Bad teeth

[Massimo]

My main BDD is related to bad teeth. As a child, my parents didn't care much about anything I did or didn't do, and there were no sane adults close by to notice the neglect. I practically never washed or brushed my teeth, and in my teens the teeth were already in pretty bad shape. Throughout the years I didn't lose any, but I had to have two root canals done and every single molar is full of fillings (the dark amalgam ones). Two of my front teeth are chipped from minor accidents.

I've always been very nervous about going to the dentist, so when I found one that didn't freak me out I stuck with him. Fast forward to about seven years ago: while discussing my crooked teeth this dentist suggested I should have my premolars removed. At this moment I should of course have asked for a second opinion from another dentist, but it made me very nervous. After thinking some days about it I agreed to go ahead with the extractions. After about a year and a half as I could see the final result, my lips closed better and the teeth now looked fairly straight — but I was very unhappy with how the rows of teeth now were very retracted, leaning inwards and practically invisible as I smiled or talked.

About a year ago I went to a good orthodontist. She made a complete mold of the mouth and took photos of my face from different angles, and told me that while she can’t promise me a movie star smile, it would be possible to reverse the mess to some degree by wearing braces again for about three years and eventually get new premolar implants, and also veneers on the front teeth. My severe overbite can only be corrected slightly (without major surgery). She also explained that the sporadic pain I suffer from while chewing is due to the roots of some of the teeth having been forced into unnatural, leaning positions. All this is too expensive for me at the moment, and my wife has convinced me that there are more urgent priorities.

So that’s the situation. There are days I feel like reaching for a pipe wrench and mess my whole mouth up, so there would be no other option except to get everything pulled out and get complete dentures. I’ve never looked at my teeth in the mirror for years, not even while brushing or flossing. Among people I get very self-conscious about not smiling too openly, and also seeing others' more “normal” teeth makes me sad inwardly. While thinking so much about this and observing others, I’ve become aware of how important teeth are as a social marker. It’s practically the first thing one looks at and judges in a person, after the eyes. Having bad or weird-looking teeth is becoming less and less socially acceptable, and it’s a major excluding factor while applying for jobs where one is in contact with the public. I recently heard on a podcast that people with bad teeth are always screened out from audiences of TV shows, and if in spite of this they must appear in an interview the make-up crew will paint their teeth over with a special white enamel. I try to reason that I should be stronger and not make a minor(?) flaw bring me down like this, but it’s a constant obsession that never leaves my mind. Not being able to laugh, or forget about teeth while seeing others' mouths.

I’d so much like to hear from anyone in a similar predicament.

[oak]

Do your teeth/gums hurt?

Objectively, are your teeth/gums in okay shape?

[Massimo]

Yes, it hurts when I chew very hard on something, because the roots aren't straight (says the orthodontist).

Objectively my teeth are functional, but look like an eight-year-old's in the face of a fifty-year-old guy. They don't look "broken" except for two front teeth with vertical cracks. I try to keep a good hygiene, but just to avoid having sore and infected gums. Whitening treatments are kind of pointless because the front teeth are so far back and don't show like on "normal" people, and because the enamel is very eroded. I didn't brush my teeth regularly until I was fifteen years old.

[oak]

I see.

In general, I think you're going to be okay. I like your chances. I am pleased you used your voice here.

I'll offer some thoughts, which you are welcome to take or leave.

In my brain, it helps to tease out different threads with long established, entwined issues like you are facing.

As I see, and please correct me as I am often wrong, I see the following issues/problems/concerns:

1. Objective dental issues.

2. BDD.

3. Financial issues

3a. With a related subsidiary issue of getting on the same page regarding finances. (This may not be an actual issue.)

I list these not to shame you, but to get everything out in the open. Then we can face each one, one by one.

The reality, as I see it, is that you need to spend money to get your teeth fixed, starting with your front teeth. You stated the extreme importance of clean, straight teeth. Socially, professionally, and medically. That you need dental care seems to be fairly clear. And you've done very well to keep going to see dental professionals. Well done.

As far as BDD, that is something that you may be facing. What to do is far beyond my ability to say, but I hope you do find some healing there.

As far as not being able to afford dental correction, your wife may very well be right. In that case the two of you need to get together and examine ruthlessly your inflow and outflow.

Dental care is a very serious matter. One of the most important things in life, in living the good life. I am glad that you are facing your dental issues, and wish you well. I am sorry I can't offer any advice, but hopefully you feel a little better seeing your concerns discussed calmly in a safe environment.

[Massimo]

Hi again Oak,

Yes, dental care is a very serious matter and I'm suffering the consequences of a sloppy job by someone who probably shouldn't be permitted to mess with people's mouths. I asked the new orthodontist if I should sue, but she said it would probably only cause me additional grief since most cases that don't involve death or very serious disability fall in favor of the professional. I appreciate your analytical approach, though for me it's hard (I'll try ) to think as logically about this. My teeth are important for me, but right now I simply have to agree with my wife that a fix can only be done medium-term since our resources are limited. There are some mitigating factors here:

• In my profession, looks aren't important.
• I'm not looking for a new partner, and my wife accepts me as I am.
• The physical pain is sporadic and not life-altering.
• The remaining teeth are functional and have a "normal" rate of decay considering the shape they're in.

So, what's worst is the psychological suffering and the BDD which prevents me for example to smile and laugh un-selfconsciously together with people, especially since I'll look obsessively at their normal teeth. I guess I should be happy about many other things in life and 'crack on' — yesterday, a guy my age with no legs sped past me on his motorized wheelchair. What would he have said if I had whined to him about my teeth?

[oak]

Thanks for the update.

It seems to me that you are well on your way: you have a job, a wife you communicate with, and a caring and professional orthodontist. A support network, in other words.

You also seem very level-headed about the realities of your BDD and dental concerns. In other words, you acknowledge that you have some issues, and want to work on them.

Having a support network and knowing there are concerns are, IME, two big steps in facing and resolving issues.

I don't know about you, but sometimes it is a big milestone to acknowledge that there is something I work on. In other words, sometimes it is enough to recognize an issue, and wait to face/resolve it. Sometimes in life the time isn't right to face something. Then, in a few months or years, the time suddenly becomes right, and limitations and burdens we found insurmountable disappear.

I am not expressing myself as clearly as I'd like, but I think you see what I am getting: expressing your concerns about dental and BDD issues are a big step forward.

Good luck! Keep us posted.