Dentists - why are we scared of them

[Ailsa]

I never used to be scared of the dentist, but for some reason, don't know what or why, over the last 12 months I've got really scared of going.

After having raging toothache all weekend I finally plucked up the courage to go to the dentist today.

I had to have a new set of records because they couldn't find mine and someone elses.

I've got 2 broken wisdom teeth which have to come out. It turns out that the wisdom tooth that isn't giving me any grief is the one that's worst.

I chickened out of having the painful one pulled today, but have got another appointment to get it sorted.

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Jasper, I am not a smoker and have never smoked. My mum however is an ex-smoker, she smoked from age 11 to about 40. She was a smoker whilst pg with me and was also on some sort of experimental hormone treatment (probably explains alot ).

Jasper while we've got you here , what do you think of the link between amalgam fillings and mercury poisoning. I have had most of my amalgam fillings removed and now have white fillings, due to some symptoms I had and I heard they could be connected with mercury from my fillings. Just wondering what your take on this subject is.

Thanks for the advice Jasper, I've got an appointment with my dentist in a few weeks time.

Sorry for asking more questions Jasper, but a friendly dentist is an absolute godsend...

We've been brushing our ds's teeth morning and night since the first four appeared, and used baby toothpaste from a couple of months later. He doesn't eat sweets at all. He's now 2 and something creamy-coloured appears to be building up between his lower incisors. What could it be? Should we be using a tougher toothbrush? Or brushing for longer or harder? I don't want to make a fuss of brushing right now, bcause I don't want to put him off.

Liamsmum, on the issue of mercury toxicity associated with amalgam fillings, hope you don't mind if I cut and paste here.
The absolute truth is that noone knows the answer.
The mercury in fillings issue in general is very controversial. The evidence is vague to say the least, and in my own extensive research it seems that you can find evidence to back up which ever side of the argument you happen to believe in to start with.
About two years ago the department of health issued a memorandum to all dentists saying that amalgam fillings should not be placed in the mouths of pregnant women if at all possible, because of a theoretical risk ( no evidence as such, just to be on the safe side)to the baby.
the memorandum also said dentists should ensure that any dental nurses who were pregnant should not be unnecessarily exposed to working with amalgam fillings. There was NO mention whatsoever of the group most in danger regards this theoretical risk - pregnant dentists!
I immediately contacted both the BDA and the department of health in this respect ( I was pregnant at the time) not because I was in the least concerned but because I thought they had made themselves look pretty silly by this glaring omission. The answer I received was even more ridiculous - it was to carry on as normal as there was NO evidence to suggest any harm could be done!
Last year I took part in a large scale study which tested several variables including fine motor control, hand eye coordination, memory, anxiety( various things known to be affected by mercury toxicity) comparing dentists with a matched group. ( I had a few misgivings about the methodology but that's another story).
Funnily enough I got the results back last week and the researchers found there were no differences at all in the two groups ( They were hoping there would be a difference)
I am not personally concerned about risks associated with mercury in fillings and would choose silver amalgam over white fillings for my own (heavily filled) back teeth.But that is just my own view and lots of dentists(and patients) think differently .
I realise this is not quite the same thing as the scenario you are describing where you had an underlying problem which you thought might be exaccerbated ( am I reading this correctly?) by your silver fillings and so you had them replaced.
I have replaced silver fillings with white at the request of several patients over the years and sadly none of them saw an improvement in the condition which prompted them to get rid of their old fillings.Of course this "proves" nothing at all.
I am very interested to hear what your experience was if it is something you are comfortable to talk about.

Glitterbabe I met a friend last week who is about 30 and has been wearing fixed appliances ("train tracks" ) for over a year and the teeth are showing a big improvement.Orthodontics in motivated adult patients is usually very successful. Let us know how you get on.

wmf without actually seeing your ds's teeth , is most likely it is simply plaque(the soft stuff)or tartar(the hard stuff).Excuse me for making this sound like a cbeebies story about teeth.
You can get quite marked plaque build up even in very young kids.
If it IS plaque you should be able to brush it off if you pin him down and give it quite a thorough brushing.Brush the area od gum adjacent to the teeth as well and don't worry if it bleeds a little the first few times.
I know what you mean about not wanting to put him off - brushing toddlers' teeth is such a faff! Don't use a firm brush, just a soft kiddie toothbrush is best.
If it is tartar, (not really likely)brushing won't shift it but don't be unduly concerned as he is unlikely to sit still for the hygenist (if he has any sense)
It is extremely rare (like, practically unheard of )for a two year old with a good diet and teeth which are brushed regularly to get decay starting in the area you describe so I wouldn't worry about that. You will have to judge for yourself whether it is worth the agro of pinning him down to get them really clean while he is still at such a tender age.

Hi Jasper,

have just discovered this thread. Do you work in the West of Scotland by any chance. I've just finished a Diploma course in Health and Safety and for our Occupational Health assignment we dealt with exposure to mercury in amalgam fillings by dentists, commenting on research done by (I think) Glasgow Caledonian University. Sounds very much like the survey you were involved with.
Btw, I've been terrified of dentists ever since my (now ex-) dentist put a filling between my two front teeth involving two extremely painful injections up into the front of my gums.

gillymac, yes I do. It does sound like the same study.
This is probably unhelpful to labour the point, but that injection you describe should be totally painless (unless the area is abscessed)and I can never understand why some dentists don't take more time to make it so, particularly as nearly everyone is scared of that one. IMO it is the easiest of all injections to give painlessly.
My dentist gives wonderful injections. You literally can not feel them going in.
A wise teacher in Dental school once told us you will have a busy practice if you
a) give painless injections,
b) can make a good denture
c) have good "patter".
I'm sure that's true.

Jasper, I was about to embark on an extensive programme of orthodontic work at the time we moved away from the UK. It would conclude with a scary operation, eek! I'd been going back and forth to a dental hospital and wondered why it was taking so long to even get to the start line but apparently, it was to test my committment to the process!

I was disappointed that I couldn't go ahead, having got all psyched up and ready to spend 2 yrs in train-tracks but the ortho consultant said I can have it done when we move back to the UK. The oldest patient he's worked on was 75!

In fact, I'm wondering if you know my Ortho Con, as I think he is based round Glasgow - it's Professor Stirrups. If you've any horror stories about him - don't tell me!!

Somewhere I read/heard that having amalgam fillings removed can actually (in theory I guess) release more mercury than leaving them in place. I only had my 1 amalgam filling replaced with a white one when it needed replacing anyway. I personally wouldn't have any more amalgam ones as they look horrible!

Jasper,

thanks for that. Since those injections have moved to a new dentist who meets two of the three criteria you mentioned (don't know how he is with dentures!) and is also v. sympathetic to me when I'm a wimp.

Soupdraggon, you are right about more mercury vapour being released when actually drilling out old fillings to replace them.Agree they look horrible, though.
I know this counts for nothing but as a matter of interest, I don't know any of my dentist pals who would opt for a big filling to be done in anything OTHER than amalgam in their own mouths. If there are real dangers re. amalgam I want to be first to know as I am more exposed to the stuff than most.
Suedonnim I do indeed know Prof Stirrups - damn good orthodontist and all round good chap. Are you outwith the UK now but returning soon? Or has the mercury vapour addled my brian and I have misunderstood you?
ks,

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jasper, my DH has had all his amalgam fillings removed and replaced with white ones. This was after a spell of depression and after he tried all the conventional treatments he started to go to a Complementary Medicine Centre and one of the things they advised was to get rid of the amalgam fillings. He had them done at a dentist who specialises in this, I believe they put some sort of a shield across the back of his mouth to stop any of the old fillings falling down your throat and he was advised that he would feel worse for a few days afterwards. He claims that it worked, although they did have him on homeopathic remedies and he was receiving counselling too. The downside is the new white fillings have apparently shrunk (he is back at the local dentist again) and are now leaking and so he is waiting for an appointment at the Dental Hospital to have them looked at again.

Sorry to pick your brains again Jasper, honestly I originally just set out to tell you his story but it does occur to me the fillings are not old at all and if they are faulty would DH be entitled to some money back from the dentist who did the fillings or even some compensation?

Must just add DH had 11 amalgam fillings and many of them were needing replaced and in his opinion thinks that when they reach this stage they are at their worst.

You said just what I wanted to hear re Prof Stirrups, Jasper. He has a gruff exterior at first (if you're a patient) but actually he is indeed a fine chap. I've been seeing him at Dundee Dental Hosp as there was a three year waiting list at Aberdeen!

We moved to Indonesia with DH's work, in May, which is why I couldn't go ahead with the treatment, but hopefully when we come home in 2-4yrs time I can go ahead then.

Jasper - thanks for your advice re plaque/tartar. I suspected that might be what it was, but I was worried that it might lead to decay despite all our efforts.

Just to add my twopennyworth to the amalgam v white fillings debate, I had a massive filling on a molar done in white for cosmetic reasons, but had to have it replaced in hideous amalgam two years later because it had started to crumble. My NHS dentist who did the replacement was not surprised and said that I should have been told by my previous, expensive, private, dentist that white fillings have a very limited lifespan and are not recommended for large grinding areas.

Huh!

Oh well, so far I am fulfilling the old wives tale of each pregnancy costing one tooth.

Suedonnim, prof Stirrups was very gruff with students too!
Demented, it's a tricky one to answer. IME white fillings on back teeth over a certain size/shape don't fare well long term as others have mentioned which is why I rarely do them.
However not all dentists think this way and indeed some set themselves up(privately, the NHS is not keen on posterior composites) as specialising in white fillings.There is certainly a market for it.
I can see how your dh would be willing to try anything if he was suffering from something as severe as depression and had not obtained relief from any other treatments.
However if a dentist agrees to place one ( or a whole mouthful as in your husband's case) they obviously have to do it properly.
If they were placed very recently and of a poor standard that will be spotted by the specialist at the dental school. However it may just be the usual problems associated with white fillings (which should have been explained to him)
Why does your dh not return to the dentist who did the white fillings? Hope he gets things sorted out.
ks, good point about not much being known of the health risks of white fillings.
RobinW the ozone treatment sounds like an exciting development.A unit delivers ozone to the decayed tooth via a special handpiece with a small rubber cup which adapts round the tooth surface; the tooth is zapped with ozone for 10-40 seconds and the ozone destroys bacteria and bacterial metabolites.
I have not seen it working ; I am in a dentists email group about it and those who do use it (only a handful in the UK) have mixed success but are generally enthusiastic.I tried to get on a course run by the manufacturer but the nearest venue was Oxford which is not practical for me at the moment.
It is only useful in certain situations and is not a replacement for the standard drills.
Vaccines - (presume you mean anticaries vaccines) -of course we don't discuss those on mumsnet

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sorry robinw , I was being flippant
It does seem to have gone quiet on the vaccine front. The intitial results from the Boston group (came out in the middle of last year if I remember correctly, although research on caries vaccines goes back to the 1960s) were quite impressive - anti caries properties being demonstrated on test groups of rats and young men (pause while we laugh at that) , but some reports suggest the effects only lasted 4 months.
The vaccine was either applied as a paint on the teeth or as a spray up the nose (the nose being another mucous membrane, and like you say, this being a less toxic admin. route than injection into the bloodstream).
I feel quite excited at the thought of children being routinely vaccined against tooth decay at their 12 month check up (does such a thing exist?) with just a puff of spray up the nose but then I am a sad case who sees a decay free world as some kind of Nirvanna. And I like the concept of vaccines.
It does raise some ethical questions though. Sugar is bad for us in more ways than just tooth decay, so if you can modify strep mutans with a vaccine so it does not cause decay, are you then giving parents cart blanche to feed their kids sugar with the other (less obvious) concommitant health risks? In a sense it is a bit like producing a vaccine which makes cigarettes not stain the teeth or cause periodontal disease. (I am exaggerating for effect)
As for the ozone treatment being operator dependant, yes I think this is probably partly the case; also patient cooperation probably plays a part. However I think the main determinant of success is probably down to case selection. It seems to work best on fissure caries, root surface caries, and recurrent caries around crown and bridge margins. Probably most of the decay I see in general practice does NOT fall into these categories.
I have to say I am reminded of laser dentistry and air abrasion in that they in turn were heralded as the next big thing but you don't hear too much about them nowadays.

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Can I interrupt to ask if anyone knows if it's ok to have a filling done while pg? Thanks

I don't know a single dentist who would say brushing twice a day makes up for eating sugar.

Practically everything is poisonous at high concentrations.

Not sure what you are getting at about dentists not warning parents about their kids being high risk. We assume all kids are high risk that's why we dispense advice to reduce the risk of caries.The advice is the same whether your child has virulent bacteria or not.The assumption is all children have or might have soon.

Root surface caries occurs next to the gum line when the gums recede and the root surface (cementum) gets exposed. You see it a lot (but not only) in older people. It can be hard to treat as it spreads fast and can quickly go below the gum line.

Monkey, no known risks of having a filling while pregnant although we are "advised" not to place silver fillings(see below).