Had my first appointment in 9 years- feeling lost on how to advocate for myself and what to ask

[charlietryin]

Hello kind people,
My name is Charlie I am 27 years old, and I have quite severe dental phobia. My back molars had fallen apart years ago, I had a couple partially broken teeth- and recently one of my premolars completely broke off. I had tried for years and years to go to the dentist, the longer I waited the worse the anxiety got. I felt so deeply ashamed and felt doomed. When my most recent tooth breakage happened- very visible in my smile line- no way to hide it. I decided I needed to just do it and go fearing that there may come a day where I had nothing left.

I cried the entire time on the phone scheduling, and the entirety of my appointment. I just got a cleaning and xrays. The whole thing went by in a blur, the dentist I saw did not really communicate with me about a treatment plan or anything at all really. She just asked me if I wanted to be prescribed Ativan for my dental anxiety. She had asked before she started the cleaning if I had any questions but I said I didn't, thinking she would speak to me more after she was done. But after she finished the cleaning she just sent me on my way and I left confused and in a daze. The staff was very respectful and kind (the front desk person even offered to give me a hug which I did take and thought it was very kind) but it felt like nothing got communicated to me at all.
I got sent to the front desk after the cleaning and they said they would send a referral for extractions at a local surgical center. I still kind of confused at the lack of communication asked if they needed anything from me and they said I was good to go.
So I left kind of confused. And went home feeling lost at what was happening. I know I need a lot of work done but going in and still not knowing how worried I should be is hard. I'm kind of catastophizing or maybe I'm not that I will have no teeth by the end of this.

I kinda started to get stuck in anxious loop again, but my partner who has been extremely supportive encouraged me to call them today. So I called, having not heard anything since my cleaning in February.
They said I was supposed to call the surgical center myself which I didn't know, they also said I needed fillings in my front teeth that they would be able to get me in this week for, so I agreed to do that this week being kind of put on the spot and then I said I would call the surgical center.

I did that, and the surgical center said that my chart said I need 7 extractions (3 wisdom teeth and 4 molars apparently). I wasn't exactly surprised by this- I've seen what it looks like back there quite awful, but surprised that this wasn't communicated really to me. That appointment for the extractions is going to be a couple months down the line (thats the soonest they could offer it).

But anyways long ramblings aside, I have an appointment I guess for some fillings now this Thursday. But I'm feeling like I'm struggling with how this process is happening. It feels very much outside of my control. Or that I don't have much of a voice. I want to know all my options I guess, I want to have some kind of say about what I am agreeing to and when.

If I have to get 7 teeth removed, and that doesn't even include my broken premolar that is currently causing me the most stress and I have another one on the opposite side that feels like its very fragile and loose, I know also from my phone call today I have lots of root canals and fillings to get- I don't know- like should I be considering other options? I have vaguely been imagining getting All on 4 with payment plans, I know its a lot of money and I know I'm quite young for such an invasive procedure, it's a lot of money I don't have but I don't know if getting this many teeth removed and having to get crowns and fillings and all that on what teeth I do have- necessarily feels better? I also feel at the very least I want to know what I can do about my premolar having a missing tooth in my smile line has made me feel so insecure, these past 2 months without it has felt hellish, I'm so anxious every time I eat and every time I smile or laugh.
And it feels odd that is what prompted my visit and they didn't even mention taking care of that whatsoever.

It also feels hard to advocate for myself and speak up when my anxiety immediately turns me into a sobbing mess unable to speak as soon as I engage with any dental stuff even just over the phone. I had tried sending the dental office an email as well before I made the phone call today hoping that way I could say what I needed but they never responded to it, hence me needing to call today.

I apologize this is so long. I am trying to be kind to myself about the fact that setting up that first appointment and going was very brave. And I am proud of myself for doing that, but I just wish I could speak up for myself more during my appointment. I also just wish I had a better understanding of what is realistic for "fixing" my teeth. I still have that doomed feeling after not really receiving good communication. And in my head I'm gonna go to these appointments and leave with no teeth left, I know on some level that won't happen but at the same time it feels like things just keep happening without much consideration about my fears. I don't know if that makes sense? I guess I just feel a bit lost about things and could use some advice about what I should be saying to advocate for my agency and choice. Or is it just better to just keep my head down and do what they say? I just feel overwhelmed.

Anyways- if you took the time to read this, thank you. Any advice or shared experiences are welcomed.

 

[kitkat]

Hello,
First of all, kudos to you for getting through the first appointment AND calling to get more information when you were unclear on the next steps to take. Second, I am very sorry that this has been your experience. I do not think that you should just keep your head down and do what they say and I find the lack of communication very strange and somewhat concerning. I recently just started out with a new dentist and he came in and did an exam and then sat down next to me and showed me all of my imaging and explained to me each tooth he was concerned about and why and what he recommended and gave me a chance to ask questions. They communicated with me throughout the whole appointment telling me what to expect and set up the follow up appointments before I left. That same quality of communication carried through to the next follow up appointment when I had procedures done and now I feel very comfortable with them.

I am happy to hear that you felt like the other staff treated you well and offered you some support and kindness. Some dentists think that “treating dental anxiety” means just prescribing sedatives and while I wasn’t there with you, this is the vibe I get from what you are saying. I think you should definitely follow up with the surgery center and get their opinion on things but as far as the rest of the treatment, it may be worthwhile to research a bit and look at other offices in the area for a second opinion? I would be concerned that if they are already not communicating well at this early stage, this may carryover to how they do procedures which may make your anxiety worse. Communication is so important for building trust and overcoming dental anxiety. If you don’t feel like there is an open line of communication, it may not be the right office for you.

 

[charlietryin]

@kitkat thank you so much for your kind words! It was a little tricky to get in with this dentist just cause I have a free health insurance through my state so it can be hard to switch it around. But it’s good to hear that it seemed strange as well and it wasn’t just me. Since I have to go there again this week for fillings- I am going to try my best to say I need more communication and if it goes the same as last time maybe I’ll try and contact my insurance and see if I can get it changed to a different dentist.
I also decided to make an appointment for a free consultation with a dental implant specialist to get their general opinion and hope it gives me a little more clarity about my options.
I talked to a friend today that said maybe I should write down my concerns and communication needs ahead of time and share that with the doctor? I’m considering that as an option cause I feel I will probably get emotional again just being there.
Also im so glad your new dentist is making you feel comfortable <3

 

[kitkat]

@charlietryin I am sorry to hear you have limited options at the moment with your insurance. Yes, I agree with the plan to write things down that you need to communicate before the fillings so you have a way of telling them what you need if you feel too overwhelmed to speak. I admire your perseverance and willingness to try to overcome challenges! It won’t hurt anything to see the implant specialist either and get another opinion so you might as well look into it and get more information. I have to go back to my new dentist this Monday for fillings so I will be with you in spirit! Yes, I feel like I got very lucky with my new dentist! My former dentist of 21 years just retired in March which was devastating to me …she’s the only good kind dentist I ever had (my mom forced me to see her at 15 and I was terrified of her and then she was really good with me and I came to love her and then I kept her til I was 36!) but the new one is giving me hope that all will be ok!

 

[charlietryin]

Wanted to update!
Okay so I went to my fillings appointment Thursday and it went so much better!!!!
I met the dental assistant who usually is always there with the doctor (apparently they’ve worked together for 21 years) The only reason I didn’t meet her last time was because she had to go home early that specific day due to the weather (the day I went happened to be a really random snowy day and she lives up high in the hills)
The dental assistant was AMAZING! She introduced herself to me and talked through everything they were going to do that day in detail. She gave me some assurances about fixing my smile. And she was so kind and gentle with me. She was very forthcoming and said “the doctor she is very clinical, and good at her work- but she’s not the best with people, I am though, I am the compassionate, answer all your questions, watch your body language, be there for support kind”
During the fillings the assistant talked though every step. And told me how long each part would be and when they were almost over.
Afterwards she said I could call and chat if I had any more questions.
Then yesterday I had my implant consult which went very well also!
They talked through my concerns and were realistic about my needs and worries. They told me that getting implants for my two premolars would be a very good idea and would help with my concerns- they told me that functionally and aesthetically I would be okay without getting implants for the other extractions and I don’t need to worry about it.
They gave me a quote for the 2 implants, which of course is expensive but given that I was kind of catastrophizing things I had thought I was looking at a lot worse.

I spent the past few years, looking at my mouth full of broken teeth and black spots and unhealthy looking swollen abscesses thinking there is just no way this is at all salvageable- they’re surely gonna have to rip them all out. What a relief!
The implant center also gave me some good questions to ask my oral surgeon that will be removing the 7 teeth that has also made me feel a bit more in control of things.
Overall I have options. And I’m not doomed. I have felt so certain for YEARS that I was doomed.
The plan sounds like the following: I’ve got a crap ton of fillings, 7 extractions, a root canal, and possibly 2 implants or partial retainer like snap on teeth that I take out at night (I think I want to try and take out a loan for the implants I think it ive come this far and I might as well do what will make me feel most confident). It’s a lot of work and time, it’s gonna take me some time to get through it all. But I don’t know compared to what I had let myself imagine, this feels entirely possible.

 

[charlietryin]

When I was a child my dentist was cold and not very friendly- but the dental assistants were worse. The assistants were genuinely cruel and made comments about how I should be embarrassed and ashamed for how bad my teeth were and how many fillings I needed and about how I was costing my parents so much money with my poor hygiene. And those assistants did more damage to my fears than the doctor did.

So having this really awesome and kind and compassionate dental assistant is enough to ease a lot of my anxiety. I don’t mind that the doctor isn’t much of a communicator as long as I have someone knowledge in the room who is able to explain things to me in a caring, compassionate way that provides no shame.

yeah wow! I don’t know feeling much more optimistic! Of course I did still cry almost my entire appointment again haha which is a little embarrassing that might just be what will happen for me each time. The staff was so friendly with me again, and they seem to really care.

My lovely partner also came with me and hung out in the waiting room while I got my fillings done and I feel really lucky to have someone in my life who encourages me so much and wants to be there for me , i feel so so very lucky!
Yeah what a week haha, I’ll continue to update as I get this work done!

 

[kitkat]

I am so relieved to hear things are turning around! The dental assistant sounds like an absolute gem! At least the dentist is able to balance out her team with staff that have strengths in areas where she may be lacking. I’ve had a mix of dental assistants…I don’t remember any terrible ones but most of them just sorta faded into the background and I hardly noticed them. I have had a few very comforting and supportive assistants though and they can really make the experience so much better! I instantly knew I got a good one at my new dentist when she instinctively rubbed/gently squeezed my shoulder during the injections at my first filling appointment to offer a calming presence. I just immediately felt this sense of quiet reassurance from her that was so nice! My new dentist is very concerned with my comfort and gives lots of verbal reassurance and checks in to make sure you’re ok but he is a bit more laid back and goofy and tries to make you laugh which I also like. The last assistant at my former dentist was also very reassuring but moreso verbally and talked a bit more than I would have liked although I did appreciate her efforts. She was just a bit high energy for me and didn’t offer that calm/grounded state that I needed. My former dentist was very serious but calming/grounded so they balanced each other out.

I am sure it is a weight off your shoulders just knowing that things can be fixed and you have a plan of action. I think it is worth it to invest in the implants if that is what you really want as you will have them forever. I am glad that your partner is also supportive and came with you to your appointment. I think with a bit more time, the tears will stop during appointments as your stress levels decrease and you can begin to build trust but it can take some time. I never cried during appointments but my heart would pound, I would sweat, sometimes I would physically tremble, and I would startle easily. My former dentist was really nervous about Covid and would check heart rate and oxygen levels on everyone before appointments using the finger pulse ox device and my resting heart rate was always 120 beats per minute (60-100 is normal) at the start of an appointment and it was always so awkward because even when I wasn’t that nervous, my heart rate would be fast and then they would think something was medically wrong or I was just internally freaking out even though that wasn’t always the case and I don’t even fully understand why it was so high. I would have to do breathing exercises to get it in the 90s which they would accept as ok before starting any work! Lol Eventually all of the anxiety symptoms faded away with the exception of a fast heart rate at the beginning of appointments but then I quickly settle in. Thanks for the update and keep us posted as things progress! I am sure you are encouraging so many others by sharing your experience!

 

[Shakinginmyboots]

I am so happy for you Charlie. I felt like you a few years ago before I went and got things sorted out. I too was googling full implants and felt doomed. I recently needed an implant for a baby tooth that had no adult tooth, and my dental phobia came back. It went extremely well and I couldn’t be happier. Congrats