The Ins and Outs of Menstrual Cups

Photo Cred: BucketListly Photos

Estimated reading time: 7 minutes, 49 seconds

“Can you tell me about menstrual cups?” she said. “I’m moving overseas and I don’t think they’ll have the products I want to use there, so I’m thinking about getting one before I go.”

Just one of many ways this conversation has started for me with many different types of people. Some are looking for new solutions to their menstrual hygiene or simply curious about this new device they’d had yet to hear anything about.

I’m pretty good at giving the low-down at this point:

Menstrual cups are a small, flexible device you insert into your vagina to collect fluid from your period. It sits directly under your cervix and can hold ounces of blood with no leaking.

They are usually made of surgical grade silicone, but can also be made of tree rubber. Be sure to confirm what material your cup is made of before purchasing as the silicone is hypo-allergenic whereas rubber is not.

Contrary to what Divacup would have you believe, there are *MANY* brands of menstrual cup.

 

Photo Cred: The Eco Friendly Family

Which menstrual cup you choose can depend on something as simple as how much money you’d like to spend or other factors like the shipping cost/time, the size of the cup, the cup design, and the business model of the company who sells it (Ruby Cup operates on a “TOM’s Model” where each cup you buy automatically donates one).

In terms of cup design, I personally wouldn’t pick one with a loop at the bottom (like the MeLuna Shorty, pictured above) because the more crevices the cup has, the more chance it has to grow bacteria in the holes and grooves. This probably isn’t really an issue with this design, but something I’m personally cautious about.

Also about design, let’s talk about size. How are you supposed to know if your vagina is the right size for a “small” cup rather than a “large” one? First off, the cups usually only come in two sizes (if that). So you have a 50/50 shot of picking one which will work well for you.

Most of the cup company websites I’ve pawed over, say that the “small” cup is for those people who have not had penetrative intercourse. I would also recommend this to someone who has a light flow or who feels a larger cup might simply be uncomfortable for them to wear.

The “large” cups are for people who have had penetrative intercourse, who have birthed children, or who have a “normal” to “heavy” flow as these cups are larger and can hold more volume without needing to be emptied.

Right, yes. You have to empty the cup. I found that, even when I was having a VERY heavy flow (2 ounces of blood or more per 24 hrs), I only needed to empty my cup 2 or 3 times per day. You can sleep with the cup in and it will not leak! This really cuts down on the number of times you have to empty it when you’re away from your base camp (wherever that may be). I found that I would empty in the morning when I woke up, maybe once at lunch, and then again before I went to bed.

Let’s dive into the strategy of the lunchtime empty. It’s one thing to empty your cup in a bathroom where you feel you have some sort of privacy. If you do need to empty it in a public bathroom, here’s how I managed. Pick a stall, any stall. I’d remove my cup (here’s a page with some how-to’s), and then pour contents into the toilet. Now, you have some options. You can purchase a sanitizing spray or wipe, or you can do what I do which is to simply wipe the cup down with some good ole’ fashioned toilet paper and then give it a quick rinse in the sink, and reinsert. I found I never had a problem with this and it’s discreet. There’s also not really any noise associated with the cup, whereas pads and tampons have that horrible plastic wrapping which alerts everyone in the entire building to the fact that you’re menstruating (I don’t miss that!).

The cup varies in price depending on where you order it from. There are finally some companies who are starting to manufacture and sell cups in the United States. Everyone before that was imported (even DivaCup is made in Canada). Imported ones cost roughly $38 dollars depending on brand and inflation and shipping. The brand “Lena Cup” seems to be running about $25 and has some good resources regarding FAQ of menstrual cups. They are made in California and are FDA registered. However, being FDA registered is kind of a moot designation as long as the device is made of %100 silicone.

I notice on Lena Cup’s website they have a sCaRy article about the dangers of tampons. While I am a HUGE proponent of menstrual cups and their ability to change people’s lives, I’m not selling them. So I have no reason to make you hate tampons (and I personally think that’s kind of a sh*tty thing to do); I just personally don’t use them anymore. However, there are a few things worth noting about the differences between tampons and cups.

Cups do not absorb anything; they collect fluid instead. This means the cup will not suck up the natural moisture in your vagina (which is NOT the same as your menstrual fluid) which, if it did, would otherwise eff up your PH balance. I often recommend people with chronic yeast infections try cups because of this.

Tampons, when left in for too long or overnight, are notorious for causing Toxic Shock Syndrome (TSS). This is a rare, but serious illness which can easily lead to death. Cups cannot give you TSS. I believe this is because they are made of silicone which does not degrade in your body, and does not (I believe) cause the tiny scratches in your vaginal wall which allow for the TSS causing bacteria into your bloodstream.

You can also have sex while using your cup. I would not recommend having penetrative sex with a cup in. I accidentally did this once (long story), and while it wasn’t terrible, after I realized what had happened, it fully explained why something felt “funny” the whole time. The cup is flexible, however, so you can engage in penetrative sexual activity and (up to a certain extent) not leak (I say “a certain extent” because I’m not sure how raucous you’re planning to get).

Oral sex is a whole ‘nother story. If that’s what you were hoping for, GO FOR IT. Literally no reason not to (as long as it’s safe, sane, and actively consensual). It’s probably going to be great and you may even forget you’re on your period.

Then, yes, there is that cool factor of not having any environmental waste. Some cup companies say you can keep the same cup for ten years, others say five, and still others (Diva) recommend you replace it every year. I personally don’t see any reason why you can’t use a cup that’s made of the same medical grade silicone for more than a year, but I think it has to do with customer retention and getting people to make recurring purchases (Think about it: If you only bought a cup once every ten years, that’s great for you and terrible for Diva cup. This is part of why I don’t purchase their products).

Environment aside, even a $40 cup pays for itself within three months of use (when replacing tampons and pads).

To clean, I boil my cup. I have a two dollar tiny pot from Goodwill and it is my “cup pot”. I use it exclusively for boiling my cup because, well, I felt like it was kind of weird to put it in the dishwasher with our plates, glass cups, and silverware- but that’s just me! Everyone’s preference are different and it is totally acceptable to use the dishwasher to sterilize your cup. I would be wary of using any kind of soap though, because some residue might remain in the tiny air holes at the top of the cup, causing irritation if it came into contact with sensitive skin.

CAVEAT: If you have an IUD or want one (which, omg we should totally also talk about :D ) you need to be aware that it is possible to “dislodge” your IUD if you decide to use a cup. In theory, it is possible that when you pull out the cup, you could accidentally pull on your IUD string and remove the IUD in the process. I have had an IUD for four years now and have been using cups for that same amount of time. This has literally NEVER even sort of happened to me, but I wanted to be sure you were aware. Some people even say the suction of the cup pulling out of your vagina could suction the IUD out of place. While I’m sure this might be true in some cases, again this has never happened to me and simply doesn’t outweigh the amazing benefits I have personally experienced from using my cup.

I truly hope this has been helpful and I really love talking about this particular subject. If you have any questions, please do email us at inkblotblog90@gmail.com. I’m always happy to chat about this, birth control, or other sexual health subjects.

Terms and Conditions of Pregnancy- Things to know

Photo Cred: Martin Vowel

Estimated reading time: 3 minutes, 23 seconds. 

My sister is the "researcher" of the family. She's the one who reads all 95 product reviews on Amazon to figure out, not just whether or not to buy a cloth diaper, but which cloth diaper is the best (do I want the bamboo fabric or the natural cotton option???).

But although there's no shortage of lengthy reading materials when it comes to pregnancy and birth, I'm composing a list of what I now consider to be must-know facts about the process- for transparency sake!
(I should note that everyone and every pregnancy is different. These are things I learned via my sister's research or her personal experience, but not everyone's will be the same.)

1) Tearing is a real thing

Babies literally tear you open. Either the doctor cuts you with a scalpel in a procedure called "episiotomy" in which the process is controlled, or the baby does it with its head. Pick your poison. Just be aware that it could tear "up" next to your clit. Yeah, you read that right.
Episiotomy used to be a routine part of childbirth, but now apparently less so according to the Mayo Clinic

http://mayocl.in/2crArbs

2) There is a pregnancy induced condition that makes you throw up for NINE months.

It is called hyperemesis gravidarum aka the fifth circle of hell

3) Pitocin is the drug of choice for Doctor's in hospitals who want to keep you "on schedule".

Pitocin can be used for good. But with great power comes great responsibility. Sometimes it is necessary to administer in order to save a baby or birthing parent from experiencing complications in birth.
Other times it just speeds up the baby's heart rate to the point where the medical team will then suggest an emergency c-section, a physically debilitating and stressful procedure. If you think c-sections are posh, take a look at this video:

(Tw- blood, graphic video of surgical procedure)
http://bit.ly/2cMvdqi

They pry the parent open. PRY. With forceps.

4) Placentas, you grow 'em, you birth 'em.

You must give "birth" to your placenta. It's literally an organ you grow while you're gestating which keeps your fetus alive. It's about the size of a human liver or like, three personal sized servings of flan.
Oh, and, like flan, you can eat it:

http://bit.ly/2cAth2b

On a more serious note, birthing or removing the *whole* placenta within a very short period of time is crucial because any remaining tissue from it can cause septicemia.

5) You will likely get a post-partum "mega period"

http://bit.ly/2chI69r

This is not something you can control with any regular tampons or dainty panty liners. It is not uncommon for birth parents to simply opt for an adult diaper to deal with this because it's that serious.

6) Pregnancy is 40 weeks.

This is not really "news", but in 2013, the American College of Obstetricians and Gynecologists decided to officially change the definition of what a "full term" pregnancy is:

http://on.today.com/2d1DPW9

That definition aside, I had never thought about just how LONG 40 weeks truly is. There is some debate about how to "count" the amount of months pregnancy lasts. As many people have noted, a month is sometimes said to have four weeks, which isn't really accurate. Most months actually have more than four weeks (4.35 weeks). So, if you're one of those people who is simply turning the pages on your calendar to mark your time, then the 9 month distinction is probably a fine mental goal for you. However, if you (like me) are likely to be counting down the exact days until you can be done with things 1-5 above, then you may want to stick to counting weeks rather than months as it's a little more precise.

7) Breastfeeding is hard and can last longer than pregnancy itself.

http://huff.to/2crB6tx

Some people are unable to breastfeed or simply don't want to. For those who do wander down the nursing path, it can be a huge learning curve involving lactation consultants, pain, and sleeplessness. But somehow, pregnancy/labor gets ALL the press for being the hard part.

These are just some of the things I now consider every time I get "baby fever". Certainly something to think about rather than getting easily swept up in the flurry of cute baby names and onesies.

IOU one IUD: Demanding Reproductive Justice

Photo Cred: Diego Delso Wikimedia Commons, License CC-BY-SA-4.0

Estimated reading time: 13 minutes, 9 seconds.


Dr.- Okay And, what's going on with the Mirena that you're concerned about?

Clair- So, um I've had it for about three years

D- Right

C- And after not having a period-

D- Right

C- for most of those three years-

D- Yeah

C- last month I got a period.

D- Okay

C- and Not spotting, it was like a-

D- Okay.

C- full period.

D- Okay, yup

C- So, I was concerned that perhaps the hormones in the IUD had begun to wear off.

D- Uh-huh. Right.

C- Um, so, I wanted to replace it with a different IUD. Um, before I was thinking about just changing it to the new Mirena. But I would prefer to get the Skyla-

D- Now, now why do you think it's not working? Or why do you- Just because you got your period?

C- Um, I think I was just worried about that possibility.

D- Yeah, right right right.

C- And because it had been three years, I mean, I know they're technically good for five-

D- They're good for 7 actually. I mean, we tell people change them at five, but they can last up to seven years.

C- Right, so I guess that was my only concern.

D- Right. It's working as well today as it was when you had it first put in for contraception.

C-Well, I don't know if I'm pregnant yet, but...

D- Yeah

C- Um, I mean that- it's just a concern,

D- Yeah

C- is that if I were to become pregnant with an IUD, which I know is a possibility that that would- that would be-

D- Right, but it's no more of a possibility today than it would have been when you had it put in.

Friend- Did you tell him about the strings though?

C- Oh, I also don't have a string. So um, the nurse practitioner yesterday said that we should do an...um, a ultrasound.

D- That's right.

C- So that we could see whether or not it was actually still in.

D- That's true, absolutely. So did she order that?

C- I have no idea. She said that-

D- Well, no you would have scheduled it if she ordered it. Right?

C- Okay, I guess so.

D- Yeah. So she didn't order that.

C- I guess not.

D- [chuckles] Okay, it would've been helpful if she had ordered that because you would've been all set at least to make sure the IUD is still in place.

C- She called me yesterday about it.

D- At least to see about why you're not getting your period- why you're getting your period.

C- Yeah, she called me yesterday at like maybe 4 o'clock so perhaps it was just too late for her to schedule it or too close. But I'm more than happy to schedule-

D- Well, she examined you right?

C- No, she called me over the phone. Um-

D- Well, how does she know the string wasn't there? You- 'cause you told her that?

C- I can't remember what it was, yeah-

F- Yes, she did.

D- Oh, so it's not that she examined you and said "I don't see the string", you just can't feel the string.

C- Yeah, that's corr-

D- Okay, alright. Okay. So, we can check for the string and see if I see it. I don't know if I will or not.

C- Okay.

D- If we don't see it then we'll get you an ultrasound to see that the IUD is still there.

C- Mm hmm.

D- I mean, that's a valid concern.

C- Mm hmm.

D- But if the IUD is there, then it's working fine. There's no reason to replace it with the same IUD essentially. I mean the Skyla is just a smaller vers- slightly smaller version of Mirena.

C- Mm hmm.

D- It's only good for three years.

C- Mm hmm.

D- The amount of progesterone in your bloodstream is pretty similar maybe a little bit less.

C- Mm hmm.

D- In fact, if you have a little bit less progesterone in your bloodstream now because that IUD is three years old, it's gonna be equal- the amount of progesterone you have in your bloodstream from the new skyla versus a three year old Mirena. It'll prolly be about the same.

C- Yeah

D- So, y'know, it won't make any difference.

C- Okay.

D- And then the Skyla will only last for three more years. So if you have this Mirena that's still there, you get two more years on Mirena.

C- Mm hmm.

D- You only get one more year after getting a new Skyla. I mean it doesn't make any sense.
Now if you didn't like the Mirena because of some hormonal side effect, then I can replace it with a copper IUD. That would make sense.

C- Um, I have had a copper IUD.

D- Okay.

C- I had it for a year. It gave me really heavy and very painful periods.

D- Okay yeah.

C- I was bleeding a matter of ounces.

D- Right.

C- Because I had- I have a [menstrual] cup so I was able to measure how much flow there was.

D- Uh huh.

C- So, I would prefer not to go back to that. The Mirena has been fine, um. I spoke with my husband about our reproductive choices-

D- Sure, sure.

C- and when we would like to have children.

D- Right.

C- I'm 26 now, we just got married and at 29 we're talking about having kids

D- Okay.

C- So, the three year mark is actually kind of when we're talking about having children anyway.

D- Right.

C- So I think that that was part of the reason why I was okay with getting an IUD that will expire in three years because I'll be planning to remove it at that point anyway.
The lower dose hormone- I understand that it is supposed to be a negligible difference. However, I also know that the Skyla is supposed to, in theory, have your periods come back, or that there's a less of a chance that you will not have a period.

D- Right

C- So, that difference being noted. I think that the hormones in the Mirena um, because I have mood disorders I am sort of trying to selectively take out anything that could be making that worse and I think that potentially getting a lower dose, um-

D- It won't end up being a lower dose in your bloodstream though.

C- Okay.

D- It'll end up being about the same.

C- Is there a reason, given all of the context that I'm trying to portray now, is there a reason why I cannot be given the Skyla?

D- There's not a reason, but it's actually a waste of resources. I mean, you have an IUD that's perfectly good and you're gonna take it out and replace it with a very similar IUD. For no good, really really good solid reason. So it's kind of a waste of reproductive resources. Of contraceptive resources.

C- Okay.

D- That's the way I look at it. So... I mean, I'll do it, but I'm not excited about it. I'm not happy about it because it's a waste...If there's a medical reason, then that makes sense. But I don't really, I'm not hearing a strong medical reason

C- Okay.

D- But, that being said, I mean, I'll do it, but I'm not- I'm not happy about it.

F- Can I ask a question?

D- Yes.

F- Just out of curiosity. So, if Clair's plan was to think about having children in three years, and she kept the Mirena in, then would you suggest she get a new IUD put in for one year and then removed?

D- You could do that, or you could actually- it's good for seven- so if you told me I was gonna get- you wanna be pregnant let's say in say three years, you could leave it in for an extra year.

F- Okay.

D- It'd be fine. As long as you were definitely planning on that.

C- Okay.

D- But...I'm not gonna y'know I'm not arguing with you. I mean, I'll do it if you want me to.

C- Um, I don't wanna make you do anything that makes you uncomfortable. Um, I think that's unfair to both of us. Is there a different practitioner in the office who might be amenable to the procedure?

D- Um, you could make an appointment with them and they may be.

C- Okay.

D- Absolutely, yeah. That's fine.
While you're here- I mean, it's no hard feelings I'm not- Do you want me to check and see if I can see the string?

C- That's probably a good idea.

D- Yeah, I think it is a good idea. since you end up...If I don't see the string, then we should order an ultrasound and check it out. Okay?

C- Sure.

v   v   v   

The day before this appointment, I received a call from YOUR nurse practitioner. She said "the doctor [which I can only presume means you] had some concerns about why you wanted to change from the Mirena to the Skyla."
I explained that my period had returned and she said that was a valid reason, and that you could likely give me a new Mirena, but not the Skyla. I also mentioned that I do not have a visible string, which was confirmed by my old gynecologist. But that was about three years ago, so I forgot that detail while you were grilling me in our patient-doctor consultation.

I told my husband and two female friends about this call. All three of us who are women found this to be odd, but my husband quickly replied "brand loyalty. I guarantee when you go in there, they'll have Mirena propaganda all over the office". I was stunned by my own naivete but sadly less stunned when I walked into your office and found he was right [about the propaganda anyway].

I understand now that Mirena, Skyla, and another BC, Essure, are all produced by the company Bayer. I expect my friends with an intimate understanding of the health care system will have something to say on this point, but for now, it looks like we can rule out brand loyalty.

My reasons for wanting a new IUD:

(Are not really your business, but I'll humor you anyway)

I want one.

It's not really your place to tell me that my request is a waste. Especially when admittedly, you don't have a good reason *not* to give me a replacement. You are speculating that this IUD is working the same as it was the day I got it. I have to trust the IUD because that's why I got it, of course. But I sure as hell don't need to trust my reproductive health to someone who bases his analysis of my choice on projected, estimated numbers rather than facts. Being pregnant calls for something a little more serious than "guestimates" and I really don't care if I'm being paranoid because I'd rather be paranoid than pregnant. Plus, pregnancy is a HUGE "waste" of resources, if you really wanna talk about that.

I have clinical depression.

I am desperate to improve my mood in whatever way I can. I am in therapy and on medication, and that isn't helping. My therapist suggested that perhaps the hormones in the IUD are making it more difficult to control my mood (albeit slightly). This is why I want to try an IUD which is marketed as a lower hormone dose than the Mirena.

I'm moving.

I am moving back to Missouri which, if you haven't heard, isn't quite as progressive on providing reproductive care to women as the Commonwealth of Massachusetts.
I will soon not have insurance and would like to get a new IUD at this time so I can have 3-5 years of coverage on a new IUD instead of keeping one which I got before I even worked at the job where I am now.
Speaking of which, you seem really sure that the Mirena is good for seven years (even though the manufacturer recommends patients take it out after five) so why doesn't any "extra time" apply to Skyla?

Since you seem to think the difference in hormones is so negligible, wouldn't it follow that the Skyla can also be used beyond its recommended date of three years and perhaps even be kept for five? If, by your logic, I can keep the IUD in for longer than recommended, then couldn't I get more than one additional year of protection from the Skyla?

The Skyla would give me three years of the recommended level of coverage for contraception, whereas the Mirena (if it's going to last until I want kids) would have to be in for one "lottery year" in which its effectiveness very well may be minimized. Though you seem comfortable with this, it's not a gamble I'm willing to take, thanks.

Which brings me to my next point...

I want to be pregnant in the next three years (but not before then)

Since I am hoping to get a new IUD soon, but I plan to have kids within the next five years, I didn't want to get another Mirena and "waste" a device that would be good for much longer than I needed it. Hence the request for a 3yr Skyla.
I really do try to be mindful of consumption, so it's not really helpful to have you try to patronize me out of getting a new device.

I don't have a string.

This isn't a huge issue on it's own, but I will say that it isn't ideal that I can't do string checks to make sure my IUD is still properly in place. Now, every time I have any kind of issue, you all order an ultrasound. I had one last year at your office because you couldn't find my string and now I'm having another one. I'm taking up an appointment slot, taking time off of work, using up the technician's time, and then using even more of it while they analyze the results.
Again, I feel *that* is a real waste of resources which might be resolved by having a properly placed, monitorable IUD with a string.

Photo Source

Now, before this turns into a huge back-and-forth like that woman who wanted a neck tattoo and the artist who refused her, it should be noted that, although there is an art to medicine, my ability to avoid pregnancy and to do it in the way which I feel is most beneficial to me and my body is not about me commissioning an artist, it's about protecting my reproductive health and safety.

If he doesn't want to take into consideration that a person's health should be paramount to whether or not a piece of plastic has completely reached its expiration date, then I question his right to serve in his current position.

That's probably what bothers me most; he is doing this to other patients. There are patients who have less experience, who are perhaps less informed, or who are simply intimidated by questioning a doctor (and perhaps particularly a male doctor) who may have left feeling belittled and disempowered by this practitioner, and that infuriates me.

And it's not just this guy. This is happening in OB/GYN offices all over the place. I know this firstly because I've experienced this attitude in many different offices, but also because I spoke with two women who are a little older than I am and who subsequently have more experience than I could have with these kinds of doctors. Neither of them seemed surprised by his terrible bedside manner, nor his disdain for my request. In fact, they both seemed to see this as standard practice, "Oh, yeah. As much as it sucks, they're not gonna replace your IUD unless something is really wrong with it".
In part, I see the validity of that argument. My IUD hasn't punctured my uterus, it hasn't completely come out of my body, it hasn't caused an ectopic pregnancy, so there's no urgent need to get that thing out of there. Sure. But why does it have to be the case that the only time my uterus' needs are given credence by doctors is when I'm dying or hemorrhaging? Why is it that preventative care for women's health is only allowable when doctors (or men in general) find it appropriate?

Foot in Mouth Disease: The struggle for compassionate dentistry

Estimated reading time: 3 minutes, 44 seconds.


Every time I go to the dentist, he says the same thing to me:

WOW, you've had a lot of work done! But you've changed your bad ways and are doing better now right?

And he is right; I have had a lot of work done.

The earliest dental work I remember was perhaps at seven years old. I'd gone trick-or-treating, eaten my fair share of snickers bars and promptly crashed from the tail end of my sugar high, forgoing my evening tooth brushing. I woke up the next day and my tooth hurt. I told my mom and sometime later I was at the dentist. But this wasn't a pediatric dentist, and he didn't have the appropriate tools for such a tiny person. They had to use full sized bit wing trays for my tiny x-rays, which were like trying to wrap my face around a small tea saucer.
The dentist said, "Open your mouth as wide as you can- big like a crocodile!" I was hip to his game and my mouth hurt too much to be placated by silly adults who thought pretending to be an animal would make this any more bearable.

My first broken tooth was a back molar, #18 from my cursory Google search. That's the one they call your 12 year molar, and it wasn't long after that bench mark that I bit into a salty, crackling Funyun and it cleaved away half of my tooth, leaving it like a chipped porcelain bowl: curved and concave on the surface but sharp and cutting at its peak.
After feeling around with my fumbling tongue and realizing that I was no longer chewing an extra crunchy onion ring, I spent the rest of the day anxiously toying with what remained of my tooth.
I don't think I told my mom for a week: "My back tooth is broken."She said, "Well, alright."

But we wouldn't  talk about it again until a year later when I decided the razor's edge living in the back of my mouth was too big of a  nuisance to ignore any longer. See, the tooth itself didn't hurt and so I didn't think anything of it until my dentist told me I'd need to have a root canal. I was shocked. I thought those were reserved for those much older than me, but no. My tooth was broken, the nerve was dead, and the decay had to be removed or I'd have a much larger problem on my hands: a potential abscess tooth.

The root canal itself was a lot like all the other dental work I'd had done before, but much more time was consumed with my mouth straining around the dentists utensils while he bored endlessly into my jaw, pushing it down with a sound like a screw into a knotted wood beam. And then there was the price: for one tooth, it was several hundred dollars and that was with insurance.
Most of the time I spent in the chair was loaded with anxiety about my Novocaine wearing off of the dentist nicking my tongue. The rest of it I spent choking on the chalky residue of tooth and resin which swirled past the hungry tube which had attached itself to my cheek.

At 16 I had another root canal and had already gotten more than 5 fillings.
While most of my peers were getting braces to straighten their teeth, I was just trying to keep mine from falling out.

I get that my dentist sees a lot of patients and he may not be able to remember every person he's given "the talking to"- the rehearsed warning scold that explains the importance of floss- but I'd really like to argue that this shouldn't be a part of dentistry at all.

The people who've had a lot of work done or who have a lot of decay, those are the people who need compassionate dentistry the most. They probably are aware of the state of things in their mouth, since they're in your chair asking for help, and that's a helluvah time to accuse someone of being "bad" when the reality is you may actually be accusing them of being poor, or ill-informed, or undocumented, or simply ashamed. Not everyone has access to care or feels safe seeking it out, so I feel it's imperative not to reproach them when they do, because they might never come back. At least not to you. So even if dentists can't be compassionate, they can at least keep their mouths shut.