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I’m Excited About My Root Canal

Steve In Cleveland

Steve In Cleveland

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(or: How I Learned To Stop Worrying and Love the Dentist)

No one sets out to have nasty teeth. You don’t stand facing the mirror twice a day, thinking, “I could brush my teeth now, but I choose not to.” There’s no motivational poster that says, “Today is the first day of what will turn out to be twenty years of dental neglect.” It doesn’t work that way.

It’s more like overdue library books. You start out with good intentions: posting the due date receipt on your refrigerator, setting the books on the table by the front door. After a while, they go forgotten, perhaps covered up by a Chinese take-out menu or a spring jacket. From time to time, they come to mind. “I need to take care of those,” you think to yourself. You start avoiding the library, knowing that your tardy books prevent you from borrowing anyway. Months go by, years. By now, your picture must be posted up on the wall at the library. The fines are probably in the hundreds of dollars. Maybe thousands. At dinner parties, you dread conversations that mention the library. When cornered, you quickly change the subject, or maybe casually throw out a library story of your own: “I tell you what, those card catalog drawers are heavywhen you pull them all the way out!” Meanwhile, the fines keep accumulating, and the books buried underneath your bed are thumping like the Telltale Heart. You’d love to be a normal library patron again, but the problem’s gotten so big...

My name is Steve, and I’m a dentophobic. I’ve lived most of my adult life terrified of one specific moment: the moment I would finally be forced to open my mouth to a dentist. (There was no possibility of my ever going softly into that good dental chair.) I’ve sat quietly at meals where entire chunks of tooth and giant metal fillings have broken free during chewing, casually tucking the hard material in a napkin, wondering if this was the damage that would finally require immediate treatment. I’ve endured sharp, shooting nerve pain and dull throbbing bone pain that lasted days before mercifully subsiding. I’ve chewed food on one side only, then the other, then a specific quarter or eighth of my mouth, to avoid whichever teeth were hurting that day. I’ve switched to softer foods, and then I’ve broken teeth on scrambled eggs and pasta. I remember every meal, every bite, that resulted in a lost piece of me. I’ve mourned each small bit of bone as it fell out.

You might get the impression that I’ve neglected my teeth, but you’d be wrong. I’ve paid such exquisite attention to every single one of them, as they’ve slowly crumbled away... and I’ve done it twice.

[part 1 of a continuing story]
 
Steve In Cleveland

Steve In Cleveland

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Part 2: Origins

Like the library example, my dentophobia started out mildly enough. As a child, I was never taught to take very good care of my teeth. I was supposed to brush them before bed, but that was never supervised and I often skipped or did a very cursory job. I was aware of dental floss as something that old people on television joked about-- on par with hemorrhoid cream. I was, however, scheduled for regular dental appointments every six months. Because I ate a lot of sugary food and rarely brushed my teeth, the typical checkup revealed 1-3 cavities. A 3-cavity checkup was not so good, but didn’t result in anyone actually helping me improve my brushing habits.

Our family dentist was a crusty old guy, with pretty blunt chairside manner. He didn’t lecture or scold, but he made no attempt to set his patients at ease. And he had a particular stinginess with Novocaine. Because I almost always needed fillings, I recognized pretty early on that I always required an extra shot to become completely numb. I’d remind him of that before each filling, but he’d always say, “Let’s start with one shot and you can let me know if it hurts.” Inevitably, he’d start up the drill, I’d shoot up my hand and yell “ow!!” and he’d give me the second shot. To this day I don’t understand why he did this.

The upshot of all this was, I came to view dental work as a) painful and b) unavoidable. As soon as I was old enough to control my own dental appointments-- about 16 years old-- I simply stopped making them. It saddens me to look back on the origins of my phobia and subsequent damage to my teeth, because both problems were so easily corrected. Today’s dentists are dedicated to administering painless dental care; and ritual daily brushing can prevent most cavities before they occur, especially when combined with routine cleanings. In short, if Dr. Wise had just given me that extra Novocaine to begin with, and my parents had taken my regular cavities as a sign to work with me on my brushing habits, I might never have gone down the road I did...

As it happened, it was practically a recipe for dental phobia: a mouthful of metal fillings, bad brushing habits (really, no brushing habit), a sugary diet, a history of painful dental work, and the freedom to avoid the dentist for as long as I pleased. With each passing year I got further and further away from a healthy smile, and so I became less and less willing to face the dentist. After all, if two or three cavities were the result of six months between cleanings, what must be in store for me after several years of rarely brushing? My decaying teeth became harder and more painful to brush, resulting in even less brushing and more fear of the pick and the drill.

By age 24, many of my teeth were visibly decaying. Large holes developed in the front of my front teeth as the enamel wore away. I couldn’t bear to look at my smile in the mirror, or to touch my teeth with anything other than my tongue. I was convinced I’d lose all my teeth before reaching 30.

One day my front middle tooth “woke up” and sent sharp, shooting nerve pain out at the slightest touch. Terrified, I made an appointment with a random dentist-- I was too embarrassed to ask anyone for a recommendation, and besides (sing along if you know it, fellow dentophobes): I was convinced that my teeth were worse than anything the dentist had ever seen. Best to pick a stranger. I somehow managed to drag my cement-block feet into the dentist’s office, and was led to chair. The dentist explained that I’d need something called a “root canal”-- like dental floss, a word I’d heard old people joke about, but never imagined would actually happen to me.

I don’t remember much else about that day, but suffice it to say I learned that root canal was not nearly as bad as the rumors would have you believe. Over the course of the next year, I had six root canals and eight crowns, plus some root scaling, crown lengthening, and a bunch of fillings for good measure. Unlike Dr. Wise, this dentist was happy to give me all the Novocaine I needed to stay numb. There was very little pain, and going to the dentist became more of a nuisance than a nightmare.

Ten thousand dollars later (no small amount for a 24-year-old), I had a reasonable smile and healthy teeth. I felt blessed to have come through it all after so many years of avoidance.

What happened next is embarrassing and disappointing. I promised myself that after all the pain and expense, I’d never go back to my old bad teeth ways. For a few months after my treatment, I brushed and flossed after every meal. The problem was, although I’d conquered my fear of the dentist, I never did develop a good oral hygiene habit. People talk about brushing their teeth as if it were some kind of primal instinct, like eating or sleeping. A typical passage from a web site about developing new habits:

You have already acquired the daily habit of brush your teeth each morning. When you were a kid, your parents probably got after you if you didn’t brush them. This habit is now so deeply ingrained in you, that if you accidentally forgot to brush them one day, you might feel a bit grossed out, and your mouth wouldn’t feel clean.

Well, I haven’t, and they didn’t, and it isn’t, and I don’t. Even at my most diligent, brushing isn’t something I do because I have a strong urge to do so, or because my mouth doesn’t feel clean. When you’ve spent years with big holes in your teeth and bits falling out during dinner, a little gravy on your teeth doesn’t qualify as “gross.” I envy people for whom brushing has become a reflex. For me it will always be a conscious act and a sticky note on my nightstand.

So, the years rolled by, and I stopped brushing, and I stopped making appointments for cleanings, and I gradually slid back. It’s been fifteen years since that work was done, and I’ve once again allowed myself to become terrified of the dentist. This time, my teeth are much worse than they were all those years ago. Once again, I’m certain that my teeth are (chorus?) worse than anything the dentist has ever seen.

I suppose this is why alcoholics refer to themselves as “reformed,” never “cured.”
 
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Steve In Cleveland

Steve In Cleveland

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Tuesday, March 20, 2012

I've been trying to figure which part of my story to tell next; there's so much I've been keeping inside for so long.

I decided it's time to talk about my root canal. Come with me as we quickly fly through fifteen years of bad oral hygiene, of teeth rotting and breaking, of constant fear of The Moment. Come with me to, well, The Moment.

I'd played this scene out in my head thousands of times. It wasn't vivid like a movie; for one thing, I simply couldn't allow my imagination to linger on the graphic details. In my vision, something had finally happened that was either painful enough, or visible enough, to force me to see the dentist. (With the exception of one missing premolar, the bulk of my broken teeth are in the back of my mouth, hidden from public view.) I'd muster up all my courage and get myself into the chair, open my mouth, and brace for the worst. I imagined all kinds of reactions: the dentist would declare that my mouth was in serious crisis, and that they'd have to do a ton of work immediately. Or he'd puzzle at the stumps of teeth worn down well below the gum line, wondering how to even approach them. Maybe he'd declare the whole mouth a loss, prescribing a round of extractions and sending me home with a toothless smile. I pictured the dentist and assistant drawing back a little in disgust before regaining their composure and politely pretending that there was nothing disgusting at all about this.

I also imagined the aftermath. I pictured coming home with giant gaps in my smile, having to explain my deep, dark secret to my wife. I wondered if I'd have to take time off work until dentures or temporaries could be placed, or if I'd have to show my mess of a mouth to friends and colleagues while the work was in progress. I imagined a summer spent in solitude, unable to go to dinner parties or even to eat normal food.

In short, I came to realize that as much as the pain of the drill and the pick, it was the shame of having my secret exposed that kept me up at night.

The morning of Tuesday, March 20th, I woke up with a sharp pain in my first lower right premolar-- #28, to its friends. For the past month or so, my whole lower jaw had been aching, as if crowded by too many teeth. I'd been keeping it under control with too much Advil, wondering when it would finally subside. Tuesday morning, as if tired of waiting for me to take the hint, #28 spoke up loud and clear. Biting down even a tiny bit caused sharp nerve pain.

Fifteen years of dread led to this day. Living with pain was one thing, but I couldn't last long without eating.

I gave myself a pep talk, and looked up the phone number of the dentist I'd chosen a few weeks back, when a midnight toothache had me convinced that that was the day. The ache had subsided that night, but not before an internet search found someone who seemed to get good reviews on Angie's List.

I put myself on autopilot. I gave myself a list of things to do, mechanically: pick up the phone, ask for an appointment, take a shower, get in the car, etc. A woman answered the phone: "Gordon Dental!" I tried to act like I did this all the time, like I was calling a plumber. "Hi, I have a toothache, is there someone who can see me?" She asked if I was an existing patient. Panick. "No, I uh, it's been a while and I, uh..." "No problem!" she chirped, just as casual as could be. In my mind I was making an appointment with the plumber, not scheduling the end of my life as I knew it. Maintain, maintain. "Can you get here in half an hour?" I poked my tooth, to remind myself of the pain and the immediacy of the situation. "Sure, half an hour would be great. I'll be right there."

I'd like to point out that no one called me a freak for having a toothache. No one said, "What do you mean, you don't have a dentist?" To them, this was as routine as a plumber's appointment.

I drove myself to the office, still pretending I was going somewhere else. I checked in, and once again was surprised when the receptionist didn't shout, "You're the one with the toothache!" She gave me a questionnaire to fill out. Approximate date of your last dental exam? Ha! I wrote, "1990's." I looked around at the people in the waiting room. Were they really so calm? Couldn't they hear all the drilling sounds?

And then, there I was, being led to the Chair. I told the dentist I was terrified, although I'm guessing she could tell from my clenched hands and all the shaking. I started to confess: "#28 is hurting," I said, "but... there's a lot of nasty stuff in there." She laughed a little, and said, "I'll tell you what: I'm just going to work on the bad tooth, and I won't even look anywhere else. I see there's some problems, but I'm not looking at that today. Let's just get you out of pain this morning, okay?" I could have hugged her. Half an inch away were molars broken down to the gumline, but she wasn't even phased. It wasn't an act-- if anything, she seemed a little bored. Just another day at the office.

On to the next fear. "I'm not afraid of needles," I told her, "but I seem to need extra Novocaine to feel numb. Can you give me double?" I remembered Dr. Wise from my childhood, and never being numb enough. "Let's give you triple!" she said with a smile. She did a full block on my lower quadrant, and extra right at the tooth. I didn't feel the needle at all.

The procedure went off without any pain at all. In my previous root canals, there was always a little pain at the root tips, but she filed and filled without any sensation at all. She stopped frequently to see if I was doing okay, and to my surprise, I was. She gave me a temporary filling, and walked me out.

Somehow, her casual nature made me want to confess. "Listen," I said to her in the lobby, "I've let my teeth get really bad, I'm sure you can see. I want to work on fixing them." "Okay," she smiled. "We'll take some x-rays next time, when you're not in pain, and make a plan." "You saw how bad they were, right?" Maybe she hadn't looked. "The x-rays will show me from the inside," she said. "See you soon!"

And that was it! No one rushed me into the extraction room. No one told me I was in grave danger. No one even seemed to think I was a freak. I scheduled an appointment for the crown and x-rays for the next week, went home, and slept more soundly than I'd slept in years.
 
Steve In Cleveland

Steve In Cleveland

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A Weight Lifted

For those of you who haven't gotten to your Moment yet, I want you to know this: the dread, the panic, the avoidance, the worried nights... all of this dissipated after an hour of painless work and compassion from a very kind dentist. At 9am I was confronting the End of Life As I Knew It, and by 11am I could hardly believe I'd been so afraid for so long. My fantasies of shame and pain and exposure were completely wrong.

Whatever your situation, I want to share these things with you:


  • You are not alone. Studies show that about one in eight adults are dental phobic, avoiding the dentist at all costs. There are a LOT of people out there hiding serious dental problems.
  • Dentists these days are trained in compassion. Look online for dentists that are well-recommended, that advertise things like "we cater to cowards", and that have a reputation for putting patients at ease.
  • YOU are in control of your dental visit. Talk to your dentist, tell them you're terrified, discuss exactly how much you can handle. The dentist will NOT work on teeth without your permission.
  • You've heard it before and it's true: dentists have seen teeth like yours, and worse, before. Rotten, broken, discolored, giant holes-- they've seen it, and there's a treatment for it. Do you think your car mechanic recoils in horror when he opens the hood? He just sees work to be done, and that's just what your dentist sees.
  • You don't have to fix everything today. The dentist can and will work on one tooth at a time, and he won't shriek, "Oh my God look at that other tooth!"
  • Your friends and coworkers? They don't want to talk about the dentist any more than you do. A simple, "I won't be in Tuesday afternoon-- I'm having some dental work done" will send most people flying away from the topic, but not from you.

I can't tell you how good it feels to have confronted my fear and shame, and to find it wasn't a big deal for anyone but me-- and in the end, it wasn't a big deal for me either.

I woke up the next day with no pain, met a friend for lunch, and life went on as normal. "I had a root canal yesterday," I told him, still trying to confess to someone. "Yuck, I hate going to the dentist," he said, and quickly changed the subject. I watched TV with my wife that night, and no longer cringed when the toothpaste commercials came on. I told her, "I'm going to need a lot of work done... it might take years." She just smiled and said, "Doesn't it feel good to be working on it though?" And it does!

And so that's why I'm excited about my root canal. Having spent so many nights, so many years, dreading what life would be like as a dental patient, it's so weird to have all that anxiety melt away so quickly.

I still don't like the dentist. I still can't look at pictures of teeth or watch what she's doing (dentists and assistants are really good at passing tools under you chin so you don't have to look at them). But I can talk about it now without shame, knowing that I'm working on it, and without the dread of being forced to face the unknown.

For the record, my full x-rays revealed two extractions and possibly as many five, four more root canals and crowns, a handful of cavities, and somewhere down the road, three or four implants. With my wisdom teeth already removed, that will leave me with twelve "real" teeth, twelve crowns, and four implants.

A lot of damage has been done, and a lot of work remains, but more than any of this, the relief of having confronted my fear and lived through it, and the lack of daily anxiety after so long, has made me so much happier.
 
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bisja

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Am so happy for you Steve, and reading your story I can relate so much with different things of how we grew up, and of course the fear fear fear!! I think you did fantastic!
 
Carys

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What a fantastically written account Steve, I truly enjoyed reading it as it was packed with inspirational phrases and insightful observations....and so much realism from the perspective of someone with a deep fear !

These were my favourites....

At 9am I was confronting the End of Life As I Knew It, and by 11am I could hardly believe I'd been so afraid for so long.
I'd like to point out that no one called me a freak for having a toothache. No one said, "What do you mean, you don't have a dentist?" To them, this was as routine as a plumber's appointment.
I can't tell you how good it feels to have confronted my fear and shame, and to find it wasn't a big deal for anyone but me-- and in the end, it wasn't a big deal for me either.
I woke up the next day with no pain, met a friend for lunch, and life went on as normal. "I had a root canal yesterday," I told him, still trying to confess to someone. "Yuck, I hate going to the dentist," he said, and quickly changed the subject.
When I read your title 'I'm excited about my root canal' I was drawn in to reading, and was trying to imagine how anyone could be excited. Now, having read your account, I understand entirely...it makes perfect sense. :D
 
Steve In Cleveland

Steve In Cleveland

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The Berenstain Bears Visit the Dentist

My four-year-old nephew came to sleep over this weekend. In order to survive the roughly ten waking hours he'd be with us, he brought about a week's worth of toys, gadgets, clothes (there were three costume changes), and his current favorite book:

berensteinBears_visitTheDentist.jpg

Not too many weeks ago, this sort of thing would have sent my heart rate soaring. I've gotten pretty good at changing the subject (if not the channel) every time some dental commercial showed up on TV, and although it doesn't feel like it to dentophobes, normal people really don't like talking about dentists either. It might have felt like I was constantly bombarded by dental talk, but that's nothing compared to a four-year-old shoving a picture book in your face.

The irony wouldn't have been lost on me. Here's a book written specifically to teach toddlers not to be afraid of the dentist, and here's a 40-year-old man filled with fear just looking at the cover. My particular toddler was fascinated by the idea of dentists, actually enjoyed reading about them, and just loved pointing at the pictures of the picks and drills.

Having recently made my peace with the dentist, my attitude about the book is a little different. Instead of being ashamed or jealous of this little boy and his perfect ease with dentists, I now see the book as an opportunity. At bedtime, we curl up on the couch and read it together. The little girl bear has a loose tooth, and is afraid to go to the dentist. Her big brother proudly shows off how easy it is, jumping up on the specially kiddie chair and getting a cleaning. My nephew and I look at each cartoon tool on the dental tray: picks and drills, and an ominous pair of pliers. I cringe, now not about the dental tools, but about introducing any idea of fear to this little guy's impressionable mind. He's only four, but I don't want anything to sit in his young mind and fester into full-blown phobia later. I don't want him to go through what I went through. My wife cringes along with sister bear: "Oh, scary! I wouldn't want to go either!" I shoot her a look. Ix-nay on the ear-fay!

"Silly bear!" I laugh. "Going to the dentist doesn't hurt!" Sister bear bravely climbs up and lets the dentist gently pull her baby tooth out with a piece of gauze (ewwwww!), and she gets a balloon and the promise of "a shiny new coin" under her pillow in the morning. My nephews giggles and makes me go through every tool again, and we laugh and laugh at sister bear for being afraid of such a simple thing.

That night, both of us sleep very, very soundly.
 
Steve In Cleveland

Steve In Cleveland

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How it Will All Go Down

I used to have a storyline that I'd worked out, about how it would all go down when I finally had to go to the dentist:

Something would happen that would make it impossible to put it off any longer. I used to imagine the various things that could happen: The worst ones involved biting down, sneezing, or coughing in a very public place, and shattering a tooth. I'd have to be rushed off to some emergency dentist immediately, probably screaming or bleeding or both.

The best ones involved being involved in some kind of car crash that resulted in lots of broken teeth and major reconstructive surgery.​

I'd like to point out at this point just how irrational phobias are. I don't have a death wish, but my fear of owning up to years of dental neglect was so great, that I actually had hoped for an accident severe enough to destroy the evidence. I imagined telling people, "I had to have these false teeth made, on account of that bad accident." It seemed like a better story than the truth, which was just that I hadn't brushed them.

Somewhere in the middle, between the embarrassing public-tooth-shattering and the sympathy-inducing car crash, was some more banal reason: a persistant tooth ache, or maybe decay bad enough to be noticed in my breath or taste buds. I'd had enough things breaking and aching in my mouth already, though, to know that I had the will to wait most of them out, however painful.

My money was on some kind of trauma situation.

Anyway, having been finally forced to go to the dentist, the next part of the story was the exam, and particularly the reaction of the dentist. Seeing all the previous work that had been done-- the crowns that made up the bulk of my top arch, none of which had been properly maintained-- and the extent of the decay on the remaining teeth, the dentist would declare the whole thing a loss. "We can maybe save a few of them, but at this point there's more damaged teeth than healthy ones, so you'd be better off just pulling them all than trying to save the rest."

And then came the part of the story I feared the most. I'd go home to my wife, and have to tell her that I'd lost all my teeth to neglect, and that we'd have to take some time off work to have the major procedure done. And then I'd have to tell all my friends at work that I would be out for a while. Maybe I could lie or be vague: "I'm having some medical work done," but then I'd have to find some way to stay hidden away while my poor mouth heeled up and I could get dentures or implants. I'd heard it took six months before you were eligible for implants, so I figured I could take a leave of absence or something while I hid at home, eating applesauce. I had a couple of close friends picked out who I'd share the real story with, after swearing them to secrecy.

Although sometimes I actually imagined that dying young would be easier, mostly I figured I'd probably be forced to live through this scenario, and I'd survive it. But it wasn't a chapter of my life I looked forward to. I figured the whole process would take about a year, and I'd more or less just have to drop off the face of the world until I could re-emerge with something that looked like a normal smile.

[HR][/HR]The real story has been much less dramatic, as you might imagine. The Moment came in the form of a fairly mundane toothache-- throbbing at first, then progressing to sharp nerve pain-- that was bad enough that I couldn't eat. And yet, not so traumatic that I needed an ambulance. The dentist didn't shriek or cringe or declare my mouth a toxic zone; she just worked on the aching tooth, and later calmly listed the work needed. It's a long list and I'll lose a couple of teeth, but I feel lucky that it's not worse.

But best of all, I can do the work at little at a time; an afternoon here, a morning there. I don't have to hide away for a year, although I did have to admit to my wife that I need a lot of work done. And, instead of hiding my secret, I now feel a sense of pride about having taken control of my situation.

The one thing I was most wrong about though: not one person has asked for an explanation. When I tell people, "I'm having a lot of dental work done," they change the subject. It turns out, no one really likes talking about the dentist (except newly ex-phobics like me), and lots of people have work that they're putting off. Mostly people end the conversation as quickly as possible.


[HR][/HR]I've been examining this story I made up lately. To be honest, I started looking at it a little even before I broke down and went to the dentist. And the thing about it is, none of it has to do with pain. Almost all of it has to do with shame and embarrassment and having my dirty little secret revealed to the world. I didn't look forward to the pain either, but I'd had enough dental work done in the past to know that most procedures don't hurt much, if at all.

The frightening truth is this:
The thing that most kept me away from the dentist was
shame. The shame of having neglected my teeth, the shame of losing my teeth. The fear of discovery was so strong that I would have rather died, or gotten into a terrible accident, than face the shame of my teeth.

I consider myself very lucky in many ways. I was forced to go to the dentist before I did actually lose all my teeth, and I don't have a lot of the phobias-- needles, latex, numbness-- that a lot of people have. I was actually afraid of the dentist, too, but when I examine my own story, it's that fear of being discovered, of revealing my secret, that really terrified me.

Isn't that amazing, the power that shame can hold over us?

About a year before I went to the dentist, I started seeing a psychologist to work through some other issues related to work and family. I never dared to tell my deep dark secret to my therapist-- part of my story involved my therapist, once she found out about my teeth, nagging me to see a dentist immediately and persistently-- but I think that some of the work we did on other issues around shame and trust and self confidence gave me the strength to start owning my own story... even the parts that involve letting my teeth rot and decay. My own inner strength, and being accepted as "normal" by my dentist, have given me some of the tools I need to start feeling okay about my teeth, and to consider myself valuable enough to take care of myself, teeth and all.

I see in this all a larger pattern, of accepting myself and allowing myself to have flaws and defects. I look around and I see people struggling with infidelity, with gambling and drugs, with eating disorders and the consequences of any number of bad choices. I wonder how many of them would rather die than reveal their secrets, and I see the craziness of that thought pattern. But I see its appeal, too. As much as I wanted not to keep losing my teeth, even more than that I feared facing my problem, even a little bit. The whole thing felt like a house of cards I was forced to keep building: I knew the inevitable ending, but I feared any wrong move would bring the whole thing down.

I don't know how much of my story, how much of my phobia, applies to other readers here. I don't want to downplay my fear of many of the same things here: the drill, the pick, the pain, the loss of control. But when I look at these things from a distance, I see that the larger fear was of admitting, "I've messed up bad, and I need help fixing it." I imagine it's a similar feeling of helplessness and loss of control that comes with many big problems in life.

I really hope that everyone here, who is feeling the same sense of dread that I carried with me for so long, finds their way through to the other side. However bad your teeth are, however extensive the treatment, I tell you this: nothing feels as good as putting all that shame and anxiety behind you and finally feeling free.
 
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carol999

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WOW Steve, your story moved me in so many ways. You are inspiring ! Unfortunately I do believe I have left it too late and will need full dentures (at least thats what the first dentist I saw told me) I would also want to urge others to go now before its too late. I want to say thankyou Steve for such a personal and succinct account of your fears, and I hope your upcoming treatment goes smoothly.
 
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Hi Steve (Michigan here) Thank you for your story. I can relate to it a lot. I am. Almost 49 and have only seen the dentist 3 times in my life. Parents never took me. The first time was 6 years ago. Two fillings. Then an extraction in April this year to avoid RC on tooth #31. Last week I got a new dentist who did an exam and I have X-rays tomorrow. I am VERY STRESSED to find out whats wrong and have to deal with it. Up until now it has been fairly easy for me to avoid my fears. My teeth don't look bad. After I told my dentist I felt like I was climbing a mountain without a rope he said it looks more like a hill. I hope my X-rays agree with that. I am extremely fearful of having a root canal. I don't know why. I've read good things but the old bad rap about that is stuck in my head and I can't get it out! Can you explain the procedure? I won't know until tomorrow if I even need one but I just have the sinking feeling I couldn't avoid things like that with so many hrs of avoidance, good genes or otherwise!

Can I ask if you are getting your treatments slowly or a lot at a time? Are you using any Niterous or any type of sedation?
 
Steve In Cleveland

Steve In Cleveland

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Patti:

Patti,

I completely feel for you. I think it's a great sign that your dentist assured you that your treatment is more of a hill than a mountain. He sounds very kind and compassionate, which is really really important.

There's so much I want to tell you... where to start? I guess before anything, I'm proud of you for making an appointent to have your mouth looked at. That's a HUGE step and it's not easy and it's scary as hell, I know. So don't feel bad about being terrified or diminish the importance of what you've done. It's a big accomplishment, and you should be proud. Okay, so some advice:

First, your treatment is just that: YOUR treatment. Your dentist should remind you of that, and you should keep it in your head like a mantra. You can go at whatever pace you want, so don't let yourself feel pressured into doing more than you can handle. For myself, I prefer to work on one tooth at a time, and I pick the tooth. I'm going every few weeks, and there are times when I take a break and even days when I just don't feel up for it, and I cancel an appointment. That's okay. I've had work done on multiple teeth at once, too. It's a little faster, because you're already numbed up, but I've found that time in the dentist chair just takes a toll on me. Being tensed up and holding my mouth open for hours wears me out, and I find I'm just exhausted after. Not really any more painful before or after, just tiring.

Also, remember that you're in control while you're in the chair. Talk your dentist before you recline and make sure he understands what you need. I've found that even compassionate dentists often forget to talk to you-- to them, a root canal is just one more procedure, and they forget that it's a major event for you. So as you're sitting down or before you even sit down, you can say, "I want to talk about this first." Your dentist can explain the procedure to you, in English, tell you about the tools they'll use, and work through some ground rules. Work out a signal for "stop" like raising your hand or holding up a finger. If you start feeling any pain (even a little bit) or if you're just uncomfortable or tired, you can stop and take a little break. The dentist never needs to take a break, but you might just want to stop and breathe for a few minutes, and that's normal and okay.

Here's what I tell my dentist before she begins:
  • I'm not afraid of needles (thank God!) so I'd prefer ten shots of novocaine to the tiniest chance of pain. Numb me up!!! I also seem to need extra novocaine to get numb, so I remind her of that too. Novocaine is cheap and your dentist shouldn't hesitate to give you more when you ask. (I have had Nitrous oxide before, even during cleanings, and I think it took the edge off. Never done the sedation thing though.)
  • I have a really bad gag reflex. So when anything gets near the back of my mouth I start choking. My dentist adjusts her technique to avoid sticking cotton balls or other things back there.
  • I like to know everything that's going on, so I ask her to talk as she's working. So she'll tell me what each tool is as she works, and what it does, and what I'm going to feel.
    • A note on tools: the dentist and the assistant have a way of passing tools to each other below your chin, where you won't see them. I prefer to stare up into the light so I don't see much while they're working. So, while she explains what each tool does, I prefer not to look at them, and I recommend not looking. A couple of the tools are really wicked looking but really are very harmless (there's a tool that looks like a big nasty set of pliers, but actually it's just used to set a tiny metal ring around the tooth, and it's used to hold the ring gently open, not wrench it shut-- the big pliers never touch or get anywhere near your actual teeth).
  • My dentist puts music on sometimes, and I find that really relaxing/distracting. If there's no music on I'll ask her to put some on.

The important thing is, talk to your dentist! It's super important to establish lots of trust on your first couple of visits, because once you understand that your dentist won't hurt you, you'll relax a lot more and things will go so much more smoothly. Dentists see terrified patients all the time, so it's really no big deal to the dentist if you have to take lots of breaks or stop and talk or have the dental assistant hold your hand, or whatever it takes.

After my dentist took a tooth that I couldn't even breath on without excruciating pain, and did a complete root canal without even a little pain, I sure trusted her to work on the next tooth.

My other piece of advice for you, for tomorrow: just do the x-rays, and talk. I understand, that's stressful enough without worrying about drilling and picking. The dentist will probably want to look around with a mirror too, to get a better look at certain areas. Also be aware that he'll probably, out of habit, use a pick or something that looks like a pick to you, to hold your cheek open or move your tongue out of the way. This scared the snot out of me, and I made the dentist promise not to actually touch my teeth with that thing. She wasn't going to anyway, but again, touching teeth is what dentists do every day, so they don't find it oogie. So don't be afraid to lay down the rules: just looking today, no touching. By the way, if you have any teeth in pain right now (i.e. if you can't hold the x-ray plate without pain), ask for novocaine. Tomorrow should be as free from pain as possible.

What you can expect after the xrays are done: You can sit up and relax. Your dentist will probably go through the pictures with his assistant, calling out each treatment: "endo on 3, filling on 4, extraction 5, etc". He might say things like, "This might be a little tricky" or something. You will NOT hear: "Ewww!" or "Oh my God!" or "How did you let this happen?" If there was something really freaky about your mouth, your dentist would have told you during the mountain/hill discussion. To him it's just 32 teeth in need of various treatments. When he's done you should talk to each other about what needs to be done, if anything is a priority, what kind of options you have, and anything else that's on your mind. If you'd rather not know all the "bad news" at once, ask to leave the room while they go through your x-rays, and tell him you just want a little news at a time.

This is also a good time to have him explain how a root canal works, if you need one. This should be a comfortable, professional discussion. The dentist won't judge you or shame you, and definitely should not force you to have any work done then and there. Even if there's something urgent, you can choose when and how to treat it. Remember: all you're getting tomorrow is recommendations. How, when, and whether you choose to get the work done is up to YOU.

On the way out, the receptionist should be able to give you a cost estimate of all the work that's recommended, if you want to see that. They'll also ask if you want to set up your next appointment. It's COMPLETELY ok to say, "No thanks, I'll call when I'm ready."

When you're done, treat yourself to something nice. Seriously, this is a big stressful day for you, and you deserve a treat for having faced your fears. Call a close friend and brag about it. Post a short post to the Success Stories forum here-- you'll get lots of good responses, and I'll watch for it too.

Good luck, you'll do fine!

[I'll post a description of a root canal later today. Really, for all the bad press it gets, the root canal is actually pretty minor and painless.]
 
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Patti

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Re: Patti:

Thank you for writing that to me, Steve. It sure helped and I will know more what to expect tomorrow. Luckily, my dentist is my uncle's good friend. My uncle is only 8 years older than I am, so I knew the doc back when I was ten and he was still in high school. He has worked on both of my parents, my uncle, aunt and cousin. He comes highly recommended. He has always been a very nice and caring person. You can see in a person's eyes if they genuinely care or if they are seeing you as nothing more than a set of teeth with a wallet attached. I felt like my last dentist was like that. When I doubled up and hyperventilated when said root canal or extraction to me, she just stood there and stared at me. NO COMPASSION WHATSOEVER. She never even asked me why I was so afraid of a RC. Perhaps if she'd taken a little time with me, I might still have my tooth! And I had no use for her snotty little 12 year old assistant who made me feel like dirt. When I went in there I told them food was getting caught in the tooth. Before I left she put that hook tool in there and pulled a piece of food out of the tooth and said, "EWWWWW! There's food in there!" Yeah, thanks for that! And then the dentist told me I needed a crown on an existing tooth but before she would address it she wanted a full set of x-rays because she saw "other issues." Right there she took me out of the driver's seat. She's NOT going to do THIS until I do THAT. I didn't like that. She didn't say what issues she saw and I didn't ask as I just wanted to get the hell out of there. Later when I called her to ask her what I would feel during the extraction she said, "Pressure... you know, like when you had your daughter." SERIOUSLY? I recall 12 hours of PAIN when I was in labor! I'm here to say that I've done both now and you cannot compare the two. Not even a little bit. Not at all, actually! :ROFLMAO:

But she's history now...

I like Dr. Bob and his staff. I prefer male doctors and a middle aged staff. I just think they're more compassionate all the way around.

Last week, Dr. Bob already took a real good look in my mouth with the mirror--which is when he told me a hill vs. a mountain and that things didn't really look that bad. Of course, he doesn't have x-ray vision so his words made me feel a little better but not totally. As for tomorrow, I am just so afraid that seeing all the cards on the table will overwhelm me. I don't know what I'll do if he says RC to me. I don't know why I'm so petrified of that? Maybe it's the time spent in the chair?

Before I went to see Dr. Bob last week, I faxed him a 3 page letter explaining my fears and apprehensions. Like you, I have no problem with the injections (that's good news!). My biggest fear is anticipating pain in the chair, which after 3 procedures now (2 fillings, 1 extraction) I've felt NONE. My dentist told me he doesn't tolerate pain, that there is simply no reason for it now days and then he started listing off all the numbing agents they have (articane, lidocaine, etc, etc) I spoke with him too about moving SLOWLY (getting my feet wet first) and he had no problem with that, although he did say he could do a numbing block (?) on the bottom teeth and could do more fillings at one time that way. We shall see... I have zero dental insurance so unless the work is pro bono, we WILL be moving at least somewhat slowly! Dr. Bob has my confidence already. If he would have wanted to fill a tooth or something last week I would have been up for it. I had no problem with him examining my mouth and he never said anything that would embarrass me or make me feel bad. It was quite the opposite. I just hope he wasn't sugar coating anything so as to not scare me. A hill, not a mountain...

You are right about the exhaustion part. The whole thing is mentally exhausting which becomes physically exhausting after a point. Small amounts of time in the chair is the way I want to start. I don't want to scare myself off. I've waited this long, what's a little longer? But you are right when you said I am in charge. It makes the whole thing MY IDEA, not theirs, so not as scary sounding.

Another thing that bothers is me is if I needed a RC in my molar he would send me to an endo. He doesn't do RCs on molars that are way in the back. Just like the last dentist sent me to an oral surgeon for the extraction because it was too close to a nerve. It takes me out of my comfort zone. Strange building, strange people, you know. It's like starting all over again.

You said you are working on one tooth at a time. Can I ask you when you started and how far you are so far? How many teeth do you have to get fixed? What treatments?
 
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Steve In Cleveland

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The Dreaded Root Canal

Patti:

It sounds like you're in good hands with Dr. Bob and his staff. I can't speak to the experience of going to an endodontist, but I completely understand the fear of leaving your hard-earned comfort zone. Perhaps Dr. Bob can make a call on your behalf and let the endo know you need a little extra hand-holding. Also it might cost a little more, but you can schedule a consultation with the endo first, and establish a rapport before doing the actual procedure.

I was going to write up a detailed description of a root canal procedure ("endo" or "endodontic" to the dentist), but this article pretty much says it all, particularly the "My Root Canal Treatment" section.

The important thing I can re-iterate is that root canal therapy shouldn't hurt at all. It really for me is very similar to getting a filling, at least the "scary" parts. The drilling feels equivalent to that of a filling-- same amount of time, same feeling, which is to say all vibration, no pain after you're suitably numb. After the drilling there's lots of detailed work with a tiny hand file, which is very quiet and calm and also doesn't hurt. Molars tend to be a little trickier for the dentist because there's multiple canals, but from your standpoint it's really not something you'd notice. Once the drilling is done, you're past the hard part.

In the interest of complete honesty, I have had a couple of "owee" moments when the file gets down to the very tip of the root. It's a skill finding this spot exactly, and on a couple of occasions with a previous dentist it hurt a little when the file tip touched the root tip. I said, "ow!", the dentist backed off a little and gave me more novocaine, and finished the procedure painlessly. I think this happened with two of the root canals I had; the other six were completely painless.

Total time in the chair is usually around an hour and a half. Sometimes they can do it in one visit; other times it takes two. (The difference, I think, is the extent of the infection. Sometimes they'll stop and fill the tooth with medication, and seal it with a temporary filling, then on the second visit they'll finish and fill it properly with gutta percha.) If there's a second visit, it's more or less the same as the first. I've gone back to work right after a root canal, and I've typically eaten normal food within a couple hours, just like with a filling. Usually my jaw is a little sore for a day or two from holding it open so long, but that's about it.

After the endo is complete they strongly recommend getting a crown fitted. This is a lot more drilling because they're shaping the tooth and actually cutting it down in size to fit the crown on top. At this point your tooth is completely dead, because the nerves have been removed, but they'll still do novocaine. Crown prep is completely painless but the amount of drilling can be a little unnerving. My dentist has a gizmo that will actually make the crown in the office, so they can do it in one visit, but often they have the crown made in a lab, and you'll have to come back one more time for them to cement it on.

I think it's a shame that this wasn't explained to you, because if endo is an option, in my opinion it's almost always better than losing a tooth. With a proper build-up and crown on top, a good endo-tooth is better than the original.

Like the author of the post I linked, I'm completely baffled by the bad reputation of root canals. There's any number of things I'd rather be doing, frankly, but if you can handle a filling, a root canal should be a cake walk.
 
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Patti

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Thank you Steve! i am going to print that article and keep it somewhere just in case. WHY did you have to have so many root canals? Were your teeth damaged? Was there a lot of pain in those teeth? I don't understand?

No, my old dentist did not say A WORD to me about what is involved in a RC or whether it was painful or not. She knew I was petrified when I heard her say the words RC. I even called her a week later to ask her about the extraction (was it painful, etc) and she still never said a word or questioned why I didn't want to have a RC instead.

When the oral surgeon looked at my x-ray, he said, "She couldn't save this?!?!" So it wasn't like she didn't think the RC would work. Yet one more reason I decided to find another dentist. And now I've got tooth #31 moving and making 3 other teeth sore sometimes because of it. And I'm not looking into getting a fake tooth drilled into my head. I'm leaving it alone.

Did you use Niterous while getting your Root Canal done?
 
Steve In Cleveland

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Re: Patti:

You said you are working on one tooth at a time. Can I ask you when you started and how far you are so far? How many teeth do you have to get fixed? What treatments?
Here's my full plan. Strange that I was so worried about people finding out how bad my teeth are; now I'm posting it on the internet!

In 1995 I started a big round of dental treatments after a long period of neglect. Then, somehow, I fell back into the neglect cycle, and didn't go back until just recently, March 20, 2012.

The first round of treatment took about a year, going every couple of weeks, and involved:
  • #2 Endo, crown
  • #6 Endo, crown
  • #7 crown
  • #8 Endo, crown (this one brought me in)
  • #9 Endo, crown
  • #10 crown
  • #11 Endo, crown
  • #14 Endo
  • A bunch of cavities
  • Root scaling
  • A little bit of periodontic surgery to lengthen a root

Because the canines (6 and 11) and central incisors (8 and 9) all needed crowns, we decided to crown the whole front arch, from 6 to 11, at once, to make it look nice. Prepping all six teeth for crowns took all day and although it didn't hurt, it made me not want to do that again.

This time around the treatment plan looks roughly like this:
  • #28 endo and crown (this one brought me in): DONE
  • #13 endo and crown: DONE
  • #14 crown: Tomorrow
  • #15 extraction: Tomorrow (my first extraction, ugh)
  • #19 endo, crown
  • #30 endo, crown... we hope. This one is worn down to the gumline.
  • #31 endo, crown... didto.
  • #3 endo, crown
  • #5 extraction. I want to get an implant to replace this because it's visible.
  • A couple of cavities

Tomorrow's my fifth visit I think. Not looking forward to the extraction but I hear from lots of people on this forum that it's not too bad.

Hopefully that qualifies me to talk about endodontic therapy. I've had so many I could practically do one myself, I think!
 
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Patti

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Re: Patti:

Wow! That's a LOT!

I can help you with the extraction! Just had one in April (back moler on right next to wisdom tooth). I wasn't even there 30 minutes and most of it was filling out paperwork and talking to the oral surgeon! I used Niterous and I strongly recommend it. They give you lots of shots then check you. I wasn't numb so I asked for more and I got them (didn't even feel those). Then I shut my eyes and enjoyed the niterous buzz. I knew he was in there doing "something" but couldn't feel a thing. Then I felt the tooth move slowly one way, then slowly the other way. That's the pressure they talk about you feeling. Then I felt nothing at all and then he said it was out. THAT WAS IT. The whole procedure itself took about 4 minutes start to finish. Then they put gauze where the tooth was, gave me oxygen after the niterous, gave me some prescriptions and that was that.

No pain to speak of afterwards either. They gave me vicodin and motrin 800. I took I think 2 vocodin the first day, motrin 800 the second day and regular Tylenol the 3rd day. Make sure you take the vicodin as soon as you fill your prescription. If it starts wearing off before you're supposed to take another one, you can take the motrin 800. You can overlap those. I started feeling pain 2 hours before I could take another vocodin and started to PANIC but just as that happened the oral surgeons office called to check on me and told me I could do that. Also, rinse with warm salt water (I think after 24 hrs) and do it often as it will heal the extraction site. I also got antibiotics in case there was any infection, which I think there was.
 
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Great. Am I to expect a million root canals?
That looks like a mountain to me. Good for you, looks like you're almost done! :jump:

If they tell me I need that much work I don't know what I will do!

Do you they give a you a list like that?
 
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Steve In Cleveland

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Thank you Steve! i am going to print that article and keep it somewhere just in case. WHY did you have to have so many root canals? Were your teeth damaged? Was there a lot of pain in those teeth? I don't understand?
Sadly, just neglect. Any time you have a hole in your tooth (from a cavity, or a lost filling, or a chip or break), and you don't treat it, the decay can progress and eventually invade the root chamber. Particularly if you don't brush your teeth often or ever. There may be other biological factors; maybe my teeth are particularly soft or something.

You would think a tooth that was bad enough to need a root canal would be causing all kinds of pain. But it's not necessarily the case. I have four teeth in my mouth that need root canals right now, and they don't hurt at all, even when I brush them. Two of them, 30 and 31, are worn down to the gumline: there's no "tooth" (crown) there at all. In this case, these had big giant fillings in them since childhood, and the filling became a kind of wedge that over time caused parts of the crown to break off while eating. Sometimes the teeth would hurt or become sensitive to sugar for a while; sometimes they never hurt at all.

Did you use Niterous while getting your Root Canal done?
Nope, just plain old Novocaine (or whatever caine they use these days). I think I might have asked for nitrous for the first one because I was so terrified of everything in the dentist's office. But seriously, it's no worse than having a cavity filled, from a pain perspective. But, like everything in the dentist's office, if it helps to calm you down, by all means get yourself some!
 
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I guess there's no way of knowing then? I think if I had known this, I would have been to the dentist a lot sooner. I'd just look at a tiny cavity and think nothing of it. WRONG!
 
Steve In Cleveland

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Great. Am I to expect a million root canals?
That looks like a mountain to me. Good for you, looks like you're almost done! :jump:

If they tell me I need that much work I don't know what I will do!

Do you they give a you a list like that?
I'm not sure if I'm helping or just causing more stress for you at this point! :D

Every mouth is different, and everyone's circumstances are different. You can work yourself up into a big lather pondering what-if's. Tomorrow, you will go see Dr. Bob, and he'll look at your x-rays and talk things over with you, and then you can start working towards a healthy smile. I can tell you that for me, getting past that point was such a huge relief, because all of the unknowns disappeared. Knowing that I have X things to fix, and my dentist knows how to fix them, is sooo much better than stressing out about all the things my imagination could come up with.

My personal advice? Get off DentalFearCentral for today and try to keep your mind off your teeth as much as possible. Whatever is, is, and tomorrow-- no matter what the news is-- you'll be in a much better place than today.

Take care my new friend, I'll look forward to hearing from you... tomorrow. :bear:
 
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