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I'm struggling...

T

Talullah

Junior member
Joined
Nov 23, 2022
Messages
6
Location
Ontario, Canada
First, thank you to everyone for these amazing boards. I've been glued to them for the past 2 months while trying to deal with my ongoing dental issues. I'm really struggling with things at the moment. I’m having a lot of difficulty trying to see any light in the future because of my teeth. I realize this is long. It just feels good to get it all out in one place amongst people who understand.

My dental fears go way back to a traumatic injury to my mouth caused by abuse. I had braces and surgery to remove a huge amount of scar tissue in my mouth as a result of this injury. Those were very awful experiences. Dentists have always terrified me as a result. The relationship is very imbalanced and I feel like I must comply with whatever they say, even if I don’t agree. I don’t want them to be mad at me and take it out on my mouth. Again, this is directly connected to the abuse. I know this rationally, but it does not stop the fear.

I also have a massive fear about my teeth. I’m afraid of my teeth. I’m afraid of what they look like, I’m afraid of how they feel, I’m afraid of them crumbling and falling out. I can’t stand to look at them.

As an adult, I've bounced around to different dentists over the years, always leaving after a bad experience. Thankfully, I always had pretty good teeth and good hygiene practices (see fear of my own teeth above. My logic is that if I take care of them, I can stop them from looking bad and falling out to help alleviate my fears). I brush (I have definitely overbrushed though, which I feel puts me at serious risk for periodontal disease) and floss the dentist recommended amounts. For the past 6 months I’ve used a strong fluoride toothpaste and mouth rinse. I've had 4 of my adult teeth filled and one root canal (on a virgin tooth).

The root canal experience was awful and really cemented my fears as an adult. I had it done with a general dentist who didn't freeze me enough. The root canal failed after about 6 months. I saw a new dentist who referred me to an endodontist who redid it. Again, I was not frozen enough (and not believed by the doctor). The new general dentist also filled a different tooth and did not freeze me enough. She did believe me and gave me more, but I honestly don't understand why dentists don't believe me when I tell them I have difficulty being frozen. It’s not that I enjoy being pumped full of anesthetic, and it’s not like I’m seeking addicting drugs or something, I just cannot stand the pain. I have nightmares about the pain. That was in 2017 and I hadn't been to the dentist since. I'd just had enough of them not listening to me.

At the beginning of 2020 I started looking for a new dentist because I knew I had been away long enough and was terrified of what they might find, but then everything shut down and it took a backseat.

In May 2022 I had an issue with the bottom right of my mouth. I was in severe pain. I found a local dentist who specialized in anxious patients and went in. I had bitewing xrays of the area. She said I did not need a root canal but had a small new cavity in the molar second from the back. She said most of the pain was muscular from grinding my teeth and I got a new nightguard. She filled the tooth with sedation (a pill and laughing gas) as this was the only way I would do it after building up all of the previous experiences in my head. However, I did not like the experience of not knowing what was being done to me. I also didn’t like how she spoke to me like I was a child. I get that you need to treat people with anxiety a bit differently, but they don’t need to be infantilized. Her billing practices were also odd. She wanted to be paid in full for everything in advance of the work being completed or else she wouldn’t do it (like the week before). That is not the normal practice here (and it turns out she has been disciplined by the governing dental college for irregular billing practices before). She said the tooth needed a crown, but I didn’t want to go back to her to do it.

I did a ton of research on dentists for anxious patients and found one who looked amazing. The earliest they could see me was December, so I would just have to be patient.

But, in late September, I was brushing my teeth and part of the back molar on the right side crumbled (my absolute worst fear) and exposed a cavity. I was so upset! The dentist I had been to in May had not mentioned anything about a cavity there, despite doing an exam of the bottom right back of my mouth, as I couldn’t locate the pain to one tooth. She assured me there was only the small cavity in the one tooth that she filled.

I found another clinic to see me the next day. Again, this is a clinic that says they cater to patients with dental anxiety. I met with a nice dentist who told me there was a large, deep cavity in my back molar. She said it absolutely would have been there in May and would have been impossible to miss on an Xray. She also mentioned that I needed the other molar crowned, which I already knew.

I went back another day (actually waiting 2 agonizing weeks, just waiting for the rest of my tooth to crumble) to get the deep filling in the back molar. It went well. I told her my history of freezing issues and she gave me extra anesthesia at the outset and gave me extra time to get numb. This is the first time in my life that this has ever happened (aside from being sedated). I didn’t feel anything and I was so happy that it could actually be done. I plucked up my courage and asked about the crown. She suggested a gold crown, which I immediately said no to. I could not see myself with a gold crown. However, I went away and looked into it and saw the benefits, especially for those who grind. I got a second opinion too, and that dentist said a gold crown would be the best option. Both dentists said if it was their tooth, they would get a gold crown. So I went for it.

The crown prep was fine. I was numbed up sufficiently (the tooth is vital). The temporary crown was fine. It needed an adjustment, but I was ok with it. Then on Tuesday I went for the crown placement and it was an awful experience and I am so distressed by having the gold crown. The dentist was 30 mins behind schedule (which was fine with me, I wasn’t upset), but the whole thing felt rushed. She said I didn’t need to be numb. But there was so much adjusting on my tooth and it hurt so much, all the nightmares came flooding back. She did stop when I said to, but she didn’t offer me any numbing, she just continued on a different part of the tooth. The placement of the crown took about an hour, which seems long to me. There was a ton of adjusting on both my tooth and the crown itself. I got into the car and just cried and cried.

I thought that the gold crown would be far enough back that it wouldn’t be noticeable. But I have a wide smile. It’s all I can see. When I open my mouth, it looks like a big hole. I hate it. It also tastes metallic. That’s bringing me back to having braces and the awful metallic taste, which is giving me flashbacks of the abuse because that’s why I had the braces. I can’t live with this thing in my mouth. I am a university lecturer and the thought of my students seeing this is giving me panic attacks. Hopefully I can have it replaced with a tooth coloured crown. But I am terrified that it will damage the tooth even more.

Now I have a full check up on December 6 and I’m absolutely terrified for that. It’s been 5 years since I’ve been assessed. I have convinced myself that they’ll tell me that everything needs to go and that nothing can be saved. Rationally, I know that’s not what will happen, but I can’t get past it. The root canal tooth was never crowned, and I am positive it needs to be pulled. Every twinge in my mouth sends me into a panic. My fears have taken over my whole life for the past two months. Getting any work done is a real challenge. I am not eating or sleeping really. I don’t want any food to touch my teeth and cause more damage than is already there. I've lost about 20 pounds. Although I do brush and floss well, I did eat my fair share of sugar, which I know is horrible and I’ve cut it out entirely now. I just fear that I’ve done so much damage and it’s all my own fault.
 
You've got a lot going and you're doing your best. If anyone else came to you and told you this, what would you say? Be that person for yourself because you're being very harsh on yourself when you deserve kindness.

If it helps, I had a tooth root canaled in my early 20s and it hasn't been crowned. Is it the prettiest thing you ever saw? No. But it is still there and didn't need to come out after nearly 5 years without assessment and worse dental practices than you.

All of your fears are real but only the dentist can validate them and any dentist worth their salt will work with you to keep your teeth because your own natural teeth are best. History has taught you some harsh lessons but at the same time, try to reframe it as a mouth MOT. The dentist does more than look for cavities. They check for irregularities that your regular doctor doesn't. You go to the body doctor, the heart doctor, the brain doctor and you go to the mouth doctor. The doctor helps, you right?

If I can get away with only having a cusp break off in almost 5 years (I grit my teeth badly and have a bite issues) and all it needed was a filling, I believe you will be okay.
 
Hi @Talullah

brilliant advice from @dentalnelly there :) .

Just a couple of things that occurred to me while reading your post:

I brush (I have definitely overbrushed though, which I feel puts me at serious risk for periodontal disease)

No, it doesn't put you at risk for periodontal disease (you'll be pleased to hear :)). Periodontal disease is caused by bacteria that are allowed to linger for too long, which makes the body produce inflammation. Overbrushing will do nothing to cause or increase this inflammation. Sure, brushing too hard might have caused a little bit of recession which can result in sensitive teeth, but that's not the same as gum disease.

I did a ton of research on dentists for anxious patients and found one who looked amazing. The earliest they could see me was December, so I would just have to be patient.

Do you mind me asking, did you cancel that appointment or is it still happening? December is nearly here now...

The crown prep was fine. I was numbed up sufficiently (the tooth is vital). The temporary crown was fine. It needed an adjustment, but I was ok with it. Then on Tuesday I went for the crown placement and it was an awful experience and I am so distressed by having the gold crown. The dentist was 30 mins behind schedule (which was fine with me, I wasn’t upset), but the whole thing felt rushed. She said I didn’t need to be numb. But there was so much adjusting on my tooth and it hurt so much, all the nightmares came flooding back. She did stop when I said to, but she didn’t offer me any numbing, she just continued on a different part of the tooth. The placement of the crown took about an hour, which seems long to me. There was a ton of adjusting on both my tooth and the crown itself. I got into the car and just cried and cried.

If it were me, I'd vote with my feet and not go back to her. I know that Gordon said in your other thread just to raise the issue with her, which might work if you're fearless when it comes the dentist. But for anyone else, I can't see the point in sticking with someone you don't feel safe with, when there's a whole world of dentists out there to choose from (unless you live out in the sticks). I'm not sure if it's really possible to rebuild trust with someone who has let you down like that, unless you've had a really solid relationship with them beforehand. But only you can know what is best in your situation, and how you feel about her now.

Hopefully I can have it replaced with a tooth coloured crown. But I am terrified that it will damage the tooth even more.

As Gordon said in your other thread, a modern tooth-coloured crown doesn't require that much more reduction in tooth structure. Yes, as with any procedure involving the human body, there's always some risk of upsetting things, but the risk may be minimal. Having said that, if you do have a bad grinding habit, then gold is a great way to go, so it would be a good idea to have another in-depth discussion about your decision with a dentist. I totally get why you'd prefer a tooth-coloured crown though, I went for the same despite knowing that gold is, theoretically, the better option. But it's not all about logic, is it?
 
@dentalnelly Thank you so much for your reply and your kind words. You’re so right. I would have so much compassion for others in the same situation. I don’t know why it’s so hard to give myself the same grace.

And thank you for sharing your experiences. I’m so pleased for you that you only had a broken cusp after 5 years. It’s encouraging for me to hear. My root canal was redone in 2015. My dentist at the time said it wasn’t critical to crown. I have no idea why. Maybe because it hadn’t had any previous work? It’s a top premolar. I think assuming it’s ok, I will likely get it crowned to prevent any new issues. It definitely doesn’t look pretty right now, but I’d just be happy with in my mouth, as opposed to removed.

I’m hopeful that my assessment won’t be too bad. Rationally I know that not every tooth is a problem. The problem for me is that my fears are everything but rational. It’s something I’ve struggled with off and on since I was a kid. I am usually able to keep it in check (thanks to years and years of therapy and drugs). This episode though has brought it back with a vengeance.
 
@letsconnect Thank you so much for your reply and support. I really appreciate you taking the time.

I’m really pleased to hear that overbrushing doesn’t lead to periodontal disease! I always thought it did for some reason, because there was less gum tissue to hold the teeth. About 12 years ago I went to a dentist who gave me a really stern lecture about my overbrushing and told me it would lead to tooth loss. I must have made some leaps of logic there. I definitely do have some recession, but on paper my gums seem healthy. They don’t seem inflamed and they don’t bleed when I floss. But there’s been that recession that’s always scared me, thanks to that unkind dentist.

Sadly, I did cancel the December appointment with the other dentist. I held onto it until after the crown prep, which went well. That was 3 good appointments with the dentist, so I thought I was ok. But now I am regretting it. And now the soonest I can get in is March, and I can’t wait that long for a full assessment. It’s relatively easy to get an emergency appointment with a dentist here, but harder to get a full exam. And the good dentists have long waiting lists. I don’t think clinics here are running at full capacity. There’s a shortage of dental nurses right now, as well as hygienists.

My first instinct was to never go back too. In the car on the way home I told my husband I would never go back. That’s always what I do. My husband thinks like Gordon. It was a bad day, give her the benefit of the doubt. At this point, I really want the assessment to stop this insane stress. Then I can decide how I feel about her and whether I want her working on my mouth again. If not, at least I have all of the base information to take to a new dentist and an idea of what needs to be done.

Honestly, I tend to agree with you that the trust is broken. I’ve seen her 4 times in clinic. It’s not a long term relationship. There will be definite ground rules about being frozen any time pain is even a remote option. My long suffering husband is the one who runs interference for me with the clinic on everything. I don’t communicate with them at all, except when I’m in the office. I just can’t.

As for the crown, I completely agree it’s definitely not all about logic. In my non-dental phobia life, I’m all about logic. I’m a lawyer by trade and I teach law students. So when I made my decision about the crown, I approached it like I would any other decision I make in my professional life. I looked at all of the facts and the evidence and applied sound judgment to achieve what I thought would be the best possible result. But I didn’t really make room for my feelings, which were likely just under the surface.
 
Sadly, I did cancel the December appointment with the other dentist. I held onto it until after the crown prep, which went well. That was 3 good appointments with the dentist, so I thought I was ok. But now I am regretting it. And now the soonest I can get in is March, and I can’t wait that long for a full assessment.

Understandable - of course you would have cancelled after the good appointments. Though if you've now changed your mind, I honestly don't think that another 3 or 4 months is going to make a massive difference. It sounds as if you're much better than most people with your diet and cleaning... just wondering, is there any chance of asking to be put on the cancellation list of the dentist with the really good reviews? That might not be a runner in your line of work, but if there are any day(s) of the week where you're fairly flexible, you could ask to be put on their cancellation list for those days only... just an idea.

At this point, I really want the assessment to stop this insane stress. Then I can decide how I feel about her and whether I want her working on my mouth again. If not, at least I have all of the base information to take to a new dentist and an idea of what needs to be done.

Makes sense. Of course, if you ask 10 difference dentists, you'll get 11 different opinions :p

Please let us know how the check-up goes, and best of luck with it!
 

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