I wrote on my other blog a few days ago that I was having a really excruciating toothache. I'm glad to say that the pain is completely gone now. However, I had a really shocking experience at the dentist's office that I wanted to share with you guys. I hope it's interesting for you; it was a bit traumatizing for me, but I'm glad that I now know more about how dentists operate here.
I was lucky enough to get a same-day appointment at a dentist near my house on the say the horrible pain started. When I got there I handed over my insurance card, filled out the first-time-patient medical history form, and waited until I was called in.
I already knew that in Japan, the dentist chairs are not in separate rooms, but all lined up in one big room with dividers between them. In both of the dentists I've been to, there was a wall with big windows in front of me, dividers on both sides, and the side behind me was wide open to the rest of the room. This didn't really bother me, but I have heard from other foreign friends that they don't like the lack of privacy.
The dentist came over, asked me about my symptoms, and took a look in my mouth. He wasn't particularly gentle but not overly rough either. After a brief check of my mouth, he had a nurse guide me into a nearby closet (literally a closet) for an x-ray of the area that hurt. The x-ray room was tiny, but the x-ray process was identical to the dental x-rays I've had in America. In Japan they only do these if they are pretty sure you have a cavity and intend to drill it; they are not part of your regular yearly or bi-yearly cleaning-and-checkup dentist visits.
After looking at the x-ray, the dentist couldn't tell which of two teeth the cavity was in (I have two teeth next to each other with old cavities in them that were filled back in America years ago, and the new cavity is right next to the old cavity, in the area where the two teeth meet and the old fillings are connected, so it's hard to see on the x-ray) so he used a tool to tap my teeth and determined which tooth the cavity was in when I shouted "Ow!" after he hit it. Not very nice, but effective. I couldn't really tell which tooth hurt until he did this, because the whole area was radiating pain.
Then the dentist said "Okay, let's fix the cavity!" and pulled out the drill. I stopped him before he could start drilling and was like "WAAAAAAIT, you forgot to give me novacaine!!!" but he said "Don't worry, I saw from your x-ray that the nerve inside your tooth is dead because of your old fillings, so you don't need it!" and started drilling. In the end, he was right, it didn't actually hurt much more than the excruciating pain I was already in. But I was really, really freaked out by the IDEA of having a tooth drilled without pain medicine. I also wish he'd explained it to me first before coming at me with the drill, but I guess it didn't occur to him that I wouldn't know any of this, since he doesn't know how dentists in other countries operate.
Then, after drilling out the old filling and the new cavity, he put some medicine inside my tooth and then told me I could go home. Once again I stopped him. "WAAAAAIT, you forgot to fill my tooth back up!" No, apparently that was intentional. He told me (in a tone kind of like he was trying to be patient while talking to a person with a mental disability) that I have to go back several times for more treatment, and when he's done healing my cavity, he'll fill it back up then. When I got home I saw that he'd put a kind of plastic/foam 'filling' inside the tooth so I could eat and not get stuff stuck in there, but it actually fell out before my next appointment and it was really freaky to have a huge hole in my tooth.
The only good surprise was the price. In the US I didn't have dental insurance past age 18 or so, and getting a cavity filled cost ~$100 with insurance and ~$300 without. The cost for my first appointment (x-ray, diagnosis, drilling, antiseptic treatment and 4 doses of painkiller to take home with me) was only 2,000 yen, ($20).
I was very disappointed that the pain didn't stop that day, or even the following day. The dentist gave me 4 pills of a decent painkiller, which I could and did take 4 hours apart. So I was out of painkillers by the next morning, and in terrible pain again the entire day at work. After work I went to the drugstore and got some over-the-counter painkillers, which worked okay if I took a bit more than the maximum recommended dose. Japanese medicines in general are reputed to be too weak for foreigners, and although I usually have no problem with taking the 'Japanese dosage' this time I took a bit more without feeling bad about it at all. Thankfully, the 3rd day after visiting the dentist my pain got weaker and now it's completely gone.
I went back for my 2nd appointment the following week, and the dentist cleaned out the inside of the tooth again, put more medicine inside, packed it up with new plastic/foam, and had the hygienist do a 'cleaning' for me. It wasn't a normal cleaning like I've had before in Japan when I went for a regular checkup; she used a vibrating tool to clean the tops of my teeth where they meet the gums, and then put a really bitter medicine on the same area, on the top teeth only. I think it was some kind of anti-cavity treatment. This time the cost was only 1,500 yen ($15).
The dentist said I have to go back 3 more times (presumably once a week for 3 more weeks) and then the treatment for the cavity will be done. I am not really sure how I feel about the Japanese system overall. I'm glad it's cheap; even with the 5 office visits, the total cost is going to be less than I'd pay for a cavity with dental insurance in the US. It's worth mentioning that in Japan, national health insurance covers dental work; you don't need to pay for extra 'dental insurance.' I'm also glad that they are thorough and cautious; I would not be happy to have an entire second drilling and filling to fix things if they filled up the tooth and it was not completely healed yet.
However I don't appreciate how the dentist doesn't really explain anything to me. It's not because he's just a nasty old man,, it's just how things work here. It doesn't occur to explain what he's doing or why, because Japanese people don't bother asking because they won't understand the technical answer anyways. So when you ask the dentist (or a doctor) to explain what he's doing and why, it sounds to him like you are implying you don't trust his expert judgement.
In any case, I'm happy not to be in pain anymore, and will be even happier when I have my new filling in place and don't have to go back in for treatment anymore.