My Dental Chronicle: The Final Chapter

[kitkat]

Yeah, I'm on 6 month recall now.

I actually don't feel traumatized by the experience but I have a very long history with this dentist so I know it's not typical to be that uncomfortable. I even had a relaxed conversation with her afterward and feel like I could go do treatment tomorrow and it would be okay. If it hadn't been for the gagging it would have been totally fine. The gagging totally caught me off guard. I wasn't even anticipating that to be a problem until she started putting things in my mouth. She seemed more nervous in the beginning than I was, I guess she knew I may not react well. She's never made me gag like that before or made me put up with gagging so I think it was just a very awkward filling. She seemed to feel really bad about it but was doing everything she could to be done quickly while trying to simultaneously reassure me. I think it was just a weird appointment all around but I really feel like it would have been better suited for a dental dam. She doesn't use them for some reason or not in my experience with her. I even remember looking at it thinking, how is she going to fix that area? I wasn't so much scared as I was stressed because I still felt in control overall even though I was not in control of my gagging at all (if that makes sense?). I have never gagged so much in my life though! I had to sort of meditate to get the gagging to ease off otherwise it could have just gone on and on. She was actually very good at talking to me to get me to ease off the gagging even though it felt like my whole throat was stuffed with cotton.

On the brightside, I feel a lot less afraid of the drill after doing it with just topical and it not hurting (even though it wasn't my idea! ) . The first preparation part was so stressful by comparison, I actually relaxed some during the drilling. All of her apologizing, reassurance, and sympathizing I think helped to keep from traumatizing me because I at least felt like she meant well. I really had serious doubts that I wasn't going to get through it today. She actually didn't technically tell me she wasn't going to numb me she just asked for the topical which I thought was to numb me for the needle and then she just jumped right into drilling and told me to stop her if I felt anything but I was feeling sorta numb from the topical so I was confused as to whether or not she actually injected me as I was having a hard time keeping track of what was going on. I even had to ask her if she injected me when she sat me up because apparently her topical is pretty strong but she usually doesn't use topical before injections so I was suspicious that she had not injected. she's lucky I didn't feel it because that was a bit sneaky on her part when we had agreed to an injection. It challenged my level of trust with her a bit but it worked out so I will let it go!

 

[kitkat]

So after going through all of that trauma over an enamel defect on this stupid tooth, it has been very sore for the last 2 days and also tastes sour/metallic where the filling is. My gums feel so angry around the tooth..it almost feels cut up but I can't really see anything... and I'm pretty sure they are bleeding slightly. It really hurts to brush/floss or when I touch it with my tongue. I'm hoping it is just inflammation that goes away on it's own but I'm feeling frustrated and irritated. Over the counter medication doesn't seem to make that much of a difference at the moment. If I have to go back for more work on this tooth so help me! I have some prescription mouthwash still so I may try to use that for a bit and see if it helps things. It seems to be more gum pain than anything! My dentist is out of the office for the next week on vacay so ...yeah. Feeling less than impressed.

 

[carole]

I think the metallic taste will go away with a bit more time. I had this when I had a filling and it does drive you mad. I also got it after my bridge was put in, odd.

I would feel like you are too. Hopefully things will settle down in the next few days. If not you know the drill, you will need to call the dentist back. BUMMER

I really hope you feel better soon, especially as you went in there bare back, and no safety net, so to speak (with no numbing)

 

[kitkat]

The taste is still lingering today but is way less intense so it's progress. The pain is easing up too (thank goodness!). I think my gums were just majorly irritated because I'm not having any actual tooth sensitivity and the filling was sort of at/just above gum line (which is mainly why I wanted numbing!!! ) I have not tried to floss today; I decided to take a short break to allow things to heal up first. Maybe I will try tomorrow . I feel like I have made it over the hump tonight though with healing and things are feeling overall a lot better in comparison. I had no idea this would suck so much! Yeesh! Nothing is ever simple!

Still processing that appointment. I still can't believe I did drilling with no numbing or at least just topical!!! and I can't believe she tricked me into doing it!!! Sneaky dentist! That whole appointment was just plain weird! The worst part about having no "safety net" is thinking you have one until the moment of truth comes and you realize it's not actually there ! Thinking back, I don't think she ever intended to inject even though she agreed to ...otherwise she would have from the very beginning and not just before the drilling started because you would need at least 5 min time to allow for the injection to kick in and my mouth was packed full of stuff by that time. So in other words, she sort of lied! I think she thought I would warmly welcome the idea of not getting a shot and figured I'd go along with her plan but then I had other ideas! The whole change of sequence really threw me off from the start too and it just got more disorienting from there! And here I was posting how I had less anxiety because I knew exactly what to expect. So much for that theory!

 

[kitkat]

So I've been thinking about my last appointment because I over analyze everything . I was reading up on how topical anesthetic works and discovered that it only numbs the soft tissues so it doesn't actually do anything to numb the tooth itself (just the gums). I don't know why but for some reason I thought it did numb the tooth on, at least, some superficial level but it actually doesn't work that way . So at first I was comforted by the fact that the topical was there to numb the tooth and now I realize that the tooth was totally not actually numb AT ALL! I'm feeling so disturbed by the thought of that.... I'm actually even more disturbed that my dentist made the executive decision to drill on a tooth with no true numbing despite our conversation just prior to starting the procedure. I know it ended well but it's the principle of the matter that I'm struggling with and the fact that it definitely could have ended differently. I don't know what to make of it. I'm just kind of more disturbed the more I think about it.

 

[kitkat]

Hi Fellow Dental Phobes!
Just checking in because it's been quite awhile since I've updated my thread. Not much is new with the dental world...I'm hoping to be around on the forum more in upcoming weeks to provide support. Apologies for my absence as things have been very busy in my personal life. My next 6 month recall was supposed to be early next month (early May, I think?) BUT I had to cancel it . Not because of fear but because I changed jobs and my insurance is currently lapsed til at least mid-June because in the US, employers do not supply you with medical benefits until you have hit 90 days as a full time employee and you are no longer on "probation." In other words, if I were to go now, I'd be "self-pay/uninsured" and be charged a fortune. Since it's only a 6 month recall, I have no current issues, and my dental hygiene practices are excellent I have decided to put it off...BUT I did already schedule an appointment for June for when my benefits do take effect so no avoiding although I can't say that I'm a little excited about pushing it back! Although now I'm going to lose my appointment buddy! Sorry Pianimo, you are on your own this time unless our lives have paralleled again and your appointment got delayed as well! If not, I will still be your cheerleader if you need one!

 

[kitkat]

I had my routine cleaning/exam appointment this morning and the appointment itself went fine. I managed the cleaning, exam, xrays with no real discomfort and only minimal levels of anxiety although my teeth are bit sore afterward. But I got some not so great news . Despite keeping up pretty well on hygiene, I need another filling...she says it's VERY small and located between my 2 back teeth on the lower right and could probably wait but it will likely get larger over time. Since I'd much rather have a tiny filling over a large filling I opted to have it filled so I'm going back July 9th. I swear this cycle is just endless no matter what I do, there is always something.

My big concern with this filling is that it is essentially in the exact same area as my last filling just on the opposite side (and this one is slightly more complicated and will take more time) and the last filling was sooooo sooo difficult!!!! You can go back and read the details of my last experience if you're interested but basically, I gagged the whole time and there were some major trust issues with the local anesthesia (i.e. discussing and agreeing to using it and then withholding it last minute! ). So needless to say, I'm going to be having a heart to heart with her before this filling because I just can't do that again! I'm already dreading this....I said I wasn't really affected by the experience initially, but time took it's toll on me and the fact that it is in such a similar area really makes me nervous that I'm going to end up re-living my last experience.

 

[Pianimo]

Hi hunny, glad your appointment went ok; sorry to hear you need treatment. Very much like my last visit, so apparently we are still mirroring each other!!

I think it's very understandable you're worried after last time. But instead of worrying about history repeating itself, try to see it as an opportunity to do things over and have things go your way this time. Be really clear with her - before the appointment if you think you might not manage to be clear enough on the day - that you DO want LA no matter what, and even if it's probably not necessary, and that it's crucial for you to know things will happen as you are expecting them to. Explain to her that although things worked out ok last time and you do trust her opinion and know she doesn't want to hurt you, it's really important to you to be able to make decisions about your own treatment and to know that she won't change her mind at the last minute - no surprises!

In the meantime, remember all the positive experiences you've had with her before and all the reasons you have to like and trust her. If she is as lovely as you know her to be, she'll understand and listen to you, and respect what you've said.

As for the gagging, there are lots of tips on here for dealing with that, and you could also ask your dentist what are the techniques/tricks she uses or suggests the most. I can't help much as I gag terribly, but IV sedation is what solves the issue for me. That, and lots of swallowing! I'm not sure yet when I'll be going back (check out my thread in My Dentistry Questions Answered), but it will definitely be after you. Hoping you have a really good appointment.....so that it means I'll have a really good one too! (I'm TERRIFIED!! ) And just cos you deserve a much better experience this time.

Nice to see you back. I've been away too - too much going on!! Hope all that's been going on with you has been good-changes and nothing too difficult to deal with.

 

[kitkat]

It is very nice to hear from you Pianimo, especially in a time of much needed encouragement. The issue is not so much about the LA itself as it is saying one thing and doing another. Since she did not hurt me last time, I think I would actually be ok without anesthetic this time if she thought she could do it without causing pain (and it may come up again because she said it's very shallow) but I need to be on board with the decision from the beginning and know I can change my mind at any time and opt for LA if it becomes too much. I just feel like my consent was violated when you ask me for input, agree, then do something else without really asking. It could have been handled a lot better had she explained why she did not think LA was needed and gave me the option to try without but have it on hand just in case or better yet just do what I ask to begin with! To be fair, she doesn't know my exact fears as I've always had a hard time communicating about them openly. She just knows I get very nervous at times and tries to address things as they come up. I really just need to know there will be follow through with a plan. Like you said, no surprises! I think in some ways the universe is challenging me to make this time go the way things were intended...like a do-over I'm not interested in!

I read your dentistry questions thread and funny enough I'm considering pushing my appointment back to August as things are about to pick up at work and am not sure I will be able to get the morning off! The longer I wait the harder it will be to face though. I really hope your treatment is a piece of cake for the sake of both of us and our mirrored lives ! I have read all of the gagging tips and I think raising the feet may help its just a matter of being rational enough to remember to do it while trying not to panic! Part of me thinks taking breaks would help but not if my mouth is still full of stuff and I feel like I can't swallow...then I just want to hurry through it and be done to get everything out faster!

Yes, things have been incredibly busy but all good things! I have been extremely blessed these past few months but I have just been feeling quite drained from everything going on and haven't had the energy to post lately. I hope the universe is bestowing good changes upon you as well!

Only 2 1/2 weeks til this appointment!

 

[Pianimo]

If it's swallowing/not gagging with a full mouth that is the most difficult part, that's something you can practise. As a child I developed the ability to swallow with my mouth open/full of dental stuff, and that was the only thing that kept me from gagging constantly and throwing up over my dentist! I still have to be allowed to swallow regularly during treatment, even with the sedation. But you can definitely practise at home - lying back, mouth open, with toothbrush or two in there, and swallowing without closing you mouth. If you know you can swallow whenever you need to, that does make things much easier.

Agree also that the most important thing is to make sure your dentist knows you can' cope with surprises and you need to know that what you agree on will be what happens.

Glad all the changes for you have been good ones! it's been a mixture for me, but things are much better now than they were 6 months ago, so at least that's an overall step in the right direction!

 

[kitkat]

If it's swallowing/not gagging with a full mouth that is the most difficult part, that's something you can practise. As a child I developed the ability to swallow with my mouth open/full of dental stuff, and that was the only thing that kept me from gagging constantly and throwing up over my dentist! I still have to be allowed to swallow regularly during treatment, even with the sedation. But you can definitely practise at home - lying back, mouth open, with toothbrush or two in there, and swallowing without closing you mouth. If you know you can swallow whenever you need to, that does make things much easier.

I normally do not struggle with gagging during appointments and it has never been a major problem before. It's not so much a general problem for me with swallowing while my mouth is full of stuff as it was a specific problem with the area being worked on and her approach to isolating it (i.e. stuffing cotton all around the lower back tooth and it taking up the entire back of my mouth). The cotton felt like it was literally resting against what felt like my anterior faucial pillar (that arch looking structure just before the throat) and possibly posterior faucial pillar (further back arch)/tonsil area and that's just an automatic gag reflex I can't control. It was a very awkward area to fix and she kept apologizing for having so much stuff in my mouth and the awkward angles so I'm hoping this time it is more accessible. This time it is the same tooth but the opposite side and rather than being on the lingual surface (facing the tongue) it is between the teeth which is more facing outward so...I'm hopeful...

Agree also that the most important thing is to make sure your dentist knows you can't cope with surprises and you need to know that what you agree on will be what happens.

Glad all the changes for you have been good ones! it's been a mixture for me, but things are much better now than they were 6 months ago, so at least that's an overall step in the right direction!

I'm going to be clear with her that I want her to talk me through exactly what she is doing as she does it which she always used to do when I was much more phobic and needed a lot more "hand holding" but has gotten away from it over the last few years as I've grown more comfortable with her.

 

[kitkat]

Only 2 more sleeps til my appointment. Not exactly panicked about it but definitely thinking about it a lot. It crosses my mind at least once every hour or so. I'm feeling really confident about communicating how I feel this time straight away (I've been practicing when I'm alone in my car ) so hopefully I can keep my nerve once I'm there. I feel like whatever happens, happens now. Either way, I feel more prepared than last time and better equipped for handling the situation should it take a wrong turn. Wish me luck...

 

[kitkat]

Well the filling is over. I wish I could say I had a good experience but eh...not so much . Well it actually started off okay and then went downhill really quick! That's 2 for 2 so I'm feeling a bit defeated! My fear was actually much better after getting started (not so good leading up to it) and I felt like we communicated a lot better. I didn't gag and I got LA (both improvements from last time!) but I could not get numb to save my life which resulted in a pretty painful experience as a whole.

Here is the run-down of the appointment. I made the appointment for 9am and planned to go into work afterward. I was seated in the chair by 9am but was not actually greeted by the dentist til about 9:30 so I sat in the chair for 30 minutes twiddling my thumbs (and freaking out internally) although the assistant came into occasionally check on me and break my concentration on not freaking out. When the dentist FINALLY came in she jumped right into giving me local anesthetic which I was completely relieved to hear because last time she withheld it.

The injections went fine as always and didn't really bother me at all and then we waited about 7 minutes or so for things to take effect. This is where the trouble started. I have only had 1 other experience with larger fillings on the bottom teeth that required anesthesia and I wasn't able to get fully numb that time (although it's rarely ever an issue on top teeth) and I was getting the same half-numb sensation as the prior experience. She asked me if I felt numb all the way to the center of my lip and I said no...it was more just in my cheek but my tongue was numb. She asked if I wanted to proceed and because I had a filling done painlessly with no anesthesia last time on a bottom tooth I was feeling brave and told her we could try it with the agreement that she would stop immediately if I felt anything. She showed me how she would be isolating the tooth to keep it dry (which was different from last time-Thank God!) and managed to not gag me at all this time!


Well I think we made it about 4 seconds into drilling before I stopped her because I definitely was NOT numb...I was far from numb...I think the tooth still had full sensation! It started out as a mild twinge so I was feeling it out to see if it would settle and then the pain intensified by a factor of 5 in a matter of seconds! She kept her word though and stopped immediately to give me more injections and then let me sit for several more minutes to get numb. After the second set of injections, I could feel the numbing getting much more pronounced in my cheek and moving towards my front bottom teeth and lip...not quite to the center but almost and not really fully numb but more tingly and we agreed to try again. This time it was a moderate but consistent twinge that got severe at times but had enough of the edge taken off that I could tolerate it in short spurts if I squeezed my index finger really hard between the thumb and index finger of my other hand to distract myself. I could have stopped her again but I needed to get to work and had already been there an hour and was losing faith that more injections would help so I just put up with it in order to be done! But it basically hurt from start to finish...and towards the end when my nerves were fried I was getting very close to my pain threshold where I would need to stop soon. It is still very sore now and almost 12 hours have passed but she said it was a very small surface filling so I wasn't expecting that degree of discomfort!

Oddly, I wasn't actually nervous after stopping her the first time...maybe because I knew I had control to stop her again if it got to be too much and my biggest fear was pain from the drill/anesthesia failing and that happened and it wasn't exactly the end of the world although VERY unpleasant! I also had an audience today of all days. She had her niece with her today (who I think is a little younger than me-early 20s) who apparently wants to learn about dentistry and she called her in after most of the drilling was done and used me as a teaching model for her. I didn't mind too much because she stayed out of the way and it ensured I had a running commentary of everything that was going on which I actually prefer but it was a bit awkward.

 

[vicki]

Sorry to hear that things didn't go so well . As you know, there are all sorts of reasons why the LA injections sometimes don't work as well as they should. I'm no expert, but over the past 4 or 5 years, I have had numerous fillings, injections, dressings and 8 root canals, all of which have been on molars and during quite a few of these, I've experienced the same as you just have.

I was seated in the chair by 9am but was not actually greeted by the dentist til about 9:30 so I sat in the chair for 30 minutes twiddling my thumbs (and freaking out internally) although the assistant came into occasionally check on me and break my concentration on not freaking out.

If you were sat for 30 minutes with nothing to do except get stressed about the appointment, particularly after your previous experience, then by the time your dentist came in to do the injections, I would imagine that you were probably fairly anxious. Anxiety can have an effect on how well the LA works, mainly because of the excess adrenaline that you produce, so that may have had something to do with it.

Individual anatomy, the type of injections required, the length of time the injection is given to work before starting treatment, the skill/experience of the dentist and which tooth it is, can all affect whether the LA works as well. Upper teeth are supposed to be easier than lower teeth to get numb and although I've had numerous problems with my lower molars not being numb, it's never been a problem for the upper molars, but then again, you tend to get injections directly in the area to be numbed for upper teeth, whereas lowers require nerve blocks which are more tricky to get right.

In my case, I wondered whether it was anxiety that was preventing the LA from working, so I tried taking Diazepam (Valium) for all the root canal treatment and even though it did calm things down considerably, I still had problems with not being numb enough with the lower molars sometimes. I can remember one appointment where I was having treatment (with my lovely endodontist who is so nice that it's impossible to be nervous of him ) and I'd had 3 nerve block injections to numb the lower left side of my mouth. Each injection was at least 15 minutes apart and not one of them worked properly - even though the inside of my cheek was numb (but not half of my tongue as it should have been). It was really strange, almost like I'd had an injection of water instead of LA, because nothing felt numb despite 3 injections. I was already half way through root canal treatment on the tooth, so most of pulp/nerve had been removed, so we decided to give it a try as it should have been OK. Just before the drilling started, he decided to test the tooth with the electric pulp tester just to make sure that it was numb and that indicated that there was no feeling in the tooth, so it seemed OK to continue. About 5 seconds into the drilling, I felt really sharp and severe pain in the tooth, so he stopped straight away and placed a dressing in the tooth instead. I was really glad that he decided to stop and not go any further rather than giving me the choice, because if he had, I think I would've probably said I could cope with it even if it was painful.

Since then, every appointment for treatment on the lower molars has taken about 30 minutes of doing injections and giving them chance to work and has involved at least 2 nerve block injections, infiltration injections and then intraligamental injections as well... so in other words, enough LA to numb a horse ... but at least it has been numb. My upper molars have been a lot easier by comparison and have only needed a couple of injections.

I do know that a few of my teeth had quite an inflamed pulp, so that makes things a bit more difficult as well. If your tooth was a bit irritated or inflamed and the filling was a bit close to the nerve, then perhaps that's why you felt pain. There could be any number of reasons really, but if the pain/soreness doesn't settle down, then I would go back and see your dentist just to check that everything is OK.

 

[chickenjen]

hi, kitkat,
Oooh, I felt your pain. A couple of years ago, when I had my root canal done.........I basically had the same experience you had. The anesthetic shot went fine, but I didn't feel as numb as I usually did. In my case, my dentist said that it was the infection preventing me from getting TOTALLY numb. He basically did what your dentist did, drilled in short spurts, which was tolerable but not totally pain-free. My dentist probably gave me 8 shots and STILL couldn't get me totally numb.
A giant to you!!!!!

 

[carole]

yeoweeeeeeeeeeeeeeeeeeeee I think you were very brave to continue as you did, I would have been a nervous wreck. I am glad it is over and done with now. I hope the discomfort goes away soon too.

 

[kitkat]

Thanks for the replies guys! Your support means a lot to me! I've been sore all day but not so much the tooth itself...it's been more where the injections were which is unusual but seems to finally be letting up now. After the second round of injections, I mentioned that we had a hard time getting me numb on the bottom last time we did this and her response was "really?! I don't remember that...". I was thinking that's probably because it was 8 years ago, you have hundreds of patients, and we weren't playing Russian roulette with YOUR teeth!

Her assessment of the situation was that bottom teeth are just trickier to get numb due to the way the nerves work and I think I agree given my past experiences. I think the problems I experienced mostly had to do with anatomy because I have been LOADS more nervous in the past with top teeth and got numb without a problem plus, this is not the first time anesthetic has failed me on the bottom. Plus, I'm usually only very nervous leading up to the procedure..once my dentist comes in and starts talking to me, I settle down which was this case this time. She has a very calming/soothing way about her mannerisms/tone of voice/demeanor as she starts working that just makes you feel very safe and relaxed. Luckily being a surface filling there wasn't a ton of drilling and I don't think she ever even used the low-speed drill (thank goodness! ). Once we finally got going, the process only took 20 minutes from start to finish; there was just a lot of wasted time with the injections. Note to self: I'm gonna have to go the sedation route if I ever need a RCT on a bottom tooth...especially if this is an anatomical issue because I won't survive it!

Oddly, once I felt pain (after the second round of injections which was a little less intense) I really wasn't nervous anymore. Perhaps it gave me something to focus on! I think because I had control (sorta-in that I knew I could stop if I wanted to as she kept reiterating that I could plus, I already had once!) and I knew exactly how much pain I was dealing with. I think my fear is not so much of pain as it is control and the unknown. The worst part was actually surprisingly not the drilling...it was the etching (acidic stuff that goes on the tooth so the filling material can bond) because I wasn't expecting it to hurt and it was this real long, lingering pain that seemed to slowly intensify and wouldn't let up and I really had no control over that part. The air/water spraying didn't feel too good either! At least the pain with the drilling was finite; it would only produce a very specific pain while the drill was in operation and would stop immediately when the drill stopped.

 

[chickenjen]

I'm with you, kitkat!!!
When my dentist was doing my emergency root canal and I wasn't fully numb, he left me alone for a bit so he could figure out what to do, I almost asked him what oral surgeon he works with that does sedation (my dentist DOESN'T offer it at all), because I didn't think I would be able to make it through the procedure fully aware.
If I have to have an elective (non-emergency) root canal, I will ask my dentist about where (who) I can go to get sedation.......................going through that experience once is MORE than enough for me!!!!!
Hope you feel better
's!!!

 

[kitkat]

Mine doesn't offer sedation either (not even nitrous oxide!) but she refers out for all RCTs anyway and then does the crown afterward when the tooth is already dead. I'm glad I discovered these issues in advance with minor fillings and not with emergency RCT treatment so at least something good came of it.

 

[Pianimo]

Hello you. Just wanted to stop by and say sorry I wasn't around for your last appointment. I was thinking of you that day and I did read your report, but everything's just been crazy so I've not been posting at all. I'm really sorry that you had another bad experience. It's given me a new thing to be worried about for my appointment now!!! But mostly I'm just really sad that things didn't go well for you. I hope the discomfort didn't last too long after your appointment and that everything's been fine since.