New to dentists and they planned a procedure I wasn't told about / I can't stop shaking at appointments

[Jordyn]

I'm sorry if I'm oversharing or in the wrong thread but I'm 17 and because of neglect I'm just now having my first dental appointments. My first visit I was scared to the point I could barely breathe in the waiting room, but it was manageable since they were only taking xrays. I had a really hard time keeping my head still enough but the people taking them were really patient with me and we finished up. Most of the staff was really sweet and patient except the dentist himself (he wasn't mean or anything but in comparison to everyone else he was really quiet and I had a hard time reading his tone which spiked my anxiety) he looked around in my mouth and I very surprisingly didn't have any cavities but one of my molars is half missing. He showed my guardian and said we'd have to get a crown for the molar, scheduled an appointment with the hygienist and recommended a consult with the orthodontist afterwards and sent me home

Second visit was with the hygienist, insurance needed more pictures of the broken molar before they'd approve the crown so they took a few more xrays and the hygienist found I had gum disease and needed a deep cleaning but couldn't do that right away because of insurance. She talked with my guardian about money for a bit and I heard something about anaesthetic not being covered so we'd have to pay for that out of pocket, we couldn't afford it on the spot so she said we could wait on that and for now she'd clean what she can. Even though she was extremely gentle with me I was really stressed out with everything in my mouth and I was trying my best not to flinch, which translated into me shaking the entire time and working myself up even more because now that I can't stop shaking what if I move too much and I make her miss and accidentally hurt me? It went okay and she sent me home, whoever heard from insurance first would call the other to plan next steps. Took about a week to get comfortable with my mouth again, having years worth of buildup removed felt really weird but not painful

The other day I got a letter from the insurance about the crown, deferred because they needed more information. There was also a denied order for a post for the crown, nobody said a thing to me about a post. I had no idea what that was so I looked it up and nearly worked myself up into a panic attack, because from what I read they only use posts after a root canal because that's where the post goes but no one said anything about a root canal either. Calmed myself down and thought they probably just made a mistake, I'll call and fix it and let them know about the deferred crown approval. Went to voicemail so I left a message.

Nobody answered so I called again today and someone picked up, I went through one by one what the insurance letter did and did not say. Crown deferred, we'll resubmit the xrays. You guys also ordered a post that was denied but nobody told me about the post at all, she puts me on hold for a few minutes to check something, comes back and says that's also getting resubmitted, doesn't really elaborate on the post itself. Phone anxiety's starting to hit so I'm just trying to get through the call and don't ask again, instead ask about the deep cleaning since it wasn't mentioned in the letter, they're also waiting on a response for it, should hear back in a few weeks, whoever hears from insurance first should call back and hopefully get to schedule an appointment.

Like I said before I never really picked up much about my primary dentist so I don't really trust him yet and I'm terrified he ordered something I don't need. That half missing molar isn't in any pain, it's been like that for years and I just thought it was weirdly shaped. I'm relatively okay with the crown itself as long as it doesn't fall off or something. The post terrifies me because the call proved it wasn't a mistake, everything I read says they only do posts for root canals, am I gonna have to have a root canal too? Apart from the mild gum disease nobody said anything about infection so I don't think I need a root canal? What if I don't actually get a root canal and they put the post in anyway and then I'm in constant pain? What if he forgot about the root canal only thing and just thinks my tooth won't be able to hold the crown on its own, he doesn't do the post and he's right and the crown falls off?

 

[Enarete]

Hi Jordyn ,

you have been so brave for going and getting through this! I’m so sorry your experience hasn’t been a better one. There are many kind and caring dentists who are happy to explain all you need to know and make sure you feel ok with the visit. Not trusting your dentist is a huge one and from what you write, they do not seem to try much to alleviate your anxiety? Making you feel in control is a biggest way to help you with your anxiety and getting the right information as well as having options and being allowed to do breaks belongs to that.

I am also sorry to read that your dentist was only talking to your guardian. I see how they are legally responsible for you but at your age it should be a collaborative thing. If I got this right, you don’t have much choice over which dentist to see, due to insurance, right? I would be super scared too if I was in your shoes, particularly with that dentist.

Now it sounds like having another chat with the dentist may be a good idea. What I suspect may be the case - if the tooth has been broken off deeply over a long time, then it‘s almost a given that it is what they sometimes call „dead“, means there was an infection in the past and now it’s not hurting but there are still bacteria. A root canal treatment in that case would only mean to clean the tooth properly from inside so that it can‘t give your troubles in the future and then putting a crown on it. So I was wondering whether your dentist just assumed the root canal treatment automatically, kind of thinking that it was clear as all teeth that are half missing may need one. Which is not an excuse for him and still a huge chunk of information missing and I get how this has only decreased your trust. You should be given all information and explained all treatment before anything goes to the insurance. It’s a part of the informed consent which you are entitled to as a patient. It also sounds as if he did not explain to you why the tooth needs treatment, what options you have, what may happen without treatment etc.

I was wondering whether you have any chance to change dentist? Also, if your guardian is someone you trust, have you tried to talk to them about how you felt and what can be done? And last thing - can you somehow pinpoint what are the things that scare you about the treatment?

All the best wishes

 

[drhirst]

Hi Jordyn,
I think you have done incredebly well so far, having a longstanding build up of scale removed can be pretty intense.
Enarete has given you some really excellent advice and there is little I can add.
I would say, don't worry too much about the post, dentists often disagree about whether to use one or not and this is just the insurance company following their particualr philosphy. Also don't worry about the crown falling off, I am sure your dentist knows what he is doing.
From your description I would not be surprised if you do need root canal treatment. There is this urban myth that they are the worst form of torture but in reality, with a modern, kind dentist you may well find the procedure less intense than your hygiene treatment, although it will take longer.
Now, I have to admit, I am not a morning person, in fact, I struggle to speak before 11am, so my lovely nurse knows to do all the talking first thing! I would recommend telling your quiet dentist that you find it really helpful to have someone talk you through the procedure, that should loosen his tongue a bit!
Good luck with everything
Lincoln

 

[Jordyn]

@Enarete I really like all the other staff, it's just the one dentist who never really said anything that scared me. I don't think I'd be able to change dentists anyway, there's two places nearby covered by insurance and the other one I couldn't find a lot of information on.

I did try to tell my guardian about the situation, she said they never told her anything about a root canal either. She ended up just making me more nervous by going on about how she hopes I don't have to have one because she heard they hurt a lot. I know from what I read that's usually not true but still not the best thing to hear and she didn't try to help. I haven't gotten a chance to talk to that dentist at all since the first visit, but because I need to call back after we hear from insurance again to set up an appointment I'll try to get it handled then.

For what scares me about treatment, it's mostly pain. The hygienist mentioned I'd need anaesthesia for the deep cleaning (from what I've read probably for all the stuff for my molar too) and I don't know how I'd respond to it, or if I'm really unlucky and it ends up not working. I'm also worried because I can't control how badly I'm shaking when people are working on my mouth, I'll end up moving too much at one point and end up getting hurt.