“Aundaray you have such a beautiful smile.”

“Aundaray I simply love it when you smile.”

“Aundaray your smile lights up the room.”

Complimentary comments said to me, yet those who heap the praise don’t know my fear of displaying that smile. If they did, then they’d find out my secret. Giving a huge smile means showing a full set of teeth that are in need of repair. I wish I could say I have a perfect set of teeth, but the truth is that over the years I let the fear of dentist get the best of me and I pray it’s not too late for the rest of my choppers. Having HIV doesn’t help, as I know that having a healthy mouth is something all should strive for, but when you add an HIV-positive status to my situation, we’re looking at a mouth full of problems.

My fear of the dentists started like most who want to run the other way when thinking about sitting in a dentist chair. When I was a child I had several bad visits to the dentist, which stayed with me forever. Those incidents marked me extremely, so much that when I was old enough to make my own appointments, I would always be a no-show. When I was a youth, my mother gave up making appointments for me as I was always guaranteed to disappear only to re-appear when the coast was clear. Although she would lash out at me, I would rather face her anger than someone telling me to open my mouth wide.

Ironically my mother eventually started to wear dentures, and maybe I felt I was predestined to do the same. Yet the thought of it terrified me. Knowing I would let my oral health get to the point that I would have my entire mouth of teeth removed.

It didn’t help that in my reckless youthful years, I paid little attention to what I ate. Junk food and sweets were my primary nutrients along with slugging down liters of Mountain Dew. Yes, the worst thing to consume as it did the most damage to my teeth, even more than Coca-Cola. In fact, if I had to guess, I would say it was the soda alone that started the damaging of my mouth.

I started to get cavities, which were only addressed when they became unbearable toothaches. In many cases, an aspirin would relieve the pain, but then my luck started to run out when my cavities started to get cavities. My only option was pushed to the next level—having a root canal. Once I went through several root canals I cleaned up my act, only to descend back into bad dental habits.

As stated before, fear of the dentist was my first reason for not going, but soon I had others to join my excuses. One excuse for me was feeling the need to lie to the dentist. Although I had no reason to fear, I sometimes felt that, when asked on the intake form, I had to lie about having HIV. I know I had a duty to disclose as the dentist and staff were going to be exposed to my blood, but I felt I would be stigmatized if I did share. I didn’t know if I would be denied service or if the quality of care would be the same. So I avoided having to place myself in that situation.

Another reason was that sometimes I couldn’t afford the co-pay or rather what wasn’t covered by my insurance. Dental insurance only covered so much. For someone like me who needed extensive work, the out-of-pocket cost was way beyond what I could afford. For a few years I was in luck as I was enrolled in a Ryan White dental program for those living with HIV, but when it was defunded I was back to square one.

Beyond aesthetics, I knew that as I aged, having an unhealthy mouth could literally be the death of me. With a compromised immune system the last thing I needed to do was encourage bacteria to compromise my system, something that can happen with the formation of periodontal disease. There’s even a debate on the mouth/heart connection and how an unhealthy mouth can contribute to heart problems. Yet by not taking my mouth serious I was opening the door for bacteria to invade my mouth.

So with my newly acquired dental insurance, I finally bit the bullet I had to make a promise to take care of my mouth again. In the process of addressing my fears I learned several important facts. The first is that I’m not alone—dental anxiety and phobia are extremely common. It has been estimated that 9% to 15% of Americans avoid seeing the dentist because of anxiety and fear. That’s about 30 million to 40 million people. So I was not alone.

When looking for a dentist, I found that being open and honest about my fears allowed me to find a dentist who knew how to address my situation. In establishing that relationship I also shared my HIV status. This was the right thing to do, and it created a two–way street of trust. Besides, there are discrimination laws in place to protect me, and if someone had an issue with my status, why would I want to give that person my business? My dentist has been great because he provided some tricks I can use during each visit, such as putting my earbuds in and listening to music during my examination. Another hint was learning how to breathe properly and not tensing up.

My out-of-pocket expenses were even reduced once my dentist was made aware of my difficulties in paying. Creatively, my appointments have either been spaced out, or the work on my mouth has been maximized to get as much done without incurring a high cost to me.

As I write this, my fear of smiling has diminished as my outside smile reflects how I feel about the inside of my mouth.