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?

Lane73- Sorry you are going through this.
Have you discussed using an
Laser instead of extraction?
The most well-known system is LANAP (Laser Assisted New Attachment Procedure), but many dentists use similar lasers under different names.
Typical process:
1. Laser disinfects the pocket
2. Gentle ultrasonic cleaning
3. Laser again to seal tissue
Often done with local anesthetic only.
Why it’s attractive for fearful patients
• Less bleeding
• Often less post-procedure pain
• Usually no cutting or stitches
• Appointments may be shorter or broken up
For someone terrified of dental work, this may be an option. Not paid for ny insurance. Check if there is dental school affiliated with a hospital near you for reduced costs.
Why laser therapy is often chosen because of Prolia
Laser periodontal therapy:
• Does not cut bone
• Reduces infection
• May help avoid extraction
• Is often considered safer than surgery in Prolia patients
Many periodontists specifically use conservative approaches because of Prolia.
The most important thing to understands
This is why preserving even a few natural teeth is so valuable:
Even 2–4 retained teeth can dramatically improve stability, chewing, and future options.
That’s why:
• Periodontists fight hard to save teeth
• Laser therapy, maintenance, and conservative care matter
• Extractions should be a last resort, not a starting plan. Cleanings must be frequent usually done every three months if you want to fight to save your teeth. Nitrous oxide (“laughing gas”)
• Very commonly used for anxious adults
• Wears off quickly
• You stay awake and responsive
• Does not interact with Prolia
• Can be used for cleanings, deep cleanings, and laser therapy. Otherwise, oral medicines to alleviate anxiety can also work as long as you have a ride home. Examples: low-dose benzodiazepine (e.g., lorazepam).

@sjs1 if not covered by insurance, do you know how much it costs?

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!

@koleke
What Collagen powder is the best for osteoporosis?

I'm sorry for the pain! I've had a lot of trouble and what felt like unending pain with teeth pulled, failed root canals, then extractions, then 2 implants. Now I'm okay. Don't give up but find a highly rated "periodontist" or "Oral Maxillofacial Surgeon". Someone else also commented on a Mayoclinic chat here that it is important that they put you on an antibiotic and a prescribed extra strong and effective mouthwash to help safeguard you against the necrosis problem. You've probably read or know all these things. I do hope you get relief! I'm 73 too and I know things can be more complicated than we would like but hopefully where there is a will there is a way!