Desperate Advice Needed

[desperatelady]

I have an extreme dental phobia, I'm 26 years old and I am pretty sure I need my wisdom teeth removed (I am now getting constant jaw and earache pain that my GP says is not medical but dentistry based, and there is a lot of overcrowding resulting in some of the other teeth becoming lose and the gums around my wisdom teeth are inflamed and starting to get cut). I'm also getting severe pain in an upper molar and I think there is an abscess behind it and I need a root canal, it may only be a cavity but I don't think so.
I am very afraid of the pain of the drill. Just the noise of the drill will set me off into a panic attack so previously I have got into the dentist chair and sat down but freaked out at the drill. I have been told all my life it does not hurt - but it does. It is excrutiating. So far having the novocaine has been pointless to me, last year I tried it without and it was exactly the same as the previous cavities I had with novocaine when the dentists told me I was imagining the pain! None of the dentists I have been to have believed me, or been in the least sympathetic. I do not mind needles and I would be happy to have as many jabs as it takes to get there but they think I am over reacting or it's all in my head.

After any drilling even a five minute cavity, I have extreme pain in that tooth for usually about 7-10 days afterwards, pain far worse than the cavity caused itself.

As a child I used to scream when I had a cavity and panic, so I was given a generel anaesthetic and branded a "troublemaker" by the dentist. In my country there was a 30 minute law for children's anaesthetic which did not require an anaesthesologist present to monitor - after 30 minutes they had to bring you back no matter what the situation. I went under at 12 years old for my first cavity and apparently they found it was a root canal, and ran out of time. The dentist used pliers to pull the teeth in the last minutes, I lost two teeth somehow - no one ever explained how, and woke up with a mouth full of blood and needing stitches. The law is a bit different now and I can no find any dental surgeries offering general anaesthetic any more only hospitals with long waiting lists.

As a teenager I had three sessions of IV sedation for three cavities. I was told I would be conscious but unaware of what was happening. I can only describe it as a really bad trip. I was fully aware of what was happening and fully aware of the pain but even worse than normal - I was paralysed and felt unable to move. A 10 minute procedure seemed to last 2 hours. I told the doctors and they said I was imagining it - again. The third time I was so terrified I wet myself in the chair and came out of it screaming, I was 16 and it was humiliating and I gave up on sedation. I have recurring nightmares about it even now 10 years later.

I had three treatments, one root canal and two small cavities with a regular dentist in my early 20s but it has now been about 4 years since I went to a dentist and I am experiencing extreme anxiety, panic attacks and nightmares about pain and the drill. I have found a dentist that offers sedation but I am scared to try it again, and they claim to be experienced with phobic people and anxiety and I managed to fill in the registration card but was having problems breathing and had to leave without even making a check up appointment to meet the dentist himself.

I need to find a way of breaking this phobia and even getting to the checkup to be walked through my options and try and discuss with the dentist the fact that the anaesthetic seems to fail so often, but I just can't get in there without panic attacks, I am not sleeping and my husband tells me I am waking up with breathing problems and nightmares throughout the night which I don't remember other than feeling like a zombie in the morning.

If it helps with any solutions, I am in the UK and eligible for NHS free dental work but the clinic I have registered at also takes private patients and offers sedation for a private fee. I would pay any amount of money to make this problem go away but so far all my dental experiences have been very bad ones, and I can't get out of the mindset that this one will be horrible, humiliating and excrutiatingly painful.

Does anyone have any advice as to how I proceed or what options are available to me? Thanks for reading this very long post.

 

[Stress Doc]

Hello and welcome to this forum

Your dental experiences have been difficult at best. In my experience patients are not "difficult or uncooperative" we just do not take the time to connect with them as people. Sometimes rules take precedence over people, that is not your fault. Inflicting pain on anyone because of a "rule" is abuse and there is no excuse. Your treatment as a child has left a lasting impression on you and you are suffering the consequences to this day.

You should not take blame for your experiences. You were treated poorly and without respect. That is wrong no matter what age you are.

In regard to the pain you feel even with a local anesthetic. I understand and I think your dentist was daft for telling you that you were not experiencing pain. Humans have an almost singular ability to overcome the effects of any medication.

I was working an ER shift early in my career. We had a patient come in with a severe panic attack they were given enough I.V. Valium to sedate an elephant but they managed to overcome it.

If you say you are feeling pain then the pain is real and should be treated as such. High anxiety and panic can cause you to metabolize medications at an amazing rate. During anxiety and panic your brain is fight for its life. Your self protection mechanism is in high gear.

I believe everything you are saying and this is very real for you. You are not crazy. You are not making this up. You are not difficult or uncooperative and you are not alone. Dental phobia is huge. In the USA almost 20% of the people suffer from this condition.

The past dental trauma you suffered has setup a powerful emotional and physical response.

Now to the good news. Dentistry has made incredible advances in the past few years. Dentists have many more option than they ever had. Oral sedation (anti-anxiety medication) is great and very effective.

You have taken the first and most important step to dealing with you phobia, acknowledging it. Anxiety and phobia thrives on feelings of hopelessness and helplessness.

If you were in my office I would take your hand and look you in the eye and tell you "You are going to be OK. This condition can be controlled and does not have to rule your life. There is hope and help."

I speak from experience. I am an anxiety/phobia specialist. I have worked with this condition for 20+ years in my practice.

In addition to medication there are also many things you can do to learn to control the anxiety response. Learning to exercise control empowers you, anxiety and phobia fade when you are empowered with the tools and techniques to successfully deal with them.

You are willing to face your fears which takes more courage than most people can imagine. Give yourself a huge pat on the back for moving forward and refusing to let this issue rule you.

If you PM me I will be happy to send you tools and techniques I developed for my patients.

You will beat this and know the joy of overcoming a true monster that has been eating at you for years.

Please let me know what I can do to help

All the best!

 

[Emita5853]

Hi desperatelady,

I read your post and can totally identify with what you are writing. My phobia is so bad now that my new dentist didn't examine me (i wouldn't let her!) she referred me to specialist services in my PCT. The PCT services didn't work as they were based upon talking to me calmly and hypnosis which i wasn't up for but just 2 weeks ago i was given an appointment at Guys Hospital in London where they have a special care dentistry unit. I went along and they chatted to me - we didn't even have to go near the chair as i hyperventilate once i'm in the room with any equipment. I have been offered weekly appointments to just come along and talk about my fear. Eventually the aim will be that I can be in a place to have treatment and they said that that treatment can include sedation or GA if I want. I have had to wait years for this and it's a real God-send, i'm really grateful that my dentist pushed for a referral here. I don't know where you are based or if what i have described would even appeal to you but if you're in London it might be worth finding a dentist who will refer you.

all the best
=)

 

[brit]

You poor thing..what nasty ignorant dentists you have encountered to date (they are not all like that honestly). Here is our link on 'Can't get numb' :

Can't Get Numb

Find out why you may not get numb enough, what dentists can do to get you numb, and how to ensure your treatment is painless.

www.dentalfearcentral.org

Stressdoc could be right about it being extreme anxiety preventing medication from working properly but there are 3 other possible causes (anatomic variation, dentist error, infection present).

Normally i/v sedation done properly would overcome anxiety so I think he's right (in the absence of GA) you need to build a relationship of trust with a view to relaxing before trying actual treatment again.
You should also look for a dentist familiar with the more advanced numbing techniques (sometimes these are required to get properly numb).

If you are eligible for the Community Dental Service in your area that might be the way to go as they would be able to resort to GA if necessary.

It could of course be a combination of reasons as to why LA has not worked in the past, if your first bad experience was dentist error and you weren't believed then it is easy to see how at your second experience anxiety could present a barrier and if you do have nerves in a slightly different place to the norm, then in the lower jaw especially you may require a different LA technique to be used to get properly numb. Dentists with TheWand apparently often have an easier job getting teeth numb which are otherwise difficult.

Given your bad trip i/v sedation experience, I would suggest that with a CDS dentist or a sympathetic (probably private) dentist who knows advanced techniques, you try after just chatting everything through and building up some trust on a personal level, you try numbing a tooth with just LA (no treatment) and see if you feel numb. If you do then you may want to try proceeding with treatment but the key difference has to be that you remain in control and if you signal pain (or need a break or more LA), they agree to stop immediately and ensure you are comfortable and painfree before continuing. This way your anxiety is reduced because you have changed sth in the mix, you are in control and the treatment will be called off permanently if you want, if they are not able to get and keep you sufficiently numb.

Using nitrous oxide as a relaxant could also help as it would not impair your ability to call a halt. If you do opt for i/v sedation again, have a trusted person within earshot and authorised to call a halt if you appear to them to be inadequately sedated...it could just be that you did not get enough sedation to be painfree but they just carried on regardless assuming you were sufficiently 'out of it'.....very best of luck....there will be someone in UK who can help but you need to find them.
The downside to GA is that it restricts the kind of restorative work they can do e.g. extractions rather than root canals. A CDS dentist who you trust may well be able to help using several different techniques so that GA is avoided (not a good long term solution anyway as so hard to come by).

 

[desperatelady]

Thanks for the help and advice so far, I really appreciate it.

I have managed to find the courage to make a checkup appointment to just discuss things and have a look at what needs doing with the dentist at the new clinic I'm registered with. I haven't met him yet but the receptionist said they are the most experienced with phobic patients in the area with sedation on hand and my appointment is with the principle dentist who is experienced with anxiety and phobia so I am hoping I will not be treated like I'm over reacting or being silly and will get someone who understands my fears and can walk me through it. It's on next Monday morning so I have a week to prepare.

I'm very very nervous about it even though I know it's just a checkup and nothing's going to happen but the receptionist didn't treat me like a pariah when I mentioned it which some have in the past and said she'd make a note on the file so the dentist would be aware and make some extra time for me so we'll see how it goes. My GP has also given me a book to read on panic attacks and controlling anxiety and has said that if I can't do it this time he will prescribe a relaxant of some sort to try and calm me but he wants me to try and get to the checkup without any drugs if I can, and I'm not keen on taking any medication that isn't absolutely necessary anyway. He also said he could refer me to a pyschological therapist but it could take about 6-12 months to get the referral through and there is no guarantee that it would help.

 

[Alexandra1973]

I had a bad experience at the age of 2, which I vaguely remember.

For some reason I needed my top front teeth removed. Dentist did so WITHOUT numbing me! He had the nerve to tell my mother that babies can't feel pain!

Since then I've never been much for going to the dentist. When I was 14-16 I had braces and the orthodontist criticized me every visit for not cleaning my teeth right, even though we had a Water Pik that I used constantly to help. I got so sick of it.

Last time I had anything done I was 19 and covered by my mother's insurance. I moved out the following year. I'm almost 36 and I need my wisdom teeth out. I still have a bit of a phobia but I'm making myself get over it...I figure, better a little pain now than a lot later. I have a few twinges of pain once in a while, nothing bad...just don't want it to get worse!

When I was 15 I had 3 teeth removed because of the braces--teeth needed room. I hated it. This time I'm going for sedation. I had partial anaesthetic while having a biopsy when I was 22...and I was pretty well high!

Then it wore off....