another appt

Back from my third appt with JC. Did the lower left quadrant today. I have one molar that has to come out on that side, so she didn't bother with it, which I think made the appt go faster. She said she did a "nerve block" today, which is much better than just shots of novocaine or whatever, and indeed, I was pretty profoundly numb for the whole appointment. That was a relief! I'm hoping the fourth appointment goes as smoothly. And then I start dealing with the other problems -- I want all my old fillings replaced. I think I need to have some kind of braces or whatever because my bite is so out of alignment that when I bite down, almost none of my teeth meet each other. That's a bad thing.

I still have anxiety, and still have Valium before each appointment. Even so, I feel myself tensing up and have to consciously relax my shoulders about every ten minutes, as I can feel they've tensed up. But it's all eminently bearable.

Today I spent a little time on google looking up dental anxiety sites. YOu would not believe how many of them there are! I mean, really! Can it possibly be true that dentists are not aware of how deep and prevalent dental issues are among the populace? I have one comment for them -- if you would gear your advertising AND your actual practice toward addressing dental anxiety, word of mouth (no pun intended) would make you the richest dentist in town.

Here are just a few sites:

Beyond Fear

Dental Fear Central (my personal fav site)

Dental Fear(actually a NY dentist's site but has some good info)

Dental Fear (looks like it's paid for by dentists, but some good info)

Web MD ( a little condescending -- for example, it says "People with dental anxiety...may...have exaggerated worries or fears". This completely negates the fact that many people with dental anxiety have painful or humiliating past experiences that make their worries or fears completely legitimate!!)

And just for fun (or a learning experience), take the Dental Fear Questionnaire here. You may find (as I do) that your level of anxiety isn't all that bad, in fact is normal.

A progress report

So it's been about a week now since the upper left quadrant was deep cleaned, and about two weeks for the upper right. Several things are happening. First, two or three distinct spots on the upper inside of my mouth are really sensitive to heat, cold and sugar. It's as if some nerves were laid bare. I'm hoping this is only temporary, as it makes it hard to drink cold water (and it's been in the 90s here) or eat ice cream!! Second, the upper gums are becoming a much healthier color, much pinker and much less red. It's easy to see the contrast between the upper and lower gums. Also, I had one tooth that you could wiggle a little bit, and it seems to be more firmly planted now.

I know the healing process is a long one, and I am doing clumsy visualization exercises when I have time -- trying to imagine the bone and gums growing and regenerating. ONly time will tell whether this will happen, but I'm hopeful.

My significant other just left for his first appointment in ten years. I'm anxiously awaiting his return. I just hope hope hope he doesn't need too much work done.

That's it for now. Next appt is Monday, when JC will deep clean and periostat one lower quadrant. She said she can give me a nerve block so that I'll be profoundly numb this time. That's an important phrase -- profoundly numb. Remember to use it the next time you go to the dentist: "Doc, I want to be profoundly numb before you start sticking sharp objects in my mouth."

cleaning redux

One of the purposes of this blog is to hopefully let other people learn from my experiences. And what I learned -- about myself, at least -- is that I shouldn't try to bite off more than I can chew (figuratively, of course!). I was hopeful that we could do a couple of quadrants yesterday, but when I got there, I realized that I am really only capable of sitting in the chair for a limited time (despite the fact that these chairs have memory foam padding, which makes for a rather more pleasant sit than most dental offices). Thinking of doing two quadrants began to seem a little overwhelming. I need to know things like "how much longer" and "when can I get out of here?" So JC and I agreed to go one quadrant at a time.

And I also think dentists and hygenists are a little like hairdressers. They need to get to know you, your needs, the way your hair (or teeth) respond. And that requires building up a bit of a relationship. JC knew this time to numb the hell out of my mouth before even beginning to clean. And whooo-eeee did she numb my mouth. I wonder if that's what Botox feels like, becuase honestly you couldn't move a muscle if you tried.

So the upshot is that we did the upper left quadrant in about an hour and a half, it was 80% less painful (I did still feel a couple of pokes, especially near the end as the numbing agent began to wear off). I tried to do a Zen kind of thing where if I felt anything, I just "went somewhere else" in my mind, which also helped a little. Believe me, any and all tricks you can use to make time go faster, and to reduce any pain, are worth it.

JC has a little radio she'll let you listen to, and a warm blanket if you want it. Some dental offices even offer movies. I've always thought it would be way cool if they brought in a foot masseuse so you could have a pedicure while the hygenist works, that way, you'd be gorgeous "head to toe", literally, when the time is up!

But seriously, the point is, do what you need to do to make your dental visits as comfortable as possible. Don't be afraid to speak up, ask for what you need, mention any concerns, do mental exercises, and most of all, keep the lines of communication open.

I go back on the 31st for the next quadrant, and the last one will be in August. Then the fun begins all over again...I want my old fillings replaced, I want some kind of braces to help with the crowding and spacing, I want them whitened. But that's all still down the road a ways.

But have you noticed I'm much calmer now? Well, I am. And you will be, too, after a few times in the chair!

2nd appt

Well, today is my second appointment with JC. I'm not so much frightened as I am just dreading it. For some reason I have a hard time getting numb in certain places and it just plain hurts. So I'm just going to see how it goes, ask for Valium, and try to relax. I hope we can do two quadrants but maybe I can only bear one at a time. I'll decide while I'm in the chair, and I'll report back when I get home -- assuming Im in any shape to type.

I need to update you, also, on the fact that I will, in fact, have to have three teeth extracted. It seems that every time someone takes a close look inside my mouth, they find something else that needs to be forcibly removed. More on this later....

A brief note...my boyfriend hasn't been to a dentist in ten years. The last time he was there, a dentist told him he needed a root canal. He never went back. This is, apparently, a common story. The tooth has deteriorated and now gives him constant pain, so he's finally agreed to go to the dentist (he's a bigger phobic than me, it turns out!) during my next JC appointment. So we'll be a household in pain for the next few months...

Dental Embarrassment

I ran across an interesting study entitled "The contribution of embarrassment to phobic dental anxiety: a qualitative research study". I mean, sometimes you wonder why they have to have these studies - they could have just given me the money and I'd have told them there's a relationship between embarrassment and anxiety!! But seriously, I'm going to quote for you the beginning premise and the conclusion of the study and then give you the URL if you're interested in reading more.

Beginning Premise:
Earlier Scandinavian studies indicated existence of a vicious circle of dental anxiety, in which embarrassment, shame or guilt have a central role in facilitating both anxiety and treatment avoidance, but they gave few details as to the exact role of embarrassment in this vicious circle.

Conclusions
Embarrassment is a complex dental anxiety manifestation with qualitative differences by complaint characteristics and perceived intensity. Some cases exhibited manifestations similar to psychiatric criteria for social anxiety disorder as chief complaint, while most manifested embarrassment as a side effect....Sensitivity and understanding about the psychosocial nature of the dental health care environment should be an aim in the education of dentists in the 21st century, in order to prevent and treat suffering from extreme or phobic dental anxiety and related dysfunctional phenomena.

In other words, embarrassment is a real factor in dental anxiety, and the degree of it is greater for some than for others. Duh! But it's still an interesting read. You can read the whole thing here. By the way, I love this chart:

Ow Ow Ow

Well, I had my first appointment. I'm not going to lie to you, it was brutal. There are so many things wrong with my teeth and gums that this is really going to be a painful and difficult process.

I had to have four Valium, and at least 5 shots of Novocaine (it isn't really novocaine, but something similar but I can't remember the correct name). I couldn't get completely numb, and that was the worst part. There were two specific spots, under the gumline, where I could feel quite completely what her instruments were doing. And that is painful. I finally decided I was just going to grit my teeth (figuratively) and not show the pain on my face. Because I knew I had to get through this.

2 and a half hours later and we had just finished ONE quadrant. Since the appointmnet was scheduled for four hours, it wouldn't have been possible to complete a second one, so my next appointmnet will be just for one more quadrant.

The tools she uses are an endoscope and perioscope. Or maybe theyre both the same tool -- but anyway, it's a tiny camera with a bright light on the tip. She sticks that way way down under the gum, inside all those pockets we're not supposed to have but we all do. The thing that's different is she can "see" a lot farther down and a lot more thoroughly than a hygenist who just sticks tools down there and "feels" for calculus. Judy can actually see - via the camera, which sends a picture to a video screen -- all the way down, and all the crap that's down there.

She also managed to get a little Emdogain applied to the upper right quadrant.

I have my fingers crossed that the next appointment won't be so painful or difficult, but even if it is, I'm determined, motivated, and hopeful.

D-day

Well, two months (plus) after my journey began, I will go for my first actual treatment today. I am already starting to panic, having shortness of breath, sweating, etc. What am I frightened about? You name it. Im afraid she'll start the perioscopy and then say it's useless. I'm afraid some of my teeth will fall out while she's working on them. I'm afraid of pain. I'm afraid of sitting with my mouth open for four hours. I'm afraid my ride home won't show up. I'm afraid...just afraid.

I'm taking deep breaths, and I have a Valium if I need it. I hope I won't. The All Star game is on tonight (if not rained out!) and I want to be at least semi alert for that. My boyfriend promised me ice cream for dinner if I go through with it. So there are reasons to ...just project past the next six hours and focus on 5pm. By 5pm I'll be home...sore, yes, but home...with this perioscopy half over...and the second treatment (a week from Thursday) should be better because at least I'll know what to expect...

Wish me well...

big day tomorrow

Well, I had a nice weekend - went to the horse races and won about $4, then out to dinner, and otherwise just relaxed. Now I'm back to reality, and facing four hours, yes, four hours, in the chair tomorrow, as JC begins the super deep cleaning, planing, whatever it's called. I can only hope it doesnt hurt too horribly much, that I can get through that length of time without choking, vomiting, panicking, crying, or dying. And then next week I have another four hour appt. Hopefully that will be the worst of it. I think she will apply the Emdogain during these appointments.

I have to give her a check for $3600 tomorrow. Insurance might pay a pittance of that, but I looked at my insurance benefits and they allow something like 50% (because she's not a "preferred provider" , and the max for cleaning/scaling/plaining is something like $150 a quadrant. I don't know if that means they'll actually fork over $75 per quad or what. I am fully expecting to be "out" the whole $3600, and am only glad that someone was able to help me out with this payment.

I will have to have a LOT more work done after this - this is just the beginning, to get the playing field ready to play on, so to speak.

Thank God I have a ride home from this appointment (I don't drive or own a car). Otherwise a cab would probably cost $30.

I am really scared.

JC

Well, I had my appointment with JC this morning -- no, not Jesus Christ, but she may be the new Messiah! I have her permission to use her name and to direct you to her website. She's Judy Carroll, her website is here, and I'm a fan. Her philosophy and methods are different from anyone I've encountered before, she's using cutting edge techniques, and she has a great attitude! And if you've been following my blog, you know I'm a cynic! Judy works out of an office in North Seattle (Lynnwood, to be exact). Not a great neighborhood, but once you enter the office you feel quite calm and in good hands. A great water feature, a comfy waiting room, and short waits. I filled out the necessary forms and went to the bathroom. While I was in there, I heard my name being called. Now that's quick!

Judy practices perioscopy, which is extreme cleaning, planing and scaling using a tiny tiny micro camera and tool. She also does Emdogain without surgery, which was a huge relief to me! I have been adamant all along that I want Emdogain, ever since I found out about it, but was not looking forward to the surgical procedure that most dentists use. So I needed no convincing about any of this. I am on board and motivated!

The dentist Judy works with (can't recall her name right now, but she's a wonderful person) stopped in and we talked about my dental needs beyond the periodontal disease. At some point, I actually may have a beautiful smile! Even if it is veneers -- at least they'll be supported by (mostly) my real teeth! I will need a couple extracted, they're just too far gone. And I'm okay with that.

Initial payments for two sessions of deep cleaning and Emdogain will run me about $4000, or a little less. Yes, that's a TON of money, and insurance will pay little or none, but again, I'm motivated and can live with that amount, for what I'll get. First appointment (FOUR hours) will be next Tuesday, July 11. I don't know what kind of shape I'll be in for blogging that day, but I'll try.

Judy accepts (and has) patients from all over the world. Check out her website before you submit to having all your teeth pulled. Or put it off for a few months, until I can give you a more complete review of how things go for me. Maybe she'll be the answer you're looking for.

It's early days yet, and I haven't actually been treated so my information is really only what I've read and heard. I will definitely keep you posted, though!