Well, I cannot tell you how petrified I was going to the dentist this morning!! It’s hard to tell in the photo (ever tried to take a pic of teeth with a phone???), but that crack goes all the way to the gum and it’s right through to the back. I’ve already lost a tooth because it cracked below the gum line, so I wasn’t holding much hope for this one.
I had also stopped going to the dentist because I was feeling I was getting nowhere. Mr. S goes to the same dentist I used to go to, and he’s happy but I’ve had two (yes TWO) fillings done twice over in the last decade or so, so I wasn’t feeling confident in him anymore. After my EDS diagnosis, I was sent to a “gentle dentist” to replace my old metal fillings. He did one-quarter of my mouth last January and I spent the next 3 months in agony and didn’t want anyone to touch my mouth again EVER.
That was till this happened over this Christmas!
Here is a quick sketch of my mouth, and that crack is through my right Lateral Incisor.
I had no idea where to go, or who to trust, I am soooo burnt by doctors who are stumped and their pride gets in the way of real help. But Mr. S convinced me to go back to my old dentist and amazingly his wonderful PA welcomed me back with open arms and found me an emergency appointment.
I don’t want to bore you with basic Biology/Dentistry, but I knew the basics of teeth as this: Dentine (or Dentin in the US) makes up the bulk of our thinner front teeth, with the pulp & root at the very centre, and a thin layer of Enamel covering the part of the tooth that’s not hidden by the gums.
Enamel has NO collagen in it. Dentine, on the other hand, is mostly collagen…. and I was born with stuffed collagen. It’s too soft. I knew this, but most tooth pictures show the big fat back teeth which have much thicker layers of enamel.
So, anyway, between my natural fear of dentists, my fear of him not being able to save the tooth and what the outcomes of that could be, my fear that they will forget and there’ll be adrenaline in the anaesthetic (which is there is in all standard locals), and my worse fear that it will wear off too quickly without it (as usually happens, and they stitch me up without any), I couldn’t see this was going to go any way but badly.
I started by explaining that since seeing him last I’ve been diagnosed with EDS. I explained that more importantly, it’s a connective tissue disorder, and that my collagen is not as strong as it should be. He responded by pulling out his book of conditions and of course, it’s too rare so it wasn’t there.
But then he did what I have rarely seen a medical specialist do and he put the info he had together and went with it! He used his brain and on the spot worked out what was going on! I was so impressed I wanted to cry!
He said that the “crack” is right on the line of the filling that he did there 3 years ago, and that while yes, it goes below the gum line, it can be redone. He said that it isn’t a crack at all (even though he could wiggle the piece!!), but that the filling had “debonded” (rejected, come unstuck) from the tooth! The bond of the filling was mostly with Dentine, which should be rock hard, but if it isn’t, then it can’t bond.
It might not be great news, but at least it makes sense now, and also explains why the other filling near the front of my mouth took 2 goes as well (and may need doing again). He said the cheapest option would be to replace the filling, which may not hold long-term of course, but both crowns and caps require filing back the enamel and bonding with the dentine, which would be a disaster in my case. An implant requires surgery and strong bone structure which of course relies on strong collagen in both the bone and the gum. So basically, we need to avoid implants, crowns and caps at all cost. Things which may be great for other people, but basically we have no option but to go with the simple filling.
The bad news is that this is going to be a problem long term, and I know EDSers who’ve lost all their teeth as early as 39. I’m passed that already but still, I have a mouth full of pain and it’s not likely to ever get much better. But at least now it MAKES SENSE which it never has before. There is a level of comfort in that.
The good news is that he said, “well, we just have to make it stick more” and as he cut away the old filling to expose the raw edge of my tooth again, one normally leaves a sharp “flat” edge. But he decided to file away the edge of the enamel so that it has a bevel edge! While still being a very small surface, it’s twice the surface it would otherwise be! How clever, talk about thinking on your feet and making a plan!
The other thing he did is smooth some of the filling material so that it is overlapping some of the rest of the tooth. The idea being that the filling is now using way more of the enamel that it would have, and we have a chance of it lasting much longer this time. So the new tooth is slightly bigger than it was before and we’ll also have to keep an eye on that, but hopefully, it’ll be fine.
For how long? Who knows, and I think I’m going to be a bit paranoid about using that tooth, but I’m paranoid about so many of my teeth now that I’m running out of options 😦
I have hope for the first time in a long time. And a few more answers!
So I’m going back on Tuesday and he’s going to check out the rest of my teeth and see if there is anything urgent and hopefully fix whatever it was that the stupid guy a year ago did.
I am pretty sure it’s the first time EVER I’m excited about going to the dentist!
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