All journeys start with the first step

[blackhound]

So I finally have my appointment set with the periodontist so he can unravel the mess that was made of my bite. Appointments with him do not fill me with dread and do not trigger my fear that my teeth are going to be mutilated. I'm sure he can fix it so I can eat normally again.

But always swirling around in the back of my mind is 'what if' I get a cavity, or another tooth breaks and I have to see a dentist. My 6 month appointments for cleaning and exam trigger all the bad feelings and those feelings are always lurking around the edges. UGH.

 

[blackhound]

I just keep coming back to thoughts about whether or not all this dentistry stuff is worth it. Periodonist stuff? Yep. Definitely worth it. But dentistry? Not so much.

I have pretty run of the mill issues with my teeth but they invariable turn into huge dramas. I just can't do this anymore. The multiple visits, the cost, and the emotional angst. Since December I have had 4 visits to try and deal with what was a small area of surface decay and my occlusion is still not resolved. It will be resolved --- tomorrow -- when I see the perio but this. just. isn't. worth. it. at. all.

 

[krlovesherkids777]

Sorry the dentist is alot of frustrations and thing seeming to spiril in the wrong direction. Really glad you have a good perio to help you figure this out and hope he can help with as much as possible and understanding. Wishing the best for your appt so you can get this sorted out.

 

[blackhound]

Thanks for the support and well wishes. This is all so frustrating when you take care of your teeth, have regular cleanings and checkups and then feel like you are failed by the professionals.

But I just came back from the perio and in 20 minutes he fixed everything. My bite is properly restored. Finally.

Teeth #2, 3, 4 were messed up as I thought. #3 was hitting the incline of the tooth below. #4 is the CEREC crown that recently came loose and the problem was the crown wasn't properly made for my occlusion. #2 was just along for the bumpy ride.

Teeth #15 and 18 on the opposite side of my mouth were also out of wack. Adjusting those two immediately made the molars on the other side close properly.

My experience with dentists has been that they hyper-focus on the tooth they worked on and only adjust that tooth. The periodontist is looking at the whole mouth and how micro adjustments affect the occlusion as a whole. He also told me that since most people have mismatched dentistry from years of restorations being done at different times by different dentists, occlusal problems are not surprising.

I also found out that if, GOD FORBID, I need another crown or general restoration to impress upon the dentist that my teeth need flat planes on the chewing surfaces because my bite is open in the front. I have no idea what that really means but I've inscribed that in stone in my memory and I can insist on any restoration being done that way.

I wish I could clone him and have his clone be my general dentist.

Sorry the dentist is alot of frustrations and thing seeming to spiril in the wrong direction. Really glad you have a good perio to help you figure this out and hope he can help with as much as possible and understanding. Wishing the best for your appt so you can get this sorted out.

 

[krlovesherkids777]

Your Perio sounds amazing!! total keeper there! So happy you got so many answers !

 

[blackhound]

updating for the record:

#2 surface decay.

First appointment the tooth was not correctly shaped and left me with a big food trap between #2 and #3 and screwed up occlusion.

Second appointment to correct the badly shaped tooth closed the food trap gap and left me with even worse occlusion.

Appointment with perio corrected occlusion.

Current: #2 is showing signs that are not good news. Sensitivity to hot and cold that wasn't there before. Surmise that the tooth is in the first stages of death and there may be a root canal in my future because that tooth was worked on too many times to fix some basic surface decay. This perfectly plays into my dental anxiety and makes me want to run and hide. Fair or not, my feelings are that I was failed and my trust violated.

So I've spent a lot of time, a lot of $$ (with even more $$$ quite probably coming down the pike for a root canal and crown), a lot of anxiety and fear FOR SURFACE DECAY that couldn't be done properly on the first attempt.

All this does is ratchet up my dental anxiety and make me want to avoid treatment at all costs. The financial burden is very real. My anxiety is very real. My distrust of dentistry is very real.

 

[blackhound]

Personal observation.

All the years of old school dentistry with amalgam fillings and, by current standards, old technology never produced issues with my teeth or my bite. I went in, had the work done, went home and moved on with my life.

All the work I've had done with modern technology has produced a never ending cycle of issues with my teeth and my bite. It's never a single visit and my dental anxiety is at a record high.

 

[blackhound]

Appointment booked with endodontist. #2 has not settled down. Hot and cold sensitivity is definitely an issue. I can't even ...... I'm hoping this experience will be on a par with the experiences I have with my periodontist.

I think a lot about dentistry and the ways I perceive it has failed me and the ways I would actually want things to be.

One of the issues I will carry as vendetta forever is the way I was monetized at a previous dental practice related to my gum disease. I had bleeding gums and deep pockets. Naively I believed they were working in my best interest. They were not. I spent 2.5 years with repeated deep cleanings, arestin placement in the the pockets, 3 month recalls, and repeated assurances that just one more procedure, one more appointment, one more this and that would make all the difference. I know now that was bunk and all it did was keep my $$ in their practice at the expense of my dental health.

When the lightbulb finally went on in my head and I went to a periodontist it was clear I had been gaslit. The pockets were so deep there was no way they could clean them without surgery. If they didn't know that? They shouldn't have been licensed to practice. If they did know that? It was completely unethical to not refer me over to a perio when I wasn't making any progress on controlling the bacterial infections. They just weren't risking my teeth they were risking my overall health.

And this is one of the failures I think about with the dental profession as a whole and how it mimics the medical profession. The absolute reluctance to call out practitioners who are doing harm to patients through incompetence or greed. I understand all the reasons why that doesn't happen but the bottom line to me is that real people suffer real monetary and physical damage because sketchy practitioners are not called out and held to account by their peers.

My dental anxiety wasn't always a thing. It was built by experience and the feeling I can no longer give the dental profession my trust while still having to visit a dentist so I can retain my teeth. It's a horrible emotional loop.

 

[blackhound]

It is very difficult to read the postings on this site and offer support since many of the posts are triggering, especially those that detail botched dental work. I wish dentistry had more predictable outcomes. Even basic procedures seem to be a crap shoot. The stress of even a cleaning and exam is extraordinary because of the fear that something will be found that needs work and it will not be done correctly. The anxiety is really overpowering at this point. I don't have fear of the process -- needles, drills, sights, smells, sounds -- I have fear of the botched outcomes that seem to dog me no matter the dentist. I don't worry about cosmetic outcome. The worry is always functional outcome which is consistently wrong.

And now I'm looking at a root canal which doesn't actually scare me at all because the endo will not be doing anything that will change my bite. What terrifies me is the second step of having a crown placed on the tooth since it is a molar and the occlusion I just had corrected by the perio will be destroyed once again.

My bite can't be that unique or difficult to manage when, of course, the periodontist manages it just fine. So why can't the dentist get this right? Ever? In the past 6 years I have had 3 different dentists because of this issue. Is this something that really isn't taught in dental school? How is it possible that 3 random dentists can't get my bite corrected with multiple tries after they do a restoration? And I'm not talking fussy, hairsplitting complaints by me. I'm talking full out wrong -- pain, teeth not meeting, not being able to chew -- not a close call at all.

I swear the only way to win this game is not to play.

 

[blackhound]

I think I am going with a new plan. I am not getting any more work done by a general dentist that can be done by a specialist.

I'm old enough to remember when dentists handled cavities and fillings and a basic cleaning. Anything else was handed off to a pro who had the additional training and certifications. Now dentists handle all sorts of things from implants to perio to endo to prosthodontics. I'm not comfortable with that the more I think about it.

Having a periodontist handle my gum disease has given me a disease free mouth for the past 7 years. I'm seeing an endo this week to deal with a rotten tooth because, like the perio, he has the additional training and board certification in his field to do the job, and hopefully this experience will be a good one. But I know one thing however it turns out -- I'm not anxious up front about his qualifications to do the job. Same goes if/when I need a crown. I'll see a prosthodontist.

 

[blackhound]

Hang on. Here we go. Off to the endodontist. I sure hope this guy is as good as advertised.

 

[krlovesherkids777]

Blackhound.. Yes, hoping the same thing for you! Let us know how it goes!

 

[Shootmenow]

LANAP surgery, Part 1.

The sheer number of injections threw me a bit. I think there were a total of 4 (maybe 5) in the maxillary and 4 in the mandible. The entire quadrant had to be completely numb all the way out to the midline. The perio tested a few spots on the mandible -- the center front teeth and the premolars -- and they weren't completely numb after the first 2 shots so he shot up the nerve that comes across the front of the lower jaw to finish.

I was sweating bullets over those lower jaw shots. That anxiety just never leaves. But the perio is a total pro and I could barely feel the shots, which was good, and he totally respects my preferences for good old lidocaine. In fact he had my file marked "Lidocaine Only". Apparently using Septocaine for perio work is quite common which isn't surprising when you consider the length of the procedures and how invasive they can be (think 'implants'). They want patients deeply numb for longer than normal appointments.

I started at 9:30 a.m. and was done just past 11:30 a.m. Halfway through there was a 5 minute break which benefited everyone I think. The worst part of the actual procedure was having my jaw open for so long. They tried a bite block but that just made the spasm worse. I think I will take a 2mg valium for the second half of the procedure to try and keep the jaw from spasming out so hard.

The first step in the process was a sounding to the bone. Apparently that is different than just taking a pocket measurement. They record the depth to the actual bone defect.

Then the first pass of the Periolase laser kills the bacteria by specifically targeting the highly pathogenic black pigmented bacteria The laser is able to vaporize these bacteria and any diseased tissue inside the pocket without carving out big chunks of your gum tissue.

That first pass also opens up the gum pocket so the root surfaces can be cleaned down to the bone defect. That was the part that actually took the most time and was the most 'vigorous' part of the procedure.

After that was done the laser pulse was changed and passed under the gums again to form a blood clot. The clot seals the gum to the squeaky clean root/tooth surface so the healing and regeneration can begin.

The Lidocaine had started to wear off by the last laser pass (which felt like a sharp sting along the deeper pockets) but nothing I couldn't deal with. I'm sure if I had said the numbing was wearing off he would have shot me up again but I'd rather just suck it up for a few minutes than deal with another set of shots and a numb face. I'm sure that's not for everyone, but that's how I roll.

The last step was to minimize the occlusal trauma with selective grinding. The perio told me that the teeth with the largest pockets are generally the teeth with the worst occlusion. The constant banging from an ill fitting bite makes a bad situation worse.

The occlusal adjustment was probably the biggest surprise. My teeth have always closed 'heavy'. I don't have pain from a high bite, they just really seem to close .... heavy. Can't really explain it any other way. Now the right side of my mouth actually feels normal and the left side (yet undone) feels way too heavy.

The gross part -- I can't brush my the unaffected side for 24 hours. The LANAP treated side can't be brushed for TWO WEEKS. No Oral B for over 6 weeks. I have the Periogard rinse which will have to substitute for those 2 weeks. OMG YUCK.

Liquid diet for 3 days. Mushy foods for the next 7. And then I do it all over again. On September 3rd I go back for my 2 week checkup and the second half of the procedure.

All I can say to anyone with perio disease, if you have the option of LANAP, take it. I've been fighting gum pockets for decades and this actually the first time I feel like I have a chance to win.

Thank you for the step by step description. I'm staring down the barrel of this procedure with a dental/ needle phobia that is so bad I have canceled on two periodontists. I'm not afraid of being numb, just getting there with the needles. I just contacted him to find out just how many injections will be needed per session so I can somehow ready my mind into it.

 

[Scaredycat23]

I just had lanap on one side of my mouth four days ago. I'm already tired of soups and soft food but I'm curious whether you found any ways to get more fruit and veg into your diet. I'm worried that if I blend spinach it's all going to get stuck in my teeth

 

[blackhound]

Sorry I didn't see this earlier. I've been dealing with dental issues myself (failed root canal). The way I did fruit and vegetables was to blend them down in smoothies. I did 'green' smoothies using spinach as a base and I didn't have an issue. Just make sure the blender runs for a while to get everything completely pulverized. Same with fruit as it tends to be fibrous. There really isn't a good answer for the dietary restrictions except that you just have to deal with it until you can move on to more substantial food. I understand it is one of the most common points of failure with the whole process. Hang in there! Let me know how you are progressing.

 

[blackhound]

Thank you for the step by step description. I'm staring down the barrel of this procedure with a dental/ needle phobia that is so bad I have canceled on two periodontists. I'm not afraid of being numb, just getting there with the needles. I just contacted him to find out just how many injections will be needed per session so I can somehow ready my mind into it.

Did you ever have the procedure? I hope you were able to work out your phobia enough to get the needles.

 

[blackhound]

Dentist places a crown on a tooth that doesn't even make contact in my occlusion. Immediately the two teeth behind it (#2 and #3) start hitting prematurely. Dentist adjusts slightly and says it's all good. It's not good. Go back 2 more times. Still not good. Dentist claims it's not my teeth it's my sinuses. Bullshit. Then dentist suggests I can go get orthodontics to fix the bite he fucked up. Again. Bullshit.


Find new dentist. She immediately sees the issue and zips the high spot and the interference is gone. She also sees a tooth that is decayed on two sides. Previous dentist apparently does not do actual dentistry. I would love to post his name and tell you to avoid him like the plague but really can't afford to get sued even though I'm telling you the truth.


See an orthodontist who tells me he won't straighten my teeth because he can't guarantee a result and it would be years of pain, money and surgery. Appreciate the honesty which shouldn't be shocking but actually is which also tells you where the dental profession is as a profession.