Print Page - RW dental problems – lack of money or culture

Very often I read on this board reports of men who bring RW to the US and have to spend lots of money on fixing their dental problems. I wonder what’s the reason for these problems.

I guess some of men would like to tell me: “Tootsie, you can talk about it because you live in Moscow, don’t have financial problems and can afford to visit the best dentists as often as you want. You have never been in shoes of poor Ukranian girls”. That’s right but let me disagree with you. Even if I was completely poor I would still hardly have any dental problems. Why? Because it’s culture here in Moscow to have good teeth.

Let’s imagine that an American was put to the Ukraine and made as much money as most people there do. Will he in some time have as much dental problems as most people there? I doubt it. First he would brush his teeth “correctly” 5 minutes in the morning and in the evening. Second he would walk everywhere with a tooth brush and toothpaste in his pocket and would brush teeth after each meal. Third he would use dental floss. Fourth he would probably wear old shoes, boots, coats but spend as much money as it is needed for the dentist. Because it’s his culture.

Dental care is not expensive if you take care of your teeth properly and visit dentist 2-3 times a year but certainly it can be very expensive if you go to dentist once in a decade and need to fix 20 teeth.

I didn’t want to abuse your spouses by this post. Probably it wasn’t their fault that their parents didn’t teach them to take care properly of their teeth and the surrounding people paid more attention to how well a person dressed than to his mouth problems.

Am I mistaken?

Tootsie

... in response to RW dental problems – lack of money or cu..., posted by Tootsie on Nov 28, 2001

Seems like all of the replies posted focused only on the bad dental work in the fsu. What about the root cause of the problem teeth? I met a beautiful lady in Ukraine that had lousy (as in messed up, ugly, black) front teeth and all of her teeth really. And I've seen so many photos where the ladies keep their mouth closed and don't smile and upon meeting them find out that the reason is not a culture that doesn't smile but rather bad teeth. What I'm saying is that although bad dentists and lesser technology has caused problems, the root problem is before it gets that far. I don't know what it is. Maybe poor hygiene, maybe lack of floride in the water, maybe weak genetic traits in that area, maybe eating or drinking stuff that is bad for teeth, maybe the environment, who knows maybe even Chernobyl??? I just broke a tooth while eating a tootsie roll and had to get a crown. The bad thing about crowns is that insurance only pays half. Anyway I tend to agree with what Tootsie says about culture and being taught by parents in Ukraine because some ladies teeth are o.k. and others are very bad.

... in response to Re: RW dental problems – lack of money o..., posted by Ramblin on Nov 29, 2001

When my wife and her son first arrived here in California, her 7 y.o. boy always demanded Coca Cola when we were out and about, she also liked Cola. I explained to her that Cola is not only loaded with caffeine but also carmlized syrup and phosforic acid...both bad for the teeth. It took them a month of cola withdrawls to finally get to them both to drink milk and more water, the water was the hard part because they think all tap water is bad to drink. Now they both drink a lot of milk at each meal.
Anna told me that it was discussed in Russia that we Americans drink milk with many chemicals, and that the milk is not "natural". In Moscow her son had never drank milk at home ...just cola, he did have goats milk at her dacha but not often.

I needed to de-bunk her theory on milk here and took both her and her son to a dairy owned by a good friend of mine.
Not only did they get close-up and personal with cows being mechanically milked, they also saw the milk processed by heat pasturation and then bottled..ready for shipment to the store under very sterile conditions . She called her mom when we were back home to tell of this "new information". (smile) She seems to do a lot of that!

Yes, fluoride is a key factor to make the enamel stronger but I think the American way of drinking milk by the gallon when we were kids says a lot also for the strength of our teeth. Good parents here do not allow their kids to demand candy and cola...as is the trend in Russia. Anna was horrified when I told her that I do not buy sweets for my child...and that my 12 y.o. daughter only drinks water and milk(she has never had a cavity). Her son is now sugar and caffeine free and his behaviour has improved a lot, he knows to not demand and accepts treats with much more appreciation now. He is a very smart kid, but lazy when it comes to doing things like reading...his spoken English is improving every day...we have to watch what we say now because he will repeat everything we say like a parrot...over and over (it was cute, but now it gets kind old) smile..

It gets better each day..with my Russian wife.

I have no real complaints!

... in response to Re: RW dental problems – lack of money o..., posted by Ramblin on Nov 29, 2001

You start with some pretty decent hypotheses about the problem, and then conclude with an affirmation of Tootsie's ridiculous assertion that it is a cultural issue. That assertion is both flatly wrong AND insulting. Have you any empirical evidence or direct observation to support your position??

As to your earler comments, there is definite merit to some of your thoughts. Clearly the lack of fluoridation in the water is a major contributor. Clearly there are environmental factors - and possibly genetic factors (though I doubt it) that could be contributory. There is also a likelihood that a poor diet (not bad foods - just not enough healthy foods) may also be contributing. Chernobyl?? Well, I'm not sure anyone can say definitively one way or the other, but the west does have quite a few people studying and monitoring effects of Chernobyl, so I think it is an unlikely cause.

The suggestion that this is either a cultural issue or one of personal hygiene astounds me. No-one who has ever spent time with the residents of Ukraine would make such a wild-assed assertion. Certainly there is a minority of people in all countries who are not concerned about personal hygiene, but that cannot be said about the population of Ukraine in general - at least not in truth.

And just for the record, Olya reminded me yesterday of one of our neighbors. She and her family are all from Russia - Moscow, to be specific. She is a beautiful lady and very charming. She has been a terrific help to Olya over these initial months. She also comforted Olya when we were in the early stages of getting dental work done and Olya didn't know what to expect. It turns out that this woman - from a relatively wealthy family in Moscow - had horrible problems with her teeth as well, when she first arrived in America. So I guess even Muscovites can fall victim to dental problems - no matter the source.

- Dan

... in response to Re:What about dental schools????, posted by William on Nov 29, 2001

When my sister was going through dental school she worked on my mother. Of course, my mother paid for the gold crowns but. But bear in mind they definately take their time when doing the work.

In fact, I had a wisdom tooth pulled at one. (Baylor in Dallas). The put the gas to me and I was out like a light.
Woke up and all the work was done.

These are usually 3 or 4th year students, so they know what's going on. The do alot of homeless people and down'n out. But this is a excellent avenue...

Has anyone tried any local barber colleges for haircuts ?

... in response to RW dental problems – lack of money or cu..., posted by Tootsie on Nov 28, 2001

Hello Tootsie!

Anna and her 7 y.o. son visited my dentist 3 weeks ago, the findings were not good. After full mouth x rays and the mouth camera snapshots Anna could not believe her mouth was in so bad shape. She visited her dentist 3 times in the month before her arrival here to "fix" a few problems and her son had a few cavities filled. She brushes her teeth twice a day and is very concerned about the whiteness and cleanliness of her teeth.

My dentist was very frank with her....she needs about $5,000
worth of re-work.When she was a teenager she had 2 root canals that in itself was o.k. but the teeth were never capped. Those 2 teeth are totally black, her russian dentist explained to her that the root canal killed the tooth so she will never have pain...but never told her that she will now lose the teeth because the enamel is crumbling
and is about to break off. She needs 2 new root canals to fix the problem her dentist caused by not drilling out the decay prior to filling her teeth. Lastly, she has never had her teeth cleaned...her gums are bleading due to lack of deep cleaning at the gums and may need to visit a Periodontist for consultation.

Her son has a different circumstance: Her russian dentist removed 4 baby teeth that were severly decayed in lieu of a root canal. This decision was made from lack of knowledge and will cause her boy to have many bite problems that can only be fixed by expensive orthodontics when he is 11 y.o. In addition he has 8 cavities that were not filled a few months ago and will definitly need 2 root canals on 2 adult teath that were filled but never drilled to remove decay.

Anna was in shock with all of these findings...had it not been for the x rays and mouth pictures she would not have believed my dentist, who by the way is a client of mine who I trust very much. He explained to her that the russian dentist just slapped a plastic filling onto the surface of the teeth and never really had explored the depth of the decay in her teeth. He warned her if she does not deal with the situation in the future, she is going to not only loose half of her teeth but will have trauma caused by the decay entering her jawbone....causing her to much pain that can not be fixed.

My suggestion Tootsie, next time you are in California visit a dentist and get consultation with x rays. If he finds you do need some work, take the x rays back to Moscow with you and get the work done there...it will be done at a fraction of the cost here. When Anna gets her green card she will go back to Moscow and her first priority to get all of her teeth redone.....she will not allow me to spend the money on her here...as always she says "too expensive".

... in response to RW dental problems – lack of money or cu..., posted by Tootsie on Nov 28, 2001

I visited dentist's office couple months ago after I lost one of my fillings... :)

That was only than that I discovered that one of my root canals was not even filled and the other filling was made out of unknown material which could not been removed by any drill.... lol

Of course my problems were not major, but I have done whatever I could this year and will be going back next year again, so that I don't have to pay anything out of my pocket and have all the work covered by the insurance....

The only thing I still do not understand why some guys have to spend $10,000 upfront, but on the other hand I guess I am lucky to have two dental care plans (from my work and secondary under my husband's plan). So, it reallt depends on the situation..

... in response to I thought so too until, posted by RW on Nov 28, 2001

When I was in the US I paid attention that the vast majority of Americans had very white excellent looking teeth. First I thought (and I still think it's correct) that it's because they brush teeth after each meal, not only in the morning and in the evening as we were taught here. Even in WC at the airport it was common to see women brushing their teeth. Is it really as common "there" as I think? Did you also start to follow this habit after you moved to the US?

When I came back I consulted my dentist about whitening of teeth. He said it could be done with acid and then with special paint and if you do it once you would have to pay $300 for whitening every 6 months (plus-minus). Also, the teeth will loose their natural transparence. Actually he recommended me not to do this. Is it common in the US? Is it also as expensive?

By the way, a couple of months ago I found out that my route canal was not filled. :) I almost got disappointed in "Russian dental medicine" but then I found out it could happen very long ago and before "perestroika" :).

Thanks in advance for your answer,

Tootsie

... in response to May I ask a question?, posted by Tootsie on Nov 28, 2001

Teeth whitening technology has recently evolved from the days when they useds an acid. This old process did in fact cause many problems ...such as thinning the enamel and as such caused tooth sensitivity to hot and cold.
The new technology is a bleaching, and fairly safe but not a perfect solution to teeth that are not naturally white.It only bleaches any stains caused by smoking or coffee/tea and can make your teeth appear a few shades whiter than they already are.
You may have seen some people with veneered front teeth, which is the process most people in the movie business get done....and that costs about $1,000 per tooth..ouch!

... in response to May I ask a question?, posted by Tootsie on Nov 28, 2001

Here in the US, the whitening agents utilized are normally a strong form of hydrogen peroxide. The way in which they accomplish the "whitening" is they go into the many small pores that compose the tooth and they clean out these pores - thus making the tooth look much whiter. It is definitely NOT conducted with an acid, though the agent is strong enough that it will sometimes irritate gums. Yes, it is true that it needs to be repeated periodically - because the pores begin to darken over time - especially if people drink lots of tea or coffee or are smokers.

Tootsie, you may not have intended it, but each time I read your original post, I get irritated. It strikes me that you were offering a VERY condescending view of anyone other than Muscovites. It further struck me that you were accusing anyone suffering from dental problems as lacking culture. Candidly, it irritated me - which is unusual for your posts. I usually find them spot on. Just wanted to bring this (gently) to your attention.

- Dan

... in response to Whitening Agents . . ., posted by Dan on Nov 28, 2001

Dan,

When I read that somebody had to spend $10 000 on teeth I just thought (before all the explanations) that probably this person doesn't know how dentist's room looks like. Sometimes I just forget that your prices differ too much from "our" prices.

When I go to dentist I usually pay:

- nothing for watching my teeth
- $3 for cleaning the teeth with ultrasound and pastes etc.
- $ 12-15 for a filling if I need one
- $3 for x-ray if the doctor thinks I need it
- $6 for computer tomography if I need it
- around $30 for treating of pulpitis (I had it once) but this includes taking off nerves, filling canal roots etc.

Can you imagine what is $10 000 for a dental work here?

Regards,

Tootsie

... in response to Sorry Dan,, posted by Tootsie on Nov 28, 2001

The technical term is "Ethnocentrism", the belief that one's own culture or ethnicity (and in particular the capital of that culture or nation) reigns supreme, and the further out you get from that center, the more inferior you find people. It is part of human nature (defending the "us" against an unknown "them") and common in ALL cultures to some degree. It is especially noticable in expansive but insular world empires such as the U.S., Russia, France, Japan, etc. It doesn't mean a lack of culture, just a lack of perspective due to insularity (a common enough malady put in remission by frequent travel abroad).

... in response to May I ask a question?, posted by Tootsie on Nov 28, 2001

I am certainly not an expert, but here is what I found:

1) Dental care in US is much better in preventive care - teeth cleaning is scheduled at least once a year, my doctor recommends to do it twice a year. I don't know what kind of material they use, but it was much better than anything I have ever done in Russia (and I visited all kind of expensive places with new equipment). Also, there was no paint involved, so I am not sure which type of whitening your doctor recommended. At my dentist teech cleaning costs about $100.... but again, may be we are talking about different procedure? I saw a lot of commercials on TV on teeth whitening, but I don't remember costs.

2) yes, americans take a good care of the teeth. The very best thing I found here is Sonicare toothbrush - the one which runs on battery and does all the work for you :)

3) vast majority of Americans have crowns which are of much better quality that the ones made in Russia. I don't know what is in the material, but it is much more resistent to the tea, coffee stains, etc. Plus if you do the cleaning regularly you will certainly have it "pure white"... :)

Russian Wife

... in response to Re: May I ask a question?, posted by RW on Nov 28, 2001

First I thank you and all the guys who answered my question. I did get a little scared especially after apk's post but I still trust my dentist and hope for the best :). By the way, in the clinics I use to go they use x-ray and regular cleaning of teeth (both ultrasound and pastes).

My next question is about this toothbrush on batteries. Several years ago I bought a very expensive Braun toothbrush (over $100 here) and was very happy because it really did all the work for me :). But my dentist was against this brush. He suggested that I used normal "cheap" toothbrushes of different toughness (hard, soft and middle) and brushed the teeth only in directions up-down. He explained that my teethbrush could ruin the enamel by its round movements. I still use it but he gave me some kind of doubt... What do American dentist say on this?

As for teeth whitening Russian dentists say that natural healthy colour of teeth is not completely white. I consulted several dentists and all they say the same: natural colour of teeth is not white (I mean real blue-white colour). I doesn't depend on how you take care of it, it's just natural colour. The technology that they use here (and pretend this is "American technology") is that they ruin the enamel with acid completely (one just has no enamel at all after the procedure). Instead of enamel they use this special paint which is good for not more than half a year. Again, I want to thank you and all the guys who explained to me the real situation.

Tootsie

... in response to Toothbrush on batteries..., posted by Tootsie on Nov 28, 2001

I just started using the sonicare toothbrush 2 weeks ago after my denist highly recommended it. They say its the best thing out there for your teeth. Not only does it "do the work for you" it also emits a ultrasound wave that helps loosen stains and cleans a little under the gumline.
And on another note, our daughter Katya went to the dentist in Ukraine in Sept and had 4 fillings done and when we brought her to the dentist here, there was no evidence of the fillings, just 4 huge holes were the fillings were. He just sealed them for now and she has an appointment on Jan 3rd when she will be on my insurance. This has Marina a little worried as she saw the same dentist and while she has never had any big problems, she realizes how bad their dental care was over there. Though she is looking forward to her appointment early next year too.

... in response to I thought so too until, posted by RW on Nov 28, 2001

There is a real mystery around the topic of dental costs and how much, if anything, dental insurance really covers.

In our case, the majority of dental work was covered under our dental plan - and the TOTAL cost was approaching $10,000 with my part of it being around $3000 or $4000. The interesting thing was, when I was transitioning to a new dental plan and there was a gap in coverage and the dentist suggested doing some work, he also offered that they would do the work at the same rate (to me) as it would have cost under the dental insurance. In other words, it would have cost me no more whether I had dental insurance or not - and the only difference was in how much the dentist's office would charge to the insurance company. I suppose what it points out is how much 'margin' is in the rates the dentists charge when there is an insurance company involved. Maybe there is a more rational explanation, but I have yet to uncover it.

FWIW

- Dan

... in response to RW dental problems – lack of money or cu..., posted by Tootsie on Nov 28, 2001

Olya takes (and took) fastidious care of her teeth. In spite of doing all the things you outlined (frequent brushing, regular visits to the dentis, etc.), her dental problems were significant.

The dentist here, who has seen other FSU patients, tells me it is due to a variety of factors, such as:

* use of poor materials. Some of the materials used for facades have difficulty bonding to other materials used elsewhere on the tooth.
* exceptionally poor workmanship. We had 2 cases of root canals that were left UNFILLED! In other cases, the dentist simply failed to care enough to polish the facades or improve the appearance of their workmanship.
* infrequent use of x-rays to see beneath the surface of the teeth. This is particularly important when a dentist has applied an artificial facade to a tooth and it obscures what may be going on subsurface.

It is worth noting that Olya too, had a good job in Ukraine and spent quite a lot on her teeth - too much, as it turns out. She also was not content to visit only one dentist - she checked around and saw several over the years.

Facts are - the dental practices BY THE DENTISTS in many parts of the FSU are vastly sub-standard in comparison to modern western dentists. That is not to say that someone cannot get decent care in the FSU - only that it will take some serious searching and study in order to find them.

Finally, lest you think I use only a single data point - I do not. I have many colleagues and friend in Kyiv and Lviv (and elsewhere) and the example I used above with Olya is typical of other's experiences as well.

- Dan

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