Sitting up position and tooth being worked on

[sharon]

I know it is easier to work on some teeth than others when the patient is in a semi-upright position rather than the greater than 180 degrees that most dentists seem to prefer.

I cannot tolerate lying down like that and need to be semi-upright. I'm having a crown done on an upper right molar this week. How hard will it be for the dentist if I don't let him put me flat out?

 

[comfortdentist]

Starting in the early 60's all dentists in USA were trained treating patients laying flat for top back teeth. This started due to a government program to decrease disabilities by dentists.
If a patient wanted me to perform a crown on a maxillary molar while upright I would be so uncomfortable doing it that I think then end result would be unsatisfactory to me so I wouldn't do it.

 

[sharon]

Oh shoot!! That's not quite what I wanted to hear. Realistically speaking, how close to sitting up can I be for a decent job to be done? Would 45 degrees work? I cannot bear to lie prone in the chair.

 

[rob wain]

The answer I'm afraid will depend upon your dentist and how prepared to risk a bad back they are!
Why don't you contact the dentist and arrange to go see him/her before the appointment in order that you can both work out a compromise position. Maybe the dentist will be able to cope but needs a longer appointment so they can take a break etc.

 

[sharon]

May I ask one more question about this? I had a crown and rc done on tooth 9 (front upper left) and a crown done on tooth #30 or 31 (lower right molar). In both of these the dentist was able to work on me in a position that was comfortable to me. The crown that will done this week is an upper right one. Would I need to be lying back any further for this tooth than I was for the other 2 or is it all the same? It probably doesn't help any that I hae a teeny-tiny mouth.

What other options are there for me if I can't sit in a tolerable position? Have it pulled? Be put to sleep? The tooth is bothering me and I fear I will also need a root canal and I really don't want to put it off any longer.

P.S. I should add that my fears about lying prone are not 100% because I don't like that position and I am afraid of choking/gagging. I suffer from a terrible vestibular disorder and lying like that can be a trigger for a vertigo attack. And I'm not talking about getting a little dizzy and if I sit up it goes away. I'm talking about a severe hours long attack in which I can't move an inch. Should this happen there I would need to be carried out by EMT's and tranported 20 miles away to the nearest ER, a most unpleasant trip with terrible consequences. This scares me more than anything else and is the main reason I can't lie flat.

 

[rob wain]

An upper molar is more difficult than a lower molar or a front tooth I'm afraid.
I don't know about the alternatives but you need to discuss this with your dentist as soon as possible

 

[EHinto]

May I ask one more question about this? I had a crown and rc done on tooth 9 (front upper left) and a crown done on tooth #30 or 31 (lower right molar). In both of these the dentist was able to work on me in a position that was comfortable to me. The crown that will done this week is an upper right one. Would I need to be lying back any further for this tooth than I was for the other 2 or is it all the same? It probably doesn't help any that I hae a teeny-tiny mouth.

What other options are there for me if I can't sit in a tolerable position? Have it pulled? Be put to sleep? The tooth is bothering me and I fear I will also need a root canal and I really don't want to put it off any longer.

P.S. I should add that my fears about lying prone are not 100% because I don't like that position and I am afraid of choking/gagging. I suffer from a terrible vestibular disorder and lying like that can be a trigger for a vertigo attack. And I'm not talking about getting a little dizzy and if I sit up it goes away. I'm talking about a severe hours long attack in which I can't move an inch. Should this happen there I would need to be carried out by EMT's and tranported 20 miles away to the nearest ER, a most unpleasant trip with terrible consequences. This scares me more than anything else and is the main reason I can't lie flat.

Hello, I realise this post was from some years ago, however I'm hoping to y get a notification/see my reply. Seeing your comment was a huge relief that I am not the only one out there like this. I'm currently having a nightmare that I'm made to feel by ever dentist I've seen that I'm the 'problem'. It's one of those invisible disabilities that to put bluntly no one takes seriously unless they have had it. I broke a tooth and after not seeing a dentist for years since I developed this condition I decided I needed to go a few days ago. He only gave me the option of attempted removal because I will only sit upright. He tried, broke the tooth and now I just have the roots left. Last thing I want is to go to hospital, so I contacted a private dentist and went yesterday. Again, made to feel like I'm the pain causing him problems because I won't lay back. I am no due to go back to him tomorrow for a surgical procedure to cut my gum and remove the molar root. He says he will 'try' his best in that position but if not I'll have to go hospital. This doesn't fill me with confidence, in fact it fills me with dread. I not only worried about this but also future dental needs. Fillings, root canals etc. Please if you see this could you tell me how you got on. I totally understand your condition and it is the worst feeling ever, I always say it is so horrible I wouldn't wish it on my worst enemy. My phobia isn't dentist, my phobia is this being triggered . I would love to hear how you got on and hopefully you can give me words of advice. If tomorrow fails then I'm still going to have to foot the £350 bill AND possibly have my condition triggered. I really don't want to go. There is little to no empathy or understanding from people. I just wish that there was more awareness of this condition and ALL invisible disabilities. What confuses me that in past times dentists didn't have these modern chairs and patients were only ever able to sit up. My partner comes from Latvia and says up until the 90's they had solid metal chairs, it was very crude and old fashioned and ALL work was carried out like this. Can an exception not be made? Anyway, I hope to hear a reply. All the best.

 

[Gordon]

I'm not sure what you mean, do you suffer from labyrinth disease as Sharon's post in Nov 2013?

I had a patient with a very severe case of this, he literally couldn't get out of bed for more than a few minutes at a time because of it. We had to manage his dental issues as best as we could, mainly treating him with portable equipment in his bedroom, otherwise I had to accommodate his posture in the dental chair as best I could do.

You would be better to ask your dentist for a referral to a Special Dental Needs specialist who would have the correct equipment and maybe more importantly the mindset to help you.

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For more information on chair position, see here:

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Quite a few people with a dental phobia prefer to be sitting up rather than lying down during treatment, but there can be technical difficulties involved. In this thread, you can also leave your own comments regarding chair position. Here's a reply I got when I asked one dentist for his...

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[sharon]

Hi, I just happened to come to this web site after not being here for quite a while and was surprised to see that I wrote this 7+ years ago.

@EHinto I'm wondering if you had your appointment and how it went. Is your problem vertigo, like mine is?

At the time I wrote this I was seeing a dentist who was trained in Russia, I think it was. And he told me that there they are trained with patients sitting in a more upright position though his later training was in the US so he was out of practice in working on patients sitting up. We had a good compromise where I was sitting at about a 45 degree angle. I was very grateful that he could do this much as it wasn't easy for him. Unfortunately he left the practice and I couldn't find were he went to. And worse, I ended up losing the two teeth he crowned, so maybe it wasn't worth it. Though in fairness he told me that I would lose one of them eventually because there was root damage and the rc and crown he did would be temporary.

It took a while to find a new dentist that I like but I found a great one, though he can't work with me sitting up. I'm not flat back either with my head lower than my feet, my head is slightly higher than my feet. Luckily, my vertigo problem has improved over the last 5 years. Just to make sure I have no problem in the chair I take both valium and meclizine before my appts. Of course, the valium helps my dental phobia and makes things easier. I also use a neck pillow under my neck which gives me a little support and also raises my head an inch or two. Now my problem I have with lying all the way back is that water drips into my throat and makes me feel like I will choke/gag.

I hope your appointment went well. I don't want to "push drugs" but if your problem is vertigo I would recommend taking valium as it's one of the best meds for hitting the vestibular system and calming it down.