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My teeth - 'medicine' phobia and periodontal battle

letsconnect

letsconnect

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Re: My teeth - 'medicine' phobia COMMENTS WELCOME

Thanks :) - hmm what I was trying to say is that I don't know if he has a "light touch" otherwise, but there certainly is no need to "poke hard" during probing which it sounds like what happened here - especially considering that you didn't experience anything like this during your last cleaning.

At a few points my eyes were watering with the jabbing pain and I did say 'this is bloody hurting, but I know it is my own fault'

no, most certainly not your own fault :XXLhug:
 
Carys

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Re: My teeth - 'medicine' phobia COMMENTS WELCOME

no, most certainly not your own fault :XXLhug:

Well, no I guess the fact that it was being done and causing pain wasn't, but the fact that I have those pockets to start with is my fault. Having never had this mapping thing done before I didn't know that it could be done with minimal discomfort, this nearly sent me through the ceiling with jabs. I can generally cope fairly well with pain too.

I am going to mention this to him in a couple of weeks. It has made me very scared though of the next appointment, and it is such a shame as he really is a nice man, very caring but he misjudged this one big time....he did keep saying sorry, sorry, sorry every time it happened. It does shake your relationship a bit though. I will need to give him the benefit of the doubt though at the moment and presume that he wasn't entirely aware of the effect on me ??

especially considering that you didn't experience anything like this during your last cleaning.


No the cleaning was absolutely fine, and she went down into those areas of concern.....it was over 1/2 hour of the hygenist working and she did the whole mouth, no numbing of any kind....all just fine.
 
J

Jaylah

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Re: My teeth - 'medicine' phobia COMMENTS WELCOME

When I had this done at my current dentist, a month or so ago, he did warn me before he began that it would be a bit uncomfortable. And it was. And, yes, there were a couple of times when I was sorely tempted to butt-walk right off the end of the chair.

Had it gotten any worse than that, I think I probably would have asked him if putting some gel on my gums would help.

What bothers me about your case though, Carys, is the seeming lack of ability to communicate which caused it to be a lot more prolonged, and thus a lot more painful than it needed to be.
 
carole

carole

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Re: My teeth - 'medicine' phobia COMMENTS WELCOME

I don't know if I am just being thick here but I don't understand how this hurts if it is just measuring pockets. My dentist told me what my pockets were so he must have measured them and I didn't feel a thing, didn't even know which tooth he was at. So either something else was done to cause pain or he was going too deep, or I didn't have my pockets measured at all. I am puzzled by this. Sorry if I'm being thick.:confused:
 
J

Jaylah

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Carole, I think it may have a lot to do with how deep the periodontal pockets are.

It was measuring the deeper pockets that I started wanting to butt-walk off the end of the chair. :)
 
brit

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Re: My teeth - 'medicine' phobia COMMENTS WELCOME

I'm sorry to hear that you had such a bad time today :(. It sounds as if your dentist was very heavy-handed - normally, periodontal probing should not be an unpleasant experience. The problem arises when too much pressure is applied and it sounds as if that was the case here. Also, plastic-tipped probes are more comfortable than the metal variety. If the tissue is very inflamed and sore, then a small amount of topical anesthetic should be offered but it doesn't sound like that from your description - so heavy-handedness is the most likely explanation.

I haven't been following your story (shame on me :redface: - but I've been too busy with the technical aspects of the forum and website recently), so I don't know if your dentist is generally gentle and just not very good with the periodontal probe. If this experience has put you off him, don't be afraid to look around for someone who is more gentle.

It probably wouldn't work for you given the injection phobia but people often get numbed up for periodontal probing if they are very sore. Even a bit of oraqix might help? OOps I see Letsconnect also mentioned topical and Carole also said you should have been numbed several posts back.

I could take a bit of pain around one tooth if it were being investigated for a periodontal abcess say while it were being probed but to sit there while they prod every single one 5 times and then some, causing pain each time...no way...they numb me or I am out of there. That sounds horrendous.
I think your dentist would have lost me as a patient with this tbh because it would signal to me as a painophobe that he didn't care enough about patient comfort.
I think by saying it bloody hurts you couldn't have been more direct unless you had said...'stop I can't stand this unless you numb me'.
Sorry you had such a different experience from the time before...dentists (and especially hygienists) are like hairdressers sometimes, they do your hair nicely the first few times and then slip up thereafter every now and then :o.
 
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Carys

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Thanks guys, you are really are the best ! :jump:The inflammation was somewhat clear once he began prodding as there was also a lot of bleeding. Mmmm, it does worry me a bit....but I'm definitely adopting the 'we are going to talk about this' attitude for my next visit and then use your advice for some topical or numbing.

The deepest pocket, I believe was a 5 at the back somewhere, well there were a few 5s near the back molars. Here is a question for you experts...if I have had a few '5s' but mostly they seemed to be 2 and 3, should I be having root planing and scaling ? This has not been offered as a treatment.
 
carole

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I am very interested in the answer to this question as I have a couple of 5s myself. So please people with the knowledge enlighten us. :dunno:
 
letsconnect

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What did he suggest? He might have mentioned a cleaning without explicitly stating that the cleaning should also be below the gumline? (a lot of people don't like clinical-sounding terminology so he may have just phrased it differently?). I also think that the term "scaling and root planing" is more a U.S. term (I might be mistaken though).
 
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Carys

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Well he said that his hygenist would treat it with cleaning and I would have to do my part and follow her set regime. So, she did a cleaning a few weeks ago, and is seeing me again 2 months from that initial appointment. She was very 'clued up' and I did have confidence in her. The thing is, the fact that it felt absolutely fine when she did it would make me think that what she did din't go down deep enough (because that might have needed anaesthesia, and would ahve hurt without ?) and it wasn't the scaling whatsit thingy.
 
J

Jaylah

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I also think that the term "scaling and root planing" is more a U.S. term (I might be mistaken though).

Could well be. I've also heard it referred to as a "deep cleaning." Probably for exactly the reason you mentioned: it doesn't sound quite so off-putting.
 
letsconnect

letsconnect

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She was very 'clued up' and I did have confidence in her. The thing is, the fact that it felt absolutely fine when she did it would make me think that what she did din't go down deep enough (because that might have needed anaesthesia, and would ahve hurt without ?) and it wasn't the scaling whatsit thingy.

I don't think it's a given that deep cleaning will be painful - we've had many people on the forum over the years saying it was fine, even without anaesthetics - especially if the pockets are not too deep (as is the case with you). So I don't think it's possible to tell just from the sensations you experience whether the cleaning was thorough or not. She might just be very gentle :)! Obviously, you can't exclude the possibility that she wasn't thorough enough (kinda difficult for a layperson to judge). But it's not a case of "no pain, no gain"!

For more info see here: www.dentalfearcentral.org/faq/deep-cleaning/
 
Pianimo

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Sorry I'm a bit late weighing in on this Carys - busy few days! **Insert run ragged smiley here!**

I don't think it's a given that deep cleaning will be painful - we've had many people on the forum over the years saying it was fine, even without anaesthetics - especially if the pockets are not too deep (as is the case with you). So I don't think it's possible to tell just from the sensations you experience whether the cleaning was thorough or not. She might just be very gentle! Obviously, you can't exclude the possibility that she wasn't thorough enough (kinda difficult for a layperson to judge). But it's not a case of "no pain, no gain"!

For more info see here: www.dentalfearcentral.org/faq/deep-cleaning/
I also have never been sure if I've had a 'deep cleaning' or not - I always assumed not because the experience was altogether far too pleasant! But that may just be because my hygienist was so amazingly wonderful! (I also had some of it done by my dentist while I was sedated, so I've no idea what happened then!) I do remember her measuring my pockets, and I had some 5s, and yet - like every part of my appointments with her - it was completely painless (the odd twinge at most), because she was very gentle and used lots of gel. So I don't think there's any justification for you being in so much pain - unless he assumed you'd prefer pain to any form of numbing because of your phobia? (See, I'm still trying to think well of him, but he's not making it easy!) Either way, you should definitely make sure it doesn't happen again.

Now, as for this:
My fear of injections seems so far in the past now, I'd have 20 of them if it meant that my gum problems instantly disappeared and I could start my cosmetic work.
there's no way I'm just letting this go by unnoticed! Carys, please tell me what that sad face is doing at the end of that sentence?! It doesn't belong there - it should be all! I understand you are really disappointed that the progress with your gums is slower than you'd hoped, and frustrated that this keeps your invisalign plans on hold - when you're giving all you've got to go full steam ahead, and everything still creeps along at snail's pace, that's bound to get you down. BUT that statement of yours is still AMAZING!!! 20 injections?! Not long ago you would have run a mile at the thought of having one! You've come a long way, made incredible progress and achieved a huge amount...and I'm not going to let you forget it!
 
J

Jaylah

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I understand you are really disappointed that the progress with your gums is slower than you'd hoped, and frustrated that this keeps your invisalign plans on hold - when you're giving all you've got to go full steam ahead, and everything still creeps along at snail's pace...

This reminds me of a phrase that I've actually heard more than once. Honest! When something seems to take forever, it's said that "it moves at the lightening speed of orthodontia."
 
brit

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It may shed some light. These seem to be the main USA ADA codes used for diagnosis and insurance claim purposes re perio cleanings:
full mouth debridement to enable comprehensive evaluation and diagnosis
Subgingival and/or supragingival calculus and plaque are cleared away in this process. The need for other procedures is not prevented by this procedure.
periodontal scaling and root planing – one to three teeth, per quadrant
Plaque and calculus are removed from root and crown surfaces. This can be utilized as a pre-surgical procedure or in the treatment of periodontal disease. This ADA code is applicable when there are one to three teeth, per quadrant.
periodontal scaling and root planing – four or more contiguous teeth or bounded teeth spaces per quadrant
Plaque and calculus are removed from root and crown surfaces. This can be utilized as a pre-surgical procedure or in the treatment of periodontal disease. This ADA code is applicable when there are four or more contiguous teeth or bounded teeth spaces per quadrant.

periodontal maintenance

This is for individuals who have had prior treatment for periodontal disease. Beginning after the active periodontal therapy, periodontal maintenance continues for the life of the dentition, at intervals determined by the particular case. Procedures may include: removal of supra and subgingival microbial fiber and calculus, site specific scaling and root planning, and teeth polishing. If periodontal disease emerges again, other procedures (diagnostic and treatment) may be utilized.
prophylaxis – adult
A scaling and polishing procedure performed to remove plaque, calculus, and stains. ADA code 1110 refers to this procedure being performed on an adult.
prophylaxis – child
A scaling and polishing procedure performed to remove plaque, calculus, and stains. ADA code 1120 refers to this procedure being performed on a child.

What is appropriate is hard to know. I think a lot depends on how much tartar has actually accumulated under the gum line, how much inflammation is present how much bone has been lost if any and how good your home care is.
.
I have a couple of stable recession areas but have never had a deep clean afaik, just very thorough regular cleans with no anaesthetic although I would opt for it if I found it painful. The first time at a new practice it was 60 minutes years ago and it is now 30 minutes six-monthly. I have good oral hygiene and do not build up plaque much anyway. My recession areas were supposedly caused by over-brushing duh!

In your case Carys, if you remain concerned even after quizzing the hygienist/dentist some more, you could ask to be referred to a specialist periodontist privately even if only for reassurance that you are on the track.
I had a friend who was referred like that and all they did was a really deep clean over two long visits under local anesthetic. She had a fair bit of bone loss though and that was the main reason for the referral.
 
Carys

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Hiyer guys, I just wanted to thank you for all the thoughtful and informative replies on this journal; Brit, letsconnect, Pianimo, carole and Jaylah. I think I must have missed reading this page properly a couple of weeks ago (actually I know what happened it was late one night and I just did my 'thanks' without reading properly and meant to come back). So, here I am 2 -3 weeks later finally reading them properly. Brit - I am due back to the hygenist in 2 weeks, so armed with your facts I will indeed quiz her. Pianimo - thanks, kind positive words as always. Thanks letsconnect, makes perfect sense.

So, tomorrow I have an hour 5 minute long appointment (yes, apparently the 5 minutes are critical lol). I am having all periodontal pockets measured in the lower jaw and then having impressions for my permanent pre-molar overlay. As you can imagine I am dreading the pointy thing and the measuring, but I am resolved, thanks to kind support here from you all, to make sure that I communicate clearly, before he begins, that the process will be stopping if it hurts and we will reassess from there on in. The hygenist knew the depth of the pockets without measuring actually, she just had an innate feel for it, so all this measuring can just go by the by if its causing problems. I have worked so damn hard on my oral care since I last saw the hygenist - every morning flossing, electric interdental brush, normal electric brush and then waterpik. Same process for the evening and sometimes I have done a quick 1/2 job in the middle of the day. I can certainly see a difference in my gums, there are no darker red areas and they are mostly a nice light pink. However, as would be expected, I can still feel plaque in areas which were not 'got' by the clean last time....in those deeper pocket areas I can feel the floss catching slightly. Hopefully she will get those next time I visit ?

Will update tomorrow after the MEASURING.....lol
 
carole

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Just wanted to say your app is at 9.40 :p :p :p DENTIST AT 9.40 :p :p :p

WHAT TIME IS IT :hidesbehindsofa: DENTIST 9.40
9.40

9.40 IS THE TIME OF THE DENTIST APPOINTMENT :p :p :p
 
Carys

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There IS a reason, for anyone reading this, that Carole is being a pain in the backside and repeating the time over and over to me. She hasn't just finally lost the plot. It's partly my own fault, but only partly......;)
 
carole

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Are you going to spill or leave everyone in suspense Carys. Did you get your reminder call today from the dentist by the way?

DENTIST 9.40 :ROFLMAO:
 
Carys

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No, I had no reminder call !!!!!!!!!! Odd isn't it. Mind who needs one with you around. :hmm:
 
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