My husband recently went to the dentist. He came home with instructions to get an electric toothbrush, a waterpik, special toothpaste, and a gel for dry mouth. He's taking care of his teeth, though he complains about how long the routine takes. "I'll see you in an hour or so," he moans as he closes the door and starts up the toothbrush.
Now he's telling me I should go in for a dental check-up.
That's like gently suggesting I make a visit to the local torture chamber. "It'll be fine, honey, just think of the nice back stretch you'll get on the rack." Right. With Parkinson's and Dystonia (or vise versa), there's enough torture without adding to it.
I do need to go in. I know I do. Dental health is important to our overall health. The other day I took my parents in to see the dentist. They both have dentures. Dad got his before he was 30. I don't exactly have good DNA when it comes to teeth. Seeing my parents struggling now with dentures that don't always fit properly (though that is probably due to using too much dental adhesive) and sores on their gums, I figured it's time for me to think about getting my teeth checked. First, however, I will talk with my neurologist.
There are a few things I know:
~ I can use an electric toothbrush only if my meds are working well and my dystonia is not acting up. Otherwise I run the risk of forcefully cleaning out one of my nostrils.
~ Some of us are at high risk for choking. While dentists have helpers who suction out the saliva from our mouths, they either can't get it all or they ask you to close your mouth around the suction tube. The latter will set off my dystonia quicker than just about anything. I get tired of having to explain this. They don't always believe me. One dental assistant physically closed my lips around the tube. I feel about suction machines like many dogs feel about vacuum cleaners.
~ Epinephrine, which is in most dental local anesthetics, can interact with our Parkinson's meds. What does this mean? At one visit, the dentist accidentally injected the local anesthesia into a vein. I started to shake uncontrollably. My heart was racing. I started going into a dystonic storm. A reaction like this should have prompted the staff to call 911, but they didn't. They let me shake and twist with a racing heart for what seemed like hours. I'm not sure how long it really was... maybe 20 minutes? It was terrifying.
~ Don't take Ibuprofen before a visit to the dentist. It can make your gums bleed, which then makes it easier for the dentist to inject into a vein.
~ Don't go to a budget dentist. In all the articles I read about Parkinson's and dentistry, they all agree that our visits should be shorter so our medication doesn't wear off during the visit. It won't happen during the assembly line dental work at a budget clinic.
Which brings me to another challenge. When people talk about Universal Health Care (Medicare for All, etc), there's never a mention about dentistry. Medicare does not pay for dentistry at all. You have to purchase a separate policy for dental coverage. I have a dental policy which covers basic check-ups and basic cleanings. Nothing else. The local dental college sees patients at about the same cost as the budget clinics. The dental college is on the other side of town, which means up to an hour to drive each way. Both the dental college and the budget dentists require either payment up front each visit or a contract with monthly payments. Dentists take one look inside my mouth and plan their next overseas holiday. There are programs to bring dental health care to children, but no programs for adults.
I know I'm not the only one out there with dentist-phobia, but before I embark on this adventure, I'm going to do some more research and talk to my neurologist.