Sorry in advance for this post. It’s going to be boring and whiny, and either depressing or annoying, depending on your usual response to self-indulgent whingeing. Best not read it. And definitely best not read it if reading about other people’s dental things makes you get all weird and twitchy, like it does me.
I am currently in the middle of a dental emergency. Long-term fans of this blog––
Long-term readers of this blog will appreciate that dental emergencies are not good for me, on account of me having a fairly pronounced dental phobia. And, you will also appreciate, dental emergencies are not just a cause of the phobia, but also a consequence of it – being very scared of the dentist = not going to the dentist = minor defects becoming major problems = proliferating dental emergencies = triggering of dental phobia = being very scared of going to the dentist… It’s a vicious circle, I guess. Or possibly a catch 22. Some cloak of easy words that masks the underlying horror, anyway.
(Yes, I did write ‘horror’. No, I’m not going back to delete it, or substitute a milder term. Yes, horror is out of all proportion to the reality. But it’s a phobia: out-of-proportion is the defining characteristic.)
This particular dental emergency relates to the last of the teeth still malingering on after my ~20 years of non-attendance at the dentist. All of the other problem teeth have been variously prodded, patched with ‘filler material’, replaced with ceramic or plastic and otherwise made good, leaving this one last tooth – a rear lower molar – as the last reminder of the bad old days. It was scheduled for attention back in the autumn but I had to cancel the appointment. I was having a bit of a MH crisis at the time, and I’m only barely able to cope with dental appointments at the best of times. Plus, the appointment was scheduled for October, which is getting late in the year.
Because, of course, that’s the other thing that long-term readers of this blog will appreciate – that there is a strong seasonal element to my mentalism. While I can experience a bout of simple depression at any time of the year, the more …interesting stuff is generally reserved for the shorter days. So it’s rather unfortunate that my decision (which does not, now, seem to have been my cleverest) to put off the work on this tooth to the spring has precipitated a crisis that absolutely requires my attendance at the dentist within days of the shortest day. This is, to put it calmly, A Problem. Although – to take proper account of small advantages – we are at least on the lengthening side of the shortest day: the light is, how ever slowly, coming back, which makes it easier to feel positive, I find.
Of course, the other thing about the timing of the crisis is that it occurred while my dentist was closed for the holidays, thus denying me the strike-while-the-iron-is-hot option of calling up as an emergency there and then. Instead, when I called up I got a recorded message telling me they were closed, and giving me the option (which, actually, I was rather impressed by) of calling a mobile number for out-of-hours attention – but only if I was suffering from ‘severe pain, bleeding or swelling’. Well, I wasn’t – and, indeed, still am not – suffering from any of those three. Given the nature of what has happened to the tooth, I would have been in severe pain if the nerve was still alive, but it evidently is not. (This is clearly a good thing – who wants to be in pain? – but also a bad thing, because if the decay has penetrated far enough to kill the nerve then the prognosis for the tooth is poor.)
Now, I could have emailed my dentist, since he has given me his address and told me in the past that I always can contact him that way if I need to at any time. The problem there was that – having once got a response from him when he was abroad on holiday, having emailed on the assumption that he would pick up the message on his return – I know he would have been bound to respond. You’d assume this is what I would want but, in some kind of weird paradox, the fact that he is so likely to respond outside business hours makes me especially determined not to disturb him. I don’t want to take advantage. I particularly didn’t want to take advantage this time, given that I knew this will have been his first Christmas with his new son, so I decided to wait until the practice had reopened.
Of course, we are now beyond the end of the holidays, and I still haven’t contacted my dentist. This is partly rational – I know the practice has reopened, but I think it’s quite likely that, with his young family, my own dentist will have decided to give himself the full fortnight off, and won’t be back in until Monday. But it’s mainly because I’ve bottled it. The problem is that, because the strike-while-the-iron-is-hot was closed to me, I’ve had time to begin ruminating (turning things over and over in my mind), and therefore to begin catastrophising (imagining worst-case scenarios). These are both things that I’m prone to anyway, but the present instance is particularly unpleasant. I’m aware of the way my own thought-processes are tending – but that only means I understand why I’m feeling as I do, not that I stop feeling it.
Anyway, all of this led to an odd situation yesterday evening. I experienced some sharp chest pains, which I immediately assumed were a heart attack. This sort of thing isn’t uncommon for me – it’s an aspect of the catastrophising I mentioned – and long familiarity means I don’t remain convinced of these kinds of thing for very long; the process of observing, identifying and rationally second-guessing catastrophic assumptions is pretty much second nature to me these days. But, during those moments when my first thought was my only thought, I did have time to notice my emotional response to thinking I was having a heart attack – which was to feel relieved because, if I died, I wouldn’t have to go to the dentist.
I hesitate to reveal something so pathetic, but that is genuinely what I felt in the moment. In the aftermath I was appalled, and then amused – a kind of gallows amusement, clearly, but it was an undeniably comic demonstration of how far gone my thought processes were. I really am so scared of going to the dentist that I would welcome death as an alternative. I was amused to be so conspicuously reminded of it, but actually this just reinforced something I already knew – that I am more scared of going to the dentist than I am of dying. This is why I find dentistry such an ordeal. It may be is pathetic, but it’s genuine.
This isn’t suicidality, of course. There is an important – and, to mental health professionals, clinically significant – distinction between thinking that one would welcome death, and thinking about taking steps to precipitate it. I have only very rarely crossed over to the other side of that line, but dental emergencies are one of the experiences that bring me closest. They are among the times when the longing for quiet oblivion is matched with an equal amount of desperation to escape, and a loss of faith in my ability to cope.
This last is perhaps the most significant. The way I get through all the shit that my mind throws at me is by believing that I will get through it. I may not have any idea when or how I will get through, but I always know that I will get through – and that belief is the means by which I do get through. I realise that doesn’t seem like the most rational of principles, but it works as a kind of self-administered confidence trick. It’s when that confidence begins to waver that I am at my lowest ebb, and when that low ebb coincides with a fairly strong desire not to exist any more and reasonably desperate feelings of fight-or-flight – well, I will admit that I do not enjoy those occasions.
I’m not suicidal. There is no danger that I will take my own life, and no need for anyone to worry that I might. I have robust, practical, step-by-step plans to get me through this crisis. I am feeling a lot of negative emotions at the moment, but I am a long way from feeling overwhelmed by them, and if I do start to feel overwhelmed I know what I will do: beginning with phoning the Samaritans, and moving on from there, if necessary. There is no need for anyone to worry. It’s just that I lose sight sometimes – with my tendency to use deliberately reductive, semi-humorous terms like ‘mentalism’ instead – that I am actually unwell a good deal of the time, and closer to an edge or two than I sometimes allow myself to recognise. Being reminded of that from time to time is no bad thing.
If you’ve been affected by any of the issues in this post…
But, seriously, if you’re feeling suicidal, please google for help, and contact the support services that are available where you are. Find someone who will listen and take you seriously, and keep looking if the first person you talk to doesn’t get it.
And if you’re struggling with a dental phobia, or dental anxiety, Dental Fear Central is the place to go: helpful articles, a supportive forum, and recommendations for dentists who are good with unusually anxious patients, or specialise in working with them us.