Power Point

WEll, I'm back from my consultation, and let me tell you, peeps, I am totally freaked out. Completely! There's too much to tell in one post, so I'll just start and then add more tomorrow. Basically I just sat through an hour long Power Point presentation on how I need all my uppers yanked and implants put in.

Suffice it to say there is NOTHING worse than seeing a giant image of yourself cast up on a huge screen, from 14 different angles. He starts with the basic image -- there you are grinning like a goddamn idiot with the hideous smile, gaps and all, staring back at you. Honestly, at first all I could see was this hair that's growing on my upper lip! Omigod!!!! One huge ugly hair! I wanted to rush home and tweeze the damn thing out right there. The picture was so magnified that you could see every pore, every every every thing. Then he moves on to the most godawful closeups of the inside of the mouth. omigod. I think I'm going to be sick! He points out all the areas of this and that and calculus and puffiness and abcess and infection and and and....

but guess what? I don't have a single cavity. Nor any erosion of the teeth themselves. Now, it just seems wrong to pull out 12 (er..how many teeth are up there anyway?) or 14 perfectly sound teeth.

The lowers seem reasonably okay, a little work and they'll be fine.

And the kicker -- he'd never heard of Emdogain.

Oh I have so much more to tell, but I'm completely wasted and exhausted right now so it'll have to wait......

Wanna see something really scary?

Deep breath....

Click here

Patron Saint?

I was wondering this morning if there was a patron saint of dental problems, and lo and behold, there most certainly is. It's St. Apollonia,

and her story, according to the website of Dr Bunn, an Alexandria, Virginia dentist, is this:
"Apollonia was born in Egypt in the 3rd century, and died in the year 249. She was an elderly deaconess, living in Alexandria, who lived in a refuge for Christians. She was martyred for not renouncing her faith during the reign of Emperor Philip. The account of the life of St. Apollonia was written by St. Dionysius to Fabian, Bishop of Antioch. One night, angry pagans began a riot and violently attacked believers of the faith. Apollonia had all her teeth knocked out after being hit in the face by a Christian persecutor. After she was threatened with fire unless she renounced her faith, Apollonia said a prayer and jumped into the flames voluntarily—which St. Augustine adamantly defended as an act of heroic faith and not suicide, which would be unsaintly. She is considered the patron of dental diseases and is often invoked by those with toothaches. Ancient art depicts her with a golden tooth at the end of her necklace. Also in art, she is seen with a pincers holding a tooth. Parts of her jaw and many of her teeth are presently housed in churches across Europe. Her feast day is February 9th."

er...I dunno, is that even interesting? I am weary weary weary of toothdom.

Holding

I'm just in a holding pattern now, waiting for my Wednesday appointment, at which time, Dr Bryant will present his "treatment plan" and I'll present my "alternate plan"!

In the meantime, a few people have asked if I'm going to post pictures. I hadn't even thought to do so, but I suppose I could...honestly I hate the way my smile looks right now but if I can bear to do so I'll get a pic and post it at some point.

Enjoy this picture of some antique dental torture device, from the Maine Antique Store. I guess we have a few things to be thankful for.

A stereoview titled Tooth Drawing, from http://antiquescientifica.com/web.dental_antiques.htm Check out the "dentist's" robe.

More about money

By the way, I am considering creating a layperson's website to demystify the cost of dental care. Go to almost any dentist's website and you'll see information about procedures, and explanations of various things, and soothing words about insurance. But nowhere will you find a list of prices. How much does a root canal cost? How much is a crown? How about a cleaning?

So here's what I propose -- how about sending me, via email, a copy of your latest dental bill? Black out the names and other identifying information - I have no interest in knowing who you are. I just want to know how much YOUR dentist is gouging you for. If there's much interest in doing this, I will create a website. We need to demystify this process, folks.

My email is dental_hell@@yahoo.com (remove the second "@"). Write me if you think this is a good idea.

I'm such a bitch.

My humor - especially in places like the dentist's chair - is pretty dry and can be sarcastic. But I also have an aversion to useless chitchat. So when the dental assistant (a new one, one I'd never met before) said, "So, how was your weekend?" I just looked at her and replied "Would it make any difference to you if it was great? or if it was horrible?"

Fortunately she didn't stick me with a sharp instrument.

So this morning I arrived at 7:55 and they got me in right away. Nicer than the 18-minute wait last week. Dr Bryant came in and said he was going to take some pictures. Ugh. I hate having my picture taken on the best of days. But with retractors holding my mouth out of the way (oh the indignity) -- I had to actually hold the retractors, which are just wire or plastic (I had both, for some reason) things that hook onto the sides of your mouth and pull it out of the way. I think he took about a dozen pictures, two while I was performing the feat of holding the retractors AND balancing a mirror on my tongue.

What am I, a circus act?

Then he said he was going to measure my skull. I told him he didn't need to, that I knew it was an "extra large". But he wasn't going for it. The skull measuring contraption actually requires a screwdriver. Now if you've ever been in the dentist's chair and you hear him murmur "I need to find a screwdriver", well, you can tell him it's probably with the pliers that he's going to use to pull all the teeth out at some point.

But I digress.

Oy, look at this. And who says dentists arent' sadists?

But I continue to digress.

The skull measuring device is so dignified! It's this huge metal contraption with things that stick in your ears and God knows what all. Not particularly painful, but you sit there and imagine what you must look like and you just know the reason the assistant is constantly leaving the room is so she can burst out laughing!

Dr. Bryant seems enamoured of all his little tools and contraptions. Which is fine, he's a guy with gadgets (this is why our dental bills are so high).

OK, what else...wax impressions, plaster impressions, measurements of those hideous periodontal pockets -- some of them were so deep you could pack groceries in 'em. Some of them weren't so bad...some 2's and 3's in there among the 8's and 9's.

It all took an hour, was uncomfortable, there was a little blood when he was measuring the pockets with his sharp instrument (can't the measure with something a little less barbaric???), and then he told me to come back in a week or so to discuss the treatment plan.

I told him about the shingles. He seemed to be vaguely interested, but not enough to make a "note on my chart". My chart is probably already filled up with notes like "difficult patient" and "asks too many questions".

The anxiety was less this time, I'm happy to report. I do feel a little more in control, despite the medieval torture perpetrated on me this morning. What I want is this: deep cleaning, scaling, planing (with sedation if possible, but at a minimum I want to be completely numb); Emdogain treatment for bone regeneration; braces; whitening.

Keep your fingers crossed for me.

Getting ready for my 8 a.m. appt -- nervous but trying to remind myself that I'm in control.

My God dentistry is expensive. It's almost impossible to find, on the web, any kind of objective comprehensive list of how much various procedures should cost. I would call this a conspiracy of silence, the dental community would probably call it a code of honor.

I'll post again later today.

I think I found a periodontist. Or an office, anyway. Funny thing is, it's on the next floor up from the prosthodontist I visited on Monday. Same building. (Okay, okay, it IS called the Medical Dental Building!) It's called Advanced Periodontic, Microsurgery & Implantology, and they offer the services I think I need, especially the advanced techniques to regenerate bone loss using a "minimally invasive" surgical procedure. But even better that that is the paragraph where they explicitly address phobia:

"We cater to our patients' individual needs and desires. Anxiety control is accomplished with oral sedation, nitrous oxide sedation, and a caring, thoughtful staff approach. IV sedation by a certified anesthesiologist is available on request."

I like that.

I dunno, maybe I'm just getting my hopes up falsely. And I think I know why. Over the last five days, I've gone through the stages of grief!I know that sounds a little strange, but when you think about it, it's not so much. Grief isn't the exclusive domain of death. We grieve for lots of things -- our lost youth, our lost dreams, our lost friends, anything we've lost, I guess. And teeth are a very very integral element of our self-image. Dreams about teeth are extremely common, and dream analysts believe the teeth symbolize anxiety about appearance, as well as fear of embarrassment (!) or a sense of powerlessness. (To read more, go here.)

So after my Monday appointment, I'll just run up one floor and make an appointment with the periodontist. In the meantime, why is it called a periodontist? I'll research that and let you know in another post.

My plan

Okay so after thinking about it for three days, here's my plan. I meet with Dr. Bryant at 8:00 a.m. Monday morning. I'll listen to his treatment plan, if he has one. Then I'll get a second opinion from a periodontist. Then I'll make a final decision.

If anyone knows of a good periodontal information site, I'd love to hear about it.

A brief comment about the Donation Button on the right. I have dental insurance, but it tops out at $1500. I work two jobs, and I have some savings. But I am looking at expenses in the $20k range, and in this particular moment in history when everything is expensive, I'm merely putting the button there if anyone feels the urge to help out. I won't ask for money, I just wanted to have a way for people to help if they were so inclined.

Now I'll say no more about it, ever. Thanks.

Emdogain Gel

Does anyone know anything about Emdogain Gel? It seems to be some kind of gel that promotes regrowth of lost bone. I'm wondering if I'm a candidate for something like this. Any thoughts appreciated, either here on the blog or send me email at dental_hell@@yahoo.com (remove the second @). Thanks.

the day after the first appt

I'm too depressed to write much today. Why is it our teeth, our smile, our mouth, is an area of such sensitivity -- and I mean emotionally, not physically -- for us? I feel as though I'm a personal failure in life, my mind is full of "you should have" and "it's your fault".

Anyway, if anyone thinks I should bother with a second opinion, I'd love to hear from you. You can either reply to this blog or write me privately at dental_hell@@yahoo.com (remove the second @).

after my first appt

Well, I'm back from my appointment with Dr. Bryant. I might as well use his full name, because after all, he has a website, and while the news is bad, I think I trust him.

I arrived at 10:20, already shaking with fear. Filled out the necessary forms, front desk was somewhat chaotic and while there was a veneer of friendliness, I still had that humiliation fear thing happening, and imagined they were all secretly recoiling every time I opened my mouth. I told them I had anxiety, and there were the usual assurances of gentleness, etc. After filling out the forms, I sat for about 18 minutes before the hygenist, "L" called me into her office. She said, "Here for a cleaning and checkup?" I said no, and my voice started shaking. I coudln't control myself very well, and my voice was loud and husky. I told her the last 3 dentists I went to said a cleaning was useless unless it was one of those deep scaling/planing ones. I was also crying. I asked if there wasn't a door on the exam room, and she said, no, none of the work stations had doors. She then invited me in to the conference room, which did have a door. We sat and talked, I told her a little about my previous experiences. The only time my tears dried up temporarily was when I told her I was blogging about all this. (I think that's because I feel that this blog is a form of control -- something one doesn't have any of in a dentist's office.)

We agreed to take x-rays. I asked her if they were digital and she said yes. 70% less radiation, but you still have to hold the hideous little thing in your mouth and sit very still while it digs into your soft tissue. She did 18 x-rays. It took about half an hour. Then I sat there crying while she charted my root canals, fillings, etc She would look at a tooth and then start clicking on the computer. I imagined that each click meant something horrible (and it did). She told me that if I were to have the deep cleaning, it would take 5 visits. One for each quadrant, and a fifth to simply go over things again. I took a deep breath and said okay.

She then went to get Dr. Bryant.

He was a nice man, gentle with the instruments but blunt in his manner. After having me nearly upside down in the damn chair for half an hour he pronounced that I was going to lose all my teeth. There was nothing he could do. He gave me three options:

1. get them all pulled now and get dentures
2. get partials or implants as each tooth fell apart, over time
3. begin a restoration process that would probably lead to me having all implants

I cried some more, bit my lip, and when I started to speak I didn't recognize my own voice. "You have a website," I said, "where you show people whose teeth have to be worse than mine, and who now have gorgeous smiles. Are you telling me that with all the fabulous inovations in dentistry there's nothing you can do for me?"

"We can do restorative work," he said, "and we can do amazing things."

"But," I said, "it sounds as though you're saying there's nothing you can do for me."

"Oh," he replied, "I think we can do some restorative work on you."

Now, you have to remember I was in quite a state, and I don't recall exactly what was said, what was promised, what was arranged. All I know is that I said I wanted whatever restorative work he could do, I did not want dentures, and I was willing to do whatever it took to get a decent smile back.

I'm not sure what he said at that point. But there was talk of periodontal this and that and mention that it would be a long haul, and I just kept looking out the window and nodding.

The upshot is that I go back on Monday morning at 8 am for some kind of pre-treatment session where they'll take measurements, do some diagnostic work, "talk about cost", and so forth.

So now I'm home, with a blinding headache, miserable.

Day of First Appt

It's Tuesday, the day of my preliminary appointment. I'm finding that I am very weak in the face of authority. As I think back to the phone call I initially made to get this appointment, I was going to ask for a "free consultation", as advertised on the website of Dr. B. But the cheery receptionist distracted me with questions, and then as we were figuring out a date for the appt, she said something like "We might as well just start the cleaning on this first visit!" in such a firm and positive way, that I thought I would sound abnormal if I said "uh, well, no...er......" so I stupidly said "Oh, okay!" trying to match her chipperness.

I know -- receptionists aren't mind readers, and even though I told her I was nervous, she didn't seem to realize that I'm actually phobic. I must keep in mind that I'm in charge, that I can "fire" these people if they don't make me feel comfortable, etc etc.

But I'm very very anxious right now. The appointment is at 10:30 and I'm already up, showered, etc and it isn't even 8 a.m.

I'm a bus rider, which is another potential problem. I just can't see myself taking a bus home from a dental visit where I've had sedation dental work or some horrible bloody procedure. I guess I can take a taxi, but money is always an issue.

Expenses! Dentists are horribly expensive. Yes, I have insurance but -- if you can believe this -- it MAXES OUT at $1500 a year. I was completely SHOCKED to discover that last night as I was anxiously looking over my coverage. $1500 will barely get me a cleaning and x-rays, for chrissake.

More on that, and the "donations" button to the right, another time.

appointment

I have an appointment tomorrow (Tuesday) morning with a dentist I found on the internet. He has a great website, he promises lasers, ultrasonic cleanings, sedation dentistry if necessary, and has amazing before and after photos on his site. I'm still dubious, but I'm going.

My three rules are: no lectures, no root canals, and no outsourcing. We'll see. I'll report back as soon as possible. We will call this dentist Dr. B.

Dental Phobia

I'm no expert, except when it comes to my own phobia, but it seems to me there are four main fears associated with going to the dentist: fear of pain, fear of price, fear of humiliation , and fear of being found dirty and disgusting. I suffer from all of them. The Dental Fears section of Dental Fears Central is pretty good at discussing those fears, and others you may have.

Welcome to my dental hell

My very first post. I'm going to give you a little background on my teeth, my phobia, my fears and my hopes. Let's start 12 years ago. I'd just turned 40, and my teeth were in pretty good shape, I had some fillings that were kind of old but nothing dire. I hadn't seen a dentist in about 5 years, and decided it was time. I made an appointment at a clinic not too far from my office. No fears, no worries. I arrived, waited 20 minutes (waiting times at dentists' offices is something I'll address in the future), finally got seated in a chair. A dental hygenist started cleaning my teeth. She used sharp pointed instruments, was extremely rough, laughed when I complained, and was just plain nasty.

"What I didn't know, because no one told me, was that this was no ordinary cleaning. This was what they call "scaling and planing", a procedure that should not be done without numbing the area being cleaned because, HELLO, IT'S PAINFUL. It's bloody (for me, anyway), it's ugly, it hurts. Don't you just love it when medical personnel say things like "this might be a little uncomfortable"? That means THIS IS GOING TO HURT LIKE HELL.

So anyway, she got a fourth of my mouth done, I was swollen, crying, angry and upset. But I was also clueless, so I agreed to come back for another torture session the next day. I did return, but my gums were still so swollen that she recommended that I not have more treatment until they'd healed, and I went home and never went back.

Fast forward to five years later. I still didn't have any pain, but my teeth were looking yellow and I knew I needed to go for a cleaning and checkup. So I found a dentist - I'll call him Dr. R -- near my house. He turned out to be rather elderly -- 65 or older -- and had a dingy little office. I was a little worried, but climbed up in the chair. He poked around, told me I needed a thorough scaling and planing, and he didn't have the equipment to do that. I would need to go somewhere else for that. He also said I needed a root canal on a lower tooth. He couldn't do that either, but he could prep the tooth and get it ready for the root canal.

The thing about the dentist office is that you, the client, have no idea if what you're being told is accurate or not. You just trust the guy with the sharp instruments. And so I did. He started drilling and drilling, and suddenly he became panicky. He told his assistant my teeth were "like sand". The tooth he was working on was crumbling. I started panicking too. At one point, he muttered, "if only I could stop this bleeding". Finally he just shoved some kind of temporary crown over the tooth, told me to make an appointment for a root canal and then come back and he would put a permanent crown over it. The cleaning could wait. He shoved a bottle of Vicodin at me and hurried me out the door.

I left, my mouth throbbing and blood still trickling out. I made an appointment for a root canal, with Dr. P. By now, I was pretty fearful. When I talked to Dr. P's office, I told them I was terrified. The nurse promised me they would give me something to calm me down. True to their word, they gave me a Valium at the beginning of the appointment. I managed to get through the appointment with a minimum of discomfort, and really, the root canal was not all that bad. It only took about an hour, the Valium was nice, Dr. P. was pleasant.

No way was I going back to Dr. R for the crown, so I found another clinic near my office. Made the appointment, got the crown (two visits). I still hadn't had a cleaning or a thorough checkup. After about six months I got my courage up and started asking officemates for recommendations. A woman I trusted gave me the name of Dr. F. I called him, made an appointment, and hoped.

Dr. F. was a friendly guy in his early 50s. He took x-rays, poked around, and said that he couldn't do the cleaning I needed. I would need to be outsourced for that. Oh, and I needed another root canal, and oh, it looks like this tooth is cracked. Oh, and this one is going to have to be extracted. He gave me the name of a dentist downtown -- Dr. J -- ("a good friend of mine" -- in case you don't speak dentist-ese, that means "I get a referral fee for patients I send to him"). I went downtown to see Dr. J.

Dr. J had a huge office with an enormous water feature in the waiting room. The sign on the door identified him as a dental surgeon. I was pretty sure this was a bad sign, I knew he was going to want to do surgery! duh!! but like a good girl I climbed up in the chair and let him poke around. He made copious notes and then I left the office, without his telling me anything. He said he would work up a treatment program and mail it to me.

Three days later I got the treatment plan in the mail. It included extensive surgery, including gum surgery, bone grafts and god knows what all. Total cost? $18,000. I threw it in a drawer and never went back.

As you can imagine, by this time my dental phobia was in full swing. But I went back to Dr. F, because he wanted me to report to him on what Dr. J had said. I did tell him. I didn't tell him I wasn't planning to go through with any of that. In the meantime, Dr. F. told me I needed a root canal on an upper right tooth right away. Turns out Dr. P, the root canal guy I'd already been to once, was a "good friend of his". So I made another appointment and had another root canal with Dr. P. Went back to Dr. F for the crown, which took two more appointments. During the second appointment, as he was fitting the crown, there was terrible pain. I squirmed and tried to complain, but he ignored me. After an inordinate amount of time, Dr F said something like "That's the best I can do" and I left his office. Three hours later I had the worst cold I'd ever had in my life. I don't normally get colds at all. My theory is that someone in the office was spreading a cold virus, and me, with my tooth splayed open, was a virtual honeypot for germs, bacteria and viruses. I was down for a week with that cold.

Dr. F's office kept calling me to make another appointment, as there was still work to be done. I put them off and put them off.

Two months later, I came down with shingles in the third cranial nerve , or at least, that's what my doctor thinks it was. My entire right eye was swollen shut and black and blue. Ugly red zits started popping up in a surprisingly linear pattern along my nose.

The doctor who examined me had no idea what it was. She called in 3 other doctors, who all came in and stared at my eye and nose as if they'd never seen anything so bizarre. One of them, at one point, said, "Well, I don't THINK it's leprosy." I was prescribed huge pills -- two sets of them, one anti-viral and the other an antibiotic. The doctor gave me both because she didn't know for sure what was wrong with me, and she was worried I would lose the eyesight in my right eye if she didn't act immediately.

I didn't lose my eyesight. Eventually the zits went away but they left pockmarks that I still have on my nose.

I went back to Dr. F one more time -- for an extraction of a lower left tooth. During that appointment I told him both about the cold and the shingles. He laughed in my face at the idea that dental work could have possibly caused either of them.

That was five years ago.

About a year ago, the teeth in the -- surprise! -- upper right quandrant began shifting. I woke up with blood in my mouth many times, and the teeth themselves drifted in various directions. That part of my mouth is now constantly painful and a couple of the teeth are loose. I worry that they can't be saved. But I still wouldn't go to the dentist anymore.

Finally last week I went on the internet and started reading about dental phobias. Most dental phobia sites are operated by dentists who promise "pain free" dentistry or "gentle dental". Ha. After my experiences I don't listen to those people anymore. But there are a couple of sites that have good information, offered by people just like me, fearful people. Dental Fear Central has a forum where you can post anything you like. I expect I'll be visiting them again. It's nice to read that you aren't the only one.