Category Archives: 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


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.

3 Ways Getting Sedated at the Dentist Can Help You Get Rid of a Chronic Sinus Problem

What does getting sedated at the dentist have to do with a chronic sinus problem? If your sinus issue is related to a tooth infection, a dentist can help you get the relief you need.

The Tooth and Sinus Connection

According to a January 2019 article published in the online journal, MDLinx, chronic sinus infections are often caused or intensified by chronic tooth infections. A tooth infection can spread into your sinus cavity. Although you might receive antibiotics for a sinus infection, after you’ve finished the medication, the untreated tooth infection can cause the sinus infection to recur.

Maxillary sinusitis of endodontic origin (MSEO) is the medical term for a sinus infection that results from a tooth infection. Usually, the problem occurs with infection in upper back teeth.

What’s the Solution?

Your dentist will examine and x-ray your teeth. If there is an infection in your tooth, your dentist will remove it with root canal treatment. If the issue with your tooth is complex, your dentist might refer you to an endodontist, or root canal specialist.

The procedure cleans out the infected pulp (living tissue, including nerves) in your tooth—completely through the roots. Your dentist or specialist will fill your hollow tooth with dental filler material and seal it. Your dentist will protect the tooth with a dental crown. About half of all patients with MSEO who receive a root canal treatment also experience sinus relief and require no further care. If the thought of dental procedures increases your anxiety, your dentist can give you a mild sedative to help you relax.

What’s the Connection with Sedation Dentistry?

Let’s admit it. If you have a lingering toothache, you’ve probably delayed seeing a dentist for it. Dental anxiety is one of the main reasons that people delay, reschedule, or cancel appointments. Sedation can make the difference you need. How does it help?

1. Relaxes You

Photo of a young woman lying in a hamock on a beach as an exmaple of how sedation dentistry relaxes you.

There are varying levels of sedation available to match your anxiety level and the complexity of the dental procedure you will receive. Nitrous oxide (laughing gas) might be all you need to unwind, but if it’s not enough, your dentist can provide you with a mild anti-anxiety pill to take before your appointment. You won’t become anxious at the sights and sounds of dental tools.

2. Decreases Your Sensitivity to Pain

Your relaxed state will decrease your sensitivity to pain. You won’t be “on alert” for a slight pinch or other sensations that you might otherwise anticipate.

3. Helps Your Dentist Accomplish More

Sedation—your relaxed state—allows your dentist to focus on your dental procedure. Interruptions from anxiety attacks or pauses in treatment won’t be an issue. You’ll have a productive visit. And you won’t have to reschedule the appointment due to anxiety.

Which comes first—the sinus infection or the toothache? It could be the toothache, and sedation can help you get rid of both.

Dr. Miranda Lacy, a female dentist in Plano, TX, sponsors this blog. She is also a sedation dentist who can relieve you of anxiety and help you have pleasant visits.

Will Sedation Dentistry Make you Nauseous?

I’ve heard that dental sedation can make you sick. I’ve never had a reaction to any kind of medication, but I’m worried. Obviously, I don’t want to throw up at the dental office, but what I’m really concerned about is what happens when I go home. Is there a real risk of vomiting and choking while I’m still drowsy at home, or am I just overly anxious?

Thanks, Jordan


It might help you to have a better understanding of how sedation dentistry works.

Varying Levels of Dental Sedation

Head-to-waist photo of a brunette woman outdoors and stretching backward with her eyes closed; for information on relaxing with sedation dentistry from Plano TX female dentist Dr. Miranda Lacy.

Nitrous oxide. You’ve probably heard it referred to as laughing gas. Nitrous oxide is the lowest level of sedation. It is fast-acting, administered in the office, and wears off quickly. It works well for anxious patients and gives you a sense of well-being. Research shows that after receiving nitrous oxide for a medical procedure, nausea is not a concern for most patients. The risk of nausea increases with longer procedures. But dental-office procedures are usually short, so you will be less likely to have an issue.

The good news is that nitrous oxide wears off before you leave the office, so you won’t be drowsy when you leave the dental office. To minimize the chances of feeling nauseous, avoid eating a large meal before your appointment.

Oral conscious sedation. Your dentist will give you oral medication to take in advance of your dental appointment. Oral conscious sedation is often used along with nitrous oxide. The types of medication that dentists prescribe vary, from sedatives to anti-anxiety medication and even antihistamines. Your dentist will likely have a list of preferred medications to help patients relax. Nausea is a potential side-effect with many medications. You will likely be advised not to eat after midnight before your appointment. Your dentist will also recommend that you have an adult with you for the rest of the day as the medication wears off.

IV sedation. This highest level of sedation has similar side-effects as oral conscious sedation. It provides a deeper state of relaxation, but unlike general anesthesia, you will still be conscious. You will need to arrange for transportation to and from your dental appointment.

Minimizing the Risk of Nausea

If you don’t have a history of nausea with medications, you probably won’t have any issues with dental sedation. It is also worth noting that most cases of nausea don’t result in vomiting. You can minimize the risk by following instructions on whether or not you can eat before. You can speak with your dentist about your concerns, and he or she will explain what you can expect before, during, and after your dental procedure.

This blog is sponsored by Plano sedation dentist Dr. Miranda Lacy.

3 Things to Remember When Choosing a Sedation Dentist

You can schedule the appointment, but you also keep rescheduling it. You drive to the dentist’s office, but you can’t get out of the car. If anyone in the dental office comes near your mouth, you grab their hand. All of these factors likely indicate that you have dental anxiety or dental phobia. A sedation dentist can help.

If you really want to take care of your oral health, but dental appointments make you nervous, a sedation dentist can help. Don’t have one? Before you select a sedation dentist based on an online search or how close the dental office is to your home or office, there are three things to remember.

1. You need to like and trust the dentist

If you don’t like or trust a dentist in general, you probably won’t trust him or her to provide you with sedation before a dental appointment. Choose two or three experienced sedation dentists, schedule time to check out the office and meet the dentist and staff members. Pay attention to how they treat you and treat each other. If you’re comfortable, schedule an appointment for an exam.

2. What levels of sedation are offered?

There are three levels of sedation—nitrous oxide (laughing gas), oral
conscious sedation, and IV sedation. An option is chosen based on your anxiety level, the length or complexity of the dental procedure, and what levels of sedation the dentist offers. Find out which levels a dentist offers. Ask for details about how the dentist administers sedation and what you can expect. Also, ask about his or her training in sedation dentistry.

3. It gets better

Head-towaist photo of a brunette woman outdoors and stretching backward with her eyes closed; for information on relaxing with sedation dentistry from Plano TX female dentist Dr. Miranda Lacy.

Many patients who receive sedation dentistry find that over time, they are less nervous for future appointments. Some patients require sedation less frequently or are able to switch to a lower level of sedation.

Cooperate with your sedation dentist by sharing the history of your dental anxiety. Ask questions to learn about your options. Remember that it is possible to relax, keep your dental appointments, and maintain good oral health.

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