This story is non-political, but might be helpful to some...

[PCIntern]

One day per week, I work in a community in South Jersey wherein many people do not attend the dentist on a regular basis. In the early afternoon yesterday a young lady came to see me who had had some issues and I had wanted to reevaluate her two weeks following my treatment in order to ensure that she had some resolution and was on the road to recovery. She mentioned that her boyfriend in the waiting room had been complaining about his teeth all the time and had a toothache which seem to be persistent for months. I said to her that I would be happy to see him today and take a look .

So she took some time to persuade him to fill out the health history, etc., and he eventually sat in my chair, and the assistant took a radiograph. I walked in the room and said, hello, went through the usual, patter of him saying how he hates dentists and my usual reply that I’m not too fond of the patients myself, so we’re even, and we both laughed and we are now officially “buddies“. I take one look at the x-ray with the flicker of my eye on the screen, and ask him what may I do for you today. And he said that he just wanted me to take a look and let him know what was going on. Without a word , I shook my head and he stared at me for an instant and I said you are not leaving today with those two broken teeth in your mouth. He said that he was really scared to get anything done and I acknowledged that and told him that in no uncertain terms we had to get these out of his mouth because they were dangerous to him in several fashions. I further told him that I would ensure that he would not feel any pain while I was doing my procedure, he might feel some pressure and if he did feel pain, I would give him more anesthetic immediately without question.

He consented to the procedure, and I gave him double the volume anesthetic for a variety of reasons which I will not go into here, and manage to elevate three horrifyingly abscessing roots out from one tooth and extract the second tooth with forceps which revealed one of the largest cysts I’ve seen in a long time attached to the tooth. I completed the entire procedure in about 8 to 10 minutes, including waiting for the anesthetic to take effect and packed him with gauze. Through the packing, he said that he didn’t feel a thing and that’s amazing and I told him that he was an excellent patient, allowed me to do my job, and he was going to feel so much better starting in about an hour and a half when the anesthetic began wearing off. He then told me that he has been suffering with the pain with these two teeth for more than two years and didn’t mention it to anybody.

I tell the story in case there is anyone reading this who is afraid of going to any practitioner of any type because of what you will have to endure during the procedure. if you attend a competent practitioner, the experience should be at worst uncomfortable, but the result will be magical. Sometimes you just have to rip the Band-Aid off quickly - two years he suffered with this and in less than 10 minutes his problem was permanently solved. It should be a lesson to all of us that dealing with an acute situation is preferable earlier and wishing and hoping things go away by themselves is fruitless and can be dangerous in many ways, including physically, emotionally, educationally, or maritally.


(Photo of the extracted teeth is available upon request😁👍

[niyad]

1. KNR

[Alice Kramden]

2. What a great story - you did good

And it's also a good political analogy

[Delphinus]

3. I could be him

If only all dentists had the same care and compassion for those of us who have very low thresholds for pain and EXTREMELY sensitive teeth.

You’re a good one, doc.

[Maeve]

4. Thank you for your service!

Yeah, I know people usually use that line for military vets, but you are doing good for people, as well, using your talents to improve lives and too often are repaid with fear.

And you write interesting posts, too.

[malaise]

5. Great post

rec

[EYESORE 9001]

7. So...can you work me in?

Just kidding.

I remember being terrified the first time I went to the dentist at age five. I tripped while running up steps, fell down and broke both top incisors on a concrete edge. The soft tissue injuries inside and outside my mouth didn’t require stitches, and I was taken to a dentist right away and both ‘baby teeth’ were pulled. The sting and white-hot acute pain of my first Novocain injection scared the bejeebus out of me. I recall apprehensions on subsequent visits to the dentist, but they subsided over time and it doesn’t bother me much at all now. It’s not surprising that lots of people dread going to a dentist, but they must overcome fear and do what’s necessary for their health.

On edit: I’d like to see those photos. My prurient interest streak is a mile wide.

[2naSalit]

8. Just getting in the chair...

Is a traumatic event for me due to childhood events at the dentist, I never had anesthesia for the first several years.

But I decided in my 30s that I had best make sure I was able to handle it since I needed a bunch of crowns. My only requirement is that I can't be lucid during procedures involving drills and needles, so I get unconscious and that makes it possible to get the work done. But i get the work done because I have suffered abscesses with no medical help available and it put me in the ER... I was homeless at the time and couldn't find a dentist who would even see me.

I thoroughly appreciate and am thankful for professionals, like you, who tend to the poor!



My situation is stable these days but I still have to travel 45 miles, one way, to get my teeth cleaned. More serious work is entrusted to a resident clinic six hours away in another state because it's the only place where I can be anesthetized at a reasonable cost.

[PCIntern]

10. Understood..

You’re not alone.

[2naSalit]

12. Sadly...

True.

Dental pain is among the most excruciating, worse than most other kinds.

Glad there are dentists like you!

[JustABozoOnThisBus]

27. Historical question: was it common to fill cavities without anaesthetic way back?

I seem to remember getting drilled and filled without any shots, when I was a kid, late 1950's maybe. Was this possible, or am I possibly remembering things wrong (not unheard of)?

Now I get numbed just to get the teeth cleaned. I hate that ultrasonic whining gizmo.

[PCIntern]

31. Yes...among asshole dentists.

Someday I’ll write a post here about anesthetic and dentistry which will almost be unbelievable since it took place in the 1970s.

[JustABozoOnThisBus]

33. The dentists that worked on me back then were at Air Force Base clinics.

All those old silver fillings are now gone, replaced over the years with some kind of white-ish ceramic or epoxy or something.

[panader0]

34. I live close to Naco, Mexico where there is a 'good' dentist at one half the price here in the

states. I had to get an extraction and he asked me if I wanted an anesthetic to which I said yes.
Apparently, many poor Mexicans forego the pain relief because it costs a bit more, Muy macho.

[Easterncedar]

42. To be fair

I had I think an excellent dentist when I was a child. He never used anesthesia and I’m afraid my siblings and I had multiple cavities over the years. The drill was big and slow, compared to those now, and it sometimes hurt, sometimes quite a bit. I wasn’t traumatized by it. I don’t turn down anesthesia, but sometimes the needles are pretty unpleasant!

[PCIntern]

50. And to be fair:

And I quite understand how you did very well in that environment with a dentist, but I will tell you after 43 years of practice with a vast number of patients whom I saw who were treated without anesthesia and were not particularly traumatized by it, had a ton of residual decay left in the tooth and the dentist filled over that decay. Now I am not saying that happened to you, but this was true for at least 90% of the people whom I treated who related an experience like that.

The new needles we use are either 30 gauge or 27 gauge and when used properly are barely felt by the patient upon entry, and if the anesthesia is expressed slowly enough , it is almost impossible to know that anything is going on. In the old days, back in your and my day, the needles were 23 or 25 gauge and were relatively dull by comparison, and the entry of them did hurt quite a bit, no question about it. The problem was that if you didn’t numb the area, the removal of the final amount of decay was beyond excruciating, and when the ultra speed hand pieces were introduced in the 1960s, it became impossible to use those without anesthetic because the nerve was vibrated at such a high rate that it was beyond agonizing. It was terrifyingly painful.

[Easterncedar]

52. Olden days

Things are better now, no doubt! Wish we’d had fluoride when I was a kid, for one thing. My dentist was very skilled. When my older sister was in Germany in the mid-70s, her dentist there called a class in to admire her fillings.

He’s long gone now, of course, but I couldn’t let the general slur stand. I do very much appreciate your professional information. Thanks.

[llmart]

58. You are not remembering incorrectly.

The summer I was 13 was the first time I ever went to a dentist, mainly because my parents were poor and had seven children. I had 13 cavities and spent every Saturday at the dentist's office that summer, as did my two youngest brothers. I don't ever remember getting Novocaine except one time. I always chalked it up to the fact that my father was trying to save money. I also remember sitting in the chair one time and the dentist started out by saying, "Oh right, you never get Novocaine" and he began to work on me. I was too shy to speak up at that time. This was about early 1960's.

I have always believed that health insurance should cover ALL body parts, including teeth and eyes.

[Hekate]

60. My mom was afraid of "drugs" &the family dentist used to keep telling me the cavity wasn't that deep

Tears used to run into my ears. Yes, this was the 1950s and halfway into the ‘60s, when I moved away to college. I have no idea if this was “normal” or not.

My recovery started when I was able to choose my own dentist — actually one of my university roomies recommended Dr. Yee, because, she said, he didn’t hurt. Two of my other roomies were in the dental hygiene program at the university, so I got my teeth cleaned for free. They weren’t allowed to tell you what they found, but from long experience I could tell when their instrument hit soft spots.

Anyhow, Dr. Yee came at me with a needle, and I asked, “Is it that bad?” He said, No, but he didn’t like his patients jumping around in the chair while he worked on them. (Oh thank God, I thought.)

It still took me many decades to be able to sit in a dentist’s waiting room without sweating. The whine of the drill in the next room was excruciating. For whatever reason, though, I am good at compartmentalizing, and I was determined to keep my teeth — so I made appointments and kept them. And from Dr. Yee onward, pain in the chair was not an issue.

[William Seger]

9. I put off cataract surgery for 4 years because I was afraid of the procedure

Putting up with failing vision for so long was the dumbest thing I ever did, I think. It was quick and painless, and the difference it made was amazing.

[70sEraVet]

11. Problems don't just go away by ignoring them?

Think you can take the time to extract the systemic racism rotting our country?

[Easterncedar]

44. Nice one

[raccoon]

13. Thanks for posting.

[mopinko]

14. i'm hard core this. at the age where i'm starting to have to replace parts.

i have degenerative disc disease. i had 2 blow in 08. it took a long time to get to surgery. too long.
c 4-6. i had pain and tingling all the way to the tip of my middle finger. the delay made that permanent. last 2 joints of that finger tingle all.the.time.
but waking up from that surgery, and zero pain, after mos, lordy. it did feel like a miracle.

had to have my rotator cuff rebuilt, too. likewise took too long. recovered rly well from that, but was told by my surgeon- when it’s inevitable that you’ll need surgery, the sooner the better. dont wait for muscles to start atrophying. and dont put up w unnecessary pain. it grinds you down on every level.

[plimsoll]

15. Another one of those things American people want to look away from.

It's astonishing how many people died of untreated dental abscesses historically. The other is maternal deaths. When people tell me we have the best health care system in the world I just bite my tongue and say nothing.

[LakeArenal]

16. The horrifying idea of a root canal DOES NOT HURT ANYMORE. n/t

[Farmer-Rick]

17. Yeah, I understand that fear of the dentist

Even if you are suffering. But Dentists around here all want to up charge me for work I don't need.

I have seen 3 different dentist in the last 3 months. The older dentist I had before COVID isn't in practice anymore. So, I'm looking for a new dentist. The first dentist wanted to upsell me on everything. She wanted to sell me a water pick, fancy new mouthwash and a credit card. She also wanted to pull all my remaining wisdom teeth that are not infected or causing a problem. Of course she wanted to do that fancy expensive deep cleaning.

Then I made the mistake of going to Aspen Dental who took tons more x-rays because the other Dentist's very expensive x-rays were not clear enough. Look up the article NPR did on Aspen Dental. Yes, again they wanted to pull my wisdom teeth but found all sorts of other stuff to do too. Of course that fancy expensive deep cleaning was available for just $2,000. They tried to sell me on a $7,000 bill. I haven't gone back.

I tried to get Aspen Dental to email their x-rays to another Dentist I found in town, but they have to go through their main office and it will take a month. And of course they won't e-mail them, they have to snail mail them. All this because I want to get just a simple cleaning.

[PCIntern]

18. Aspen is just one of these miscreants...

They’re everywhere.

[TuxedoKat]

32. Ask your friends and neighbors

for their recommendations and listen carefully. If you have the Next Door App you can ask on there for local dentist recommendations.

[Farmer-Rick]

53. Yeah, I did

Aspen Dental was their recommendation. A company so bad they have to bilk widows and the elderly to make money.

The third Dentist, the one I'm trying to get my x-rays sent to, was my uncle's favorite dentist. I always thought he was a bit high on his prices. But what the heck. Any dentist is going to be better than Aspen Dental with their $7,000 price tag.

[nuxvomica]

19. I've known well-off people with bad teeth

Because despite having enough money, they fear going to the dentist. It's too bad because dentistry has come a long way in providing complex services with speed and comfort. In crowns alone, I've seen remarkable progress from the old hot goop mold process to the new digital scanning that is faster and more precise, reducing bite issues afterward.

[oldsoftie]

20. I have an unhealthy fear of doctors. But I FORCE myself to get a yearly physical

Men especially are notorious for NOT going to the doctor & growing up I heard, more than once, my parents talking about someone who had died. And I'd hear; "Well they said if he'd just gone to the dr when he started having problems they would've caught it in time"
And I decided I never wanted to be one of those guys.

[Warpy]

21. Three things will never get better on their own

1. something on fire

2. something leaking

3. teeth.

I'm glad this poor guy was talked into having those teeth out. He might not have lasted much longer.

[Aviation Pro]

22. Showing this to my wife, the DDS

She had an issue with an alignment yesterday that took her two hours to resolve.

[MLAA]

23. I will no longer refer to you as Dr PCIntern, from this day forward you will be Sir Improver of Life

and bringer Health and Happiness. Well done!

[Aviation Pro]

24. This also speaks to the importance of dental hygiene

Your digestive system starts with your teeth. Take care of them and they'll take care of you.

PCIntern, did you make it to New York over the Thanksgiving weekend for the convention at the Javits Center? It was pretty eye opening to me as a guest seeing all the technology.

[kwijybo]

28. Directly related to cardiac issues, too

I remember a study that linked bad teeth with cardiac issues. The infections in the mouth ended up in the heart or affecting the heart.

[PCIntern]

30. I used to go to that convention/exhibition

But haven’t in recent years since it moved from the NY Hilton to Javits

[usaf-vet]

25. Not the least bit afraid of any dental procedure EXCEPT being able to afford the procedure.

In my area, you cannot get a dental appointment for months out. NO dentists are accepting new patients.

There are no free or reduced options.

So the bottom line is what I learned 60 years ago..... a monopoly.

We have decent supplemental health insurance but no dental or eye care.

Medicare doesn't pay for either.

My wife and I both had good jobs and saved what we could while raising four kids.

The 2008 crash set us back years, with insufficient time to recover completely before retirement.

Medicare doesn't pay for either because the REPUBLICANS won't let it happen because they want to privatize both healthcare and social security so they can get their greedy hands on the money in both programs.

Not the least bit afraid of any dental procedure EXCEPT being able to afford the procedure and the REPUBLICANS who want to make it worse!!


Thank you PCIntern for caring and doing what you can to help.

[IrishAfricanAmerican]

26. K&R

[jaxexpat]

29. I'm guilty on dentist fear, too.

My mom took me to an ex-marine sadist as a child.

[panader0]

35. I had some work done here in my town by an Indian dentist in a shop run by Vietnamese owners.

The work, the facility and the owners were all great. My girlfriend works at the local radio station
so I did a free promo that airs a few times every day and has for a few years. I always wanted to be
on the radio.

[iscooterliberally]

36. One of the key secrets to living a happy life is to just rip that band-aid off.

Put the bad stuff in your wake so you can move on to happier times. I'm fortunate to have a great dentist. He saved me from a possible root canal twice. The poor guy went through a couple of porcelain crowns with me though. They both broke before I made it out of the office. Apparently I have a very strong bite. He gave me gold crowns instead and I've had them for years now. My dentist was also the first one who noticed that I had high blood pressure. I went straight to my regular doc and got that sorted out right away. Happiness is going to the dentist once or twice a year! OK, it's not that fun to go, but the end results can be magical. Thanks for the story!

[iluvtennis]

37. @PCIntern - thank you for what you do for people.

ps I'm nervous everytime I go to the dentist and I've had/have ones with excellent bedside manner. I've learend through the years thatpain from your teeth can take a body down, so you gotta attend to keeping the mouth healthy.

[albacore]

38. A national health care plan would cover dental. But that would be sensible, so..... nt

[LittleGirl]

39. Can I ask you a question?

I go to the dentist tomorrow to prepare for additional work that needs to be done.
I had a tooth pulled last month and I told the dentist that I can’t handle Novocain so he shot me with something else. I don’t know what it was but will ask tomorrow.

After the tooth was pulled, I stood up and got dizzy. The doctor and hubby picked me up and put me back in the chair where I spent the next 30 minutes shaking uncontrollably. I was breathing in and out to try to calm my body. I told the dentist, I can’t handle epinephrine. My BP was 180/120 for that long and scared the crap out of me.

So what numbing agent is used for us weirdos that can’t handle Novocain? My friend suggested Lidocaine? Is it similar?

[PCIntern]

40. I have never in my career given Novacaine...

Lidocaine with Epinephrine is the anesthetic of choice. If epinephrine is not tolerated well, we usually give Carbocaine 3% with no vasoconstrictor.

If you told the dentist that you can’t handle Novocain, then he, or she didn’t even pay attention to that because it hasn’t been used since forever. what do you need to say is that I have trouble with block anesthetic administrations which contain epinephrine. Infiltrations with Epinephrine contained in the anesthetic usually do not affect the person in the same fashion because they aren’t injected intravascularly which can occur by mistake.

[LittleGirl]

41. Thank you for that quick reply.

I really appreciate it. I can’t thank you enough.

Yes, he didn’t listen to me and I tried to keep my temper in check while the epi ran its course. I needed a wheelchair to the car.

Then it took 6 hours for the numbing to wear off. That was the second time it happened to me. Last time was ‘97.

[PCIntern]

49. Are you sure the dentist didn't use Marcaine?

That lasts a very long time.

[LittleGirl]

51. I don't know

But I will ask.

I have the MTHFR gene mutation and I don’t process a lot of medications like normal people.

Thanks again.

[tblue37]

43. Or politically.

[W_HAMILTON]

45. Random dental question...

If someone had a tooth removed and a bone graft put in with the intention to eventually get a dental implant, will the bone graft essentially last forever? Or will it wear away after a certain point if the dental implant had not been performed yet?

[PCIntern]

46. It is "permanent"

The graft simply acts as scaffolding around and through which the bone grows

[W_HAMILTON]

47. Thank you!

I had the removal and bone graft process performed over a year ago, but, for various reasons, haven't been able to make it back for the actual implant, so I was wondering if the bone graft part would have to be redone in the future or what.

[bluestarone]

48. Well i gotta say, YOU sound like a hell of a great Dentist!! (one in a million)

I'm surprised that after dealing with this for two years, there was no infection? TYVM, for caring for the common person!!

[TigressDem]

54. Not only much better, but alive.

I had heard to never fool around with an abscessed tooth, because it can send infection to the rest of the body.

Potentially lethal sepsis?

[ecstatic]

55. I thought you had to take antibiotics before procedures like that.

It's really cool that you helped them and others in need. I avoid dentists because I always feel like my time and money gets wasted (not to mention all the xrays that have probably caused invisible damage by now). For example, I went a few weeks ago because I thought I might have a cavity. She said I didn't and that was the end of it. No explanation for the pain (but later I self-diagnosed the issue to pain caused when food gets stuck between teeth).

[duhneece]

56. I have Trigemenal Neuralgia-two brain procedures

Second one, in 2018, was (mostly) successful.
I have a tooth that needs to be pulled.
My dentist won’t pull because of how close it is to that middle ‘branch’ of Trigemenal nerve so referred me to oral surgeon who said the same.
I’m thinking of asking for a referral from neurosurgeon.
Sound reasonable?

[PCIntern]

57. What's the story with the tooth?

[duhneece]

59. It's mostly 'filling'

I got a toothache, saw dentist who said the tooth needs to be pulled, gave me an antibiotic and pain disappeared.

I’ve had swelling and minor pain but gargling with Listerine has kept it at bay. I considered calling a third oral surgeon but not telling him about TN.

I live in south central New Mexico, Alamogordo.

The oral surgeons are in El Paso, Las Cruces or Juarez (much cheaper although I got dental insurance for 2023.

My neurosurgeon is in Albuquerque.

[PCIntern]

61. If it has a pulpitis is or is abscessing

it can affect your ganglion of your trigeminal nerve and cause “tic attacks”. Whereas I understand the hesitancy to remove the tooth but the stimulation from the pathology may also constitute a problem. Best of luck in your clinical course.

[duhneece]

63. I'll call neurosurgeon Monday

Tuesday at the latest. I rarely call anyone on a Monday. I’ll get that sucker out.
You are the best. DU has given me another gift in you, PCIntern.

[PCIntern]

64. My pleasure.

[Skittles]

62. as someone who has had trouble with my teeth all my life

I can honestly say I've never felt any real pain at the dentist (I admit shots really don't bother me either)....they deaden my gums GOOD....