Does anyone else *HATE* the dentist??
March 13, 2013 3:03 PM   Subscribe

I have impeccable dental hygiene, and yet my gums insist on making good on their mutual suicide pact. This results in epically difficult, frequent, and expensive trips to the dentist. I'm looking for advice from any mefites who have dealt with similar issues.

I've always had bad gums. I was treated for periodontal disease when I was 18 (I had 2 procedures where grafts were placed over receding gum lines). There was a time in my 20s when I was a bit clueless (and a smoker), but that was several Presidents ago, and now, thanks to a dentist who put the fear of the gods in me, I am nigh on religious about my dental care: I brush (Phillips Sonicare, Sensodyne), floss, and use Listerine fluoride rinse at least 2 times per day, NO MATTER WHAT. I have gone to the dentist every 3 months for about the last 12 years. At this point, it's bad enough that the regular dentist won't see me, he insists that I see the periodontist - which is a drag because, as a freelancer, I'm responsible for my own dental insurance, and the plans I have researched don't cover periodontal visits.

But the expense aside, I'm frustrated and scared about what will become of my teeth. At this point, a regular cleaning is painful enough that I require novocaine. In my early 30s I was told that I had the gums of someone in his 50s. That was several years ago, and things haven't really changed. I am assured that my teeth are not the problem - I've never really had cavities, and the periodontist tells me that my hygiene is good. It's just that my gums suck.

So now there is talk of surgery. There is a lot about this that is scary, but in general I am okay with necessary but short-term discomfort and expense for a greater good. What worries me more is that I am facing the beginning of a slippery slope that will result in me losing teeth LONG before I am ready to, for reasons that I can't really control. You know those recurring dreams people have about loosing their teeth? It feels like I'm in a slow-motion version of one of those.

Anyway, I'd love to hear from anyone who can relate; who has similar issues; who knows anyone with similar issues; who has any expertise on any of these issues; or who cares to send a pat on the back my way. I'm frankly pretty self-conscious about this whole thing, but I wasn't sure if it was an appropriate use of an anonymous question, and I want to be able to participate in any ensuing discussion. I hope that doesn't sound disingenuous... I realize I am after all posting intimate details about my teeth in a public forum...
posted by fingers_of_fire to Health & Fitness (17 answers total) 8 users marked this as a favorite
Have you ever been tested for nutritional deficiencies? Have you ever discussed these issues with your GP in addition to your dentist?
posted by These Birds of a Feather at 3:20 PM on March 13, 2013

No answers, but definitely similar issues. I hate going to the dentist, find it painful and really dislike the whole process, even without the pain. I've had a several periodontal cleanings, and each one is worse than the last. And they don't seem to be able to numb me enough - I always feel pain. Nitrous Oxide helps, and I insist on it. But it's painful, uncomfortable, expensive and really frustrating when, like you, I'm very careful and conscientious about my dental hygene.
posted by still_wears_a_hat at 3:25 PM on March 13, 2013

When I was a kid (I'm in my mid 30s now) I was forced to go to a dentist as part of some public school program where I guess the Government paid to make sure our teeth were OK. These were not pleasant experiences and instilled in me a lifelong fear of dentists. I basically never visited a dentist ever again...

... until I was at University (in the early noughties), and a wisdom tooth decided to shoot through my gums, causing me an extreme amount of pain. Being an impoverished student, I had no choice but to visit the cheapest form of dentist there is... the student dentist working in the public health system.

As I waited for my torture session to begin, I was freaking out. After almost two hours I was let in. I told the dentist that I was scared shitless about this. He said he'd give me a lot of anesthetic and that I should tap my hand if I feel any pain. And so the procedure began.

I felt the prick of a needle delivering that sweet, sweet anesthetic in my gums, and it was uncomfortable, but not painful. The dentist started messing around in my mouth. I heard a weird noise inside my head, and while I was trying to figure out what it was, he pulled out my wisdom tooth (turns out that was the sound I was hearing). And that was that. He stuck some cotton in my mouth and sent me on my way.

I've since been to the dentist twice more to get my teeth fixed and checked and man, it didn't hurt at all. Dentistry in the early 80s should have been banned by the UN as a form of torture, I'm certain. But I guess somewhere between the time we were kids and now (roughly 30 years), dentists realised that people hate them and worked out new and exciting ways to fix our teeth and gums without causing excruciating amounts of pain.

In short, I understand your fear (really, I do) but know that dentistry today isn't the same horrible ordeal it was when you were little, and if you get a good dentist, you probably won't feel a thing. And you could always pay extra to be put to sleep while it happens, if you really want to...
posted by Effigy2000 at 3:30 PM on March 13, 2013

My mother has bad teeth/gums. Her siblings do, too. So does their father. Thanks, I think, to fluoridated water, my teeth are in marginally better shape than theirs were at my age, but I can see how my tooth issues now are on the same path, just slightly delayed.

What has helped me is looking at my family members and realizing that they're OK. Bridges and dentures are an annoyance, but they're not the end of the world. In the US we tend to turn medical issues into moral failings, but having bad teeth or gums is just an accident of genetics. Knowing that my family members have gone through the same thing has been helpful for my own feelings of inadequacy.

Is there anyone in your immediate circle of friends/family that you can discuss this with? Preferrably someone who also has difficult teeth? Due to the whole "your health is a moral issue" thing we all seem loathe to discuss our medical problems, but I bet if you put feelers out you will find lots of people to commiserate with. I was facing my first root canal a few weeks ago, and I was shocked at the number of people who had the procedure in my immediate circle of friends.
posted by muddgirl at 3:36 PM on March 13, 2013 [4 favorites]

I feel for you! I don't have your gum problems, but at my recent cleaning they charted several areas that are receding. The dentist asked about my toothbrush and I indicated it was a Braun electric. He said to make sure I had the softest head they made for it and if it had a less intense setting than high, to use it instead. He also said to let the toothbrush do the work and not to add any additional pressure, holding it just enough to aim and not drop it. I'm sure you've already gotten the same lectures, but wanted to mention just in case.

And yes, I hate going to the dentist. Nice man, dismal chore.
posted by cecic at 3:39 PM on March 13, 2013 [1 favorite]

Best answer: do some research on dr ellie phillips. She's a passionate exponent of the idea that managing the flora and ph levels of the mouth is of paramount importance.

There was a recent bbc interview with her and another dental expert that is informative.

One of her websites.

50 min lecture that I found convincing and informative.

She has a system of rinses and xylitol usage that she recommends.
posted by spacediver at 3:53 PM on March 13, 2013 [1 favorite]

Periodontal disease is very manageable, and there is no reason whatsoever that you should lose your teeth based on what you've described (basic good hygiene, regular visits for scaling to remove deposits, willingness to have treatment).
There are a number of different reasons for gum surgery, with a number of different aims in mind.
Are you having surgery to reduce the depths of your pockets, or to cover up exposed root surfaces? You should make sure you are comfortable with 1) the diagnosis 2) the reason for the surgery 3) the cost/benefit should you treat surgically vs nontreat .
It's ok to consider a 2nd opinion.
You may have to modify your diet to keep your gums healthy; you may have to modify your lifestyle to keep your gums healthy.
There may indeed be systemic factors that have or have had an impact on the health of your gums (diabetes for instance). discuss these with your dentist as well.
Don't give up, and best of luck.
posted by OHenryPacey at 4:09 PM on March 13, 2013

If you inherit the wrong mouth bacteria, there's not much you can do. I get my teeth cleaned 5 times a year and I'm currently getting my 4th implant.
posted by Obscure Reference at 5:18 PM on March 13, 2013

Best answer: Oh yes. I too am religious about dental hygiene, and unsparing of expense. I have teeth cleanings 4 times a year, and just over the last 5 years spent about $35K (failed bridges, OK dental implants etc.). I try to go to only the best periodontists and dentists - highly recommended ones, and ones who teach at the UC dental schools and have a hand in research etc.. My dental hygiene is legendary - flossing twice a day, brushing after every single meal, gum massages, water jets, don't overbrush etc..

With all that, I feel like I'm barely on top of it. I've lost 4 molars, and one incisor and have several root canals. You wouldn't know it, because I have implants and very clean-looking teeth.

I think it's just genes. Odd, in that nobody in my family has ever had bad teeth. Just bad luck.

Having said that, I reached the conclusion that all the hygiene in the world and all the world's dentists and periodontists won't do you any good, unless you pay attention to your diet.

My diet is excellent. But, the only way in which I can keep periodontal disease at bay is to keep my blood glucose as low as possible. I recommend the same to you.

Here's what I'm getting at - it's not just about the direct physical impact of food on your teeth; yes, avoid sticky sugary things (or acidic - kills your enamel - try not to soak your teeth in it), don't leave your teeth coated with food for longer than absolutely necessary, try not to snack and don't eat too frequently. I only eat twice a day - that reduces the amount of time my mouth/teeth come into contact with food.

But it's more than about that. It's about blood sugar. When you eat, your blood sugar goes up. That has impact on your gums. Think about why diabetics have problems with wound healing - that's right, it's the uncontrolled blood sugar. Your gums cannot heal, and are subject to attack, when your blood sugar is elevated. I'm not diabetic, or even pre-diabetic, but when I was getting my implants the periodontist warned me that one of the reasons implants fail is because of high blood sugar. It's murder.

Now, I have what I consider evidence - for my case - that even a transiently elevated blood sugar is bad for my gums. Every year I travel in Europe for a few weeks. That's when I sort of depart from my spartan diet, because I love to try out various restaurants, plus I love pastry (I almost never eat pastry in the U.S., because I find it too high in sugar). What I do not neglect is my teeth - my hygiene is exactly as rigorous as ever during those trips. Yet, like clockwork, I develop dental/gum problems within a week of being in Europe - it's happened the last 6 times or so. I have lost two bridges and back molars after these trips. It's bizarre. I have a checkup before I leave - dentists are delighted by my gum health (no pocket deeper than a 3, and most 1-2). But already on the trip I experience pain in my gums - despite impeccable dental hygiene.

My only conclusion is that somehow I'm extremely vulnerable to higher blood sugar. Now, with tens of thousands invested in my implants, I'm paranoid, and may have to desist from my culinary adventures while travelling.

However, as I indicated above - when at home, I eat a very low glycemic diet. And I eat low-calorically. I exercise. I leave at least 17 hours between my dinner and breakfast, and I eat only twice a day. I do all I can to keep my blood sugar low for as long as possible. And with this regimen, plus rigorous dental hygiene and constant dental cleanings and supervision - my gums and teeth don't deteriorate. I think it would work for you too, if you gave it a shot. I don't know if you can - I eat this way for other reasons of general health not just dental - so I don't know if this is practical for you. But this is the only thing that's worked for me.
posted by VikingSword at 5:41 PM on March 13, 2013 [1 favorite]

I have a similar dental history, and my mom had no teeth by the time she was 40. I've done a lot better, but I still thinks genetics play a big role. Unfortunately, I didn't get my father's teeth genes: he's 86 and has never even had a cavity.

I do everything right and still have problems. I've wondered if breathing through my mouth plays a role in this too. And alcohol probably doesn't help either, but I rarely drink anyway.

The one thing that does seem to help a bit is that I carry around those little skinny brushes and use them (discreetly) after I eat to clean any food stuck between my teeth.

Good luck, I feel your pain. Oh yeah, and if you know they're going to cause you some pain when you go to the dentist take a couple of ibuprofens an hour before.
posted by mareli at 5:41 PM on March 13, 2013

Yes, I hate going to the dentist.

I have impeccable teeth, have always had good dental hygiene - never had a cavity in my entire life (I'm in my 40s). In the last 5 years though my gums have turned to absolute crap. I've had two very expensive multi visit gum treatments in the last four years. Following my dentist's instructions I brush twice a day with an excellent quality electric toothbrush, floss religiously every night and use an interdental brush between my teeth and the the pockets on both sides. I alternate between using a natural antiseptic product, baking soda and water or, when the bleeding is really bad, baking soda and peroxide (though this can only be done short term). I've been doing this for five years, with the routine getting longer over time. Brushing my teeth takes me about 20 minutes each night and I never, ever miss a night. And yet my gums are still falling apart. I'm supposed to go in for a reassessment again next month, then probably laser treatment on some of the worst areas, and then on to the peridontist because my dentist is quite frankly admitting that I'm beyond what he can handle. I'm otherwise in excellent health but I've just had bloodwork done because my dentist can't understand what is going on and wants to rule out any underlying condition (though my last bloodwork a few years ago came back totally clean).

I haven't had grafts yet but I am getting very long in the tooth and I'm sure it won't be far away. I think my dentist wants to try and do everything possible to reduce pockets and kill the infection before moving on to grafts. Fun times ahead.

VikingSword, thanks for your comment. I'll have to look into that.
posted by Cuke at 6:38 PM on March 13, 2013

Another option - do you have any digestion issues? I had (well, have) terrible gums. My dental hygienist one day asked me about my diet - it was decent, could use more veggies but nothing atrocious. She asked me about other health issues and steered me toward (finally) figuring out that I have celiac disease - and as such, I wasn't absorbing the nutrients from the food I was eating and my gums suffered so badly for it, they bled when I looked at my toothbrush.
posted by skittlekicks at 6:54 PM on March 13, 2013

Do you use Peridex? It's an... antifungal I think... my dentist gave it to me because even though my teeth are good, my gums are sensitive and bleedy, and this stuff really helps! You brush it onto the gum line after you brush your teeth and 30 mins before eating. If you haven't tried it, try it! It's available as a generic in a big bottle.

(NB I see it referred to online as an "oral rinse" but my dentist said not to that because it can stain teeth. Just brush it onto the gum line with one of those gum brush thingies.)
posted by fingersandtoes at 7:05 PM on March 13, 2013 [1 favorite]

I'm in a similar situation: great teeth, poor gums and terrified of losing my teeth. I didn't get a lot of answers when I asked a related question, but they were good ones and I took the advice.

I've since quit smoking, got a second opinion and because of the second opinion, I changed periodontists. I also now alternate between my periodontist and regular dentist every three months, which I think helps. My oral hygiene routine is down to a science with all the flossing and brushing and rinsing. The periodontist even has me using this rubber tip tool to use to go around my mouth and push on my gums (about 5 times each area). I'm told this will tighten up the pockets around my teeth so I won't get infections. I try to do this, but its the one thing I just keep forgetting to do.

I've tried to stave off the surgery because the whole idea just skeeves me out, but I fear it is inevitable. Glad I at least waited until I quit smoking, I understand its much harder to heal as a smoker. My advice to you is get second opinions and inform and educate yourself so that you can make the best informed choices.

As an interesting aside, I once read that if you have a dream where you are losing your teeth it means your life is out of your control, which makes a lot of sense to me.

Best of luck to you.
posted by NoraCharles at 7:58 PM on March 13, 2013

Best answer: I have hate hate hated going to the dentist for the last five years. When I was about 28, I went from never having had a cavity to a needing root canals on three teeth with significant cadaver graft on the bones below (my jaw bone had "necrosis" -- something you never want to hear about the inside of your body!). After the root canals were placed, my cavity free teeth turned into zombie madmen and I suddenly had fast moving decay, around a dozen cavities at once. My jerk of a dentist simply noted this as "meth mouth," looked at me sideways, gave me a dozen fillings, and sent me on my merry way. (I had no idea he was attributing it to meth until I went to an ENT to try to get to the bottom of whether my fast moving decay was a medical issue and that was in the records sent over. Needless to say: no meth involved. I was in a lot of pain! And completely indignant!) It turned out, from my visit to the ENT, that my body was rejecting the cadaver jaw bone grafts. And also I have an autoimmune disease called Sjögren's Syndrome, which makes my body attack my salivary glands. Many Sjögren's patients lose all their teeth by the time they've had the illness for 10-15 years. Fillings fall out rapidly.

Theoretically, dentists should know it is a medical condition and treat people with respect, and not as if it's a hygiene issue (or a lack of funds to get a "smile makeover" issue)? But they don't. Dentists seem to feel like I could somehow hygiene away my autoimmune disorder (or cosmetic dentistry it away). It is hard for me to feel like their profession has much integrity. I personally am not a candidate for implants, after rejecting the cadaver grafts and I have a lot of shame about the three unobtrusive bottom-near-the-back missing teeth I have. The good news is that the partial denture I wear is made of pretty amazing material, Valplast. It is so comfortable that I accidentally fall asleep with it in once in awhile. And dentists don't seem phased by it. I guess a lot of athletes end up with partials at a young age?

I feel like I'm living your same nightmare scenario. I have come to just accept it. I hate when people use missing teeth as short hand for class or intelligence or desirability. Losing my teeth because of autoimmune disease has brought out the raving marxist in me.
posted by sweltering at 8:23 PM on March 13, 2013

Smoked for twenty years, have periodontal disease. Quit smoking in 2003, got gum surgery in 2004. Teeth held together pretty well for about eight years, and then started to slide like hell despite same care routine. I am now 43 and missing a front top incisor (bone loss in jaw, tooth had nothing to hold onto). It is not... good and probably will not get better going forward. I cannot get implants because you need bone for the implant to be implanted into and I don't have bone.

Gum surgery (the resection of gums, reduction of pockets) does more-or-less work for a period of time that you only have partial control over. It will hurt like hell. It is excruciatingly unpleasant. Gum surgery is expensive (I paid 4500.00 ten years ago, it's probably more like 9K now). Your teeth will be wiggly for about three weeks afterwards and they will look much "longer" than you are used to them looking.

I did gum surgery and I am reasonably glad I did. However, I will probably lose most of the upper arcade before I am sixty. The bone in my lower jaw is in somewhat better shape (it's denser to start with) and we'll see what there is on that front in due course. I go to the dentist 2x a year and the periodontist 2x a year. It is painful and unpleasant every time... so I feel your pain, OP.

I am not real thrilled about the situation, but if losing my teeth is the worst damage I managed from twenty years of smoking, I'm getting off cheap. It could have been small cell lung cancer, after all. Teeth... I can get fake ones.
posted by which_chick at 8:28 PM on March 13, 2013

Response by poster: thanks for sharing, everyone.

I haven't looked in to the whole nutritional/dietary angle of things, but that's very intriguing. I'm a vegetarian who occasionally eats fish (pescatarian?) and have a natural proclivity to run away fast from junk food (snacks of choice tend to be veggies, nuts, fruit, etc.).

s_w_a_h - today was my first cleaning with novocaine, and it was fine, with two caveats - the actual injection itself is - not painful so much as uncomfortable. And then you walk out of the appointment numb and unable to talk for about 2 hours. But in terms of shielding pain during the cleaning - it was flawless.

spacediver - thank you!

VikingSword - THANK YOU!

sweltering - profound sympathy. good luck to you!
posted by fingers_of_fire at 10:30 PM on March 13, 2013

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