Help me visit my dentist for a checkup.
June 14, 2013 3:30 PM   Subscribe

I am seeing the dentist Monday. How can I make this experience less painful (in all senses, physical, emotional, financial)?

This dentist and I have, ah, a history. He diagnosed bruxism last year and commissioned a custom mouth guard that does not fit very well, so I have not used it very often because it murders my sleep. I am angry at him. I think that being angry at him is contributing to my teeth-grinding all by itself. I was going to not see him, but now I find that anything very acid (as in soda) or very sweet makes my teeth hurt. I expect that he will at least do a re-surfacing and filling and I am afraid of some more aggressive and costly procedure.

My specific question (for those complaining that many AskMes are just venting by the OP) has three parts.

(a) Is there something I can take or put on my teeth or gums myself beforehand that will make the cleaning and probing less painful? No Oxycontin or other hard drugs, please (I have to get myself to and from the dentist).
(b) How can I not get angry with him? I am stewing whenever I think of this history.
(c) I am considering asking him to redo the mouth guard so it will not hurt when I wear it, but I have sneaking thoughts that he made it not fit ON PURPOSE so that I would have to have more work done. Should a custom mouth guard be made from rigid plastic (cast from a mold) and fit rather stiffly? Since the guard was expensive, if a new one is going to fit just the same way, I don't want to waste my money.
For those who advise medical DTMFA, I really want him to refer me to someone else within my network. I am only going to him for the sake of continuity.
posted by bad grammar to Health & Fitness (15 answers total) 1 user marked this as a favorite
Why would you trust this guy to give you a good referral? If you think he is actively cheating you by mishandling your issues in order to get more money, then you shouldn't take his advice on anything. You certainly shouldn't see him again, or agree to any additional procedures.

Check your insurance company's website and call around to find someone new. (I've had good luck in the past asking for recommendations from coworkers, since they'll be working off the same list.) Life's too short and money's too tight to see bad dentists.
posted by restless_nomad at 3:38 PM on June 14, 2013 [4 favorites]

"I have sneaking thoughts that he made it not fit ON PURPOSE so that I would have to have more work done"

I think this is extremely unlikely. You need to tell him that it doesn't fit, you can't sleep when it's in and you need it re-done or modified. And also tell your insurer. If he doesn't respond, get another dentist.

Usually the dentist takes a mold of your mouth and sends it off to a lab for the manufactuer of the guard. Light grinding--softer guard. Hard grinding--hard guard.

Take an OTC pain reliever before you go in.
posted by Ideefixe at 3:40 PM on June 14, 2013

I agree with restless_nomad on this. Unless he is going to provide some services gratis in order to rectify the problem he may have created (and that is a legitimate question for you to ask before you sit in the chair), find another dentist.
posted by HuronBob at 3:40 PM on June 14, 2013

My hygienist is always happy to apply a numbing gel when I tell her I have sensitive gums. So that combined with a couple advil in advance should help with the pain for the general cleaning part (probably less so if you need a filling).
posted by tan_coul at 3:49 PM on June 14, 2013

I think seeing this dentist only for the sake of continuity when you feel this way about it is wrong. You should find a new dentist, either through a friend, coworker or online reviews.

Totally anecdotal but I find co-q10 helps my gums. Your doctors might be able to provide klonopin if you're very nervous about a dental visit.
posted by milarepa at 3:49 PM on June 14, 2013

Yeah, I don't know why you really need to rely on a referral from him. Just get a new dentist by checking who's in network for you and reading some online reviews or getting recommendations. The hassle of finding a new dentist will surely be easier than you stewing about and resenting your old dentist, and unless you're in the middle of having some involved dental procedures done, continuity of care isn't such a big deal with dentists.
posted by yasaman at 3:53 PM on June 14, 2013 [1 favorite]

Is there something I can take or put on my teeth or gums myself beforehand that will make the cleaning and probing less painful? No Oxycontin or other hard drugs, please (I have to get myself to and from the dentist)

Anbasol, Oragel, and generic alternatives can numb up a mouth.

On the bruxism issue and the splint he made, he likely hasn't fixed the problem because no one has made him aware there is a problem.

I use self made splints from football/hockey mouth guards. They work well for me. I can put them in near boiling water and remold them if I need to. I get them for less than 5 dollars. I have many and don't need to worry about losing them.

And as others have said, other than trying to get him to fix the splint I can not think of a reason you wouldn't just find a new dentist. If I feel hatred of a business or practioner I do them and me a favor and move elsewhere.
posted by logonym at 3:59 PM on June 14, 2013 [1 favorite]

My boyfriend is in the dental biz and people who have things that fit badly (mouth guards, tooth whitening trays, dentures, fillings, etc.) generally go back to the dentist as soon as they notice the fit is off and the dentist fixes it, free of charge, until it fits correctly. I'm sorry you're having trouble with this guy but you shouldn't have waited for a year and stewed about this ill-fitting mouth guard but instead spoken up and told him what was wrong. Get him to fix it and then find a new dentist because this doesn't sound like a good doctor-patient fit for you.
posted by jabes at 4:04 PM on June 14, 2013 [10 favorites]

You really need a new dentist.

I've gotten myself through root canals with a kind of self-hypnosis. Basically I close my eyes and imagine, as vividly as I can, that I am driving a speedboat. (Actually I imagine that I am driving the little hovercraft thing from Beyond Good and Evil. But for relatability's sake, let's call it a speedboat.) The constant whir of the dental equipment becomes the whine of the boat's engines, the gross spritz of water in my face becomes the spray of the ocean. When the drill goes ZZT ZZT ZZZT and I feel the pressure of it, that's the boat bouncing across the choppy waves.

It certainly doesn't make dental work fun, but at least it makes me feel a little more in control of the situation.
posted by Ursula Hitler at 4:30 PM on June 14, 2013 [1 favorite]

If you truly believe that your dentist is sabotaging your health in order to make more money, what possible reason could you have to ever go back to this person (or trust their referral)? Ask you co-workers for recommendations, or if that's a no-go for whatever reason, check out Yelp in combination with your insurance website (they should have a list of approved dentists in your area). At this point, for whatever reasons, it sounds like you have way, way too much baggage with this guy to end up with a positive visit.
posted by rainbowbrite at 4:36 PM on June 14, 2013

I doubt that your dentist is actually sabotaging you. I imagine that sometimes mouthguards aren't made right and you have to go back and have them make a new one. That said, the time unfortunately to deal with that was right after you go tit.

I have bruxism and I hated the first mouthguard I had. It was a hard material and really awkward and it would give me weird dreams and I would take it out in my sleep! A different dentist made me a softer one that is much less obtrusive.

Really, though, if you don't like the guy, find a new dentist.
posted by radioamy at 4:53 PM on June 14, 2013

Response by poster: This is a compromise. I want him to address the pain and any cavities immediately. I will ask this guy for a softer mouthguard, and if he won't do it, I am taking myself elsewhere. It may take a little while to line up a new person.

When I say I don't trust him, it is the pain and lack of sleep talking. I tried the mouthguard again last night and did not sleep well (when I did, I had weird dreams too) and my gums hurt. I am reading the nonviolent communication thread at MetaTalk. ;)
posted by bad grammar at 5:23 PM on June 14, 2013

I find different dentists cause different degrees of pain when cleaning and scaling teeth. I think it depends on what instruments they use. I finally found one that doesn't hurt at all, even though she seems to do an effective job. She uses a ton of water and something that vibrates a lot, rather than the metal pick and brute force approach of the dentist I tried who hurts the most. The non-hurty dentist charges about twice as much for her clean-and-scale, but for me it's worth it.

So yeah, don't go back to this guy. Shop around.
posted by lollusc at 7:26 PM on June 14, 2013

Nitrous Oxide. I have gum issues that make cleanings painful. I was wary of nitrous when my dentist suggested it since it doesn't actually get rid of the pain. However, it does make me far less anxious about the pain. I still feel the pain, but I don't mind it as much. The feeling is very difficult to describe. It made cleanings a lot easier for me. I won't have any dental work done without it anymore. It wears off after a few minutes, so you can still drive yourself home.
posted by parakeetdog at 10:59 AM on June 15, 2013

Response by poster: Follow-up: I was in pain when I wrote the question and made it sound as if I hate the man with the passion of a thousand suns. I think he is second rate but not incompetent. This is a major city so first rate dentists would probably be impossible to get an appointment with.

I went for the appointment today and the assistant did a gentle but thorough cleaning (which hurt, but not as badly as I was fearing). She and the dentist found several cavities which I will have filled when I go back next week. I made my point about the mouth guard not being comfortable, but the dentist said that it was supposed to fit tightly or it would not work. The assistant suggested soaking it in warm water before putting it on. They insisted that I should wear it every night and avoid drinking soda (I'm a Diet Coke addict during my work day) and floss regularly. My teeth are close together so flossing is not easy.

I was able to talk out a little of my anxiety with the assistant. The last two times I went to this dentist, I had a different assistant who was competent but barely spoke English which made the procedure more anxiety-producing.

The dental care is covered by my workplace insurance. I have been panicking because my father (who is in his 70s) also has a long-standing tooth-grinding problem, serious erosion and gum disease, and has had to have major implants.
posted by bad grammar at 4:36 PM on June 17, 2013

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