I apologise in advance for the length of this... it's my first post, I have a tendency to ramble. I wasn't sure whether to post in the support or questions forum, so I kinda split it up.. there are some issues I'd like to get feedback from the dentists on, but I chose here for my back story. I guess many people will just want to avoid the detail - it's not always nice. I'm sorry in advance if I trigger anyone else off with my tale.
I must admit I feel like a fraud compared with most people here. I have low level anxiety and compared to most people here, I'm dramatically lucky in that respect - my housemate is so phobic that he only recently plucked up the courage to go to the dentist after best part of a decade. He now needs fillings/extractions done but is having it done under GA as he can't even bring himself to walk into the clinic for my appointments. Problem is, it appears that the hospital he was originally referred to appears to not do restorative work under GA, which isn't good because the surgeon he saw basically just wants to pull everything - and he's utterly miserable about that, so we're working (with the dentist) to get him referred elsewhere if they refuse to do any restorative work (i.e. fillings etc).
I guess my fear is a combination of a dentist who refused to anaesthetise children because "a child's teeth don't have any nerves" when I was maybe 5 or so (this was barely in the 80s but hardly any excuse), the dentist I have not-so-affectionately termed "the butcher" after he mangled three of my teeth and rather than fill them separately, just drilled a "trench" (unnecessarily) between them (premolar and two molars on the bottom right) and basically just plastered amalgam in one solid block, leaving me with three buggered teeth and several years of pain. In addition, I have a lot of the issues mentioned in the article about survivors and dentists - control issues, being lectured, not being able to stop things, gagging, afraid to voice concerns or discomfort, etc.
I'd never been the most regular of dentist visitors.... but generally I went once a year at least, definitely at the first sign of trouble. Apart from a few fillings, I kind of just.... gritted my teeth, pardon the pun, and dealt with the anxiety. My discomfort around dentists might have meant me being uncomfortable (and shaking/adrenaline rush) in the chair, feeling faint and/or nauseated on standing, and crying my eyes out and shaky again after leaving the office but... I guess I'm a baby with dental pain, and I have a.... fairly big fear about visibly damaged/missing teeth, or having to have dentures, so I tried to keep them fairly healthy. Apart from this, I'd only needed a few fillings in a few molars, my wisdom teeth removed under GA because all four were impacted, partially erupted and the bottom one were damaging the 2nd molars (hence the fillings on those) and that was about it. Eventually I needed a root canal done on the 2nd molar on the bottom left after the damage from the wisdom tooth and a subsequent abscess but that was it really.
My problems started only the last few years. I suffer from a medical condition called endometriosis (and a few other related issues) that currently have me on long term incapacity benefit. As a result, over the last few years (say 5 years) I have been treated with three courses of drugs called GnRH analogs - these basically force your body into a chemically induced menopause - for 6 months at a time. Not a whole lot of fun, especially as it didn't really work at the end of the day. While it's well known that these drugs can deplete your bone density, no-one ever mentioned dental issues (either peridontal/bone or with the actual teeth themselves). The frustrating thing is that there is little mentioned about this, anywhere, although it appears that there are a whole host of people who have reported dental issues much like mine after taking these drugs.
The initial collapse of the tooth that was eventually root canalled occurred within months of the first course of this medication - about a third just literally broke away - no prior decay that I could feel or see, no holes, no pain, no sensitivity, no warning - nada. Only a small filling on the surface between 2nd and 3rd molar and broke on the opposite side (i.e. the 1st molar side) from said filling - abscess, followed by root canal. A few weeks later, 2nd molar, top right, back half completely disintegrated - not even while eating this time. Just felt funny as I closed my mouth, poked with my tongue, tooth fragment fell out in one chunk - again, no warning, no gradual decay, no holes or sharp edges, nothing. That one had fractured below the gum line, had to be extracted. Thankfully, that seemed to be it, and I was back to my pretty healthy teeth, though somewhat distressed by my horrible bad luck. The dentist figured that bruxism was the problem - I knew I did clench and grind my teeth in my sleep, after all - so I had a mouth guard made.
Things seemed fairly OK over the next year or so. Then, I was given the second and third courses of medication, within a couple of months of each other. That's when things really went bad. With about 6 months of finishing up with them, I was back in the dentist to have the bottom right second molar pulled after losing another 1/3 to 1/2 in 2 chunks at once (either side of the filling at one time, however), again below the gumline, again, no warning. On extraction, the tooth kind of disintegrated and came out it many bits. I was thoroughly lectured on how it must have been a longterm decay issue (as I had been for the previous miraculous collapsing teeth), even though I'd been into the dentist less than 6 months previously. Within a couple more months, the 2nd molar on the bottom right did the same thing - in only a few weeks, I had lost all of the surrounding remaining tooth, and was left with a nice, sturdy, root canal as the only remnant left above the gumline.
I'd moved at this point, from the south of England (and the ability to pay for private dental treatment) to the north west (and living on incapacity benefit with no NHS dentist available). It took me 28 months to finally find an NHS dentist who was taking new patients this last December, and actually get onto the list before they were completely filled within hours. By this point, I'd lost a whole heck of a lot more teeth in the process. If I have the numbering right, it was as follows:
15 - unrestorable, half missing.
18, 20, 29, 30 - root remnants.
19 - currently needs root canal.
8 - sliver missing between it and 9 that just broke off during flossing
27 - tip chipped off while eating
Plus about 15 others needing fillings for very minor "white spot" type damage - I had about 5 healthy teeth. And I can't believe I just admitted that to a whole bunch of people. :'(
I'd never been so mortified in my life. My dentist initially made me feel utterly wretched and humilated by telling me he'd never seen a mouth that bad - turns out he meant "get that bad in so little time" but even so... everyone's greatest fear, I guess. Certainly was one of mine. I was so utterly destroyed I didn't even want to leave my bedroom for a week, and I still can't smile or talk to someone without covering my mouth. Thing is, apart from the chip visible at the front, my teeth didn't look that bad - they weren't exactly sparkly white, but most of the work needed wasn't obvious to the casual observer.
Initially I didn't think there was any way I could face going back to him - thankfully, the return visits, he has been friendly and supportive, without any prompting. I'm sure he didn't intend to have the effect he did - and it wasn't given as a lecture (in fact, he suggested some of my medicines might be to blame which was, honestly, the first time I made the link). But a careless off the cuff remark like that can be so very hurtful. Since then, he's been pretty good though - he's worked on me every 7-10 days, gradually going through the work that needs doing, and he's always been considerate, stop signs, plenty of opportunity to pause, sit up, rinse etc - even without prompting. I guess he spots my anxiety almost even before I do. And he's never commented like that, since. Even today, for the final extractions despite problems getting numb (I've had issues on the bottom right with that before, branching nerves or weird extra innervation I guess, got pretty much all of it in the end after about 9 shots) and recalcitrant teeth refusing to come out in whole parts - a visit which is still making me tearful and anxious even though he was very careful to make sure I was numb before he did anything. It's mostly done now though, thank goodness. A root canal to do (oh yey - thankfully the left side which anaesthetises well), the front tooth (not entirely sure if it will be just filled or need capping etc), and possibly a few more surface fillings on the front top. But about everything else is done now, I think.
I've lost a total of 11 teeth now, I think, and basically have just the one bottom molar. How very depressing. I honestly don't know if I can face dentures. Just today, it seems all my fears crystallised and I'm still shaken now even though my dentist was actually wonderful (the nurse was pretty annoying though - on my saying through clenched teeth and gags that it was making me retch, her only reaction was to say "just keep biting on it" - not very helpful to say the least) and actually twice took the sucker off the dippy nurse to make sure the various fluids didn't make me choke/gag.
I'm just glad he turned out to be more supportive and caring than that careless comment suggested... because I really didn't have an option. It was stick with him, or return to the fruitless search for another 2 years for yet another NHS dentist actually taking patients who isn't completely full with multi year long waiting lists. By that time, I would have pretty much lost most of my teeth, I think, with the rate they've been disintegrating - despite brushing, flossing, gargling/rinsing with various stuff trying to keep my teeth healthy.
I just have this sense of fury - apart from the hormonal stuff, the situation was worsened by a medicine I use to control nausea and vomiting which is dissolved between the lip and gum. Of course, they make it out of.... sugar. Yey. Add into that various pain medications and the like which cause the most horrifically dry mouth... yeah. So that's how I managed to destroy my mouth in two years, pretty much. And I don't know who I am angrier at. The drug makers for not listing teeth problems in their leaflets or websites.... me for being too stupid to think about that (I actually trained up as a medical microbiologist.... so I should know better)... the doctors/dentists in the past who never once warned me of the risks to my teeth.... and I've settled on blaming myself. The fact that my oral care is exactly the same as it was before is irrelevant in my warped view, I should have known to take more care of my teeth. I should have realised the risk. And by the time I did, it appears to be too late. Now I think I am condemned to losing gradually more teeth month by month... and I simply can't face false ones. I'm 30 years old, for crying out loud.
Anyway, I should stop whining. I'm just stuck on this kinda anxiety-pity-party loop thing, I can't talk to my housemate (also my best friend) because I'll just send him into a full blown panic attack needing valium, and I'm feeling kind of miserable right about now (especially after 3 difficult extractions and a very pissed off nerve in the right side referring pains to all parts of my upper and lower jaws and teeth). If you managed to work through this... thank you. I know it was a monster of a post.