Tag Archives: sedation dentistry

Sedation Dentistry

Root Canal Issue Seems Like It Will Never End

I am concerned about a root canal issue that seems will never end. Last November, my dentist filled a small cavity. But the tooth became sensitive to cold on and off. My dentist said I needed a root canal and a crown. He completed treatment, but my dentist had problems getting the bite correct. I was beginning to get jaw pain and earaches. The tooth settled down a bit but was still a little sensitive.

Within the past two weeks, the sensitivity increased. When I visited the dentist last week, he said he might need to repeat the root canal. But I am five months pregnant now and need another X-ray. And I am a little frustrated because it delayed my teeth whitening appointment. How do I know if I need repeat root canal treatment? I don’t know if I can get through the work without sedation. It’s so frustrating. Thanks – Nakia

Nakia,

Although Dr. Lacy would need to examine your tooth and crown, we are concerned about your dentist. It is unusual for a small cavity to end with an infection and root canal treatment. And your dentist has been unable to resolve tooth sensitivity completely.

From Small Cavity to Root Canal Treatment?

When a dentist tells you that they filled a small cavity, but the tooth soon needs root canal treatment, the dentist’s diagnosis is incorrect. The cavity must have been large, or your dentist missed signs of infection.

Tooth Sensitivity After a Filling and Crown

A tooth infection may be causing the sensitivity. But your dentist may have made a mistake while placing the filling or during your root canal treatment.

Dental X-rays During Pregnancy

We understand your concerns about exposing your baby to X-ray radiation or chemicals during pregnancy. But dental X-rays emit low radiation. So, you can review the American Dental Association’s recommendations about dental care during pregnancy. But if you have a tooth infection, it can potentially spread into your bloodstream and become more serious.

If you are skeptical about your dentist’s care, we recommend finding an advanced cosmetic dentist. The dentist will examine your tooth to identify the cause of sensitivity, jaw pain, and earaches. The dentist will also determine if you have a tooth infection and need to repeat root canal treatment. Although the process delays teeth whitening treatment, it is best to resolve it now than have the issue recur or worsen during pregnancy.

Based on your medical history, talk to your obstetrician and dentist about safe sedation options during pregnancy.

Best wishes for a quick resolution.

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

Sedation Dentistry

I Think My Dental Implants Are Failing

I think my dental implants are failing. My 2021 full-mouth reconstruction included implants, crowns, and veneers. I think several of the implant teeth are infected, and two crowns have fallen off. My gums are swollen, and it hurts to chew. Unfortunately, the dentist relocated, and I cannot find a current listing for him. I am concerned that another dentist must replace my implants and that I will need a repeat full-mouth reconstruction. I do not know where to begin, and my anxiety level is increasing because I am afraid that I will need implant surgery again and who knows what else. – Thank you. Vadim from IL

Vadim,

We are sorry to hear about your horrible experience. You certainly do not want the dentist doing additional dental work for you.

Infection Around Dental Implants

Infection around dental implants is peri-implantitis, a form of gum disease that can lead to dental implant failure. Signs and symptoms of infection include:

  • Bad breath or a bad taste in your mouth
  • Bleeding around the implants
  • Difficulty chewing
  • Loose implants
  • Pain, aches, or discomfort around the implant
  • Pus around the implants
  • Red or puffy gums
  • Visible implant threads

Treatment for Infection Around Dental Implants

Depending on the extent of the infection around your dental implants, treatment options may include:

  • Antibiotics
  • Antimicrobial therapy
  • Laser therapy for your gums
  • Surgery

Find a Skilled Implant Dentist

Yes, you need to find a new dentist. But look for a dentist with advanced implant training or who partners with an oral surgeon or periodontist to complete implant surgery. A highly trained implant dentist or surgeon will explain your options. You can also discuss your anxiety level and ask about sedation options to keep you relaxed throughout the procedure.

Man on beach portraying sedation dentistry, available form Plano, TX female dentist Dr. Miranda Lacy
Sedation can help you relax throughout dental procedures

It is essential for your new implant dentist or surgeon to perform a 3-D x-ray (CT) for a detailed view of your jawbone and oral anatomy and identify the cause of the problems with your dental implants. Please only trust providers who are willing to perform a CT scan.

Best wishes for a smooth recovery.

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

Sedation Dentistry

Should I still have intense pain after a tooth extraction?

On April 2, my dentist extracted an upper left root canal tooth that broke. She sectioned the molar into sections to make the extraction easier. Since the extraction pain somehow refers to my lower and spikes in the afternoon through the evening. The side of my face feels numb, and I feel pain in my ear. Why is the pain intense in my jaw when the upper tooth was extracted? And why is it lingering weeks after the extraction? I called my dentist, but she is prescribing pain relievers, which do not help. Should I see another dentist before my anxiety gets worse? Thank you. Alana from NY

Alana,

Although the pain you describe is not unusual after a tooth extraction, it should not linger more than a week. If you have felt pain for three weeks, something is wrong.

Lingering Pain After Tooth Extraction

Pain after tooth extraction can linger for several reasons, but a dry socket or an infection is most likely. Although Dr. Lacy would need to examine and x-ray your extraction site and the area around it, the source of pain might be near the extraction.

  • Dry socket – This painful condition results when the blood clot at the extraction site dislodges. Without the blood clot, nerves and bone are exposed, causing intense pain.
  • Infection – Bacteria can enter the extraction site and cause inflammation and pain.

Antibiotics for Lingering Pain

If you have an infection, antibiotics will help. Although the extraction was for an upper molar tooth, pain can refer to your lower law. Never pressure can cause you to feel numb.

What to expect – A dentist may begin treatment with a strong antibiotic like clindamycin and follow-up to see if you feel improvement. If you do, you should continue the antibiotic three to four days after all your symptoms are gone. But it would be best to get an examination before treatment.

Get a Second Opinion If Necessary

If you are not comfortable returning to your dentist for an examination, schedule an appointment with an experienced dentist right away. Otherwise, the infection will continue to spread—possibly affecting other teeth and putting them at risk. You can ask about sedation options to help you relax.

Sedation Options

You can ask about sedation options to help you relax. Nitrous oxide or oral sedation are two forms of sedation that may work depending on your anxiety level.

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

Sedation Dentistry

Can I Trust My Dentist to Get My Crown Color Right This Time?

I fell in August and broke three upper teeth, including one front tooth. And I broke a lower front tooth. I did not like the dentist I had at the time, so I chose another dentist. I was so traumatized that they had to give me sedation even before an exam. The dentist did root canals and crowns on all my broken teeth. The crowns were the wrong color and tooth thick. Then he tried again with only slight improvement.

Now the crowns look light gray instead of almost medium gray. It is still unacceptable. The dentist said he could try again, but he does not sound confident. Also, my anxiety is increasing. Even though he sedates me, I am anxious about being sedated because I do not know how my crowns will look.  Is it worth giving my dentist another chance? Thank you. Cailia from Idaho

Caila,

Dr. Lacy would need to examine your crowns to identify the issue. Although you have not told us what types of crowns you received, you say they look gray. We guess that you have pure ceramic crowns with metal posts and cores to reinforce the insides of your broken teeth. In that case, the metal is showing through the crowns and making them look gray.

The issue is that your dentist does not know enough about cosmetic dentistry to give you crowns that fit your mouth, are not bulky and match your natural teeth.

How to Prevent Dental Crowns from Looking Gray

A dentist with advanced cosmetic dentistry training understands how to prevent ceramic crowns from looking gray. Three approaches include these steps:

Composite core

  • Perform root canal treatment
  • Insert a fiberglass post in each tooth
  • Add a composite core close to the color of your natural teeth

Metal core

  • Bond composite over the metal to block the color
  • Bond the crown over the opaque layer

Opaque the crown enough

Another alternative is to give the laboratory technician instructions about metal core color and extent and ask the tech to opaque the crown enough to conceal the metal.

Get a Second Opinion

Woman's face with her eyes closed while she receives dental work
You can relax with sedation and dentist you trust

An expert cosmetic dentist understands color manipulation and how to give you crowns that look natural. After two attempts from your dentist, we recommend that you find another dentist to replace your crowns and get them right.

Schedule a consultation first to ensure you are comfortable with the dentist. Although you probably still need sedation during crown replacement, you can have confidence that a cosmetic dentist will resolve the problems with your crowns.

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

Sedation Dentistry

My dentist pre-ordered a crown, but my Repeat root canal may fail

My dentist took the crown off an abscessed molar and did a second root canal on the tooth. I had my first root canal in 2013. After the root canal, I had an ongoing infection for six weeks. My dentist referred me to an endodontist who got rid of the infection, but he told me not to wear a crown for a few months. I decided that if the tooth gave me any more problems, I would have sedation and an extraction. My dentist ordered a new crown, which I paid for half in advance. I asked for a refund because the specialist told me not to get a crown for a while, and I want to see if the tooth will last. But my dentist’s office will not refund me. Am I unreasonable? – Lola from SC

Lola,

Your request is polite and reasonable. It is not wise to crown a root canal tooth until you know treatment is successful. And the specialist recommended that you wait, too. Some root canal treatments fail the first time. But this is the second treatment for your tooth. So, the risk of failure increases. And your next appointment may be for sedation and extraction.

Getting a Refund for a Pre-Ordered Crown You May Not Need

Woman's face with her eyes closed while she receives dental work

Your dentist did not necessarily do anything wrong with your root canal procedure. But it is fair for him to be responsible for ordering a crown without knowing the treatment results. Your dentist should be aware of the risks of repeat root canal treatment and be willing to refund you for the crown and all fees.

You can contact your dental office again and ask to speak with your dentist. If that doesn’t work, you can schedule an appointment with your dentist to examine the tooth and use the time to talk about your concerns. Other options are to report the issue to your insurance company or the state dental board or file a case in small claims court. Or a call from an attorney’s office might work, too.

Miranda Lacy, DDS, a Plano, TX female dentist, sponsors this post.

Sedation Dentistry

New cavities after pregnancy and my fillings hurt

I am writing about an increase in cavities and pain after new fillings. My third child was born in December 2020. And within a few months, I began feeling severe pain whenever I ate anything sweet. When I went to the dentist, she found two cavities. My dentist placed composite fillings. In March, after my dental appointment, my dentist found four more cavities. Two fillings are fine, but I still have pain when chewing with the other two.  My teeth ache sometimes. My dentist checked by bite, which she says is fine. She offered to replace the fillings. And she mentioned that the teeth might be cracked. Why would formerly healthy teeth be cracked? I had no issues before delivering my baby in December, and now I have multiple cavities that seem to be increasing. I brush my teeth at least twice daily and at least once daily. Why is this happening? Do I need to find a dentist who specializes in fillings? But aren’t fillings basic treatment? My anxiety is increasing with so many dental appointments. Thanks in advance for your suggestions. Kashvi from GA

Kashvi,

Although filling teeth is not a specialty, your dentist’s technique with composite fillings might be faulty. Dr. Lacy would need to examine your teeth and fillings, but we can offer some insight.

Pregnancy and Cavities

Pregnant women can experience tooth decay and cavities for several reasons:

  • Hormonal changes – As your hormones fluctuate, it can increase the risk of gum disease. And gum infection can promote tooth decay and lead to more cavities.
  • Increased eating – Some women eat more during pregnancy. Frequent eating or snacking increases bacteria on teeth and promotes decay. Rinse your mouth well after eating and brush your teeth more frequently—but not excessively.
  • Morning sickness – Stomach acid from vomiting can erode tooth enamel. Rinse your mouth well and drink plenty of water.

Pain When Chewing on a New Filling

If you have pain when chewing—not biting—on a new filling, it is usually a problem with how the dentist bonded the filling. Your pain will probably resolve if a dentist removes the fillings and bonds them properly. But take care of it promptly. Pain when biting on a new filling would have a different cause.

Pain with Multiple Tooth Fillings

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

When multiple tooth fillings are painful, your dentist does not understand how to place or bond the filling completely. Amalgam fillings are easier to place than white fillings and require less skill. But composite fillings require advanced training to place and bond so they will last without causing discomfort.

Many dental schools still teach students to place amalgam fillings on back teeth. After dental school, a dentist must pursue continuing education to understand composite bonding and do it well. But some dentists try to use the techniques they learned for amalgam fillings when placing composite fillings. And it just does not work.

Schedule a Second Opinion

Look for a cosmetic dentist with advanced cosmetic dentistry training. Check a few dentists’ websites for their credentials. After a consultation and examination, a cosmetic dentist will explain your options for replacing or re-bonding your fillings and relieving your pain. If your anxiety level remains high, speak with the dentist about your options for sedation.

Miranda Lacy, DDS, a Plano, TX female dentist, sponsors this post.

Sedation Dentistry

How much does sedation dentistry cost?

Can you tell me how much sedation dentistry costs? I have put off dental work for some time, knowing that I have severe decay. I have delayed going to the dentist because I did not have dental insurance for years. And although I got dental insurance in September of last year, I did not make a dental appointment due to anxiety. I’ve had three dentists over my lifetime, and two of them had poor patient care and were unnecessarily rough. I always left appointments in pain regardless of the procedure. Last weekend I fell and cracked a tooth. The crack doesn’t look that bad, but my tooth hurts. The pain throbs on and off. I think that I can make a dental appointment if I get sedated, but I would like to know how much it costs. If sedation is expensive, I can save money from each paycheck over the next two months. Thank you. Amit

Amit,

Thank you for submitting your inquiry to our office. Your throbbing tooth pain is a symptom of internal tooth damage. See a dentist promptly for an examination.

Although sedation dentistry fees vary and you must speak with your provider for exacts costs, we can provide estimates.

How Much Does Sedation Dentistry Cost?

The cost of sedation dentistry depends on several factors, including the type of sedation you receive, the length of your dental appointment, and where you live in the U.S. because dental fees vary by location throughout the country.

Types of Sedation

Although dental offices vary with the sedation services offered, the types of sedation available include nitrous oxide, oral conscious sedation, and IV sedation. Many dental offices do not offer sedation at all, but others provide at least one option. The costs below are estimates. Call your dentist’s office to ask what type of sedation is available and how much it costs.

Sedation Dentistry with Nitrous Oxide

Nitrous oxide, also known as laughing gas, is the lowest level of sedation.  You breathe in nitrous oxide through a small nose mask during your dental procedure. After the procedure, your dentist will give you pure oxygen to breathe in and quickly reverse the effects.

How much does nitrous oxide cost?

The average cost of sedation dentistry with nitrous oxide in the U.S. is $80 to $150 for the first hour. Your dentist may charge an additional fee if you require nitrous oxide longer than an hour.

Oral Conscious Sedation

Oral conscious sedation is in pill form. Many dentists use the medication Halcion (Triazolam), while others may offer diazepam or lorazepam for sedation. You will take the medication before your dental appointment so that you can arrive relaxed.

How much does oral conscious sedation cost?

The average cost of oral conscious sedation in the U.S. is $250 to $500 per hour. If you need to remain sedated beyond an hour, you may incur an additional fee.

IV Sedation

Intravenous sedation works faster than nitrous oxide and sedation dentistry. The amount of sedation your dentist gives you can vary from making you drowsy to putting you in a deep sleep.

How much does IV sedation cost?

Although the depth of sedation affects the cost, on average, in the U.S., IV sedation costs $500 to $1000 per hour with an additional fee beyond an hour.

Will Insurance Cover the Cost of Sedation?

Woman's face with her eyes closed while she receives dental work
Ask your dentist’s office about sedation dentistry fees and contact your insurance provider about benefits

Each insurance plan differs. Contact your insurance provider and ask if they provide benefits for sedation dentistry. Most insurance plans that offer sedation benefits have restrictions on the length of time coverage is provided for a procedure. For example, an insurance plan may provide benefits toward the first hour of sedation only.

Your dentist’s office will explain sedation dentistry fees and how long you will need sedation during your dental procedure.

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

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

Ezra,

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 bridge – Three 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.

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

Danni

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.

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

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.