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Crown appointment and paralyzed with fear and depression



Well-known member
Sep 8, 2012
Hello, I'm Sharon and found this web site tonight while searching for forums for those with dental phobia.

Week after next I have to have a crown put on, I'm not new to this, having had at least a dozen (and this is the third time for this tooth. :( But it's been 20 years since my last one and my fears and phobias have increased greatly in this time.

I am not afraid of pain, noises, drills or needles but I have a terrible fear of vomiting and because of this I am petrified of most dental work, specifically the dental impression. I am about to lose my mind over the fear of what will happen when he puts that in my mouth. He said he will use a smaller one but even that will be too big for me. I have honestly been pretty non-functional for the last two weeks. I have been prescribed 5 mgs of valium to take the night before and 5 mgs to take the morning of. I think that would be enough to help me get through the appt if I didn't have to have the impression.

I read the page on this site about the fear of gagging and I felt somewhat comforted knowing others have this also but there was nothing there that made me feel any better about going through this. One suggestion said to always breath through the nose. A friend of mine told me her dentist said to always breath through the mouth. So which is correct? Or is it either, and it's just that by concentrating on your breathing you supposedly keep your mind off other things?

My other horrible fear in the dental chair is that of the postion he puts me in - fully reclined with my head lower than my feet. I get scared lying like this I can't swallow and water and saliva start dribbling down my throart making me feel like I will choke and gag. Also I have a vertigo disorder and this position makes me feel more on the verge of vertigo than usual.

The tooth to be crowned is #10. Can anyone tell me - how common it is to gag during impressions? How long does it have to stay in my mouth? Is the bottom impression as bad as the top? Is the smaller size really any more tolerable? Does he have to use a rubber dam when doing a crown? Do I really need to lie in that position or can I sit up somewhat? I asked him once and he said that is the best position for him. BUT WHAT ABOUT ME?????? I wanted to cry out.

Can anyone help me? I am desparate.
You are the one in control and unless the dentist tells you a viable reason for you to be positioned that low, there is no reason for it. If you don't feel comfortable with that, you need to let them know and they need to work with you, not the other way around. And if they don't, find another dentist who will. ESPECIALLY with you having issues with vertigo. They HAVE to respect that. And again, if they don't. Leave. That is a medical condition that they have to work around. That upsets me that they would disrespect you that way.

I know my dentist has the CEREC system, which doesn't use the traditional impression goop and trays. It takes a picture of your tooth, and then the system makes your crown right there. I'd suspect it's more expensive (or maybe not considering it save the practice lab bills, adjustments, and multiple appointments with you), but if it is, sounds like that might be an expense worth it to you. I know my dentist is a tad more expensive than others, but he has so much of the latest technology with lasers, air abrasion, etc that it's worth it for me NOT to have to get shots.

Here's more information about the CEREC system... it's very cool.
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Hi sharon,

I completely understand. I had a ton of dental work done about 15 years ago, and thought I was "cured" but then I drifted away again and went right back to the old fear and anxiety.

I'll second everything MC said. The issue of being reclined is a sticky one, because most dentists are trained to work with the patient fully reclined. They need to be able to see what they're doing, and the prone position also allows them to comfortably and accurately position their tools. Still, you need to be comfortable. My dentist will raise the chair a few degrees so my head is slightly up (about the same a lying flat in bed with a pillow), and that makes a huge difference for me. Sometimes for the lower back teeth she'll ask to recline me a little further, but she's always very careful and tells me to stop her if I get dizzy or uncomfortable.

I would think that for a front tooth like #10, the dentist would be able to raise you up a bit to accomodate you. If he just won't, it doesn't make him a bad dentist, but he might not be the right dentist for you. It's VERY important that you are able to be comfortable (well, relatively :hmm:) and not feel sick or out of control while you're getting work. So you might want to look for a dentist who can work with you in a slightly elevated position.

My dentist also uses CEREC, and I love it! There are no molds or impressions. Instead, the dental assistant uses a little wand with a camera at the end to take digital pictures of the prepared tooth, and then the computer figures out the correct shape from those. My dentist's version of CEREC won't do crowns below the gumline or bonded crowns like on my molars, but for the easier crowns, it's awesome! Plus it makes the crown right in the office, so I don't need to come back a second time. Definitely look into this, it might help you avoid the impressions.

For the #10 tooth, I think they can use a very small tray that just takes and impression of the tooth and its neighbors. It looks kind of like a toothbrush and is about the same size; it's not the giant full-quadrant tray they need for molars.

I have a really bad gag reflex, and I've always been told to breathe through the nose. I find that if I hyper-focus on breathing in and out of my nose, I can kind of ignore the giant thing in my mouth (whether x-rays or impressions). I breathe really fast and deep, and I concentrate on it: in, out, in out, over and over. It seems to help, a bit. Also sitting fully upright or even leaning forward a bit during impressions helps. (The dentist doesn't need to recline you to take an impression).

What else did you ask? Oh, yes, it's very common to gag during impressions. The impression usually stays in for a full 2-3 minutes. It feels like 5-10! If there's a clock on the wall or if you have a watch with a second hand, you can stare at that and it might help a little. I find top impressions a little easier-- a lot of my gag reflex involves things touching my tongue. Front impressions are also easier than back. Yes, the smaller size helps a lot! I don't think a rubber dam is necessary for a crown. My dentist only uses them for doing internal work like a root canal. And yes, it should be possible to sit up "somewhat". For the drilling and shaping, you'll probably have to be lying mostly down, but should be able to have your head elevated a little to prevent vertigo. See if they can sit you right up for the impression.

I hope that helps! Just to reiterate what MC said, you are in control and your needs and comfort are very important. If your dentist can't or won't work with you to keep your vertigo under control, it might be time to find a dentist that works better with you.

Good luck!
Hi sharon :welcome:, I don't have much to add to what Steve and MC have already said, but just wanted to mention that we have a page with information on chair position here: www.dentalfearcentral.org/fears/loss-of-control/#chair

It's definitely breathing through your nose that makes you feel less gaggy (I know when I have a cold and my nose is blocked, I get all gaggy when trying to brush my teeth for example!). Either your friend's dentist got it wrong, or your friend remembered incorrectly :).
Hi Sharon and a very warm :welcome: to you. Having impressions done is one of the things I think a lot of people fear and worry about. I know I was, and I had some done the other week, and still got all in a tizzy over it. It isn't the nicest of things to have to go through, but it is also not the worst. As Steve said, although in reality the timescale is only a few minutes, it seems as if it is going on for a lot longer. My dentist kept telling me how much longer it would be, and I found that helped a lot.

I have a bit of a gag thing, which I didn't really think about until some months ago, when I was prescribed a different companies tablet to the one I usually get. It was like the size of a horse pill, and boy did I find out about gagging when I was on those :yuck:

So, knowing I would need impressions was a real worry to me, but dentists in general are aware that people can react with things in their mouths, and so are prepared. I think we feel worse because we think it is just us that it will happen to, but you are not alone.

And I can second lets to the breathing through the nose, as that is what Lincoln told me to do (along with holding my leg up ;) it was a further distraction measure)

I truly hope you get on alright, let us know.

Take care.

Oh thank you so much for your responses and for being here to understand my fears!! I never heard of CEREC before, my gosh, this sounds like an answer to my prayers. I doubt my dentist does it it or he would have mentioned it to and would have it advertised all over his office I would think. But under the recommend a dentist section here someone mentioned a very gentle one that happens to be not too far from me. I did a search on him, found his website and he does CEREC so I will call Monday and see what they can tell me about this. When I read about CEREC I felt such a relief come over me because I am so afraid I can't do the impression and I will leave the office with a big gaping hole in my mouth. I do have concerns and questions on it and I am going to post those on the ask a dentist question. My main question is can this be done on a #10 tooth, from what I read it's not real good for front teeth.

The chair problem - thank you for pointing me in the right direction to that page - I didn't see it before. Just looking at the picture of someone lying back in the chair gave me the willies. I think with enough valium and with a dentist who will let me sit up a tad bit more than usual I may be able to get through that part. But I don't think there is enough valium to get me through the impression.

I'm having a horrible day thinking about this upcoming dental work I have to have. I've been reading a lot about CEREC and because there is so little tooth left under my current crown I fear I will have to go the traditional route. I honestly don't know if I will be able to get through it.

MC, yes, the vertigo issue is quite a problem. I haven't talked about that specifically with my denstist, but have only talked about me not liking to lie back. I woudn't like it even if I didn't have vertigo, but the vertigo problem just makes it so much worse. And with all my worrying about this crown and the impression I am afraid I will give myself a vertigo attack.

I am feeling so sick and depressed about this. I am literallly barely functioning.

Last crown I had done was about 15 years ago. I got through the impression okay and felt such relief when that part was over. Then he did some more work and then he did another impression. This was after he had already told me there would me no more impressions, I was done with them. I was so upset and asked him why he lied to me. He said if I knew I had to have another impression I would have been very nervous so he wanted to help me by telling me there were no more. I lost a lot of trust in him and this is one big reason I don't want him to do the crown. He said he will use a smaller impression, but will he really? of is that another lie? He is a good dentist, very gentle and a perfectionist but I can't trust him obviously.
As someone mentioned to me that helped a lot.... set time aside to panic about this, but only during that time. The rest of your day, try to enjoy it. And I can also tell you that is easier said than done, believe me. But I'll plant the seed like he did to me when he suggested it, and it did help.

At this point, it sounds as though you need to see about whether or not CEREC can be your option. Until then, try not to worry about it until you have all the information. Again, I know that is easier said than done. I was in complete panic mode until I found out the results of my x-rays and I was so relieved and much more relaxed after I found out. I made it much worse than it was, and I spent a lot of time worrying about something that turned out to be nothing. I completely sympathize with you though that it's hard to not think about and get yourself worked up over. I wish I could hug you!! So here's a virtual one!:XXLhug:

And if your dentist lied to you, then no, you cannot trust him. And you need to find someone who will work with you. On every level. Whether it be the vertigo, not being comfortable lying back or the impression. I know we will all keep our fingers crossed that the CEREC machine can do the trick. Or if not, that there is easier method for the impression. :clover::clover: