Dear Dr Pinder, I am a fifty one year old woman who hasn’t been able to visit a dentist in over 20 years mostly due to embarrassment and shame over the state of my teeth. I haven,t smiled with an open mouth for years, refuse to be photographed at the very few family events i feel i can,t get out of and hate people staring at my mouth when i talk. My mother had all her teeth taken out when she was twenty one as it seems to have been the done thing at one time and so never took much notice of her own children’s dental needs. As a result my brother and i had very poor oral hygiene and our visits to dentists over the years have been sporadic and only associated with emergencies. I know how awful my teeth look , i know i should see a dentist but find myself shaking and near to tears to even think about it. Strangely enough I have always insisted on my two daughters having regular six monthly checkups and they both have excellent teeth. My twenty one year old has yet to have a filling. I even take them to the dentist because i am at least confident about their teeth, just not my own. How do I begin to make progress?