Smile at the dentist

smile-dentist
Dentist Smile Photo courtesy of http://www.nationalsmilemonth.org/

So I’ve just been to the dentist for a clean and descale. It’s a must-do, twice-yearly chore.

As I walk back to the car I’m looking for suitably long grass to spit out the remains of the fluoride wash. As I near 70, I’m hearing dental horror stories from my peers. Most of these anecdotes involve four-figure quotes for implants, bridges or crowns. I still have most of my own teeth and a couple of implants that set me back $1,600.

Maybe 25 years ago, pain drove me to a dentist. Luckily, I picked a good one (out of the phone book). He packed the problem tooth with antibiotics, put in a temporary filling and booked me in for a proper filling in a week’s time. It was the start of a process, overcoming dental phobia and accepting an expensive course of dental remediation. Some thousands of dollars later, I was at a stage where I could safely book in for a six-monthly check-up.

I’m doing this on a regular basis now and it’s been a while since we had any issues. I did crack a filling once on a chunk of dark chocolate, but OMG, it was such a nice piece!

As we age, we are more prone to gum disease, our teeth more likely to crack or shatter, and more importantly, those large old fillings we had in our childhood start to fail. Some of our teeth may have been saved by root canal treatments, which permanently kill the nerve but preserve the tooth.

Put your teeth in the glass, Mr Wilson

My Dad’s generation had a quick but not entirely painless solution to teeth and gum problems – they had all their teeth extracted. After going around gummy for a number of months they were fitted with dentures.

I was reading Annie Proulx’s novel, Barkskins, which charts the history of two families of wood cutters, carving out a life in New France – 16th century Quebec. There are many things that could catch your attention in this 700-page, richly imagined generational epic, but this one stood out. Proulx’ character Charles Duquet suffers from gum disease and has had his teeth extracted. A vain man, he seeks out a denture-maker. Duquet’s new teeth are made from ivory. The French denture-maker explains that the teeth are ‘only for display, not for chewing’ and that he should take them out when eating. Also, they will turn yellow with exposure to sunlight, so perhaps Monsieur would like to order a spare set?

I figure the author of The Shipping News and other fine novels would be a peerless researcher, so I checked out the history of dentures. Then as now, dentures are a luxury poor people can rarely afford.

A full set of dentures in 2017 can cost from $2,000 to $2,500. Factor in about $150-$200 per extraction and it’s no cheap exercise. However, as those who replace amalgam fillings with porcelain or opt for caps and crowns can testify, dentures are a relative bargain.

The ever-informative Wikipedia (now banned in Turkey), tells us that dentures were available as early as the 7th century (usually partial plates made with human or animal teeth and held together with gold bands). The Japanese invited full wooden dentures in the early 16th century (and continued using them until the 19th century).

US President George Washington’s dentures were made with ivory from hippos and elephants as well as gold, rivets, spiral springs and even real human teeth.

As recently as the Victorian era, young men and women were offered dentures as a 21st birthday present.

Manifold improvements in dental care have seen demand for dentures dwindle over the centuries.

A 2009 survey in the UK found that only 6% of adults had no natural teeth, a big improvement on a 1978 survey when 37% were entirely edentulous.

An Australian government report (2013) said that 19% of adults aged 65 and over had no natural teeth.

Our generation at least went through childhood with regular dental care. In New Zealand where I grew up, every school had a dental clinic, staffed (usually) by one qualified dentist and a team of dental nurses.

The nurses did the inspections and de-scaling and also filled cavities under the watchful eye of the in-house dentist. As a result of a life-long craving for sweets and chocolate, a lack of fluoride (a subject for another time), and less than rigorous brushing, my mouth is full of mercury amalgam fillings.

Other things can do your teeth in, including facial injuries from traffic accidents, assaults, playing sports and other mishaps.

One of the biggest impediments to maintaining a healthy set of teeth is dental phobia. Almost half of UK adults surveyed for National Smile Month in 2009 said they feared going to the dentist and 12% of them suffered from extreme dental anxiety.

This Monday marks the start of the 40th National Smile Month in the UK, a dental health awareness campaign. Australia has a national dental care week in August, at which time we’d hope to have more recent data than 2013. Here some current UK figures.

  • One in four adults don’t brush twice a day, including a third of men;
  • One in ten admit they regularly forget to brush their teeth;
  • 42% use only a toothbrush and toothpaste for their oral care;
  • Less than a quarter of adults use dental floss regularly;
  • One in three have never flossed their teeth;
  • The UK spends £5.8 billion a year on dental treatments;
  • Half of adults visit their dentist every 6 months;
  • 25% have not visited a dentist in the past two years;
  • Around 2% of the UK population (about one million) have never visited a dentist.

An Australian report says that uninsured adults are more likely to have experienced toothache (20%) than insured adults (12%). I was too cheap to pay $17 for the whole report (with 2013 data), so I’m quoting the media release from the Australian Institute of Health and Welfare (AIHW).

The report shows that of those who were eligible for public dental care in 2013, just over 20% experienced toothache, compared with almost 15% of adults who were not eligible. Only about half of Australians have some form of private dental insurance.

Expenditure on dental services (except those in hospitals) in Australia was $8.706 billion in 2012-13.

“The largest source of funds for this expenditure was individuals, paying directly out of pocket for 58% of total dental costs,” AIHW spokesman Dr Adrian Webster said.

Today’s children, flossing daily, their often near-perfect teeth the product of fluoride and orthodontics, are a reminder to the rest of us to make do with what we’ve got.

In my case, that means living with an undershot jaw; a genetic condition exacerbated by a face-plant motorcycle accident 40+ years ago. For a visual cue think dog breeds – Pekinese, Shih Tzus, Bulldogs (or Albert Steptoe).

When my current dentist first looked inside my mouth and asked me to bite he said something like “Holy Cow.” I know what he meant to say.

Last week’s FOMM − a reader wrote to say Dexy’s Midnight Runners may have been a one-hit wonder in Australia with Come on Eileen, but they also had another number one hit, Geno, in the UK.