American dentists: an Englishwoman's perspective

We knew before we arrived that American dentists are among the best in the world. You only have to look at the shiny straight white teeth in the average American's mouth to know that American dentistry is a great thing. Of course, the shiny straight white teeth come at a price and if one can't afford to pay that price, one is more likely to have a crooked assortment of yellowing and blackened teeth. Crooked rotten teeth are a major indicator of American social class or English nationality.

My children love watching Phineas and Ferb, a children's cartoon in which there is always a back story from the bad guy. For this blog to truly make sense, I feel that I need to engage in a little back story at this point... So, indulge me for a moment as we leave New England behind and return to an Olde England in which dental care was freely provided by the NHS. In those halycon days, my relationships with dentists were complicated; although, as with any complicated relationship, I now realize that blame and responsibility should have been acknowledged by both parties. 

1. My first dentist retired shortly after I bit him. I don't think the two incidents were related.

2. A new dentist replaced the bitten dentist. He didn't have any great belief in anesthesia or personal hygiene. After being coughed on and spending pain-filled moments staring at his yellow-headed acne, I decided that dental care was unnecessary. 

3. In Sheffield, I had a glimpse into an alternative world where dentists could be gentle and kind and talk uninterrupted for three hours while carefully addressing a root canal infection in my mouth. The dentist fiddled and poked and explained in minute detail how I should clean my teeth. He promised to explain flossing in our next appointment, but I never returned. I was too young to be able to appreciate his advice. 

4. Six years later, a dentist called Mr. Yapp followed me out of his surgery after I fled at the sound of his pressurized water jet. If it had been a film, beautiful soul-filled music would have led up to the moment when he stopped following me. I ran out into the East London traffic and he must have known in his heart that I had left him forever. It was a sad day for us both. 

5. By the time that I was in my thirties, the dead tooth at the front of my mouth (the one that the Sheffield dentist had saved) was almost black and badly chipped. I had been appointed to my dream job, but should have realized that things weren't going to go well when my new employer told me that one of the first things that she had noticed about me was my dead tooth. Not my brilliant mind, charm or wit, excellent contacts, or outstanding work ethic... but my dead tooth. Friends convinced me to take advantage of the free dentistry that was available to me as a new mother. By this point in English history, a new era had commenced in which the NHS had decided to take a separate course, leaving dentists to work out their own businesses and to charge patients what they wanted needed to. A South African locum had great fun carving out my front tooth and fixing it up with a new crown. He did a good job and even managed to make the tooth look fairly straight, although I was shaking. 

6. The English dentists who are most successful nowadays are the ones who follow the American model. I have been relentlessly determined that my children should have good teeth. In Penrith, we found a dentist who believed in charging lots of money to be nice to children. We paid him lots of money, even when we lived in Newcastle and had to drive for several hours to see him, and it seemed to work. My children like going to the dentist and that has paved the way for our American experiences...

Now we live in a world where there is no concept that dentistry should be funded by the state. Dentists are well paid professionals. For the past thirty years or so, they have been able to invest extensively in professional development and equipment. Over the past thirty years in England, dentists have seen their state funding steadily cut to a minimum and then, in most cases, scrapped completely. A friend of mine works as a dentist in England; he tells me that it is only in the past decade that English dentists have had the freedom (provided by the new corporate structure) to invest in state-of-the-art technology and professional development. In America, dental patients are customers who are paying for a service. If the dentist hurts his or her patients' teeth, then they are unlikely to return to that dentist. It's a fairly simple business model. American dentists like happy patients (which probably explains the widespread use of laughing gas). My experiences with English dentists suggests that they care less about what the person sitting in the chair thinks: it's not as though the patient can audibly complain anyway. 

My girls' attend a pediatric dental practice filled with toys, funky equipment and very beautiful dentists. The girls hold mirrors to watch what the dentist is doing in their mouths. There is lots of upbeat praise about how well they are doing. They get stickers and toys and rewards for attending. My children have never bitten a dentist and I am very proud of them. 

I'm a recovering dentaphobe (given that there is a word for this, I'm sure that I could find a support group if I looked closely enough). The crown which was fitted seven years ago has reached the end of its life span and this has motivated me to attend a local dentist. The receptionist treats me as though I am a recent convert to her faith. She telephones me to discuss my feelings and encourages me to make appointments that are convenient to me. She hasn't had any stickers to give me, but she gives me lots of brightly colored appointment cards and big reassuring smiles which showcase her impeccable American teeth. The dental hygienist was very excited when she found out that I hadn't had my teeth cleaned for five years. We had a great time together. She wanted to prove that teeth cleaning doesn't have to hurt (it doesn't) and I learnt all about her childhood in Brazil. My dentist is a South African man with enormous hands. He is very gentle but doesn't talk much. We like the same music. He sings fragments of lyrics, and I hum occasionally with my mouth wide open. His nurse is from El Salvador. We all got on like a house on fire. I have a brand new shining white tooth and I haven't bitten any of them. I'm very proud of myself. 

I need to remind myself to mention all this on our green card application: we can't go home. The dentists might hurt us.