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Old 09-29-2015, 11:00 AM
 
9,237 posts, read 19,800,973 times
Reputation: 22333

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I've always known I have a small mouth cavity. I can't take huge bites of food I see other people take. I can't even eat sushi in one piece like others seem to (I have to ask for a knife and cut it up, which people make fund of me for ).

But no big deal, I just deal with it--I cut my sushi, I take small bites of food--Until this week, when I had to get a filling in a back tooth. The dentist kept telling me "open wider" "open wider!' and I wanted to punch him. My mouth is open as wide as it will open. It's not like I'm a snake that can unhinge its jaw! Then a few times I could not even breathe. He kept saying "breathe through your nose." But in order to breathe through one's nose when one's mouth is being held open, one must block their throat with the back of their tongue. But he or the assistant kept using a retractor thing to move my tongue, which opened my throat, thereby preventing me from breathing through my nose. When I tried to calmly explain this to him, he was dismissive and acted like I was just some difficult or histrionic patient. He believes my mouth is so small, and my tongue is just in the way.

But isn't it common sense that you can't move a person's tongue away from their throat and expect then to keep breathing through their nose? I mean, try it right now, open your mouth wide and try to breath through your nose. In order to do it, the back of your tongue must block your throat.

He also is insistent that I should get my wisdom teeth out. I'm 46 so it's too late in my book; many sources say that the older you are, the more complications you'll have. They grew in in my 20s and never caused problems, never got impacted, so my old dentist said I could leave them. Now 20 years later I got my first cavity in a wisdom tooth (actually I had two--one in each of my bottom wisdom teeth). That's a pretty good record I think. Many people have many more cavities than that. But this dentist is saying "see the wisdom teeth ARE a problem--you have two cavities." I'm thinking so what, a person can get a cavity in any tooth, and dude, I'm 46 and I've had these wisdom teeth for 20+ years.

I'm very afraid of getting TMJ if I get my wisdom teeth out. I've read tons of anecdotal stories online and I know several people who have TMJ, and they all seem to relate it to when they had their wisdom teeth out. It seems that oral surgeons often over-extend the opening of the jaw (because you're asleep so they don't care) when they take out wisdom teeth. sure, there seems to be no empirical proof (yet) that over-extending the jaw during oral surgery causes or contributes to TMJ, but hundreds of examples point to SOME correlation. Since I have such a small mouth cavity, I just know they would do that to me (over-extend my jaw). I do not want the risk of a life-long pain disorder that is often considered "all in one's head" or "exaggerated" and that no insurance covers the treatment of. No thanks, I'll keep my wisdom teeth and if they get a cavity, I'll get it filled.

So now I'm worried because he filled the one, with the problems I described above, and now I have to get the other one filled. He's still not going to understand the breathing thing. How does he not know how the upper respiratory system functions?

Has anyone else had this problem? I can't be the only adult with a small oral cavity. I would think that dentists would have seen lots of adults with small mouths. I know some people who work in the field come here, so they might also have advice. I realize I'm mostly just venting here, but I do welcome advice.

Obviously I need to find a new more sensitive dentist when this other filling is completed, but how do I address this in the future? I am not a "difficult" patient, and I don't want to come off as histrionic or exaggerating. I just want a dentist who understands the small mouth and who won't harass me about getting my wisdom teeth out. I also deal with how difficult dental X-rays are with my small mouth, but that's been tolerable at least. I just hold my breath and try to not gag for a few seconds.

Anything I can tell the current dentist this week when I go back?
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Old 09-29-2015, 05:49 PM
 
Location: Stuck on the East Coast, hoping to head West
4,236 posts, read 9,840,057 times
Reputation: 8786
I can completely relate to this, particularly "open wider" and having trouble breathing. My dentist was a male, too. He actually tried to blame my mouth for his inability to fill one of my teeth. He apologized, but it was too late. I was already on my way out the door.

I now go to a female dentist. She has smaller hands (overall she's a smaller woman) and it makes it much more comfortable for me.

I HATE the xrays---so uncomfortable, but I just deal with it.

Re the wisdom teeth: can't help you there. I had to have mine removed when I was in my 20's because they were impacted and I had a cyst, etc. Long story. Incidentally, their removal has not made my mouth any bigger, lol.
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Old 09-29-2015, 06:55 PM
 
2,934 posts, read 4,662,278 times
Reputation: 2815
Just a thought here - pediatric dentists have no problem treating small children.

I agree with finding a dentist with smaller hands (a lady?) or even look into seeing a pediatric dentist if the issue really is troublesome for you.

Of course, the problem could be your dentist, not you !
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Old 09-30-2015, 07:02 AM
 
5,273 posts, read 12,879,863 times
Reputation: 5809
A few thoughts...

First, shame on your dentist for not being more accommodating. I might suggest finding (if you can) an Asian female dentist. Small hands, used to working on smaller mouths... Or maybe a female in general as they have smaller hands and can work in tighter spaces.

Second, wisdom teeth. There are 2 schools of thought. Extract so as not to cause problems later or leave them until they are problematic. I tend to belong to the thinking that it is probably best to leave them until it becomes clinically necessary to have them removed. That said, due to the size of your mouth, I would strongly encourage you to have an oral surgeon remove them due to the size of your mouth. It's very important.

With respect to TMJ. It isn't all that common, and that is also why you should be evaluated by an oral surgeon and not a general dentist for these types of things.
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Old 09-30-2015, 07:45 AM
 
9,237 posts, read 19,800,973 times
Reputation: 22333
I just checked my paperwork, and I'm a little relieved, the cavity I have to have filled tomorrow is not a wisdom tooth after all, but the molar ahead of it. So I only had one cavity in a wisdom tooth. So at least tomorrow he won't be so far back in my throat (I hope). Yes, I think him having hands that are too big is also an issue. I think he also ticked me off because he kept pausing in his work on me to watch General Hospital, which was on the TV for my whole visit. If the dental work hadn't been setting off my gag reflex, that surely would have all by itself!

I'd rather keep the wisdom teeth. I would not get an appreciable amount of room in my mouth, and they are all non-impacted. To me, the risk of jaw damage is a crap shoot and I don't want to even roll those dice. If the wisdom teeth ever need to be drilled & filled, I'll do that. If one ever gets so bad as to need root canal, then I'll just have it removed.
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Old 10-02-2015, 02:21 PM
 
9,237 posts, read 19,800,973 times
Reputation: 22333
Ugh, frustrated again. He first gave ne two injections, to numb the upper and lower left side of my mouth. The upper area got numb and he fixed the top tooth (replacing an ol filling). Then he asked if the lower jaw/lip area was numb and I said no, actually, it's not numb at all. So he gave me a third injection, supposedly for the lower jaw. We waited and still the lower jaw did not get numb at all, but the anesthetic somehow went upward to the upper face area. So now I had 3 injections that all went to my upper mouth, which left my cheek, my whole orbit around my eye, and half my nose totally numb. And nothing went to the bottom of my mouth.

So he said I have to come back another day because the bottom didn't get numb. I told him he could try to just drill it anyway, as I have a high pain tolerance, but he wouldn't.

Now the kicker: it's somehow my fault this happened, because I have such a small mouth. If the angle of the syringe is just slightly off, it could send the anesthetic in the wrong direction, and this is more likely to happen with a small mouth. I'm thinking, this guy has to be an experienced dentist who's been doing this at least 30 years, and he can't get the syringe in the right angle? Sure, I may have a small mouth, but it's not freakishly small, and it's not like his hand had to be IN my mouth, it's just the angle of the syringe.

So my eye and nose and cheekbone area were numb until after 8pm. I was like "hey I've been meaning to get LASIK, now that my eye is numb, I don't suppose you can do that?"

So now I get the pleasure of going back to him again. I really don't think big hands are the issue, but his dexterity. It's not like his hands have to fit inside my mouth. There are skilled jewelers and watchmakers with big meat-hands, after all. I just have to make sure I don't schedule during his General Hospital again!
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Old 10-02-2015, 03:12 PM
 
2,934 posts, read 4,662,278 times
Reputation: 2815
How long have you been seeing this dentist?

He doesn't sound very skilled.

Sorry that you're going through this now. Feel better.
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Old 10-02-2015, 03:26 PM
 
9,237 posts, read 19,800,973 times
Reputation: 22333
Only this past year. I'll be shopping around again after this current work is done.
All these people rated him so highly. Oh, well, could be worse I guess.
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Old 10-02-2015, 10:15 PM
 
5,273 posts, read 12,879,863 times
Reputation: 5809
TracySam, I hardly know where to start.....

First, yes, you need a new dentist. Let me see if I can help explain a thing or two.

What you experienced is called blanching (at least in this part of the country). They hit a vessel with the needle. Since all injections are given "blind", that can happen to any dentist at any time. I wouldn't hold that against him. It's also happened to me before.

But failing to numb a lower jaw is bad dentistry in my opinion. You have nerves that run along the lower jaw and when injected it numbs the whole area- called a "block" injection. I can understand he as afraid to go too low (hit a nerve there and you could end up with permanent numbness potentially). But still, come on, dentists work with small mouths all the time. I suspect after blanching you he was just plain afraid of giving the block injection.

TS, please, go find a new dentist.
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Old 10-14-2015, 11:30 PM
 
Location: Dallas
27 posts, read 57,713 times
Reputation: 17
The digital sensor is quite a mouthful. A patient with a larger oral cavity generally does not have problems. Any mouth smaller can be a big problem.
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