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In Desperate Need Of A...Toothful...Dentist
ANTVGM64
Registered User regular
Registered User regular
Hello friends.
My mouth could charitably be described as the kind of place Donald Trump would want to refuse immigrants from. A shit hole, if you will. I've avoided the Dentist pretty regularly since...6th grade, and have been back for emergency fillings and then the beginning of some serious work around this time last year...but promptly fell off due to work and just general...fear.
My situation is this: my top front tooth is suddenly displaying insane sensitivity, a back right tooth is half gone and also now in pain, and several appear loose / chipped. Safe to say, my mouth remains a disaster area. Worse, it appears pain in right back tooth is causing some weird ear-related stuff. That could just be in my head though. Regardless, I'm pretty sure fake teeth are in my future.
The problem is that I've found every time I've gone to the Dentist they want to start me off with a cleaning, bring me in for a scaling, and then start filling teeth, without ever really telling me the plan; and I eventually either cancel an appointment or stop going.
Thus, I was curious if there's form of special dentistry that can just knock it all out in one fell swoop. Knock me out, fix it up, implant whatever teeth are going to be gone (I suspect a few) and then ship me out, with a new fake smile to boot.
Is there a word for this?
Basically, I'd rather go to the dentist one or twice, fix everything I can, be in some considerable pain for a bit, and be done with it. Whenever I bring this up to a dentist they tend to deflect. For example I had to go to three different appointments to fix *one* crown? Another dentist I went to said that was some bullshit.
Is there concern regarding 'being put under' because I'm a larger gentleman?
Please advise!
Thanks!
My mouth could charitably be described as the kind of place Donald Trump would want to refuse immigrants from. A shit hole, if you will. I've avoided the Dentist pretty regularly since...6th grade, and have been back for emergency fillings and then the beginning of some serious work around this time last year...but promptly fell off due to work and just general...fear.
My situation is this: my top front tooth is suddenly displaying insane sensitivity, a back right tooth is half gone and also now in pain, and several appear loose / chipped. Safe to say, my mouth remains a disaster area. Worse, it appears pain in right back tooth is causing some weird ear-related stuff. That could just be in my head though. Regardless, I'm pretty sure fake teeth are in my future.
The problem is that I've found every time I've gone to the Dentist they want to start me off with a cleaning, bring me in for a scaling, and then start filling teeth, without ever really telling me the plan; and I eventually either cancel an appointment or stop going.
Thus, I was curious if there's form of special dentistry that can just knock it all out in one fell swoop. Knock me out, fix it up, implant whatever teeth are going to be gone (I suspect a few) and then ship me out, with a new fake smile to boot.
Is there a word for this?
Basically, I'd rather go to the dentist one or twice, fix everything I can, be in some considerable pain for a bit, and be done with it. Whenever I bring this up to a dentist they tend to deflect. For example I had to go to three different appointments to fix *one* crown? Another dentist I went to said that was some bullshit.
Is there concern regarding 'being put under' because I'm a larger gentleman?
Please advise!
Thanks!
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From a size perspective there is an interesting story (I don’t know the validity) where they created a table for sedating larger fellows based on how much Andre the Giant drinks before getting tipsy, and sedated him and others of that size using that table. Practically I’m a larger fellow and have been sedated for having wisdoms extracted with no problems.
From my experience, a good dentist will typically want to start with an XRay and/or camera imaging before or after cleaning and then use that to set up a real treatment road map with you. It likely will take more than two visits if it's bad, there's not much you can do about it if you want this resolved.
Also avoid "lower income bracket" dentists, because you'll be treated like cattle. You may have to pay a bit more but a good dentist is worth their weight in gold.
conventional dentistry is not going to do all that in one appointment, because they prefer to not shoot you up with that much novacain in single day
it sounds like you're going to need like... at least 8 hours solid of dental work, probably more, i think no matter what you do you can expect multiple appointments
the longest appointment I've ever had was about 3 hours... dentists are people too, they take breaks :P
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Let's go with the hardwood floors metaphor here.
First thing's first: they need to really clean the shit (literally) out of your floor. No matter how many times you sweep with that stupid little dustpan and brush you have, there's just no way for you to clear all that away effectively so they can see what kind of shape the surface is in. They need to clean it thoroughly first. No they cannot fix it all that day. They need a plan of attack. Do they do parts of the room together, different procedures, how much can they do at once, does anything need to just come up and be replaced and what kind of time and tools will that require? And even more importantly, the cost. How much does the homeowner have set aside for this room, and what are their priorities. All of this needs discussion; it's a big project with a high potential cost, and of course you don't really know what you're going to find until you start tearing up boards.
Seeing the dentist is kind of like that. No dentist worth seeing is going to be able to give you more than a rough idea of what's going on without cleaning you up; they're going to sit you down, maybe give you an idea of what they see at a glance, then clean you up, take your picture, and catalog the issues. It sounds like a long list. Sometimes a suspected cavity turns into a root canal. It happens. No, they can't do it all in one or maybe even two visits.
If you want to speed things up, you can try to find a dentist that makes their permanent crowns in-house. Otherwise they'll need to order one for you and that takes time. Conscious sedation has been a godsend for me, because everything goes more smoothly from start to finish if I don't know what's happening. A lot of the time they really can do more if you're out, but even then most are only willing to do so much of your mouth at a time.
As someone who avoided the dentist for far, far too long because it turns out my nerve clusters are slightly off from where they're supposed to be which meant I had two crowns put in with virtually no anesthesia when I was in middle school: Go to the dentist.
You're probably looking at a crown on that tooth at the very least and likely a root canal. This will suck. It's entirely possible you're also looking at needing 10+ fillings. When I finally went in I needed two crowns, a root canal and seventeen fillings. It took two years because of benefit limitations.
Nitrous oxide (laughing gas) should make the process virtually painless. Personally I just found a dentist that believed me when I said I wasn't numb (which is how we found out my nerve clusters are in odd spots).
As far as dentists not giving you a plan? Fuck that dentist and every single dentist that does that. If a dentist isn't giving you a full plan to fixing your teeth then find another dentist. I wasn't exactly pleased to find out I needed all that work done but it at least let me wrap my head around holy shit I need to take care of this and also plan it all out financially.
Full on anesthesia goes that's to cost more and while I can't speak to specific risks based on size my understanding is that full anesthesia carries with it a lot more risk because full anesthesia always carries risk.
If money is no object? You can totally get everything done and have it done while you're under. I looked into what it would cost to replace my visible smile with implants and then fix everything else and the cost was estimated at just under 20k, which, well, that's 20k.
You are looking at at least 2-5 sittings at any reputable dentist.
From what I gathered the problem is that infections are bad and can kill you, and tooth trouble often involves infection. If you go cutting and chopping away like mad at an area that is infected you can end up spreading the infection and making things much worse.
As a result the process as I understand it involves treating the infection first (which may involve drilling out/cleaning teeth to get to an infected area, antibiotics etc), and then waiting for your body to do its thing so that any surgery/filling/crowning is done to a healthy mouth.
I'm guessing this is may be why you are having trouble finding a dentist to fix everything quickly or give you an exact timescale. By asking them to do things quickly you may be essentially asking them to risk your health and their career.
I'm not a dentist though and may have interpreted what he said way wrong of course.
Depending on the work being done this is absolutely true.
For example iirc the work I was looking into would have been a minimum of six appointments and possibly upwards of nine.
Apologies if I wasn't clear. I wasn't trying to imply it would be a single visit but rather that full anesthesia for everything would be an option if money was no object.
I had to get a single crown and it was four visits with two different people. Initial consult -> root canal -> extra filing down of tooth, figuring out stuff for crown -> actual crown-go-in-now. They needed to fabricate the crown, and the dentist was uncomfortable doing the root canal (which I appreciated!) so, two or three at a minimum.
And it turns out I have hilariously long roots to begin with (the endodontist had to take extra X-rays to see the end), so I'm glad I was referred to a specialist! It took exactly the right number of visits with the right number of people.
there's a machine now that can make them in-house... i had a single appointment root canal/crown
it just depends on the dentist... also some dentists will not do root canals on molars, but it's subjective. my dentist thought he wouldn't do mine, then he looked at it and went "ahh that's not so bad" and i was able to avoid the surgeon
we also talk about other random shit and clown upon each other
Being "Put Under" means different things to different people. If you're talking about a general anesthetic, don't get one at a dentist unless they have a CRNA or anesthesiologist on site. If you need general anesthesia, you should probably also be seeing an oral surgeon, not a dentist. Even if an oral surgeon is what you need, they will still require that you clean things up first. Jaw line infections are no joke and cleaning up your dumpstermouth is one way of preventing something like that from happening... if you have an infection in one location and they decide to root canal another location you can end out with anything from having all your teeth pulled to sepsis.
Get the deep-clean and x-rays. Ask about nitrous oxide and getting some Ativan before the visits. Nitrous is usually an extra 15-20$ and Ativan may be covered by your insurance medication benefits and only have a co-pay. Ativan is Valium's big brother and can be taken with dissolving sub-lingual capsules that work very quickly. For deep cleans my dentist does a total of four visits, each lasting an hour and they use local anesthetic (novocaine) to numb each quadrant of your mouth so if you can put up with the pinch of it it's painless thereafter.
Ultimately they're going to keep telling you to brush and floss, and much like you I avoided the dentist for a decade. My mouth does in fact feel better now that I brush and floss and get regular cleanings and I have no doubt you'll be thankful you had it all taken care of.
The being a "big guy" question, the answer in a more general sense is yes. Airways are judged on something called mallampati classification. If you go to a dentist and they mention anything about intubation and there's no CRNA or anesthesiologist, find a different dentist.
Edit: I think we actually have a few nurse anesthetists and anesthesiologists on the forums if you had questions about that sort of thing.
HATE.
as such, I had to have nearly $1,500 worth of crowns (2) put in my mouth. It was terrible, but it scared me straight. After the literal hell of getting them put in and getting used to them, I am so happy I did. My mouth pain is gone and I'm not embarrassed to smile anymore. It sucked, but it's worth forcing yourself to do it. It will not get better, but will get worse the longer you put it off.
also, the technicians kept asking me if I was going to faint. but I showed them! I stayed cool the whole time and had a minor nervous breakdown later in the parking lot.
edit: also, in addition to Novocaine, they have this gel that they can actually shoot (using a very small semi-rigid rubber tube) in between your teeth that numbs everything so you really don't feel much besides a mild tugging or scraping for the most part. Still terrible imo, but much better than nothing at all.
I have had the following tooth procedures done in the last year:
I totally, completely understand not wanting to go get a cleaning (I have one in two days that I am dreading) because it is easily the most painful thing on that list, but it is integral to making sure that all the other work they're doing on your terrible teeth doesn't cause infections. The area they're operating in needs to be clean!
That said, I don't think it's totally unreasonable to want things to happen with some expediency, especially if you're in a lot of pain. Because my initial immediate situation was fairly similar to what you're talking about here, I thought I'd go over how this has played out for me:
I had a long first appointment with an initial cleaning and x-ray, and then my dentist sat down with me and showed me my x-rays and outlined a plan of attack in detail. It is not unreasonable to specifically ask for that to be gone over with you!! For me, that meant answers to the questions, "how many fillings can safely be done in one hour-block visit?", "how long will there need to be between visits for the swelling to go down?", and "which areas need to be the priority?" - what wound up happening was, I had about 2-3 fillings per visit, with about 3 weeks in between visits, for pretty much this entire last year. The root canal and crown happened across 3 visits, but those were all within 72 hours (Tuesday: evaluation and referral, Wednesday: root canal, Thursday: crown). Every visit, they'd do a new x-ray of my teeth and go over it to make sure I was aware of any changes in which teeth took priority or our overall roadmap.
Now, the thing where I feel most similar to you here is this - while I am not afraid of dentists or dental procedures, I DO have a BAD NEEDLE PHOBIA, and a resistance to novocaine, so I have to be stabbed 2x as much as a normal person and then I am still usually not completely numb for whatever procedure. When I told my dentist this, she prescribed me Ativan. I take .5mg to 1mg of Ativan before every dentist visit depending on how scared I'm feeling that morning- not enough to knock me out or impair my ability to go to work afterwards (for most of the year I was basically getting fillings in the morning as a, like, pit stop on my commute) - enough that I am not terrified and I don't come away feeling shaky or sick. When my dentist prescribed me the Ativan, she said that it was common for them to have to prescribe something for dental anxiety anyway. Explain to your dentist that the reason you have not been on the ball with this is that you are so afraid of dental work, and ask if there is something they can give you so that visits are not so terrifying.
Anyway, hope this was helpful, and good luck!! Go to the dentist!!!!!
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Pretty much what everyone here is saying is true. You aren't going to get this all done in one or two visits. There are medical reasons for that. What you need to do is some homework and find a Dentist that you feel really comfortable with, who can see you and come up with a plan to fix your mouth. This dentist should break this down into steps as far as what needs to be done first, and what can wait. Typically anything causing you pain shoots to the top of the list. Do your homework, ask for referrals. This is not easy, as many people don't Yelp their dentist, so it's hard to get info like ratings and things like that. I would ask friends and co-workers, family etc.
Anyways, for me it was never about the pain, or money, or time. It was just about the shame. About going there the first time and imaging the look of horror from the dentist. Thankfully, that never happened, though I did get a good talk or two about the state of my teeth, a plan of attack, and how to move forward.
I will repeat what everyone else has said here- cleanings are important. Yeah, they suck (to me they've actually been the most painful thing, and I've had filling, root canals, a crown, and wisdom teeth pulled out). Don't try to take a shortcut, don't be embarrassed. Just go do it.
ESPECIALLY because most dental health insurance plans have yearly cap limits, so unless you're really well off, you're going to want to prioritize and space out your procedures.