Getting clear answers out of my dentist is like pulling teeth...
June 29, 2019 12:39 AM   Subscribe

I have always had bad teeth and bad gums. I now need a lot more dental work after pregnancy, and I am feeling so scared and miserable about it.

I’m sure I’m not taking care of them as much as my dentist would like, otherwise they’d be okay. But I brush twice a day, I use mouthwash, I floss, I even got the hygienist to show me how to floss better since I clearly wasn’t doing it well enough. And yet, my teeth are a mess.

They’ve never been brilliant; I had wisdom tooth extractions, three fillings and a root canal before I was thirty. Then I got pregnant and had hyperemesis (much vomiting and prolonged terrible diet) and that just seemed to trash them. Bunch more fillings, gum disease, redo the root canal.

They were all right for a couple of years after that. Then we moved away from my old, lovely, dentist and I was terrified to register with a new one, partly because of general dentist fear stuff and partly because after my first birth (which was a bit traumatic) I got awful flashbacks when lying flat on the dentist chair. And then I got pregnant again - more sickness, more terrible diet. So I went about 18 months without seeing a dentist.

I saw my new dentist a couple of weeks after my baby was born and the sickness had gone, and yep, now I need another load of work doing! More fillings. Another root canal. I have gum disease to the point of bone loss. And to top it all off, she thinks the existing root canal has got infected and that the tooth has a poor prognosis, which means probably an implant, which means yet more dental work.

I am so down about this. It doesn’t help that my new dentist is hard to communicate with and not forthcoming with information. I still am not totally clear on the procedure for extraction, after asking multiple times, and she initially said that I had to choose between breastfeeding or dental work but now after me questioning that says she can do the dental work after all. She has made it clear I have only myself to blame for the state of my teeth and reminds me of this repeatedly, and is just bleak and disapproving about everything. I can’t change dentists at the moment though so I’m stuck with her.

I really miss my old dentist, who was honest about the work that needed doing but also was clear and informative and said things like “this is all work we can DO - it’ll take a while but you’ll be fine by the end.” Now I feel like I don’t know whether this is all work they can do, or whether I will be fine at the end, or whether my teeth are just going to spontaneously combust on me or something. Which would not surprise me at this point.

I am finding all this so upsetting and so worrying. I am lying awake at night panicking about implants and wondering what tooth will go wrong next. A very big part of me just wants to avoid dentists forever, although that wouldn’t help.

How do I get myself past this?
posted by Catseye to Health & Fitness (14 answers total) 3 users marked this as a favorite
 
Get yourself past this by getting a new dentist. A dentist who blames and shames and communicates poorly is absolutely not going to be the partner you need in getting this sorted. Because while what we do has an impact, our genes and circumstances play a huge part in our dental health. It sounds like you weren’t dealt a great hand, and that sucks. But it’s not your fault. Anyone treating you like it is isn’t doing you any favors. Health outcomes are heavily dependent on our mindset and expectations. Feeling like we have hope gives is energy to do what is necessary. Being shamed just drains us and puts ua in a shame spiral.

You know that all dentists aren’t like this woman, because you have had a good one in the past. It’s ok to request your medical records, including xrays, and take them somewhere else. You can get them from the receptionist without ever interacting with that horrid dentist again. Just call and say that you would like your complete file sent to Dr So-and-So who will be taking over your care. Hell, the mew dentist might even do that for you.

Laying awake at night is a very clear sign that you do not have the confidence necessary to continue with this dentist.
posted by stoneweaver at 12:52 AM on June 29, 2019 [27 favorites]


Fire that dentist like yesterday. Shaming is just wrong. And in my experience dentists use that attitude to push you into unneeded dental work.

Get consults from a couple of dentists who are willing to explain to you what needs doing and how - take notes and compare. Fix all they agree on. And then ask for recalcifying treatment because between pregnancy and vomiting, your enamel isn't tough enough to protect your teeth from further damage. GC Mousse daily for a year, not rinsing for at least an hour, worked like magic for me in a similar state.

For the gums, get a periodontal consult with brushing instructions - you'll probably have to switch brushes and floss to ultrasoft and change brushing techniques to ones specifically for poor gums, plus the right toothpaste. There may be a short course of ointments to reduce inflammation so that you can clean everything properly without bleeding.

And this isn't anywhere close to really bad teeth. Did you know scarlet fever weakens enamel? At 22 my dentist thought that I'd need dentures by 30, I had over 20 fillings and so much more work needed. I was brushing badly because my teeth and gums hurt too much. Fifteen years later I have all my own teeth and not even a root canal, plus unreceded gums. It's all fixable if you get a dental team who know their stuff, including their bedside manner.
posted by I claim sanctuary at 1:59 AM on June 29, 2019 [11 favorites]


How are the hygienists at this office? Are they sympathetic at all? I've learned more from them than I have from actual dentists (things like proper brushing, etc. and tips like wiggle your toes when you are anxious in the chair, it helps distract you).

Been to good and bad dentists, started to have gum disease in my early 40's. Finally wound up getting dentures on top and partial on the bottom. The guy I went to seemed okay, but his comments turned me off and I quit going to him. When I complained about the lower denture not fitting right, he said I just had to keep wearing it, despite them not fitting properly and the metal clasps just did not fit, then he said my teeth had migrated while waiting for it to be finished. But his assistant did the impressions, while he was in another room, and it took her several tries, and she had to call him in, and he somehow told her to just deal with it, and think that's why it was wrong, he allowed someone with little experience to use me to practice on.

In the end, I was out for quite a bit of money, and my insurance only pays for new dentures every so often. Finally found a new dentist (in a different town now), my husband had some work done with them, and they are like a breath of fresh air.

I had to have scaling (deep cleaning) several times, and so has my husband. He still has most of his teeth, mine was too far gone, so I finally bit the bullet and got the dentures. It was an adjustment, for sure (orzo mixed with tomato soup became my friend for the first week or two), but I don't think about it much now. Am going to set up an appointment with the new dentist's office to get my remaining bottom teeth cleaned. Have been told by another dentist that there is no way to salvage the bottom partial appliance, you'd think they could do something with that metal clasp, but who knows? I will ask these people what they think.

I don't always wear my dentures at home, you'd be surprised at how many things I can eat w/out the uppers in. They are still good after a few years, had some adjustments made the first few weeks, hardly ever get sore spots, they fit well, and I feel okay going out in public. I may opt to go full lower at some point in the future.

My husband's still plugging along, as long as he keeps up with the cleanings, he should be okay keeping his teeth.

I'd say if you can't switch, talk to the hygienist, as you will probably need more cleaning at some point, right? See what their attitude is. Sorry you are going through this, it sucks, I know. If you have to use this dentist, just do the bare minimum and get the necessary work done and any cleanings (amazing how the deep cleanings help tighten up gums!).
posted by Marie Mon Dieu at 3:16 AM on June 29, 2019


I also have had a lot of dental work despite practicing pretty good dental hygiene. I brushed twice a day, flossed religiously, used mouthwash....I just have bad genes. I had 5 root canals before I was 35, one of which was a redo of a failed root canal.

First of all, I have always only worked with dentists I trust. Fire anyone who shames you. There are people for whom dental health is a major problem. Three of my four grandparents got dentures in their twenties. My mom has always had weak enamel and gum disease. These are things that run in families and no matter how much we try, our biology betrays us here. I shouldn't be shamed for a genetic predisposition towards depression, and I won't accept being shamed for a genetic predisposition towards cavities.

Second, all that said - an electric toothbrush really made an enormous difference. I wish a dentist had suggested one earlier. I switched five years ago, and have had a single new cavity since then, along with some work to repair or replace twenty-year-old fillings. That time period includes a pregnancy, which as you know are very hard on womens' teeth. But I went from a root canal every 18 months to a single new filling. Unbelievable. I balked at the price at first, but new toothbrush heads are way cheaper than crowns! Somehow this has also done some work to restore my gums, although it hasn't fixed the bone loss where they receded. But I have less pain and sensitivity overall (same toothpaste, so I attribute this to the brush).

Third, easier said than done, but try not to stress out. It sucks to have teeth that need a lot of work. It sucks to be concerned about your smile. It sucks to spend all this money just to have a functioning mouth. But there ARE treatments for everything you're experiencing, and you can get them done. You deserve to get the work done by someone who won't shame you for it, and there are people like that out there (search "gentle dentistry" to find dentists who specialize in working with people who are very fearful of going to the dentist). Good luck!
posted by peanut_mcgillicuty at 4:58 AM on June 29, 2019 [4 favorites]


She has made it clear I have only myself to blame for the state of my teeth and reminds me of this repeatedly, and is just bleak and disapproving about everything.

One thing that took me a lifetime to learn is that medical professionals are not the gods of health. They are people being paid to perform a service. You get to talk back to them if you don't like that service. If you really, truly can't change dentists (and if you give your reasons, people might be able to help with that), you can tell her that she needs to quit talking to you like this. You can say:

"It's not helpful when you blame me for the state of my teeth. Please stop."
"Please do not talk to me like that."
"You've already said that. Please don't say it again."

When I was a child, I had extremely bad teeth because that's one area where my parents didn't have it together. We had a dentist who yelled at us. My parents sent us to a different dentist, and my dad called the office and told them that the dentist was not to criticize us about our teeth. If you're not comfortable with the above, can someone call the office for you? The way this dentist is acting is extremely unprofessional.

The inability to communicate well is a bigger problem. It sounds like you're pushing back and asking for clarification - that's great and you should feel proud of yourself. You can also push back on general behavior.

(I still have awful teeth, so I really sympathize with you. Good luck.)
posted by FencingGal at 5:17 AM on June 29, 2019 [5 favorites]


I just saw that you're in Scotland. NHS Scotland says you can change dentists, presumably slightly easier than changing your GP surgery, since it looks like you're not limited to ones nearest to you. Private treatment may be expensive, but worth it for kid-gloves for your anxiety - especially if you're just seeking another opinion.

Once you have a consensus list of what actually needs doing and if you can leave your kids for a weekend, consider struggling with Ryanair and get treatment in a slightly cheaper country - I can vouch for the professionalism of Polish dentistry at half to a quarter of UK prices, and Czech specialists have low prices and good quality as well. There are entire clinics specialising in English-language patients.
posted by I claim sanctuary at 6:19 AM on June 29, 2019 [1 favorite]


Have you ever tried a WaterPik? It does an amazing job of flushing out all the bad bacteria, much more effective than flossing. Do you use a fluoride mouthwash? I think the non-alchoholic ones are best, less irritating to the gums.

Genetics is a huge factor in dental health, so try not to blame yourself. I have one child with no cavities and very healthy gums. With my other child it has been a struggle since infancy to keep his teeth healthy. Same diet, same hygiene routines, but very different outcomes.

What finally worked for us is the WaterPik. The way that it flushes out plaque and decay causing bacteria that is hiding between the teeth and under the gum line is unparalleled. Start with a low setting and gradually work your way up.

I always had poor gum health (but no cavities), despite a very dedicated routine of brushing, flossing, and flouride mouthwash. Finally, I told the dental hygienist that I had been flossing religiously since childhood and didn’t understand why my gums were in such bad shape. She lowered her voice, and somewhat conspiratorially told me to get a WaterPik. It has worked wonders!
posted by GliblyKronor at 8:33 AM on June 29, 2019 [2 favorites]


1. Water flosser. The thing that freed me to use it was the hygienist saying "Use this whenever you can. it doesn't have to be at night." Need five minutes to yourself? Water flosser time!
2. Electric toothbrush.

[These are expenses. I'm an American, and the investment up front in these tools has reduced my dental bills, all of which I'm responsible for. They are much more costly than brush and flosser!]

3. Listen to stoneweaver, and to those here saying "Genetics matter to the state of your baseline dental health." I am so damn sorry you've been shamed like this. No wonder you want to become a dental fugitive! She was mean to you, and if you have to see her, you need scripts like "Shaming me isn't helping" and "I've asked several times. Can you please give me the bottom line?"
4. Please tell your GP about this. Worrying and lying awake are tough on a nursing mother. (Assuming that your GP is not as bleak and disapproving as the dentist is.) You deserve to have a medical practitioner in your corner, gently helping you help the current and future you. Good luck.
posted by MonkeyToes at 9:11 AM on June 29, 2019 [3 favorites]


Get a new dentist!

But if you really can't get a new one, have a conversation with this one. Something to the effect of, "I am doing the best I can to take care of my teeth. I floss, I brush twice a day, and I use mouthwash. A lot of the damage to my teeth happened while I was pregnant and had hyperemesis. The state of my teeth is causing me a lot of anxiety, and making me feel guilty or ashamed is not helpful. Please help me by doing the work you need to do without any judgement. If you have any suggestions for things that I can do at home to better take care of my teeth, like a toothpaste or mouthwash I can use, let me know."
posted by kinddieserzeit at 2:42 PM on June 29, 2019


+1 you should get a new dentist. I once saw a dentist who told me I needed a dozen or more fillings (in my pretty averagely health teeth.) I went back to my old dentist, who recommended zero. That was 3 years ago and I haven't had any problems from the "cavities" I didn't fill. I don't know if there are legit differences of opinion, or if some dentists are scam artists, but if something doesn't seem right to you, move on. In the US, this much dental work would be a huge out-of-pocket investment for most people, even with insurance, so it would be very prudent to get a second opinion, even if you had to pay for it.

+1 also this is not your fault, and your dentist is terrible for shaming you. Your hygiene sounds above-average to me, and you didn't cause your hyperemesis or choose your genes.

Most dental stuff, unless you're in pain, is not an emergency. You don't have to make an immediate decision. You can talk to your (new) dentist about what work is most urgent, and what you could come back to in 6 months or a year. You are allowed to prioritize nursing your baby over fast dental work if you want to.

And finally, I have also had an anxiety attack in the dentist's chair that was not exactly related to dentistry. Dentists are actually really used to people feeling anxious during procedures, and you should talk to your new dentist up front about that and see if you can a Xanax or something to take when you're having the work done.

Good luck!
posted by juliapangolin at 4:14 PM on June 29, 2019 [1 favorite]


Some dentists make it all so much more difficult. I am the 5th child, 7th pregnancy my Mom had. Calcium is 1 thing that gets depleted easily, and my Mom didn't have a healthy lifestyle, if anyone even knew about that 60+ years ago. I have soft teeth;my younger brother's are worse. It's an expensive pain,here in the US. Stop blaming yourself, it's just bad luck.

Get the new dentist to prioritize the work to be done. Make sure you use toothpaste with maximum flouride. Flouride strengthens your teeth while in contact; I brush my teeth, and try to keep the foamy toothpaste in my mouth while I wash my face.O often have to spit, but I try to wait to rinse; keeps the flouride on the teeth a minute or 2 longer. Eat food with calcium, and maybe add Vit. D. My dentist encourages patients to bring earbuds and music, and it helps.
posted by theora55 at 5:50 PM on June 29, 2019 [1 favorite]


This has been really helpful, thank you. I feel hugely reassured and will be investing in all the product suggestions made too.

The reason for not switching dentists is that she’s the only one local to me taking on new patients, all the others have full lists and it’s a practical nightmare to travel further afield right now b/c baby. I also need some of the work doing pretty soon due to pain. But I am now going to find out how long it’ll take that practice to move me to one of the other dentists even if there’s a long waiting list, and then switch as soon as is possible. Will also look into what I can afford for private practice.

And I will indeed be asking her to stop it next lecture I get about (and I quote) “well this is either due to not brushing your teeth or smoking, and if you’re not a smoker... *meaningful look*”.
posted by Catseye at 1:30 PM on June 30, 2019 [1 favorite]


I got lectured for years at the dentist and then I finally came across a dentist who listened when I said I did all the things they said I ought to. She asked if I had antibiotics a lot as a kid, which, yes. And she said that actually did lead to the kind of teeth I have. Which is a huge relief. It really freed up a lot to do my best to take care of not-as-great teeth, instead of assuming I was doing poorly at taking care of great teeth.

You were given difficult to care for teeth and you're doing your best by them. Pregnancy alone is hard on teeth, but along with emesis is really brutal. No wonder you're struggling with them. It's not your fault. I hope you can get on a waiting list at another dentist soon.
posted by Margalo Epps at 7:54 PM on June 30, 2019


Update: I have found another dentist that I’ll be moving to in a few months. I had a consultation with him today and feel a lot, lot better and clearer about what needs doing now and in the longer term, and am reassured that it’s not nearly as a bad a picture as it previously seemed. Also he charges a lot less for implants than the clinic that my current dentists had planned to refer me to.
posted by Catseye at 4:45 AM on July 3, 2019 [4 favorites]


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