Super high anxiety, can anyone offer any reassurance, please?

[Judythecat]

I suffer from atypical pain which shifts about my mouth. For that reason I am on three monthly checkups. Everything was clear at my last check in January.

For the last week or so I have had a bit of pain when I chew on my upper right premolar. I put it down to the atypical facial pain, and also ongoing sinus issues. Today I mentioned it to my partner over lunch, and instead of his usual “it’s just your nerve thing” he said if it was on biting, I should probably make an appointment to get it looked at.

Now I have gone from zero to worst case scenario and am terrified the tooth is going to need to be extracted - my anxiety is through the roof. The tooth was fine on 30 January, but does have a small filling. I had four pre-molars removed for orthodontic reasons as a child, and this tooth is very visible when I smile. Is it likely the tooth could have deteriorated to such an extent in less than two months that it will need extraction? I realise no-one can see it, and I am going to ring the dentist on Monday.

Something that might be relevant is that until the beginning of this year the lower premolar and next door molar were missing, and had been for about ten years, so it had no opposing tooth. I now have a little flexible partial denture there.

Thank you for reading if you did. I feel like I am always asking questions on here, mostly stupid ones, and am really sorry. I am actually not at all scared of the dentist or treatment, but have had a bad run dental-wise over the last few years, so get irrationally anxious.

 

[Judythecat]

I’ve just zoomed in on a photo if it has to come out the gap would be just at the edge of my smile. The one next to it (molar) has a crown. Could it be used for a bridge? The one on the other side has no restorations.

 

[Dr. Daniel]

I’ve just zoomed in on a photo if it has to come out the gap would be just at the edge of my smile. The one next to it (molar) has a crown. Could it be used for a bridge? The one on the other side has no restorations.

I don't think that within two months things have tremendously changed with the tooth's cavity. If it has anything to do with the tooth, it is probably something related to the gum which can be solved with a simple cleaning.

 

[Judythecat]

I don't think that within two months things have tremendously changed with the tooth's cavity. If it has anything to do with the tooth, it is probably something related to the gum which can be solved with a simple cleaning.

Thank you for replying. The gum score was zero in that part of my mouth, but I do currently have the burning feeling on the cheek side round that area which is part of the AFP. Could a gum problem cause pain on biting? The filling doesn’t look like any of it has broken, but as I said, it is pretty small.

 

[MountainMama]

Just a thought...could it be bruising of the ligament from not being used to having an opposing tooth? Now that you have the partial, maybe it has to adjust? Just throwing ideas out there.

My two lower 1st molars started hurting when biting once I had the 2nd molars extracted, due to more impact on them. They both apparently had cracks that may have been there for awhile, but didn't show up since the 2nd molars took most of the chewing pressure. Maybe worst case scenario is that it is cracked and needs a crown?

 

[Judythecat]

Just a thought...could it be bruising of the ligament from not being used to having an opposing tooth? Now that you have the partial, maybe it has to adjust? Just throwing ideas out there.

My two lower 1st molars started hurting when biting once I had the 2nd molars extracted, due to more impact on them. They both apparently had cracks that may have been there for awhile, but didn't show up since the 2nd molars took most of the chewing pressure. Maybe worst case scenario is that it is cracked and needs a crown?

I actually did wonder that, plus I am a clencher, so it kind of makes sense. I have my next checkup at the end of April, and was going to hang fire until then, but think I will ring on Monday and see if she can see me sooner.

Logically I know an extraction is the absolute last choice for a dentist, so hopefully there’s a quick and easy fix. For some reason my anxiety has just hit the ceiling and gone to the worst case scenario, which is actually not that common for me.

 

[Dr. Daniel]

Thank you for replying. The gum score was zero in that part of my mouth, but I do currently have the burning feeling on the cheek side round that area which is part of the AFP. Could a gum problem cause pain on biting? The filling doesn’t look like any of it has broken, but as I said, it is pretty small.

A gum problem could cause pain with biting but not in all cases. Sorry, but I have to see you before saying anything meaningful.

 

[SallyUK]

I actually did wonder that, plus I am a clencher, so it kind of makes sense. I have my next checkup at the end of April, and was going to hang fire until then, but think I will ring on Monday and see if she can see me sooner.

Logically I know an extraction is the absolute last choice for a dentist, so hopefully there’s a quick and easy fix. For some reason my anxiety has just hit the ceiling and gone to the worst case scenario, which is actually not that common for me.

As you know I can sympathise with the anxiety. Your mind is trying to help you deal with the uncertainty and it's really hard sometimes. Logically I am fairly certain extraction would not be on the cards. Have you tried any jaw muscle relaxation? Gently stretches maybe. See if it makes any difference to things. In any case it might help the anxiety ??

 

[Enarete]

Hi Judy,

I totally get your anxiety after what you have been through in the last year. Also there really is no such thing as a silly question, however I know how easy it is to feel like a bother posting here. I am sure your tooth won't get extracted, an extraction is the last resort and no dentist will suggest that as the first treatment and even more if it's a front tooth.

Talking about cracks. Few months ago my healthy molar without any work done started giving me A LOT of sharp pain anytime I would bite on it. My dentist suspected a crack and filled the tooth as the less invasive treatment. It helped. One week after that the molar behind that molar started to hurt when eating. I got a night splint, my dentist painted some fluid on the tooth to seal it and the tooth is put under surveillance for further visit as my dentist is reluctant to treat it too quickly. My point is, there are always options and not every pain has to end up with an extensive treatment. I know you are having a hard time with your atypical pain, but if you catch yourself panicking, think of your dentist being your partner and always wanting to find the less invasive and best option for your dental (and mental) health.

Keeping my fingers crossed for you to need just a cleaning.

 

[Judythecat]

Thank you all for being so kind. I have worked myself into a total frenzy! My dentist doesn’t work on a Monday but if I ring tomorrow hopefully she will be able to see me soon.

Being logical, I think there are three possible scenarios.

1) there’s something up with the premolar. Given that it has a small filling, hopefully there is an easy fix.
2) there’s something up with the next door molar, which has had root canal and crown this time last year, by an obscenely expensive specialist. This might be a disaster, but I had x-rays in November and it looked fine.
3) there’s nothing up with any of the teeth at all, and it’s “just” the atypical facial pain doing its thing.

I feel like a total nuisance to my dentist, and also worry about needing time off work - I teach, so fitting in appointments can be really awkward. I have two weeks off for Easter starting on Friday, so hopefully she will be able to fit me in during that time. If not I am in for a checkup on 24 April. I would rather not wait that long in case I end up driving myself mad.

 

[Enarete]

I feel like a total nuisance to my dentist, and also worry about needing time off work - I teach, so fitting in appointments can be really awkward. I have two weeks off for Easter starting on Friday, so hopefully she will be able to fit me in during that time. If not I am in for a checkup on 24 April. I would rather not wait that long in case I end up driving myself mad.

You might know it yourself on a logical level but here is a reminder: you are not a nuisance to your dentist. You are a kind lovely person facing dental difficulties currently needing help and reassurance with a new problem.

A patient coming in when they need help is a good thing. Patients waiting too long or ignoring things (and I do not mean because of insecurities or fear) are frustrating (you are, as a teacher, surely more happy to help students who let you know if they need help rather than those waiting for the last minute, aren’t you?). Anyway, essier said than done, I myself often keep on postponing voicing concerns out of fear of being a bother.

 

[Judythecat]

You might know it yourself on a logical level but here is a reminder: you are not a nuisance to your dentist. You are a kind lovely person facing dental difficulties currently needing help and reassurance with a new problem.

A patient coming in when they need help is a good thing. Patients waiting too long or ignoring things (and I do not mean because of insecurities or fear) are frustrating (you are, as a teacher, surely more happy to help students who let you know if they need help rather than those waiting for the last minute, aren’t you?). Anyway, essier said than done, I myself often keep on postponing voicing concerns out of fear of being a bother.

Thank you for this. I was too scared to ring today! It is so silly, because I am not scared of going to the dentist or of having treatment, but I hate the phone. I can’t bear the idea of the receptionists saying “oh god, not her again”, or my dentist sighing when she sees my name on her list.

Yes, I always want students to ask me if they need support. But honestly, at the same time, there are some who I do sigh when I see their emails pop up - people who are full of excuses, need constant reassurances, and take up more of my time than I can really afford to give without it impacting on other students, my marking time etc. I know that sounds awful. I guess I see myself as a needy student who actually just needs to take some ownership of themself.

 

[Enarete]

Ok, I see your point with the students. When it comes to your tooth, the fact is that you do not know what is going on and whether you need a treatment. There is no way for you to assess how 'serious' things are. Your dentist can. I believe more dentists get upset about patients having a problem and not letting them know than patients who come too often. Sure, there are patients who might make the dental team sigh, but I can't think of any context where a new, different pain, in a tooth that haven't bothered you before, would be seen as a nuisance.
Would it be an idea to email them?

 

[Judythecat]

Ok, I see your point with the students. When it comes to your tooth, the fact is that you do not know what is going on and whether you need a treatment. There is no way for you to assess how 'serious' things are. Your dentist can. I believe more dentists get upset about patients having a problem and not letting them know than patients who come too often. Sure, there are patients who might make the dental team sigh, but I can't think of any context where a new, different pain, in a tooth that haven't bothered you before, would be seen as a nuisance.
Would it be an idea to email them?

You are very wise, I know. I just can’t bring myself to call! My colleague offered to ring for me, and so did my partner, but that makes me feel even more stupid. In 2017 I was there 50+ times, last year over 20 - the atypical facial pain makes it really hard to know if it’s a real thing, or a nerve thing. (I didn’t get the diagnosis until last year, and in 2017 I think I possibly had unnecessary treatment because I was in a lot of pain with no identifiable cause.) I feel like they must laugh at me. I also hate having to use the phone, full stop. I am embarrassed to be so pathetic.

 

[MountainMama]

You are very wise, I know. I just can’t bring myself to call! My colleague offered to ring for me, and so did my partner, but that makes me feel even more stupid. In 2017 I was there 50+ times, last year over 20 - the atypical facial pain makes it really hard to know if it’s a real thing, or a nerve thing. (I didn’t get the diagnosis until last year, and in 2017 I think I possibly had unnecessary treatment because I was in a lot of pain with no identifiable cause.) I feel like they must laugh at me. I also hate having to use the phone, full stop. I am embarrassed to be so pathetic.

I am exactly the same way, and I hesitate to call as well. I also hate to use the phone, and my dentist does not have email.

I feel like such a nuisance this past year and this year as well, although my husband gave me some good advice that may help you as well. He said to remember that we provide their livelihood. Without patients, they wouldn't be in business. Yes, some patients are more "work" than others, but like teaching (I taught for 15 years before starting my own business), even though some students annoy you, you still want them to do well and would not turn them away.

The last time I went to the dentist to get a treatment plan, I had a whole page of questions and concerns written out. I was scared to bring them because I felt like it seriously made me look neurotic, but the dentist was great about it. He laughed about the list, but not in a mean way, and went through every question with me. He was patient even though I know he was super busy, as he had to absorb all the patients from my dentist, who had just left.

So remember that they are here to help us, amd ultimately just want us to be pain free.

 

[Judythecat]

I am exactly the same way, and I hesitate to call as well. I also hate to use the phone, and my dentist does not have email.

I feel like such a nuisance this past year and this year as well, although my husband gave me some good advice that may help you as well. He said to remember that we provide their livelihood. Without patients, they wouldn't be in business. Yes, some patients are more "work" than others, but like teaching (I taught for 15 years before starting my own business), even though some students annoy you, you still want them to do well and would not turn them away.

The last time I went to the dentist to get a treatment plan, I had a whole page of questions and concerns written out. I was scared to bring them because I felt like it seriously made me look neurotic, but the dentist was great about it. He laughed about the list, but not in a mean way, and went through every question with me. He was patient even though I know he was super busy, as he had to absorb all the patients from my dentist, who had just left.

So remember that they are here to help us, amd ultimately just want us to be pain free.

That was really helpful, thank you. I called this morning, and have an appointment next Wednesday morning. I'm now also worried about my lower molar, and have just got myself into a right state, so Wednesday seems like ages away.

 

[MountainMama]

That was really helpful, thank you. I called this morning, and have an appointment next Wednesday morning. I'm now also worried about my lower molar, and have just got myself into a right state, so Wednesday seems like ages away.

I am glad you got an appointment. Yes, the waiting is the hardest part! I go back to my endodontist April 16, to see if my front tooth responded to the Clindamycin. I keep having pain here or there and want to call and get it checked out earlier, but have to hold myself back. I am just wanting to know NOW. Lol. I am too impatient!

 

[Judythecat]

I wish I didn’t have to wait until Wednesday for thus appointment. I am convinced a load of teeth are bad and going to need extraction now. I feel like I have hardly any teeth left now (24) and three of those have had root canals, some of the others fillings. Four of the missing teeth were extracted when I was a child for orthodontic reasons.

The gum is up round my upper wisdom tooth again, and I had bleeding between the lower molar and next door wisdom tooth earlier in the week - I am scared that tooth has something wrong, and have convinced myself it’s loose because it anchors my partial denture.

I need to remind myself of the following things, so I am writing them down here:

If the upper wisdom tooth has to go, I had a really easy time when it’s matching tooth was extracted.

The dentist told me she wouldn’t have allowed me to get the partial denture if she didn’t think the abutment teeth were strong. She specifically said she was very cautious on that.

I had a checkup on 30 January. My teeth and gums were all healthy. The highest gum score in my mouth (on the top left section, so the opposite side) was 2. Surely things can’t have gone so badly wrong between now and then?

 

[MountainMama]

Nothing could have gone that bad between now and then...at least highly unlikely unless you cracked a tooth. I understand the anxiety. 24 teeth is doing really well, though! I have had 22 teeth since my teens, as all 4 wisdom teeth were out before they even came in, and I had 4 teeth out for orthodontics. I didn't ever feel like 22 was not enough. Now I am down to 20, and I can tell a difference on the bottom, hence getting the implant.

I understand going to worst case scenario, though. I have had the worst case scenario happen with two teeth, so I am terrified everytime I have something done. I am scared to death to get my two lower molars prepped for crowns. I keep thinking it is going to end up with me losing the tooth.

You already are able to rationalize that it isn't likely. Keep telling yourself that and on Wednesday you will get confirmation that everything is okay.

 

[Judythecat]

Nothing could have gone that bad between now and then...at least highly unlikely unless you cracked a tooth. I understand the anxiety. 24 teeth is doing really well, though! I have had 22 teeth since my teens, as all 4 wisdom teeth were out before they even came in, and I had 4 teeth out for orthodontics. I didn't ever feel like 22 was not enough. Now I am down to 20, and I can tell a difference on the bottom, hence getting the implant.

I understand going to worst case scenario, though. I have had the worst case scenario happen with two teeth, so I am terrified everytime I have something done. I am scared to death to get my two lower molars prepped for crowns. I keep thinking it is going to end up with me losing the tooth.

You already are able to rationalize that it isn't likely. Keep telling yourself that and on Wednesday you will get confirmation that everything is okay.

I think I have different issues at play which are all contributing - the atypical facial pain, plus I have had a cold/sinus infection pretty much constantly since mid-December. It is so hard not to worry though.

My dentist told me about the “shortened dental arch” concept, which I think possibly originated in Germany. It suggests that a person needs only 20 teeth to function with a decent dentition. I have gaps on both sides at the bottom back, plus one upper wisdom tooth missing. I had pretty much forgotten about the four that were taken out when I was 11, because I feel like I never really had them - now I wish I did! I get so cross and despondent about all of this, because I have always taken care of my teeth, never, ever missed a checkup or not had treatment if I needed it, and my teeth actually look good to the point people comment on how white and straight they are. Just a pity half of them are missing.