A Trip to the Orthodontist with Chronic Fatigue Syndrome: A Resource for Persons with CFS

Going to the dentist or orthodontist is a hassle in the best of circumstances. It takes time and costs money, involves scheduling an appointment during the daytime, when you might have other duties and responsibilities that get shunted to the side, and sitting in a chair for an hour or more while you get poked and prodded. Chances are good it isn’t your idea of a great time.

If you have Chronic Fatigue Syndrome (CFS), though, going to the orthodontist graduates from hassle to downright misery. Just getting there and back can be a haul, while all the intermediary steps – not to mention the pain and anxiety you may frequently suffer from – can make the process truly exhausting. This leads to a greater chance of getting sick and a harder time fulfilling your other responsibilities.

So what should you do instead? Believe it or not, with the right steps, a trip to the orthodontist can be manageable, even if you’re having a bad day.

What Is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome, commonly abbreviated to CFS and also known as Myalgic encephalomyelitis, is at this time a poorly understood medical condition. According to the Mayo Clinic, “Chronic fatigue syndrome is a complicated disorder characterized by extreme fatigue that can’t be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn’t improve with rest.”

CFS can affect anyone, and typically develops between either 13-15 years or age, or between the ages of 20 and 40. The disease may be attributable to viruses, hormonal imbalances, immune system problems or stress, but researchers aren’t yet sure what it’s root cause may be. Because of this, it is often hard to treat properly.

How Does CFS Affect Daily Life?

Due to the lack of reliably effective treatment methods, most people are at the mercy of their CFS symptoms. Among the most common problems are fatigue, which can hit very suddenly, pain that can’t be treated and doesn’t seem to have an underlying cause, and anxiety, which can cause trouble driving, working and even otherwise simple tasks like eating or dressing.

People with CFS usually can’t work full days like others can, and must take time off their feet for long stretches each day. They have to avoid strenuous physical exercise, and even tough mental challenges can leave them wearied and drained for days. Unlike normal fatigue, CFS does not respond to long stretches of sleep, and often comes with insomnia as well. This means that even if you do manage to get a lot of rest (say, in preparation for a big trip to the dentist), you may not even notice a difference.

Most people respond to these facts by drastically reducing their commitments and shortening the amount of time they’re on their feet. This can take different forms, and even planning to be up and about less doesn’t necessarily make it possible for people to live a normal life.

As one CFS sufferer described it to the Office of Women’s Health, “I am currently able to be up and about for roughly five hours a day, and then I must rest with my feet up. I don’t ever feel ‘normal,’ and there are many times when I feel quite ill.” She adds that she manages her symptoms using a variety of methods, including meditation, pharmaceuticals to manage sleep and dizziness, and staying positive. If you suffer from CFS, you likely have your own ways of managing symptoms, but these ways may not always be enough to manage the significant pain and anxiety that can attend the disease.

CFS, Pain and Anxiety

Pain and anxiety are two of the most common symptoms of CFS. While the name often leads others to believe that this disease just “makes you tired,” it is in fact a complex neurological condition that can result in serious pain and angst. As Molly’s Blog points out, unexplained pain in the muscles and joints are two of the nine official symptoms of Chronic Fatigue Syndrome. Headaches, sore throat and swollen lymph nodes in the neck or armpits are also common symptoms.

Unfortunately, many people are already naturally anxious about going to the dentist or orthodontist, according to Colgate. Being poked and prodded isn’t fun, and when you add drills, needles and scraping tools, the trip quickly becomes nightmarish for some. Adding the generalized anxiety many CFS sufferers naturally feel can sometimes create an overwhelming scenario.

Challenges of Going to the Orthodontist

When it comes to the orthodontist, feelings of depression, anxiety, fatigue, pain and general inability to cope can make even a teeth cleaning – let alone a more complex treatment such as a filling or dental surgery – feel downright dreadful. Plus, many people with CFS make strict schedules of rest, such as this example from Treating Chronic Fatigue Syndrome and Fibromyalgia, which make the symptoms more manageable. Breaking away from that schedule can make it very difficult to maintain balance.

Other challenges of going to the orthodontist include the fact that it can be exhausting just to get to and from the orthodontist, especially if you have to take public transportation. Plus, the orthodontist presents a lot of social challenges, including talking to people at the reception desk, chatting with the hygienist and sharing your oral history with your orthodontist. Moreover, CFS often causes pain in the mouth/face/head area, which is where orthodontists work, and having your jaw propped open for long periods of time can make that pain even worse.

Luckily, there are ways to minimize the associated stress and other symptoms while you’re at the orthodontist. Let’s talk about them below.

Preparing for Your Trip

The best plan for having as pleasant a trip to the orthodontist as possible is to make a solid plan regarding the steps you will take before, during and after the visit.

It’s important to brush your teeth before you see the orthodontist, so you should do it while you’re still at home. By the time you arrive at the office, you may already be tired and adding an additional chore in a strange bathroom won’t help you conserve your precious energy. Do it at home where everything is familiar and muscle memory will give you a hand.

Pack everything you’ll need the night before you go to the orthodontist. This includes your insurance card, your credit card or the cash you will use for copays and your purse or wallet. Include a house key, a snack if your orthodontist is a ways away and you will be gone for more than a few hours, and an extra layer. Orthodontist offices are frequently chilly, which can sap your energy even more.

If your dentist or orthodontist has recommended it for nerves, take a low dose of anti-anxiety medication before leaving. Make sure that you have tested this medication out before. Right before you do something already draining or frightening. You want to be sure your body reacts well to this medication before you put additional stress on it.

If you have a filling or surgery planned and are too anxious to the low-dose meds your doctor may have provided, talk to your orthodontist beforehand about other forms of medication that may make the visit more tolerable. According to WebMD, there are a number of medications to knock you out or just relieve your stress during a procedure, but it’s best to arrange for them beforehand so you don’t have to use your energy making complex decisions in the orthodontist’s chair.

Getting to and from the Orthodontist

Now it’s time to figure out how you’ll get to the orthodontist. First of all, not everyone with CFS can even drive. It is sometimes too painful, too disorienting, too distracting or too tiring to operate a vehicle, and many people opt not to do it. If you’re wondering whether or not it’s safe for you to drive a car, you should check out this article by Very Well, “Is Driving Safe with Fibromyalgia & Chronic Fatigue Syndrome? What to Consider.” It takes a close look at the various issues involved with driving when you have CFS.

Even if you do normally drive, don’t plan to do so for the trip to the orthodontist. Even a routine cleaning can take up to 90 minutes, and can be especially draining if you have to go stand up for X-rays. You may be too worn out by the end of it to get yourself home safely.

Instead, arrange for a ride from a family member or friend days or weeks ahead of time … preferably at the time you make the appointment. That way, you don’t have to scramble to get a ride the day before (or, even worse, on the day of the appointment itself). If you don’t have someone who can drive you that day, you can arrange for one from the Department of Health and Human Services in many states. Just search “get a ride to the orthodontist” plus your state name.

Keep the information about who will be giving you a ride with the information about your appointment, so that it’s all in one place and you don’t have any additional stressors the day of your appointment. This is also the time to arrange for a caretaker if you’re getting surgery involving anesthesia, and therefore you won’t be able to nurse yourself for the remainder of that day.

You should also leave extra time so you don’t have to stress about being late, but not so much that you spend more than 15 minutes or so in the waiting room, which can tire you out. Your goal with every stage of the transportation process – pickup, driving to the office, getting the procedure, getting home – should be to minimize the extra time so you can conserve your energy, strength and good humor.

Strategies to Make Your Visit Easier

Once you’re at the orthodontist, there are a number of strategies you can employ to minimize both pain and anxiety.

First of all, you should tell your orthodontic team that you have CFS and explain what that means. If you see a regular orthodontist, you will only have to do this once, and they will know how to treat you from then on. If you’re seeing a orthodontist for the first time – or switching to a orthodontist who may be more sensitive about chronic fatigue and its symptoms – you will need to have a conversation. If you can prepare them over the phone, that’s great, but usually to get time with the orthodontist, you’ll need to do your explaining at the office. That can be draining, so bring a partner or friend to help you if need be.

Once the cleaning or procedure is underway, be sure to take breaks when needed. Just hold up a hand and ask to rest or work your jaw around for a bit. This may not be possible at all points in the procedure (for instance, when the orthodontist has a full array of equipment in your mouth for a filling), but you can find time to take breaks if you need them. Preparing your team for this beforehand will help.

You can also ask for a “bite block.” These help prop your jaw open so you don’t have to hold it open, which provides a much-needed break for the connective tissue and muscles in your jaw and face. This can significantly reduce pain and make the visit a lot less unpleasant for you. Plus, they don’t obstruct the orthodontist’s vision, so they’re perfect for most types of procedure. For best results, ask your orthodontist about getting a bite block so they can recommend one that will actually work, won’t accidentally put more stress on your jaw, and won’t bother them while they’re doing your cleaning or procedure.

Distracting can also help take your mind off of pain or anxiety. If you meditate, the orthodontist’s office is a perfect place to practice these skills. According to Health Rising, “Research indicates meditation and mindfulness exercises have real health benefits and they can turn down the flight/fight response that appears activated in ME/CF and FM.” This link includes a brief introduction to the skills involved in meditation, or you can take the more comprehensive approach offered by the New York Insight Meditation Center.

Less involved forms of distraction may also work well. For instance, you might want to put in headphones to block out the sound of the drill (as much as you can) or just listen to something funny or enlightening. Ideas include:

If you’re worried about being rude, simply explain to your orthodontist ahead of time that it’s helpful to you to listen to something during the procedure to help keep you calm. Most will understand. If yours doesn’t, you may want to look into getting a orthodontist that is familiar with CFS and can be more sensitive about it.

After the Visit

After your visit to the orthodontist, it’s important not to just collapse in relief once you’re finally home. Dental procedures like tooth extraction – and even just teeth cleanings – can leave your mouth, face, neck, jaw and gums sore and sad. Take a pain reliever if you need to, and use heat or ice on sore jaws or muscles. Do this right after coming home so that the well-earned rest you have afterward won’t be interrupted by intense pain.

If you are still anxious and keyed up from your trip, you can engage in further meditation exercises to calm down, or can take another anti-anxiety med. While you shouldn’t overmedicate, these can help you form calm, positive associations with your trip to the orthodontist, increasing the chances you will go regularly, so it may be worth it.

On a final note: If you have been put under for surgery, make sure your caretaker knows exactly what medications you’re using and how to administer them. Most people are groggy and disoriented after waking up from a procedure and cannot be responsible for their medications. When you add the fatigue and brain fog associated with CFS to this equation, it’s critical you have someone there to help avoid overdose or other complications.

Make a Better Routine

Because dental health has been linked to heart disease, says Colgate, it is especially important that you make a good oral care routine a part of your life. While there is no truly CFS-proof plan, because you never know when your disease will make a day or a task feel unmanageable, putting safeguards in place can help you get to and from the orthodontist without totally exhausting yourself or creating a downward spiral from which it’s hard to escape. The above tips will make your visit less pleasant, will reduce the dread of going, and will make it easier for you to form a dental health routine that you can maintain long into the future.

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