The never ending tooth saga

For more or less, this is a whiny post. For the past month in a half, I have been in horrible tooth pain...again. I feel like this will never end. I think this infection has been brewing since January, but none of my dentists seemed to take me seriously - all thinking it was residual from a filling. I'm very frustrated by this, as I feel like if it had been dealt with then, I would not be in this situation now. But isn't this the story of all of our lives?

I called my endodontist this past Thursday as I am scheduled for a root canal on Tuesday, but they were out of the office until then. I called my regular dentist, but they said they could only recommend painkillers, and since I do not do well with just about every one (percocet is the only one I did okay with but had nausea and discomfort this time around), that was out of the question. I asked if I could at least be put on another antibiotic, no answer there. Since the pain has worsened and now the gum surrounding the tooth is infected/swollen, I called my regular dentist after hours. I'm hopeful she calls me back. I've tried some natural remedies, like onion and clove to no avail. They only gave very temporary relief. I've tried alcohol just to numb the tooth pain and gum, as well as tea bags with no success

So, I feel like I'm doomed to a lot of ibuprofen and tylenol. It's been within safe limits, but it's uncomfortable taking that much amount of meds to be honest, especially with past liver issues (now fine).

On top of all this, I have another infection in my mouth as well. With that one, it is in my gum surrounding my one tooth on my upper left side (used to have a bridge there). We cannot figure out why the infection won't drain and just stays there. This has caused intense itching, and again, has been for quite some time.

Then, in general, this is all a huge amount of money to fix. :sigh: Even in recovery, the after effects of an eating disorder looms. It is really disheartening.

Teeth issues don't go away

Yesterday's dental appointment wound up disasterous. First, I was 20 minutes late, having gotten lost going a different way or a way that I thought was the right way. By the time, I arrived, I figured I would have to reschedule. But they allowed me to have my dental cleaning since the person who was after me never confirmed her appt.

This appt. was a basic cleaning-no big deal, right?  At the end of my appt., the hygienist said there was a shadow on one of my upper teeth.  She went ahead and did an x-ray.  When the dentist came in, it was confirmed a large cavity.  Then, I had the dentist look at this one place on my upper gum line that has been irritated for months.  When I last asked about this, she said she did not see anything but some trauma.

Well, a new x-ray showed a massive infection there.  Ugh!  I knew something was not right there.  Several weeks ago, I even had a few blood-like blisters.  So the treatment is either a root canal to save the tooth or remove the tooth.  If I remove the tooth, there would be no teeth left on my left upper side which seems like a horrible option.  But then, if I go with the root canal and crown option, I will max out my dental benefits for the year and would owe about $1,000.  Apparently, they can make it slightly cheaper for me by only doing part of the crown, then waiting until after the first of the year to do the rest.  

To be honest, neither option sounds great.  I know in my last post about my dental problems, I sounded pretty good and tried to make a point for others not to follow in my footsteps.  But yesterday and today, I just feel upset about it.  It's like my teeth issues will never get better and will likely just go with me to my grave.  I know that sounds so morbid, but I just feel like I never get  a break.  I've put off some of the major procedures simply because they are too financially costly--think at least 3 implants and  new bridge.  

There is something else with all of this that runs in the back of my mind.  If my teeth are this bad as a major consequence of purging, imagine if I'd been a multiple-a-day purger.  My guess is that I wouldn't have any teeth left at all.  

For now, I'm on antibiotics for the infection and will go back to he dentist in a few weeks for the root canal.  In some ways, I feel like not saving this tooth, but I hate feeling toothless too.  Argh, what a horrible conundrum!  I hope others do not face my plight!

Let's talk about teeth!

Today's topic is teeth. Yeah, I know, I've talked about it before on here. But I think it is one of the neglected parts of our bodies we talk about with eating disorders. And let's face it realistically, many of the symptoms, ie starving, purging, chewing/spitting, etc. can all cause some major teeth damage. It's only been fairly recently that we've realized how early dentists can pick up on the preliminary effects of an eating disorder, though I'm still not sure how much it is discussed in general (for one, none of my dentists ever said anything, I had to tell them)

For those off you who don't know my story, I was bulimic for many years. For over a decade now, I've had some numerous teeth problems, costing thousands of dollars, no joke! It is sadly probably one of the permanent damages from my eating disorder. Currently, I need like 3 or 4 implants and a bridge replaced. No fun, everyone. It sucks to lose your teeth to harsh, violating acts you have done on your body.

So here's the thing. Though logically I knew my teeth damage was likely permanent, I did have some hope I could reverse part of the damage or at least keep it at bay by not purging which I kicked when I began my "true" recovery about 2 1/2 years ago (gosh, it has been hard to believe it has been that long) For me, training for the marathon that year (2008) was part of the impetus to end that bittersweet love affair. There have been some other complications with that, but that is another story for another day.

A few weeks ago, I had a dental appointment. This was for a general cleaning (last time, they just did a light cleaning due to some "pockets") and to have 3 cavities filled. Yes 3! Prior to this, I didn't have any indications other than some slight tenderness to coldness. There hasn't been any purging in a long time, there was no major killer infection or toothache this time, yet still, I was surprised to have 3 cavities! I also have an irritation where one of my teeth was extracted, but my dentist said she could not find anything. It's annoying knowing that something is causing that irritation but not to have a reason.

In some wrong assumption (you know where logic fails you), I had thought that once I stopped purging, all my teeth problems would be resolved. I had felt that just like I was taking care of my body, I was also taking care of my teeth in the same way. I brushed, flossed (okay, this could be better), rarely drank soda or carbonated beverages, etc., but problems still arose. Don't get me wrong, I have far less trouble with my teeth than before, but it is still a reminder that I must be vigilant about them. And that, yes, I will likely always have some susceptibility to teeth problems.

So people, the take home message is don't forget about your teeth! You may not think you are doing damage now, but this like other symptoms of an ED can be lasting and permanent. This certainly doesn't mean that if you have teeth damage, then the hell with it, there is no hope. But rather, be vigilant, remind yourself that you only have your teeth once, so just like the rest of your body, they are important to take care of. (there's only been a very few people that I've known who could actually grow teeth!) Go see your dentist! Just like you would see a medical doctor, therapist, psychiatrist, or dietitian/nutritionist, your dentist is important too!

Okay, I'm done for my spiel of the day. :-)

Follow-up: dental appointment

I had my dental appointment today. There was no major fanfare or inquisition or anything like that. Actually, the most vivid memory I have is of the donkey in the movie Shrek jumping up and down and yelling, "pick me, pick me" over and over again. That happened about halfway through the appt. when the dentist left to see another patient, and I was drifting in and out of sleep. Apparently, it was the end of the dvd and no one had pushed play again.

The appointment was pretty straight forward. The dentist just asked why I was there--mostly to get the bridge re-cemented. The bad news is that there is a huge hole in it where the cement has worn off which is likely the culprit of the cold sensitivity. This also means I'll have to get this bridge replaced or an implant put in. The good news is that the teeth that are under the bridge look good. Once she re-cemented it (and with some lovely stinging pain), I was good to go.

The next appt. will be more comprehensive and other questions then may be asked about my teeth. I pretty much stuck to the basics of my general dental history today. At another point in time, I'll bring up the ED history if she has already not guessed it.

The ironic thing is that my boss knows this dentist! Apparently, she had some work done by the dentist's husband a few years ago. Smallish world I guess.

Note: *Just a quick observation This dentist was tiny! I normally never feel a certain way with professionals, but I felt like the Marshmallow man (I guess technically that is Marshmallow woman) standing next to her.

New area, new dentist

It's been over a year since I've been to the dentist, but I decided to go ahead and make an appointment today. I figured it was the end of the year, so I might as well use my dental insurance rather than feeling like I'm paying for nothing. In a way, this is a good sign, because in prior years, I practically lived in the dentist's chair. This also means that I haven't had as many problems in general with my teeth at all. Another kudos for me! This also equates to virtually no purging either! (I say virtually, because since 2008, it's only been a handful of times) Yeah to me!

Anyway, clapping ends now, because I'm also going to the dentist due to some recent sensitivity in my mouth as well as my bridge loosening after eating nip candy. This collision has happened before, but I just never seem to learn.

I'm a bit antsy as this is a new dentist, and just like a first appointment with a therapist or doctor, I'll have to go through my whole history again. "Now, just why do you have 2 holes in your mouth, a loosened bridge, a space where a bridge used to be, and a chip in your front tooth? And you're how old again?" Argh! Most never ask those questions in that particular style, but that's how it runs through in my head. You know expect the worst and be happy that it usually doesn't turn out that way. Of course, I could be completely wrong too, but we just won't go there.

The appointment is Wednesday morning, so a day to rehearse just everything I will say. Actually, I have gotten better with divulging my eating disorder history with dentists, but it still cause some anxiety. I was actually very hopeful when I looked in the phone book and recognized a name, a dentist who shared a practice with my other dentist where I used to live. Sadly, I think the phone book is wrong and she is no longer there as there is no evidence of her on their website. Wishful thinking I guess.

Restorative teeth

Ever wonder what your teeth could look like from bulimia? Here's an example:

Here's a result after major teeth restoration:

This specific case of a young woman who had recovered from bulimia was featured in the Journal of Cosmetic Dentistry Spring 2008 and is retold here by a Virginia dentist. The press release goes into much detail on the treatment plan and how her teeth were restored.

Besides these interesting details, the conclusion was the best part. This dentist said, "This patient's case involved many of the challenges we face daily in our practice. Just a few years ago, however, I would not have known in which direction to take her treatment. Perhaps I simple would have provided her with a bruxism appliance, while "patching up" some of her fractured restorations and attempting to improve her smile be restoring some of her anterior teeth with direct resins. these would have failed repeatedly, causing us both much frustration."

Though I certainly see this as a wonderful step in cosmetic dentistry, I hope that other dentists will follow in suit. I often wonder how many of us stop smiling or become more self-conscious due to our poor teeth conditions. It's kind of a sad predicament. I hope one day we will all be able to have our smiles back whether it is through cosmetic dentistry or not.

Note--*all images from Full Mouth Rehabilitation and Bite Management of Severely Worn Dentition

*Though the article doesn't talk about it, since this is cosmetic dentistry, the monetary costs for these procedures is quite substantial.

Bulimia is a dental disease

We all know that eating disorders can wreck havoc on oral health. Bulimia, most notably can take a heavier toll at first symptoms which continue to accumulate further as the eating disorder progresses. In this press release, Dr. Brian McKay, a dentist in Seattle, discusses his new book, Bulimia is a Dental Disease.

McKay's goal is not only to educate about the damage of bulimia to one's oral health, but also to bring together the dental community in helping eating disorder clients. McKay says, "We need a change in the Standard of Care. Dentists must form alliances with eating disorder professionals. Together we can treat both the mental and oral aspects of this disease and the result should be a higher success rate. There is nothing more inviting than seeing someone smile again."

To my knowledge, this is the first book exclusively addressing bulimia and dental health. I have no clue how the book is, but I think it is a good step to help educate and bridge the gap between dentists and eating disorder clients.

In my opinion, I think even if dentists may know there is a problem, there is a hesitancy in bringing up the issue despite the fact that some clients may come in multiple times or simply for one visit never to be seen again. As much time as I've spent in dentists' offices over the last twelve years, not one brought up or asked about my eating disorder. It kind of felt like the giant elephant in the room. It wasn't until a few years ago when I changed dentists and decided to be completely honest that it was discussed. I found them (there were two at the time) to be non-judgmental and helpful, even when I was so frustrated that the damage was completely irreversible despite reducing my purging behavior.

The take home message is that dentists and professionals need to collaborate together to help their eating disorder clients. In effect, this will allow clients to communicate and discuss these issues, even if it is only about damage control, like Lola posts about here.

Tooth extracation day over

Just to report back that my tooth extraction went much better than either the periodontist and I had anticipated. I was in and out of there in an hour. It's definitely good that I was really numb, because periodontics is like the orthopedics of dentistry. I found it funny, because even though I had a sheet over my eyes, I still found myself closing them. Dr. V. said it was so water wouldn't splash into my eyes, but I think it's more for any tooth fragments that might fling into the air and hit your eyes.

Dr. V. was also very good about prescribing the meds I wanted, i.e. an antibiotic and pain med that doesn't give me side effects. Luckily, I have not had much pain at all. I think it's because he did not have to cut into my gum. I'm super glad about all this, however, chewing and eating are a bit challenging.

If you look at that dental x-ray picture in my previous post, basically imagine the entire upper left side gone but one tooth (originally, a bridge was there which they had to section), then a hole beside that tooth from the previous extraction. On the lower right side, a hole halfway between the back and front of my mouth. That's essentially what my mouth looks like now until I get the holes replaced with implants at some point in my life. I'm hoping nothing happens to that sole remaining tooth, then I'm up a creek without a paddle. Same goes for my right upper side which has a bridge as well.

As I left the office and was waiting to schedule my follow-up appt., I glanced over at another x-ray which was very similar to mine except that the person in the chair was much older than me. It was one of those moments of realizing how young I am with this much damage. People my age are not supposed to have ruined teeth. Even my mom who doesn't have the greatest teeth still have ones better than mine. And to think I used to compete with her as to not having cavities when I was younger.

Anyway, I'm now going to stop whining about my teeth. I can't change them for now but just accept it and move on just like the rest of life.

Tooth extracation day

image: about.com

I've been dreading this day since I made the appt. two weeks ago. I'm not even sure why I am so worried about it. I've had countless dental appointments unfortunately and a year in a half or so ago, another tooth extracted. I think it's the pain I'm concerned about. I'm never like this either. Pain to me is like a bone sticking out of your arm or blood gushing out of you. I'm not a wimp about pain, but teeth pain seems to be the hardest for me to deal with. I'm also worried that the dentist is going to end up prescribing some pain killer which gives me awful side effects despite me voicing my concerns about it. This has happened before, so it's not my imagination.

Please don't think I'm nonchalant about losing my teeth, because it really does sadden me quite a bit. It's a grim reminder that even if I never purged multiple times a day, my teeth are still ruined from it.

So at 2:30 PM today, be thinking of me. Hopefully, it'll go better than expected. I guess I should think "happy," positive" thoughts. Maybe it'd be better for me to go off to some la la state where I'm sitting on a beach sipping some non-alcoholic beverage watching the sunset. Okay, I know, a little cliche, but I can dream for the moment, right?

More holes

So I had the dental appt. on Tuesday. Good news is that my teeth look about the same as six months ago. The bad news is that it's not just one tooth that has to be extracted but two. I had broken one awhile ago and had a temporary filling which fell out back in October. Normally, I'd put this off, however, after the last very painful toothache I had in November, I am hesitant to do that. I made an appt. with the oral surgeon a week from this coming Mon. I'm just praying he will not give me a rx for a pain medication that gives me horrible side effects. So there goes the $700 for an online class I was thinking of taking. It sucks how much dental expenses are. By the way, all those missing teeth are going to have to have implants. Why not just do dentures now? It would actually save money in the long run as awful as that sounds.

The rest of the week didn't go too great. I saw my lawyer for the dog bite case. We've offered a counter offer in hopes the other insurance company will budge. If they don't, then it goes to trial and all that jazz. I'm hoping it doesn't come to that, as it is just more time, work, and a big gamble overall. I also had a lousy conversation with a good friend. I'm still upset about it, but I can understand where she is coming from. Then I was asked to work an upcoming conference in March, however, there is a conflict by a day. The coordinator didn't seem too happy about this. And me, being the sensitive type, am just take it personally.

Then all my runs this week with the exception of one were just totally slow and off. My mood has also been a bit down. I'm finding little stuff is irritating me, like not meeting with my main physical therapist but someone else instead. I'm really trying to tell myself that I need to snap out of this funk before it heads into some full depression. I need to remind myself of things I need to do so I don't get to that point:

I need to breathe.
I need to eat better.
I need to sleep uninterrupted.
I need to journal more.
I need to be honest with myself.
I need to clear myself of negative energy.

The week will be time to start fresh again.

Tooth misery saga

Now, it's Monday (well technically Tuesday). The pain was a little better today overall. I saw my dentist in the morning. She did an x-ray and looked at the tooth which confirmed the infection yet again. I had a similar infection in this same tooth a little over a year ago. Basically, she said I had to have it extracted. Otherwise, it would just be a continuous cycle of infection, getting better wit antibiotics, infection again, etc. On top of that, the infections would be more frequent. I was so not happy to hear this. This side of my mouth (upper left jaw) already has a bridge there which I'm still paying for. I almost regret getting it now and feel suckered into it even though it was the only option at the time.

My dentist wants me to have his done soon, but my problem is my dental insurance won't kick in for any major work until after the first of a the year. I already have another crown that needs to be done as well. I know my insurance is not going to cover the extraction. One of the dental assistants asked me why I don't get the extraction done now? Well, basically because I was in a huge amount of pain afterwards with no pain medication that worked and it's very expensive. My mom paid my last one, and it's just the whole guilt thing there. She spent a lot of money on me this weekend. It was her choice of course, but still I just feel undeserving of it. She told me it was a part of Christmas, so I hope she sticks by that.

Anyway, I will now have three holes in my mouth when I get that extraction done--one hole from my previous extraction, the second from the new extraction, the third from the missing half of my tooth that needs a crown. This is all in conjunction with also needing to redo my bridge on the right upper side of my mouth. This is when I just think ripping out all my teeth and having dentures is the way to go. I mean it would be a lot less costly then.

I tell my parents this news. Neither are happy of course and feel badly for me. My dad replies with "geez, you're not going to have any teeth left. I'm glad you're over that "problem" (meaning bulimia). I'm just sad you have to go through all this tooth trouble." My mom's reply was, "I knew the eating disorder caused some problems. I wonder why you're having such problems?" Does anyone not see how neither connect the dots or something? My reply to my mom was "well, yes, eating disorders cause damage to teeth. It's individualistic with some not having many teeth problems, while others do. I was unlucky I guess."

In the end, it just sucks how much damage can be produced on your teeth due to an eating disorder. Even without consistent damage, the effects can be devastating and continuous. I'm proof of that.

Post-Thanksgiving and killer toothache

The tooth pain started around Thanksgiving day sometime. It really didn't bother me that much. I just noticed there was some soreness when I'd chew on my left side, so I stopped chewing on that side. However, there were several instances when I accidentally chomped on that side and had shooting pain in my tooth. Crap, I knew this was bad.

On Friday, the pain progressed. Again, not excruciating but definitely painful. By that evening, it was really beginning to hurt. I tried taking some tylenol which helped some. I also began the etodolac for my leg which also seemed to provide some comfort.

By that night and the following morning, I was in absolute excruciating pain. The pain would not stop. I took more meds. That Saturday, I have no clue how much medication I took, but it seemed like nothing would stop the tooth pain. I have had pain in that same area before, but no matter what, the pain is always worse than I anticipate.

On Saturday evening, I called my dentist on her cell phone. I felt horribly bad calling her on a weekend, let alone a holiday weekend, but I was in some serious pain. I took more medication which was very short lived. I remember waking up at like 3:15 AM in horrible pain. The dogs at that point thought it was time to get up. I ended up letting them out but trying to go back to sleep until my alarm went off.

On Sunday, the pain was not much better. My dentist finally called back that afternoon. We agreed it was probably and infection. She ordered an antibiotic and a pain reliever. This is where it gets tricky. I have bad side effects with many pain medications. She decided to try a vicodin-like one, thinking maybe the combination of hydrocodone and ibuprofen would be okay. Well, it wasn't, and i had similar side effects as I normally did. So as of now, codeine, hydrocodone, darvocet, lortab, and tramadol are all scratched off my list for pain medications.

I started the antibiotic on Sunday after my mom went to the pharmacist basically posing as me. She was very afraid they would not give her the meds, so she said my birthdate. That led to a very funny. Plus, if she had the same pharmacist I had from a previous few days who knows me by name, that woman must have really looked at her funny.

By this time, I had really wished, my dentist would have prescribed something that would have knocked me out rather than me feeling desperate to making this damn tooth pain go away!