My situation/fear of diagnosis after 15 years away from the dentist

[SA-Dandy]

Apologies for the long account.

I am in my early 30’s and haven’t been to the doctor since I graduated high school. I had some rough experiences as a child, but got back into the groove in my teenage years. At my last visit, the dentist thought I had two minor cavities (no previous cavities in my adult teeth) and recommended I remove my wisdom teeth, which had not fully come in. On the topic of needing the wisdom teeth out, his sentiment was essentially “don’t be a wimp” and, on that day, a switch flipped and I have been terrified of the dentist ever since, with no follow-up visits.

Fast forward 15 years. I have been very good about my dental hygiene – brush twice a day with a fluoride toothpaste, floss a few times a week, and use mouthwash. I also chewed pens and used those little plastic brushes in my teeth religiously, almost to the point of obsession – hopefully that helped keep things out from in between my teeth, too. In recent years, I have done research and improved to use an Oral B electric toothbrush, ACT non-alcoholic mouthwash, and even a waterflosser. I smoked for about 8 years, but haven’t puffed a single one in nearly 4. I don't drink coffee, only a bit of tea, and maybe a few sodas a week.

Like I said, my teeth are pain free. I do have some black spots in the pits/crevasses of my molars, but they were already there at my visit many years ago, so I hope that is not necessarily an issue. From what I have researched here, that doesn’t always mean there is an issue and can also be related to the sealants I received when I was a teenager. Smoking also made it worse, I suspect. That said, despite the seemingly positive factors, I am terrified of an initial diagnosis – that there is some underlying huge issue, and this will be the beginning of a myriad of issues.

The other major cause for panic is my wisdom teeth. As I indicated, all 4 are completely “in” and pain free. That said, I noticed about a year ago that the one in the top left (facing me) is missing a “chunk” on the side of the tooth, above the gum but below the “flat top.” It’s essentially carved out a bit – I suspect you could fit 1/3 of a pea in there, to give you a sense of the size, and it’s quite jagged. This is another huge cause for panic – essentially, I am convinced that I will need to have it removed, and all 4 at the same time. I simply can’t fathom the notion of doing this while conscious, so I have been researching/fretting full GA as my only possibility, and that is terrifying.

I know I can’t be diagnosed over the internet, but am hopeful folks have some calming thoughts on my situation. Am I likely looking at a huge amount of work on my non-wisdom teeth? On the wisdom teeth, do they definitely need to come out? Specifically, the one with a missing part – is there any way to save teeth like that?

For whatever reason, I have really freaked out about this in the past few days. Keeping me awake at night, difficult to eat, breaking out in sweats. Frankly, my ideal situation is to address this over the course of a few months to a year – would like to try to get in better shape (eat healthy, but haven’t exercised in a while), get a general physical (haven’t been to a doctor due to similar fears), then get my teeth in order. Right at this moment, however, I feel completely consumed with the situation to the point where I am essentially daydreaming that my teeth are just going to collapse.

Many thanks to all of you. I hope that one day I can be a source of reassurance of others here, because I know how challenging it can be.

 

[Steve In Cleveland]

SA-Dandy,

The short answer to your questions:
"Am I likely looking at a huge amount of work on my non-wisdom teeth? "
I doubt it.

On the wisdom teeth, do they definitely need to come out?
Maybe, maybe not. They're fully in by your age, so you might want a second opinion.

Specifically, the one with a missing part – is there any way to save teeth like that?
Yes, this is often very easy to fix. But it depends on how healthy the rest of the tooth is (mostly below the gumline).

As you said, there's no way to diagnose you over the internet(plus the tiny little detail that I'm not a dentist), but it doesn't sound like you have much to worry about. If you're brushing and flossing regularly, you're probably keeping most of the nasty bacteria at bay, and since you're not in any pain you probably don't have any immediate or major issues.

I don't know too much about wisdom teeth, but I think that removal of fully grown, adult wisdom teeth is a little controversial. Usually the concern is that they'll become impacted (not have room to fully grow out) or will crowd out other teeth in the arch. In any case, remember that a dentist's recommendation is just that-- a recommendation. Even if the dentist is completely correct, you still have the power to just say "no thanks." That's not even really rare; people delay or avoid treatment for all kinds of reasons-- fear, finances, or just not seeing the need to treat a condition that isn't bothering them.

The important thing to know is that the dentist won't refuse to examine, clean, or work on the rest of your teeth just because your wisdom teeth might need some work. At worst, he might mention it to you at each visit. But you shouldn't let that prevent you from taking care of the rest of your teeth. Spoken from personal experience, I avoided the dentist for almost two decades largely because of one tooth which was broken, eventually to slightly below the gumline. Lots of other teeth got much worse while I stayed away (unlike you, I didn't brush at all), and when I finally went back, I was shocked at just how uninterested the dentist was in that tooth. It did need to be extracted by then-- a procedure that took all of fifteen minutes-- but even then there was no urgency. It sat in my mouth for a full year before I finally got around to having it done a few weeks ago.

No guess on the treatment for your one wisdom tooth with the chunk missing. Usually, issues above the gumline can be corrected with a filling, inlay, or crown, so long as the tooth below the gumline is healthy. Again, from personal experience, I've had teeth where the natural crown is completely missing, haven broken off over many years, and was able to have them treated and crowned, and they've just like natural teeth now. Having a big chunk or hole feels like a major thing, but it's usually pretty easily treated. I don't know why your dentist recommended having the wisdom teeth out; if that's a valid diagnosis, it's probably not worth investing in saving a tooth that needs to come out. But then again, if it's not bothering you, you can still choose to do nothing.

(By the way, the risk of ignoring the dentist's recommendation is that, eventually, the tooth will probably cause additional problems that are more painful/complex/expensive to treat later. It's like when your car mechanic tells you your brake pads are worn. Fixing them now might be fairly straightforward; letting the pads go might mean new rotors and calipers and lots more down the road.)

Fear of diagnosis is a major part of dental phobia-- been there, done that, for decades!-- so no amount of facts are probably going to help. But seriously, from what you described, you probably aren't looking at a lot of work, if any. But the big important thing to remember is, YOU ARE IN CONTROL! You can get yourself examined, or have your teeth cleaned, and then it's up to you how much of the dentist's recommendations you choose to act on. Also, teeth generally are kind of independent beings-- dentists can work on one tooth even if the tooth next door has major issues. So it's not like the dentist will say something like, "I'm not even going to work on this filling until we fix that wisdom tooth." So, if your exam turns up a couple of cavities, you can work on those (or not) even if the wisdom tooth issue is still out there.

Good luck, and keep posting and reading here. There's plenty of us that faced the scary diagnosis monster, and lived to tell about it.

 

[SA-Dandy]

You, sir, are a savior. It's been a terrifying few days worrying about this, literally paralyzed on bed, and your thoughtful response could not have put me more at ease. I know that took a lot of time, so thank you very much. I am certainly not holding you to a good diagnosis, but the rational commentary on what can/can't be fixed, how I can take any advice and walk away, and the ability to treat my non-wisdom teeth separately - all makes me feel like you have lifted an enormous weight off my shoulders. Like I mentioned, I have a plan laid out to get a few health items sorted out over the next few months, and this is tremendous reinforcement. In the meantime, I will keep up the good habits and hope to maintain my dental health as much as possible.

 

[Patti]

Dear SA:

last year at this time, and at 49 years old and after only seeing a dentist TWICE IN MY LIFE (in my 40s for 2 fillings) I had made an appt for what I thought would be a couple of fillings. I was told I needed a root canal in one tooth & a crown on another AND that there were "other issues" in my mouth. I PANICKED! I had the root canal tooth pulled because it was a tooth nobody would see anyway. I freaked out about that but it turned out to be quick & painless (oral surgeon). The dentist I had I didn't trust and she had very little patience for someone scared as me. I went to a family friend who is a dentist and could put up with me. I was SO SCARED to find out what could be wrong and what I was facing due to my avoidance due to my fear. Turns out, it was a bunch of fillings. I did get 2 wisdom teeth out but there were only fragments left. I can't even tell you the years of pain I went through with those. I let them rot until they were gone. The other 2 wisdom teeth my dentist put fillings in. The oral surgeon wanted to pull them! Always good to get a second opinion. Anyway, I know your fear and I will tell you I convinced myself things were far worse then they actually were. I went every week for 3 months to have all the work done. BTW,I never got the crown but a filling instead although I will be making another appt because it is starting to bother me now. Still petrified of hearing the words ROOT CANAL but if It comes to that ill do it. Nothing that has happened yet has been nearly as bad as I feared. The fear was worse than anything else. Dentists REALLY CAN fix your teeth without pain these days. REALLY! If you have any questions just ask or private message me. If you can find my thread here from last year and you have a couple hours (LOL) read it. It really is a success story and should ease your mind.

Also worth mentioning, after my 3 month long marathon of dental visits, nothing really phased me after that. My dentist prescribed Ativan to chill me out for visits and I only took them for 2 visits. After that it was just like visiting an old friend. I sort of looked forward to the visits--in that I was so proud that I was getting things done finally. I carried the checklist with me of the procedures I needed and checked each tooth off one by one until it was all done.

I won't say I'm still not a little skeeved right now about the tooth bugging me BUT its butterflies, not sheer terror, and whatever it is I will take care of it and move on. I lost 15 pounds last year due to fear. Sadly, I found that 15 pounds again. Maybe I need another good scare? LOL

 

[Steve In Cleveland]

You, sir, are a savior. It's been a terrifying few days worrying about this, literally paralyzed on bed, and your thoughtful response could not have put me more at ease. I know that took a lot of time, so thank you very much. I am certainly not holding you to a good diagnosis, but the rational commentary on what can/can't be fixed, how I can take any advice and walk away, and the ability to treat my non-wisdom teeth separately - all makes me feel like you have lifted an enormous weight off my shoulders. Like I mentioned, I have a plan laid out to get a few health items sorted out over the next few months, and this is tremendous reinforcement. In the meantime, I will keep up the good habits and hope to maintain my dental health as much as possible.

Big hugs to you... no one should have to live like this, although I did myself for way too long, as did many people on the forum here. (And countless more who are still suffering.)

It does get better, and I can't even describe the feeling of relief you'll have once you find a compassionate dentist.

 

[Patti]

Steve, you are awesome. I'm glad you are still here paying it forward.

Big hugs to you... no one should have to live like this, although I did myself for way too long, as did many people on the forum here. (And countless more who are still suffering.)

It does get better, and I can't even describe the feeling of relief you'll have once you find a compassionate dentist.

 

[SA-Dandy]

So in my infinite wisdom (pun intended), and to add to my wall of worry, I did some poking around in the back of my mouth to see if I could detect any other problems. Noted a line of black tartar just above the gum line of one of my wisdom teeth. It's part of the tooth that often rests "snuggly" against my cheek, so I am hopeful it is, indeed, tartar that's built up and stained over time. From the scary research I have done, that seems like something relatively straightforward. Honestly, over the coming weeks/months, my goal is really to prep myself to face the initial diagnosis without the fear of a surprise.