Adventures in Dentistry
Ah yes, dentists.
I think it's one of those flipside benefits-and-problems of being an adult, that you probably don't go to the dentist as much as you did when you were a child. If you're British, you may not go for check-ups so regularly because it's no longer free on the NHS. Of course, perhaps you also don't eat as many sweets anymore, and no longer need all those shiny silver fillings. Perhaps you don't need Mr. Metal Pick yet for wincing cavities, blazing abscesses, and mysteriously missing teeth. And if you're lucky, perhaps you never will. Good old fluoride in the water.
However. If you don't go to the dentist regularly, the following two points apply.
1) You avoid the dentist, and all their little discomforts. See point 2.
2) The dentist is now very, very scary.
These thoughts occurred to me as I frowned over the question, 'When was your last visit to a dentist?' in the reception of Amsterdam Dental. I retracted my memory by a few years, counting through Christmases. It would have been around that time, since that was when I would be spending the most time at my parents' house, and my dad, for all reasons previously stated, would have suggested taking a trip to the family dentist on his reasonable NHS rates. Not much of a Christmas treat, I once thought, but I have changed my mind since. Let's continue.
-December 2011- I decided. It was probably right. An error margin of a year or so. It was always going to be far too long ago. Guiltily, I also admitted that I did not floss - I had decided to start doing it last autumn, but I had promptly lost the conveniently tiny box of floss I bought, and never bothered to buy another one. In the household I grew up in, flossing was outlawed by our unique family snobbery. Like buying any other toothpaste than SR Mentadent, shampoo that wasn't Vosene, or soap that wasn't Imperial Leather or - god help me - Coal Tar, it was designated as something for foolish people. Finally, I rated my smile as a '4' on the 1-10 scale. Crooked teeth, you see. I handed the form back in, and the experience began.
Since my trip here, people have asked why I went to this specific dentist, an expat himself, instead of a Dutch dentist. Honestly? His website seemed good. And he offered consultations on both dentistry and orthodontistry, both of which I wanted consults in. Having to get health insurance in the Netherlands had nudged me into pursuing a general health overhaul. I decided I would get my missing filling replaced, get braces for the second time in my life, an eye test and prescription update, maybe even a health check. This chap had degrees from Harvard and a membership of the American Academy of Cosmetic Dentistry. And a few expat forums recommended him. So there we go, and there I was.
The dentists' office turned out to be pretty small and dingily lit. There were three people working there, Dr. T himself, another female dentist, and the receptionist. All three were having lunch behind the reception desk when I walked in. Setting the scene for the entire experience, all three kept eating as I stood there, wondering why it wasn't bright and white inside, like I thought all dentist offices were. Through mouthfuls, the receptionist bid me to fill in the form. Form filled, I went to the adjoining backroom and obligingly hoisted myself onto the creepy dentist chair, a hundred memories of increasingly uncomfortable consults beginning to trickle rapidly through my mind.
"So you have a filling that needs replacing?" said Dr. T. He didn't seem sure of what I was there for. But overall he was a casual, friendly figure. As it turned out, way too casual. Nonetheless, I wondered uneasily if I was their only patient at the time for a reason.
"Yes. And I'd also like to know about getting braces, as my teeth are crooked. I think I'd have to have some teeth taken out..."
"I try to avoid removing teeth. That probably won't be necessary."
Really? Actually, I'm not that attached to my teeth. I could easily stand some detachment. There are too many of them, even after a set of extractions. And they're big. My Asian mother's genes daringly bucked the ethnic trend by delivering fairly large teeth. And my dad's teeth... well, he's British. They were never going to be easy teeth.
"Bite?" Dr. Tsang offers.
I close my teeth in a grimacing grin and show him. He looks at them from a couple of metres away.
"No, it won't be necessary."
"Oh, okay." I feel disappointed. After a few seconds, I ask. "Are you sure?"
This becomes something of a theme throughout the session as I find myself essentially goading him to remove some of the damn things. I am not an expert in giving dentistry, only at receiving it. As the owner of these teeth, I know that there is very, very, little space in this mouth for teeth to get pushed around.
Dr. T remains completely laid-back about the whole affair, and completely unwilling to discuss removing any teeth. He actually seems completely uninterested in the whole topic of braces. He approaches to take a look at my missing filling.
Now, the fear.
Why is it that the dentist was so less frightening when I was a kid? I suffered all kinds of indignities back then without batting an eyelid. I had numerous powdered dry blue rubber fingers poking into my mouth, drying out my lips and making those irritating little rips in the stretched lips that take ages to heal. So many fillings that the numerous different pitches of drill sound darting in and out of my mouth became a drill-bit symphony of high toned wheees and gritting brrrs. Weird tasting powders, fiery liquids, strange ray guns, x-rays requiring bizarre mouth-pieces and awkward hunched positions over sternly cream-coloured machines, blue rubber bibs, the rapid-fire chatter of numbers and oddly scripted-sounding inane chat firing over my head between dentist and dental nurse. At least once during casual check-ups, the dentist suddenly rammed a wobbly milk tooth right off its bed of dangling but tenacious flesh roots without warning. I had a battery of injections into my mouth, including two painful ones deep into the soft tissue of the back of my gums where numbing gel does not help at all, before having four teeth bodily jerked out with what felt and looked very much like a metal car wrench, jets of blood hoovered cheerfully up by slurping pipes operated by the closely peering face of the nurse, raw gums and red nerves exposed to my childishly interested tongue. I had tight metal covers rammed around my rear molars, wire faces welded to my teeth, heat-sensitive wire ratcheted up to unbearable tightness along each layer. I had - and this was my big, shameful secret - headgear. I wore it at night for over a year and every morning the first thing I would do would be to yank the painfully hot spikes out of my aching teeth and fling the whole contraption as hard as I could into the farthest corner of my open wardrobe. Believe me, I do mean every morning. I had all that...
...and I was never scared. Heck, the only time I cried was after one session with the orthodontist, after he'd finished equipping me out with a full set of metal, put the headgear on me and casually demonstrated to my dad how it would pull back like this! like this! on my indignantly screaming teeth...
...and now, lying flat on the chair, mouth held open, I feel like I'm engaging in complicit torture. I am offering myself up as the victim. I have my hands folded across my stomach and my rigid nails digging as hard as they can into the backs of my hands. If I break the skin, the pain will be a welcome distraction. Sweating in fear, I watch as the dentist bears forward. Any second now he will use the tool I have come to fear and hate the most- the metal wire pick.
First, though, Dr. T casually operates his little mirror in my mouth. He does this one-handedly, and without the close-lean-in-an-inspect that I'm used to. Is this a sign of professional ease, or just carelessness? One side, the other side, and he delivers a few short comments.
"Oh yeah, I see the hole. It's pretty deep." He takes the metal pick and pokes it in. The feel of that skittering little wire haunts me in my nightmares. It makes my toes curl in horror and my skin dampen with sweaty fear. Mercifully, my tooth seems entirely insensitive and dead to pain. Mind you, maybe it is dead.
I've mentioned my wisdom teeth as another potential problem. My British dentist had suggested it was possible I'd have to have them removed. Again, my thoughts on this topic has always been very amenable to that idea. I don't need wisdom teeth, I have more than enough in here already. Like the rest of my teeth, the damn things crested early, too. Take them out!
"Oh yeah, one wisdom tooth is impacted. You might have some problems there as food can get stuck... cause a cavity."
That's all he says. He does some x-rays. It is novel that I don't have to get up. He has a moveable x-ray machine that he pulls down and prods into my cheek. Then he calls the other dentist to come in and do the filling.
"You know you can send me any questions you like about braces," he adds, turning to leave.
I have to quickly call him back to get my 'consultation' in orthodontics. I winkle information out of him. Like eating winkles, it is an unnecessarily complicated procedure for very little reward. Invisi-align braces won't work, because my teeth are too crooked. I wonder if this is why Dr. T seems so bored when talking to me about braces. Perhaps he is 'Invisi-align' only. Anything else, no thank you. Wire braces will be the best bet, this is fine with me. I ask him about prices. He manages to evade the question.
"Won't my teeth just move straight back into crookedness after braces, like when my wisdom teeth crested? I mean, I don't even understand why they went crooked after I had all that work done..."
"There's, like, fibres, that hold your teeth in place," he says. It sounds like the sort of easy explanation he could just be making up to placate an idiot. "That's why they can go crooked. So you'll need to wear removable braces for a long time."
"For all my life?"
Again, somehow, he doesn't answer the question. "It's like, you know, I tell people it's like wrinkles. The fibres. They just happen." The other dentist enters and takes over. Disinterested Dr. T is ready to leave and let the other dentist do the filling.
They do, however, first spend a few minutes clattering around with equipment. It's pretty obvious this is not a smoothly running affair. Bits of things are missing. There are questions from her to him about what to use. Drawers are opened and shut. The other dentist searches for things. I think longingly of the cold clinically sterile room of my British dentist. The neatness of it all. The shiny white surfaces. The lack of scrabbling for the right equipment. Suddenly, I miss him. Suddenly I love him. There is a cobweb attached to the light bulb in the ceiling.
A slurping tube is hooked over the other side of my mouth, which turns out not to work particularly well, so I have to swallow at intervals or risk choking on water and tooth enamel dust. When she can put the drill down, the dentist helps by sticking another suction tube in to save me from swallowing or coughing. But she only has two hands, and it's either drill or suction. It's a far cry from my dentist and his ever-present assistant. For the first time, I wish there were two sets of hands tending to my mouth. What on earth did I ever complain about?
She has a really, really good go at my cavity with the pick, trying to elicit some pain until there are grating noises and she's using a lot of force. I try to brace myself against the inevitable scream, the reaction I will surely have as I reflexively leap out of the chair once the pick stabs into soft tissue. Mercifully, it doesn't come. Absurdly, I realise halfway through the pick ordeal that the dentist is also risking her well-being by putting fingers in my mouth. At any moment I could shut my teeth and bite. This actually gives me a semblance of control over the situation and I am able to hang onto this through my fear.
She spreads a generous amount of pina colada-flavoured numbing gel in my mouth, and gives me three injections of anaesthetic. I don't think my British dentist did this to me the last time I had fillings, so I mentally chalk one in favour of Amsterdam dentistry. Of course, he might have just been saving me money. Since 2011, dentists here have been permitted to raise the prices of their treatments above fixed rates, and they have done so despite a slew of grumbling complaints from the Dutch public.
I spend the whole session staring fixedly at a black blob in the fluorescent light, drawing out the debate in my head about whether it is a spider or not. The actual drilling and filling does not take long, but after the resin has been packed in, there is about 20 minutes of reshaping and grinding down the resin so that it fits into place neatly when I put my teeth together. I decide that it is a spider, and it's dead now.
Afterwards I have to go and pay. It's rather more than I expected. The anaesthetic has spread its rubbery coldness up my cheek and into my nose, which stings and runs all day. Dr. Tsang wanders in and out of the reception and treatment room, eating something crunchy as he does. At least he did not do this while my mouth was splayed open. I ask him once more about how much braces would cost.
"How much is it in England?" he asks first.
I don't remember, other than it being enough to put me off getting them.
"I could probably do them for about 2000 euros," he finally says, still supremely uninterested.
I've never met a less interested dentist. I feel our interaction has been exhausted. I am beaten.
At that point, a man lurches into reception. He has a homeless look about him, a thousand-yard stare with eyelids ratcheted obligingly back and out of the way of his stare. He wordlessly bares a set of separated, yellow teeth at us, pointing at his lower gums.
"Yes, can I help?" Dr. T says mildly to this silent, staring, mouth gaping man. He is certainly unflappable.
They stare at each other.
I turn to punch in my code into the PIN machine and pray that my health insurance will sort out the costs quickly.
Thankfully, when I turn around again, the strange man has left and I have a clear route to the door.
Amsterdam Dental. No, I would not recommend them.
Not quite a blog, but things that I have written. Please note - these writings are unedited, for the purposes of flexing my fingers, and no doubt contain grammatical errors and carelessness of expression I wouldn't allow in professional writing.