Category Archives: 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


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 bridgeThree 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.

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


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.

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


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.

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


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.

What Causes Pain After New White Fillings? And How to Resolve It

I need to find a dentist who is skilled at restoring cavities and who is willing to sedate me while I’m getting the work done. Although cavities haven’t been a problem for me in the past, it started after I had my baby in February 2019. Last July, I went to the dentist in severe pain. I had six cavities that the dentist filled at a second appointment. When I returned to the dentist in February of this year, I had two more cavities. One of the two most recent white fillings on a molar tooth is painful when I chew on it. My dentist checked my bite and said it looks good. She offered to remove the filling and replace it. She said that the tooth might have a crack, and she can x-ray it. If it’s cracked, I need root canal treatment.

I decided to wait and do nothing because I don’t understand why I’m having so many problems with my teeth. Meanwhile, the tooth with the possible crack hurts when I floss around it, and it hurts to chew on that side of my mouth. Within the past two weeks, when I’m chewing, I sometimes feel a dull pain in two of the first six fillings that I received. They are molar teeth also. I’ve had some post-partum stress, and this situation is making it worse. I didn’t have dental anxiety before, but I’ve decided that I need to switch dentists and find one who is willing to sedate me to figure out what’s happening with my teeth. I’m not sure if I need a cosmetic dentist, but I would like some advice on finding a dentist who knows if I have more cavities and how to do white fillings correctly.  Thank you. Gabrielle


Sedation dentistry can make getting new fillings easier

We understand your concern about your dentist’s technique with composite fillings. You described pain when you chew. When and where you feel pain will help a second-opinion dentist determine what’s causing the problem. Look for a dentist with training in cosmetic and sedation dentistry. Ask friends or family members for a cosmetic dentist—not a general dentist. If you don’t get any recommendations, search online, and read each dentist’s bio to determine if they have post-graduate training.

How to Resolve Pain After Getting Composite Fillings on Back Teeth

Pain when chewing, not clenching – Usually, pain while chewing results form improperly bonding the filling to your tooth. A cosmetic dentist with advanced training in composite fillings will remove the filling and replace it using proper bonding techniques.

Composite fillings on front vs. back teeth – Some dentists who place composite fillings don’t have advanced training in the technique. They rely on what they learned in dental school for placing composite fillings on front teeth. But the method for back teeth is not the same. It’s essential to find a dentist who has training in composite filling techniques.

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

3 Reasons to Be Concerned about PTSD and Teeth Clenching and Grinding

I suffer from PTSD, and for the past 4 years, I clench my teeth during the day and grind them at night. I have some neck pain and headaches that I think are related to my habit. I’ve had the same dentist since 2011, and he says my teeth look okay. But I’m starting to feel short spurts of dull pain in my lower molar teeth. My last exam and cleaning appointment was in mid-February. I’m afraid of the dentist anyway and need sedation for all my appointments. Now with the COVID-19 restrictions, I’m not going to any dentist. Besides, the office is only open for emergencies. I’m wondering if the dull pain and pressure on my lower teeth might be due to cavities or from teeth grinding. Is there anything I can do about this at home? – Thanks. Quinn from San Antonio

Quinn – We’re not sure why your dentist though your checkup appointment was good if you’ve been clenching and grinding your teeth for about four years. And you’re feeling pain and pressure in your teeth. That’s a problem.

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Sedation will help you relax throughout dental procedures

Dr. Lacy would need to review your x-rays and check your teeth and mouth. We’re concerned that your dentist didn’t thoroughly examine your teeth.

When you clench and grind your teeth, more than cavities and fillings are involved. Other oral health issues can arise, including

  • TMJ disorder
  • Gum disease
  • Poor occlusion

We recommend that you seek a second opinion from a dentist who will be more thorough. The pain you’ve described could be from gum disease or the trauma of grinding your teeth. In either case, you need an examination. Without an exam, gum disease can progress and lead to jawbone loss. Grinding your teeth will wear them away.

Your new dentist may be able to resolve your pain and discomfort with a custom night guard. It’s worth it to contact a new dentist and at least have a video conference to describe your symptoms. You’ll receive recommendations on what you can now and how to handle the situation before you see a dentist.

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

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

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


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

What Happens When Root Canal Filling Material Is Unprotected?

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

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

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

Do You Have Dental Anxiety?

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

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

Her Sinus Peforation Still Hasn’t Healed

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

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


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

What’s happening?

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

Will you need to be sedated?

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

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

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

3 Facts You Need to Know About Pain and Sedation Dentistry

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

What Is In-Office Sedation Dentistry?

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

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

What About the Pain?

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

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

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

Levels of Dental Sedation

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

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


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


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


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

Talk to Your Dentist About Sedation and Pain

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

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

5 Reasons Not to Be Afraid of Sedation at the Dentist

Isn’t sedation dentistry supposed to relieve your fear of the dentist? It does. But many patients are still nervous about receiving sedation. Consider five facts that can give you the confidence to move forward.

1. Your Dentist Is Trained

State dental boards regulate the practice of sedation dentistry. If your dentist administers it, he or she has completed training to do so. Ask your dentist about his or her training or certification in administering sedation. You can also increase your comfort level by asking how many sedation patients your dentist has seen. Your dental team is CPR (cardiopulmonary resuscitation) trained, and your dentist has received training in Advanced Cardiac Life Support.

2. Communication Helps

You won’t be given sedation without your consent. In advance of your dental procedure, your dentist will explain what to expect before, during, and after the appointment. You will still be conscious and able to respond, answer questions, and speak to the dental team.

3. You’ll Never Be Left Alone

During your dental procedure, a staff member will be with you. If you’re afraid of a medical emergency or some other event that might endanger your health, let it overwhelm you. The dental team will monitor your vital signs throughout your appointment, and you will not be left alone in the treatment room.

4. Your Health History Will Be Reviewed

Be certain to let your dentist know your medical and dental history, including prescription medications. Your dentist will ensure that the sedative you receive will not conflict with any of your current medications.

5. Other Benefits than Being Drowsy

Sedation dentistry has several benefits that result in a better dental visit.

  • You’ll feel relaxed and have a sense of well-being.
  • It decreases your sensitivity to pain.
  • It prevents you from recalling what happened during your dental appointment.
  • While you’re relaxed, your dentist will be able to complete more work than it is possible to complete without sedation.
  • You can ask for sedation for dental cleanings, root canal treatment, and cosmetic work. Regardless of how simple or quick your dental procedure is, sedation can help you relax and get the care you need.

No Pressure

You don’t need to commit to sedation right away. Schedule an appointment to speak with your dentist about it. The consultation can include:

  • Discussing the cause of your anxiety
  • Learning about the types of sedation your dentist offers, as well as which medication will be used
  • Asking questions that will help you understand the process and what you can expect

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