Living in a foreign country, a person gets to experience many new things. Taking care of one's body is part of life wherever you live. However, visits to foreign health care providers can be intimidating, not only due to language, but according to cost, quality, and more.
Though none of us love going to the dentist, the mouth should not be neglected. Every country has dentists, but how do they compare?
Looking up stats on dentists around the world, there is more published about quantity and less written about quality. Therefore, I'm sharing a few of my experiences with the pressure and pain of dental visits overseas.
Just the Basics
My first encounter with a foreign dentist was in Rocky Point, Sonora, Mexico. I wasn't the patient; a fellow traveler with a group of friends had a bad toothache and needed care immediately. The only one in the group who spoke conversational Spanish, I was chosen to arrange the visit and accompany her to a friendly and professional dentist we were lucky enough to see without an appointment.
Most details are vague now, since that took place at least 35 years ago. Nevertheless, what remains vivid is the image of the one-room dental clinic off the main boulevard: a tidy, well-maintained, and minimally furnished facility, adequately equipped for its purpose. With just a treatment chair, a small counter, and a few essential instruments, el dentista was able to attend to the young woman's dental needs. Wary at first, the young American patient was surprised by the end of the treatment that so little could do so much, yet overjoyed and appreciative that the pain was gone and she could enjoy the rest of her trip.
The Hammer
While living and working in Germany, I had a regular dentist - Dr. Knoblauch (whose name means "garlic") - for checkups and cleanings. Dr. K gave me confidence in German health care from the very beginning, with her pleasant and inviting demeanor, facility, and proficient staff. Two years later, when a molar deteriorated and had to be pulled because of aging fillings, she referred me to a nearby specialist.
Several weeks later, after administering local anesthetic and yanking unsuccessfully for a few minutes, the healthy female dentist who attempted my extraction couldn't pull my tooth out. This was because of a tennis injury, she said, and out of the procedure room she went. A few minutes later, in came the powerful and handsome Dr. Hammer to do the deed. His name certainly fit his chosen occupation, though he did more pulling with his adept muscles than he did pounding with any terrifying tool.
Lectures and Learning
Towards the end of my stint in Germany, I was employed by a highly-regarded dentist and oral surgeon who also bottled schnapps and made sausage, selling his homemade wares. He was the father to three girls to whom I taught English and tutored in other subjects every weekday afternoon. Mornings in winter, when Schnaps production slowed, I was privileged to work as an assistant to his dental assistants, cleaning instruments, stocking cabinets, greeting patients, and absorbing as much as I could.
Befriending the girls who worked in the office, I learned much - including more German. As my time there progressed, I eventually assisted once or twice during a surgery, holding the straw-like, perforated suction tube that evacuates moisture (saliva or blood) from the mouth. If I didn't have to go back to school to become a medical assistant, I would have loved to have stayed on for the interesting work, changing careers.
Though I had medical and dental insurance (a requirement for German residents), I received free dental care while under the dentist's employ, not having to pay anything extra for more advanced procedures like repairs, fillings or fills.
When the big boss wasn't around, our dashing, bright intern Dr. Braun looked into my mouth if I had a problem. He was proficient and gentle, yet prone to lecturing about any bad habits that would cause my teeth problems down the road. Germans are very conscious of doing what is correct, and acting responsibly for the sake of one's own health isn't excluded. (Now that my teeth and gums are more advanced in years, his words come back to me.)
No Pain, Much Gain
Thankfully, I suffered no pain during my German dental visits. Nor did I ever feel any great discomfort while at our friendly family dentists in the States during my childhood and teen years.
My teeth were well cared-for. I survived a wisdom tooth pullout alongside my older sister. Likewise, visits to the orthodontist who managed the straightening of my teeth during middle school caused a bit of pain during installation and tune-ups of my braces, but that was to be expected.
The dread of discomfort and anticipation of agony are fears that arise whenever we hear the word "dentist," but my worries had always been groundless.
I made it through most of my life without having to endure much, if any, pain at the dentist. And my teeth are in relatively good shape.
A Japanese Dentist
My current home in northern Japan is in a city of about 40,000 residents. Since I work on a USAF base, I have been told that I have the best of two worlds, American and Japanese.
Health care for some federal employees (such as myself), however, is not always a guarantee. Many Americans who are offered jobs in Japan turn them down due to the inaccessibility of English-speaking (and free) medical care when needed. To get treatment outside base gates, one usually needs a translator, and that becomes inconvenient and/or expensive. Health insurance isn't accepted by most Japanese providers, so Americans have to pay up front and get reimbursed later.
Due to generally good health and a tendency to take risks (like flying off to a country I'd never been to) rather than worry excessively, I wasn't too concerned about having to go to a doctor, or dentist. I'm also curious to see how common things work in other cultures, so it would be a learning opportunity for me if I had to go.
Nonetheless, I have personally encountered the limited availability of treatment, especially when it comes to dentistry. To access oral care on base, I fall under the "Space A" category, which requires me to wait for an appointment slot to open up as a result of cancellations by military personnel or their dependents.
Because of this situation, now having dental insurance once again, and not having visited a dentist for a checkup since the pandemic, I opted to consult a dentist in Japan. I'd also heard that Japanese dentistry is less expensive. Since I couldn't get an appointment on base, I wanted to make sure everything was hunky-dory in my mouth.
Assuming that Japanese dentists and their trained assistants follow the same pain-free philosophies as other countries I had lived in, I asked around. My Japanese friend Takako recommended her dentist and made me an appointment, promising to go with me to act as translator. She booked herself for a cleaning on the same day.
Japan is a lot like Germany with regard to efficiency, cleanliness, and trustworthiness as exhibited by their citizens and the way their world turns. With the experience I'd gained in Germany, I assumed the Japanese dentist would be just as knowledgeable, professional and pain-free.
The dental clinic Takako took me to was small, with a reception counter and seating area. There were magazines, in Japanese of course. With help from my friend, I filled out the forms given to me by the receptionist. Everything was going to be fine: I was looking forward to experiencing what I thought would be top-notch care.
Starting out in the x-ray room, the attendant fitted my mouth with a large plastic piece, moving it from one side to the other, in ten different positions, almost filling my whole mouth. Each time, I had to bite down on the device. Gagging more than once, several pauses were necessary before I would allow the tech to re-insert. It wasn't painful, just extremely bulky, even for my big mouth, and my tongue had nowhere to go. There were no reassuring words - even in Japanese - just patience from the tech. It was a relief for both of us when this part of the visit were done.
Led to a dental chair in another room, I greeted and smiled at the two masked young women present. The impressive display showing the x-rays of my oral cavity - jawbones, roots, teeth, fillings and all - was easy to view on a large monitor that showed to the whole space.
Squirming in My Seat
One of the two women sat at a computer, and the other positioned herself behind me. With a curved, pointed instrument every dentist uses, she poked at my gums.
This is when the pain began. The individual seated behind me, later revealed as the younger of the two dentists in the practice, prodded my gums with her tool until I reacted, my whole body jolting with the pain. Did she believe that unless she probed deep enough to elicit a pain response, her examination was not successful? Feeling twinges once or twice would have been tolerable and expected, but it seemed to me like her aim was to provoke a reaction with every jab. She probed around each tooth, digging into my gums approximately forty times, upsetting my whole mouth... and me in the process.
Of course I'd had this "test" before, but never with any discomfort. Dentists simply maneuvered the tool around my mouth, pulling gently down in some places, or pushing into softer areas around my teeth, examining gum health.
Tears were rolling down my cheeks during the Japanese poking procedure. This was the second in a series of experiments in which I wasn't willing to be a lab rat.
Next, announced the dentist, would be the machine that would detect loose teeth, a device she now held in her hand. Waving her away, I turned down that service. I'd gone through enough and couldn't predict what torture would come. Would it rattle each of my teeth, one by one? I wasn't going to take the chance.
Resigned, the pair of women announced they could do my cleaning. Considering the uncalled-for agony I'd already suffered, gagging through x-rays and being made to twitch and cry, I couldn't imagine that a cleaning would be any less uncomfortable. I called it off and announced my intention to leave.
The young dentist, who spoke enough English for us to get by, summarized her findings. I had six cavities, she said, and 60% of my mouth had gum disease. That wasn't all. I needed two bridges, because my teeth were obviously moving because of my two missing teeth. The dentist then said that bridges could not be put in place until a cleaning was done, and would I like to reschedule that cleaning now? She also told me that I would eventually need implants, because the bridges would fail.
All this bad news was the psychological pain compounding that in my now sore mouth. Had my oral health deteriorated so much since the last time I'd been to a dentist?
Thankfully, my Japanese friend came into the room and spoke with the dentist briefly, telling her we would reschedule the cleaning.
Walking out, I told Takako the story of my mistreatment. She wasn't too surprised; every time she goes to the dentist, she said, it hurts.
Outrageous! Is it possible that Japanese individuals have a higher pain tolerance, or were these dentists - the ones she'd been seeing for years - like all the rest in the country? Is causing pain with pointy instruments a reliable method for detecting dental disease? Was it standard to inflict pain, or was the Japanese dentist we saw the exception to the rule?
The sad thing is, Takako will continue to go to this dentist for agonizing cleanings and other dental interventions - probably for the rest of her life. What's even more shocking is that her dentist recommends cleanings every three months (!!!).
I couldn't bear it. If it was a well-known fact that Japanese people have excellent oral health and very white teeth, going more often would be understandable. I hadn't seen a lot of them showing off their chompers with pride. If true, was it worth it for regular doses of pain? Unimaginable.
When I got home, I researched all the things the dentist told me, as well as how to "fix" my mouth naturally. One website, a dental clinic in the States with a German name (so I trust it) had some very useful tips I've already employed (see link at bottom of post to learn more). I also ordered a well-recommended mouth rinse and began flossing more diligently. Brushing more than twice a day is a new part of my regimen. I've also re-incorporated apples into my regular diet, because it has been shown that an apple a day may help keep the dentist away.
There was no way I was gonna let that Japanese dentist scare me into having bad teeth. Ha.
Back Into American Hands
Having decided I wouldn't be returning to a Japanese dentist, I got lucky. Calling the base for an appointment as soon as summer vacation started, there was a cancellation the very next day.
Interestingly, what was unique about my intake was the dental tech checking my blood pressure, obtaining details about supplements I ingest, and asking if I've ever had suicidal thoughts. (These precautions help keep our soldiers healthy, I suppose.)
Taking about the same number of x-rays as the Japanese tech, but without placing a giant mouthpiece for each view, the dental assistant also carried out most of my cleaning using a gentle polishing tool and warm water wand before the dentist came in to check my teeth himself. So far, my visit was quite pleasant, with no pain or sensitivity.
Telling the dentist about my experience off base and the prognosis given by the Japanese dentist, he didn't agree.
A bridge would only be necessary, he said, if I was having trouble chewing my food. Regarding the possibility of future implants, he remarked that my sinus cavity on one side was too close to the teeth, so an implant wouldn't be feasible. (Hadn't the Japanese dentist noticed that on the very large rendition of my teeth and jawbones?)
"I get paid the same no matter what you get," he added, noting that he receives no commission on bridges or implants. I appreciated his minimalist, don't-fix-it-if-it-ain't-broken stance.
And cavities? He found a couple of spots using the "poking device" that needed filling, but I felt no pain during his examination. Two teeth, he said, had small cracks and may need to be repaired, and a fill on one canine in the front was also recommended.
Afterward, still pleased with the results from the American dentist, I'm now not so worried about my mouth. And though there was no lecture, pain or tears to accompany me home, I'm going to do my best to keep these teeth healthy and far from foreign dentists... for now.
Here is a link to a website explaining natural ways to better your oral health:
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