I have the worst teeth you have probably ever seen. What can I do about this?
February 1, 2011 1:09 PM   Subscribe

I have the worst teeth you have probably ever seen. Now what?

I was born with weak enamel and saddled with no insurance, resources or even much spending cash until I was in my 30s.
Over time I have lost about four or five rear lower teeth, suffered impacted wisdom teeth, had to learn to talk with a closed mouth and a constant awareness of which angles I allow people to see me talking from so that I can hide my upper front teeth which are all virtually broken like a set of Greek ruins.

Is there any "out" in this? I have finally climbed my way up to making pretty good money (about $48k) but the years of being poor certainly didnt help my credit rating any.

I have seen nothing but horror stories about getting dentures put in and even then I would need to have a lot of teeth pulled to clear the way for them.

I am tired of feeling embarrassed and living with constant anxiety of being "found out" about my messed up teeth.

Sadly, during this entire time I have tried hard to take as good care of my teeth as possible. They were just too weak to hang I guess. I havent really had any issues with them (pain, etc) for the last 4 years or so and they seem to have stabilzed in their decay.

So yeah. I really have no idea what to do.
Im not wealthy enough to get a bunch of nice implants and not poor enough to qualify for some sort of assistance.

I have literally no idea what to do.

I am in California if this helps.
posted by anonymous to Health & Fitness (27 answers total) 11 users marked this as a favorite
You start by dentist shopping. Go in for consultations, see what your options really are. People here will probably give you a good idea of the types of things that can be done, but only a dentist with access to your mouth will really be able to tell you for sure.

Once you have a better idea of what's available, you'll be better equipped to make this decision.

Good luck.
posted by phunniemee at 1:12 PM on February 1, 2011 [3 favorites]

Does your current job provide dental insurance? Or will this be entirely self-financed?
posted by amicamentis at 1:14 PM on February 1, 2011

As far as the daily habits go, you don't say what exactly you currently do. I'd really recommend getting a Sonicare toothbrush, use it at least twice a day (after breakfast and before bed, if not also after lunch), and be diligent about getting replacement brushes on the appropriate schedule. I couldn't believe how much cleaner my teeth were after getting one of those, and the replacement brushes make a difference!

Also, about a year ago I committed to flossing twice a day, along with the twice a day Sonicare. Once you get in the habit of doing that (if you aren't already), it is really easy to do and it feels kind of gross not to. The last time I went to the dentist, my teeth and gums looked so good that they congratulated me with a pair of free movie tickets!

Good luck!
posted by bigd at 1:18 PM on February 1, 2011 [2 favorites]

Start with the basics, a dental exam and X-rays. You know your teeth need a lot of work, but you really need a dentist to take a proper look and figure out what all needs to be done.

If you have Groupon in your area, sign up for it and watch for cheap dental services to pop up. I've seen about one a month come up in Portland, OR for exam, X-ray and cleaning for under $100. Yeah, it's probably going to cost a lot of cash, but it will be worth it in the long run.
posted by Mister Fabulous at 1:23 PM on February 1, 2011

See if there are any dental schools in the area, and have a consultation with them.
posted by spinifex23 at 1:28 PM on February 1, 2011 [1 favorite]

How close to the Mexican border are you? There seems to be a thriving dental tourism thing going on down there.
posted by jquinby at 1:29 PM on February 1, 2011 [2 favorites]

I am so sorry to hear you have suffered with this. I also have a lot of issues related to bad braces when I was younger (making lots of soft spots on my teeth) and inherited weak enamel. I've had seven root canals and several teeth pulled but over many years. I am in my early forties.

Many dental offices/clinics with several locations have their own lower cost dental insurance for a small monthly fee or sometimes just a one-time fee. Call around and find out.

The best thing you can do is go in and see exactly where you stand, and then you can decide where to start. You won't be able to fix everything at once, but I bet that once you get started your self esteem will start to improve right away, and you can't put a price on that! Good luck.
posted by Glinn at 1:34 PM on February 1, 2011

Im not wealthy enough to get a bunch of nice implants and not poor enough to qualify for some sort of assistance.

would you consider dental tourism? people routinely go to mexico, thailand and a whole bunch of other countries to get medical and dental procedures done by us-trained (and often us-certified) doctors at a fraction of the cost they would be in the us.
posted by lia at 1:39 PM on February 1, 2011 [1 favorite]

Just a comment about dental insurance - it generally maxes out at $1500 per year (check your plan) and it only pays half for the complex stuff, so you would get $3000 worth of dental work in a year and they pay half/you pay half. Having had multiple crowns and now starting on implants, I can tell you that $3000 is not going to cover very many teeth. So don't base any of your decisions on whether you have insurance or not, unless your dentist recommends a plan that covers the next 10-ish years, doing a few teeth each year until your mouth looks good again.
posted by CathyG at 1:43 PM on February 1, 2011 [2 favorites]

Seeking out personal recommendations for a dentist is a great way to start. Also consider a dental school for a primary treatment plan. California has 2 in the SF area, 2 in LA and 1 one the IE.

The dental school treatment plan will give you a good base to start. If you are willing to exchange time (a lot of time) for money, then the school may be a good way to go. With that plan in hand you can hopefully find a dentist who has comparable ideas about how to treat you. You may be shuttled into the graduate prosthodontic department.

Not every case can be treated in stages but there are many that can be. This can extend treatment time and also extend the time needed to pay for it. Unfortunately, dental benefits help little for many complex cases. That said, you should be able to maximize your benefits if you undergo treatment over multiple years.
posted by Cuspidx at 1:44 PM on February 1, 2011

Look into going to a dental school where students supervised by dentists do the dental work. Their rates are much more reasonable and they are often open to payment plans. You may need to do the work in phases but it will be worth it in the long run!
posted by maxg94 at 1:49 PM on February 1, 2011

Oops someone walked into my office before I hit post, and Cuspidx beat me to it.
posted by maxg94 at 1:50 PM on February 1, 2011

Ditto the others who have mentioned dental tourism in Mexico. I've heard very, VERY good things about going to Tijuana for dental work.
posted by deadmessenger at 1:51 PM on February 1, 2011

If you are near L.A. and looking for a recommendation of a gentle, affordable dentist, mefi-mail me.
posted by Scram at 1:58 PM on February 1, 2011

A neighbor of mine, who had worse teeth than you describe (holes on top, almost nothing on the bottom, tons of damage), and made a similar salary, AND was terrified of dentists, has gotten implants, caps, repairs, etc., and now has a pretty normal-looking smile. He financed a lot of it through the dentist at pretty favorable rates. (I think they actually finance through a local credit union that we all use anyway.) It took him a few years to pay it off but it was affordable for him, and VERY worth it for his comfort and for his self-esteem.

Definitely shop around and ask about payment plans and things. It IS doable.

(BTW, my grandfather had what was left of his teeth pulled in 1945 while the Navy was still paying for it and has had dentures ever since ... even back then they weren't that bad, and today he finds them really very comfortable! If you do decide on dentures, it's not the end of the world, and they're not that bad when they're properly fitted. But there are so many good non-denture options available these days! Check them out!)
posted by Eyebrows McGee at 2:29 PM on February 1, 2011 [1 favorite]

Check out this Slate series from 2 years ago, and maybe email the writer (June Thomas).

And good luck to you. My parents were among the first in their families out of the hills & hollers and into the middle class, and they had the dental bills to prove it.
posted by toodleydoodley at 2:41 PM on February 1, 2011 [1 favorite]

Use flouride. It makes the enamel of your teeth harder. Use toothpaste with lots of it (check the label) and brush longer, so the flouride is in contact with your teeth longer. Floss. Brush often. Maybe use a rinse or mothwash with flouride.
posted by theora55 at 2:55 PM on February 1, 2011

If you are in SF and need a good dentist for an eval, I can share ours who I actually enjoy seeing after spending about 15 years avoiding dentists at all possible costs.

Start with a consult with one or two dentists, see what they recommend, then see if dental tourism looks like it's something you might be able to swing or interested in.
posted by iamabot at 3:00 PM on February 1, 2011

Have you looked into CareCredit?
posted by elsietheeel at 3:00 PM on February 1, 2011

You're describing almost exactly the story of my teeth. Luckily I never had impacted wisdom teeth, but had similar issues. I still have gaps (had 11 pulled), but have also learned how to make it so that people are shocked to learn I'm missing any teeth.

I'm about 4 years into slowly putting my mouth back together by using any insurance I can when I have it and paying what little I can out of pocket. I was terrified on that first trip in, but I found a dentist who came well recommended and she walked me through my issues and a plan without judging or talking down to me. She also understands money issues and is working with me to put together short- and long-term plans around my budget and schedule. These have been the key factors in me feeling better physically and mentally about my teeth. You should be able to find a dentist who will take a look around for little (or maybe even no if you get lucky) money and let you know what the story is so that you can decide how to go about this.

On the dental tourism angle. I too have heard great things and am not discouraging it, but my uncle very nearly died due to a botched root canal in Tijuana. His resulting US dental bills were thousands more than they would have originally been. I know it's anecdata, just sayin'.

Feel free to mefi mail me if you have questions, etc. I know how it goes...
posted by Clinging to the Wreckage at 3:12 PM on February 1, 2011

The most important thing here is that you start the process.
By and large dentists are trained to diagnose and solve problems like yours. As embarrassing as it might seem to you it is unlikely that you will present with anything like the worst mouth any of us have ever seen.
That being said you should be prepared for this to be a lifelong process. Your diet and behavior may have to change. Time and resources will have to be spent not only on correction of decay and /or gum issues, but rehabilitation of your bite, and long-term maintenance of good oral health (regular check-ups and good home care).
Convince yourself that these investments are worth it to raise your self-esteem, make you healthier, and improve your function and appearance and you will be motivated to take care of your investment.

As far as tourism dentistry goes, I have only anectdotal evidence from my own practice to go by. I also see many patients who come to my office specifically because they can't receive the care in their own country that they can in this country.
Not every country requires the strict infection control that the CDC recommends for practice in the US, and not every country requires strict adherence to materials guidelines. In short i have seen more shitty work than good work in the mouths of patients who have gone overseas and shopped for cheap dentistry. you get what you pay for, and who do you go back to for continued care, adjustments, repairs or replacement if something is wrong?

Get cracking and good luck. I wish you good health.
posted by OHenryPacey at 3:18 PM on February 1, 2011 [1 favorite]

Does your job offer you an FSA account for health expenses? My husband needed 19K worth of dental work; we managed to work it out over four years so that it was all paid for either from the dental insurance or out of the FSA. It's a lot better to pay for stuff out of untaxed real money than it is to finance it and pay taxes AND interest.

Also, another relative had about 120K worth of work done at our local dental school for just a shade over 40K, all told. (She had problems worse than yours. A bad boyfriend had broken her jaw 20 years prior and not let her get it set correctly; they had to re-break it, take out segments of jawbone on each side, pull all her teeth on the bottom save four, plus three of her top teeth, and do bone grafts and implants for every tooth.) Dental schools are often really excited about difficult, complex jobs, because they represent great and unusual learning opportunities for their students. It takes a lot longer, but my god it is cheaper.
posted by KathrynT at 3:47 PM on February 1, 2011 [1 favorite]

Just a comment on the denture horror story aspect of your post.....Mr. Adams suffers from very soft enamel (apparently a genetic trait, as his father and one brother also have the same problem). Despite fastidious dental care over the years (regular dental appointments, as well as regular brushing/flossing at home) his teeth deteriorated to the point where he was loathe to smile broadly in public. What finally coaxed him into facing the inevitable was a series of three serious tooth infections (not an abscess, but an incredible simuation) within a year. Our dentist finally convinced hiim to consult with an oral surgeon to consider dentures..... Mr. Adams went into the appointment kicking and screaming - he was only in his mid-30s, he was too young to have false teeth, etc etc. I reassured him that I would prefer him to be pain-free and infection-free and able to eat whatever foods he craved without worry about it breaking an already sketchy tooth and that seeing his teeth in a jar at night wouldn't bother me a bit. He bit the proverbial bullet and the only "horror" was the first day/night after having his upper teeth removed. He experienced pain similar to those who've had wisdom teeth pulled. I changed his gauze and fed him clear broth and, surprisingly, by the second day the bleeding had completely stopped and he didn't ask for one of his prescribed pain pills until just before bed time.

He was fitted with an upper denture shortly afterward and hasn't looked back since (that was 10 years ago). He has a beautiful smile which he never hesitates to flash and thus far hasn't had any ill effects. By that I mean thus far he hasn't had to use Polident or any other sort of "grip" and hopefully it will be another 10 years or more before his jawbone changes enough to warrant a new upper plate.

Cost-wise, I can't really advise you since we had dental insurance at the time. But if you're able to work out a payment plan with a dentist, I would strongly suggest that the "fear of dentures" be the least of your worries - I think you'll be happier with a presentable, serviceable set of false teeth than with a mouthful of deteriorating, infection-prone natural teeth.
posted by Oriole Adams at 4:24 PM on February 1, 2011 [2 favorites]

Re dentures, I can tell you...

My parents grew up in the same small town, pre-flouride days, and as a result both had bad teeth. My dad had all his pulled as a young man in the Air Force and wore dentures from then on...and they did not cause him problems, and he never regretted getting them. He had a very nice smile that looked natural.

My mother, on the other hand, fought and struggled and had bridges and caps and fillings and root canals to cover up the fracturing nubs of her old teeth, and quite honestly, suffered far more because she was horrified at the idea of dentures than if she'd just gotten them and moved on.
posted by emjaybee at 5:54 PM on February 1, 2011 [2 favorites]

Just start the process! Ask everyone you know for a dentist recommendation. Make an appointment and tell the person answering the phone your situation. They've literally seen it all and will know what to schedule for you to start.

A close friend of mine had a lifelong fear of the dentist and hadn't been in 20 years. And you could tell if he smiled a lot (black around the gum line, crusted plaque, etc.). But he got insurance recently, had a bad toothache, and finally decided to go. And it's been about six visits, scaling, cavity filling, and extractions, but he's already got fresh breath and his gum line looks great and the extractions were reasonably painless. He'll need some crowns or bridges later, but at least now he has no pain and can smile again. And his fear is gone.

I asked him about the cost, and the initial work (before insurance) was under $1,000 for all that. Insurance knocked it down to $200.

Get your mouth healthy, then deal with the aesthetics later.
posted by clone boulevard at 7:12 PM on February 1, 2011

I don't want to put forth any miraculous contrarian solutions at the expense of modern dentistry, but there certainly is a lot of compelling information out there on the topic of tooth remineralization - what flouride is supposed to do, but does poorly. I've read many reports of cavities healing via dentine regrowth, which can be triggered (or rather, un-retarded) by a few simple changes in diet and vitamin D supplementation.

It's definitely worth looking into, and rather depressingly it seems you can't always depend on your dentist to be 100% au courant with such new findings.

Whole Health Source: Tooth Decay Reversal Diet
posted by Kandarp Von Bontee at 7:59 PM on February 1, 2011

Kandarp Von Bontee: can't always depend on your dentist to be 100% au courant with such new findings.

It seems those "new findings" were discovered by a couple married in 1914. Anyway, that bullshit blog clearly talks about early stage tooth decay. The original poster has already lost four or five teeth.
posted by spork at 12:48 AM on February 2, 2011 [1 favorite]

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