Dental Chronicles

[Mrsmorton]

I have noticed a number all of the dental related questions on MN get repeated once a month or so; this may be entirely unwelcome but what I intend to do is to make a series of detailed posts answering the most common questions so that I can signpost posters to an answer. Often they disappear in chat and then resurface.

I am a dentist (that's no secret on here) but I have no way of proving my qualifications and neither do I feel the need to. I hope that this will be of some assistance to someone at some point!!

If you don't count your wisdom teeth then abt 13/14. You should get DS to google it, he might be inspired into becoming a dentist!!!

The dentist said that DS1 is the oh patient he's had that tries to talk while the dentist is looking at his teeth.

Only not oh. Fat thumbs.

I'm hoping they won't get my fear of dentists. I spent most of 2013 in pain as I was too scared to go.

I have the odd patient who's mouth I keep my finger in, just to keep them quiet their teeth dry.

Thanks MrsM. I'll pass that on. Mighty reassuring and sounds sane, so I'm sure it will help.

Hi Mrs M, can you help me with my phobia? I knew I didn't like dentures but I saw a set at the dentists yesterday and had a full blown panic attack, the first I've had in over 10 years. I've always had a fear of dental treatment, not so much the pain but due to the fact I cannot bear to have anything in my mouth. Yes, it sometimes extends to food and (TMI!) umm...body parts. Mainly it is a fear of choking I think.

So dental treatment is a nightmare and consequently I have very bad teeth. Not helped by 1970s practices ie drilling away masses of the child's tooth which only had a tiny bit of decay. Plus I have tetracycline damage and fluridosis (sp) caused by 3 monthly visits to have teeth soaked in a bath of fluoride - a trend at that time also

I got NHS veneers on all my upper front teeth due to the above, 15 years ago. But recently I bit something wrongly and my lower tooth knocked a chunk out of my main front tooth behind the veneer - is that called Left 1? The dentist said it was decayed and filled it. But the first time I ate that evening the bottom tooth hit the back of the filling and knocked it and my veneer out. The tooth is three-quarters rotted away at the side right up into the gum. I do wonder why the beginning of the decay was not noticed long ago as I had managed six monthly check ups for the last 10 years at least

Anyway, that turned into an epic. My problem is, the tooth cannot apparently be saved although I thought they put gold crowns on much worse teeth than that. It has to come out. I have to have a falsie. I made it absolutely clear that I would not be able to tolerate a plate due to my phobia. She showed me a beautiful private denture which was exactly what I wanted, small and delicate and hardly touching the palate at all - maybe only 5mm deep behind the teeth. £500 but I was willing to pay that.

But then I asked what I should do while the socket healed. She said I'd have to have an NHS plate for a while and then get the private one made. She said they can be made thin...and then she got one out of the drawer. That's when I had the panic attack. So what would you advise if I have to touch/wear this thing for a while, how am I going to cope? I am going to see my GP tomorrow to get prescribed something for anxiety but I'm diabetic and can't take beta blockers. What should I ask for? Thanks for getting this far!

mandy perhaps you could ask your GP for a referral? Some CBT or something? Have you spoken to your dentist about seeing your GP? It's better to get something that they have both agreed on as if you turn up to the dentist smacked off your tits on something they didnt provide, it can invalidate any consent you have previously given.

You don't have to wear a denture! I know we're all horrified about having gaps but given a space or a panic attack, I know what I'd choose.

What have you done to stop the decay recurring? It's absolutely preventable and you don't want to have to shell out another £500 in a few years because something else has decayed.

Thanks for getting back to me. I am not totally averse to gaps but once I've had the decayed big tooth and the loose one next to it removed all I will have left on that side of my upper jaw will be one canine. I had some pulled for a brace as a child and a couple more because it was cheaper to have them out than treated at that time. Plus my partner has a real aversion to gaps.

I will really try to step up caring for my remaining teeth. Due to several problems (two frozen shoulders, depression, lichen planus) brushing and flossing has been neglected for the last couple of years. I wish I didn't find it so painful and upsetting to see the hygienist.

I had one of my lower wisdom teeth extracted last Thursday - and it's really hard to know if it is healing normally or not! I was very swollen but this has gone down over the past couple of days, just bruised now. And the pain is slightly less now, just left with a stiff feeling and a very dull throb, with no painkillers.

But the stitches are all over the place, and there is white stuff around the edges of the gum incision and what looks like an ulcer posterior to where the impacted tooth was. I can't see the socket as it is inside my cheek, but it looks a bit white and gunky there too. Horrible taste.

I don't know if it is granulation tissue / normal healing, or if it is infected. I wasn't given antibiotics. But if it was infected, would I expect an increase in pain / swelling? I am a 4 hour train ride away from my routine dentist and the dentist who did the extraction, so I don't want to make an emergency appointment where I am now, if actually it's likely to be nothing? I could post a picture but I don't think anyone wants to see the inside of my mouth at present!

Thanks for any help.

If you can manage it with painkillers and its not disturbing your sleep then it's probably fine. If it's keeping you awake then not quite so fine at this stage.

Thanks MrsMorton - past 2 nights it has not kept me awake (coinciding with most of the swelling going down, and with minimum/no painkillers). Due to have the other one out in a few weeks time so don't want any delays in this one healing up!

This is a long one.

I have very bad teeth. Both of my top two wisdom teeth have been removed in the last 6 months. Dentist wants to remove bottom left and a broken molar on the bottom right. Am massively dental phobic but managed to sit through both top extractions no problem, it was pain free and quick.

However when it came to the bottom two, it didn't numb properly. The right side of my face was so numb that I couldn't open my eye yet when he started trying to remove the molar I ended up screeching and having a panic attack. I let him try a further two times and the same happened.

The molar has now broken to the point where there's only half of the outer left and next to no middle as I end up spitting more of it down the sink each time I brush. There is no pain however.

Went back yesterday for an exam and to try again. Cue panic attack. I already take heavy anxiety meds and had taken extra in preparation but I ended up sobbing shaking babbling hyperventilating etc.

I also need 2 fillings, a scale and polish and other "considerable" work he said.

I have begged him to send me to somewhere that will sedate me. He insists it doesn't exist unless I pay private. I posted here today on another section and a MNer found my local community dentist and the website NHS confirmed that they do all treatment under inhalation sedation for nervous patients. I have to see him again next Wednesday. My DH is coming with me to advocate for me because he is tired of seeing me in physical pain and seeing me so depressed and terrified. I also have bi polar disorder and 2 DDs aged 6&4 to look after and its destroying me to be blunt. I have tried a total of 4 times to sit through it and I just can't, and I can't bear the thought of trying again.

Please help me, I'm looking at it taking a year to save to have it done privately, and I have no idea how to manage the pain for all that time.

That sounds horrendous, I had pretty much same thing happen, had top wisdom teeth out years ago, no problem.
Bottom ones however were a different story.
My nhs dentist referred me to hospital dental clinic & I got IV sedation, was totally fine.
Dentist must be able to refer you.

The two wisdom teeth out with IV sedation only cost me about £40.

It may be that your PCT doesn't commission sedation in general practice and he doesn't consider you a community patient.

You can see any dentist you like although some specialists will require a referral from a generalist first. If your dentist isn't ticking your boxes, you can and should find another dentist. And sooner rather than later before you develop toothache.

FWIW, what the NHS websites say about dentistry and what the PCTs (or whatever they're called now) will pay for are often two massively different things.

Would my GP be able to help with this?

He did mention referring me to Community but I was so hysterical I didn't really take on board what he was saying.

As for another dentist, if the current one won't refer me despite seeing me in a state several times, I don't hold much hope for another. I have tried as much as I can and just the thought of trying again is sending me spiralling.

No idea about your GP.

To update my wisdom removal post... turns out it was dry socket. I was getting a bit more pain at night and whenever I bent down so thought I would go and see. I am surprised she said it was dry socket though as I was only taking a few paracetamol a day and didn't think it was painful enough, from what I have heard.

Questions that I didn't ask:

• Is the brown stuff packed into the socket meant to work its way out, or will it break down in the socket?

• Can dry socket cause / worsen numbness? I am almost certain that I didn't have any numbness after the extraction, but a few days ago I noticed half of my chin was numb! I find it hard to believe that it was always like this as it is really noticeable when I put make up on etc.

Thank you! Really don't want to go back in a couple of weeks to have the other side done

The brown stuff will either break down or come out. Try to forget about it and it will be fine.

As far as the numbness goes, I think I may have read about the dressing being capable of causing temporary parasthesia but I honestly can't remember, it's not the dry socket per se that would cause it although significant infections can cause numbness, dry socket isn't an infection. It's highly unlikely to be permanent, was your tooth high risk for nerve damage can you remember?

Oh I am so delighted to read this thread but can I just check....dry socket developed day 7 after terrible extraction (one molar root fused to bone and left behind). That was Wednesday, dentist packed it gave me antibiotics for 5 days. Went back today to have teeth cleaned (urgh!) and he redressed the socket, said it was healing...then two hours later it fell out when I was having a drink. Luckily I didn't swallow it....there is a bit of niggly pain, nothing like when I had one before (I must be the only non-smoking, non-sucking person I know that always gets one). So do I need to go back and have it packed at emergency dentist or will the pain just settle? The hole looks like a brown scab, not yellow (sorry if that's too graphic for anyone!). Thank you so much :-)

I see people at my OOH clinic every so often who say the dressing has fallen out but when we look actually there's plenty left in there.

Be guided by your symptoms rather than the dressing etc. if the pain is no better/worsening then go back. If it's improving then you'll be fine.

Thank you so much, I am pain free this morning so I guess I am on the mend x

Hi MrsMorton, me again. As I mentioned above I'm having implants in a gap to replace two molars pulled out many years ago. I have a baby tooth, Upper premolar? It's the third one in. It's very high, and makes my smile look uneven. I know if I had a implant there that it would change my smile completely BUT partner thinks I should leave a healthy tooth alone. What would you do? I know it will probably come out earlier than the rest of my teeth and if I can't afford to replace it then I'll be left with a gap that you can see. So my reasoning is, do it now whilst I have the money and also whilst it works out a little cheaper per tooth as I'm having two other implants at the same time.

The third one is usually the canine? I think the first thing to do would be to check if it is healthy and if it is, you could possibly get it built up by the dentist. That's not destructive and is pretty painless for everyone involved!!

If it's got a limited prognosis then it may be that an implant is a good option. They are predictable and have a good long term prognosis in non smokers. Sooooo... No actual answer for you I'm afraid.

Sorry, it's third in from the back, so the tooth just before the 2 molars. Thing is its very high and even if I have it built up the gumline looks uneven if that makes sense. And, annoyingly enough, it's the healthiest tooty I've got, lol, hence the dilemma. You basically answered my next question though which was whether the implants are a phase at the moment and all going to start failing in a few years time. Or whether they're as reliable as teeth

Ah yes, premolar. It is possible to disguise the gum line discrepancy with a pink filling material. That doesn't damage the tooth at al, may be worth a try as it's quite cheap and easy (relative to an implant anyway).