Friday, May 20, 2016

A Trip to the Japanese Dentist

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. 


  1. Based on my experiences with Japanese dentists and doctors in general, I agree completely. They are very well versed in what they are doing, but don't really explain what they are doing beforehand. When I had my accident, they just went to town on my mouth (though luckily they did give me Novocaine, thank Christ).

    The lack of privacy didn't bother me much, either, though I did find it a bit strange.

    Either way, I'm glad everything went relatively well with your tooth and that you're not in pain! :D

    1. Yes, this!!! All I can say is YES, lol. Everything you said is correct. I'm glad you got novocaine, though.

  2. Japanese doctors that I have been to in the past have been extremely well versed but you are right they did not explain what they were going to do beforehand. I am glad that in the end everything went well with your tooth and you are not suffering from any pain. It’s also a bonus that it’s cheap, thank you.

    1. Yes, I'm so glad that it's over and it was inexpensive. As you said, the doctors definitely know what they're doing, it's just a bit nerve-wracking not knowing what's going on.

  3. It really is crazy how we take things here for granted, and how different they are in other countries. I think because we get so social with our dentists here, that they tend to talk more. Perhaps the dentist just assumed you knew or has not really had the experience to explain all the procedures to each of his patients in the chair.

    1. Yeah! A lot of things in Japan that you would expect to be different are actually quite similar to the US, so I was surprised that the dentist was so different. I wonder if I ever end up going back to the US if I'll have reverse culture shock when the dentist (and also doctors) makes small talk with me.

  4. Doctors here are not used to a dialogue with patients because for a long time doctor's actions were like a God's rule. Even now, some doctors dislike if you say you're gonna consult other specialists.
    I got lucky with my dentist in Tokyo really though. She was a young woman and very westernized in terms of thinking and I received really great treatment.

    I also have a tooth with a dead nerve (more like it rot around 10 years ago), dentists in Russia are very good and cheaper than here, I think (Well, it was free for me anyway since it was my mom's friend). But she healed my tooth in only two appointments.
    Since it hurt she made sure to cleanse everything there, and put inside a temporary filling which also fell off quite quickly but you're actually NOT supposed to use that tooth for for chewing with the temp in.
    Then I came again, she took it off, and put the filling all the way from the roots to the top of the tooth. The filling shattered only this year (10 years later) because my tooth started crumbling since it's basically death without a nerve.
    I reckon your doctor either cleansed your tooth in a rough way, OR he didn't clean all the way inside.

    Actually I'm surprised you said it didn't hurt much because in my case I got novacaine in injected even inside my tooth because the rotten nerve caused the swellling of the skin therefore it hurt like hell. But I took painkillers only twice after that.
    Sad to hear you experienced that but maybe you should look through recommendations? Although I know it's different from Tokyo where you can find a foreign doctor and all.

    1. You're so right, the older doctors and dentists think they are on the same level as God!

      Thanks for telling me about your experience. I think I would be even more afraid to go to a dentist in Russia. How are the dentists there? Do they use modern equipment and techniques or is their knowledge a bit outdated?

      I have had problems with this tooth for a long time, and I think my dentist in the US removed most if not all of the root previously, so whatever happened this time resolved itself quickly. Personally, I think he should have given me antibiotics to fight the infection but for whatever reason he did't.

      I actually usually use another dentist, who is much more westernized and was recommended to me by a Japanese friend, but this time I couldn't go there because they were completely booked up for 2 weeks, and I needed treatment right away because it was too painful. But if possible I'll use the place my friend recommended if I get another cavity.

  5. No no, Russian medicine is good actually. But it depends. I mean, some parts of it are bad but simply because they lack funds. My mom's a doctor (She does blood analysis for hormones and so on), and their equipment costs millions.
    Overall equipment is the same as in America.
    The only really bad part about Russian medicine is that if you're staying at the hospital, for example, after the surgery, no one's going to look after you (like change your diapers or whatever) unless you pay them because they lack personnel. My mom stayed with our granddad day and night there. But of course if it's a more expensive hospital everything's perfect.

    I go to the dentist near Shin-Okubo station (in Tokyo) and since Shin-Okubo is famous for being a multinational community, the doctors there are used to foreigners, and I really liked my doctor. However, my friend went to the same clinic but to another dentist and she didn't like her.
    I'm sorry but on a completely unrelated note, where do you live now? I'm currently doing some job-searching, and I'm also thinking of Karuizawa, Kyoto, and Sapporo among other options (Of course, Tokyo included). It's just that Tokyo summer is too hot for me and my heart, and I don't really feel well in summer. But I've heard that Kyoto's even worse(( What do you think?

    1. Wow, that's really interesting about the Russian medical system! I can totally understand the under-staffing issue, it's a problem in the US too, but even bribery doesn't work there :P The staff just get to you when they get to you.

      I live in Shiga prefecture now! I definitely couldn't survive in Tokyo, it's way too crowded. I think the summer is unbearably hot here too, but I've never really been to Tokyo so I can't say if it's hotter here or not. I love Shiga, because there are a decent number of foreigners here of different nationalities (mainly southeast asian and brazilian factory and nursing-care workers) and the local people are not too freaked out by the sight of non-Japanese people. In the cities they get a lot of non-Japanese-speaking tourists, so the Japanese people there learn to expect foreigners NOT to be able to speak Japanese and speak English to every non-asian they meet, often refusing to speak Japanese even if they can't speak English well and the foreign person can speak Japanese fine, because they assume the foreigner can't possibly 'really' speak Japanese, and in the end you become unable to communicate. Haha, this is probably more rare than I make it sound but it bothers the heck out of me, so when it happens (usually only in big cities) it stands out in my memory. And I think you can definitely get married whether it's inaka or city, depending on the type of person you're looking for. Certainly in the Inaka you might not find a fellow Russian to marry (if you firmly want to marry someone of the same culture) or you might not find an English-speaking guy, but a lot of the normal Japanese guys in the inaka are kinder and less of players than city guys, so I definitely recommend you don't entirely rule-out the inaka.

  6. And, if it's too inaka then the odds of me getting married are very slim.

  7. When you have a toothache, the only proper way to treat it is by going to the dentist. I find it very interesting that in Japan the treatment differs than in the United States. I do think it is great that they fill up the cavity with medicine to actually heal the cavity before filling it. I hope your tooth is better soon.