Mind the gap

A brief trip around the world in the dentist's chair

A dental surgeon treating a seated man. Painter unknown. 17th century. Wellcome Collection.

My real history with dentists began with a cricket ball. ¹ It was lobbed gently in my direction during a cricket practice in primary (elementary) school. The person who threw me the ball had been a semi-professional player, was an outlying member of the English gentry, and was also a cousin of a TV star that my mother thought was particularly “dashing”.

But none of that prevented me from looking at the low parabola of the ball as if it was independent from my bodily involvement in the action. My hands, which for all the control I had over them at that moment might as well have belonged to someone else, failed to rise in time. I lost half of each of my bottom incisors in the impact.

*

When I wrote last year about my experiences in the hairdresser’s chair, I was guilty of failing to imagine the other side of this mostly wordless but very intimate dialogue.

So in writing now of the dentist’s chair, I feel I should say that dentistry is one of those jobs I feel lucky others are willing to do. I couldn’t do it, and someone has to. So thank you, dentists!

*

But like many people, I’ve had mixed experiences over the years – in my case, while having dental work done in London, Shanghai, Ankara, and Mexico City.

I’ve been thinking of my history with dentists while I’m in the chair here in Tokyo. My face is fully covered against the bright light, and there’s some kind of powder or spray being applied. I’m expecting some discomfort.

I’m lucky though. The assistant dentist seems perfect for this job. I haven’t seen her face, as she never takes her mask off. But she’s so gentle, quiet and calming that she is almost absent… almost as if the work was being done itself.

And yet, surrounded by monitors, ² and subjected to multiple mechanical interventions, I feel, as I usually do in such chairs, that I am reduced almost to a machine – at best, merely a body.

*

In response to the loss of the top halves of my incisors in that childhood accident with a cricket ball, the local dentist, a Mr Smith, gruffly covered the stumps of the teeth with some kind of protective coating and left it at that.

And that was the way they stayed for the next twenty-five years or so.

I now ask myself why I didn’t get those teeth fixed as soon as I was able. Of course, there was the usual concern about pain or discomfort and the issue of finding a new dentist every time I moved city or country.

But there was also a kind of disregard for my teeth that I’d imbibed from the NHS. The guiding philosophy seemed to be that if it didn’t hurt, there was no need for any action. And it almost made sense: The state, which paid for this, was there to keep us healthy, not to make us look better. ³

*

Back to Tokyo. As I sit in my reveries under the calm ministrations of – let’s call her K San – the treatment begins. Like many people, I’ve experienced pain at the hands of dentists. But my body doesn’t even flinch under the gloved hands of K San, who takes calm efficiency to a new level.

Remarkably, she’s somehow able to disappear into the work she’s doing. I almost feel I’m alone. And despite the whirrs of machines and the glare of a canopy of screens and lights, I feel my body relax.

Later I found that my smartwatch registered this period as a nap.

*

I finally took the decision to fix those bottom incisors in Mexico City in the late 1990s. I remember the male dentists in the upmarket establishment I went to – they had glittering teeth, sparkling smiles and eye-watering prices (fortunately covered by my insurance). Their surgery was huge, spotless and gleaming – it hardly seemed to correspond to the everyday reality of the gritty city that I loved. This was a brave new world for me, a place where there was an expectation you’d pay whatever it took to have perfect teeth.

But while I had some minor treatment there, I still resisted getting those incisors fixed, to the evident disappointment of the smiling and dazzling dentists. I decided to wait until I was posted back to London.

*

By then, NHS dentistry was already a thing of the past for most people in the UK. The same high expectations I’d seen in Mexico, a kind of dental arms race towards perfection, seemed to have arrived back in my home country.

Walking to the surgery, I noted the new Mercedes outside, and when I got inside, I found prices that explained its presence. The dentist, a man slightly older than me, did a decent job, and the two teeth were finally complete again after two and a half decades. When I looked at myself in the mirror, I thought it absurd that I hadn’t had such work done years before.

*

But more dental woe was to follow. In Shanghai, a few years later, I faced root canal treatment. I’d heard frightening things about such treatment. But though the work dragged on for weeks, the dentist, a young woman who almost certainly got to her place of work via public transport, not in a fancy car, worked well and considerately. It was certainly painful. But the natural light and hubbub of that dynamic city coming through the window and the low-key and efficient approach of the dentist helped me through it.

I was also able to develop, for the first time, the ability to zone out from the pain in the moment, almost pretending it away. I believe this would have been impossible in the bustling presence of the male dentists in Mexico City or London.

*

Dentistry has been around for about 7,000 years. The first named dentist that we know of was called Hesy-Re, who was practising in Egypt in 2,600 BC.

And for most of that time, it has been a pretty brutal business – until, that is, the invention of modern anaesthesia in the 20th century.

*

However, that 20th-century innovation was of little use to me when I had a wisdom tooth taken out in Ankara. The young man who extracted, or rather tried to extract, the tooth was very pleasant. But he was responsible for my worst ever experience in the chair.

I’ll spare you the details (I’m squeamish myself), but the tooth was stubbornly determined to stay in place. After more than 90 minutes of futile and increasingly desperate effort on his part and equally fruitless pain on mine, the young dentist reluctantly gave up and called in his boss, who worked upstairs. The first thing the latter did after he’d walked calmly down the steps and reviewed the situation was to give me another jab of anaesthetic.

I understood later that the young dentist had injected too little anaesthetic. Thinking the prolonged and sometimes severe pain was “normal”, I foolishly suffered the butchering without too much complaint. And I’d tried with limited success to bear it using the “zoning out” approach I’d developed in Shanghai.

But I hope the young dentist learnt a valuable lesson that day; it would make me feel my suffering wasn’t entirely in vain.

*

I awake from my reverie. The treatment by K San is over. No pain at all.

But just before I leave, the senior dentist appears in the room and points at the screen. All my teeth look the same to me in the image, but he warns that one of them will require a rather uncomfortable procedure.

Will I be returning to the empire of pain? I sense my flesh tensing.

I ask who will give the treatment. When he tells me it will be K San, I feel my body relax. My muscles and nerves have decided, with little input from my dazed conscious mind, that there’s nothing to worry about if she’s in charge.

I feel air leaving my lungs in relief and then watch with patient detachment as my body bows and slowly leaves the room.

1. For my US readers: a cricket ball is slightly heavier and a little harder than a baseball.

2. Who decided that patients want to see photos of their own teeth on a huge HD screen?

3. As a child growing up under the NHS, all my medical and dental care was free. I’ve been covered by insurance of some sort ever since, which makes me feel lucky. Japanese dental fees are mostly covered by the country’s mandatory health insurance.