27 February, 2014

Rosacea and the dentist (aka: Dentist Hell)

UPDATE: I have just changed the blog-theme, lay-out and background colours of this blog, as the old format turned out difficult to read on smartphones, but I'll need a few weeks to adapt each of the 71 blog posts here to match the new colours. So apologies for the blog STILL being difficult to read due to light pinks and greys in the text (which are now unreadable with the new light background). Am changing it all in the next weeks.  

This will be a bit of an outrageous update, I'm afraid. I want to stress that what I've been through the past month is not something I would advice anyone else with vascular rosacea to chose for. I don't know any fellow rosacean who had problems with dental work like I had, and I don't advice anyone to go the route I have taken. 

The past month has been a little bit of a nightmare. I had dental work done for the very first time in my life. My dad was like the toothbrush nazi, we used to joke as sisters, making sure we brushed our teeth 3 times a day (well, he did it until we were 12 years old) AND every time we ate something sweet. Granted, none of us ever had a cavity. Until now. I had a few! The dentist was surprised as well and mentioned that I started to look really pale; there was no need for despair, it were just cavities. He wondered if I have some autoimmune or inflammatory disease perhaps, as they rarely see people over 30 developing their first cavities. Did I have reduced saliva perhaps? I also had inflamed gums. I told him that I take quite some meds for chronic inflammation issues and also antihistamines which cause a dry mouth. I explained that I have a very reactive skin problem and also seem to react pretty weird and disproportionally to chemicals. That I was worried about filling the teeth. And that I was very suspicious of composite fillings (amalgam was out of the question anyway, due to its metal contents -I react bad to nickel and most other metals and never wear even jewelry- and my leaking worries; I once read about stubborn acne cases due to the amalgam fillings so no, thank you). The dentist said we could try zirconia, which he described as a type of ceramics. I asked about porcelain. He said he would look into zirconia.

The dentist was very busy and would be on a holiday for a week, but I had pain in one of the cavities, which was pretty advanced and big the assistant said, so right before his holiday I called and asked to clean them up already. The drilling wasn't too bad, although I was trembling from stress. He didn't even use any type of anesthetic or numbing, all in typical Dutch fashion, where they also let women give birth without pain medication typically. But luckily it didn't hurt and the dentist put a temporary filling material in, called Cavit. He said it had very little potentially aggravating ingredients, mainly zinc oxide and a type of plaster, as he called it.Things went ok that week, my skin was not too bad and I noticed only a slight worsening of the rosacea, but nothing worrisome.

One week later, on a Monday night (straight after he returned from a skiing holiday in Colorado USA), I had my fillings placed. I had spent hours and hours on end studying the ingredients and types of dental cement. I read that once the tooth is drilled and filled, it takes about 2 hours for the dental fillings to reach the blood stream, through tiny tooth vessels. It caused me a slight worry. I realize this might sound a bit crazy, OCD and hypochondriac-like, but after 15 years of this shit, I know by now what triggers my rosacea badly and what doesn't. For instance, I had a little piece of ear cartilage taken out by dermatologists on 3 occasions now to determine if I have cartilage inflammation or a carcinoma. Turned out to be inflammation luckily, but one time my German derm stitched it up and the other time my Dutch derm was adamant that he would fill it with a special filling material. A sponge like matter, that probably consisted of some gelatin. I told him that I might react to it and to opt for old fashioned sutures but it was already in before I could prevent it. I was bright red and had a mighty swollen face within half a day, and after 3 days even my family started to get worried -usually not too sensitive about my rosacea. It had to be cut out again. All I can think of is that the body sees it as a foreign substance and sets up some immune related, inflammatory chain of actions.

So, I was worried about the dental cement. I read about different types of dental cement; water-based acid-base cements like zinc phosphate, Zinc Polyacrylate and glass ionomer. Calcium hydroxide-based sealer were said to be the least toxic sealer amongst the chemicals tested, but they do not bond every type of filler.. Glass ionomers release low grade fluoride, which I react to to rosacea wise.. If my filling releases it, I have no control over it and cannot NOT use it for a week, when flared, like I can with fluoride toothpaste. There are also zinc oxide eugenol and Non-eugenol zinc oxide. These contain metal oxide fillers embedded in a metal salt matrix. There are resin-based Acrylates (not ideal for me as they are linked to latex allergy which I have) or methacrylate resin cements, including the latest generation of self-adhesive resin cements which contain silicate or other types of fillers in an organic resin matrix. See more on this at the bottom of this post*.

Unfortunately, I didn't look long enough to find some to the point tips and suggestions. Instead I went with what the dentist suggested to me, which turned out to be the exact thing I had said I didn't want :(  Only later, when things had gone really wrong, I got the idea of looking up what natural dentists suggest for fillings for those with chemical sensitivities; generally the people who respond worst to products with the highest chemical load.

I only read the basic info at that time, not the reviews from chemically sensitive patients. And I think most people, even those with rosacea, have absolutely NO bad reaction to dental fillings. I don't know why I react this badly to simple things, even to the smell of someone elses perfume or air freshener. But I do. So, at this point in time, I was weary of dental fillings, but without much of a choice I decided to ask if the dentist could do zirconium or porcelain fillings with a calcium hydroxide based sealer. Had read they might be the least problematic for problematic people like me. Of course, that was a problem. The dentist said he needed to use a glass ionomer for this. I was already in the dentist chair, when he said he had thought of something else. I wanted it to be over and done with and was still positive that we would find something compatible and non problematic. I was also grateful that he saw me right after returning from holiday, in the evening hours and that he was so considerate of my concerns. He said they used a type of ceramics, or something very much like ceramics, which had very little toxic substances. He would also use a resin based cement, with less toxins. And he had some type of nail sealer which he would prime the tooth cavity with first to prevent leaking. Of course, in hindsight anything synthetic that is used on nails is a bad idea for me. I remember having a really bad p&p outbreak at some point, really full blown acne all over my cheeks, and I never had that before. I only have the redness and flushing normally. Turned out I got it from the cheap red nail polish I was wearing. Once I cleaned it off the skin calmed down again in about a day. I was shocked and a bit deflated by it, how could that stuff come into my blood stream through the nails?? When I retried, the same thing happened. Haven't used nail polish since, or any type of make up for that matter (apart from the odd ones mentioned in the  Make-up thread here, usually only for one day). So anyway, he fixed the teeth, it looked good. I was red and my cheeks were extremely flaky. The dentist apologized and was a bit shocked, but I reassured him it is normal for my skin and must have resulted from him using pressure on my cheeks.

At home, I started making daily pictures of my face, as a means to document my skin a bit keep track of the recovery. That evening it was ok, I needed the fan to stay unflushed but I didn't notice huge worsening. The flush from the treatment calmed down. The next day, I woke up with a very tight and burning face. The skin wasn't beet red however. The two didn't add up, because I can usually determine or predict by the amount of burning and the type of burning, how red the face is. I felt massively on fire but didn't look terrible. All day and evening I felt the acid like burning. Not just my cheeks but also my forehead, which normally never burns. In the next days this got worse and my skin and face started to become very patchy and red as well. Including my forehead, nose and chin, which usually also stay relatively ok. After about 5 days I was truly worried and was certain I was reaction to something. I had 2 previous treatments at the dentist where my teeth were cleaned and I got some instructions for the gum inflammation, and I had spent a lot more time then in the dentist chair under the bright lights, than during the teeth fixing session. I knew therefore that this flare wasn't from the bright lights (I had quite calm skin both times when I came from there). I called the dentist and asked what materials he had used exactly. To my surprise, it turned out to be a composite filling after all. He said it was like a ceramic, but when I read the website of the manufacturers, It seemed he was wrong and this was merely a fancy composite from Swiss (Saremco), with some chemicals left out.

So the info is in Dutch, but it says that this is a light curing hybrid composite. It contains no HEMA, TEGDMA and free Bisphenol-A (BPA). But, it still contains other fillers: (LINK) A large group of different aromatic and diacrylate monomers and oligomers is used, such as bisphenol A-glycidylmethacrylate (Bis-GMA), ethoxylated bisphenol A-methacrylate (Bis-EMA), triethyleneglycoldimethacrylate (TEGDMA) and urethane dimethacrylate (UDMA). "Many of the alternative materials release ions such as fluoride, strontium and aluminium ions." In this LINK the authors describe more toxic aspects of dental fillings. So this product wasn't a ceramic, but a composite (partially plastic), which can consist of all sorts of different stuff obviously, but seems to not be as neutral as I had hoped. After some time I had such problems with my rosacea, was so purple/red and swollen and in pain, that we went to the dentist and they decided, on my wishes, to take the fillings out again. I hoped he had cleaned the fillings entirely and I read how the primer and bonding agents (stuff I probably don't handle well) seep into the underlying teeth dentin so I needed to be sure he got all of that out too. I was petrified that he wouldn't remove all of the fillings, and all of the dental structure that might have been impregnated with the substances from it, but he said he had taken it all out, and when I asked how he was sure, he said you can see it at the color difference; teeth is darker than composites. He was very nice about it luckily... I felt such a freak. I mean, he noticed I was about 10 times more red than the previous time he had seen me, but I still felt a complete psycho for coming back and asking him to remove (?!!) fillings..

But despite it being all removed again, the redness didn't quite subside. Maybe a little bit initially, but not for long. I got that desperate feeling again, that I knew from when things were really bad back in 2005. Acid horror burning, and 24/7 flushing hell. I didn't have an anesthetic at all, for neither two treatments, he just did it like that so I know its not the anesthetic/novocaine or anything either that causes this flare. I received the temporary filling Cavit again. In the weeks that followed, like I said my rosacea only calmed down a little bit, and then got worse again. The Cavit is a mixture of Zinc oxide, calcium sulphate, zinc sulphate, glycol acetate, polyvinyl acetate resin, polyvinyl chloride acetate, triethanolamine, colour pigment (source). The problem is that Cavit is only supposed to act as a temporary filling and that it leaks and dissolves in the mouth after some time. I had a couple of cavities and I could soon taste the bitter taste of the Cavit dissolving in my mouth. More unwanted ingredients for my immune system to kick against and there was the constant pressing issue of what to replace them with.

My skin prior to the tooth issue 

My skin after the filling came in:

I went back, we tried some other cements and filling types, and I got more and more swollen and red. This went on for over a month, where I couldnt stop burning and being beet red and in agony, day and night, I am used to a flare each day, but not this non stop hell. I couldn't sleep, I had two fans on both sides of my face all night, and nothing seemed to help getting the fire down. I was at my wits end and eventually asked the dentist to extract the molars, the 2nd top and bottom molar, so the furthest away in the mouth so who would care about them?  Luckily they were opposing, so you don't get the problem of an underlying tooth growing exponentially. But my dentist refused. There was no way he would extract a healthy tooth. Back in was the Cavit again. I muddled on for some time, and only spent time in my bed with 2 fans (one on each side of my face) or in a cold room, trying to keep my research work up. What a misery. I asked other dentists in town, nobody wanted to help. I emailed my dermatologist and called the other, not even they wanted to tell a dentist to extract the teeth. They meant well and I'm sure they were out of their debts and zone here, but one said I should be seen by an allergist (this is no allergy doc!) and another said I should up my clonidine and take mepacrine or plaquenil again to combat the inflammation (I already tried them a couple of times, see other threads here on the blog - didn't work for me). I started to feel extremely low and depressed. Finally my parents managed to explain my situation to my stepdad's dentist, who said I could come over and he would help.

I wrote to my friend about it:

"Right now, 2,5 days later, I'm still in HELL :( :( Car drive of hours on end last night and my face was in extreme flushing state, It hurts so bad. This is a massive flare, I haven't had it this bad for years. I now worry that some traces of the filling infiltrated in my normal teeth underneath perhaps. Or that the temporary filling is reacting too now; the two outer molars (luckily they are the ones entirely on the back of my mouth, right side top and bottom). I found out whats in the temporary filling and its not just zinc oxide and calcium oxide, but also a type of PVC and some other things, I am starting to worry about them too. This flare is absolutely out of the ordinary, so aggressive. Will try to get an emergency meeting with my derm here next week and see the local dentist. I might ask if they can remove the 2 molars or look for an even more simple temp filling. I have no hour of rest or being unflushed anymore. I try to stay as relaxed and non stressed as possible, to rule stress out here. I doubt the dentist will remove molars though but maybe with the advice of the dentist she will. But then, how do they close the gap from the removal? I don't handle stitches either. And what if there will be an infection, oh my god that will ruin my rosacea too :( Hope you are doing a little bit better than me."

Extraction, I was terrified and trembling all day. Literally was shaking in the chair. He saw that I was very red and swollen and was very nice, and said it is ultimately my body and my life, and what needs to happen needs to happen. It took almost an hour and over 10 injections of Ultracaine anesthetics to get them out, the lower molar was very resistant and broke off. One root tip was impossible to remove for the dentist in the end and he said I might get away with it, or it might get infected and then I would need to go to an oral surgeon in the hospital to get it out, because it was buried quite deep near the only wisdom tooth I have left in my mouth. He said one of the molars had a massive hole! My other dentist didn't tell me that. In fact, he had filled it already, but clearly not properly... This dentist said it had surely needed root canal surgery if I had left it in and well I never ever want that done as its linked to auto immune disease onset. In the days after the extraction my face calmed down immensely. My parents, partner, everybody I sent pictures all admitted that it made a huge difference. I bought a dentist mirror to check if the sockets were healing properly and if there was no dry socket developing or an infection. The lower right molar did get infected. A weekend dentist gave me a course of amoxicillin to combat it and said it was quite usual for that socket, as it is big and it is easy for food debris to get stuck in it. After a week the infection seemed gone. I went back to the dentist for a check up and he said I was better off getting the root removed after all. It would be a source of potential infection and it was easier to remove it now, than when it got fully embedded in new bone tissue. I also still have some mild numbness and pins and needles sensations in my upper lip and the area between nose and mouth. The dentist said it could be a complication, but to give the nerves some more time to heal, hopefully.

I went to the hospital 2 days prior to the scheduled extraction, to ask if there was any risk in getting more local anesthetics, as I still felt some numbness and also the left outer side of my cheek felt tense, tingling, burning. It felt like the nerve pain I had for 6 months, back in 2007, on my other cheek, when I fell asleep on a frozen coldpack. I had wrapped it up, but not good enough. I slept at a friends place in Ireland at the time and was flushed. I take remeron, which knocks you out to sleep after about 30 minutes of intake, and one moment I was awake and cooling the right cheek (lying on it but careful to only apply it for a short time), the next I woke up with a freezing cold stiff cheek. After a day that cheek began to throb and burn badly, and felt very swollen and tense. It took me 6 months and visits to a neurologist and a pain center in the hospital (and Neurontin/Gabapentin and Lyrica as meds) for it to finally subside. The neurologist had explained at the time that the nerves had been damaged by the freezing and that nerves take a long time to recover. Typically months and months and I had to expect a 6 month time frame. He was right and it finally normalized after around 6 months. I explained my worries to the receptionist and asked if there were options for general anesthetic. She said that there was a waiting list of 6 months for that and that she would discuss it with the surgeon. He came out and said he could see me right there and then.

I now explained what had happened and the numbness in the area right under the nose. He said it could be a complication from the anesthetics, but that this doesn't happen very often and that hopefully with time, up to 3 months, I would see improvement. The left side nerve sensations were a different story he said. He didn't see how local anesthetics in the mouth could cause that. I told him I was slow to respond to numbing and that I had received some jabs in the hard palate of my mouth, as well as the cheek and tongue. Even then, he said. He wanted to make a panoramic X-ray of my mouth. I was a bit worried (AGAIN, sigh) for it to stir my face up further. I posted about the rosacea flare I had after a few neck X-rays (which also covered my face) back in 2007 on The Rosacea Forum (Link to the thread). It took about 4 weeks to calm down again back then, so I asked the X-ray lady if she could zap below the cheeks perhaps? Nope. She was friendly but decisive. In order to get the roots of the teeth on the picture, the cheeks needed to be zapped as well she said. It was a modern type of machine, with a white thing going all the way round my face and a red light zooming over my face. Scary, but in the end it was good it was done, because now the surgeon could see that my jawline showed some signs of bruxism; teeth clenching and grinding. I knew I clench my teeth... I think it is from lying more in an upright angle (for the flushing) and from feeling in pain at night often. He said it would be more likely that the pain at the side of my face came from the muscles being tensed there from the clenching. I hope he is right, because the tingling and burning and stretching feeling I have there, about half of the vertical side of that cheek, is stirring up the redness and flushing there. Usually it was my left cheek that is paler than the right, now its the other way around.

The surgeon said the doctor in charge on Wednesday would only numb the gum line, with 2 small injections and not to worry. When I asked about general anesthetic, he said that regardless of, they would STILL numb the gumline with 2 injections then, and on top I would have the general anesthetics in my body. I was reasured. He also said that the molar was a bit infected and really needed to come out. No doubt about it. The others looked fine and healing. So, another round to the dentist on Wednesday, yesterday. I was happy that I faced another very nice younger doctor, who seemed understanding about my short medical story/talk before the procedure was done. I asked for non solvable sutures, and that was fine with him. He also said he would only give 2 injections on both sides of the gums. But like the last time, I seem to respond slow or poorly to anesthetics and he ended up giving me about 6 injections. After the initial 10 minutes he asked, "So do you feel numbed up?" Nope... "No thick tongue and cheek?" No, sorry... Ten minutes and 2 injections further the same scenario and finally he said that my muscles might be lying slightly different than normal and the last 2 worked. So well in fact that I couldn't feel my entire right side of the face anymore either. The nurses had cleaned my mouth and lower cheeks with alcohol and as soon as I smelled the alcohol I was like "STOOOOOOOOOOP, not my cheeks! Sorry, skin issue". So they stopped before big damage could be done and cleaned the cheeks. Not much trouble from it though. The operation itself went well, the surgeon needed about 15 minutes and some drilling to get the root out. They were so friendly and chatty and the doctor told me constantly what he was doing. I have only 3 non dissolvable stitches/sutures, which can be removed in 7 days, have an app with them again. He told me the dentist could do it but I said my dentist is on holiday... :) He asked, also next week? I said Yep! Would they mind taking it out perhaps? Luckily they would do that, I rather don't go back to my old dentist who didn't want to extract the teeth, my step-dads dentist is 150 kilometers away and I rather have the surgeon do it and check how my gums etc are looking :) Nothing beats the verdict of a specialist. The root and hole were looking fairly good he said, no bad infection, just a little bit and they cleaned it out and it should heal by itself, no need for more antibiotics or penicillin. Yay. He said that the wisdom tooth next to it could stay as well and he expected it to move a bit into the hole, which would be good.

Had a massive cheek for a few hours. Doc said that was as predicted and that it would remain swollen for some days. Got some iboprufen 600 and needed to take that soon once the anaesthetics wore off. The anesthetic took over 7 hours to wear off though. We discussed in advance if he wanted to use adrenaline with the anesthetic, as that acts as a vasoconstrictor (oddly enough, I would associate it with vasodilation). He said he would, I said he might want to given my widened blood vessels. They use it so that the anesthetic is trapped in the nerves and system longer and lasts longer. Usually 2-4 hours, so when 5 hours had passed and I still felt rubbery and swollen and numb in the right cheek, I googled it. I think the other vasoconstricting medications I take for the rosacea might have added to the injected adrenaline effect and trapped it even longer. By the evening things returned to normal again. I think the adrenaline also helped me not to be excessively beet red after the procedure perhaps, because like the first extractions at the dentist, I also this time didn't look more red than before. Day 2 is a different story however... Burning and red again. But, I take into account that my skin has endured 2 round of hefty dental extraction work by now, a week of infection, a course of penicillin, increased blood flow there for gum healing, increased inflammation markers for all this, sutures that my body might not like and on top a nice X-ray, so I hope in time it will calm down, finally!!

I am pretty tired and worn down from the relentless rosacea. In Sicily, only a few months ago, my skin was so calm and pale and now I look and feel horrendous. My dear rosacea friends have been emailing me and supporting and pepping me up. Thank you dear ladies and sir. My dad has been round almost every evening, to watch movies and series and help me cook and clean a bit. On the food front, I lost a lot of weight, a full dress size at least. I didn't eat from the stress for some weeks, then I only ate baby food in a jar for 2 weeks, to protect the tooth socket and not get it inflamed and because my mouth was pretty sore. Then finally, I am eating some meat and normal good stuff again on my left side of the mouth.. finally eating solid, then wham, root needs out and I can start all over again with yogurt and baby fruit and mashed up veggies :)  I hardly am hungry anymore as a result, I guess I could do with some weight loss.

Dad and I watched lovely movies for distraction (no not EXtraction lol):
And a rewatch of my all time favorite movie, a real emotional experience and must watch for you too, La Meglio Gioventu (the best of youth: http://www.imdb.com/title/tt0346336/?ref_=fn_al_tt_1)
We'll watch Ingmar Bergman's Persona tonight. (http://www.imdb.com/title/tt0060827/?ref_=fn_al_tt_1)

I have been struggling to deal with the set backs and pain, constant burning and throbbing and flushing the past 2 months. I feel I am allergic to anything and everything, that my life is lived in a controlled bubble, and although I have better moments where I can even travel, right now its such a hot red mess again that I feel pretty beaten down. People don't understand, unless they have rosacea themselves I found. I am starting to wonder if I have chemical sensitivity or something.. My rosacea friends S and E and L and J all don't have these problems with dental fillings, while they all have my type and pretty severe rosacea... What the heck?? I react so severely to even perfume, that I let my partner check if there is air freshener perfume in the public toilets before I enter..

Multiple chemical sensitivity (MCS) is a chronic medical condition characterized by symptoms that the affected person attributes to low-level chemical exposure. Commonly accused substances include smoke, pesticides, plastics, synthetic fabrics, scented products, petroleum products, and paint fumes. Symptoms are often vague and non-specific, such as nausea, fatigue, dizziness and headaches, but also commonly include inflammation of skin, joints, gastrointestinal tract and airways.

Skin inflammation, I guess rosacea will apply too then? It's just ridiculous.


Some posts from my rosacea friends. In light pink my responses 

"N.,  Happy to get your update. What an ordeal! And the drive For the dentist. Your skin looks like it is calming down. And if this is so, you were. Absolutely right about the materials used for your teeth. Your poor mouth. Hang in there and I know. You know but lots of vitamin C right now-- hope u can  eat citrus fruit?  Supplements? Sleep....Losing teeth can be emotional--your ordeal is very emotional. Let me know How you are doing when you have A moment. Hugs to you, P."

"Hi.The left side of my face (right in the pictures) has some nerve pain, numbness, pins and needles and burning. I also still have a numb upper lip so it must be from all the anaesthetics and dentist might have touched a nerve accidentally. He says it should recover with time, hope its not asymptopic neurological face pain :( That cheek is mighty flushed now as a result. Feeling very tired and in pain and fed up and done with everything and as a bonus I need to have more work done on Wednesday on the remaining root tip in the right lower molar."

"Well, the one side of your cheek is clearly pissed off. But on a good note, the rest of your face is recovering from the looks of the latest pics.  Do you think the treatment on Wednesday will involve antibiotics?  ( I think it may) You do not want to mess with chronic infection in your mouth, So if you have to, perhaps just do it and get it done with? I don't know if the link below will have anything for you, but thought I would try. You are already very well researched and you know so well what you can tolerate. My skin did react to eating the muffin the other day, but I just didn't care enough. I needed " life."  I hope you do things to get out-- you're a gorgeous girl with a skin problem. But bundle up with fat scarf and get out walk have coffee/ tea/ water! Big hug to you." 

"oh my sweet darling :(  :(  :( You look so much in pain, the other cheek is normal? 
 Its so unfair. I look less red I think than you but I already struggle to deal with the immense heat and pain, I can't even start to think about your agony. Is this an evening flare? Does it subside again after X time or do you have this for long periods of the day?xxxxxxxxxxxxxxxxxxxx L."

"Dear L, I asked my dermatologist here to help and he cant do anything he says. I asked him to ask a dentist to remove the teeth and he can't he says. Then went to another local dentist, who is unwilling to help as well. She said they won't extract. She will fix the teeth with all the possible filling materials  she has and view if I react or not. I don't want that obviously. I'm in agony, i'm 100% positive this reaction is from the fillings, even the temporary ones still in my mouth. They give a nasty metallic taste as well. All this happened as soon as the dental work was done. Is there perhaps anyone you know, any dentist, who would be willing to extract 2 all the way in the back molars? As a medical immergency? I realize none want to do this to relatively healthy teeth but I never had a cavity before and will try to never have one again after these 3. Right now my rosacea is so aggressive and it was totally acceptable and fairly ok before. Apart from a few days now and then of worsening. None of the dentists want to help basically, I emailed my own to ask him, but I doubt he will.  I might have to look into going to the USA or Spain or Marroc or somewhere else they will help me. Lol maybe India ;) Didn't this used to be the gold standard at some point in time?? Maybe you know someone in the US who wont mind? xxxx"

"I've looked and looked and I can't find anyone who will do that.   They all want to have an ongoing patient relationship with you first,  and they none of them believe that fillings can cause such a bad reaction. You know how it is, healthy people often just cannot believe how oversensitive we are to common things,  and how much simple things can cause us pain and misery. How are you today,  are you getting better or are you getting worse? The only thing I can think of is to look in the papers or online for doctors who advertise that they remove mercury fillings. They're the only folks I can imagine who could do this on short notice. Why does your dentist who did the fillings refuse to pull the teeth? My rosacea has long ago reached the point of no return, I am housebound for 8 months of the year,  you are wise to try to avoid that worsening.   It sucks,  it's so bad that I know I will exit when C. does,  what life would I have,  isolated,  like a prisoner?    It's awful. I wish I could find a way to help.   Do tell me how you are now? Love.."

"Thanks for thinking about me and showing your interest, here is a short update. I had the teeth removed. After explaining and asking a dozen dentists, my mothers new partner found his own dentist, who is a friend, willing to. Was super scared for side effects, bones loss, sinus infections and what not but also grateful. The lower molar didn't want to come out so it took ages and all in al over 10 (!) injections of pain killers overal. He was very very nice, very good guy and talked to me about what anaesthetic to use and he gave me an empty ampul: Utracaine http://en.wikipedia.org/wiki/Articaine The lower molar took forever and he left one part of one of its roots in :( Couldn't get it out and he said it was sterile and not infected or anything so shouldn't cause problems. If I get fever and increased pain there I will need to go to an oral surgeon to get it removed. The other went ok, just have a sore jaw from all the pulling. He later said he's rather have stitches it but decided against it as I am sensitive to sitches too. Lets hope it forms a blood clot soon. He said one of the molars had a massive hole! My other dentist didn't tell me that. In fact, he had filled it already, but clearly not properly... This dentist said it had surely needed root canal surgery if I had left it in and well I never ever want that done as its linked to auto immune disease onset. There is one piece of root left in the jaw unfrt, it was stuck behind a wisdom tooth and he had been butchering that tooth for 30 minutes already, breaking it in pieces etc. Hope it won't cause infection, he said it would prolly be just fine
My face was very very painful and hot. But the next day my skin already calmed down (now 32 hours after operation). Less on fire and starting to feel more normal

"Oh noooooo this is the worst news ever, I am so sorry to read this.Okay, babes you got to go into damage control, can you start taking diclofenac at the highest safe dose, if your not already at the highest dose and you can increase the clonidine and propranolol to a higher dose I would do try that and look at increasing the antihistamines if it's safe to increase them aswell. Just make sure you don't overdose. But I would really try get the flushing down with meds if you can. Okay, babes you got to go into damage control, can you start taking diclofenac at the highest safe dose, if your not already at the highest dose and you can increase the clonidine and propranolol to a higher dose I would do try that and look at increasing the antihistamines if it's safe to increase them aswell. Just make sure you don't overdose. But I would really try get the flushing down with meds if you can. The article says that this composite is non allergenic because it doesn't have two particular chemicals that it says are allergens to some people, unfortunately maybe you are reacting to something else in the composite. Is there any list of ingredients anywhere? I didn't see any in there. Yes I've had composite fillings, actually I've had resin fillings, their white fillings that are used commonly now. I haven't had one for over 14 years, long before I had rosacea, and my filling has broken and is leaking so I assume I've swallowed some of it over the years and I need to have it redone plus have two new ones. The dentist said if I'm not reacting to the one already in my mouth for the past 14 years it should be fine to get it redone, but I doubt it will be with the exact same stuff so I'm a bit worried about that, having read composite can be pretty toxic, zirconia filling material isn't available here. I'd have your filling removed and redone with the zirconia if that's possible. I would pull the teeth out as a last resort as my concern is that you might regret it later. Didn't you have a temporary filling out in last week? Can you get the dentist to remove this new composite filling (that should be entirely possible I would think) and put the temporary filling stuff back in and wait for the zirconia? If you have a bad reaction to that (unlikely, zirconia is similar to a diamond, very very pure) but if you react to that then pull the teeth. 
Sorry I can't be of anymore help. :( Im so sorry this has happened, it's not fair! I wish I was there with you an could help calm you down, honest to God I know exactly how your feeling, I am hyper reactive to things and it's so difficult to know whether to push through or completely eliminate the trigger. I can see the redness in the last four photos significantly, not as much in the  first ones, maybe the yellow light softens and fades things, it doesn't look as strong there. We're you already flushing in those first pics? The peeling skin is something I get aswell, sometimes all over my face. :( it's so weird because my skin also gets oily even though it's terribly dry. I don't know what that is. :( I flush just from having the pressure of the dentists hands on my face!! Not to mention the equipment he uses resting against my face. I hate going to the dentist because of it, I flush in the chair, and the nurse uses wet cloths to cool my skin down (she is absolutely beautiful and very sympathetic) until now I've worried more about the physical contact and pain in my skin I get from that, equal too or more than than the chemicals in the treatments. Sending you strength and hugs, it will be okay Xoxoxoxoxoxoxoxo"

"So the secretary said the temporary filling can be used a bit more than just temporarily? That's great. It gives you time for things to settle and recover before having to look at anything else. Zinc sounds fairly inert which is fantastic and at least you know you didn't react to that. I think only there were a zinc based composite. I was wondering why not try pure gold? Can you wear gold jewellery? Would it be an allergen? I'm guessing you considered this and there's a reason not too use it. It also probably faces the same issue with the cement aswell. But I think there'll be something on the market that's tolerable as a cement. Even a glue of some kind. I don't sit under the dental lights (I ask them to use a torch in my mouth) but its very good that you don't react to them (I do) so ruling the lights and anaesthetic out, Id say it's definitely the filling that your reacting too. I wish I could just scream in sympathetic agony on your behalf. That's what I feel like doing! Yes I think it does sound like you have Multiple Chemical Sensitivity, I always thought of that condition when reading your blog even before I wrote with you, I don't know if it's the chicken before the egg or vice versa but if you didn't have rosacea would you have MCS and if you didn't have MCS would you have rosacea? But things like reacting to plastics (what you had said about the steering wheel of the car) and also reacting to moisturisers on other parts of your body, show that you are chemically sensitive in your immune system, because those things aren't coming into direct contact with your face. When my rosacea was really bad for the first four to five years, I reacted to numerous things, everything almost, perfumes, scents, odours, chemicals, etc."

"You poor thing first two look really sore, I feel your pain.  defo looks better last ones, real improvement, a lot paler and less sore looking. hows it today xxx"

"im so sorry you r there on your own at mo. i have been that low and desperate N. i truly understand. all i can advice for now. is to just deal with one day at a time. are you on zispin still?? did u try the mepacrine again? ill keep trying to check my emails inbetween dealing with S. so sorry u having such bad time. I defo think it will subside.  When I have been have an bad episode triggered by something, ive thought at the time that it was the end of the world and that I would be left this way for ever, you are only feeling like that as you are depressed and rightly so.  Things always do improve and when they do, they will probably flair again but they will then improve again, with rosacea as you know there are ups and downs, unfortunately you experience more downs, but things will get better hun, you just have to ride it out as best you can. You really should just deal with the now, you are putting to much pressure on yourself if you think into the future. Hard I know. Do you have family and friends nearby? or are you like me when you are bad you don't wana see anyone? xxx"

"i think i might of added 1/2 zispin when really bad and a tablet Dr C. gave me for the swelling. cant remember what it was called though. dont think they made alot of difference though, was a matter of riding it out and basically sat in my warm dressing gown with a hot bottle and blanket in front of a fan on full blast and holding icepacks to my face. thats all you can do.xxx" 

"You know, I'm still having trouble accepting that my life is essentially over.. (..) Why won't my skin stop burning? Why can't doctors shut it down and turn it off? How come when I eat anything other than chicken and salad, I pay for it with pounding pain? How do you deal with these dark thoughts? How do you continue to go through each day as though we had a future? (..) My life revolves around making my face burn less. Do tell me how you cope? Love L."

"Please vent. I am going through similar struggles, and looking for meaning in life. What helps for me, is perhaps that I am dealing with this longer than you? I have it since 1999.
Besides, you don't want to die, obvously. You just want the suffering to stop and you feel you are pushed in the corner and are left with no possibilies and no control. Things were awful at some point with mine. But once I started taking proper medication (remeron, clonidine etc), saw a good derm, I started to improve. I strongly belief that laser/IPL made me permanently worse. But the other flares, like now from the teeth, from infection, from wrong foods, anything transient, I know my face will go up and down and I can calm it down again. It was so deep throbbing red and awful in 2005 and it still could be brought back to a good deal better in the years afterwards, so I keep hope. I sit out the bad times and enjoy the good ones. My dad used to say: when you're dead, you'll experience nothing anymore, no bad but also no good. Nothing. There is eternity to be nothing, so as long as you can enjoy even 15 minutes a day of feeling good, being interested, seeing a good movie, watching the news and feeling good for that time, he feels life is worth it. I understand you are mourning your old life and I fully understand what a horrendous drag and pain it is to go through all the things in life. Its all about controlling the burning, its shit. But well, this is how I try to move on. Let me know how you are dear, xxxxx"  

"The putty type stuff which is used in  temp fillings can cause reactions. It does in me, but I seem to do ok these days, as long as none of it  is dropped inside my mouth. The dentist has to be extremely careful to only put it inside the tooth. I am better these days, but I still have some burning in my mouth following procedures. Also I react very badly to cleanings and certainly to fluoride.  I know I have had many fillings done with something called Fuji. 
It is a type of glass. I googled cavit, but I can't see what it is exactly. Your immune system is in hyper mode at the moment and seems to be a complete systemic reaction given the fact  are having full body flushing:( I Know this is not going to be of much help to you in this particular moment, when you need to shut this reaction down instantaneously, but  I found that the only regime which helped me was the GAPS diet. With modifications for  my particular case. I am currently off ALL antibiotics and now drink raw goats milk and have small amounts of raw goats milk kefir each day. Initially it made my face very reactive, and I still do react, but over time, reactions have become less and  I have found that my reactions to life ( chemicals etc) have also become less. Having said that, I am still battling some flushing and still have to be strict with my personal regime. 

Still some improvement is less than nothing. I have taken artemisinin to calm my hyper reactive immune system, but not sure how that would work in you.  There is always prednisone of course, but you know how that can backfire badly:( Or you could find an immunologist who specialises in desensitisation techniques. There is one near where I live. I might be going to see him myself. He has great interest in reducing the hyper reactions of the TRPV1 receptor, which is also abnormal in rosacea/flushing. I really don't think having your teeth extracted in the answer I am afraid. The reaction has been initiated and  losing teeth causes it's own set of problems. One of which is, you may not heal properly and could get pockets of abnormal immune activity where the teeth roots used to be. Even a denture, it could irritate your gums, which would irritate your face. That is one major reason I don't want a denture. I will lose two more teeth pretty soon:(  I really feel sorry for you, as I know that kind of hell you are experiencing, but I have no solution for immediate relief:(( I am trying to think of things to try, but of course, in people like us, an opposite reaction could occur.For instance. L Lysine. It reduces nitric oxide, and in me, it calms my face within 20 minutes. It also calms down the immune reaction to  endotoxins. Perhaps it would work against foreign material reactions too? But it can also feed fungal infections and possibly trigger something else in your body. Still, in general it is a harmless agent to try. I mean, it won't upset your blood chemistry etc.I'd start at 1gm and wait 30 minutes. It if doesn't work I'd take another 1 or 2 grams. What about coffee? What effect does that have your your system?"

"Goodness, that is really bad:( The ONLY thing which  calms my skin when it is a vascular mess, is sulphur. But my skin is used to it now. You can always see the rosacea lurking underneath the sulphur dried dead layer of skin, but at least it is not angry in that state, and no pain and much less flushing.  And because it is frozen in that state, ie the skin is not so flexible, it gives the vessels  a rest , which allows the  abnormal levels of receptors to down regulate... which reduces symptoms."

"I am so glad u had them removed! Are u doing better? Those pics look so damn painful! I cant believe u had to drive so far to get this done. I am still struggling. The Tegretol was intensifying things so I stopped it. I  am just out of words, out of breath and full of exhaustion."

"This is horrible!! I have looked like this so many times. 
Im so sorry X is not with you. I have been purple like this alot. I just dont understand wy we're suffering this way N.. There has to be answers!! Im so sorry for both of us :( praying for you always xo" [..] My face is doing better- If it's the Remeron, it's doing well and honestly I don't know how I could even take 15mg if the drowsiness I feel is from that-- yes I started it and I am falling asleep all darn day! -- but a lot less flushing. How is your face doing from those last  pictures? I am having a hell of a time trying to stay awake to work! oxo" 

 "I am so sorry! Well I have to say Yes, it will calm down because I felt that way so many times and it always does. That relentless burning is just too much to deal with. I am so tired of freezing to death from the fan. I don't get red from things like you're explaining, so I see why the antihistamines work so well for you- you must be allergic to a lot of materials-- and tooth pain is so painful, it's not like you can choose not to do anything, especially with the infections. It's ridiculous!!
I just called my dr and left a message that I am going to double up on my Remeron to 15mg so hopefully she'll be ok with it. I sat here all day yesterday and could not keep my eyes open- it was terrible- but no pain at least. I have also noticed that the tea tree oil soap helps a lot- it is so so soothing! I hope and pray this is all over for you soon. No one should have to go through this CRAP!"

Here follows some general information I found about dental cements; scroll further down for continuation of my personal story and updates

Dental cements are hard, brittle materials formed by mixing powder and liquid together. They are either resin cements or acid-base cements. In the latter the powder is a basic metal oxide or silicate and the liquid is acidic. An acid base reaction occurs with the formation of a metal salt which acts as the cementing matrix. Dental cements are used for a variety of dental and orthodontic applications, including use as luting agents, pulp-protecting agents or cavity-lining material. Furthermore, they are used to form an insulating layer under metallic or ceramic restorations, and protect the pulp from injury. This helps in sealing or fixing and casting inlays, onlays or any such substance to both dentin and enamel. Dental cements which contain an acid component may have an intense sour taste.

Ceramic restorations that are built on zirconium can be cemented using traditional cements, resin cements, or self-etching resin cements. Since zirconium cannot be etched, there is no advantage or need to use a total-etch technique with these types of restorations. I commonly use self-etching cements, or resin-modified ionomer cements for zirconium restorations.

Cements are classified on the basis of their components. Generally, they can be classified into categories:

=Water-based acid-base cements: zinc phosphate (Zn3(PO4)2), Zinc Polyacrylate(Polycarboxylate), glass ionomer (GIC) (not this one, glass ionomers release fluoride, which I get badly flushed from in tooth pastes. See ** below). These contain metal oxide or silicate fillers embedded in a salt matrix.  
Calcium hydroxide-based sealer was the least toxic sealer amongst the chemicals tested in both cultures. 

=Non-aqueous acid-base cements: Zinc oxide eugenol and Non-eugenol zinc oxide. These contain metal oxide fillers embedded in a metal salt matrix. (try to avoid metal related products) 

=Resin-based: Acrylate (No, try to avoid, are linked to latex allergy which I have) or methacrylate resin cements, including the latest generation of self-adhesive resin cements which contain silicate or other types of fillers in an organic resin matrix. 

Cements can be classified based on the type of their matrix:
-Phosphate (zinc phosphate, silico phosphate) 
-Polycarboxylate (zinc polycarboxylate, glass ionomer) 
-Phenolate (Zinc oxide–eugenol and EBA) 
-Resin (polymeric)  

The results showed that elutes from resin-based, zinc oxide-eugenol-based, and calcium hydroxide-based sealers were cytotoxic to primary human PDL cultures and V79 cells. Calcium hydroxide-based sealer was the least toxic sealer amongst the chemicals tested in both cultures.


Glass ionomers and fluoride release
There are several fluoride containing dental restorative materials available in the market including glass ionomer cements, resin modified glass ionomers, polyacid modified resins (compomers), giomers and resin composites. Fluoride containing dental materials show clear differences in the fluoride release and uptake characteristics and may act as fluoride reservoir to increase fluoride level in saliva, plaque and hard dental tissues, or may help to prevent or reduce secondary caries. Short and long term fluoride release from restorative materials are related to their matrices, setting mechanism and fluoride content, nature of fluoride incorporated into resin based materials and also depends on several environmental conditions.

Fluoride is generally not considered dangerous at low levels—the key is to make sure you don’t get too much. Data from the National Toxicology Program indicates that fluoride may be a carcinogen. 

With the exception of a very few reports, there is a general consensus that resin-containing restorative materials are cytotoxic (Link) The cytotoxicity and genotoxicity of substances leached from resin based materials and metallic elements have been the subject of extensive studies using cell culture techniques and bacterial mutation test (Ames test). Substances such as TEGDMA and HEMA cause gene mutations in vitro. Studies on the intracellular biochemical mechanisms have clarified various effects such as cell membrane damage, inhibition of enzyme activities, protein or nucleic acid synthesis etc. (Schweikl et al. 2006). At present, the clinical relevance of these in vitro studies is uncertain. 

The results showed that elutes from resin-based, zinc oxide-eugenol-based, and calcium hydroxide-based sealers were cytotoxic to primary human PDL cultures and V79 cells. Calcium hydroxide-based sealer was the least toxic sealer amongst the chemicals tested in both cultures.


I found this eventually on dental info for chemical sensitivities:

What Dental Filling is Safe for me?

By Dr. Stephen A. Lawrence
"Over the last 30 years I have tested over 300 of my most sensitive patients and have found a few products that are safe for most of my patients. The following are some of the current dental products I use for most of my dental treatment:

Direct resin filling (Bonding) or soft resin fillings:  Grandio SO resin with Futurabond U cement (glue) by the VOCO company. (I’ve learned that Grandio contains no fluoride and is bpa free).

Indirect inlay/onlay/crowns or hardened fillings/crowns:  IPS emax porcelain or Zirconia cemented on with Futurabond U and Dual cement by Ivoclar/Vivadent.

Temporary fillings:  ProTemp Plus material cemented on with Superlon

Impressions:  Splash by Den Mat

Anesthetic:  Carbocaine 3% plain or Septocaine 4%

There are many other products in Dentistry to choose from and the products are constantly changing and improving. If you want to get tested by the Clifford test ask me for the kit, to have the test performed. If you have questions or concerns about dental products call me at 760-729-9050, drop by the office or reply to this blog. I use the VOCO product line from Germany because they are very good cements and resins without fluoride added to them. They have many products in their company including the products I use. I currently use their Futurabond U and Bifix SE cements, their Grandio SO resin, Grandio SO flowable and Grandio SO heavy flow products because they do not have added fluoride and they are great products. They do have the Admira resin, Admira flowable, and Admira bond products that have no added fluoride. See their website http://www.voco.com for more information. I use their flowable for a strong sealant with the Futurabond U. I like the Septocaine 4% because it has not been associated with the aniline carcinogens like other anesthetics. All of my most sensitive patients are ok with Carbocaine, as an alternative, if they are trying to avoid epinephrine.

GrandioSO resin does have BisGMA, BisEMA, and Triethylene glycol dimethacrlate. The amount that disassociates to BPA in the mouth is so small that labs have a hard time measuring it. None of my most sensitive patients have reacted to it and all have tested negative on an immune system reaction to it. Dose, exposure time, and bioavailbilty are always important when looking at toxins not just chemistry. Voco does have a new resin on the market, called Admira Fusion. It is a pure nano-hybrid Ormocer (Organic Modified Ceramic). It contains no classic monomers such as: BisGMA, BPA, UDMA, BisEMA, HEMA, or TEGDMA, … It uses a silicic acid instead. This may be the future of non-toxic dentistry but it is too new to know for sure. All direct resin products and their bonding agents have long chemical names and reactions. When dentistry got away from the simple gold fillings and simple cements the chemistry got very complex. With all the new porcelains on the market, like emax, we are simplifying dentistry again. Emax is a lithium disilicate and avoids aluminum problems, bonds to the teeth 3 times stronger than the tooth, and looks natural. I always prefer this product for larger fillings, crowns, and bridges."

This is another good page, from a dentist who knows a lot about biocompatible dental materials and who lists the best ones available in his view.

And another chemical sensitivity patient wrote

"I wish reading this were not like such a case of been there, done that and STILL living with it. I was one of the ones with MCS who had stuff repeatedly ripped out of my mouth, and now have a FLexite upper denture as of this past year. (Am in the process of getting a new and I hope FINAL one soon.) Am going to do a Flexite partial on the bottom after I have the 5th of the 5 planned oral surgeries sometime later this year. HOWEVER, I have NO regrets about removing the mercury, and totally eliminating ANYTHING that comes out of the ocean or any other mercury source out of my life.It was in the end, either my teeth or my life. It is about the only thing I have done in the 30 years that I have been battling this mess that I can say made a HUGE difference. But as you know, we are all different! Hopefully, if you can use gold and or porcelain, you will be able to restore if you find the right dentist. With MCS that bad I would pretty much rule out ALL composites and would be very leery of implants. It's one thing to have a titanium crown you can remove later if you become reactive. It is quite another to decide what to do about it when it is implanted in your bone! 

I can use a zinc phosphate cement called Harvard , as can just about everyone else I know with MCS. Bad news is that it is from Germany, and the closest place from which to import it is from Canada. It can be used to cement most gold or porcelain crowns or inlays I THINK. You would need to ask your dentist about specifics on that. There are probably other forms of pretty non-reactive zn. phosphate cements around avaliable in the US. Cements tend to be more toxic a lot of times than the material they are used on. For what it is worth I have had zero problems with my previous 4 oral surgeries. Found a very skilled oral surgeon/MD who agreed to do it with only local. I used Citanest (preservative-free prilocaine) with no problems. I don't have any active viruses as far as I know however. Good Luck. The dental thing has to be about the MOST frustrating thing to deal with when you have MCS on the face of the earth, and it never seems to end. However, for some of us, it is TOO crucial to ignore, Harvard cement won't be available in the U.S. I was able to get it across the Canadian border with no problem. There should be other zn.phosphate cements with a minimum of ingredients. As for the partial and denture material. The Flexite material which most people with MCS tolerate is a nylon, rather than an acrylic-based product. However, they do have several different types of Flexite I have both the clear nylon type called Flexite II (that one is usually used for partials) and another type which is pink and called Northerm. The lab. should be able to supply your dentist with samples to test. None of the Flexite products have monomers, even the acrylic ones, which seems to be the worst sensitizing agent. I hate the whole denture, scene, and am hoping this last one is going to be much better, fit and otherwise. There just aren't any really good options with dentistry, as you know. Again, good luck.

Forgot to mention the impression materials when I posted this before. They have to use several different materials in different phases of the process. The alginate stuff never bothers me, is a pretty natural substance. There is ONE however, that KILLS me when it is being used. It is an ether-type smelling thing that burns everything it touches, etc. HOWEVER, with all of them, they are only in the mouth a couple of minutes, and you should be okay if you rinse really thoroughly afterward.

1. Local Anaesthetic: a). If a local anaesthetic is required, use 3% carbocaine without epinephrine in a single-dose disposable ''carpule'' with no preservative. b). Epinephrine comes with a bisulfite preservative, which is often very disruptive to hypersensitive patients. In addition, the epinephrine itself is often degraded more slowly by an inefficient cytochrome P-450 system (detoxification enzyme system); hence, small doses give large effects to these patients.
2. Avoid eugenol or substances containing eugenol. Even in small quantities, eugenol has been devastating to many patients.
3. Avoid the use of ''varnish'' to coat the inside of the tooth prior to treatment.
4. Avoid protective plastic tooth coatings, as they are often not tolerated.
5. Root canals. The root canal ''caulking'' paste is often not tolerated by chemically sensitive patients. This paste contains cytotoxic substances such as eugenol and halogenated hydrocarbons such as chlorothymol, iodothymol, as well as resins. These substances frequently produce insidious chronic reactions. (Ed. Note: Root canal sealers and fillers made of calcium oxide or calcium hydroxide have been well tolerated by chemically sensitive patients. A product called Biocalex which is based on heavy calcium oxide, is capable of being used without the addition of any cytotoxic substances).
6. The following substances have almost always been well tolerated: a). ''ZOP'' (zinc oxyphosphoric
acid) cement (be careful not to have ZOE inadvertently substituted, as ZOE contains eugenol).
b). High gold alloys that do not contain palladium.
7. Some individuals are intolerant to composite dental materials used as a replacement for amalgam. To find out if you are intolerant to the plastic-containing fillings, replace one small filling and wait two weeks. (Ed. Note: Please ask the dentist to cure the composite thoroughly, using additional time with the curing light if required. If at all possible see if the dentist can have an inlay or onlay fabricated in a dental lab as the restoration of choice. Composites cured in the laboratory are usually done under high heat and pressure, providing complete curing of the composite). Observe for any reactions over this two-week period. If you have not had any adverse reactions during this two-week period, then replace a second small filling and wait another two weeks and observe for any possible reactions. This is done as a double check to make sure that you can tolerate the plastic.
8. Toxic reactions to mercury vs. allergic reactions to plastic: It is common to have a toxic reaction to the mercury vapours resulting from the removal of the mercury-containing fillings. This toxic reaction takes place during the first week and over the second week gradually lessens. Do not confuse this with an allergic reaction to the plastic, which starts during the first few days and which
will not lessen but will worsen over the next one to two weeks. If you determine that you are reacting to the plastic, have the dentist remove this test plastic filling immediately. In this case, do not proceed to the second trial
“ I had a problem with sutures so my dentist used organic cotton thread which I bought. He sterilized it with heat (autoclaved), doubled it for strength and used that.
Composites are plastic and release xeno-oestrogens. These xeno-oestrogens play havoc with the hormonal system and are implicated in period problems, infertility, prostate cancer and breast cancer to name just a few.

Here is more inform
ation on dental fillings

Here is some info on the (blue) curing lamps for dental fillings:

Exposure of teeth
The curing lamps with high energy output intensity may cause local thermal emission. Laboratory studies show temperature rises, at 3 mm distance from the light source, from 4.1°C to 12.9°C, and from 17.4°C to 46.4°C for LED and QTH lamps, respectively (Yap and Soh 2003). In vitro studies with thermocouples placed in pulp chambers of extracted teeth show a moderate rise in pulpal temperature. In a vital tooth this does not seem to be a problem, possibly due to the effects of the blood circulation. However, the recent introduction of the high-intensity LED-lights might change this situation. Light as cofactor in photobiological reactions.

Most manufacturers state in the instructions for use that dental curing lights should not be used in patients with a history of photobiological reactions - or who are currently on photosensitising medication, including 8-methoxypsoralen or dimethylchlorotetracycline. Phototoxic and photoallergic reactions are potential problems, but there does not seem to be any case reports on this issue. The dose or output from the high intensity lights are in the same range of what is used for dermatological skin testing of photobiological reactions. Phototoxic or photoallergic reactions have not been documented in the context of oral medicine. The possibility of photo-related reactions should be taken into account in evaluation of dermatological conditions in dental personnel.

Healthy alternatives for conventional fillings?

More on curing lights:

Clean your teeth!  Brush and floss every day.  But believe it or not, toothpaste is NOT important... in fact, this study found that brushing without toothpaste removed more plaque than brushing with it (2).  Plus, I've heard some talk about the ingredients in modern toothpaste preventing re-mineralization... I'd play it safe and stay away if you're really giving this a try.  If you're into it, use baking soda.  Or make your own baking-soda-based toothpaste.

Reply: I love this! I was just at the dentist where my mom works and the woman that cleaned my teeth was really into natural remedies. She is awesome and told me how to my own toothpaste with coconut oil, a little bit of baking soda, peppermint, and something else I forget. She also told me about this online series called healthy mouth summit at healthymouthsummit.com. She is really into paleo, it was awesome! It is free and starts sometime in January so you should check it out! 

I also followed some tips from this modemade toothpaste blogpage:

Article on reversing tooth decay: 

Make your own toothpaste:
See this article:
"I’ve talked before about the link between nutrition and oral health and shared the recipe I was using to make homemade natural toothpaste. That toothpaste works great, and it certainly gets teeth clean, but as I’ve read more about oral health since then, I wondered if that recipe could be improved.
There is a lot of emerging information about tooth remineralization, a process that many dentists previously thought was impossible. This article goes into detail about the science behind tooth reminerlization and the dietary steps necessary also. (It also explains why ingredients in most toothpastes, even natural ones, can demineralize teeth and cause tooth decay!)
The information I found in researching this was mirrored by my own experience over the last few months with natural toothpastes and a remineralizing diet."

And a good article about toothremineralisation:

I now use toothpastes from Squigle and love them. They have a lot of xylitol and very mild ingredients. I use a fluoride one during the day and a fluoride containing toothpaste from them before bedtime.


My own camera is broke and I have been waiting for a shocking 3 months for it to be repaired (repair ppl made the problem worse instead of better). Apart from the old ones, these were taken with a crappy camera and the redness was a good deal more bright than it appears in them, but I take that is something most people with rosacea are familiar with unfortunately..

Before, last 6 months during good period

Day one, right after dental fillings and cavity treatment


Weeks after temporary fillings and cavity treatment

:( On fire

After root extractions, there we go again

February 3rd 2014, update

Things are not going well... The lower socket is still infected and I asked my surgeon for some more amoxicillin. My rosacea is pretty aggressive and angry. I assumed from the ongoing source of infection. What is most worrisome is the left cheek, which has ongoing nerve pain. It feels like burning and very tight tingling, it's painful and uncomfortable and it runs along the side of the face and also on the apple of the cheek now, under the eye. My forehead is also feeling like it's been botoxed. I asked the doc again if this can come from damage to the Trigeminal nerve, and if it can be some sort of Trigeminal neuralgia. He said he doesn't think so. He says extracting a tooth, even injection too much anesthetics in the region of this nerve, still wouldn't cause these symptoms.
I hope once the infection is gone, things might perhaps improve. I will ask my doctor for carbamazepin, if he wants to help, to hopefully put a dent in the nerve pain. I tried Lyrica and Neurontin in the past and my face went very red from them. So that was the end of the trial automatically. People in the hospital today actually were looking at my face, you saw them turning around and wondering what's wrong with me  :( Right picture taken a few months ago, skin still good and calm. First one taken back in 2007,
skin way less swollen and puffy and problematic.

March 12th, 2014
I see slight improvement.The surgeon gave me the green on Monday to go to my friends place, who lives not in the city like me but in the countryside. The infection was mostly gone and it just takes a bit longer for my lower molar socket to heal, but no more need for antibiotics he said, just keep rinsing and irrigating it with a salt water solution. Today is the first day in a long time where I woke up not flushed and not burning. See pics. A few hours later, whammmm redness and burning is back, but at least it's a slight improvement. I am taking the mastocytosis medication again the past 4 days, mainly inorial and zaditine, because it's spring weather here with lots of pollen and allergens. I hope the clean countryside air also helps the rosacea calm down a bit. 

March 13th, 2014

I really wanted to start using a drug called plaquenil again. I was on it 2 years ago and 4 years ago, both times they made me paler, but gave sore eyes. I thought I had some left here but can't find it anywhere. I want to use it as an anti inflammatory. Then use less than the generally used 200 mg a day, so I can hopefully prevent sore eyes. I also wear no contacts at the moment so hope that will lessen the reaction as well. I just need something to calm down this inflammation. Dr Chu emailed me to start taking the antimalarials again, friend called my local derm here for a prescription, she said she would, then sent me a totally different prescription, he called today, she said I had said I had side effects (eyes) so no, they wouldn't prescripe it like that anymore. Oh no. She even went in to talk to the doctor, he said the same. So I am waiting for dr Chu to respond (with him being super busy, that can take quite some more time), and my GP just prescribed me Lyrica.

March 18th, 2014

Finally some improvement. Have been feeling less hot, on fire and I look less red too. Still having some flushing periods, mainly in the evenings and after waking up, but its a lot more bearable and manageable again. I sunbathe (bod only) in the afternoon for an hour when possible, to crank up my very low vitamin D levels. I'm using my normal meds, and the mastocytosis meds inorial and zaditine, but at a low dose. Finally some relief.. Tooth sockets are also healing well now, I think this is one of the reasons that my skin is calming down again too. I've been making my own toothpaste, sortof following the tips in this blog entry about homemade toothpaste. I bought a type of green clay from the organic bio shop, it comes in  handy tube, almost like a toothpaste itself. I add coconut oil to it (melted but not warm) and some boiled water with sea salt (also cooled down). I now will buy Xylitol powder and Calcium carbonate powder and mix it all up to a great toothpaste, without any fluoride, essential oils that make me flush, no peppermint and no glycerin.

This whole ordeal made me wonder; what did dental care and treatment look like in the middle ages? Nowadays people all have great smiles, veneered up, polished, whitened, patched up. You don't see any effects of cavities and most other dental problems anymore. Whereas I have my first few cavities and need to get butchered like this (well, my own choice and quest more so). So what happened back int he days when people had cavities?

Middle Ages
Dental treatment is as old as toothache itself. The middle ages was a brutal time for the toothache sufferer, as the main treatments available were dubious toothache remedies and extraction. Dentistry was not a profession in itself, and often dental treatment such as extractions and tinctures were offered by barbers or barber-surgeons, and by the marketplace charlatan, the tooth drawer, and later the 'Operator for the Teeth'. Dental treatments comprised tinctures and styptics - extraction was a last and painful resort. Forceps and the 'Pelican' were the most common extracting tools. The dental pelican, invented in the 14th century by Guy de Chauliac was often made by the village blacksmith, needed little skill to use and often caused terrible damage and pain. The pelican was replaced by the dental key in the 1700’s which, in turn, was replaced by modern forceps in the 20th century.

Throughout the Middle Ages in Europe, dentistry was made available to wealthier individuals by physicians or surgeons who would go to the patient's home. Decay would sometimes be removed from teeth with a "dental drill," a metal rod that was rotated between the palms. Soft filling materials provided short-term alleviation of discomfort by keeping air from the open cavity. Dentistry for poorer people took place in the marketplace, where self-taught vagabonds would extract teeth for a small fee. From the Middle Ages to the early 1700s much dental therapy was provided by so called "barber surgeons." These jacks-of-all-trades would not only extract teeth and perform minor surgery, but they also cut hair, applied leeches to let blood, and performed embalming.

Oral hygiene during the middle ages was very basic. Teeth were cleaned with pieces of linen or sponge, or by using toothpicks.

Ancient Times
Researchers have found that dental drilling dates back 9,000 years. Primitive dentists drilled nearly perfect holes into teeth of live patients between 5500 and 7000 B.C. Researchers recently carbon- dated at least nine skulls with 11 drill holes found in a grave- yard in Pakistan. This means dentistry is at least 4,000 yrs older than first thought.
Researchers figured that a small bow was used to drive the flint drill tips into patients teeth. Flint drill heads were found on site. This dental drilling probably evolved from intricate ornamental bead drilling. The drilled teeth found in the graveyard were hard-to-reach molars. Although it is speculated that the drilling could have been decorative or to release "evil spirits" more than fighting tooth decay, the hard-to-see locations of the drilled teeth in jaws seem to rule out drilling for decorative purposes. No sign of fillings were found.
Dentists were highly knowledgeable even in ancient times. This is highlighted by the fact that to drill into the teeth, they used hard stone for example obsidian, which is strong and hard and can puncture bones. Drilling and any form of cosmetic or restorative dental work can be painful, and the possibility of using herbs to kill any pain, before and after the procedure, cannot be ruled out. The fact the dentistry was really advanced in those times is proven by the evidence that those dentists had the skill and technology to drill into the teeth without touching the delicate pulp in the tooth, it seems like they did know the importance of avoiding that and knew the damage caused by infection could result in loss of the tooth or teeth.

According to Jimenez, to bond semi precious stones like jade, to the  teeth, they used a paste made of natural resins, such as plant sap, which was mixed with other natural chemicals and crushed bones. This was certainly long lasting, as the semi precious stones are still in place after hundreds of years. People of ancient times believed that the stabbing pain of a toothache was caused by a toothworm, which either had appeared spontaneously or had bored its way into the tooth. If the tooth pain was severe, it meant that the worm was thrashing about; but if the aching stopped, then the worm was resting. Cultures all over the world, many of whom had no contact with each other, held stubbornly to this myth. The folklore of the toothworm persisted from ancient times to the beginning of the eighteenth century.

18th Century
By the early 1700's, dentistry was considered a lesser part of medicine. By the end of this century, it had begun to emerge as a discipline in its own right. In the late 1750's the term 'dentist', borrowed from the French, started to be used in Britain to describe tooth operators. Italian sources from the 1400s mention the use of gold leaf as dental filling material. Later, the French described the use of soft lead fillings to repair teeth after decay was removed. Pierre Fauchard (1678-1761 ), a French surgeon, is credited with being the "father of modem dentistry." His book, The Surgeon Dentist, A Treatise on Teeth. describes the basic oral anatomy and function, signs and symptoms of oral pathology, operative methods for removing decay and restoring teeth, periodontal disease (pyorrhea), orthodontics, replacement of missing teeth, and tooth transplantation. Fauchard’s text was followed by others that continued to expand the knowledge of the profession throughout Europe. Two popular books, Natural History of Human Teeth (1771 ) and Practical Treatise on the Diseases of the Teeth (1778), were written by English physiologist John Hunter, surgeon general to the British army. Throughout this period of change quackery was still widespread and charlatans were a common part of rural life. Only the very wealthy could afford the skilled dentist or operator for the teeth. For many the only option was the village blacksmith and tooth drawer offering painful extractions. Tinctures, toothpowders and abrasive dentifrices could also be purchased at the market fairs. The upper classes could afford a greater range of treatments, including artificial teeth (highly sought after by the sugar-consuming wealthy). Ivory dentures were popular into the 18th century, and were made from natural materials including walrus, elephant or hippopotamus ivory. Human teeth or 'Waterloo teeth'-sourced from battlefields or graveyards-were riveted into the base. These ill fitting and uncomfortable ivory dentures were replaced by porcelain dentures, introduced in the 1790's. These were not successful due to their bright colors, and tendency to crack.

Dental practitioners migrated to the American colonies in the 1700s and devoted themselves primarily to the removal of diseased teeth and insertion of artificial dentures. Paul Revere, historically noted for his "midnight ride," was by trade a metalworker who constructed dentures from ivory and gold. George Washington had dentures made of metal and carved ivory, or metal and carved cow teeth, but none made of wood. Until the mid-1800s, dentures continued to be individually constructed by skilled artisans. Gold, silver, and ivory were common components, causing them to be very expensive and available only to the very wealthy. In 1851 a process to harden the juices of certain tropical plants into vulcanized rubber was discovered. The ability to mold this new material against a model of the patient's mouth and attach artificial porcelain teeth allowed the manufacture of less expensive dentures. Later, acrylic plastics replaced the use of rubber and porcelain in denture construction.

19th Century
Before the 1800's, the practice of dentistry was still a long way from achieving professional status. This was to change in the 19th century - the most significant period in the history of dentistry to date. By 1800 there were still relatively few 'dentists' practicing the profession. By the middle of the 19th century the number of practicing dentists had increased markedly, although there was no legal or professional control to prevent malpractice and incompetence. Pressure for reform of the profession increased.
The introduction of anaesthesia had a dramatic effect on dentistry. Alongside ether and chloroform, nitrous oxide became the most preferred option and most surgeries were equipped with general anaesthetic equipment by the end of the century. Many people were now prepared to have their rotting teeth extracted, which led to an enormous demand for cheap and efficient dentures. The introduction of vulcanite in the mid 19th century meant that now dentures could be mass-produced and affordable, replacing the expensive ivory versions. Source: http://homepages.gac.edu/~mreiff/project4/history/19century1.html

Medieval Times and Dental Health

Dental health is perhaps not the first thing you think of when you think of people living in medieval times; however, there is a great deal of evidence to support the fact that medieval people did make an effort to take care of their teeth and gums. Evidently, oral hygiene products were not nearly as advanced as they are today and people didn’t have access to the range of toothpastes, dental flosses and mouthwashes that we do today. Instead, people in medieval times relied on natural products, which were derived from a variety of sources, including spices and herbs including rosemary, sage and mint. Sometimes, the herbs were chewed and sometimes they were crushed and combined with a liquid, which was then used as an early form of mouthwash. Treatments came from other European countries and became more advanced as time went by. Most people’s oral hygiene routine was centred on using liquids such as vinegar and caustic substances as mouthwashes and scrubbing the teeth using a cloth and a mixture of herbs and abrasive substances, which rubbed bacteria off the teeth. Strong, pleasant smelling substances, including mint, musk and bay leaves, were also used to freshen the mouth and prevent bad breath; contrary to popular belief, medieval people were meticulous about personal hygiene and were constantly looking for new ways to make them look better and smell sweeter. There is also written documentation proving that people used fine sticks to remove food deposits, much like we use toothpicks today.

I'll update on every day stuff post dental treatment further in this ongoing post

Update, September 17th 2014

I had a wisdom tooth removed yesterday, what an ordeal. (One left now but that one is not yet problematic). Nice young Belgian doctor and I told him that the last time I needed more than 12 anesthetic injections and he thought it would be different now, but turned out the same way. Showed the X ray and it was a very tough wisdom tooth, completely breached and with difficult roots intertwined with an important nerve, so he said he would remove the top of the tooth first and then decide if it was safe enough to get the root out. Luckily that all went well and they had a whole team called in to see how you remove such a hooked tooth, but after 5 injections he started drilling the tooth off and it still hurt badly, so needed another 7. Tough to get the hooked thing out and they needed to drill quite a bit off my jawbone. Yesterday rosacea was fine, I think from the immense amount of adrenaline they put in the anesthetics, to keep it longer in the nerves and have the blood vessels constrict, but today, massive inferno and my jaw feels so painful. I can't sleep from it.. had four 600 mg ibuprofen but they burn my stomach so take nothing now. Feel so smashed up. Asked for antibiotics as I always get infections but this is Holland and that means extreme conservatism with medication, so I didn't get any. Hope it wont get infected as the others did in February but will keep an eye on them. Look like a red chipmunk.Yesterday my rosacea was calm all day despite the procedure, but today rosacea is bad. Just starting the whole circus all over again :) Well, slightly. Hey, the good thing is that most of the nerve pain resolved itself within 6 months, as was predicted. It's always good on the day itself, maybe because they put so much adrenaline in those jabs and they are strong vasoconstrictors, to keep the anesthetic longer in the nerves. But today its pretty red and sore and my mouth feels like its butchered, reallly sore today. Thought it would be better instead of worse. Feel like shit.

Update, September 20th 2014

Update on my own little issues; skin was ok'ish today, not too bad and the pain is finally getting a bit down. It was kind of brutal the past days. I took 600 mg ibuprofen (a type with no bright pink coating nor orange zest chemical flavors, just simple white pills) but the pain came through nevertheless and after 2 days my stomach hurt so bad from them that I tapered it off. Couldn't sleep Wednesday night from the pain, but now it's Friday night and I haven't taken the meds all day and it's fairly diminished by now. Am rinsing my mouth very often with sterile salt water to prevent infection, so far as far as I can see with the flashlight it doesn't look infected.  But now that the pain is diminishing I can feel that the right side of my chin is still pretty totally numb and the right lower part of my lip too again. when I rub it it starts to tingle really annoyingly and painfully and when I just lightly touch it, it still feels number up, like during the procedure. I can press my nails in the skin very hard and feel as good as nothing..I had the same happening in February with my upper lip btw. The same feeling. Doctors then said it should recover nerve sensory in 6 months and as I just wrote, it mostly did. Friend thinks it is because they used again soooo many anesthetic jabs again now.. The upper lip is almost back to normal, but it took indeed 6 months! I bloody well hope this goes away sooner It is only localized there, so I don't assume the doctor hit that risky nerve after all.. Can't imagine a crucial nerve only limitedly serving the area of right side of the chin and right lower part of the lip. What the bleeb is wrong with me, every time this happens. Rosacea is not too bad, not as good as it was either, but I still have sutures in, plus wound healing, so I guess that will all stir it up right now.

Update August 5th 2018

I like to reshare the wonderful toothpaste I use. I was tipped off by a rosacea forum member, antwantsclear, who wrote me a year and a half ago "I saw your problems with toothpaste on your blog. I thought you may be interested in the toothpaste I get from mouthulcers. I started buying it to stop mouth ulcers but then realized it helps with the rosacea as well. It's called Squiggle toothbuilder." Thanks again Ants, I love this product! So mild, and it has a ton of xylitol. I use the fluoride free green one during the day and the fluoride version before bedtime. No flushing or skin reactions from these toothpastes and I haven't had a cavity or tooth problem since using it.

My 2 year period of using fluoride free toothpaste and 'remineralizing' my teeth with clay and calcium and baking soda made me end up with cavities! I'm going to trust the dentist and the dental surgeon who told me forcefully in the hospital; use fluoride toothpaste! 


  1. Wow! So sorry to hear of this. I hope your skin settles down as your wounds heal.
    Earlier you had said you were on 3 mastocytosis meds, then stopped 1. Wondering if that changed the diagnosis, as there is research being done on this condition (and not for rosacea as per the NIH website). They have 2000 subjects already (which includes a lot of other conditions under the same umbrella). Please consider contributing your dna to research. If they can find the gene for a condition it makes it a little easier to figure out a treatment.
    I sure hope you get better soon.

  2. Thank you anonymous for your kind words. I was tested on mastocytosis with a blood test, they looked for tryptase levels and they were all normal, so that exclused me as far as my doctors say. I found the 3 mastocytosis meds helpful for a good few weeks and then I noticed more and intense flushing and my skin had become very dry. I already take a lot of other medications that make my skin more dry and unfortunately, mine doesn't tolerate topicals so I stopped the masto meds after some time and stick to Xyzal, 10 mg a day now... I am curious about the dna research you mentioned, thanks! Will look into it. My flushing is only in my face/cheeks however, sometimes the ears join in, but never my neck or chest. I doubt I have mastocytosis to be honest, but do find antihistamines helpful in combatting flushing and redness. Hope you are well

  3. Hi
    I am glad you don't have this other condition on top of the rosacea.
    I have not found any dna research studies run by universities. The above study for a rare set of conditions involves 3 professors/doctors collaborating with a for profit company that does direct-to-consumer testing. If you had qualified, the testing would have been free, otherwise 23andme charges $99 plus shipping $50-80. There are worries of genetic discrimination (I think only Americans have laws against this). You, however, have already put all your health details for all the world to see, so don't have such worries. They take saliva samples (genotype) and have health questionnaires (phenotype). They ask "Would you like to participate in research?" "Do you have rosacea" among other conditions. Aggressive advertising recently resulted in the FDA shutting down their health reports so they only give ancestry results. But you can get the raw data and put it in Promeathese to get similar reports (I'm not computer literate enough to figure that out). Since rosacea is more common in Celtic and Eastern European people, maybe they will find the gene as their data pool grows (500,000 customers as of Nov 2013). If enough fellow Rosaceans use this as "citizen science" to find the gene(s) responsible this might lead to better treatment (or at least a stern warning to others with my bad gene not to exfoliate at all or use AHA cream or sunscreen). When I saw their health reports I was not that impressed, but it's the promise of future results that I care about. I would do a lot of reading on this topic if you are interested. I only had one week of acute pain from the rosacea; I feel terrible that you and others have to go through this still. Hang in there, you never know what amazing discoveries are just around the corner.

  4. My heart just goes out to you. Most people take for granted going to the dentist but when you have an underlying condition that can get stirred up it can become a nightmare. I am so scared to go. (and NO-no because of you-haha. I was scared before I read this. I have a cracked tooth and need some filling and my gums hurt and I can't help but think there is a connection. I am not scared so much of getting work done but that that the dentist is not going to get my concerns and treat me like any other patient.

    Have you ever heard or tried oil pulling? It's an Ayurvedic practice that is gaining some mainstream usage. I keep thinking I might try it because it is supposed to be really good for oral health along with other health benefits such as detox and allergy reduction. I don't know enough about it really but I do have this bottle of olive oil here...

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  6. Thank you anonymous. I am absolutely petrified about my teeth now. Its just god awful, this whole dental thing. I am feeling such a fool to have not kept up with the meticulous way I cared for my teeth all those years, as I always feared that a cavity would cause some issue perhaps (not this bad though!) as even wearing jewelry makes me flush. Its insane and madness and nobody will understand this unless they suffer from it themselves I guess. Yeh I do the oil pulling now, I have a jar of virgin coconut oil and read its great to brush and flush with, I also use green clay as a toothpaste and the coconut oil mixed with calcium powder and a little bit of sorbitol. Hoping I can limit further dental damage but feeling like I am forcing myself to live as in the Medieval times here, its too outrageous to even start to explain to anyone not familiar to the horrors of daily flushing why somebody would willingly...Face is back to how it was now though, not having the crazy deep red flushing anymore that I had earlier this year after the dental work. But it's a massive imaginary sword now hanging over my head :( Can't get more dental work done, can't get in a car crash because what if I need some sort of metal inserted in my body? I love sweet foods but feel guilty and stressed now when eating them. Never expected I would go to such drastic measurements for my rosacea and feeling a little bit ashamed about it too to be honest. Thanks for your understanding and suggestions.


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