@lane73 Good morning, from across the pond. ☺️ I’m chuckling with your comment about the dentist “being a bit of a pig”. I’ve had choice words about some myself but, well, I’m a ‘bit more assertive than you are’ and pig was too tame. 😂
Sorry to hear you also have neuropathy and had difficulty getting a medication from your doctor. However, that shouldn’t stop her (or your dentist!) from providing you with a one-time anti-anxiety medication for dental procedures. In the US it’s difficult to get these drugs too, but all I had to do is ask my doctor for lorazapam for procedures or if I have to fly. He knows that I am not one to take meds unless absolutely necessary. But I’ve had several 3 hour MRIs for which I needed to lie absolutely still. Well, that “ain’t” gonna happen without drugs!
Funny story…for my first MRI I was really anxious, being told it would be 3 hours and I’m claustrophobic. So my doctor actually recommended the lorazapam. Said to take 1 pill, an hour and a half before the appointment. Then 1 pill again at a half hour before and then…1 pill in the waiting room! I did. But I wasn’t feeling any differently when the tech brought me back into the room. I was concerned maybe it wasn’t working?
So I lay down on the table, the techs put a frame around my head, stuffed pillows around me, positioned me where I was supposed to be and then left the room. I heard the two techs, both males, talking to me over the microphone. I was comfy but not in the tube yet. Then the table moved into the tube and the disembodied voices asked if I was feeling alright and ready to get started. They asked if the lorazepam kicked in. I said, “How will I know?” The tech said, “You’ll feel like you downed a couple shots and have a buzz.” to which I replied, “I’m starting to feel it, but not ready to go home with anyone yet.” OMG the viewing room erupted with laughter and I was laughing so hard they had to come in to reposition my head! True story! 😂
Anyway my prescription that I have on hand is only 10-5mg tablets. And I only need 1 to do the job! So I hope you’ll at least try to call your family physician, explain the anxiety and that this isn’t something you’ll take daily. It’s for dental procedures only. It may help you get over the initial anxiety for the extraction and the first cleaning or so. After that you may not feel as fearful and no longer need them,

As for worrying about developing ONJ (Osteonecrosis of the Jaw) while using Prolia or other bone building medication, It’s very rare for healthy patients to develop this after an extraction. More often it is an infection of the bone that can happen in highly immune compromised people such as patients receiving chemotherapy. If it occurs in someone taking osteoporosis drugs, it’s treatable! People with osteoporosis who develop ONJ receive treatments such as oral rinses, antibiotics, and oral analgesics to ease pain. These treatments are usually effective. Hopefully this will allay some of your fears.

However, it’s great that your dentist has knowledge on how to approach the extraction because of the meds you’re taking. You may be given a special antibacterial mouthrinse right beforehand to reduce the bacterial load in your mouth.
After the extraction it’s important for the site to heal correctly. Your dentist will give your explicit instructions for after care. But here are some highlights: Make sure you keep biting on the gauze for the recommended time to help form a good blood clot. No swishing vigorously, no brushing near the site, no smoking or drinking through a straw for at least 48 hours to prevent a disruption of the blood clot. You can certainly brush your other teeth and if you feel the need, you can sip water in your mouth and let it gently roll over your tongue, then spit out. Just nothing vigorously.
Not sure if you’ll have sutures, though they can help close the site for better healing.
I know you were embarrassed about last visit. Just pull up those big girl panties, smile confidently, hold your head up, shoulders back and walk right into that appointment like you’re sure of yourself! You get a fresh do-over!Here’s to a Happy New Year!
Let me know how the appointment went, ok??