Cracked my main eating molar; haven't been to dentist since I was a kid.

[FrightenedJerk]

@NervousUSA Just curious why you did not want to do sedation. I have concerns about that myself. What anesthetic did you have for the extraction and the implant?

The dentist I went to said that the overall process for an implant would be 6-8 months. Apparently you have to sit with the screw in and a cap on it for several months while the bone accepts it, then go back and they put the tooth on it. So even if I elect to get it, I'd still have no tooth for a while in those areas.

 

[NervousUSA]

I have always been massively horrified by the idea of sedation, possibly because of having it as a preschooler and having a paradoxical reaction to it (a situation I don't remember well but enough for it to be really disturbing). The final straw for me quiting seeing dentists at 15 was the dentist was trying to push my parents to have all my unerrupted wisdom teeth surgically removed (with full sedation, maybe even general anesthesia). It actually really upsets me they acted like that was urgent, or the only option, a more honest discussion of different options could have led to things going a lot better for me later. I had the teeth removed while middle aged with local anesthetic. I worked with sedation and anesthesia at a pet clinic as a teen, and my experience of it there was it was pretty brutal, could be dangerous, I saw bad reactions, and side effects. One most notable one was that animals who had had it many times could seem mentally affected and spaced out permanently, but also animals screaming, moaning, and seemingly hallucinating while coming out of it. I researched the side effects of it for humans, and didn't want to risk them, also there is the fact you can die from sedation, and a small number of people do so during dental procedures every year. I would not risk death if I don't have to. The way my dental fear/phobia is, is that going through the procedure in the chair is not what frightens me, I fear being decieved, overtreated, harmed by a treatment, not given informed consent, manipulated, or a treatment goes wrong, not going through procedures, so I don't have a need for sedation, it won't help me with what I fear. I also fear sedation maybe a hundred times more than any dental procedure. I had local anesthetic for all the procedures. I had infiltration for the extraction of the tooth that was replaced by the implant, and a nerve block for the implant. For me the whole implant process was 7 months. It would have been 6 but I stopped treatment in December because my insurance was maxed, and started again in January. I had the implant fully buried in my jawbone for about 4 months, then a surgery to expose it and put on the cap, so I had the cap in place about 3 months. Adding on the time from when my tooth was extracted until I had the implant surgery, I think 8 months total.

 

[FrightenedJerk]

Oh, crap. I think I just made my situation worse. For 15 days I've been eating gingerly on both the upper molar that newly cracked and on the lower molar on the other side that cracked 15 years ago. I didn't really have any pain in that newly cracked tooth, which surprised me. Then this evening I was eating a cookie, and it crunched up inside the cleft of the cracked tooth and I guess crunched through something that might not have been crunched through before. I have a definite toothache and nerve pain that feels like it extends down to my lower jaw. Never really had a severe toothache before that I can recall. Does the pain in my lower jaw just come from a common nerve between upper and lower?

So I'm worried what this means. Even if the pain goes away or subsides some, does this mean the tooth could be infected, and could the infection spread to other teeth or into the jaw? I'm wondering if I should consider this an emergency and try to get the tooth out before I was ready. I was hoping to "maintain" with the cracked tooth while I got the deep cleanings and got the fillings, and in the meantime I'd explore my options and maybe visit an oral surgeon for a consultation, as the dentist last week seemed to suggest that at his place they are incapable of removing the tooth due to it being so badly broken that it might bust apart when removed. That might no longer be possible.

 

[NervousUSA]

@FrightenedJerk Sorry to hear about this! I would suggest you go over to the Ask A Dentist forum to get some more information about this from Dr. Gordon. I think the upper and lower jaw have separate nerves, but am just a layperson. If it were me, if I felt serious pain, I would consider it an emergency and go in to the dentist. I have had infections before and they didn't go away on their own, I had to get antibiotics and treatment.

 

[FrightenedJerk]

I went to the first of two deep cleaning sessions. The hygienist was nice and the process of the session went well. The scraping on my teeth "went through me" or "broke threads", as they say, but I'll take that over what could be coming. She mentioned on the last appointment and on this one that I have some bone loss. I didn't go into a whole conversation about it, but asked her a bit, and she said it can occur as you age or if you haven't been to the dentist (as I haven't), as far as tartar eating away at the bone. Even though I don't have any right to hope for anything given my absence, I just hope that with continued maintenance and visits that it could be arrested.

I didn't go into too many questions with her about other stuff, but I did ask about implants, and she mentioned the idea of bone grafts being a possibility before the implant is placed. Has anybody else dealt with that?

At the moment (outside of this session), I really can't eat comfortably at all. I'm hesitant to chew on my right side for fear that something will get up in that cleft and re-spark the toothache. Then on the left, I can only eat on the most forward teeth, not that cracked lower molar as much, as it does cause a bit of a dull ache when I put too much pressure on it. After they come out, it would be worse.

I'm definitely still filled with a deep shame over not doing this regularly, and I'm paying the price. My issue isn't fear of pain at the dentist (though that is a consideration), but a deeper psychological issue of lack of care and lack of regard for self, as well as inertia and procrastination and OCD (not stereotypical OCD, but it's complicated) that affect not just this but many other areas of my life. I also don't go to the regular doctor for check-ups, but do for things like ear wax removal and the skin lesions I had on my face this year.

 

[NervousUSA]

@FrightenedJerk It's great you went to the session and it went well. When it comes to bone loss, legally, hygienists can't diagnose, so I would take anything she says with a grain of salt until it is confirmed by a dentist. Hopefully as you move forward, things will get more comfortable and eating becomes easier. I actually found eating with a missing tooth just fine, way better than eating with a painful dying tooth. I think it is really positive you are taking action, helping yourself, and improving your situation. You are dealing with these personal issues that get in the way too, and I think it is great you are finding a way to work through that, and do what you need to do.

 

[FrightenedJerk]

@NervousUSA Thanks again for the support. I haven't looked up much detail about bone loss yet and am leery to do so. I've only read it mentioned regarding when people have one or more teeth removed, that the bone starts to disappear. Mine might be obvious enough that she was able to tell right away. I don't know what that means for me going forward, whether ongoing maintenance and visits could stop further progression.

After the deep cleaning/root planing, I didn't feel any real discomfort throughout the rest of the day. It might be my imagination, but my molars feel slightly stiffer as you mentioned when I clench down, but not really different than they had. Don't they dig down into the pockets of each gum/tooth connection, like way down into the roots? It didn't feel like she did that, but of course I was numbed up. It seems like something that invasive should cause some residual discomfort.

 

[NervousUSA]

@FrightenedJerk I really wouldn't worry too much about bone loss unless you have it diagnosed by a dentist. I have had hygienists say all kinds of things about the condition of my teeth that the dentist didn't agree with, and suggest treatments, or make statements about treatments that they thought I should have, that the dentist didn't agree with. They don't have the education level of a dentist, though they are often very good, I have learned to wait for the dentist to confirm. Though just a layperson, I think doing the deep cleanings and then going forward with ongoing maintainance and cleanings would stop further progression, might be worth going to the ask dentists forum about that one. I haven't had any more serious gum problems after getting all problem teeth extracted and having regular cleanings. I think that stiffer feeling could be a good sign! They do go down into the pockets for a deep cleaning, and I have had even normal cleanings that caused residual discomfort, so I don't know why you didn't feel any discomfort. Maybe it is a good sign that you got some irritants and bacteria cleaned out of there. Possibly Dr. Gordon would know.

 

[FrightenedJerk]

I had my second deep cleaning appointment today. It went well, and she applied some type of substance and used polishing that she didn't do last time which appears to have whitened my teeth some. That's a nice bonus.

The hygienist wanted me to make an appointment for the first set of fillings, so rather than slough it off and say I'd call, I made a tentative one for later in the month. I still need to do some research. An issue for me is that I have what I term "OCD" regarding all interactions with ink and writing. I would not want to have ink in my body. It's nothing to do with safety but just the knowledge of it. The most stressful part of the biopsy on my lip I had a few months ago was the fact that they needed to mark up the area with a surgical marker; I was freaking out when I got home that ink might be circulating in me from being folded into the stitched area. This issue can extend to something like paints, dyes, colorings, or pigments even though those aren't as big of an issue as ink itself. Same thing, though - I wouldn't want to have paint/dye/coloring/pigments on an object like a filling or implant that is permanently in my body. That sounds so stupid, but OCD is stupid even though you can't escape it. So I need to find out exactly what resin fillings are made of (since apparently amalgam, which I already have some of, is rarely used), as well as implants. I did some preliminary asking of dentists online, but want to get more info.

I might also need to raise this issue with my dentist via email, since talking about it in person is difficult. The dentist office doesn't have any email address on their website, but I asked the hygienist for it. I didn't clarify whether the dentist would be able to respond to this or if it would just go to office staff. Do dentists and other doctors balk at answering your questions outside of your appointment hours (perhaps for liability reasons)? Just wondering.

I also need to look into a consult with an oral surgeon. If anybody has gone to an oral surgeon after being told to do so by a dentist, do you know whether they will do their own x-rays or just use the ones done by the referring dentist?

 

[NervousUSA]

@FrightenedJerk Glad to hear the cleaning went well! The substance was probably an abrasive paste, with fine grit in it, that is what is used for polishing. When it comes to the ink and finding out about the ingredients in these things, I think there is a pigment in composite fillings, but not an ink. I think the dental implant itself, that goes in your body, is pure metal. The crowns are ceramic with a glaze, they are not in your body but they are in your mouth. I think the email goes to the office staff it always has for me. You might be able to ask them to ask the dentist a question for you in the email, or ask them if you can talk to the dentist directly. A couple of ideas, you might be able to request a metal filling. It also might be good to tell the office staff about the issue with ink, if you haven't already, I would probably tell them if this was me. I say this because I made sure to tell my dentist clearly and repeately that I didn't want sedation, since I was having procedures that most people have sedation for as well as being visibly anxious. Since my wishes aren't what would be most usual, people don't understand automatically if I don't tell them, and I can't get what I want if I don't ask. The dentist clearly thought my wishes were unusual but did what I wanted. I wonder if you might have a bit of the same situation with the ink. The oral surgeon x-ray question is going to be different practice to practice, and it will be best to ask that to your dentists office staff, they can tell you what that particular practice does.

 

[FrightenedJerk]

@NervousUSA It's hard to explain the OCD stuff and why it's an issue, but it's a definite consideration as far as being okay with this stuff on a mental level. It's not an ink, but it's a pigment which to me isn't much different. I'm trying to get over it, but I might need to ask them what they use and request amalgam. If they can't do amalgam, not sure whether I would go to another place that does or what that would entail as far as transferring records or needing to get a whole new treatment plan from that place. I asked online, and the implant crown could be of a few different types; I'd want one that doesn't have a "glaze" or painting to it.

At any rate, I need to consider "getting on" this and setting up appointments, as difficult as it is. The hygienist the other day said that I need to get going on the fillings so they don't turn into anything. She must have forgotten that I've not been to the dentist in 30+ years, and have had these cavities for years (it's fine if she has forgotten; I'd rather not repeat it to anybody). The newly cracked molar is a bit more urgent, no doubt.

 

[NervousUSA]

@FrightenedJerk If it were me, I would probably call or email the office, and ask and try to request amalgam. I wouldn't go to a filling appointment if I wanted the less popular type of filling, without discussing it first, I think it is quite likely they would assume you want the composite kind if you don't talk to them about it. I think this because I have never discussed what filling material I want and have always been given the composite kind automatically. I think if you switched places you could transfer your records, but you would get a new treatment plan. I am glad you got some information about different crowns. I did a search online myself and learned there are full metal implant crowns available. Again, this is probably something you would have to specially request, I think the glazed porcelain ones are the default, that is what I was provided with with no discussion of different types. I think it is really positive you are doing reasearch, and moving forward setting up appointments, it sounds like you are making positive progress and working on improving your situation.

 

[FrightenedJerk]

@NervousUSA I wouldn't go so far to say that I'm setting up appointments yet; I'm still procrastinating on that. I have an appointment for fillings at the end of the month, but I'm not sure if I will keep that. I did ask via email whether this dentist does amalgam fillings, and was told that they do not. So I need to decide whether I'm okay with the resin composite as it relates to my OCD issues. I've been asking online about some of this stuff, and one dentist said it's possible to request a resin without coloring, and another said that all resin composites have coloring agents. The implant materials are another matter.

I'd prefer not to go to another dentist because I don't want them to give me a different treatment plan that might be worse for me, and I like this hygienist I've been to twice and who seems to be the one "assigned" to me. Still, I'm going to email a few dentists and find out whether amalgam is something they offer.

 

[NervousUSA]

Even a tentative appointment that you may or may not do is progress, and so much better than nothing. It sounds to me like it is possible the two dentists you talked to online were using different types or brands of resin. I wonder what your particular dentist would say if you put that question to them? It is true that different dentists give very different treatment plans, and I actually switched dentists because the first treatment plan I was offered wasn't good for me. It sounds worthwhile to find out what amalgam options are out there. I wonder if an older dentist would be more likely to offer that, since it is an older treatment.

 

[FrightenedJerk]

I called up to cancel the appointment I thought I had for this Thursday. Even outside of my desire for amalgam which they don't do, this week is too busy. It turns out they don't have an appointment scheduled for me. Not sure what happened. I had asked them about amalgam fillings and that being my preference, but I don't think they would have canceled my appointment without consulting me. I tentatively rescheduled it for three weeks from today, but I haven't done any additional call outs to places about amalgam fillings. Need to get on that, and also figure out whether I'm fine with resin.

If I went to a new place, that would probably be something out of pocket for me depending on my insurance, at least the initial visit. I really should have focused my original search on places that have amalgam, but I didn't totally think about that aspect of it or how it would bother me in an OCD way.

I also need to research oral surgeons for at least a consultation. I realize that I need to get going on this. I can't allow the fact that I've been eating pretty well on the left side (opposite of what I've been doing for 15 years) using the teeth in front of the lower cracked molar to cause me to think that I can delay this too much.

 

[NervousUSA]

It sounds like you need more research before you act. Hopefully you can get your research done and make your decisions about fillings. I think it is good you are thinking about getting going on it and avoiding too much delay.

 

[FrightenedJerk]

I'm realizing that if I were to get both the molars out at the same time (which are teeth 3 and 19), I really wouldn't be able to eat, or at least nothing but soft stuff like rice . . . at all, on either side. I'm thinking of how I have been using, on the left side, the teeth in front of that lower left molar (20 and 21) to chew, but also the whole part of the cracked 19. That 19 is vital in chewing, and the same is the case with 3. The teeth in front of that really have no role in regular chewing. Given the hypothetical amount of time that it would take to be completely operational with an implant, that would be time that I could not eat in any normal way. So I wonder if I should ask if doing them consecutively is possible. Don't know if they'd go for that due to how badly cracked both are (though I've existed with the left bottom cracked for 15 years but haven't eaten on it until now, and it gives me a slight twinge when I eat on it in certain ways). Regardless, I don't believe that I will have the fortitude to do either of the extractions this month/year due to how hectic December is. I should, however, still try to look at oral surgeons and going in for a consultation. Overall, though, I'm starting to lose my nerve.

 

[NervousUSA]

@FrightenedJerk Maybe it would be worth making a new post asking for people's experiences with eating in situations like this. I had a friend who ate fairly normally for years who wasn't able to use their molars at all, they used their front teeth only to "chew" their food, so I think that it might be hard to know how that kind of thing works out, I wouldn't have guessed they would be able to eat as well as they could in the condition they were in. This person had reacted to being scolded and put down by dentists and hygienists for not having good enough hygiene, by stopping any cleaning of their teeth whatsoever while they had braces on, they also stopped going to the dentist and orthodontist, and just left the braces on while all their teeth rotted, cracked, and broke, no brushing, no flossing, no nothing. I would never have believed they could eat as normally as they could. I would say it is worth asking the dental office or dentist any possible question you may have, or getting any possible information you may want, so I would ask about doing things consecutively. When it comes to losing your nerve, when I feel like that might be happening to me, but I want to move forward, I might ask myself, if you do that, what will the outcome be? Another good line of thinking for me, is how has delaying worked out for me before, did I gain any benefit, and did I feel good that I had done that, or regretful? Also, another question I ask myself, is it really an option? I got to the point where there was no option, and I was forced to move forward, it would have been better to not wait until things got that bad, so there was never really an option where I could get out of anything.

 

[FrightenedJerk]

Regarding fillings, I found that apparently, it takes more drilling to make an amalgam filling stick than it does for a resin filling. Hmm, that sucks. I definitely wouldn't want more of my tooth drilled than is necessary, especially since my enamel is already likely reduced. So I might be stuck with resin.

 

[NervousUSA]

I wonder if that is always true, or if it something that is different case by case or dentist by dentist. It might make it worth going with resin.