How can I find a dentist for my boyfriend who has no insurance and is terrified of dentists?

November 15, 2004 9:26 AM

My boyfriend needs to go to the dentist. He recently chipped a tooth, and hasn't been in ages. The problem is two-fold: One, he's TERRIFIED of going, especially because of his long time away from the dentist, and because of deep-rooted fear of the dentist and two, he has no dental insurance. He's agreed to go if I can find a dentist that will accept him without insurance and I go with him to hold his hand. How do I find a dentist that will see him without insurance and will be accomodating to his fears? 1-800-dentist seems secretive at how they arrive at their recommendations.
posted by agregoli to health & fitness (21 comments total)

A dentist gets listed at 1-800-dentist by paying them. It means nothing.

The best way to find a dentist is to ask around.
posted by free pie at 9:42 AM on November 15, 2004

I recently had a chip fixed. There is zero pain, none whatsoever. They put a putty like substance to fill in the chip, shine a bright light gun that beeps, then file down with a drill. Takes about 4 minutes. The whole thing cost $250, I think. Any dental schools/clinics in your area can do it, they don't care about insurance.

As for the long time away from the dentist, seriously, that's gross and potentially dangerous. Don't just think in terms of dental health, but everytime he swallows he is introducing the oral plaques and gingival bacterias into his stomach/body. Bad for the heart, bad for his health. And no offense, but every time you kiss him you are getting some of it. A regular cleaning ( twice a year ) is an absolute must.

Tell him being afraid of the dentist isn't very sexy, he'll be there in a flash.
posted by remlapm at 9:43 AM on November 15, 2004

I am well aware of how bad it is to skip the dentist - he knows all that as well. He's not lazy or unconcerned - he's SCARED.

The dental school idea is a good one though, thanks.
posted by agregoli at 9:47 AM on November 15, 2004

I know here in San Francisco there are some dentists who specialize in treating people who are phobic. Like this guy. Maybe they can recommend someone in your area, or if there's a dental school where you are, maybe they can recommend someone. There are some dental specialties that have a psychological component, like TMD, and so people who treat these conditions might be more sensitive, innately. Also, you could call around to some mental health people in your area, like people who treat phobias, and ask if they can recommend some dentists who they've had success working with.

You can also call around local dentists and explain the situation and see how you feel about their responses. The question of whether you can be with him to hold his hand is an excellent screener - ask and see how they respond.

Having no insurance just means that you have to pay upfront. Most dentists would be delighted with this, and some may even offer a discount, as they don't have to hassle with insurance.

AFAIK, 1-800-dentist is just a paid referral service. Practitioners simply meet some minimal standard (like having a current license, malpractice insurance, etc.), and pay to get their names listed. Maybe I'm wrong about them, but most professional referral services work like that.
posted by jasper411 at 9:49 AM on November 15, 2004

The dental school would be cheap, but one I looked at here in Chicago said that appointments for a simple cleaning can take 3 hours or more because of the increased learning time of students. I don't think that the long time in the chair is going to help his nervousness.
posted by agregoli at 9:57 AM on November 15, 2004

I haven't had dental insurance for the last seven years. I still go a couple times every year for cleanings. As long as I'm willing to whip out the checkbook at the end of the visit, no one cares if I have insurance. Now, if you're looking for a dentist who would be willing to set up payments... well, that's a different story. The only time I was able to do a payment plan was when I had an emergency wisdom tooth extraction, and that was with a dentist I had seen many times previously. I don't think a chip counts as an emergency, but you may get lucky.

The dental school thing SOUNDS like a good idea until you call for an appointment. In this area, anyway, they kind of laugh at you and offer up a free slot in 2007. See, Medicare and Medicaid don't pay for dental, so everyone who has those two forms of insurance try to go to schools and clinics. They are VERY very busy.

I can relate to the dental fear. However, there is a new trend in dental education that stresses pain free dentistry. I haven't seen a dentist in the last 10 years that didn't take every precaution necessary to guarantee that the pain would be absolutely minimal. Even novacaine shots are pain free now, because they swab my gums with a topical anesthetic agent before injecting the novacaine. If your boyfriend simply announces that he is terrified to the man or woman standing over him in the mask, they will take care of him.
posted by xyzzy at 10:03 AM on November 15, 2004

All not having insurance means is that you have to pay. Not a big deal. Not seeing a dentist for a while is not necessarily a big deal either. I hadn't seen one for two or three years, the dentist looked at my mouth and said it was fine. Chipped tooths are easily fixed by dentists.

Tell him to reeeeelaaaaax.
:-)
posted by xammerboy at 10:11 AM on November 15, 2004

I'd say I'm fairly similar to your boyfriend. When I was a kid, a few dental experiences were just awful, a dentist lost his patience with me due to novacaine simply not working when I was younger (my face would feel puffy, but not numb, it was odd). I also got a nasty flu from a dentist that worked on me while he was sick.

So I avoided the dentist for like 15 years.

Anyway, the key here is to ask around through every friend you got for the most caring, understanding, and patient dentist anyone knows. And when you find someone that everyone says is nice, on the first visit make a big deal about how stressful dentistry is to you. The last three dentists I've had have all been great and have gone the extra mile for me because I warned them upfront.
posted by mathowie at 10:20 AM on November 15, 2004

Also reassure your BF that modern dental anesthetics are outstandingly good. For some reason - mouth chemistry, the makeup of my porcelain - my teeth are a happy hunting ground for caries, but despite many, many fillings, more root canals than I care to remember, and a high sensitivity to pain, it's been at least three decades since I've been seriously hurt by a dentist. Just make sure to tell the dentist you need more until you don't.

But get your BF there. Most importantly for the reasons in remlapm's second graf, but also because you can end up needlessly losing teeth that could have been easily saved.

[On preview, what xyzzy said]
posted by mojohand at 10:20 AM on November 15, 2004

I just heard about a process called "Sedation Dentistry" where they give you a one pill sedative before you come in and then take care of you after that. It might be just up his alley. We'll talk it over and see, although whenever we talk about it, he all but freaks out.

Thanks for all the suggestions, I hope it all leads to less fear and healthier mouths!
posted by agregoli at 10:23 AM on November 15, 2004

I have some level of dental phobia and I usually drag myself in, but it's tough and I sympathize. A few points mostly echoing what everyone else said

- if you can afford to pay, most dentists will take you without insurance, so don't worry about that.
- pick a dentist that specializes in phobic denistry or ones that advertise being pain-free because often that also means "fear free" or they try anyways.
- if you can, make the appointment first thing in the day, get up, avoid coffee if you can [caffeine aggravates anxieties often] and just get to the dentist. explain the problem and go in to hold his hand. have something planned for afterwards that you can both look forward to.
- chat with your boyfriend ahead of time about stress-relieving techniques like meditative breathing, counting to ten, etc. encourage him to speak up about things that concern him at the dentist things like "I'm not numb yet" or "how long is this going to take" One of the things that really differentiates dentists that are used to dealing with fearful patients is that they try in advance to say what they are going to do, how long it should last, and how much it may hurt. they work with you to get you out of the chair with a healthier mouth. Just hearing "this will hurt but not for more than ten seconds" is better than getting stabbed in the mouth for an indefinite period of time.
- I had one dentist who would prescribe a low dose of valium before the appointment for her extra-tense patients [not me] and this helped people a lot. Valerian root or your sedative of choice is a completely acceptable way to deal with going to the dentist [no alcohol though, you'll bleed like crazy]

Good luck!
posted by jessamyn at 10:34 AM on November 15, 2004

Re: finding a dentist. Ask friends/colleagues. You may also want to ask how price (they charge differently), friendliness, efficiency, general comfort zone, etc. Most people will say their dentist is okay or good; some will say s/he's wonderful, etc. Look at the latter.

Re: nerves. If your bf gets nervous, you can ask for nitrous; about $40 a pop where I am. They fit a nasal mask a few minutes before the procedure begins, and off you go. The good thing about nitrous is they switch you over to oxygen at the end and you walk out of there clear-headed (not the same with sedatives).

Re: insurance. No insurance is not a problem for the dentist. No insurance plus no credit card is; take a cc.

Other stuff: As a new patient they might want to charge you for a consult, to get you on the books. $50? They might also do walk-ups though. They might also ask BF for a cleaning, as he hasn't been in years. This will (first time) include x-rays etc. $100-$200. They *may* find a bunch of stuff that needs fixing - the sky's the limit here. But this is individual; some folks can go without seeing a dentist for years and have great teeth; others (like me) can have a complex cleaning regime and still have things fall apart all the time. It's genetic, I think.
posted by carter at 10:38 AM on November 15, 2004

Dental phobia isn't much different from fear of flying, whatever: agoraphobia, or the like. (Particularly because people always say "stop being scared and get over it!" as if that ever helped. Ahem. We know our phobias are unreasonable, but that doesn't make the experience any less real.)

1. Noice-cancelling headphones with nice happy-making (or angry-making) music for use in the chair.

2. Don't show up hungry or caffeinated. Edginess and blood sugar levels add to the anxiety and phobia.

3. In really advanced cases, you can do it just like they do it for flying: first step, a trip to the dentist, then back home. Second step: actually go in the office. Third step: Take a look at the dentist's chair, panic, go home. Come back a week later. (For phobic flyers, the first step is a trip to the airport. Usually you don't even go inside.)

4. Drugs, baby, drugs.
posted by RJ Reynolds at 10:40 AM on November 15, 2004

At my dentist, you can ask for laughing gas even for minor procedures. It's $50-80 more I think, but man, is it worth it.
posted by GaelFC at 12:52 PM on November 15, 2004

Like some others, I had a crippling dental phobia for many years -- so I just didn't go for at least 10 years (maybe 12). What motivated me to change was that I finally had the opportunity to get braces and jaw surgery (which I'd wanted for awhile), but knew that I had to have my teeth in much better shape to move ahead.

My first couple of forays into dentists were not great, but not nearly as terrifying as I imagined (largely because I was only in there for cleaning, not drilling - which is the thing that absolutely terrified me). They seemed vaguely impatient and irritated that I had any fear at all, although one at least let me bring a friend to (literally) hold my hand.

Finally, I got a recommendation to see another dentist, who is the kindest, loveliest guy on the planet (any L.A. MeFites who need a great dentist, please email me and I'll give you his info). He asked me specifically what frightened me, which I'd never thought about calmly (in this order, it was pain of getting drilled [the injection of novocaine doesn't bug me at all], the "smell" of a tooth being drilled, and the noise). He told me I wasn't beng at all silly (it was a mean childhood dentist that had scarred me, too), and reassured me that I would be in total control of the situation -- the moment I felt any emotional or physical discomfort, I could raise my hand and he would do whatever it took to make me feel better. He said I could always have a friend with me (and, in fact, encouraged me to come with a friend for as long as I wanted -- especially if I wanted to take a tranquilizer before-hand!).

I approached my first filling with trepidation -- and it was a piece of cake. Seriously. I took half a Xanax and he gave me a Beatles CD to listen to, went to work, and I felt nothing. The sound was much less jarring than it was when I was a kid, and the topical novocaine that he gave me even before the shot had a vague bubblegum scent/flavor that helped mask the smell of the tooth stuff whizzing out of my mouth. I now genuinely look forward to my appointments with him -- something I could never imagined in my wildest dreams feeling a year or two ago! (And I pay out-of-pocket as well -- my company switched dental insurers, and he's not on it anymore. A cleaning runs about $89, and a filling runs about $150.)
posted by scody at 2:10 PM on November 15, 2004

I hate the dentist's office. It's really not so much fear as hatred. I've never had anything more invasive than a deep -cleaning (well, except for one cavity when I was 6), but cleanings are always ridiculously uncomfortable for me, not necessarily painful, but at the same time agonizing. Sharp hooks scraping relentlessly around all the contours of my teeth do not compose my idea of a good time.

But the worst part of all is the doggamn hygienists. I floss. Daily. Mercilessly. Faithfully. Properly. I brush my teeth and massage my gums with the best dental implements a perpetually broke twenty-something's money can buy. And I get my cleanings just as regularly as the dentist prescribes. Yet every time I'm under the hygienist's hook, orally unable to express my model dental practices or my present displeasure, I am subject to the most evangelical lectures about the evils of plaque, the need to floss ever more often (at least three times a day, the last one said), the unending tortures of the toothless life.

The lectures kill me. I'm only barely post-collegiate, so I've moved around too often to have a regular dentist/hygienist, and I'm too cowed by the hygienists to state my hatred of the lectures beforehand, although I vow to do so at my next cleaning.

Hate.
posted by grrarrgh00 at 2:32 PM on November 15, 2004

Is Evanston too far for you guys to travel? If not, the absolute nicest dentists around are the Fischls, in the Carlson Building at 636 Church. Dr. Marie in particular has got to be the most accommodating, thoughtful, kind, soft, gentle, and concerned dentist I've ever met. She offered me a CD player and headphones when I went to get two fillings done, stops what she's doing instantly if you express any fear, pain, or worry, starts her first appointment with you by just having a normal non-teeth conversation, and is always asking what she can do to make you more comfortable as things progress. I HATE dentists. I have no insurance. And I love Dr. Marie.

I was there just this morning, and they're always open for referrals by current patients. Just let me know if you need one.
posted by picopebbles at 3:02 PM on November 15, 2004

i have a very good dentist in dupage. a bit of a drive, but he's very calm, explains everything in great interesting detail. his hygenists don't lecture and he sees patients without insurance all the time. don't know if he'd let you go back and hold the boyfriend's hand, but i would not be surprised if he did. send me an email and i'll send you his #.
posted by crush-onastick at 3:08 PM on November 15, 2004

Oh hey, we're in the same zip code. First Family Dental on the corner of Clark and... something (not Foster, a street or two further north) is cheap ($45 for a cleaning! Plus they give you three free toothbrushes). They also use electric scrapers so that part goes really quickly, which should help alleviate fear somewhat -- less time in the chair, less time to panic. Also the cleaning part will hurt less. And they have TVs above the chairs so he can take his mind off the visit by watching TV. They give you a remote control, too.

I've only had cleaning done there, but my SO had a crown replaced and I don't think he had any issues. They definitely don't require insurance. You can email me if you want more info on the SO's crown replacement. Or if you want to go out for a drink after the appointment. :)
posted by jennyb at 3:45 PM on November 15, 2004

Damn, you're voodootoaster.com. You have pictures of my apartment building on your website. Neat.
posted by jennyb at 3:54 PM on November 15, 2004

You must be my next door neighbor, literally. Small world! Thanks for the advice. I'm going to talk over these options with my boyfriend.
posted by agregoli at 7:38 AM on November 16, 2004