Friday, November 11, 2005

Long in the Tooth.

This post is about the tooth.

No, seriously.

The tooth, the whole tooth and nothing but the tooth.


I tend to abuse my teeth badly. Not that I neglect them or anything. I brush, floss and use mouthwash regularly. It is just that one of the ways I subconsciously react to stress in my life is to grind my teeth. Literally. And it does not help that my regular snacks - apart from the chocolates and icecream treats - are foods like dried fruit bits, raisins, and nuts. All of which wreck havoc on teeth. And my omnivorous eating habits (more like scavaging actually) does not help either. And not to mention motorcycle accidents and martial arts training accidents that have broken a couple as well. More than one dentist has commented that my teeth are very worn-down and that I have more than my fair share of chipped teeth for somebody my age.

Many many years ago, I broke the corner off one of my molars chomping on something hard. The broken tooth eventually picked up some decay, leading to a filling. Unfortunately a few years later the area around the filling also got decayed (food stuck in it) subsequently lead to a root canal job which must have weakened the structure of the tooth.

At this point, I was throughly sick of dentists mucking around with that tooth. And I was prepared to leave well enough alone. No pain is a good thing in my book. So you can pretty much guess what happened next as I continued through the years chomping and grinding.

The tooth broke.

Yup, it clean broke off about a year ago at the gum line leaving about half it embedded in the gum. Only about 25% of the original tooth above the gum line remained intact. The broken tooth naturally got infected with swelling in the gums. Fortunately there was no pain as the nerves has been earlier removed in the root canal job.

At this point I sought dental attention at the dental clinic one of the country's biggest tertiary healthcare hospitals. After having to make an appointment two weeks in advance, and waiting in the waiting area for more than a couple hours (since it was not considered a medical emergency), I finally managed to see a dentist for a "consultation". The dentist put me on a course of antibiotics and told me to make another appointment to return.

The next appointment available was an entire month later. I duly returned and waited a few more hours in the waiting area, prepared to have the tooth extracted cleanly. Only to have the dentist in attendence discourage an extraction quoting potential complications (having to cut the gum, infection, other teeth will move because of the gap, etc). Taking the dental advice to leave well enough alone, I opted to do a patch job on the tooth and not have it extracted.

(On hindsight, I cynically suspect that the overloaded education-bonded dentists in the government clinics who are measured by the number of patients that they can "process" may not have their patients' long term dental interests at heart as top priority.)


So anyway, everything was going fine until a couple days when I broke another chunk of the same tooth munching on salted cashews. The area then promptly gets infected (again).

So I make an appointment at a dental clinic here on Monday. The appointment was today for Wednesday. I walk into the clinic and fill up a two page form summarising medical history. The nurse rechecks my medical history verbally. I wait about 15 minutes to my appointment time as I had arrived slightly earlier. My appointment starts on the dot. The dentist takes one look at the broken tooth and recommends that it be extracted immediately. He explains the possible complications and asks if I understand them.

One hour later, the tooth is removed (all three roots, without having to cut the gum back). Stitches are put in. The entire process is handled professionally and efficiently. Unlike my previous dental experiences, there was not mucking around looking for the right tool, no having dental assistants being switched around in the middle of the procedure, no calling in trainees or senior doctors to "take a look at this case", and no idle chitchat. I am kept informed along the process in layman's language of what is being done.

After the extraction, instructions are given (verbal and printed sheet) on after-extraction care. I get handed to the reception for payment and follow-up appointment for a cavity discovered, and I get sent on my way.

Total time elasped was less than 90 minutes.

Needless to say, I am impressed. The procedure was handled in a professional, businesslike manner. Now to see if the wound heals without complications, as long as I keep it clean.


I suppose you get what you pay for. The procedure was not cheap - costing me about a month's rent. Good thing I am holding down two jobs - because I am going to need the money.

Dental care is not covered by Medicare. Australia has free dental care for children under 12 and for pensioners above 65. Dental care is also covered in the cases of life-threatening emergencies, or if it is assessed to have life-threatening impact (e.g. in case of diabetes or chronic illnesses). Otherwise you are on your own.

I suppose I could also get similar efficient professional businesslike dental care on the small island, if I steered clear of the cheap public dental care system and opted only to use private dental and medical care. However it had never crossed my mind as my grandparents, my parents, my siblings and all my relatives have only had experienced the public (government) health and dental care services where long queues, long-in-the-future appointment schedules and minimal patient care seems to be the norm.

I wonder if the Australia public healthcare / medical services are in a similar disarray as the "subsidised" medical services on the small island?

Perhaps private dental and medical services are affordable on the small island. I do not know. However as serfs, there is this mental barrier that "private" medical/dental care are for the rich on the small island and that we working-class peasants have to make do with what we have. No matter what the academics say, there exists a caste-system (even if it is just in the mindset of the populace).


And for the record, the dentist appears to be a first-generation immigrant from the Middle East. I am guessing from the his appearance, his slight accent that I could not place and his total lack of an Aussie accent and total lack of use of any common Aussie phrases.

(I add this note because I would otherwise expect to put up with the rude "Ang Mo tua kee" comments that seem to infest any attempt to reasonably compare / contrast different systems to how things work back there.)


The road by the beach which is regularly take back from the pizza job in the dark of night has a quiet serene beauty in the quiet of night. It is equally, if not more, amazing in the light of day when you can actually see the wild scrub and dunes against the sky and sea, lit by a setting sun. I was pleasantly reminded of the fact when taking the long way back along the beach from the dentist.

As I post this on Friday I would like to add the wound has healed niced. Still feels strange to have a gap in my back teeth, however the absence of constant pain is a welcome relief.


Blogger elin said...

Sharing my tooth problem. My R lower wisdom tooth has been an intermitent problem for the last 6 years - it would try and erupt, gums would swell and bleed and oh, that CONSTANT, GNAWING DULL pain... relentless - once, I could sleep lying down cos gravity would cause pooling and make the swelling worse and pain more. I got a consult here in Australia - very professional, but quoted 3K to have it and the other 2 remaining ones removed under GA. Of course I dont have 3K - I still dont. Went back to SG, dentist there said he could pull it out on the chair for 300. I dont know - one said GA cos the tooth was only partially erupted, one said no sweat lets just do it in the chair. In the end, I chickened out of the SG option, could not afford the AU option, so had to just live with it. Then I discovered - if I brush my gums really hard till they bled, and take anti-inflammatories to reduce the swelling and numb the pain, and avoid chewing on that side when the tooth played up, I could deal with the inflammation in the area and anything that bled really couldnt be infected. Hmmm.... So that has been my solution for the past 4 years, and 6 months ago - MY GUM FINALLY SPLIT. So now the tooth isnt a problem anymore when it tries to erupt. :) WARNING ; DONT TRY THIS AT HOME!

November 11, 2005 1:04 PM  
Blogger Tym said...

Glad your mouf is better :)

I used to go to a private dentist in Singapore when my parents paid for it. Yeah, you get what you pay for --- though while I had superb dental treatment, I did always have to wait at least half an hour or more after my appointment time. In contrast to you, I've been to the public dental health system and had decent treatment each time, without an excruciating waiting time. Then again, I've never had compicated tooth infections, either.

November 11, 2005 6:45 PM  
Anonymous mrs budak said...

I go to a private dentist in Ang Mo Kio and pay about $25 each time for cleaning. No nice sofas and no piped-in music (more like TV hanging from the ceiling showing Channel 8) but the service is decent. The dentist is a butcher but he gets the job done. I'm usually there early plus the dentist operates by appointment only so waiting time is not a problem.

But that's for normal cleaning.

For more complicated procedures, private will cost. Think about $1,000 for root canal and crown. Public dental care will cost half that, but you must wait 2 years for the crown (which apparently isn't as critical as the root canal itself). Most people I know go for private.

I had 4 wisdom teeth removed at NUH about 10 years ago. It had to be done at the OT as 2 of them were very badly impacted. Cost me $500 including ward stay (C class). I thought the service was excellent as I was operated on by the head of department itself.

In any case, I suppose you can say we're fortunate because budak's uncle is a dentist (not that we go to him for free treatment). Big brand name with branches in Bt Timah and Tanglin, but he started as a government-bonded dental officer as well...

November 13, 2005 7:19 PM  
Blogger -ben said...

I also grind my teeth in my sleep sometimes.

Thanks for the horrific write up.

Ugh! I dread visits to the dentist!

November 14, 2005 9:31 AM  
Blogger Venitha said...

Okay, so, like, don't you now need a bridge? I didn't think it was a good idea to just take a problem tooth out without reserving its space so the other teeth don't shift into it and cause even more problems. Of course, perhaps I've been brainwashed by overzealous dentists eyeing my insurance.

November 14, 2005 2:04 PM  
Blogger KnightofPentacles said...

Your comments totally bite!

Never thought readers would sink their teeth into such a toothy entry. And here I was thinking the blog was undergoing a slow decay.

Maybe I can cut my teeth as a writer on this entry? I would have to struggle tooth and nail - not to mention I would have to brace myself for all those rejections that would hurt my fillings.

Guess I best stick to my day job to extract the money to pay my rent. Not to mention to bridge the debt I hold across the ocean, which threatens to crown me with bankruptcy.

[ But on a serious note, no pain is good. As for the other teeth moving into the gap, that will take years to happen - if at all it happens. ]

November 17, 2005 1:26 PM  
Blogger Mr. Winston Smith said...

xzx xzx

November 21, 2005 3:28 PM  

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