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This fearful and neverending path

L

laughingloon

Member
Joined
Apr 19, 2011
Messages
31
Location
Upper Midwest USA
I appreciate all the courage shared here and the amazing support. I have been "lurking" for a couple of weeks but haven't posted as I don't know if my experience fits in after reading other stories.

I am very anxious about going to the dentist. For me, it seems to be getting worse, not better. Childhood trauma (held down for fillings, having to walk after school alone to dental appts.) and for the last 18 years having to have extensive treatment all contribute to the fear.

During graduate school I worked at a home for adults with severe developmental disabilites. One night I was injured in my jaw and teeth. I saw my dentist the next day and my back teeth didn't touch. It is a long story, but over the years I ended up with root canal therapy in all my teeth, crowns, TMJ surgery and regular follow-up care over the years (and ongoing pain after dental visits). Many of the teeth have needed to be retreated and a few have needed apicoectomy done. I am told that because of all the work I have needed I now have what is called neuropathic pain. Imagine having a toothache, forcing yourself to the dentist through the fear, seeing a tooth x-ray that in most everyone else would show an abcess needing RCT or extraction only to be told it is part of a "pain illness." Three teeth have required removal and have or are currently in the process of getting implants. "Neuropathic pain" is a very real condition. Because of all the work that has been done, nerves going to a tooth or teeth become "de-sensitized" leading to low grade chronic pain. We have "watched" teeth that react to all the diagnostic tests for endodontic issues over several years. I don't want to have any teeth removed--they have told me that the pain won't go away even after the tooth is gone since the nerve irritation goes past the mouth area. Here is the challenge: after a tooth like this ends up being removed there is indication of infection (though my dentist and TMJ specialist say that since my periodontist who did the extractions didn't send it to the "lab" it could be a benign type cyst not infection. Problem is my periodontist has been in practice as long as the other two dentists tenure combined.

How can all this be paid for? It was a work injury and so insurance has covered it. That also means that I have to continue to see the "treating providers." My general dentist is really nice. She bought the practice of my last dentist who I saw over the time of the injury and who did most of the root canals.

I see the periodontist because my case is more complex with crowns, etc. She has been on the dental school faculty of the major university in the metropolitan area where I live and is highly regarded by colleagues who refer patients to her and by patients. The oral surgeon who did the jaw surgery 16 years ago managed my case follow-up over the years. He too was top of the line in terms of reputation and loved by patients. When he retired, my therapist (a health psychologist on the dental school faculty--imagine that, a dental school that has classes on psychology!) refered me to an oral medicine/chronic oral/head pain. I have been seeing him for the past 5 years. We just finished making a new "nightguard" that I don't like so much since it is higher than the last one but it has to be.

I am sorry to rattle on like this. I decided to post in case any one else can give me support and to let people know that other than full dentures, I have had most everything done, I am amazed how everyone with dentures seems happy with their decision and their new teeth. I think it is great, but I hate the partial denture I have to wear since the last tooth removal several months ago. (It is temporary, but still is 6 months or more after the next implant surgery in the next week or two--I'm too scared to schedule it.)

The dental anxiety was doing fine for several years--I didn't like going but didn't lose sleep days before getting work done, panic attacks in the dental chair, etc. Nitrous oxide, that heavenly discovery sometimes doesn't take the edge completely off, even with pre-medication.

I am a bit envious (lol) of many of you who have seen the dentist after years of not going and have overcome your fear and finished or are on the downhill side of getting your dental work done. For me, there will always be another crown, another tooth will need removal, going to the periodontist for perio cleaning 4x a year (they have to numb my whole mouth to get under the crowns all the way). Not going is not an option--the insurance company would say I'm not being compliant with treatment.

I need to get the implant surgery for where tooth 14 used to be but I am more scared than I have been in a long time. I've been through it before but last time the anesthetic wore off while the periodontist was doing the sutures. I thought that since we were almost done why bother with a top-up. (I should have asked and will going forward.)

Is anyone else dealing with the dental anxiety roller coaster--you go for awhile managing pretty well but then it come back. Perhaps it is like depression, my other chronic and disabling health condition.

I've put this out here. This may have been too much or no one else can identify with me, but I wrote this thinking and hoping that "depressive" thinking is wrong. Anyone?
 
Hi laughingloon, I can definitely sympathize with you. I started a journey to repair my teeth less than 2 years ago after a long absence (dental phobic).

Unlike you, I am paying for all of this myself, but that was my choice as I do not want dentures. I've had multiple opinions to give myself that reassurance that all of this work is indeed necessary to meet my goals. But I've also had some pretty big "bumps" in the road along the way.

Like you, I have what I consider a very good team which took me half my journey to find. I still need sedation, even after all of this, the victory for me is actually getting in the chair and persevering, and as Mike would say- having a neutral experience.

Dental anxiety, unless dealt with head on does continue to get worse, you just keep feeding it, each experience adds to the negative perceptions of dental work, sedation does not allow positive memories to occur. The emotional roller coaster is real, I've actually had a conversation about "is this depression" in regards to my teeth and what I am going through, and he says understandably, yes. Not chronic depression but clinically yes.

I am recovering from 4 implants done earlier this week (#14,19,29 and 30) and trust me compared to the apicoectomy this was a walk in the park.............
Gearing up for the surgery I had this week is very much like a marathon runner in the last leg of the race, exhausted to the point of not being able to continue, but spurred on by seeing the finish line- I am almost there.....but as long as I have teeth - it will ever "end"

best wishes
 
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Thank you for replying to my thread. It was hard to write all that and wonder if anyone else could identify with me at all.

You wrote that being under sedation for work means it is harder to deal with the roots of the fear and overcome them. I have the opposite experience--maybe it is depression/anxiety on top of dental fear or some recent procedures that were not totally pain free. Like I said I can't really go out on my own to find different providers without the insurance company's permission. Dealing with them has involved getting an attorney over the years so it only increases my anxiety in general.

In the next month I have to go in for implant surgery for tooth 14. The periodontist doesn't think I need sedation (beyond nitrous oxide and pre-medication) since we've done it before. I can't find the right way to explain to her that being awake for those is what has led to more dental anxiety for this one. :scared:

It feels like as soon as "dental work" is finished for another round something comes up a few months later. I admire everyone here who has overcome their phobia and are getting things "sorted" and will end up on a regular 6 month cleaning/exam schedule. No matter how good my home care is, there will always be more it seems.

Dentures would be nice, especially after reading how much people on this forum like their decision. Won't happen for me--none of my doctors would sign off on it. TMJ issues would only get more complicated. I am glad for my current smile and the investment made, but my original teeth looked about the same. On the worst days, I feel like these are my "real" teeth. Of course, they are but I still grieve over something that I couldn't and can't control. :(

Your comment about there always being issues as long as we have our own teeth (or implants) seems right. But being edentulous and needing dentures has its issues as well, especially for those of us with TMJ and orofacial pain/muscle issues.

Thanks again. :jump: Good luck in your journey. It is nice to not feel so alone.
 
I don't think your periodontist should make the call about sedation- that's up to you. And what is really key is that open communication to let her know how you are feeling and why. And then tell her that IV sedation is a deal breaker.

My total restoration is primarily becasue of TMJ issues, and missing teeth for a long time certainly contributed.

The sedation I think is a double edged sword for me, can't have work done without it, can't move on emotionally with it. And I went from nitrous to oral with nitrous to IV......But per my dental phobia doc "the important thing is getting the treatment done, not how you got there"

The finish line will be "see you in 6 months", but I'm doubtful I'll get there as well, that's why my journal is "life long battle" a dentist told me to prepare myself for that 20 years ago. My OS said my mouth is like a fancy car, a high-end vehicle that will always need maintenance with expensive parts. At least with the implants we can build on that.

:XXLhug:

rp
 
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So true. Dentures aren't for me either when my wise mind is active. Probably an emotional thinking thing wishing for a way to have dental work over and done with. Interesting how dental anxiety has gone up for both of us as this just keeps on & on. TMJ stuff is so frustrating too. This forum is great for support and not feeling so alone.
 
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I need some advice. I am due to have implant surgery (tooth 14). As I have said in my long posts above, my dental anxiety is increasing. The periodontist who would do this is someone I trust, however pre-medication/nitrous oxide isn't cutting it as much. She doesn't do sedation.

My dilemna is this:

Do I see Dr. Jane and do it like we have before--2 mg clonazepam before and nitrous oxide and risk having a difficult experience emotionally or squirming in the chair? I'm out of it just enough to not feel totally in control, but not enough to not have increased physical anxiety reactions.

Or do I ask her to refer me to a OS or periodontist who does sedation but who I haven't seen before and so don't know how good the result would be? I know I shouldn't feel afraid after having so much dental work done, but I'm still scared and getting more so trying to figure this out. Any kind advice would be much appreciated.
 
Can she bring someone in to do dental IV sedation/anesthesia...you may both be surprised at what's out there and offfered..
 
I can ask, but I don't think she can. If I had needed a sinus lift (I don't--whew!) her husband at another location (same practice) would have done it with sedation. I've seen him a couple of times post-op in the past and it makes me more anxious--not the same gentle approach. :censored: For the extraction of this tooth 6 months ago I asked about doing it in the hospital but she thought I could do okay. I sort of did, but anesthetic wore off during sutures and I just toughed it out. :cry:

Thanks for your idea. :XXLhug:

Reading on this forum has helped me understand that there is no reason to tough it out even if at the end of the procedure--ask for a top off. I think I need to re-establish the hand raise signal as it has been ignored some lately and until being on DFC I didn't realize how important that is and for it to be honored. Brit and letsconnect have helped in their responses. So we carry on.
 
Re: This fearful and neverending path Good News

Well my anxiety about the implant surgery is over. I did it. Surgery over.:)

When I had my teeth cleaned a few weeks ago we talked about how I might do okay if there was no advance notice--taking out the pre-appointment anxiety of sleepless nights, shaking on the way there, etc. Their idea was to set up the appointment with my SO (she checked my calendar) and a ride so I didn't have to worry. :hmm: They are so kind, but I was wondering if it was going to happen or if I should call to push for sedation. My periodontist did call me back two days ago but the message got lost. (Teenagers!)

Anyway, this morning my SO told me the implant surgery was at 9 AM and the cab was coming at 8:30. She had the pre-med pill. So all I had to do it get up, get ready and go. Not enough time for the anxiety to get so bad I was shaking. As soon as I was at the office I was taken right back and they started the nitrous oxide right away. It ended up being like sedation as I fell asleep (conscious sedation) I don't even remember the numbing shots or the sutures at the end. I could hear the drill for the implant once, barely. Not even close to as bad as I remembered or thought it could be. It was all good. ;D

Now I'm pretty sore in that area but can deal with that.

I did it. Now 6 months (cross fingers) until the next appointment for dental work (apart from a cleaning/exam).

It feels like bragging but I am proud of myself. I am also proud of my SO and my great dentist and her office. :jump::jump:
 
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