Unexpected Gratitude. . .

chickenjen said:

I'm chiming in on the TMJ issue. I have had bruxism since I was a child.....one of the few times I went to the dentist as a child....they noticed the wear on my teeth.
Believe it or not, I first knew about my TMJ when I was taking singing lessons (I'm a semi-pro musician). My teacher, who ALSO had TMJ, brought it to my attention when she noticed how I was opening my mouth to sing. My current dentist says I have TMJ....but so far has not addressed the issue.
There are times when I can't open my mouth wide enough to take bites out of a flattened sandwich, so I resort to cutting it up into minute pieces that I can handle.
Yes, a nightguard is in your future since you have bruxism. It's a clunky piece of plastic specially fitted to your bottom teeth. It takes a bit getting used to it, but helps save your teeth at night. I also grind during the day, so my dentist is trying to come up with ways to help me through that issue, since you can't wear the guard during the day.
Wishing you all the best!!!!

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My non-phobic husband was diagnosed with nocturnal bruxism a few years ago and wears a night mouthgard, so unlike a lot of people, I wasn't offended when Dr. Yes told me at my first appointment that my teeth showed evidence of the same thing. . .although wearing night mouthgards isn't exactly the kind of marital togetherness I usually have in mind! Because we share our home with companion rabbits (who must eat hay and gnaw other chewables to keep their ever-growing teeth trimmed), I like to think that when we're asleep, we're just imitating our rabbits by grinding our teeth down!

So far, I don't grind during the day but occasionally clench. When I catch myself clenching, I stop. . .but do I always catch myself? That is the question.

I hope your dentist or another healthcare professional addresses your TMJ, especially since it may come to interfere with your vocal training and performing. One of my aunts has TMJ and at least used to take regular Botox injections to treat it. . .yikes! I think I'd only submit to Botox as a last resort.

Thanks for reading and commenting!

iDent,

So glad you called Dr. Yes today! I hope that the call put your mind at ease at least a bit. In terms of pain in your other tooth, I have been told that referred tooth pain is very common. Prior to each of my RTCs the endodontist asked me if I had any other dental work done recently b/c the pain in one tooth could have easily been from another. Also, prior to the second RCT, when the endodontist tested the tooth in question, he also tested the one next to it. This tooth also tested as quite sensitive, but calmed down after the RCT on the problem tooth. It was totally healthy. I think sometimes, when one tooth is irritated, it can cause general irritation all around.

If you do end up needing RCT, hopefully Dr. Yes will be able to give you a referral to an endodontist he trusts and has referred patients to before. I'm fortunate that, though for each of my RCTs I've had to adjust to a new provider, my dentist has an endodontist who comes to his office a couple of times a week to see patients there. So, at least I didn't have to adjust to new surroundings. And, the endodontists (both times it was someone different), have both been really great and super understanding of my fears.

But, it probably doesn't make sense to worry about something that likely won't even need to happen. Please let us know how things go on Wednesday. Until then, take good care!

iDent said:

My non-phobic husband was diagnosed with nocturnal bruxism a few years ago and wears a night mouthgard, so unlike a lot of people, I wasn't offended when Dr. Yes told me at my first appointment that my teeth showed evidence of the same thing. . .although wearing night mouthgards isn't exactly the kind of marital togetherness I usually have in mind! Because we share our home with companion rabbits (who must eat hay and gnaw other chewables to keep their ever-growing teeth trimmed), I like to think that when we're asleep, we're just imitating our rabbits by grinding our teeth down!

So far, I don't grind during the day but occasionally clench. When I catch myself clenching, I stop. . .but do I always catch myself? That is the question.

I hope your dentist or another healthcare professional addresses your TMJ, especially since it may come to interfere with your vocal training and performing. One of my aunts has TMJ and at least used to take regular Botox injections to treat it. . .yikes! I think I'd only submit to Botox as a last resort.

Thanks for reading and commenting!

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I relate to the clenching........I do catch myself at times, but, like you, do I catch myself ALL the time.....I doubt it.
My dentist was going to prescribe a short course of Valium for the night time clenching, but I objected, at least for now. I take many prescription medications for other conditions......and I really didn't want to take another. Plus, taking Valium for a period of time scared me a bit.
A friend of mine had stopped smoking using a licensed medical hypnotherapist.......I might try that route first.
's.

Unexpected Gratitude: Part VIII

May Mercy Season Justice

When very nervous and forced to sit in waiting rooms, I've had a practice of engaging in rapid-fire free association since childhood:

Root canal
Cities with canals
Panama and Venice
The Merchant of Venice
The quality of mercy

Since speaking with Dr. Yes near noon on Monday, my mouth has come to resemble a low-budget mutant movie with too many sequels. By late Monday night I am no longer reasonably certain this is only TMJ redux, and by Tuesday I am researching endodontists on the internet. Since my husband has not yet had the pleasure of RTC, on Tuesday evening I call my parents, who between them have undergone at least six root canals. Neither one is an odontophobe; my father, whose first encounter with RTC was in the 1980s, says that from his perspective, things have improved over the years.

Wednesday, the day of my appointment with Dr. Yes, is a calendar-worthy first: I am in so much pain that I am actually looking forward to a dental appointment, because I hope it will mean an injection from The Wand!
Once in The Chair, I confess my suspicions to Dr. Yes, who confirms them after a brief examination. We are both disappointed at the development of late-stage infection, because things initially went so well. I blame the quantity of raspberry lemonade I drank on an abnormally hot July 4th, as I don't regularly drink sugary drinks. Although I tried to be careful and rinse my mouth periodically, did all the sugar create a breeding ground for bacteria? Dr. Yes, who dedicated an exceptional amount of time and skill to a difficult-access tooth only to have this happen, is about to leave on vacation: after this, he deserves it more than ever!

I know Dr. Yes refers his patients to an endodontic practice in the Architecturally Significant Medical and Dental Shrine, which I will call ASMDS Endodontists, and I have the names of two other practices that, like ASMDS Endo, also have good reputations. My one reservation about ASMDS Endo is strictly internet-based. I consider myself an above-average internet researcher, and absolutely could not find a practice website. In the 21st century, I find it somewhat hard to trust a professional practice that doesn't have a good website, much less any website at all! What I tell Dr. Yes (and this is also true) is that I brought the names of two other practices in the event that ASMDS Endo cannot accommodate me today, because after nearly a week, I do not want to live in pain any longer: one of the practices I found online appears to guarantee same-day service.

Dr. Yes's dental assistant informs me that ASMDS Endo can give me an appointment within two hours. Considering this and the fact that Dr. Yes says he has referred to them for years, I decide to trust his judgment. I admit I'm not accustomed to selecting healthcare providers this way: normally I'd combine Dr. Yes's recommendation with my findings, research everyone on the list, and make my own final decision. But time is of essence, and I don't want Dr. Yes to think I don't trust him. Aside from the fact that I'm a healthcare control freak (yes, I admit it) biased toward practices with good internet presences, there's no reason for me not to go to ASMDS Endo.

Filling out paperwork in the ASMDS Endo waiting area, I debate about whether to tell the office staff that I'm phobic. Did Dr. Yes's office send a warning? Sometimes my mind goes into what I call "brain ricochet," where I just cannot decide whether I should or should not do something. . .it's part of one of my anxiety disorders. Eventually, I realize this: in endodontists' offices, maybe everyone is presumed to have dental phobia.

Finally, my name is called. It's a good thing that I've never seen The Marathon Man.

After I am settled in The Chair, I receive unexpected news: all along, Dr. Yes has not been working on my second molar, but my third (wisdom tooth). Hope, his office manager, has great interpersonal skills, but is not always as adept with paperwork details. The documents she gave me weeks ago indicated that I needed work on #15, not #16, and all this time he's been working on #16. The good news is this means Dr. Yes is so skilled with The Wand that I couldn't tell! The bad news is that #16 will be harder to treat, and may have a lower success rate. Why save a wisdom tooth? Because years ago, I lost #14 to decay, breakage, and abscess. As long as I have #16, I don't miss #14.

Meet your endodontist! Mine, whom I will call Dr. Endo, has the personality of a calm and friendly GP, but of course she's a skilled specialist. She asks me what I've heard about root canals, and I reiterate what my father said: better than they used to be.

Considering the nature of this forum I will spare everyone the details, except a few:

• Unlike Dr. Yes, Dr. Endo does not use The Wand. Although I don't have needle phobia, the three injections, especially the second, are painful. However, they are effective! Except for the injections themselves, I really don't feel a thing.

• Twice during the procedure, Dr. Endo says things that make me laugh. While I appreciate her sense of humour, I don't want to laugh when I have a mouth full of dental tools!

• The worst thing for me about RTC? Allergies. I already had minor allergy/sinus symptoms when I awoke in the morning, and they worsen about halfway through, making it harder to breathe.

• As others have written before me, the entire RTC process, while not enjoyable, is not nearly as terrible as its reputation. As always, keep your mouth open and your eyes closed!

The quality of mercy is not strain'd,
It droppeth as the gentle rain from heaven
Upon the place beneath. It is twice blest:
It blesseth him that gives and him that takes.

To be continued. . .

Did your dentist confirm that it was actually decay that caused you to need a root canal??
When I had my toothache in May, my dentist took an X-Ray, confident that I had probably fractured the tooth. When nothing abnormal showed up, he could only deduce that I had pulpitis caused by my bruxism. My constant grinding (and it must be during the day, because I wear my nightguard pretty regularly) had irritated the nerve to the point of no return.
I, too, could not wait for my dentist appointment. I couldn't eat, talk or sleep for 3 days because of the pain, my toothache happened on a Friday evening.......had to wait til Monday to seen by my dentist.

chickenjen said:

Did your dentist confirm that it was actually decay that caused you to need a root canal??
When I had my toothache in May, my dentist took an X-Ray, confident that I had probably fractured the tooth. When nothing abnormal showed up, he could only deduce that I had pulpitis caused by my bruxism. My constant grinding (and it must be during the day, because I wear my nightguard pretty regularly) had irritated the nerve to the point of no return.
I, too, could not wait for my dentist appointment. I couldn't eat, talk or sleep for 3 days because of the pain, my toothache happened on a Friday evening.......had to wait til Monday to seen by my dentist.

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The decay is my own speculation, as Dr. Yes did not take any new x-rays himself. First he visually inspected the area, then found that I had a highly-positive percussion examination. The only new x-rays were taken by Dr. Endo, whom I didn't ask.

It's possible that bruxism may have been a culprit, since my jaw pain was often (but not always) worse after a night's sleep. What made me blame the July 4th raspberry-lemonade binge is the fact that I was in pain but seemed to be gradually recovering until the evening of July 5th, when the pain changed from a consistent dull ache to alternating bouts of something sharper and stronger.

Regardless of the cause and the obvious setbacks of additional pain and expense, there may be some silver linings: first, I learned that RTC probably only deserves 30% of its negative reputation. Due to the length of the RTC procedure, I think I learned to breathe a bit more regularly in The Chair, at least until my allergies/sinuses rebelled! Also, now that the nerve in #16 is dead, I won't have to feel the strange sensations I felt when my first tooth (which has a healthy nerve) was crowned.

After 16 Years, Paying the Piper

Dr. Yes and his staff are all on vacation: it's a small practice, so they apparently close for two weeks every summer. I don't have a dental appointment for nearly three weeks, which I think is the longest I've gone since all this started in May. . .so in a sense, I'm on vacation too!

Time off gives me time to contemplate a subject I know I'll have to deal with eventually anyway: how to finance the consequences of my dental phobia.

As mentioned in my original post, I live in the U.S. and don't have dental coverage, because the voluntary option my employer offers doesn't pass my cost/benefit analysis: my husband and I would pay over $500 in premiums (together) for $1,500 (each) in maximum annual benefits. Also, since the dental plan is "managed care," it may or may not cover what Dr. Yes thinks I need. Especially for someone who needs major dental work and will definitely exceed the annual maximum benefit level, it's simply not worth it.

Instead, we enrolled independently in Brighter.com, a dental-discount plan introduced in 2011 that received favorable press from some reputable business publications. Brighter promises discounts up to 60%, but very few Brighter dentists in my area offer discounts this high, and frankly, I doubt I'd trust those who do: any dentist offering a 60% discount is probably desperate for business, treating patients in a factory model, and/or providing lower-quality service. Like most Brighter dentists in my area, Dr. Yes discounts his services 10-20%, which takes the edge off (also, I have the Brighter online directory to thank for helping me find Dr. Yes in the first place!). The only negative thing about Brighter for me so far is that when I needed an endodontist last week, their specialist options in my region are very limited. The few endos close to me are in chain practices I don't trust; the few others are in suburbs that are not geographically practical as I don't drive. Therefore, I paid full fees for my root canal.

To date, I've probably spent approximately $2,500 on dental work, including last week's unexpected adventure with RTC, and still have an expected $2,000 to go, not including eventual periodontal surgery. So far, everything's been charged to a credit card with a low interest rate. I've paid $1,000 from my healthcare reimbursement account, which is minimally funded by my employer and was a bit flush with unused funds from previous years. Since I don't want to draw my HRA down to nothing, this option is essentially finished. Withdrawing from my own investment savings account is out of the question for several reasons. I have available credit, but do not want to use it: I've always followed my 10% rule, which is never owe more than 10% of your gross annual income (ideally less than 5%) in unsecured debt. Therefore, I've decided to liquidate an old 401(k) retirement account that was funded by a previous employer. Because I wasn't fully vested, the amount in this account is less than $5,000. I know I'll be charged a somewhat high tax penalty, and can almost hear our accountant screaming. However, this old 401(k) is a fairly low-performing investment, and since I'm no longer employed by the organization I can legally liquidate it. Also, for any other U.S. residents here, I've often found that when the IRS advises us to do (or not do) something, it's not necessarily in our overall best interests. Nearly everything I've read on the internet says "don't liquidate an old 401(k), go into debt!," but if I had that much unsecured debt, I wouldn't be able to sleep at night. Also, in my experience, the more unsecured debt one has, the more one acquires. . .the same sort of subconscious reasoning that may lead the morbidly obese to eat two desserts on a regular basis!

Do I wish the U.S. had dental and medical care that was even partially funded by government programs, regardless of income? The question is complicated, but my best answer is this. Several years ago, I worked with a nurse from the U.K. who is now retired. As I once explained to her, a nation with a profoundly corrupt, corporate-controlled government cannot be trusted to run a decent national healthcare program. I've taken some serious criticism from other people in the U.S. for not supporting national healthcare in this country, yet I always say: first stop corporate totalitarianism and return to government in the public interest, then work on implementing a better healthcare system. Do it the other way around, and we'll end up with a nationwide version of the Kool Smiles/Small Smiles children's Medicaid dental controversy. Exclusive government funding of corporate healthcare providers is already known to be a problem with renal dialysis. U.S. patients with chronic renal failure who are dialysis-dependent are all covered by Medicare regardless of age; two private corporations primarily control the hemodialysis market, not always providing quality care.

For now, do I believe in a better safety net for the poor? Absolutely. Do I support the public option that we didn't get with the corporate-welfare plan known as Obamacare? Yes, because I believe big government and big business need to "check and balance" one another so that neither takes ultimate control. Do I wish some brave company sold high-deductible dental coverage that only paid benefits when annual expenses exceeded at least $1,000? Maybe we need to start one!

To be continued. . .

In regards to "Obamacare", it also does some good by not letting insurance companies charge higher rates or exclude people with pre-existing conditions. I mean, if you don't have health insurance and you have the misfortune of getting some catastrophic disease like cancer, you run the risk of LOSING everything you own just to get SOME health care.
I have a couple of pre-existing conditions and right now I'm covered by my husband's insurance. If he retires in a year (he could if he wanted to), could I get coverage?? And if I found someone to cover me, could I AFFORD it?? I only work part time, so getting insurance there is not an option, unless I could talk them into taking me on full-time.
I don't know what the answer is, but I do believe that ALL of our citizens deserve health care......not just a privileged few. Access to health care isn't a luxury, it's a necessity.
Sorry, ident, I'll get off my soap box......it's just a touchy subject with me because so many in my family have suffered ill-health because they could not afford to get care BECAUSE they didn't have health inusrance.

Re: After 16 Years, Paying the Piper

iDent said:

As mentioned in my original post, I live in the U.S. and don't have dental coverage, because the voluntary option my employer offers doesn't pass my cost/benefit analysis: my husband and I would pay over $500 in premiums (together) for $1,500 (each) in maximum annual benefits. Also, since the dental plan is "managed care," it may or may not cover what Dr. Yes thinks I need. Especially for someone who needs major dental work and will definitely exceed the annual maximum benefit level, it's simply not worth it.



Do I wish the U.S. had dental and medical care that was even partially funded by government programs, regardless of income? The question is complicated, but my best answer is this. Several years ago, I worked with a nurse from the U.K. who is now retired. As I once explained to her, a nation with a profoundly corrupt, corporate-controlled government cannot be trusted to run a decent national healthcare program. I've taken some serious criticism from other people in the U.S. for not supporting national healthcare in this country, yet I always say: first stop corporate totalitarianism and return to government in the public interest, then work on implementing a better healthcare system. Do it the other way around, and we'll end up with a nationwide version of the Kool Smiles/Small Smiles children's Medicaid dental controversy. Exclusive government funding of corporate healthcare providers is already known to be a problem with renal dialysis. U.S. patients with chronic renal failure who are dialysis-dependent are all covered by Medicare regardless of age; two private corporations primarily control the hemodialysis market, not always providing quality care.

For now, do I believe in a better safety net for the poor? Absolutely. Do I support the public option that we didn't get with the corporate-welfare plan known as Obamacare? Yes, because I believe big government and big business need to "check and balance" one another so that neither takes ultimate control. Do I wish some brave company sold high-deductible dental coverage that only paid benefits when annual expenses exceeded at least $1,000? Maybe we need to start one!

To be continued. . .

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So... I don't want to get into a debate about national healthcare, but wanted to respond to a few things. The first is that dental insurance is ONLY worth it for those of us who use it. If you're paying $500 and have a $1,500 limit, it could be a $1,000 savings for you if you use your entire benefit. Plus, the $500 is likely taken out "pre-tax" by your employer which means that it's probably actually costing you $350-$400/yr in post-tax dollars. Dental insurance managed care is not managed in the same way as medical managed care and generally, they have VERY clear rules and guidelines about what is covered (that are explicitly spelled out in the policy). I work on managed care (and, the grass is always greener -- I say every day that I would give up my job for a single payer health care system -- but again, this is probably not the place to debate the merits of this) and I can tell you that managed care for dental insurance is so much easier to navigate than other forms (I would say it's most like pharmacy benefits managed care, but even less restrictive). Generally, the rules are around how often the same procedure can be performed on the same tooth (i.e. the same tooth cannot be filled on the same surface more than once every 2 years -- as it is assumed that if something is needed sooner than this that the originally filling may not have been done correctly in the first place and the dentist should fix it free-of-charge). I pay for dental insurance through my employer and have used the maximum benefit for the last few years. I was grateful each time that the first $1,000 (or $1,500 -- depending on the plan) did not have to come out of my pocket.

Just some food for thought. I continue to enjoy reading your posts as they are as entertaining (your writing style has a way of keeping me interested to the last word) as they are informative. Thanks for continuing to share your story with us!

Stiff Upper Lips: Fact, Stereotype, or a Bit(ten) of Both?

By birth, I am a U.S. citizen. However, my ancestry is approximately 2/3 U.K. (a grandfather was the most recent immigrant), which is not the norm in the U.S. region where I grew up and still live. I've often felt more stoic than many people of non-U.K. ancestry I know, and am uncertain if this is a cultural attribute that's been nurtured through generations, a specific family-of-origin attitude, and/or a combination thereof.

After my most recent abscessed tooth earlier this month, which was followed by RTC, one of the MDs with whom I work said he had no idea I had been in severe pain. The first time I remember biting the bullet like this, I was five years old and had a serious ear infection. By the time I acknowledged pain and was taken to a doctor, the worst was over; I learned, years later as an adult, that treatment delay probably resulted in mild hearing loss. Ten years ago, I lived with a moderate rotator-cuff injury for a month before admitting it wasn't going to heal by itself and seeing an orthopod.

When I first saw replicas of "Keep Calm and Carry On" in the mid-2000s, I felt that regardless of what it said on ancient emblems, I'd found my family of origin's real motto: even though no one ever said this during my childhood, the belief and practice were evident!

I really don't mean any disrespect (much less want to resume the war of 1812 ), but I'm honestly curious: is extreme stoicism a genuine U.K. cultural attribute, an unfortunate U.K. stereotype, or just my family of origin's most accomplished form of strength/dysfunction (pick one!), ancestral culture notwithstanding?

All in good humour. . .if this is considered offensive, bring on the drill without The Wand!

I'm completely English by ancestry at least back to Great-great grandparents but I am in no way stoic. If I'm in pain everyone will know about it. I whinge a lot! I think the stereotype is more what people think of England in the past. England isn't like that, at least not any more. A lot of my friends have visteded england and been dissapointed we don't live out Notting Hill and 4 weddings and a funeral!

Also if you think the English don't whinge see if you can watch 'an idiot abroad'. Its hilarious but proves some English people whinge more than I do!

Summer of Dentistry / Anticipatory Anxiety

After nearly a month, I return to Dr. Yes this Thursday.

Like everyone else, I have certain summers that are memorable to me for especially good (or sometimes both good and bad) reasons. Although it's not quite over, 2012 may be added to the list.

2012, the Summer of Dentistry. Definitely not what I had in mind, but not necessarily bad.

What did I do this summer? Went kayaking for the first time, read several new books, cared for two foster rabbits, and had two crowns and my first root canal!

Part of me is looking forward to going back and keeping progress in motion. Another part of me knows that, come Thursday morning, fear will again be my companion.

To be continued. . .

iDent,

I often find it more difficult to go back after a long break than the times when I was going nearly weekly. The longer the time that passes between appointments, the more difficult it can be for me to remember that I trust my dentist and that the things I fear most never happen.

I will send good thoughts your way on Thursday.

Re: Summer of Dentistry / Anticipatory Anxiety

iDent said:

After nearly a month, I return to Dr. Yes this Thursday.

Like everyone else, I have certain summers that are memorable to me for especially good (or sometimes both good and bad) reasons. Although it's not quite over, 2012 may be added to the list.

2012, the Summer of Dentistry. Definitely not what I had in mind, but not necessarily bad.

What did I do this summer? Went kayaking for the first time, read several new books, cared for two foster rabbits, and had two crowns and my first root canal!

Part of me is looking forward to going back and keeping progress in motion. Another part of me knows that, come Thursday morning, fear will again be my companion.

To be continued. . .

Click to expand...

Definitely the Summer of Dentistry for me as well and my next appointment is Thursday morning complete with raw, white knuckled fear.

BH

Unexpected Gratitude: Part IX

Going Viral / Murphy's Crown

Eventually the body rebels.

11 July: After my root canal, I am prescribed antibiotics. Although I take wild oregano regularly to prevent/decrease the severity of most common viral infections, I rarely take pharma antibiotics for reasons relating to population and personal resistance, especially since I'm allergic to the penicillin class. However, I may be wary but I'm not usually careless (not unlike my lifelong attitude toward dentistry!). I fill the prescription and take the seaside-colored capsules until they are gone.

29 July: In honor of a friend's birthday, three of us go kayaking, me for the first time. Once I master how to steer well (not as easy as it looks!) I am very comfortable on the water, but trouble comes later. Dressed in black nylon (a t-shirt and knee-length exercise pants), I have sunscreen on my face, neck, and arms but not my legs, which were covered by a kayak most of the day. On the short walk back to the car on what has become a very sunny afternoon, my legs become fried (sometimes I am, indeed, careless ). A few days later, what I thought was a bad first-degree sunburn develops into a second-degree (partial-thickness) sunburn. I am competent in first aid for skin wounds and able to prevent infection with twice-daily cleanings and dressing changes, but wonder how much more my immune system can take.

8 August: After nearly a month away, my next dental appointment is tomorrow, and I am sick. Not psychophysiologically ill, as in "I don't want to go to the dentist," but sick sick. I awaken with a sore throat (which I hope is just an allergy) and feel my lungs begin to swell on the way to work (which I actually hope is asthma), but develop gastrointestinal symptoms, including a distended abdomen, by early evening. Clearly some strange virus. It's too late in the day to cancel my dental appointment, and amazingly, after all the unexpected developments and consequent delays, I don't want to. Please, let's finish Crown #2!

Arriving home, I learn my husband is also not feeling well, though his symptoms are somewhat different from mine. Neither one of us wants dinner. Next I develop a fever, and take acetaminophen and additional wild-oregano capsules, hoping to fight the infection so I can keep tomorrow's appointment. Finally, I fall asleep.

9 August: Morning. Though my lungs are still swollen, I am no longer acutely ill. Having lived with minor asthma for eight years before it was diagnosed, I learned long ago to function with reduced lung capacity. I am less worried about being able to breathe in The Chair (though this is one of my ongoing phobia challenges) than I am about infecting Dr. Yes and his staff. However, because I am feeling better, because this is not, strangely, a coughing/sneezing/nasal-and-sinus-congestion virus, and because they wear masks and gloves, I decide (with some trepidation) to risk it. Before leaving home, I rinse my mouth and throat with hydrogen peroxide a second time.

One peculiarity about my anxiety disorders is that they mildly improve whenever I am physically ill. My muscle tension is reduced, and I actually worry slightly less. Perhaps my body literally does not have the energy to fight infection and produce whatever neurotransmitters and stress hormones are responsible for the anxiety. Therefore, on the way to Dr. Yes's office, I am relatively calm. The short-term cure for dental phobia? In my case, an oddball viral infection!

After nearly a month, back to the Architecturally Significant Medical and Dental Shrine. Back to Dr. Yes's office. Back to The Chair, so #16 can be reduced even more to accommodate a porcelain crown. Since #16 is post-RTC I don't necessarily need a local anesthetic, but Dr. Yes offers one anyway, since he'll be working near the gumline. I don't refuse!

Knowing pain is essentially impossible makes drilling easier. Even though I'll probably never relax during the drilling process, I think I am learning to breathe more during it, despite my lung status! Also, although I've never been one to dig my fingernails into the chair armrests, I tend to develop stiff "claw" hands while being drilled (picture the Bride of Frankenstein's fingers poised over an antique harpsichord keyboard!). Today my hands are nearly normal, and I am finally scheduled for Coronation #2 in a little over two weeks!

After I am finished in Dr. Yes's office, I realize I am very hungry. Last night I ate no dinner due to gastric distress, and I still have not mastered the practice of breakfast before dentistry, much less the art. The only place I know of downtown that sells anything I want to eat in the morning is a bagel shop a few blocks away, so I stop and order a sandwich with Swiss cheese, tomato spread, and three different vegetables (even before I became lacto-vegetarian years ago, I disliked "breakfast" foods). Eating at the transit stop, I am halfway finished when I feel my temporary crown fall off.

Oh, $%*&.

I wasn't even chewing on that side of my mouth. I never chew on a side that's had dental work until at least the next day.

Maybe I can replace it myself.

At least I didn’t swallow it.

At least I'm not in pain.

The temporary is stained in two tiny crevices with red-orange tomato spread. They'll know I was eating; I'll have to confess. But I was not chewing on that side. Was I?

Oh, crap. Not brain richochet again. . .

After 5-10 minutes, I call Dr. Yes's office.

. . .They're probably already lost money on #16, and now they'll lose more. . .

Though I've no doubt interfered with their morning schedule, Dr. Yes and his staff are actually pleasant about my unexpected return. Maybe because I'm phobic, and like experienced clergy, they know they must be very careful with new converts who could easily revert to skepticism? Maybe because even though #16 may be a financial loss, overall I'm still financially a four-figure asset to their practice this year? Maybe because (and I really believe this) they genuinely are good people? All of the above?

Full details have not been explained to me, but based on inductive reasoning, I have come to understand that my #16 is not only large (like most third molars) but rather misshapen, hence the problems to date with the impressions, dental lab, and now, it seems, this temporary crown. After inspecting and repairing the damage, Dr. Yes “thinks he knows what happened” and gives me an ultimatum one never, ever expects to hear from a dentist:

Absolutely no flossing around the temporary until I return for Coronation #2!

To be continued. . .

Unexpected Gratitude: Part X

(Dental) Morning Person / Metal Vs. Plastic

According to my husband, I'm a "morning person." What this really means is that I'm a "morning person" compared to him. . .as is probably everyone else on the planet, with the possible exceptions of vampires and Batman. Several years ago, I told a nurse at the medical center where I work that if I were a nurse, I'd probably volunteer for the 11:00 p.m.-7:00 a.m. shift!

There is, however, one thing that will make me gladly rise well before dawn, and that's knowing I have an early (as opposed to later) dental appointment. On some days Dr. Yes starts at 7:00 a.m., and once or twice I've scored 7:00 or 7:30 appointment slots. Usually my appointments have been 8:00 or 8:30, and these are fine with me as well. Last time I had an 8:30 appointment, and walked away with a return (for Coronation #2 and a drilling-and-filling, my first in over 16 years) for late afternoon this coming Monday.

Why did I do this to myself? Well, there must be a lot of other people like me who prefer to "get it over with" shortly after morning rush hour, because if I wanted an early-morning appointment I would have had to wait more than 2.5 weeks. I know it may seem strange to want an appointment sooner rather than later, but if you've followed my story, you'll know that I was originally supposed to have Coronation #2 over six weeks ago! As much as I'm not looking forward to the drilling-and-filling (fortunately I only need one), I really do want to finish my second crown. Then it will be two down, one to go. . .

If there's one thing I dislike nearly as much as being drilled, it's having to leave work for any kind of personal appointment and return later the same day. Therefore, my dental and medical appointments are always scheduled for early mornings (before work) or late afternoons (after work). I booked Dr. Yes's latest-available appointment because I felt fairly well-adjusted at the time, but now I admit I may have to deal with anticipatory anxiety all day Monday. When I was a young teenager my mother would usually schedule my dental appointments for late afternoons, and I would spend entire days at school in fight-or-flight mode. If I had to take tests, I'm sure my grades were affected!

It's one thing to not eat breakfast before an early-morning dental appointment, but missing breakfast and lunch is asking for a migraine, especially on a Monday (I tend to get Monday migraines after being away from the noxious office fluorescent light, a huge migraine trigger for me, all weekend). However, I'm fairly certain I'll be able to eat breakfast but not lunch, and if so, I should be fine. As for work, I think my days of fight-or-flight mode are over. Will I be nervous? Almost certainly. Will I be terrified? Probably no longer.

Regarding drilling-and-filling, as I understand, the decay is between two molars. I really don't want more amalgam fillings because of the mercury, but have had so many since childhood that my mouth, even freshly brushed, should probably be classified as a toxic-waste site. Will one more really make a difference? I contemplated calling Dr. Yes's office and asking if he'd consider using a composite even though it's not a visible area and composite is more expensive. . .and then I read about BPA in composite fillings on the DFC website! As my husband would say, "everything causes cancer."

Tomorrow I have a full day planned. . .platelet donation followed by a salon visit, and hopefully a trip to the state fair. When I was a child, I know I really tried to enjoy the day two days before a dental appointment (the day before was clearly a lost cause!), and never, ever succeeded. Lifelong habitual patterns may not change, but outlooks can. . .and so can outcomes.

To be continued. . .

Re: Unexpected Gratitude: Part X

iDent said:

(Dental) Morning Person / Metal Vs. Plastic

According to my husband, I'm a "morning person." What this really means is that I'm a "morning person" compared to him. . .as is probably everyone else on the planet, with the possible exceptions of vampires and Batman. Several years ago, I told a nurse at the medical center where I work that if I were a nurse, I'd probably volunteer for the 11:00 p.m.-7:00 a.m. shift!

There is, however, one thing that will make me gladly rise well before dawn, and that's knowing I have an early (as opposed to later) dental appointment. On some days Dr. Yes starts at 7:00 a.m., and once or twice I've scored 7:00 or 7:30 appointment slots. Usually my appointments have been 8:00 or 8:30, and these are fine with me as well. Last time I had an 8:30 appointment, and walked away with a return (for Coronation #2 and a drilling-and-filling, my first in over 16 years) for late afternoon this coming Monday.

Why did I do this to myself? Well, there must be a lot of other people like me who prefer to "get it over with" shortly after morning rush hour, because if I wanted an early-morning appointment I would have had to wait more than 2.5 weeks. I know it may seem strange to want an appointment sooner rather than later, but if you've followed my story, you'll know that I was originally supposed to have Coronation #2 over six weeks ago! As much as I'm not looking forward to the drilling-and-filling (fortunately I only need one), I really do want to finish my second crown. Then it will be two down, one to go. . .

If there's one thing I dislike nearly as much as being drilled, it's having to leave work for any kind of personal appointment and return later the same day. Therefore, my dental and medical appointments are always scheduled for early mornings (before work) or late afternoons (after work). I booked Dr. Yes's latest-available appointment because I felt fairly well-adjusted at the time, but now I admit I may have to deal with anticipatory anxiety all day Monday. When I was a young teenager my mother would usually schedule my dental appointments for late afternoons, and I would spend entire days at school in fight-or-flight mode. If I had to take tests, I'm sure my grades were affected!

It's one thing to not eat breakfast before an early-morning dental appointment, but missing breakfast and lunch is asking for a migraine, especially on a Monday (I tend to get Monday migraines after being away from the noxious office fluorescent light, a huge migraine trigger for me, all weekend). However, I'm fairly certain I'll be able to eat breakfast but not lunch, and if so, I should be fine. As for work, I think my days of fight-or-flight mode are over. Will I be nervous? Almost certainly. Will I be terrified? Probably no longer.

Click to expand...

Hi iDent,
Just reading your thread for the first time (I think ) and this post really rings true for me. I go through the same trials and tribulations about afternoon appointments and I too would dread those "after school" visits that you were left to worry about all day long as a kid. Although I am not a morning person, I try to get the very first dental appointments in mornings for a number of reasons. 1) the office is less busy 2) I am more tired/groggy (and perhaps less aware of my surroundings) 3) like you, if it must be done, I'd rather get it over with as quickly as possible and move on with my day rather than it consume my entire day with anticipation. Although, I find with early appointments, I tend to have an adrenaline crash following the event and have a huge headache and feel drained and pretty worthless for the rest of the day but can function well enough to get by with some ibuprofen and caffeine. I think some people are more physically affected by anxiety than others and for those unfortunate individuals, we need early morning appointments to survive! Anyway, just wanted to let you know that I can relate!!!

Unexpected Gratitude: Part XI

Yield

Arriving at Dr. Yes's office for a late-afternoon appointment surprisingly hours past anticipatory anxiety and with time to spare, I feel almost normal. Listening to the drill in the waiting area, I think about how it is a sound I will probably always dislike, but it no longer sets me on edge, even when I know it will soon be used on me.

Once in The Chair, assistant Serena removes my temporary #16, which I haven't flossed between as directed for over two weeks. I mention that I don't want to know what's between it and #15, especially since I ate corn on the cob at the state fair on Saturday, and she doesn't tell me! Soon Dr. Yes comes in, and, despite all the storm and strife leading to it, Coronation #2 is routine.

Next, drilling and filing. To date, all the work I've had since May has been on upper teeth, but the drilling and filling will be in the lower-left quadrant. Even though I've read that lower teeth are more difficult, Dr. Yes's previous skill makes me nearly nonchalant about local anesthesia. With eyes closed as always, I don't know if he's using the Wand or not, but for the first time in his office I experience a slightly painful injection. This in itself is not serious, because I don't have needle phobia. However, when he starts drilling minutes later, I feel pain. Real pain, not pressure. Since I am relatively calm, this is not gate-control theory in action (although I certainly experienced it many times before in my life). Knowing I am hesitant to signal, Dr. Yes stops drilling after several seconds and asks. I admit to pain, but tell him I can deal with it, as I had to nearly every time I was drilled as a child.

I can advocate. . .sometimes quite assertively. . .for other people and animals.

I can write to politicians and use the word "fascism."

Why the hell can't I request more local anesthesia for myself, especially when I know it won't be denied?

Because even if things aren't all right, you have to pretend that they are, and maybe they will be.

Because if you show excessive vulnerability, people will use it against you.

Such were the lessons of my early childhood, unspoken yet loud. Or innate faulty beliefs of my own? Nature vs. nurture, or both? Regardless of the source, they are essentially "hardwired" and very difficult to overcome.

Dr. Yes administers a second injection, mentioning that according to professional literature, about 20% of patients need extra anesthesia. When he resumes drilling I no longer feel pain, but my breath is once again infrequent and ragged.

Why is breathing during drilling always the hardest part for me?

When they are finished with my composite filling, Dr. Yes and Serena remind me that, except for a crown on #2, my restorations are nearly complete. #2 is decayed but not as severely as #16 was; although there is no urgency, Dr. Yes says that, if I want to, I could probably come in later this week. I decline: really, two weeks or more is fine! Since it's another upper tooth, I know it should be easier than today. On what I hope are good terms, I leave with an early-morning appointment three weeks away.

To be continued. . .

I feel for you, iDent, just having gone through 2 painful procedures with my recent root canal (procedure # 3 coming up next Thursday.....a crown I think).
I don't hesitate to let my dentist know I'm in pain, either moaning loudly or waving my hand. He then asks me if I need a top-up of Novocaine........which he doesn't hesitate to give no matter HOW many injections I have had.
I don't think telling a dentist you're in pain will "be used against you" in any way shape or form. In fact, if the dentist KNOWS you're comfortable, I would think it would make a procedure easier on BOTH of you. I think if you look at asking for more Novocaine as maybe asking for more cream for your coffee, maybe it would make it easier for you TO ask.
My gynecologist once told me "I work for you and if I stop working for you, then you need to find another doctor". Needless to say, he's been my gynecologist for 23 years. I think if you think of the dentist as your employee rather than an authority figure, it might make it easier for you to ask for Novocaine when you need it and not suffer through needless pain.
Many 's and good on your next appointment.

chickenjen said:

I feel for you, iDent, just having gone through 2 painful procedures with my recent root canal (procedure # 3 coming up next Thursday.....a crown I think).
I don't hesitate to let my dentist know I'm in pain, either moaning loudly or waving my hand. He then asks me if I need a top-up of Novocaine........which he doesn't hesitate to give no matter HOW many injections I have had.
I don't think telling a dentist you're in pain will "be used against you" in any way shape or form. In fact, if the dentist KNOWS you're comfortable, I would think it would make a procedure easier on BOTH of you. I think if you look at asking for more Novocaine as maybe asking for more cream for your coffee, maybe it would make it easier for you TO ask.
My gynecologist once told me "I work for you and if I stop working for you, then you need to find another doctor". Needless to say, he's been my gynecologist for 23 years. I think if you think of the dentist as your employee rather than an authority figure, it might make it easier for you to ask for Novocaine when you need it and not suffer through needless pain.
Many 's and good on your next appointment.

Click to expand...

Chickenjen, thank you for sharing your experience and wisdom on this issue.

Regarding authority figures, I generally respect people who use their power well (most healthcare providers and some educators) and generally disrespect those who abuse it (most politicians and many Wall Street executives!). Working with healthcare providers, I regularly see both their "deity" sides and their (all too) "human" sides, therefore I don't put them on pedestals. However, I still think of them as superiors, not as equals.

I wish my particular problem of "biting the bullet" was easy for me to solve, but because it's nearly lifelong, it's not.

Sometimes I think I have overcome 50-75% of my dental phobia. . .and then something like this happens. I trust my dental team, and have seen so much of them this summer that when I go in, the overall atmosphere has almost become one of "hanging out!" In fact, at the appointment described in my original post, they even asked (since I only have one crown prep and placement left), entirely in good humour, "What are you going to do when you don't have to come see us all the time any more?"

Clearly my current problem does not originate with an unsympathetic dental team, but with me. Without relating my entire history, it's definitely rooted in the fact that I have multiple neuro/psych issues that make me hypersensitive to environmental and emotional stimuli, yet come from a family of origin that expected and even encouraged emotional repression. Being innately hypersensitive in many ways, I learned very early (based on a family story, perhaps as young as age three) to be "strong," lest I be considered more "defective" than I already was.

I don't like to complain about my childhood, especially since a long history of emotional neglect fades in comparison to the physical and sexual abuse that some members of this forum experienced. Also, in other ways my parents were good parents. There are some benefits to having been raised with a stiff-upper-lip mentality, but there are certainly many disadvantages as well, the greatest being that I am often afraid to ask for what I need.