentures

Sedation Dentistry Can Help

Your oral health needs more attention than usual. Sedation dentistry can help you get the dental care you need. Before you receive sedation, your dentist will determine if you’re a candidate for it.

Your medical and prescription history will be thoroughly reviewed. Your dentist may want to collaborate with your medical doctors to take necessary precautions and to determine which form of anti-anxiety medication is best for your needs. Most patients are candidates for sedation dentistry even if they have other medical conditions.

Speak with your dentist about your concerns with sitting in the chair too long. He or she will schedule multiple visits, if necessary, to ensure your comfort.

What can you expect after receiving sedation dentistry? It’s important to closely follow after care instructions to prevent injury.

  • You will still be drowsy.
  • The dental office should have a wheel chair ready to take you to the car. You won’t have to worry about falling and breaking fragile bones.
  • You will have arranged for transportation home, and that person or another responsible adult should stay with you for the rest of the day.
  • Rest in bed or on the sofa, and limit your activity around the house. Someone should assist you with necessary tasks to prevent you from falling.

Your dentist will work with your and your doctors to limit the effects of osteoporosis on your oral health. With proper screening and planning, sedation dentistry can help.

This post is sponsored by Plano dentist Dr. Miranda Lacy. Dr. Lacy’s office is convenient to Addison, Allen, Carrollton, Farmers Branch, Frisco, Garland, Highland Park, and Little Elm.


How long should a dental cleaning take and why aren’t they sedating me?

I want to know why my dentist isn’t sedating me. My past 2 dental cleanings took almost 2 hours. The first time it took so long that my underarms were soaked and my shirt was wet. It was the craziest experience. My gums were bleeding and when the hygienist rinsed my mouth and told me to suck on that straw thing to dry my mouth, I almost gagged. So did she! I heard her make a gagging sound. At the end of the appointment she and the dentist told me I have gum disease so I have to floss more often and I need to go back more often to get my teeth cleaned. I’ll do whatever it takes to get rid of gum disease but what is taking so long with these cleanings? I only have 23 teeth, so what is the problem people? Last week I went back again and this 2nd appointment took almost 2 hours again. This time neither of us gagged. Maybe that’s improvement… Is the time involved normal? And with all of this bloody mess and my soaked underarms after the appointment why are they not sedating me? How long should a dental cleaning take? Thanks. Geoff

Geoff – Your concern about the length of your dental cleanings and your level of anxiety without sedation are understandable. And your dentist should provide you with the answers.

Average Time for a Dental Cleaning

A dental cleaning for a patient who has good oral health and maintains excellent oral hygiene at home takes about 30 to 40 minutes. The time can vary, depending on the condition of your teeth and the hygienist’s speed. Keep in mind that when you receive a dental cleaning, more is involved than just cleaning and polishing your teeth:

  • X-rays are taken.
  • Your hygienist will check the space between your teeth and gums for signs of periodontal (gum) disease.
  • Your dentist will also need to examine your teeth, gums, tongue, and other oral cavities to ensure they are healthy and disease free.

The “extras” are necessary to help you maintain good oral hygiene. And they naturally add more time to your dental visit. But let’s discuss what might be taking your appointment so long and why you aren’t being sedated.

What’s Taking So Long?

So what’s affecting the time it takes to clean your teeth? Several factors might be involved:

  • The condition of your teeth – A professional dental cleaning removes plaque, tartar, and stains from your teeth. The amount of plaque and tartar buildup is related to how often you brush and floss your teeth. The more you floss between your teeth, the less plaque and tartar there will be. Stains can develop from everyday eating and drinking, but if you smoke, or if you are a heavy coffee or tea drinker, your teeth will have more stains.
  • Periodontal (gum) disease – When the pocket, or space between each tooth and the surrounding gum tissue, is infected, the gum tissue pulls away from your teeth. Deep periodontal pockets need to be thoroughly cleaned to get rid of gum disease. This process, scaling and root planing, is a deeper cleaning than normal and takes more time. In cases of severe periodontal disease, a specialist (periodontist) might be needed.
  • Your anxiety level – It takes a little more time and patience to provide dental care for anxious patients. If your dentist and hygienist know you’re anxious, they will work at a slower pace to ensure your comfort and to take time to explain what’s being done throughout the dental procedure. Some dental professionals do this regardless of a patient’s anxiety level. Sedation can help make dental cleanings easier for you.

Why Aren’t You Being Sedated for Your Dental Cleanings?

Perhaps your dentist and hygienist haven’t noticed your sweaty armpits. Maybe it’s not that noticeable to them, or maybe they need to be more observant. Have you explained how nervous you’re getting with the lengthy dental cleaning appointments?

Your periodontal disease needs to be well controlled, so it’s time to let your hygienist and dentist know just how much the cleaning appointments are affecting you. Ask for sedation so you won’t start to dread your appointments—and possibly start skipping a few.

Your dentist should work with you to provide a level of sedation that matches your anxiety and the length of your dental appointments. If he or she isn’t responsive enough to your anxiety, it might be time to look for another sedation dentist.

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

Can I find an affordable dentist to help me stop sucking my thumb?

I’m wondering if I can find an affordable dentist who can help me get my thumb sucking habit under control. I wish I could just stop cold turkey, but I can’t.

I’m 37 years old and am fortunate enough to have a private office at my job. Most of the time I can work from home and I am single, so most people don’t know I suck my thumb. Stress is a lot of the problem but it’s an embarrassing habit.

Twice within the last 3 months, someone came into came into my office when my back was turned to the door and I was sucking my thumb. Neither colleague mentioned it, but I know they saw me. Otherwise the habit is hidden from my family and friends.

I know that dentists often help kids stop sucking their thumb, but what about adults? I don’t want to have to spend a lot of money on this, but I do need to do something about it. Thanks for your suggestions. Leah



It’s good that you’re looking for options to help get your habit under control. There are some things you can try yourself, without having to worry about finding an affordable dentist for treatment. We’ll name a few:

Brush-on deterrent polish – You can buy over-the-counter, deterrent nail polish and brush it on. The polish is designed to help you stop sucking your thumb or biting your nails. You’ll get a foul taste in your mouth that causes you to take your thumb or fingers out of it.

Cover your thumb – Try covering your thumb with a bandage or something similar that will make sucking it uncomfortable. Although you can easily remove a thumb cover, at least it will make you think before you put your thumb in your mouth.

Address the stress – If you think your thumb-sucking habit is stress related, address the stress. If you have trouble controlling your anxiety, speak with your doctor about it.

You might benefit from massage therapy, counseling, or other stress-reducing techniques. If you can reduce the level of your anxiety, it can help you address bad habits and improve your overall health.

If you continue to suck your thumb, it will eventually affect your bite and the alignment of your teeth. Be sure to ask your dentist for an examination to determine if orthodontic treatment is needed. If your bite has been affected, it’s best to get it treated to prevent other oral health issues.


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

Missing Teeth and Your Heart

Research published in a December 2015 article of the European Journal of Preventive Cardiology shows that the risk of death in patients with coronary heart disease (plaque buildup inside the coronary arteries) who are missing all of their teeth. The 3.7-year study included more than 15,000 patients from 39 countries. About 16 percent of patients in the study had no teeth at all, and another 40 percent were missing half their teeth.

Compared with patients who had all of their teeth, those in the study who were completely endentulous (all teeth are missing) had a series of increased risks that included: 27 percent for a major cardiovascular event, 85 percent for cardiovascular death, 81 percent of all-cause death, and 67 percent for stroke.

During the study, 746 patients had heart attacks. During follow up, 1,543 of the patients surveyed had major cardiovascular events; 705 experienced cardiovascular death; 1,120 died from other causes; and 301 patients had a stroke. In the follow-up events, an increase in tooth loss was associated with an increase in the risk a cardiovascular event, death by other causes, and stroke. Results were not as conclusive with patients who had heart attacks during the study.

Who were the most at-risk patients?

  • Women, who were also:
  • smokers;
  • less active;
  • and more likely to have diabetes;
  • higher blood pressure;
  • higher body-mass index;
  • and lower education

Why Are Coronary Heart Disease and Missing Teeth Related?

The most common cause of missing teeth is gum disease. Inflammation from gum disease affects the heart, and it increases the risk of heart trauma in people who have heart disease, or who are at risk for it. Poor dental hygiene contributes to gum disease.

The study emphasizes the importance of daily brushing your teeth and flossing between them. Brushing alone isn’t enough. Flossing removes bacteria-producing debris that causes inflammation and gum disease. Regularl dental exams and cleanings remove plaque and tartar from your teeth, and greatly reduce the risk of gum disease. Examinations from your dental hygienist and dentist provide early detection of gum disease.

The conclusion? Good oral hygiene habits keep your teeth clean and can contribute to a healthier heart.

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

Marijuana before my dental appointment

Marijuana makes me feel easy and calm like I’m hand gliding over the beach on a warm day. I use it on weekends to help me relax. Every once in a while I will use it during the week depending on my stress level. I have been on anti-depressants before and they made me get thoughts of hurting myself, but I’ve never had those thoughts with MJ. So I don’t need it as often as I took the prescription meds. I’m going to schedule a root canal for one tooth, another one needs to be pulled, and later I’ll get a dental bridge for the one that will be pulled. After the dentist described everything he had to do, I thought to myself that a little MJ before my appointment would be in order. Instead my dentist talked to me for 10 minutes about sedation and a little pill I would take before the appointment. I am not feeling the anti-anxiety meds idea, not at all. So here’s my question: if MJ is my relaxation method of choice can I refuse sedation and maybe sign off on something to say that I realize what I am doing. Thank you very kindly. Mitch

Mitch – Although you use marijuana to help you relax, it shouldn’t be used before or after your dental appointments. Here’s why:

  • Smoking of any sort interferes with the oral healing process. An abstract from February 2008 Journal of the American Medical Association noted that in one study, it was found that periodontal (gum) disease is linked to regular marijuana use—and it increases the risk.
  • When a tooth is extracted or when a root canal is performed, your gums are at risk of infection. It’s best to avoid anything that can prevent proper healing. Keep in mind that the things you need to avoid after your dental procedures aren’t limited to smoking. You will be given instruction for proper after care. The goal is to help you have successful, infection-free treatment.
  • The action of sucking or drawing from tobacco or marijuana cigarettes can dislodge blood clots. The smoke itself is harmful to the teeth and gums.

Sedation dentistry provides a low dose of anti-anxiety medication. It is not for daily, long-term use, but instead is taken before your dental appointment. Speak with your dentist about your concerns for the medication used to help you relax. He will answer your questions and discuss your options.

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

Rheumatoid arthritis and your teeth

A German study published in the Journal of Periodontology shows that there is a link between rheumatoid arthritis (RA) and your oral health. People with RA are eight times more likely to develop periodontal (gum) disease.

Rheumatoid arthritis is the result of an overactive immune system. Oral inflammation and infection can travel through the body and promote inflammation in the joints, making RA worse. Good oral hygiene can lessen the severity of RA.

A separate study published in the Journal of Periodontology shows that severe RA symptoms improve when people get oral and gum infections treated, and consistently maintain good oral hygiene at home. This starts with regular, deep cleanings at your dentist’s office.

Good oral hygiene at home must include daily flossing to keep gums free from the plaque buildup, which promotes gum disease. If you have difficulty using regular floss, experiment with different flossing methods including floss holders, floss threaders, or floss picks.

As it advances, gum disease loosens your teeth. If it is left untreated, teeth can fall out. Other studies also link gum disease to heart disease, diabetes, and stroke.

If you need assistance with maintaining good oral hygiene, your dental hygienist and dentist will offer suggestions and show you how to brush and floss for maximum benefits.

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

Bruxism – Teeth Grinding

Bruxism is the act of clenching or grinding your teeth. The problem occurs mostly at night, when most people are unaware that they have the habit. An estimated 8% of adults are teeth grinders, and 1/3 of parents report that their children have the habit.

What are the causes?

Exactly why bruxism occurs is not clear. But there are circumstances that make people more susceptible to it.

  • Anxiety and stress – People with nervous tension, anger, pain, or frustration can put forceful tension on their teeth. It is estimated that 70% of bruxism is related to anxiety and stress.
  • Sleep disorders – Snoring, obstructive sleep apnea, sleep talking, or aggression while asleep increase the likelihood that a person also grinds his or her teeth while asleep.
  • Lifestyle – Bruxism is much more common in people who use psychoactive substances (antidepressants, anti-anxiety medication, sleep aids, tobacco, caffeine, and alcohol).

What are the symptoms of teeth grinding?

  • Gum recession, abnormal wearing of the teeth, tooth pain
  • Neck pain, jaw pain, earaches, headaches
  • Jaw clicking or popping
  • Sensitivity in the teeth

Why seek treatment?

If teeth grinding is left untreated, the results can be damaging to your oral health and overall health. In addition to toothaches, headaches, and facial pain, your sleep can be affected. If the problem progresses, it can lead to tempormandibular joint (TMJ) disorder. Teeth can wear and break and require restoration.

Bruxism treatment

An occlusal split, or mouthguard, can be custom fit by your dentist for maximum effectiveness. The mouthguard moves your lower jaw forward to limit teeth grinding. It also relaxes the jaw, which in turn relieves jaw pain and soreness.

If it is suspected that teeth grinding is related to sleep apnea, a sleep study may be recommended. A sleep apnea machine (CPAP) or an oral appliance can be used to alleviate sleep apnea.

Behavioral approaches, including relaxation techniques, medication, or reducing stress factors in life may be recommended.

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

Chemotherapy and oral health

It is helpful to identify and treat dental problems before chemotherapy treatment begins. Gum disease cavities, loose fillings, broken crowns, and other dental problems can become worse during chemotherapy. When the immune system is weak or when white blood cell count is low, the risk of infection increases, and existing oral health issues can worsen. Chemotherapy can also prevent cells from dividing, which slows the healing process in the mouth.

Oral complications of chemotherapy

  • Dry mouth
  • Easy bleeding in the mouth and ulcers
  • Changes in taste
  • Inflamed mucous membranes
  • Tooth decay
  • Gum disease

 What you can do about it

  • Dry mouth – Drink plenty of water throughout the day. Use fluoride toothpaste. Tell your dentist about your health condition. He or she may recommend or prescribe mouth rinse or saliva-producing medication.
  • Easy bleeding and ulcers – Use a soft toothbrush to brush your teeth several times throughout the day, but avoid aggressive brushing. Rinsing your mouth with a mixture of salt water and 3% hydrogen peroxide can assist with healing of any sores in your mouth.
  • Changes in taste – This is often a result of dry mouth or damage to the taste buds. After your chemotherapy treatment is complete, your sense of taste may gradually improve in a few months.
  • Inflamed mucous membranes – Regularly rinse your mouth throughout the day. Keep your teeth clean, and use a soft-bristle toothbrush. Replace your toothbrush often. Your dentist may recommend a water-soluble lubricating jelly to keep your mouth moist.
  • Tooth decay – Gently floss between your teeth and gums daily. Use a soft-bristle toothbrush after every meal to keep your teeth clean. Keep your regularly scheduled dental appointments for examination and cleaning. If you wear dentures, clean them daily and keep them moist.
  • Gum disease – Floss gently, but regularly. Your dentist will recommend an antibacterial rinse. Keep your dental appointments.

Although it may be difficult, try to eat regularly and maintain proper nutrition. Avoid junk food and carbonated beverages, which can create additional acid in your mouth, reduce saliva production, and increase the amount of bacteria in your mouth.

Chemotherapy may affect your oral health in other ways. Maintain open communication with your dentist to ensure the issues are properly addressed.

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