blood, tears and celebrity dentists

The first time I saw a DIY dentist kit was in the early 90's, when I was working in France and a workmate, who had previously worked with Voluntary Services Overseas in Tanzania, showed me his. The tools looked standard dentist's issue, with enough temporary filling to last until you could get to a dentist, but I never worked out how you would be able to use the mirror while keeping your eyes in their sockets.

Last year the Telegraph's Lara Clout reported the case of grandmother Elizabeth Green, who was in a desperate state due to her toothache but, having phoned round dentists' surgeries after government reforms of the industry, was unable to find any that were taking on NHS patients. Luckily the two front teeth causing the problem had become loose, so she was able to pull them out manually after working them forwards and backwards with her fingers. Even though dentists whose caseloads are predominantly made up of NHS patients can earn up to £96,000 ($138,500), their reluctance to take on more NHS patients who are now less rewarding has led, according to Ms Clout, to people repairing broken crowns with glue; she even found one person who had performed several extractions with houswehold pliers.

Not that dentists and their goods and services don't have their uses: in Croatia, Stipe Cavlovic's life was spared when a bullet with his name on it was stopped in its tracks by his false teeth. Perhaps dentists know something that the makers of bulletproof vests don't?

In my hometown of Glasgow, false teeth are called wallies, after the tiles made of china ("wally") that lined entrances to the more élite tenements - something the same as the US regional terms "chiny teeth" and "chinaware" to describe prosthetic laughing gear. When my Mum came of age, which then meant turning 21, the NHS hadn't yet been set up, so her family saved up so that she could have all her teeth removed as a special present. This would save her many years of prohibitive fees - or so she thought; two years later, the Health Service was founded.

I understand that we have to contribute to dental care, as only certain materials can be used in such a sensitive, vulnerable part of the body, and must be manipulated by highly-trained individuals. But, as in the rest of medicine, as time goes by more treatments are available in more highly refined formats, and there has to be a limit as to what can be partly or even wholly funded by the state. For example, last year I took my brother Asinus' daughter Perturbata to the orthodontist to have braces attached on the NHS and therefore free as she is a minor - something which, according to one website, can cost up to £7,000 ($10,000). Asinus is looking for dental wax at the moment, to shield mouth ulcers that perturbata's developed from the braces, which are exacerbating them.

I don't grudge Perturbata her braces, especially as their wearers are enriching orthodontists through playground peer pressure, and children who try to resist this can find themselves targeted. I'm not suggesting a return to eighteenth century dentistry, especially as braces were known to the ancient Greeks and their predecessors; but I wonder how closely related the perceived need to have perfect teeth is related to that of conforming to other attributes of assorted supermodels and stars, like starving oneself half to bewilderment and mortgaging one's life for enhancements.

Dentistry can of course be absolutely necessary. Perturbata contributes robustly to her NHS dental treatment; when she wanted a tooth taken out because it was causing her severe pain, the dentist refused, putting her through the first part of a (more expensive) root-canal treatment, in breach of the General Dental Council's Standards for Dental Professionals, which states that practitioners should

Recognise and promote patients’ responsibility for making decisions about their bodies, their priorities and their care, making sure you do not take any steps without patients’ consent (permission).

To cut a long story short (there are a couple of links to backstories at the bottom), on the second visit, during which I accompanied her, the dentist decided that an extraction was now indicated but the tooth had been weakened by having a hole drilled through it, and snapped, leaving part of the root in her mouth.

Patientia was referred to Addenbrooke's hospital on a non-emergency basis. What a difference: the dentist there sat her down in an ordinary chair, not hovering above her and offering expensive options while she was semi-recumbent, bleeding and in tears, in a dentist's chair. He went through the options and guided her towards a decision, but armed her with the information that there would be pain and blood.

Unfortunately, Patientia neglected to mention this to her friend Fidelitas who, both Asinus and I being unavailable for the appointed day, accompanied her to the outpatients' dentistry department. When Fidelitas realised that Patientia would have to have her gum cut open in order to remove the fragment of root, she informed her that she was terrified of the sight of blood.

So Patientia followed the nurse alone into the clinic shaking somewhat, but was a little relieved, somehow, when she saw that the dentist bore a passing resemblance to Brad Pitt. (Maxima accuses me of being jealous of his looks, but I protest that I simply don't understand what women see in a man with a face like a bag of spanners.)

Anyway, Patientia sat in the dentist's chair and, suddenly blonde, said "do I really need to have this done?" Brad the Dentist nodded and, root extracted and the reservoir of blood and pus it had been blocking sucked out of her mouth, she left with dissolving stitches in her gum. She half-reluctantly said goodbye to him.

There's certainly a lot of unmined potential in dentistry. For example, last August scientists removed the pulp from the wisdom teeth extracted from a ten-year-old girl, which they have frozen should the need arise for stem cells to be created for her, with no embryos destroyed nor any wannabe Frankenstein emboldened.

Generally, though, the government advised people to go to their dentists less in 2004, two years after the present downturn had first shown its ugly face. I won't find that a problem - unless the NHS starts hiring dentists that look like Gillian Anderson.



Related posts:

The Orthodoxy of Orthodonty

Good dentistry - it's like pulling teeth