30yr old, need extraction, $20k estimate, terrified and feel alone

[CardsAndDice]

Hi,

I've been looking through some threads here for a while and I wanted to reach out. I hope that maybe one day I can turn this into a journal, but now I think I'm just looking for some immediate feedback, but it also just feels better to write everything down.

When I was younger, I hated going to the dentist, but I'm not really sure why. When I was in my early twenties I finally went after not having gone for a few years. Things seemed ok at first, but I really didn't like my dentist. He kept telling me very specific things I had done wrong, that I shouldn't be eating salty foods, that I should drink any sugary drink all at once and not sip on it. It just felt so nit picky. I didn't think very much of it at the time. I had a couple fillings done and was ready to get on with my life. That was probably 8-10 years ago.

As I started to get older I found that life pretty much kept going on as normal. I neglected going to the dentist and told myself as long as I did an adequate job of cleaning my teeth things would be ok. Then, when I was 25, I was playing in a game tournament and during a lunch break I was eating a burger and felt an unusual crunch. It was so strange and foreign to me, yet somehow I knew exactly what it was. The consistency like sand and the gritty bits not seeming to break apart under my molars. I had lost a piece of my tooth.

It felt so scary, like all my worst nightmares were coming true. I found a bit of tooth that had broken off and for some reason put it in the cup holder of my car. I don't know why. I think maybe some part of me wanted to remind myself that I need to take care of things. But I never did. All I wanted to do was hide away. Pretend that it didn't matter, that I could reverse it or at least keep things from worsening. That was five years ago.

Since that time another tooth has started the same decay process. Starting slow with a small hole and then eventually leading to a crevasse for food to hide and to be picked out for minutes trying to get things out. The tooth that originally broke started to decay away, no matter how much I tried to clean or pick it still progressed. I got lazy and complacent. I found all kinds of things to pick at the hole, tooth picks, bits of plastic, finger nails were the best and I could usually make one to pick at any food stuck inside that hole.

Eventually my partner started to notice. This is where I started to feel the reality set in, where I wasn't going to be ok. She started noticing that after years of our relationship, I hadn't been or talked about going to the dentist once. I never confided in her this horrible secret that I had been keeping.

About 4 weeks ago I made a dentist appointment. I was so scared and so worried about all the things that could be wrong. When I finally went, it was bad. I learned of some laser cleaning procedure I needed as well as a root canal for my one tooth, the original that had the break in it. I also learned that the other tooth, further back in my mouth, needed to be extracted. The word “extracted” just hit my soul like a gut punch. I found it odd that the tooth that had been decaying for longer would just need a root canal, but the tooth that I hadn’t had as much trouble with needed to be extracted.

There was so much information and many pieces of paper detailing the things I needed. Some fillings and cleanings and wisdom teeth removal. At the end of it all, even with my insurance, the quote was $20,433. This just seemed like a make believe number. Something I didn’t want to accept and didn’t feel real. I could afford it but I have so many other things in my life right now. I can feel myself, even now as I type these words, reach for excuses.

So this brings me to today. I knew I wanted to write something on this site if only to bring my heart out. I had been reading things on this site and it had made me feel a little better about getting care. Then, on Sunday the 29th the tooth that had been decaying for a while lost another big piece. It always had a hole, but now it was visible. It was in my smile line and harder to hide away. This sent me down a terrible dark spiral for the past few days. Tears of shame would flow through my eyes as I looked at myself in the mirror, wanting to hide myself away or become nothing so no one would ever have to look at me again.

As of right now there are 3 things on the forefront of my mind.

1. This is my fault. I have a good family and good upbringing. I don’t think I have any trauma from dentistry. I don’t struggle with abuse or addiction. I am a very normal and healthy person. And yet I have had this struggle for so many years. I feel so much shame in not being able to take care of this, that something is wrong with me. I feel so inhuman as I look at other people’s teeth and I see that they can take care of themselves. The rot in my mouth feels like a rot in my character. I should be able to take care of it but for some reason I just cannot. It feels like I’m so young only just turning 30 to have these issues. That if I cannot overcome this, what hope do I have of accomplishing anything meaningful in my life. The constant picking at the holes in my teeth with the tip of my tongue are a constant reminder that I have failed. This cycle of shame and embarrassment leads me to avoidance which leads to worse outcomes. I have to break this cycle, but I don’t know how.
   
   
2. The money is bearing on me. My partner and I are going to get married next year. The wedding is already costing a lot of money and I feel that this bill would take away from our life. I know my partner also wants to buy a house in the future. However, I feel that I am ruining our chances to be happy with my mistakes. All of the money that I would spend on my dental care are because of my failures. Maybe there might be a way to prioritize what needs to be done first, but the large bill just feels like I have dug myself into a hole so deep that it would be better to deal with it after, later, after some other life event, after the wedding, after the house, or the first kid, but later never comes and it ends up being never. The money I would spend on my teeth would make me curse and hate myself so much for not being able to give the love of my life the life that she deserves.
   
   
3. I think the hardest part about all of this is that I am alone. I have no idea how to talk to people about their dental health. I feel so ashamed about myself, if anyone had these issues as well I imagine they would feel similar. I feel that I have no one to talk to about these problems, no one to work through or confide my struggles with. It’s like the world is either filled with people that can just take care of these issues or with people who can’t and are looked down upon with disappointment. I tried talking to my father about this when he and I had taken a trip up to Seattle together. He seemed like he didn’t know how to address it. I think there was a short back and forth but nothing else. I mentioned some of the things that had been bothering me and the most I got was “Yeah you should get that taken care of.” This hurt so much, because I love my father because he is the most compassionate, understanding and nicest man I know. My mom is usually the hardass about these things. But if I couldn’t get the best man in the world I knew at dealing with issues to talk to me about how I was feeling, I knew I might just walk this one alone and that hurt.
   
   
4. The last part is the fear of pain. Oddly, I haven’t had a whole lot of pain in my teeth. There are times when I do feel food or a pick strike a nerve and there is pain. But the hard part is, there is not really any day to day pain. I can manage a very normal life without having to worry about it. There have been 2 times in the past few years with big tooth pain. One when I went camping, and the other when I was working late in Portland. It was difficult and annoying, but after a while of the same pain I could ignore it. I would take painkillers only in the most desperate of hours and usually it wouldn’t last more than 6-8 hours. I knew that if I could make it through a day I would be ok. I would just continue to try to clean the area, gargle some salt water and it would pass. However, every once in a while I would chew a piece of food or use a finger nail to pick at an area and strike a nerve. One time, when putting a pick in just the right spot at one point I hit something unbelievable. I thought I knew what pain was. I thought I understood what it meant to be in pain. This was something on a whole different level. That instant I felt that paint, it hit me in such an odd place in my heart and held a lump of stone in my throat. I felt fear. The ripples of that pain reverberated through my whole body until my stomach churned. It only lasted a second, but I knew that if that place got struck again, it would be the most pain I’d ever feel in my life. When I did go to the dentist a few weeks ago, I remember myself back to this same moment and I had to have her stop a few times for fear that some slight mistake would strike this nerve again.

So this brings me to today. I want a second chance, I want to get help, but it’s hard to know where to start. So here are my actionable questions for the community.

1. I wish that my dentist could communicate just with email so I don’t have to have phone call after phone call, getting put on hold and worrying about asking all the questions I need right then and there. That would be a huge improvement. Is this something clinics do or is it all over the phone in the United States?
   
   
2. I have a mild blessing in that I need to get my wisdom teeth removed anyway. While they do this procedure can I get my root canal? I know I can do my extraction, but can the root canal also be done while I’m under. This might be a long shot, but it feels like an opportunity to have a second chance. To do all the work that needs to be done and wake up with fixed teeth. If not, I’m so scared of the potential for the root canal to hit that deep nerve that has scared me before. To be put under for all of this work would be such a blessing.
   
   
3. Should I hold out for better insurance? I hadn’t put a lot of thought into my dental insurance through my work, because I had never really used it. Would it be more cost efficient to do the work needed now and any fillings or later work for next year. I do feel the time pressure and maybe it would be better to deal with everything now rather than put it off again, but in the case of cost, it might be better to be realistic.
   
   
4. How do you deal with moving forward? How do you feel knowing you’ve made this prolonged mistake and trying to pick up the pieces and make something better. Often it feels like all our lives we’ve been moving forward, it's hard to admit reality that there are some faults we have and changes we need to make. It feels crushing and insurmountable. I fear that one day I’ll wake up 10 years from now with half the teeth I do now wondering what went wrong. But deep down I’ll know the thing that went wrong is me. How do I overcome this hurdle of the easier path to avoid and save the hardship for the future.

Some final thoughts. I would really like to thank anyone who has read through this far. I feel so alone and it is nice to know that there are people out there struggling with similar things. Reading some of the journals and support threads, it makes me feel like a person again. I’ve attached some pictures of my condition. The one more forward in my mouth being the need for the root canal, but I’m also worried that my condition has worsened since my last visit and it will need to be extracted. The back one, my dentist said that it would be extracted, which could be done during my wisdom teeth extraction anyway which is nice.

If all goes well, maybe I can document this in a journal post. I hope one day I will be proud of discipline rather than ashamed of it.

 

[Enarete]

Hi CardsAndDice,

thank you for sharing your story with us. Writing things down can be relieving and also help to get some order in own thoughts. As you probably noticed, this forum is full of people who have or have been experiencing all kinds of emotions around the topic of dentistry, so you are definitely not alone here.

I feel like jumping into the first four things that you described as being on your mind, and then going to the latter four things you listed as questions.

1. This being your fault. While I was reading it, seeing the intense feeling of shame and almost self-punishment, the cruelty you are exposing on yourself in your thoughts, the very harsh judgment about making mistakes and the punishment you see for yourself, I was just thinking "this is not the kind of relationship happy content people whithout past struggles have to themselves". You are writing about a rot in your character and you are concluding so based on dental problems. So first of all I strongly disagree with everything you believe about yourself. Secondly, yes, maybe you cannot see a direct connection to something in your life and your relationship to dentistry (and yourself) but still, there must have been something or someone "helping" you to develope such shame and self-judgment. The good thing is - if you find a dentist who will treat you with kindness and respect, it may have an overall good effect on how you see yourself. I so wish you would be able to make that healing experience.

2. It is a lot of money and if you are not a millionaire, it will be bothering you. I hate how expensive care is in the US.. and it could have happened with any other health condition. I also feel like the style of dentists - giving people a quote with the whole treatment at once - makes it so discouraging to even start the journey. It makes it look like one big thing or nothing - you either pay those 20k and everything is okay or you do nothing at all. It also narrows your thinking to treating all at once which is a terrible approach for anyone who has difficulties going to the dentist. Seeing your dentist several times for smaller things over a period of time makes so much sense - you gain trust, you get to know yourself and things you prefer or find helpful during dental visits, and your dentist learns these things as well, you gain confidence etc. You have none of these effects if you treat all at once and then even under sedation. So teeth may get fixed but the mental block - the thing that made it so difficult for you to go regularly - will stay there in the first place. I also believe that the love of your life deserves a happy relaxed self-confident you that feels light and able to smile. But I also know that things are not so easy.

3. So sorry to read about the conversation with your father. You tried to open up and I can only imagine how difficult that was.. and you got no response. Many people have a difficult relationship to dentistry. Statistics day that almost a half of people have dental anxiety of some kind. I think most people are embarrased themselves or find the topic - maybe unconsciously - so difficult that they can only run away from it by delivering statements like "you should get it fixed" or "nobody likes the dentist" etc. What may play a role is that many people are not good "carrying" difficult feelings of others so if someone is experiencing something difficult, like intense shame, sadness or helplessness, many people will try to deliver a quick solution instead of offering an open ear. Is there anything in particular you would have wished your dad to say or do to support you?

4. That pain you experienced sounds terrible and I think it is highly unlikely you would feel that with a dentist. So called "pain management" is a number one priority, because even people who are super able to go to the dentist hate being in pain. If you consider any treatment, it may be good to have a good discussion with your dentist about how they plan on making sure you are not in pain. I am also glad you were able to stop your dentist last time to make sure they would be careful not to cause you any pain.

Now to your questions:

1. I totally see how communicating via email would be your preference and I think it can be such a good way to build trust. Also, being flooded by information while being stressed, like you experienced in your first visit makes it difficult to absorb all the information so an email makes more sense. I think some dentists do not offer that because replying to an email takes time which won't be payed and a dentist only earns while they are treating, but if you keep on looking, you will find someone who cares enough to allow you to communicate via email. It is a no brainer that writing is easier than phoning. Does you practice have no email at all? Or maybe they have a main email where you could write and ask them to forward it to the dentist? Or maybe explaining them that you find it easiert to communicate in writing and asking whether your dentist has an email address you could reach out to directly?

2. I am sure they will be able to put you under for any treatment you wish if that is what would be helpful for you. May be worth discussing with your dentist. With that said, it may be also a good thing to have a good plan in place to make sure you will be able to go to regular checkups after the second chance. There is this phenomenon when people get a lot of treatment under sedation but then start avoiding directly after - because all is well - and all problems start again. I wished this would not happen to you.

Can't comment on 3 as I am not familiar with the insurance in the US.

When it comes to 4, I wish you to find some kindness towards yourself. It is not you what went wrong. I know the shame is trying to tell you that, but shame is a liar.

All the best wishes and keep us posted about your further thoughts and journey

 

[CardsAndDice]

Hi Enarete,

Thank you so much for your thoughtful response. It really means a lot that someone took the time read everything I wanted to tell someone for so long but didn't have an outlet.

I'll just go in order of my thoughts.
1. The dentist chain that I see right now I found with a quick search through my insurance. The emails the send are all automated-non replay telling me to call them so it feels that my only option is to call. I suppose I could shop around, but I'm worried about losing my momentum if things become tough.

2. I've been talking in therapy about this and I think the one of my issues is that I feel that I don't deserve compassion unless something has happened to me outside of my control or I've been trying my best. If I fall short of doing my best I feel that there is no room to feel sorry for myself or have these kinds of issues, so avoidance is my unhealthy choice here. This would be the main thing that I would change; an acceptance of my flaws in a way that makes me feel like I can work on them. You say that "this is not the kind of relationship happy content people whithout past struggles have to themselves." This strikes me as a hard paradox. I want to feel like having these issues are normal, but at the same time this makes me feel like there must have been something abnormal happen to me make me feel this way.

3. I saved this one for last, because I'll probably start crying as soon as I write it. The thing that I think I was hoping from my father was some kind of reassurance that it was normal. He's a lot older than me and has lived a longer life. I thought that maybe he had dental issues in the past (I think he had his wisdom teeth removed in his late 40s) and I thought that maybe he knew someone or some kind of story that would make me feel like things would be ok. That this was a human struggle that many people faced. I wanted him to tell me that I was normal. But the lack of response just made me feel like this is something that other people have figured out how to deal with and I didn't.

It's hard to think about all the time that was past. Its hard to think about times when I just had a crack, when I just had a small cavity, when it was all ok. And I have a lot of anxiety about looking back at this point and now and thinking how lucky I am to only have the problems that I do and not so much worse. This fear that I will do nothing and revert back to avoidance. I feel I have to do something and I have to make something happen and just hearing your words and response makes me feel real more about my care than I have ever felt in my life. Thank you.

 

[letsconnect]

Hi @CardsAndDice

I don't really have anything to add to what Enarete has already said, but I noticed that you mentioned seeing a dental chain dentist. Would you be up to getting a second opinion? Dental chains in the U.S. have a a horrible reputation for overdiagnosing and over-billing, and what you save through your insurance, you may pay in additional charges that may not be charged elsewhere. Obviously, there may be exceptions to this rule, but I don't know of any dentists who would consider visiting a chain dentist in the U.S. themselves.

We've collected some tips for searching for dentists here:

How to find a dentist for nervous patients

Discover how to find a dentist who is good with nervous, scared or phobic patients - and who to avoid!

www.dentalfearcentral.org

How to find a high-quality dentist

How do you know if a dentist really cares about the quality of their work? Here is what to look for and expect from a high-quality dentist.

www.dentalfearcentral.org

As Enarete already mentioned, there's rarely a need to do everything at once. Just like with other medical treatments, it might be a good idea to compare several treatment plans and compare several dentists to see what your options are and get an idea of what you might be looking for in a dentist. It's a lot of money one way or the other, so you're entitled to shop around, spend it wisely and be happy with your choices