Looming extraction (?) and I am panicking

[pigeonkisses]

Last year, I broke my bottom right wisdom tooth. I went to my dentist who tried to fix it, but I had to go back and needed a needle so took some diazepam before my appointment. It went as expected, I had a panic attack in the chair anyway. But he pulled off the piece of tooth that was broken (no root) and put a temporary filling. Sturdy stuff, it has held in until recently when I think maybe a little bit fell off or it cracked or wore thin. Dentist patched it up. That didn't last long, about a week and started hurting again.

I went back today, he patched up and we asked if I could be referred to the NHS dental clinic for anxious patients where they offer IV sedation. He said ok but all they would do is remove the tooth, they would not try to save it. So I mentioned having read about a private dentist on here, who comes highly recommended. My dentist has heard good things about him too. So he would refer me, but he is further away from me than the NHS clinic, and he is private so costs a lot more. Also I have the top right wisdom tooth that's been causing me problems for years and is wobbly so that probably could be taken out at the same time.

I had almost decided that I'd go for the private dentist who does sedation too, but the idea of extractions terrifies me, and the aftercare, the clotted revolting holes left behind, pain, possible infection, swelling and mental issues. All this is snowballing as the fix of today seems to have done nothing at all

So after agonising, I am left with the probability that whoever I do choose the end treatment will be the same, only one would cost me a lot more. But the NHS one might be rubbish. And I can't think, I can only panic and cry. And my tooth is still sore.

What would you do?

 

[MountainMama]

I would probably go with the one that is more likely to do a better job with anxious patients. If you can afford it, the recommended private dentist may be a good option. I am not as familiar with the NHS system, but you don’t necessarily know who you will get, do you?
My first adult extraction, after horrid childhood experiences, was done using nitrous oxide. It was so much easier than I had been expecting. I was literally hyperventilating in the chair and they were having to calm me down to get me to take deep breaths for the nitrous. Once it kicked in, it was super easy. I left there thinking, “that was it?”. The anticipation and your imagination will build it up much more than what will actually occur.

 

[pigeonkisses]

MountainMama thank you for taking time to read and reply, I really appreciate. My phobia comes from something completely unrelated to dental experiences, which makes it even more difficult to get my head around. I had a try of nitrous oxide a few years ago when there was talk of removing my wobbly upper wisdom tooth and it didn't work, all it managed to do was to stop my panic tears but I wasn't able to allow them near me with a needle, never mind pulling my tooth. I think I was so full of crazy hormones that it barely had an effect sadly. I think maybe a benzo before setting off for the appointment might be something I will discuss with the dentist. The anticipation anxiety seems to be the worst isn't it.
Did they put a stitch in your extraction site? That is another issue I have to get my head to deal with, the clots especially if I have two teeth pulled.

I have read good reviews on the NHS clinic, but the receptionist I spoke to didn't sound like someone who should be working in a clinic for anxious and phobic patients, so she didn't fill me with confidence. However, she kept putting me on hold to ask a colleague what I'd asked her so maybe she as new. And the receptionist wouldn't be the one doing the dental work.

I'll have to think about this. The distance to the private dentist is also a bit of an issue. I'll make a separate thread to see if anyone had experiences with that particular clinic.

 

[letsconnect]

Hi, I’ve read the reviews of the NHS clinic and they do sound excellent. I doubt there’s any point in desperately trying to save a wisdom tooth (unless, for some reason, you are exceptionally attached to it?), so it wouldn’t really make any difference in outcome. The only problem with NHS sedation clinics is that in some areas, there can be long waiting lists - any idea how long it might take to be seen?

Also, do you know if they happen to provide ongoing care (regular check-ups etc)?

 

[pigeonkisses]

Hi, I’ve read the reviews of the NHS clinic and they do sound excellent. I doubt there’s any point in desperately trying to save a wisdom tooth (unless, for some reason, you are exceptionally attached to it?), so it wouldn’t really make any difference in outcome. The only problem with NHS sedation clinics is that in some areas, there can be long waiting lists - any idea how long it might take to be seen?

Also, do you know if they happen to provide ongoing care (regular check-ups etc)?

Hi letsconnect, no I am not particularly attached to my tooth, altho I do prefer my teeth to stay in if possible! I am just really freaked out by extractions, most medical procedures in fact, so an extraction, in my head, equates to trauma and an assault. All invasive medical procedures are considered, by my crazy brain, to be an assault. Of course my rational brain knows it isn't but my crazy brain always wins that argument unfortunately. And to that brain, an extraction is an invasive procedure, as is a mouth injection. So one and possibly two wisdom tooth extractions is a massive deal to me.

Also, I have an open bite and I brux (probably related, my bite has moved loads in the past 10 years or so), so the only teeth that normally touch, to chew, are my molars and to an extent, my wisdom teeth. I also have one tooth missing in front of my lower wisdom tooth so it will end up all alone and bear the brunt of my grinding all alone, I worry it will get damaged too.

I was referred to a MF surgeon a few years back about facial pain and my bruxism, my toothguard doesn't stop me bruxing, just softens the blow and the wear I guess. The consultant wasn't interested in helping out at all, told me to rub voltarol on my face and to 'get out of that bad habit'.

As for the Dental Access Clinic offering check ups and that sort of things, I don't know, I don't think that they have a regular patients list, I think they are referral only. Luckily I am ok with hygienist appointments (mine if very good and gentle) and check-ups which usually involve my dentist giving the nurse some numbers

I just spoke to the single point of access team, and the referral waiting time is 18-22 weeks, for the initial consult! God! I guess I might have to go down the private route, or ask my GP for a better sedative than what I take for my 'normal' anxiety and ask my dentist to take out the temporary filling and put some proper filling in.

And I asked for you, they do check ups and hygienist, that sort of thing but only for specific cases and referral only.

 

[MountainMama]

Maybe a combo of benzo and nitrous? My endodontist offered that to me before my first root canal, as I was shaking just at the consult. I opted for just the nitrous since it worked for me.
I did have stitches for most of my extractions but I also had bone grafting in preparation for an implant. With one extraction I did not have stitches and it was worrying, but I made it through. The first two days are the worst, worrying about the clot, but if you follow the after care instructions exactly you won’t have issues.

 

[letsconnect]

Thanks for all that info @mouthsewnshut! That's a fairly long wait, especially if you're in pain. And thanks for the explanation re. wanting to keep the wisdom tooth - makes sense.

I suppose the advantage of seeing the private dentist would be that they could give an honest assessment of whether the tooth can be fixed long-term, and if so, they'd be able to offer sedation?

I didn't realise you had such a good relationship with your current dentist and hygienist, so the other reason to see the recommended private dentist (continuity of care) isn't really such a biggie, by the sound of things.

 

[pigeonkisses]

Maybe a combo of benzo and nitrous? My endodontist offered that to me before my first root canal, as I was shaking just at the consult. I opted for just the nitrous since it worked for me.

My dentist doesn't have nitrous oxide. It was the NHS clinic locally that had it and it didn't work. There was one dentist I saw there I would never want to see again, I don't know why he works with anxious patients, he made a 'joke' about how in the old days they used to rip everyone's teeth out and filled buckets with teeth and blood. How I laughed
The other time I went I saw a lovely dentist but I was still too scared to let her do anything and that was for one upper wisdom tooth extraction. So I am not sure a benzo and nitrous would be enough, especially not for two wizzies

I did have stitches for most of my extractions but I also had bone grafting in preparation for an implant. With one extraction I did not have stitches and it was worrying, but I made it through. The first two days are the worst, worrying about the clot, but if you follow the after care instructions exactly you won’t have issues.

Do they use this soft sort of dressing at yours? Mine said they have something which is sort of like that spongy stuff you have in flower arrangements, you know the green brick that absorbs water? But not that. You are very very brave to have had all that done, especially bone grafting. My 'crazy' brain would make me run a mile. I need therapy :|

 

[pigeonkisses]

Thanks for all that info @mouthsewnshut! That's a fairly long wait, especially if you're in pain. And thanks for the explanation re. wanting to keep the wisdom tooth - makes sense.

yes it wasn't very clear

I suppose the advantage of seeing the private dentist would be that they could give an honest assessment of whether the tooth can be fixed long-term, and if so, they'd be able to offer sedation?

Yes they would be able to use sedation regardless of the fix, whether it's an extraction or a new filling. My current dentist is private too but he doesn't have the facilities for sedation. All he gave me once was temazepam, but I found it had very little anxiolytic properties, so I was very dopy but silent tears of panic were rolling down my face for the whole flling, a really small filling might I add. But needles etc

I didn't realise you had such a good relationship with your current dentist and hygienist, so the other reason to see the recommended private dentist (continuity of care) isn't really such a biggie, by the sound of things.

I am ok with non-invasive things so shouting numbers at a nurse doesn't fill me with dread
Going to the other private dentist is not a big deal no and I found another one who is closer to me that I might go to if I can find recommendations.

 

[MountainMama]

I have come a long way with dental treatment. Two years ago I could barely get in for my regular cleanings. Due to all the issues I had as a kid, I made sure to keep my teeth clean and get regular cleanings to avoid further need for treatment. Then I had a tooth break and needed a crown. The crown was done poorly (and was a terrible experience) and around two years ago my habit of clenching my teeth at night caught up with me and I had some cracked teeth. All seemed to hit at once and I had two years of a lot of dental work. Some great oral surgeons and dentists have really helped me to get past some of my deep rooted fears and now, although I am still scared, I can get into the office and sit in the chair without panic attacks.
Oh and bone grafting is nothing. Once the extraction is done, they just pack the site with bone graft particles and sew on a membrane. Nothing worse than that.

 

[letsconnect]

Going to the other private dentist is not a big deal no and I found another one who is closer to me that I might go to if I can find recommendations.

If you like, send me a private message and I'll check if we have received any feedback for them in the past that's not published here on the forum ?

Oral sedation can be a bit hit-and-miss, so seeing someone who offers other types of sedation sounds like a sensible move.

 

[pigeonkisses]

I had one of those years last year, from tooth grinding doing a number on old wisdom tooth fillings, I broke two. Teeth make me so unhappy.