Seeking Encouragement About the Fate of My Teeth

May 31, 2007 10:29 AM

Due to some psychological issues, over the last one to two years, I've brushed my teeth ... well, probably no more than ten times, total. Having somewhat exorcised whatever little demon caused this neglect, I'm now trying to work my way back to dental health; I need some encouragement that the next step isn't going to be dentures. As always, there's

Don't ask me why I neglected my teeth for so long; I'm not sure I could tell you. There were certainly some self-esteem issues involved, as well as issues of hiding from the world and making myself unattractive. Also, I perfectly understand that this may engender a really big "ewww!" factor, but the reaction's not helpful to me. Neglecting the most basic of basic daily maintenance routines is a symptom of depression; that's just how the dice hit the table with me. Sorry.

Basically, I'm looking for two aspects of recommendations from the Mefite community.

First, I'd appreciate recommendations with regards to equipment. For toothpaste, I'm thinking I'd get one of those brands that are supposed to address gum problems and/or enamel issues. Is one of those subbrands better than the other? (i.e. is Crest 'Everything and the Kitchen Sink' better than Colgate 'Super Duper Miracle Gums'?) And I have no idea what brand toothbrush would be best. I'd appreciate recommendations for both manual (for now) and the fancier kind (for later) ... I've heard good things about Sonicare. Is it worth the $120ish?

Second -- and this is the primary question, the reason I ventured into Ask Mefi, albeit anonymously -- I'm looking for reassurance from people who've had the same problem and rescued themselves, or from any Mefite dental professionals. Namely, I'd like any reassurance you can give (a) that I can get to a point where a dental visit won't equate to a visit to Guantanemo, and (b) that it's unlikely that my next step will be dentures, i.e., that it's not likely that I've wrecked my mouth altogether.

The plan is to twice daily prerinse with Plax, then brush, and then follow up with Listerine. I'm going to follow this routine for three months, during which time I'm going to look for a good dentist. (I know — flossing. I'm not going to worry about that for now. I hate flossing, because I've got these huge-ass fingers that I can't navigate in there with. And those little hand tools never seemed to work at all for me. I'm hoping the double-rinsing will do enough for now. I think flossing frustration might've been part of the derail in the past.)

I know you can't see my teeth or gums, but there aren't any major twinges or pains bothering me. I don't see any cavities, although I'm not entirely sure what to look for. The worst I can see is that my gumline around the bottom incisors has pulled back a slight bit, and there's one spot near one tooth where the gumline looks a bit darker (I think it might be periodontitis, if I understand the term right), and there's some heavy tartar deposits on my bottom cuspids.

(Also, I know age might be a factor in answering this question. I'm in my early thirties. And I had good dental maintenance up until a few years ago, and my teeth were sealed with flouride when I was a child, which, from what I understand, is a plus in terms of adult tooth health.)

Thanks in advance to anyone who worked their way through this rather yucky query.

posted by anonymous to health & fitness (48 answers total)

Get to the dentist, now. I've got a friend who's a dentist, and trust me, they've heard and seen far worse horror stories. It is amazing what a dentist can do.

Don't worry about self-care, at this point; your main priority is to get to a dentist. They see this stuff all the time. It is widely known that neglect of teeth is a symptom of depression, etc.
posted by jayder at 10:38 AM on May 31, 2007

You should go to get your teeth cleaned by a professional. Tell them you haven't been in a while and need a "super cleaning" (at least that is what they call it at my dentist). Dental hygienists are professional and have seen very plaquey and dirty teeth.

You will not be able to get them cleaner on your own. Go and get them cleaned and then start on a routine of brusing and flossing.
posted by sulaine at 10:40 AM on May 31, 2007

I have so much encouragement for you!

After 12 years of neglect due to a phobia about dentists (due to childhood bad stuff) I recently got my shit together, bit the bullet and went back into the big chair.

After those 12 years my teeth were a rotting, stinking mess, literally. I was crying the first time I went (I am a 30 year old man) and had to be Valiumed to stay in the seat.

I was sure I would need dentures too and although I did need a lot of work dentures are still way off in the future, I needed about 12 fillings, two root canals and 3 crowns BUT I did it and learned a few things in the process:

1. I am not a gross person

2. Dentistry has come a long way in 12 years and is much more patient focused

3. I experience nearly zero pain, some discomfort but nothing near as bad as my fears

4. Shopping around for a special dentist who is recommended for tough patients works!

5. Telling myself, while in the chair, that this really isnt that bad, all things considered, helped a ton

I'll probably add more later but I want to post this now so you read it.

It wasn't that bad!
posted by Cosine at 10:40 AM on May 31, 2007 [2 favorites]

Oh, and the dentist recommended an awesome toothpaste, Colgate Previ-dent 5000, you need to as a pharmacist for it but it's helped already!
posted by Cosine at 10:41 AM on May 31, 2007

You might consider one of the tiny little brush things you can now get at the drug store. It's in among the toothbrushes, but it's about 2" long, and the end is kind of like a tiny bottle brush. These are good for cleaning in between teeth, where you're most likely to get cavities.

Since you're not into flossing, stimulating your gums becomes tricky. It's important because otherwise you'll bleed a lot when you _do_ go to the dentist, and you'll also increase your risk of gum disease, gums receding, etc.

This little brush will not fit between all your teeth, but will help in some cases.

Something else you might consider is a Water Pik; this will also stimulate your gums. I use mine occasionally, and especially before going to the dentist. I often dissolve baking soda into the water, believing that it helps freshen my breath. Also, it's kind of fun and it feels good. Your gums will be very tender at first, but this will help them become healthier. Don't worry if your gums bleed a lot at first; they should get tougher after a few days or weeks.
posted by amtho at 10:42 AM on May 31, 2007 [1 favorite]

Speaking of teeth neglect: When I was in grad school, I went several years without visiting a dentist, and was scared shitless when I finally worked up the nerve to go. I was surprised, I had no cavities. Things are often not as bad as you expect.

And with regard to looking for a good dentist --- I would recommend you not spend three months doing so. Going to a dentist would be preferable to being really choosy at this point.
posted by jayder at 10:44 AM on May 31, 2007

Also, bleeding gums usually do not hurt much if at all. At least for me.
posted by amtho at 10:44 AM on May 31, 2007

I just went back to the dentist after an 8 year hiatus (I didn't grow up going to the dentist--it was a matter of money, so I have to constantly learn to make it a habit) and so I kind of understand your problem, although I've been brushing regularly and intermittently flossing.

Anyway.

You need a good, soft toothbrush--Oral-B will not do you wrong. And you need to start brushing your gums. They will bleed for a while but then it will stop.

Toothpastes don't matter: you need fluoride, everything else is gravy. There is not much the anti-plaque, anti-tartar formulas can do for you right now--they're preventative at best but cannot dissolve gunk that already exists. Colgate, Crest, Tom's of Maine: whatever. Just find one you like, taste wise.

And you need to floss. And it's going to make your gums bleed, but eventually, it will get better. The Reach Flosser has made it totally easy to floss, at least for me.

Rinses? Eh. I use Crest Pro Health Wintergreen (the other formula apparently has some staining issues) and like it more than any other rinse I've ever used.

Most of all, make a dental appointment now. You need to get in and get an assessment and a basic cleaning immediately. Talk to the dentist before you go, if you can--explain that you're looking to be proactive. Get dentist recos from friends.

Honestly, there will be some pain and discomfort but it's all for the good. You're making a change now and that's important.
posted by gsh at 10:47 AM on May 31, 2007

Dentist. Now. The longer you wait, the more likely something serious will be wrong. That's true even if you start taking perfect care of your teeth today and flossing 18 times a day and gargling with mouthwash continuously for three months. See a dentist as soon as possible.

I promise you, any dentist you see has seen worse teeth than yours. If it makes you feel better, you can lie about your oral hygiene habits. But get to the dentist as soon as you possibly can.

It is unlikely that you have wrecked your teeth forever. I am not a dentist, but I have pretty crappy teeth and I've had a lot of dental work done myself, and my dentist told me that he almost never pulls teeth in patients younger than 50 unless their teeth have been damaged due to injury, medical procedure (some medications apparently rot teeth like crazy) or hard drug use. However, if you need fillings, root canals, etc., you can't fix those problems by brushing and flossing, and waiting will only make them worse. Waiting will mean more pain, not less. Dentist. Now.
posted by decathecting at 10:52 AM on May 31, 2007

Dental care doesn't hurt as much as it used to. I just had a root canal and it didn't hurt. Honest.
posted by Comrade_robot at 10:54 AM on May 31, 2007

Oh, and if you have serious dental phobia, ask about sedation dentistry. That's where they give you gas to knock you out, even for cleanings. It makes going to the dentist a little more complicated, but may be worth it if it gets you to go.
posted by decathecting at 10:55 AM on May 31, 2007

I can certainly empathize with you - I didn't go to the dentist for six years and when I went, I had an alarming number of cavities. (It's genetic - I actually did and do brush my teeth twice a day.) The thing to do, as everyone has pointed out, is go as soon as you can. Don't think about it, just call and make the appointment. When you get there, explain that you were unable to get to a dentist for a few years and are subsequently feeling a bit nervous. I'm sure they will treat you gently - psychologically and physically. :)

Equipment-wise, Act is widely considered to be one of the best mouth washes b/c of the fluoride. I would recommend you start using it.

And if you have some money to invest, I would strongly recommend you get one of the Sonicare toothbrushes. They are definitely expensive, but seem to be popular with dentists. (Everyone in my apartment has a different dentist, but we were all told to purchase one.) I really like mine and my sister said she noticed a real improvement in her gums after a few weeks.
posted by anonymous78 at 10:56 AM on May 31, 2007

I opted out of going to the dentist for most of my 20's, and wasn't too good about the rest of it. When I finally got around to it, I had lots of problems. The dentist I got was very, very good. He said one of them had to go, but the rest were saveable- including some that looked terrible.

I spent about 9 months with a lot of dentist visits. 25 years later, I haven't lost any more (even though I still didn't do everything like I shoulda). I still needed lots of maintenance, being a major soda drinker. Many of the fillings had to be capped.

I think most dentists these days don't resort to dentures unless absolutely necessary. Find a good dentist. Ask around in your town.

I would recommend the Oral-B electric. As far as toothpaste, I use regular old Crest from my childhood. My dentist has me on a prescription of flouride toothpaste. I like the Listerine (one of the green ones, NOT the original), but it may be too harsh for me. I've been using Crest Pro-Rinse. Flossing I do (like Ellen DeGeneris says) religiously- Easter and Christmas.

Last three checkups- no cavities. I think it's a personal lifetime best.
posted by MtDewd at 10:56 AM on May 31, 2007

I had a long period of poor dental hygeine as well, and I finally went back to the dentist this year. I wasn't brushing for a variety of reasons, one of which was shame for having bad breath (ha ha). And I had never flossed regularly, due to the opposite problem that you have: my mouth is pretty big and I couldn't reach all the way back in there to get all the teeth. Well come to see I had six cavities that I didn't know I had. A wisdom tooth was pretty well rotted in the back. But they popped that one out, and filled the holes in the others, cleaned me right up and put me back on the road. It was all pretty painless (terrifying, paralyzing, but not painful), they were 100% cool with me. Now I brush and floss regularly now, and I don't want to retch at the smell of my pillow in the morning. I'm 29.
posted by pamccf at 10:56 AM on May 31, 2007

You do know that in Africa, people go their entire lives without brushing their teath or visiting a dentist. And they have perfectly alright teeth. So nothing to worry about, just visit the old guy at your leisure.
posted by markesh at 11:03 AM on May 31, 2007 [2 favorites]

Nthing a lot of everything above me... get thee to a dentist, pronto. Believe me, they've seen worse. If you're going to do all this work now, it's *so* much better to start with a clean slate, so to speak.

My dentist also recommended Prevident toothpaste. It's expensive, but it makes a difference. And a mouthwash that was heavy on the flouride, but I can't remember what brand it was.

Get an electric toothbrush. My dentist commented on the improvement in made in my brushing habits within a matter of weeks.

If you do have cavities, ask about "sedation dentistry". In a nutshell, they give you a valium-like pill (mine was halcion) and although you're not completely out, you really couldn't care less about what they're doing, and chances are you won't remember a thing either. I actually fell asleep during a root canal...
posted by cgg at 11:06 AM on May 31, 2007

A couple of years of neglect with no pain and no obvious rotting? I think you'll be just fine. What yuo shoud do is get a dental appoinment now and in the few days before your appointment just start brushing. In a few days your teeth will just look like average bad teeth. You sound American so you've been getting a big dose of flouride every time you drink tap water.

I really doubt there's a DIY fix here as you dont have the tools the hygenist has nor do you know how to use them.

But if you want to wait 2 or 3 months, I'm sure it wont be a big problem, but the end result may be just as ugly as brushing for a week. Perhaps a good lie is in order. Say you've been out of the country and living rural and did not have acccess to 1st world products. A turkish prison perhaps. No one wants to hear stories about a prison. When youre alone with the dentist you can tell him the truth if it makes you feel better. Good luck!
posted by damn dirty ape at 11:06 AM on May 31, 2007

I was in a somewhat similar situation two years ago, after many years of major dental neglect. I'm pretty much all cleared up now, and no dentures were involved. I had to have a cleaning and scaling, and several cavities filled over the course of a couple of visits, but it wasn't major and it wasn't nearly as scary as I'd feared. You'll be fine, really!

One thing that might be useful to know - while I do have a much better dental care regimen now, my dentist told me that it wasn't really going to help things until after I had that first professional cleaning, to clear out all the old plaque so my at-home routine could work. So if you can manage to get yourself past the phobias, you might want to go sooner rather than later - it's possible that your at-home regimen isn't going to be effective until you've had a good professional cleaning to get you to a good starting point.

Once you're all up to speed with cleaning and any fillings, etc., your dentist will probably recommend more frequent cleanings than usual for a year or so - I was going in for three-month cleanings instead of six-month for a while. But then you will be right back on track, your teeth will be fine, and it'll be as if the whole scary dental-neglect mess never happened. And you'll be really, really relieved that you finally got it dealt with.
posted by Stacey at 11:07 AM on May 31, 2007

Even if some of your teeth are in such bad shape that they need to come out, they will probably give you a dental implant. I got one as part of a root canal (which you probably won't be getting - trust me, you wouldn't be putting off going to the dentist), and I can't tell it apart from my natural teeth.
posted by yohko at 11:09 AM on May 31, 2007

I wrote a lengthy reply, but, on preview, most of it was covered. A few things I'd like to stress:

- Flossing is really quite important. I used to neglect it, for the same reasons you do. Trust me, it'll save you quite a few fillings.

- I'd recommend visiting the dentist sooner rather than later. It'd be like if you were going to visit the doctor because you had major health issues, but decided to wait until you had started an exercise regimen and a new diet. The dentist can do better than you can, and can surely give you advice on how to go about it.

- Start today! I could be completely wrong, but your 'plan' sounds a lot like mine--well-structure, and something that'd be great if it was carried out. But every day, I vow to start it tomorrow. And then the next day. And the day after. If you're anything like me, start today or you never will. (It's better to start today and do a mediocre job than to wait to do a great job tomorrow.)

- There's totally hope for you! I doubt your situation is really that uncommon, actually.

(I'm pretty sure that, in Africa, they don't drink liters of soda a day and chew on candy all day. And actually, I'm going to be visiting an African orphanage this summer, which is trying to get a dentist on-site because of the appalling state of most peoples' teeth.)
posted by fogster at 11:09 AM on May 31, 2007

Make a dentist appointment for a few weeks from now and
START FLOSSING. I highly recommend mint flossing tape.

If you maintain a flossing regimen faithfully for the next few weeks, your visit to the dentist should be much easier.

Floss at least twice a day. Rinse w/ Plax. Brush 3x/ day.

Do not skip your dentist appt and do not fret over what they say- they see everything.

If you maintain a flossing regimen faithfully for the next few weeks, your visit to the dentist should be much easier.

Do not worry if your gums bleed at first. If it's painful- do it slowly and gently- but you want to get into the spaces not just b/w individual teeth, but b/w your teeth and gums. Gently!

Good luck.
posted by mistsandrain at 11:11 AM on May 31, 2007

The Reach Access flosser makes it much easier to get at the back teeth. My teeth are very closely spaced, so the thicker floss can be tricky for me, but this system really does help.
posted by Rock Steady at 11:16 AM on May 31, 2007

Well, everyone else has said what I was going to say, but make a dentist appointment as soon as possible.

But, do put some time into asking around for a GOOD dentist. I've had BAD dentists, and they are the reason people hate going to the dentist.

If you're anywhere near Saginaw, MI, go see Delynn Shattuck. She is the best dentist I've ever had. If you're anywhere near Philadelphia, see Deborah Backiel, the second best dentist I've ever had.

Good luck!
posted by misanthropicsarah at 11:19 AM on May 31, 2007 [1 favorite]

I'm sorta the polar opposite of you (remember that scene in Little Shop of Horrors, the guy played by Bill Murray? That would be me). Here's my favorite OTC dental equipment (note: none cause pain).

The SonicCare Elite. Idiot-proof brushing and well worth the price. By far the most effective brush I've tried--I really have tried them all--the cheapo battery-operated jobs sold by Crest and Oral-B simply do not compare. Just hold it to your teeth and it hums at you when it's time to move the brush to another section of your mouth. Angle it up toward your gums for maximum effectiveness.

The Oral-B Hummingbird. For those who hate to floss. The vibrating toothpick is awesome, and for flossing newbies, it will show less blood than string floss. It's fun, cheap, and if you end up hating it, you can use it as a lock pick. If you love it, you'll find yourself lovely poking it in between your teeth at every opportunity.

Tom's of Maine Naturally waxed flat floss. For slipping into your pocket when you don't want to stick a tiny vibrator into your mouth in public. No cloyingly gross fake-mint flavor and the flattened shape allows you to deftly scoop around your teeth where they sink into the gums.

Listerine Agent CoolBlue Plaque-Detecting Rinse. I stole this from my kid: you brush, rinse with CoolBlue, spit it out and then smile in the mirror. Any spots you missed will be highlighted in screaming neon blue. Repeat brushing. Sadly, this product is under a voluntary recall so it will be temporarily difficult to find in stores, but if you do find a bottle, store it in the fridge.

Don't worry about your first visit to the dentist. When calling around to find out, explain right up front that you're a little shaky in the chair and you are looking for a practice that will be sensitive to that and when you choose a practice, make sure to tell the hygienist about your fear as soon as you sit down. A good practice will listen to you.

Finally, an anecdote: A friend of mine avoided dealing with his mouth for years, when he finally went in he got very angry afterwards because he said "The dentist made a bunch of holes in my teeth!" Turned out, those were the natural gaps between his teeth that his tongue was feeling for the first time in decades: the hygienist had to take out a *lot* of built-up plaque. Don't worry: the dentist has already seen it all.
posted by jamaro at 11:23 AM on May 31, 2007 [4 favorites]

Last time I looked up a peer-reviewed clinical study of electric toothbrushes, it said that there was no significant difference in the effectiveness of the cheap supermarket brands vs. Sonicare, but the Sonicare caused more bacteremia. Yuck.

Glide floss is easier to use, IMHO. You need to floss. Really.
posted by grouse at 11:49 AM on May 31, 2007

I'm also terrible at getting myself to the dentist, but I have good news for you: you are not going to need dentures. Unless you are seriously misreporting, you are just someone who has neglected your teeth for too long. Good for you for getting on it! I pretty much agree with what people have said with a few add-ons

- Get a dentist, get a dentist who is good at dealing with people with dental anxiety. Go to an appointment. If you don't like the dentist, pack up and go to another one, it's easy and it's no big deal. Keep in mind that pretty much at any time if thigns are upsetting or not working out, you can just walk. Granted this shouldn't be something you need to resort to, but you also shouldn't feel trapped in a relationship with someone you're not comfortable with. I have had good and bad dentists and I go to the good ones more.
- Find a way to floss. Get one of those little flosser pick things or the bottle brush picks that amtho mentioned so your hamhands don't matter. Find some time to do it, it doesn't even have to be tooth-brushing time. My sister and her roommate made a team activity out of it, they'd idly floss while watching a certain TV show.
- Simplify. Find a regimen you can keep to even if it's just brushing in the morning or night. An easy way to sort of overdo it is to develop a complicated regimen and then not do any of it. I recommend a few levels of tooth care where the basic level [brush twice a day] is MANDATORY and the rest is a good idea. If you're in bed and you think "shit I forgot to brush" get out of bed and do it. If you run out of rinse, get it the next day but still brush.
- I have a radius toothbrush that has made the difference for me with wanting to brush and not. I had a sonicare but it was too many parts and scared my cat.
- If you like to read about dental care in a non-scary way, see if your library has the very outdated but also very straightforward book The Tooth Trip. It talks in plain anguage about dental health and is reassuring, I think, to all but the most serious cases,.

In short: good for you. Now, set yourself some reasonable goals [will call dentist next week, wil brush twice a day, will floss during LOST) and do whatever it takes to make it happen. Good luck!
posted by jessamyn at 11:49 AM on May 31, 2007 [1 favorite]

I'm in love with my Sonicare, although I have the same type of avoidance issues that you have had. The Sonicare not only leaves my teeth smoother than any other toothbrush I have used, but also is very soothing. It has a nice hum to it that lulls me into using it for the entire timed two minute cycle (which is another reason I love it, otherwise I would only brush for 30 seconds). It's totally worth the money, and it will last for quite a while. I've had mine for three years. My mom goes through about one a year or so, but she travels with hers (all over the world) and beats it up rather badly.
Good job deciding to work on your issue. I'm still trying to address mine, so your question is rather helpful and inspiring.
posted by nursegracer at 12:06 PM on May 31, 2007

I have to join the pile-on to say, get a dentist and go as soon as possible. You cannot rectify the problems caused by neglect of your teeth with normal dental hygiene, and potential problems (cavities) could get much worse. You will save the most time and money and in the long term, your teeth by getting a professional cleaning and starting a normal routine of dental care now. You don't need to explain your mental dental issues to your dentist, you can just say yeah, I really neglected my teeth the last few years but I'm working on it now.

Your dentist can assist you with working out flossing or some substitute as well. You can't have a complete program of dental hygiene without it. The fact is that you are still being weird about your teeth and you need to go the extra mile and do the intelligent things.

I've seen a friend and experienced myself going through a period of long term dental neglect (well, I brushed more than you, but no dentist for multiple years). You'll be fine - my friend held out until he was in constant tooth pain, and got by with no worse than a few root canals - no fun, but much, MUCH better than losing teeth! Go to the dentist!
posted by nanojath at 12:11 PM on May 31, 2007

Worst case scenario after two years, you'll have a couple cavities and need a root planing. I'm in my mid-30s, brush twice a day, only go to the dentist every 6 years or so, have never flossed in my life and have never had a cavity. Did have to get a root planing once, though.

More importantly, you've talked to a psychologist about your hygiene issues, yes?
posted by M.C. Lo-Carb! at 12:36 PM on May 31, 2007

(I know — flossing. I'm not going to worry about that for now. I hate flossing, because I've got these huge-ass fingers that I can't navigate in there with. And those little hand tools never seemed to work at all for me. I'm hoping the double-rinsing will do enough for now. I think flossing frustration might've been part of the derail in the past.)

I think your wasting your time and everyone elses if you're not willing to go 100% into this. A half ass attempt to fix the health of your teeth is not going to help you. Flossing is not "just a part" of healthy gums and teeth its a HUGE PART. Ask ANY dentist. Do it right or stop worry about the results.
posted by crewshell at 12:45 PM on May 31, 2007

Unlike many of the respondents above, I also didn't brush my teeth for a significant amount of time.. mainly because I felt I didn't need to, but eventually it culminated in a LOT of pain. I went through some of the same stages you appear to have.

The only thing I can say to convince you to go is.. you WILL get a LOT of pain if you keep this up.. so much so that you'd consider shooting yourself in the head a great remedy in the worst of it. Toothache, at its worst, is THAT bad. So.. get it sorted now.

A good dentist will cause you no (or little) pain and it sounds like you can still be rescued. I was, and it's been an excellent experience. I now clean every day, feel great, and it all worked out well.. and I even seem to have better teeth than most people I know! So.. get to the dentist, ignore the crazies who think having your teeth out and living with dentures is acceptable, and avoid a whole ton of physical pain.
posted by wackybrit at 12:50 PM on May 31, 2007

And read this amazing site. It teaches you so much about dentistry, what they do, etc.. it's very reassuring and goes into the whole process. It's not as bad as it seems without knowledge.
posted by wackybrit at 12:50 PM on May 31, 2007

I'm a fan of the Sonicare as well, and you can get the basic models in the $60-ish range if you shop around a bit.

No matter what kind of brush you choose, brush your teeth for a full 2 minutes. I think the 2-minute timer is a big part of the "secret" of the Sonicare performance. If you're not brushing long enough to get bored, you're not brushing long enough.
posted by altcountryman at 1:03 PM on May 31, 2007

A couple of recommendations that have not been covered above:

1.) When you call to make the appointment explain that you might need extra time for a cleaning.

2.) After your check-up book your followup check-up right then. It's too easy to blow it off and postpone it. If it's already on your calendar in 6 months you don't have to do anything extra.

My product recommendations which have been covered above: Colgate Total toothpaste, Sonicare toothbrush, Glide floss (makes a HUGE difference if your teeth are spaced closely together). I usually dab toothpaste onto the length of floss for extra mint-y goodness.
posted by Soda-Da at 1:10 PM on May 31, 2007

I think you're overestimating the grossness-factor here. Once you brush your teeth a few times, you're just going to have an excess of plaque and maybe a few cavities. Nothing whatsoever a dentist hasn't seen before. None of the above responders have been grossed out - and believe me a dentist, who's a professional, won't be either.

If you absolutely aren't ready to go to a dentist, at least get an electric toothbrush. My dentist had me get one when I had braces and use it on a timer for, I think, at least 5 minutes. He said they get your teeth cleaner than manual brushing. Plus, get one of those smaller attachments for cleaning between your teeth as best you can.
posted by hazyjane at 1:33 PM on May 31, 2007

(I know — flossing. I'm not going to worry about that for now. I hate flossing, because I've got these huge-ass fingers that I can't navigate in there with. And those little hand tools never seemed to work at all for me. I'm hoping the double-rinsing will do enough for now. I think flossing frustration might've been part of the derail in the past.).

Please floss!!! Last week I went to the dentist after a few years of avoiding it. I brush my teeth every day and I rarely eat sweets. Looking at the surface of my teeth my dentist complimented them and thought I was doing a great job. Then she got to the xrays and found tons of decay between them. Enough to require several visits and a couple thousand dollars worth of fillings.

I hadn't been flossing because I just didn't like it. My mouth is small and it's awkward to get my hands in there. I still don't like flossing, but wow, did I ever learn my lesson - I do it anyway now.
posted by jheiz at 1:57 PM on May 31, 2007

During a period of deep depression, a relative of mine went through a similar boycott of dental care. He went to my dentist because I swore the dentist would be totally supportive. When he called to make the appointment, he briefly said he had neglected his teeth and gums and that he didn't want any guilt, but only encouragement. He was prepared to just walk out at the first hint of negativity, but the dentist was completely positive.

And with good reason. A person can drastically improve his/her gums by doing a combination of things: professional cleaning, brushing, flossing, taking vitamin c and using anti-bacterial mouthwashes. I HATE flossing, but there are devices that make it a lot easier.

Please don't wait. The plaque below your gum line needs to be removed. Once it's gone, your efforts at home will mostly be aimed at preventing new build-up, and with encouraging your gums to get back to their old pink selves.
posted by wryly at 2:04 PM on May 31, 2007

I think my Oral B / Braun toothbrush is wonderful. The time spent sitting in the chair is much shorter now -- cleanings go by faster. Consumer Reports says there's not a big benefit to electric toothbrushes over manual, other than that people are more likely to brush the full two minutes when they use them.

My dentist told me there's not a big difference among the various brands of toothpaste, so long as they have flouride and are ADA (if you're in the US) - approved. Oh, and she doesn't recommend baking soda ones.

When you call to make the appointment, tell them you're nervous. Tell them you're frightened. Tell them you might need multiple appointments to get it done. I'm a very nervous dental patient (to the point of tears), and I've never had a dentist or hygienist act like I was odd.

If you're really terrified and need a lot of work done (although it doesn't sound like it), it's possible to have the work done under a general anesthetic.

If, by any chance, you're in the Seattle area, feel free to e-mail me for a recommendation -- my current dentist is great.
posted by The corpse in the library at 2:42 PM on May 31, 2007

You might want to avoid whitening toothpastes (which are everywhere) for a while... they can make your teeth sensitive.
posted by IndigoRain at 2:45 PM on May 31, 2007

And read this amazing site.

Wow, thats informative but chock full of disturbing photos.
posted by damn dirty ape at 2:48 PM on May 31, 2007

Wow, thats informative but chock full of disturbing photos.

Yeah, though I found that reassuring.. if people with freakishly bad teeth like that can end up with them looking like new with only minor surgery.. then my teeth must be really easy to sort out! (and they were :))
posted by wackybrit at 3:31 PM on May 31, 2007

I neglected my teeth for a long time too (extreme phobia combined with depression), and didn't go back until I had the mother of all toothaches and had no choice. I felt like my head was going to implode. After an initial visit to the dentist, a subsequent visit to an Oral Surgeon for an extraction, a few more visits to my regular dentist for scaling, a root canal, and a filling, I have an okay set of choppers.

The scaler treatments were a little rough for me, but nothing that a good mix cd or ipod full of tunes can't help you through. They did mine in two appointments. I tell you, the feeling after that scaler though was incredible... well worth the effort to stay in the chair.

If you have to do oral surgery, I highly recommend the gas and general anesthetic. I found the initial nitrous high quite exquisite. The surgeon could have cut of my arm and I wouldn't have cared. Very, very good stuff. Of course, your mileage may vary.

Regarding flossing... I was really bad about it too, until I discovered the Reach Flosser (as mentioned above). I have a half dozen of the handles scattered around various touch points in my daily life (1 in my desk at work, 1 in my truck, 1 at my desk at home, 1 in the bathroom, etc...). This way, whenever I think of it, I can floss. My most productive flossing time is during my commute to and from work.

Toothpaste: try a bunch and find one that tastes good (and is ADA approved). I use the Crest Pro Health because the mint isn't too sharp. My dentist says it's fine... and I can't argue with him.

If you're in Richmond, VA, Tom Cooke is a heck of a guy and has an office in the East End, as well as the West End.

Just keep in mind, It's really going to be okay as long as you start moving in a productive direction.

Best of luck.
posted by friezer at 3:33 PM on May 31, 2007

Wow, anonymous, wackybrit and askmefi! Thank you for this very timely info. My sig other is having the same issues, but much worse. My mother just offered us $10,000.00 to have his teeth fixed. (If it sounds like a lot, take a look at some of the "before pics" on wackybrit's link. It is gonna take every penny of that.) My SO was leaning toward dentures, and I thought that seriously might be the only way to go. I can't tell you how much I am encouraged by your link, wackybrit. Thank you. Oh, and thank YOU, Mom!
posted by thebrokedown at 3:48 PM on May 31, 2007

I'm surprised not to have seen more recommendations for the Waterpik. I love mine. It's packed up in my parents' garage (complicated move, long story) and I miss it horribly. It's loud but feels great and really cleans the betweens.

Also, I just ran out of Glide and went back to using regular floss and I had forgotten how much flossing totally sucks.

I put off seeing a dentist for about four years (student, bad dental insurance, etc) and had a cleanish bill of health. They said I had one tooth that would probably develop a cavity in the next five years and they could knock a hole and fill it now, or wait and fill it later. I opted to wait.
posted by crinklebat at 8:01 PM on May 31, 2007

Doesn't sound like you're in very bad shape. Dental caries hurts; if you needed to have all your teeth pulled you'd be in some pain.

I've been toying with the idea of making an FPP about these sonic toothbrushes (I use a Sonicare Elite myself) but I can't figure out how to do it without it degenerating into either a collection of PubMed abstracts or a bunch of toothbrush-manufacturer websites. The data's pretty compelling; if you use the sonic toothbrushes right they keep plaque off under the gumline, even while they are abrading your enamel less than regular brushing does.

You need to go to a dentist now, though. Don't worry what the dentist thinks of you; the dentist thinks what you and I think, which is that you deserve to have good oral health. The reason you need to start with the dentist is that the calculus and tartar that has accumulated needs to be scraped off first in order to enable you to keep the teeth clean afterwards.

You should figure out a way to floss, too. Most people overthink flossing and think they have to do a 10 minute dental detailing twice a day. Probably dates from those commercials with the dude with the Oral-B voice intoning, "Then, form a C." No. Just jam the floss down to the bottom of the gap in between each tooth, twice a day, and call it quits. Takes like 30 seconds.
posted by ikkyu2 at 11:20 PM on May 31, 2007

Yeah, I did the same thing. Didn't go to the dentist for about five years - didn't even brush my teeth most of the time. In my final year at university the NHS (I'm in the UK) decided I was poor enough not to have to pay any medical charges so I finally went. My dentist told me I should have come sooner because it would have saved me time and money in the long run, but that was the only negative comment he made. I needed three fillings - one I knew about, the others were a surprise as I didn't have any pain - and two root canals, but the teeth needing that were literally falling apart so I expected it. I also had two wisdom teeth removed. Got it all done free over a period of about two months - went to the dentist once a week and they'd prep for a crown or do a filling. It was fine. A bit boring after the fifth session of sitting in the dentist with your mouth wide open looking at the ceiling, but that's about it. And I had everything on the cheap - no gas, just injected local anaesthetic. I care for my teeth now - I have to pay for treatment and if those crowns get damaged I've got to pay some ridiculous sum to get them replaced.

After everything was fixed it was a minor revelation - I'd gotten used to the constant low-level pain that I honestly didn't realise it had hurt me until the pain was taken away. I can now eat ice cream! IT IS AMAZING.
posted by terrynutkins at 3:09 AM on June 1, 2007

Flossing is cool and it works! But not all floss is the same and you need to find which type will work best for your teeth. I have really tightly packed teeth, and I need something with wax on it or else the floss can't get in between my teeth.
I have a Rotadent toothbrush. I have a tendency to be too aggressive with my toothbrush, which was causing my gums to receede. With the Rotadent (or any mechanical toothbrush), the heads spin on their own and do all the work. Rotadent has a great head attachment which is pointy (but made of bristles, so it's soft) and is excellent for getting in between teeth. Their literature shows that the bristles also get under the gum line to get plaque out from under your gums (which is how people get gingivitis and bone loss). I see Rotadents on Ebay all the time and while they are a little pricey, they are totally worth it. I love it!
Good luck!
posted by FergieBelle at 4:24 AM on June 1, 2007

I had both a Rotadent and a Braun Oral-B electric toothbrush. Both broke in less than a year. Each just stopped working for no apparent reason. I never traveled with them, and they just sat on the counter when I wasn't using them. Make sure you get a warranty.

Most dentists will tell you that flossing is much more important than brushing. If you're only going to do one, choose the floss. I'm surprised so many people floss twice a day, though; all of my dentists have recommended doing it just once.

Modern dentistry is nearly painless. My dentist used a laser to replace a filling, eliminating the need for a shot of Novocaine. Didn't feel a thing, just sat back and watched CNN while he performed the procedure.
posted by Thoughtcrime at 3:53 PM on June 1, 2007