Children having their teeth checked at school.
by Dan Moeller
I set up an appointment with one of the local dentists on my small island. I am a sucker for adventure, but this journey was just another biannual checkup. I slipped on a pair of maroon indoor slippers and shuffled in. After offering up my national health insurance card, I asked for a little help on the “new customer” form. The receptionist was more than glad to help. I sat down on one of the waiting room benches and perused the reading material: a half-sized bookcase that was almost entirely manga.
After a little while, I was called into the main room, which was shared by two dentist chairs the rusty yellow color of antique furniture you might find at a low-budget beach house. Behind the seats were the reception area and a back area with the x-ray room and what I assumed to be the dentist’s office. A radio was blasting one of the two tunable stations on the island. You might have guessed easy listening in a medical office, but it was loud J-pop coursing through the air. To my right, there was a tray of picks and tools so various and neat that it would have delighted one of the lunatics from “Hostel.” I guess America generally thinks that tools should be stored out of view unless needed.
The dentist (along with every other Japanese professional I’ve met with overseas experience) seemed delighted to dig into his rusty English arsenal to hash together strange and entertaining conversation. He talked about removing the “stains” from my teeth and that I would be “easy” during the whole process. Nice. It was the same strangely homey feeling I often get from interactions with helpful Japanese people speaking Japanese (which I may or may not understand). He explained that this visit would only be the top row of teeth and the next visit my bottom row. I’m guessing the previous ALTs had sharpened his explanation skills on the subject.
He showed me into the x-ray room and, even though he didn’t offer one of the lead vests that make me feel comfortable about my organs’ welfare, the x-ray only took 30 seconds. There was none of that “here-bite-on-this-uncomfortable-plastic-slide-sheet-while-I-leave-the-room-and-flip-a-switch” or “oh-didn’t-I-mention-there-will-be-six-or-seven-of-these-depending-on-if-you-stayed-still-through-the-pain.” He showed me the panoramic slide of my teeth and made sure to point out the “stains.” I was rather embarrassed I hadn’t brushed after lunch that day.
How clean are YOUR teeth?
As the assistant clipped on my dental bib, the dentist averted my attention to my top row in the x-ray. As it turns out, I am of a select few that has no back molars on the top row. Why am I just hearing this now? I have regularly been to the dentist since I was a kid and the dentist here in Japan is the first to have caught this? Moving on.
Now, I am not one of the scared-stiff breed that fear the dentist, but I do loathe the nagging about flossing, and hearing that if I’m not careful my gums will recede and my teeth will fall out. If your home country dentist forgot to mention the sin of negligence, then the grisly posters that line the walls serve as faithful reminders. As a kid, I was convinced for years I had one of the poster-diseases because my gums would bleed when I brushed them too hard.
The bib I wore served as a guard for any water that might have spattered on my shirt. In a strange contrast, American dentists smear the bib with your own blood and plaque as a sign of either (A) how much they accomplished, or (B) how incompetent you are at cleaning your own teeth. As the dentist shined the rays of God into my unprotected eyes I was once again reminded of how inevitably awkward interactions become when there’s a vacuum tube, a pick, and the dentist’s fingers in your mouth.
Overall, the Japanese dentist didn’t hurt nearly as much. (Is that a good thing?) Visits to my American dentist usually include him finding a little crevice in a tooth with that sharp hook instrument, digging it in, and pulling too hard for too long. Then he meanders off to some other innocent tooth as if it had all been a chance encounter. Also, the Japanese tooth polish was nothing comparable to the unpleasant, gritty mint polish they slather on your teeth in America, which inevitably coats your mouth and some of your throat. I’m realizing that having my teeth cleaned is like getting a tattoo.
A “dental explorer,” found in every dentist’s arsenal.
It’s time to rinse and spit. In the U.S. I’m used to rinsing with a small plastic cup of water dispensed from a small faucet. You can imagine my surprise when I was provided with basically a mini public drinking fountain. I could see various colors of dirt coating the drain and around the faucet nozzle. In general, I would say the medical community in Japan is a bit minimalistic in terms of health precautions. Just off the top of my head, I remember spotting bloody tubes carelessly dangling from an unmarked trashcan in my local doctor’s office.
After my top row was finished, I sat up and chatted a bit more with the dentist. Maybe as a foreigner I was granted a few liberties, but I’m guessing he was rather busy. I asked why this cleaning has to be broken into two visits. I found a lot of research saying Japanese doctors don’t make a lot of money. In America, besides payment for each procedure, dentists make money from referrals, overcharging insurance companies, and, well, generally most things concerning the monopolies of our corrupt medical industry (including but not limited to brand name drugs). This is not to mention their general salary which depends on whether they are private or public.
The Japanese don’t make a killing like they do in the States. The industry is highly regulated. Surcharges don’t fluctuate or rise. The costs are low, especially when we’re talking about the longer and more painful procedures. This is rumored to be one of the reasons why visits are broken up into various sessions. More visits means more co-pays, and more co-pays means more money.
My dentist assured me this was not the case. This is what I understood from his broken English and my broken Japanese: there is a dental insurance guideline in Japan stating that a patient’s routine visit must be broken into two separate visits. Doctors sometimes disregard this rule but they are punished if they are caught. This could mean a slap on the wrist, a fine, or worse. Why does this rule exist? He had no idea and neither do I.
I’ve heard some horror stories about Japanese dentists and I’m sure some of you have heard your share as well. Some stories are about the Japanese tendency to avoid heavier sedatives even for surgeries. Scary. Also, I’m pretty sure Japan bans the use of fluoride in toothpaste as it may be detrimental to your health. This may or may not be the reason half of the adults living in my neighborhood have either a gold tooth, a strange wire construction around their teeth, or missing teeth altogether. (Maybe it’s just genetics.)
As for my check-up and cleaning, I would say it was a rather pleasant experience. The first visit was 2,630 yen, including the x-ray. The second visit was 1,060 yen. These prices reflect the 30 percent I pay, whereas the health insurance covers the other 70 percent. As I slid the money through the window to the receptionist I decided I was looking forward to next year’s visit. (Isn’t it supposed to be every 6 months?) The receptionist said “Odaijini” and bowed on my way out. I’m guessing this “take care of yourself” or “take care of your teeth” could roughly be translated to, “Don’t forget to brush!”
All photos used with permission from Wikimedia Commons.