Complex anxiety about episodic dental pain & dental care

[Icy_Mast]

Hi all,

I found this forum because this is a new one for me, after having OCD and PTSD for half my life, and I’m not sure how to approach it.

Due to my mental issues, I admit I’ve not taken good care of my teeth. I do generally keep up with my dental work however. I had a tooth with a big broken filling that turned into a cavity, then needed a crown, then probably needed a root canal as well. I put it off, switched insurance, had to wait until I’d had the insurance for a year, so on and so forth.

Anyway, last year I had a couple episodes of incredibly intense nerve pain in the tooth. They’d wake me up out of a dead sleep, have me getting irregular pulses of nasty electric shock pain for 20-45 minutes, and then go away totally. Went to a dentist, got basically shrugged off and pushed out the door because they were overbooked, got married a month later, put it off. Went in to the dentist in December for an evaluation, got told the nerve was probably dead since the pain went away for 4+ months, and made an appointment for a root canal a couple days after the new year.

Anyway, cut to the new year, and I woke up again with crazy tooth pain. Orajel and ibuprofen didn’t help. This time, it was 10/10 electric shock pain all the way up and down my jaw and into my ear. I’ve had major abdominal surgery with no pain relief after, I’ve had severely displaced broken bones, I’ve gotten all types of tattoos and piercings, and this was the worst pain of my life. Long story short, my husband convinced me to go to the ER.

Also a good time to mention that my PTSD and OCD trace back to a very terrible medical trauma. Even after 15+ years, I can’t step foot into a doctor’s office without flashbacks and severe anxiety. So we got to the ER and I had the worst PTSD trigger I’ve had in years, and I booked it out or there. Pain went away within another 30 min.

So now I got the root canal done, and that was painful but OK. The tooth was pretty infected and it hurt, but nothing unbearable. The dentist assured me that I would have no more pain episodes. I’m now waiting to just get my wisdom teeth out on that side and then have a crown placed.

Now to my problem…I’m apparently now terrified of the pain reoccurring despite all assurance to the contrary. The tooth looks fine. I can chew on it again. I have a little gingivitis and a couple smaller cavities, and the root canal was pretty rough on my jaw/nearby teeth, so I’ve had some little aches and sharp twinges here and there. But I have a constant creeping dread that the dentist missed something, lied to me, and that nerve pain will come back…and there’ll be nothing I can do about it.

I’m currently laid awake, for the 5th time in the last week, because I’m scared I’ll trigger the pain in my sleep some way. I’m scared to move or open my jaw. I’m supposed to get the wisdom teeth out, but I’m so scared of triggering the nerve pain with dental work that I canceled my appointment and haven’t rescheduled it.

How the hell do I get over this? I had an infected tooth with an open and inflamed nerve…like, of course that’s what caused the pain. I think the aborted ER visit probably just went and melded it with my medical PTSD. But how in the hell do I get my brain to accept this and let me sleep and eat and brush my teeth and finish getting my dental work done?

 

[Enarete]

Hi Icy_Mast ,

sorry to read what you have been through, the pain sounds brutal. I also see how it gets even more scary due to the fact that it happened at night without you triggering in in any way. If certain things or people lead to pain, we can avoid it, but if something happened just out of the blue, it means it can come up out of the blue again, right? So avoiding brushing and being careful in your sleep is actually a very smart way to stay guarded because if it is out of the blue, why not just be careful during any other activities, right?

One thing that may help is a bit of information on how teeth work. The pain you described sounds like a pain of a nerve that is infected and has not been treated. When someone needs a root canal, it means that the decay reached the nerve and what you described sounds like what could happen if not treated. The coming and going of the pain may be connected to parts of the nerve that got affected later. Now if you had a root canal treatment that was finished (means the tooth got cleaned out from the insight and there is no nerve anymore, but the canals where the nerve was got filled), then no pain can occure anymore. Your tooth is like a stuffed animal and there is no life in it. Nothing can hurt or react anymore. The dentists make sure to x-ray the teeth when this kind of treatment is being done and they also know how many canals which teeth usually have to make sure to clean it all. If you feel you do not believe the dentist, it may be a good idea to get an apt to look at the x-rays and let them reassure (and show you) that the tooth will be fine.

I appreciate that the trigger you had in the ER was not helpful and may have set you back with your PTSD. With this kind of diagnosis, it is important to take things easy and in controlled way to avoid being triggered. If your fear is so paralyzing that you cannot set foot in a doctor's office without flashbacks and anxiety, than the best thing would be to stop doing it and start tackling it with a mental health professional. Processing what had happened, identifying triggers, learning techniques that make you feel safe and learning to feel in charge and have a saying during these appointments. Very often just trying to push through is not very effective.

I suppose you had any kind of psychotherapeutic treatment in the past as you have these diagnoses? Was there anything helpful? And is there any chance of finding someone to work with again to make sure you can feel safe again? I know this is not always easy or possible as not everyone has access to these things, but still would be the best approach.

All the best wishes