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Dentistry/What should I do? Complicated situation

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Question
Hi. I am thirty years old and have a lot of dental problems. To complicate matters further I have a bad case of TMJ, which makes keeping my mouth open for a long period of time causes me excruciating pain, and sometimes even causes my jaw to lock on me! I have lost four teeth already, and I am terrified that I am going to lose more. I was devastated over the loss of my teeth, and am still very depressed over it (it makes me self-conscious, ugly and unloveable). I lost two teeth (bottom row) on each side, and I am so afraid that the five other teeth will go next (like a domino effect!). The teeth that are next to the ones that broke/came out don't feel steady to me, and I'm afraid to eat for fear of breaking them! I currently don't have a dentist (I had a disagreement with my former dentist, and he dropped me during the holidays via a letter that came in the mail!). I thought that was extremely unprofessional, not to mention downright mean! How am I supposed to find a dentist over the holidays? No one wants me because basically I am a high maintenance patient, and am on a disability pension so I can not afford things like crowns and veneers or implants. And even if I could, I don't think I could handle getting implants. Way too painful for me! The disagreement was he kept pressuring me to go and have the teeth that broke/fell out removed because he says they are going to get infected. But I am too afraid to go! I had a REALLY bad experience once in O.R. and even though it happened a while ago, I still have nightmares about it. I am a very anxious person and I feel panicky just thinking about it. I don't handle pain well, and I am afraid that something will go wrong during the surgery. When I met with an oral surgeon he mentioned a lot of risks, including the possibility that another tooth could break, my jaw could be broken, my sinuses could be injured requiring painful surgery etc etc I don't know what to do. I don't want to go for surgery, but everyone keeps pressuring me to so. What do you think? Could it possibly cause my TMJ to worsen? And honestly, how painful will it be? I was told that in the case of two of the teeth the gum has grown over them, so they will have to be dug out! That sounds AWFUL! Also, I am very overweight with diabetes and other health problems, and so I am afraid of being put under (they want to do it under general anesthetic). I would appreciate it if you could give me your opinion of the situation and also any advice/suggestions would be greatly appreciated. Also, I realize this question is long already but I have one more quick question if you could please bear with me! I have these very painful sores (I think they are canker sores) on my tongue and cheek, but the most painful one is on the side of my tongue. It is making talking, chewing and even swallowing very painful! I tried applying some baking soda to it, and oh my god! It burned so bad it felt like someone was trying to cut off my tongue! It was terrible pain! And I have not been able to brush on that side of my mouth either (and if I go even a little while without brushing due to my very dry mouth I get cavities!) because toothpaste also makes it burn like fire! It's just painful all the way around, and it refuses to go away! It's been there for weeks now! I was able to get into see a dentist on an emergency, walk in basis (he knew my mom so he agreed to see me, but is retiring soon and no longer has hospital privileges so he can not be my regular dentist even though he is very nice and I would like that)to file down one of the broken teeth that was cutting my tongue. He said that once the root of the problem was gone (sharp tooth cutting into my tongue) it SHOULD go away and feel much better. But it hasn't gone away, and feels about the same if not worse! Any suggestions? What can I do to make it go away, or at least alleviate some of the pain? Thank you so much for your time. I really appreciate it.

Sincerely,

Melanie

Answer
Melanie - The simplest and most effective method to reduce inflammation in that area and at the same time reduce soreness.  You need to simply rinse with warm salt water for a full 5 minutes in that sore area.  Do that rinsing 4-5 times a day and the soreness should get somewhat better.  The only way to get it fully healed is to start with the rinsing and then the soreness should get better and then treatment should be possible.

You also should seek advice from the dental society in your city or province.  Ask them to help you and they should be able find someone to help you.  I'm sorry I can't be more specific, but until you feel better and speak with the dental society about treatment it is a little difficult for me to know who exactly to help you.  The dental society shoul know so speak with them.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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