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Saturday, Sep. 8, 2012

JAPAN LITE

Do you overestimate your dental IQ?


I really feel sorry for dentists because they have to deal with difficult patients, especially those who have inflated ideas about their own dental IQ.

I recently went in to have some dental work finished that had been started six months ago. I just hadn't had time to get back until after the summer.

The dental hygienist looked inside my mouth and said, "Do you floss?"

I answered honestly: "I floss every day. Sometimes twice." The dental hygienist seemed surprised, as you might expect a dental hygienist anywhere to be, but especially in Japan where flossing appears to be a recent phenomenon. When I first came to Japan I had to buy dental floss directly from my dentist because I couldn't find it in the stores. It was sold in quantities more fit for bailing twine. And forget mint-flavoring, waxed or unwaxed. It was all closer to bailing twine.

"Do you eat sweets?" the dental hygienist asked. "Not often," I said, trying to hide a total chocolate addiction.

The dentist came in and worked on my teeth. In a short time he had completed the work he had started six months ago. Then he said, "Now that we have finished that part of your mouth, we need to talk about the rest of your teeth."

"The rest of my teeth?" I said curiously. It sounded serious. Had my teeth been misbehaving?

"You have five cavities," he announced.

Five cavities?! I couldn't believe it. Surely there must be some mistake. It didn't feel like I had any cavities, not even when eating chocolate, which is like, every day.

The dental hygienist handed me a little round mouse-size mirror, which I used to watch the dentist point an instrument at a brown spot on the surface of one of my lower incisors, down near the gum line. I hadn't even noticed the hole, already the size of the Grand Canyon. If I had waited any longer to have it filled, I'd be attracting tourists.

"You brush too hard!" The dentist scolded me. For some reason, he felt it was necessary to say this in English, the same way your mother feels it necessary to use your full name when she really wants to get through to you.

"I do not!" I protested. "Maybe I brush too often, but not too hard." Hey, I had a rigorous dental routine to defend here. I use a medium-bristled toothbrush and I never wear down the bristles like some people do (and you know who you are!).

"And you have plaque!" He said, again in English, which I found rather condescending. I suppose I should have contained my plaque to fenced-in parts of my mouth with electric-wired fences.

Another dental hygienist came in, presumably to start de-plaquing my teeth.

"Can she speak Japanese?" I overheard her ask the dentist. "Yes, she'll understand if you speak slowly." After 18 years in Japan, not to mention years of study, kanji school, and Japanese Proficiency Tests, this is what I get?

The problem is that when someone thinks you don't understand Japanese, even if you do, they slow their speech down so much that it takes them almost a week to end a sentence. By the time you leave the dental clinic, a month has passed. That's what happened to Rip Van Winkle — he went to a Japanese dentist. I did not wish to spend my 100th birthday at the dentist's office, so I tried to speak at twice the normal speed to make up for the hygienist's half-speed.

I explained to her that when I was in the U.S. my dentist told me that I had periodontitis. My mother had it too. So perhaps this was part of the reason the cavities were so close to the gum line.

The dental hygienist looked at me doubtfully, then had a bright idea. "Shall we do a check for periodontitis?"

I agreed, having no idea what such a check involves.

It took two hygienists, one to call out numbers while sinking a needle into my gums to measure the thickness of the gum above or below each tooth, and the other to record the findings. She explained that a No. 3 was no periodontitis and a No. 2 was a little bit. See? No periodontitis, she said. They were all 3s except for one 2.

Well, they proved me wrong, didn't they! The dentist came back in and barked out occasional labored English words, attempting to show off to his dental hygienists.

"You brush too hard!" said the dentist again in that accusatory way.

He leaned the chair back and then suddenly stopped, instruments poised above my mouth. He was thinking about the next unhelpful English phrase to bark out. Perhaps it was the word "open," but I was already open, lying there gaping, wondering what the meaning of life was.

After this long pause, not finding the word he was looking for, he started filling in two pre-cavities in addition to the Grand Canyon, all of them incisors next to each other.

He explained to me, in Japanese, that because of my brushing habits, I was creating curvatures in the tooth's surface where food can gather and rot the tooth away.

I guess you're right, I said sheepishly.

But I still wasn't convinced you could get cavities from over-brushing, so when I came home, I looked it up on the Internet. Several articles confirmed that you can over-brush (or brush too hard) and wear away the dentine on your teeth, leaving the tooth surface exposed. So, I'd have to go back in for another appointment to have the rest of the five cavities filled after all.

This difficult patient had been put back into her place — the dental chair.

Follow Amy Chavez on Twitter: @JapanLite


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