Unable to assert myself at 73...I have Severe Osteoporosis

Hi @lane73. Hold your hands out…I’m tossing you a life line!! You are certainly not alone with your anxiety about dental appointments! I’m the same way and ironically, I was a certified Dental Assistant for 32+ years of my dental career. Loved being on that side of the chair, assisting and helping patients. But I’m one of the worst when sitting still in the chair! My poor boss. 😅

I’m sorry that the dentist you’re working with is so brusque. Having a dentist and staff with a positive chair-side manner can make or break an experience. But since this dentist has advanced knowledge in treating patients using Prolia, that’s important for you. However, you do not have to be intimidated around dentists or doctors. From my personal experience and using one of my mom’s old expressions, I know they ‘put their pants on one leg at a time’…just like the rest of us. So whether you’re timid or brusque yourself, don’t hesitate to ask questions or for information. What you can do to organize your thoughts and not get tongue tied with the doctor is to just jot down what you want to ask. Most dentists/assistants/hygienists truly do want to help you gain a better understanding of your oral health.

Your dentist is trying to help you keep your remaining teeth. By having cleanings every 3 months for a while, this will help reverse the periodontal disease that’s been taking place. The gums and bones will heal and then after that perhaps you’ll be able to return to cleanings every 6 months. You don’t want to lose your teeth and have dentures if possible.

Between now and your appointment on Jan 8, give either the dental office or your primary doctor a call and request a prescription for an anti-anxiety medication such as Lorazepam. It really works well in taking the edge off the appointment. You can also use it when you have your teeth cleaned. Generally the dosage very low and you only need to take one pill an hour before the appointment. However, it may cause a bit of drowsiness for a couple hours so you’ll need a ride to and from your appointments. But it’s much better using the anti-anxiety meds so you are relaxed and don’t walk out with fingernail impressions in the palms of your hands from clenching your fists!

Another helpful idea is take your phone and some Bluetooth earbuds so you can listen to music or podcasts while you’re having your cleaning.
You mentioned being 74, we’re close in age. Do you remember Lamaze for childbirth and focusing on a picture or hole in a ceiling tile…concentrate on breathing? That’s a simple fall-back for distraction. But for your level of anxiety right now, having an anti-anxiety med is a really easy route to take! It’s not out of the ordinary for a dentist to prescribe this for dental anxiety!

Have you ever used an anti-anxiety med?

Sounds to like you and your dentist aren’t a god fit for each other. I love the lorazepam suggestion.

I would add to keep going to this dentist 4x a year but to work hard on finding a new dentist. I was in healthcare and doctors would occasionally be asked for a “meet and greet “ a 5 minute free visit to ask a few questions and try to get a vibe on if u wanted to make an appointment. Perhaps dentists do this as well. Lori, Volunteer Mentor, do u know the answer?

I have found good, caring dentists are hard to come by but they're out there. I think you've been given some great advice!
Plus, put some weight on your bones to strengthen them. Lifting weights is a great way to exercise. I have osteoporosis, I'm 72 and am taking nothing except collagen powder. I ride my bike, walk and lift weights regularly. I'm praying I'm holding my own with bone density. Best of luck to you!

@loribmt hi Lori and thanks for your reply..I worked as a Medical Secretary myself and found being pleasant as second nature..at 74 I have I can honestly say never been rude or short as we say in Ireland...I presume your American ...I have gone to assertiveness courses but to no avail but as you say this is a Good Dentist...another thing we Irish say is" he is a bit of a pig" but my GP is new and would not give anyone a Benzo..I have Neuropathy and needed a pain killer but she gave me Lyrica which did not agree with me ...
I stopped taking it....but I am caught now in the timeline of Prolia and this guy does know his stuff so my next appointment is the 8th..I was so embarrassed leaving his office I nearly fell out the door...omg the cringe..
So I will get the extraction and then do the cleaning and hope to God I don't get ONJ...I live in Galway the West of Ireland...as in Galway Bay....I will let you know the outcome of my next appointment and thank you for your kindness....Patricia

You might consider asking your primary doctor for an anti anxiety medication to take before your procedure. After one eye injection, I talked to my doctor and was prescribed Lorazepam. It made a world of difference. I only take it before the eye appointments.

Hi @laura1970 The dentists and staff at the office where I worked were happy to have a quick meet, greet and look-see for a potential new patient if they had questions or concerns. Not every professional relationship is a good fit. So that brief meeting can go a long way to quiet any fears or raise red flags…works both ways. ☺️
@lane73 mentioned she lives in Ireland so there may not be the options we have in the US for as many dental facilities. And especially a dentist with knowledge of appropriately handling situations such as extractions for a patient on Prolia or other osteoporosis medications.

Happy New Year, Laura!

@loribmt yes I hadn’t thought of the Ireland situation. Good pick up!

@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??

A gum surgeon wanted to do an extensive gum graft, but I was dealing with CRC and in no shape for that…ended up with a ‘holistic’ dentist with specialty in gum health- bottom line, no surgery and my teeth are doing well…I am concerned that OP meds can hurt the jawbone, a problem I wish to avoid…

@loribmt it is my understanding that treatments for ONJ are treatable, but only minimally effective. Am I wrong? Have an appointment to discuss meds and am very concerned about ONJ