My Recent Tooth Journey
I didn't expect a dental appointment to lead to emotional healing
December 2023
"You need a crown," the Good Dentist said while hovering over my open mouth with mouth mirror. "Your tooth is cracked.”
"How?" I squinted underneath the LED dental operatoratory light.
"An old filling was overfilled.” The stress from the old filling on the tooth caused a slight crack on the side of it.
My chest plummeted. "How?"
He shrugged. "Someone didn't do the best job."
I already trusted the Good Dentist after being a patient of his practice for a couple years. His observation, though, earned him more of my trust. While previously living in Philadelphia, I'd regularly saw a Bad Dentist who I'd later learn earned a reputation of botched dental work, not-so-coincidentally from fellow queers on Medicaid.
This wasn't the first time the Bad Dentist's sloppy work caught up to me. A stain on my front tooth—that the Bad Dentist told me "was just a stain"—turned out to be a cavity that practice ignored for years, which fortunately the Good Dentist filled on my first ever appointment there in 2021.
"No cavities?" I asked.
"No cavities," he assured me.
I exhaled. At least there was that.
I've lost count of how many fillings I have. A better question is if I have any teeth that don't have fillings. I've been told that I've inherited my parents' poor dental genetics.1 I dread dental appointments because for so many years because for me, cavities were expected.
Sometime during my childhood
“I can’t stand the sound of the drill,” my mother said every time she waited in the dental office with me.
She was terrified of the dentist, even when she wasn’t the one being seen. She, too, expected cavities during biannual dental cleanings.
January 2024
I returned to the Good Dentist's office. I'd gotten a crown before, so I understood the process: that day I'd get a temporary crown and in two weeks, I'd come back to replace it with a permanent crown. Easy, I thought in the waiting area, no cavities, yet I carried a Mookaite Jasper crystal, intended for healing ancestral karma, in my pocket.
When the Good Dentist hunched over me that afternoon, he swabbed my gums on the cracked tooth with numbing gel. The Parking Garage episode of Seinfeld—a personal favorite at my request—played on a television on the ceiling.
"You're not going me novocaine, are you?"
"Uh, yes," he said. "I need to give you lidocaine to prep the tooth for the crown."
"The shots makes me anxious," I plead.
That is an understatement. I don't know if I've always had such a drastic reaction to lidocaine, but it was only in recent years where I've been so attuned to my feelings enough to acknowledge and really feel them.
The handful of times I've received lidocaine in the Good Dentist's office, I've gotten full-blown panic attacks. When I've expressed feeling "dizzy" after the shot to a hygienist, they've assured me it's normal and left the room shortly after to tend to another patient in their busy office. Then, I'd sit alone with my heart palpitating in a thought spiral wondering if I'm about to have a heart attack and die in a beige vinyl and leather upholstered dental chair.
August 2023
At a dental appointment, I spoke up about my symptoms. In between tears, I expressed my heart raced to a hygienist.
"It's normal," she repeated like all the others. "It's the epinephrine in the lidocaine." What the fuck? I didn’t have the words to describe my confusion. Even if it were “normal”, why was it treated so nonchalantly? I was freaking out.
Because my phone ease drops on my conversations or whatever, my TikTok algorithm got the hint I recently went to the dentist.2 A video on my TikTok For You page affirmed what the hygienist said:
"So you get to [the] dentist and now you have to get dental anesthesia. I know it hurts, but at the same time, the worst part is the panic attacks you get, right? Your heart beat rises and you don't like this anxiety, this anxious feeling. The reason is [the] most common anesthesia is Lidocaine that has epinephrine in it."
Epinephrine is the adrenaline neurotransmitter and hormone that plays a pivotal role in the body's "fight-or-flight” response. In injectable lidocaine, epinephrine holds anesthesia to numb a part of the body, such as the area around a tooth.
Notably, this video highlighted an alternate option. The fuck you mean there’s another option?! In the video, Dr. Gul Leo Makhdoom mentioned an alternative anesthetic without epinephrine, mepivacaine, that will numb you without causing a panic attack. (It's also not the only alternative.)
January 2024
“One moment,” the Good Dentist disappeared.
Ten minutes later, he returned with a hygienist. She held my hand and I started to tear up.
"I'm going to use an alternative anesthetic." The Good Dentist returned to his seat. "I use it for kids." He leaned over with the needle. I didn't ask for an alternative—he just saw me in distress and made an informed medical decision.
There was a pause. "I'm ready."
The Good Dentist lowered the dental chair and leaned over. I took a deep breath as he injected the alternative anesthetic. I braced myself and began practicing box breathing: inhale, two, three, four, hold, two, three, four, exhale, two, three, four, hold, two, three four. He rubbed my forehead with a finger, which interrupted my focus on counting.
It was over.
"How do you feel?" The Good Dentist asked.
I blinked, unphased. "Like I didn't even receive novacaine."
According to a 2019 international study published by the National Insitute of Dental and Craniofacial Research, different inherited genes can cause tooth decay and defects.
It could’ve totally been a coincidence, but in this digital data-sharing age, is anything coincidental anymore?
I need one of these dentists! I also have poor dental genes and am terrified. It also hurts more than it seems like it should when I have dental work and in 2020 I found out why—I have Ehlers Danlos Syndrome which means 1) I have very receded gums which is why they bleed so much during cleanings, and 2) injectable numbing agents don’t work as well on me, which is why they give me the max amount they’re able to and I can still feel pain.
Thank you for sharing this story. It's so interesting to me how often fear and anxiety are dismissed by medical professionals. I'm glad this dentist was empathetic and provided thoughtful care. Also, I did not know lidocaine has norepinephren in it. I feel like as a patient you just have to advocate so much and question everything. Thanks again for this post!