Tag Archives: sedation dentistry

Effects of Tooth Roots Left Behind After Extraction

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


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.

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.

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.

I am still nervous after nitrous oxide at the dentist

Am I a candidate for sedation dentistry? I have a really embarrassing fear of the dentist. My current dentist is really nice but every time I have to go I get so nervous I shake and I am sometimes literally sick. I’m afraid I’m going to need a cavity filled or something. My dentist before wasn’t that nice. When I leave this dentist everything is fine but when it’s time for the next appointment I start freaking out again. They say it gets better every time you go. But it hasn’t for me. Any tips? I have another apt in 2 weeks and I want to prepare myself for a better visit. I am asking about sedation because my dentist only uses nitrous and it doesn’t help at all. I am still nervous after I receive it. Thanks Brendon

Brendon – Bad dental experiences are a source of fear and anxiety for many patients. It is good that you have found a gentle dentist. You may be a candidate for a higher level of sedation dentistry. Your medical history will need to be reviewed first.

To start, tell your new dentist about your fear and the reason for it. He or she will pay extra attention to the things that make you particularly nervous. Sometimes, a more thorough explanation of the procedure, and what to expect during and afterward will calm you.

You can take an I-pod and listen to music to distract you from the dental procedure. Or, some dentists have televisions in the treatment room.

If you are very anxious, you may need a dentist who uses higher levels of sedation than nitrous oxide, such as as a small amount of anti-anxiety medication that you take in advance, or IV sedation. Dentists vary in the type of sedation dentistry they offer. Not all dentists provide sedation for their patients.

Sedation dentistry completely relaxes you so that your dentist can complete your treatment while you are free of anxiety.

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

Any problems with taking Xanax before a dental appointment?

I’m sure that my question about taking Xanax before a dental appointment pretty much tells you how much I hate dental appointments. I already have a prescription that I use as needed. So I am thinking that taking the medication before my appointment is probably a good way for me to chill and get the work done. Two of my crowns need to be replaced and although I don’t anticipate having a whole lot of pain I am still nervous. Is there any problem with taking a Xanax before my appointment? I haven’t found a new dentist. My last dentist was a woman so I am again looking for a female dentist who also does sedation. Interestingly I have found that two of my previous male dentists were not sympathetic to my anxiety. Maybe it’s because I am a guy. Who knows.  If Plano wasn’t so far I would try your dentist. I don’t think it will be too hard to find one, though. I am rattling on. Thanks for answering my question about Xanax. – Gene

Gene – Before any patient is given sedation dentistry, his or her dentist will carefully review prescription and medical history. Be sure to let your dentist know that you already have a prescription for anti-anxiety medication and let him or know the type of medication. Since your medication that works well for you, it won’t hurt to take it in advance of your dental appointment.

Dental anxiety is common among millions of Americans. It’s good that you are willing to make an adjustment so that your anxiety won’t prevent you from maintaining good oral health.

Many dentists focus on catering to anxious patients. The dentist and staff ensure that you have a good dental experience. Remember that you will need to arrange for transportation to and from your dental appointment.


This post is sponsored by Plano, TX dentist Dr. Miranda Lacy. Dr. Lacy is a female dentist who provides sedation dentistry to help patients relax.