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Decision time

K

kittiwake

Junior member
Joined
Mar 10, 2011
Messages
6
Location
UK
I hadn't been to the dentist for years, but recently was forced to go due to an abscess. I suffer from anxiety anyway, but have always been scared of dental work despite having undergone a lot of treatment over the preceding years. Anyway, the dentist (private) turned out to be excellent and I have managed to have deep cleaning, all my fillings replaced and a few of the RCTs redone. I felt proud.

The trouble is that the final part of the dental work is some upper incisor extractions (currently crowns on posts) then a big decision. But I've about reached the point where my anxiety is flaring up badly due to having over 10 appointments in the last 2 months - I've reached my limit stress-wise and it's affecting the rest of my life. The teeth currently have a temporary bridge on them and I'm under intense pressure to decide on the proposed treatment plan as the extractions are urgent apparently.

So I WILL have the extractions in spite of the fear, but the rest of the treatment plan is 2 years of very complicated orthodontics to get everything straight, including periods when I will have missing teeth in front. I also have an anterior open bite and am told that it will cause big problems later if I don't get it sorted (just to prod my anxiety a bit more). :(

Altogether this will relieve me of over £11,000, much of it up front. I've already spent over £5k this year that I hadn't budgeted for... :o

The dentist is reluctant to do a compromised treatment as he is a perfectionist, but I think I'll probably die of stress if I have to keep going to the dentist every 2 weeks for 2 years or more, plus the discomfort of ortho work. I'm not sure I can go the distance. I feel trapped.

I'm in my 40s and just want to be healthy - aesthetics aren't the top priority.

He has stated that he will very reluctantly do just the bridgework as is, but it feels like he would be offended if I don't agree to the ortho as he has done a lot of diagnostic work already. I don't want to ruin the relationship.

We have already had a long talk about it. I came out of there thinking "yeah I can probably do this", but as soon as I got home I thought "Pain + stress + £11k - what the hell are you thinking, woman?!". ;D

Any thoughts?
 
I don't see why orthodontics would necessarily have to involve pain and I can guarantee that for most people so long as you like your dentist, the more you go along, the more quickly the fear lessens.
However I am concerned that fear is being used as a lever to get you to complete an expensive treatment plan that you are unsure about.
If I were you, I would get a second opinion just for peace of mind.
I'd be concerned about extracting any teeth unless absolutely necessary.

A lot also depends whether you can afford this sum...over 5 years it sounds more reasonable if optimal care is a priority for you. Optimal care is usually what a dentist would do in their own mouth.

Functional dental health is not the same as cosmetic perfection but if you have to do major restorative anyway, you may as well make it look pleasing (even if not perfect) so long as this does not involve compromising more tooth structure than the less invasive option.
 
Thanks for your quick reply Brit.

I agree that the more you see a good dentist the easier it gets, but having had 3 appts per week for a couple of months it got a bit overwhelming.

I just assume braces will hurt because most things I've read say they do. I also get lichen planus flare-up every few years and so I know that will hurt if it coincides with treatment. He wants to use invisalign (hence the up front costs) as it will conceal the missing teeth. But is also saying that if I commit to the treatment, I have to agree to give him a free hand in making any changes to the plan along the way otherwise he'd rather not be involved. He mentioned possible mid-course correction, further extractions etc plus metal braces after the invisalign because there are elements that won't be corrected by that alone. Then there's grinding teeth down to correct the bite.

He says the three incisors have to come out as there is significant bone loss (one with a failed apicectomy from years ago) and he keeps saying all three are unpredictable and could abscess at any moment, hence the urgency. :(

I do trust him but am having trouble committing to a plan with so many variables. Is it normal to be presented with a plan with such conditions?
 
Is he an actual orthodontist? If not go and see someone who is. Check they are on the GDC specialists register for orthodontistry.
General dentists dabbling in complex ortho is not a good idea and I do find the pre-conditions strange tbh.

I still think it is second opinion time before you extract those two teeth. So what's the rush, if they abcsess then extract them...it's all just a theoretical risk.
 
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