Hi Debi,
First, welcome to the forum, and you should be proud of yourself for telling your story and reaching out for help. As I hope you've learned from reading the forums, you're far from being the only person in the world who hasn't been to the dentist in ages, or who has broken teeth in need of much repair.
No one here is going to be able to diagnose you, obviously, but I can tell you that I've had root canal teeth that I put off crowning for years, and my dentist was still able to prep and crown them. I wouldn't let the black bit attached to the tartar scare you too much, either. It doesn't mean your tooth is actually black inside or out-- discoloration often happens on the surface just due to food and bacteria and whatnot-- again, I've had bits of tooth break off (there's always a black part), and have been able to have the remaining tooth filled/crowned and restored to healthy.
So really, nothing you've described is shocking to me, and I doubt it will be shocking to any dentist. I had big chunks of tooth broken off, teeth that were broken down to the gumline or worse, black/yellow/green you-name-it discoloration, bleeding gums... my dentist just took some x-rays and calmly made up a list of what each tooth needed. There was no lecture or questions about why I'd let my teeth get so bad. My dentist is very compassionate and has been patient and skillful at restoring both my teeth and my trust in dentists.
There's no easy way to get you past the first steps-- making an appointment, and getting yourself into the chair. Unfortunately, that's something you'll have to talk yourself into. All I can tell you is, don't focus on the past, just focus on the future. Whatever you've done, or neglected to do, is behind you, and it can't be undone. But you can start taking the steps to get your teeth healthy, no matter how bad you think they are, and you can get through and smile and eat and brush like a "normal" person again. It seems like a huge mountain but lots of us here have found it's not so bad, but it does take the courage of a warrior to get past the phobia.
I'd recommend checking the internet, the find a dentist board here on DFC, or even asking friends, and try to find a dentist who either specializes in phobics, or at least who is recommended by other nervous patients. Many people have luck writing up a letter (or just copy your post) and mailing/emailing it to the dentist ahead of time. This will help the dentist understand that you have some special circumstances and need a little extra gentle care.
When you're able to, I'd recommend just calling and arranging an initial exam-- not a cleaning. You don't have to explain or apologize, just say that you've been away from the dentist for a while, and have some problem areas, and want the dentist to take a look. For the initial exam, the dentist will have a look around your mouth (no poking or scraping, just looking), and probably want to take some x-rays. Any dentist who's recommended will be very unlikely to want to lecture or judge you-- most dentists are very sensitive to the fact that people are pretty terrified on their first visit back. Instead you can expect to have a calm conversation about what procedures are needed, what options you have, etc. Almost everything can be done with local anesthetic (root canals, crowns, extractions, etc) so you can also talk about any fears you have about anesthesia.
You should not worry about the dentist immediately "going to town" and starting to pick and scrape and work on your teeth without your consent. Nor should anyone lecture you, shame you, or draw back in horror-- they *have* seen worse, trust me. And, nothing in your mouth is likely to be an emergency, so no one's going to demand to clean/extract/drill anything right away (this was a big fear of mine). The whole purpose of the exam is to start a conversation with the dentist, understand what work needs done, and discuss what you want to do. What YOU want to do. So even if the dentist recommends something you can't handle yet, you have every right to go home and put it off for as long as you want.
I think you'll be surprised at how kind and helpful everyone is once you're able to make that first appointment. You have some serious trauma in your past, so it's going to take you a little extra to overcome your fears and build up trust (and it might even take some drugs-- there are some wonderful calming drugs out there). You might even want to start with just a conversation with the dentist, outside of the Room, just to discuss your needs and history, before you even open your mouth. A good dentist should be willing to work slowly with you and help keep your mind at ease that you're in good hands.
I encourage you to read the Success Stories and Journals here. There are lots of people here who are at various stages of conquering their dental phobia, and hopefully reading our stories will help you know that you're not alone, and that it can be done.
Good luck, and keep posting! It's not going to happen all at once, but you've made a big step coming here, and you will get there...
