Severe phobia and can't avoid any longer

[Anne2021]

I have visited this site in the past and just joined in the last week. I have a severe dental phobia and have been trying to put things off until my youngest is legally an adult. I'm that scared that something bad will happen and he will lose me before he is an adult. That's just over four more months and now I am having symptoms I can't ignore. I so wanted to wait until after his birthday. I have an appointment this Wednesday, July 14 and I am filled with terror and dread. I think about it all day and wake up depressed and anxious. It's like this is my whole life now. If I lose one more tooth I think I will need to get a partial and I am terrified at having something in my mouth and adjusting, but there are no good options left. I dread needing the local anesthetic and everything associated with all of this. I want to run and hide. (I am scared of catching COVID there, too).

 

[Dr. Daniel]

Dear Anne2021,

I am glad to read you have an appointment soon. It is an opportunity for a new start, getting dental issues treated and improving your quality of life as far as teeth are concerned.
After years of not going to the dentist, everything will be new and frightening. I think it is crucial you tell the dentist from the start that you have not been to the dentist for many years because of anxiety and you need them to work slowly and explain What they are doing, in order to let you get familiar with the dental situation.

 

[Anne2021]

Dear Anne2021,

I am glad to read you have an appointment soon. It is an opportunity for a new start, getting dental issues treated and improving your quality of life as far as teeth are concerned.
After years of not going to the dentist, everything will be new and frightening. I think it is crucial you tell the dentist from the start that you have not been to the dentist for many years because of anxiety and you need them to work slowly and explain What they are doing, in order to let you get familiar with the dental situation.

Thank you so much for answering and encouraging me, Dr. Daniel. My initial post left out a lot of details so I should explain the situation a little more. I have actually been to the dentist as recently as two years ago, but I have not been getting the work done. I had an exam and cleaning in 2017 after about six years of nothing and an exam and cleaning in 2018. Those exams showed work that needed to be done that I am too scared to do. I started with my current dentist in 2017. He filled a tooth with a deep cavity without root canal when others wanted to do root canal because I am absolutely terrified of root canal and if it gets to that point, I have opted for extraction. He filled that tooth and I got two more years out of it and had it removed after it abscessed in 2019. I have lost five teeth already besides my wisdom teeth (#2, 12, 15, 18, and 20). I am not a good candidate for implants either (general poor health, bruxism and even grinding my teeth while awake). Well, I managed to push through that filling in 2017, another in 2019 and two extractions with oral surgeons in 2019, but each time was a major battle and I am even more afraid to go now than I was then. I think another tooth is at the point of a filling not being enough, as well as the fact that there has been decay around the gumline of four of my five remaining molars (all are crowned). He wanted to try to fill them with the crowns still on and if it went too far, to then remove the crowns. Three of those were first noticed four years ago so it is probably too late, and the thought of him removing the crowns and getting in there and what he will find scares me so. If they need to be extracted, he will send me to an oral surgeon as he prefers not to extract at all and will definitely not pull molars himself. What shape would I be in after the crown comes off and then I have to go to the oral surgeon another day? Two of them are together (30 and 31) and he would want to both at the same time. And all of this means partials once I lose another tooth. #13 and 14 are the area of concern for tomorrow. If I lost one or both of those, my upper left is useless for chewing. My teeth have been shifting since I lost #20 in 2017 and #12 in 2019. My gums are receding in a lot of places, too. I'm just so frozen. No amount of reasonably tolerable experiences takes away the fear. My support system is almost gone now, too, because my mother and/or my daughter would come with me or text me during my appointments and while I would panic during the numbing taking effect, feeling like I can't breathe or swallow. My mother is now unable due to her age and cognitive decline. My daughter is always working during those hours now. I feel so alone.

This dentist is probably about 70 years old. He is a kind man, but he always looks perplexed when I talk about the phobia. He doesn't get it. He will talk about implants even after I have told him I can't do it. So he is always kind and gentle and patient but not from a place of understanding, but that is better than unkind. Well, when I called last week to make the appointment, the scheduler warned me that he is transitioning to retirement and a new dentist is coming in to take over his part of the practice. She is already there. There are two other dentists as well. This new one graduated dental college one year ago. I don't think that is going to work for me. There is another female dentist in that office who is about 40 years old and has been in practice there about ten years and gets good reviews and I thought about asking him if I could see her. I see dentists online in town who deal with phobic patients, but I have no idea if they do good work. I chose my current dentist because others knew him and I could trust his expertise and character. My appointment tomorrow is still with him.

I am also one of those who is so bad that I avoided brushing and flossing my teeth because I just couldn't even think about my teeth. Brushing them actually scared me. (Even driving past a dentist's office triggers me). I have forced myself to brush and floss every night the last nine nights in a row and it is stressful, but I am pushing through, hoping to save every tooth that I can.

I truly don't know how I am going to make it tomorrow. My son will drive me because I wouldn't be able to drive knowing where we are going, but he is not emotionally supportive.

 

[letsconnect]

Hi Anne2021, just wanted to wish you the best of luck for your appointment today. You said in your initial post that you "dread needing the local anesthetic and everything associated with all of this" - do I take it that you are afraid of the effects the local anaesthetic might have on you, or something else?

Perhaps you could ask if you could meet the female, more established dentist who gets good reviews just for a chat? We have a downloads section here on this website with a patient form that you could fill in and take with you (or send to her via email beforehand):

Downloads

Free worksheets and a questionnaire for nervous patients which you can use to let your potential dentist know about your fears.

www.dentalfearcentral.org

Keeping my fingers crossed for you today

 

[Enarete]

Good luck today Anne2021! Let us know how it went!

 

[Anne2021]

Hi Anne2021, just wanted to wish you the best of luck for your appointment today. You said in your initial post that you "dread needing the local anesthetic and everything associated with all of this" - do I take it that you are afraid of the effects the local anaesthetic might have on you, or something else?

Perhaps you could ask if you could meet the female, more established dentist who gets good reviews just for a chat? We have a downloads section here on this website with a patient form that you could fill in and take with you (or send to her via email beforehand):

Downloads

Free worksheets and a questionnaire for nervous patients which you can use to let your potential dentist know about your fears.

www.dentalfearcentral.org

Keeping my fingers crossed for you today

Hi, letsconnect. Thank you for asking about my situation.

I fear everything about the whole process, but my mention of the local anesthetic is specifically the sensation of being numbed. I feel that I can't breathe or swallow. It doesn't help how many times I have had it. Every time it terrifies me. It's bad whether it's the top or the bottom. Of course, if it's bottom, the feeling that my tongue is swollen is bad. Also, once when I had an upper second molar removed, it wasn't just the sensation, but I believe the anesthetic infiltrated the palate area so much that it really was "full" of the anesthetic fluid and I felt like I was suffocating. Is this normal for there to be so much that it fills the tissues that way? There are other fears, like them hitting a nerve and doing permanent damage, but the numbing is the worst part. I also don't get topical numbing because then it goes down my throat and my throat is numb. (I can't even stand sore throat lozenges that numb any part of your mouth or throat when I have a sore throat. It sends me into panic).

I did ask my dentist about seeing the more established female dentist there when he is gone, and he said that would be fine. I know from past experience when I was looking for a dentist before I settled on him that she is generally scheduling far out in terms of time because she is so busy. I was a little concerned about COVID protocols at the office, though, and now I'm not sure what to do. The receptionist had said that they are following CDC guidelines and everyone would be masked and they would sterilize the room and so on. Well, the receptionists were masked and generally patients and staff were and they had plexi-glass up and hand sanitizer everywhere, but then my dentist pulled his mask down to talk to me. That made me nervous. Also, no one did any sort of screening at all as far as asking questions about exposure or taking temperature or anything like that. His previous assistant was not there and when I asked the new assistant about her, she told me that she left shortly after the COVID situation began for a different office and alluded to it being about COVID. I'm wondering if other offices are more strict or less strict and if that had something to do with it, as I have health issues and am at-risk.

(I also posted a longer description of the visit in another comment below).

 

[Anne2021]

Good luck today Anne2021! Let us know how it went!

Well, I went. It felt awful to go, but I went through with it. I expected bad news and I got bad news, but there was one bit of hopeful news. My lower right molars both need to be extracted. I had known there was decay under the crowns for some time and was just too scared to mess around under crowns. [As a side note, I got a crown when I was about 23 and then had that one redone and had four more when I was 29 for a total of 5 crowned molars. I will be 51 in the next few weeks. Until I was about 47, no one had told me that I needed to be more careful about taking care of crowns. I feel really stupid, but I honestly and naively thought that they were covered now and would be safer than a regular tooth. I don't remember anyone ever saying a word about it and was in total shock in 2017 when I was told I had decay around the edges of teeth with crowns]. Anyway, back to today, he took x-rays of those two molars because I was having trouble getting food stuck in the gum tissue around one of them and some soreness and bleeding with both when I brush - no pain chewing or at any other times. If I don't brush or floss them, they don't hurt. Well, even with PFM crowns on he could see so much decay now on the x-rays that he says they need to come out. He thinks they are probably dead and it's just a matter of time before pain and abscess. He refers to an oral surgeon. I've used one that is kind, but I'm still scared. I've also never had to remove a crowned tooth before and never one, much less two, with so much decay.

I also was concerned about my upper left. I am already missing the first bicuspid and the second molar and was worried about the remaining bicuspid and first molar. The bicuspid needs a filling. I told him that there is some pain with biting pressure, but he still thought a filling would work. I don't know if I should worry that it's too late because of that pain. It's not intense and there is no sensitivity to hot, cold, or sweets. So, if he's right, that's the good news, I guess. The first molar is crowned and has significant visible decay. He knew it had decay 2-4 years ago. He says if we don't get to it, it will end up like the other two. He still thinks we can try to save the crown and fill it without removing the crown. Then when he gets into it, he will see if that is the case. That tooth has felt odd since the second molar next to it came out in 2009. Like I sense it more. Not pain. Almost like it's loose, but not loose. It feels a bit like when I have read about sprained tooth syndrome online. Anyway, I'm scared if the crown comes off, the tooth will not make it. Too much trauma for it. He suggested that we should not do the two at the same appointment even though they are next to each other - probably due to my phobia.

His first recommendation was to remove the two lower right molars first. I said that right now I can at least still use them to chew. So, he moved on to scheduling the bicuspid filling. It's scheduled for August 24 - which is almost 6 weeks. (They offered four days earlier, but that is a Friday and fillings on Friday scare me in case things go wrong and everybody is gone for the weekend). I don't know what to do next. I could ask him to send the referral to the oral surgeon any time, I know, since he won't do those, but how will I eat? I'm already short four teeth on the left side and am kind of guarding over there. If he gets into the upper molar and it's too far gone, I won't have anywhere to chew unless I am prepared to move forward with a lower partial before I just pull teeth without any direction.

He is planning to leave by the end of the year and is already only scheduling mornings according to the receptionist. I have no idea when we could work on a partial denture if he is scheduling more than five weeks out and I need two appointments with him for fillings (if I can even follow through). I'm wondering if I should see a prosthodontist for the partial instead of a general dentist. I have no idea whether I will get metal or all plastic or any of those details. I also have a gap where I lost a lower left bicuspid four years ago and the neighboring tooth has been shifting and tipping into that area so that my dentist wasn't sure how a partial would work in that spot. We have a dental college in my city that is supposed to be one of the best in the country and I have visited the faculty practice before. I just know the faculty keep short hours and in the past did not find them more understanding of my phobia. I thought about trying there for the partial. I also mentioned concern over COVID protocols in a comment above, and I just don't know about staying where I am. The logistics of this is overwhelming me.

I mentioned at first, too, that I wanted to wait until my son is not a minor anymore so that at I wouldn't fear dying as much and thought that might help me with some resolve and courage, but that is just over four months away. I keep hoping those molars could hold out until then. Of course, he poked around a little there today and so now I am more aware of the soreness and figure they will start hurting when they didn't before. I really am just overwhelmed about what course to take next. Any advice from dentists or anyone would be much appreciated. I know you commented above, Dr. Daniel. If you have any thoughts, I would be very grateful.

 

[letsconnect]

We've got a page on fear of feeling numb here which contains lost of information and tips:

Fear of Feeling Numb

Are you scared of the numb feeling you get from local anaesthetic injections at the dentist's? This page provides lots of practical tips and advice!

www.dentalfearcentral.org

I heard that @Dr. Daniel uses the Quicksleeper that is mentioned on that page quite a bit. Daniel, if you're reading this, can you tell us a bit more about it?

 

[Dr. Daniel]

The Quicksleeper is very comfortable for patients because it is very localized, the tissues around such as the tong, lip , floor of the mouth and more, are not numbed. By the way, other computerized dental injection systems can achieve the same comfort.
Dear Anne2021, if I understand correctly, you prefer not to extract anything. Would that is the essential concern. Is that correct?

 

[Anne2021]

The Quicksleeper is very comfortable for patients because it is very localized, the tissues around such as the tong, lip , floor of the mouth and more, are not numbed. By the way, other computerized dental injection systems can achieve the same comfort.
Dear Anne2021, if I understand correctly, you prefer not to extract anything. Would that is the essential concern. Is that correct?

Hello, Dr. Daniel. Thank you for asking. I have so many concerns it's hard for me to communicate without getting too wordy and lost in details. I am sorry about that.

I know I have to extract teeth. I know there is no way around it. Over the years, I have avoided dental work due to the phobia and have lost five already. I should have gotten partials to keep teeth from shifting, but I didn't. I know that 30 and 31 have to go. They are too far gone. I accept that. I fear the appointment and the numbing intensely. It's hard to believe that I won't actually die in the chair or end up with permanent nerve damage or something. I also fear adjusting to partial dentures, which I will surely need now. I am a bad candidate for implants, and the cost is too much, but the fear of them would stop me anyway, so it's definitely partial dentures for me. I don't know if I should get something prepared before the extraction or just get them pulled and then what? Extracting 30 and 31 was what my dentist originally suggested doing next, but though he is a kind and qualified man, he always seems to just be looking at the next step and not the big picture. With retirement so close and working half days, that seemed even more the case this time.

I'm no help either. I have generalized anxiety and complex PTSD due to a long abusive marriage. I was not like this before that. The dentist never even bothered me at all. I am divorced now for the last two years, but I have feared for my kids for years should anything happen to me. I am so close to my youngest being a legal adult (4 months and 3 days). Once he has his birthday, even if I die, he could live with an adult sibling until he is ready to be on his own. If I die before that, my ex will undoubtedly do all he can to make him live with him for the remaining time. It is a very complicated situation, but that really would be a very bad situation even for a short time. That anxiety drives me as well when I think of going to the dentist. I keep thinking that if I have the choice to put it off and I choose to go and die, I have put my son in jeopardy. (I still have nightmares about my ex and had two just last night as I am contemplating this decision). I talk to a counselor about all this, but there is not much she can do.

Of course, now, after seeing the dentist and the x-rays, I am scared that the two rotten teeth will turn to intolerable pain on a weekend if I don't rush in to get them pulled. I've never had that severe dental pain that people have described and I don't know if I could handle it. I'm a mess.

 

[Dr. Daniel]

If your dentist has some kind of an alternative for the classic alveolar block, that might be a solution. It might one of the compurized injection systems or an intra-ligamentary anesthesia. In the end, it is your dentist’s decision how to numb. There is a chance you will need to get the classical alveolar block.
regarding the denture: in most cases it is better to make a denture with a metal frame. It is much more stable and needs less adjustments, compared with a denture without a metal frame. The metal frame makes it a bit more expansive but it is worth it.

 

[Anne2021]

If your dentist has some kind of an alternative for the classic alveolar block, that might be a solution. It might one of the compurized injection systems or an intra-ligamentar anesthesia. In the end, it is your dentist’s decision how to numb. There is a chance you will need to get the classical alveolar block.
regarding the denture: in most cases it is better to make a denture with a metal frame. It is much more stable and needs less adjustments, compared with a denture without a metal frame. The metal frame makes it a bit more expansive but it is worth it.

Thank you for your response. Regarding the partial denture, ideally should I be getting something prepared before the extractions of the two molars or after? On the left side I am missing a bicuspid and molar on top and the same on the bottom so I have limited chewing surfaces over there.

 

[Cctoo]

Anne, I am exactly like you about fear...and I was married to a dentist who I trusted completely but he retired long ago....During this pandemic many of my teeth started breaking off at the bullied. e..had not been to any dentist in years. Two days ago I had to have two upper front!! Teeth!! Extracted! Petrified as my blood pressure goes up to over 200/94!! Terrified I would have heart attack!..One dentist wanted 11 teeth extracted ..all upper as five broke at gum and just fell out!! I go now to a kind dentist who may not be clinically the best but he understands my anxiety. Had one oral surgeon extract two lower teeth when he was supposed to do upper ones and he was mean..but no pain afterwards!! I too worried about his lack of covid protocol!! Then needed two top teeth done ..call several other surgeons and are booked till Sept soft. And need to get four front provisional crowns soon!! My dentist made fake teeth on a retainer! He suggested provisional as alternative to dentures as can't do implants..worry about them working as only middle font tooth left. But do not worry about the shots!! Just a stick and very safe. I cannot even take them as epinephrine in them give me terrible chest pains!! I have to get carbocaine...which does not last as long!! To numb. I am 84 and alone!! No support except daughter who is very ill and can't drive! I went to a very scary looking oral surgeon two days ago...just looking at him raises my BP!! He was only one who worked me in fast! So I can get crowns!! But now been worried if I should have gone to mean one as I had no pain after those extraction s afterwards but now I have pain...worry about dry socket and also my only remaining front tooth feel kind of loose and hurts!! I guess this is normal..so just hoping it settles down soon. I just could not get eleven teeth pulled !!! From now on I wan IV sedation ...it was so scary for me....the minute I sit in dental chair get nervous...take tranquilizer now first...but does not help with extraction! I, like you, go to a dentist who does the very least to fix anything.....but does not extract teeth! Not sure he is the best. I was not even tiny bit scared going to hospital alone for breast cancer surgery!! But dentists...Yes!!!

 

[Anne2021]

Anne, I am exactly like you about fear...and I was married to a dentist who I trusted completely but he retired long ago....During this pandemic many of my teeth started breaking off at the bullied. e..had not been to any dentist in years. Two days ago I had to have two upper front!! Teeth!! Extracted! Petrified as my blood pressure goes up to over 200/94!! Terrified I would have heart attack!..One dentist wanted 11 teeth extracted ..all upper as five broke at gum and just fell out!! I go now to a kind dentist who may not be clinically the best but he understands my anxiety. Had one oral surgeon extract two lower teeth when he was supposed to do upper ones and he was mean..but no pain afterwards!! I too worried about his lack of covid protocol!! Then needed two top teeth done ..call several other surgeons and are booked till Sept soft. And need to get four front provisional crowns soon!! My dentist made fake teeth on a retainer! He suggested provisional as alternative to dentures as can't do implants..worry about them working as only middle font tooth left. But do not worry about the shots!! Just a stick and very safe. I cannot even take them as epinephrine in them give me terrible chest pains!! I have to get carbocaine...which does not last as long!! To numb. I am 84 and alone!! No support except daughter who is very ill and can't drive! I went to a very scary looking oral surgeon two days ago...just looking at him raises my BP!! He was only one who worked me in fast! So I can get crowns!! But now been worried if I should have gone to mean one as I had no pain after those extraction s afterwards but now I have pain...worry about dry socket and also my only remaining front tooth feel kind of loose and hurts!! I guess this is normal..so just hoping it settles down soon. I just could not get eleven teeth pulled !!! From now on I wan IV sedation ...it was so scary for me....the minute I sit in dental chair get nervous...take tranquilizer now first...but does not help with extraction! I, like you, go to a dentist who does the very least to fix anything.....but does not extract teeth! Not sure he is the best. I was not even tiny bit scared going to hospital alone for breast cancer surgery!! But dentists...Yes!!!

Cctoo, we do sound much alike. I am so sorry for all you have gone through and are still going through. I also don't take epinephrine due to rapid heart rate. I think it is Carbocaine that they have given me. I hate the numbing so much though that I usually don't mind it wearing off quickly even if there is pain. I'm so sorry you are alone, too. My daughter used to come with me, but now she is always working during office hours, so I feel very alone. I have had many health issues and was never so scared as this getting breast biopsy (thankfully, no cancer), muscle biopsy (though I would not want to repeat that, I just wasn't this scared, I don't think), EMGs and more. The dental decisions are so hard, too. Hugs.

 

[Dr. Daniel]

Thank you for your response. Regarding the partial denture, ideally should I be getting something prepared before the extractions of the two molars or after? On the left side I am missing a bicuspid and molar on top and the same on the bottom so I have limited chewing surfaces over there.

In most cases there is no need for an immidiate solution unless there is an esthetic issue. Usually we wait a few weeks, even two months till the definitieve denture is made. Again, this must be answered by your dentist.