welcome to the tooth rort

Medicare.  Denticare.  Public health.  Anyone see the photo of the big tent in Tennessee in the latest Weekend Australian?  Set up in remote areas to provide health care for those who cant afford or access it any other way.  Set up by a retired Englishman.  Most of what’s going on in the big photo seems to be dentistry and if you read the article most of that seems to be extractions of teeth past help.

What was it like in the Olden Days Ma?  What do I know?  Not much but I’m going to learn.

Galileo (the First Scientist) had a beloved, brilliant daughter who was sent at early age to a convent.  This seemed to her old man the best solution as his kids were illegitimate and he couldn’t afford the dowry needed to make her marriagable.  Or he was stingy and selfish.  She died at about 30 but years before that had lost all her teeth. Galileo used to bring ingredients to make nourishing soups for her and the sisters.  (You can reach a point where you never want to see another bowl of soup or fruit smoothie. I did in Feb 2012.  I get thinner every day.)

Thomas De Quincy started losing teeth in late teens and wrote that 25% of all human misery can be ascribed to tooth pain.  He would blame it for starting him on his career as an English Opium Eater.  But he would, wouldn’t he?  (In the immortal words of the glorious mischief maker Mandy Rice-Davies)

Queen Elizabeth I used little paper cut out squares to fill in the gaps to look better for the court.

And there is Louis XIV, the Sun King.  About the most powerful man in the world in his day, at least in Europe.  Whatever was the ‘gold standard’ in healthcare at the time Louis XIV got it.  The Sun King could pay.  He got an abscess in an upper tooth, one suspects an obvious front tooth.  The “gold standard” bearer of the court assured him that with his most modern treatment the tooth and Louis’ royal looks could be saved.  By the time they’d finished with him the whole mouth was infected and all the top teeth had to be drawn.  Tough luck for Louis, but better than being hung, drawn and quartered.  As that genius Neal Stephenson points out he could have got a better deal off the first barber-surgeon he came to on the nearest bridge over the Seine.  For a tiddly fraction the cost and much less pain.  Just pull the bloody tooth and paste a little white square over like Good Queen Bess.  Vanity vanity.  And who is  this jospanner person anyway who gets her history out of science fiction?  What a dippy flake!

Why does it all cost so much?  Why do we have to suffer so much?  And don’t lecture me about overcoming suffering by abandoning desires (for lack of pain I suppose).  Bit hard to put in the necessary concentration when each breath is a spike through the head.

But what a RORT.   It is a truth well known to every dealer in drugs that people in pain will pay anything they can for relief, and thank you afterwards for robbing them and leaving them a bit more disabled.   Dentistry is a “profession” for upper middle class stand-over merchants:  “Pay up Charley or the pain will only get worse.”

You want implants?  You?  Ha ha.  Got credit card?  That’ll do nicely, what’s your limit?  Only $10k.  Not high enough.  Got a house you can mortgage?  Any salable assets whatsoever?   We’re not fussy old moralists here darling, its the 21st century.  Or, maybe you are what my charming local doctor describes as a “cashed up bogan” (now I’ve heard the term is used all over the place) and you can take yourself off to Thailand or wherever and Dr Sunil or Dr Patel can fix you for a fraction of what you’d pay in Oz and you can have a holiday too.  And no need to worry anymore about their competence says Doc Goodguy, mostly they are trained here or in America.  Yes, it’s a pity most of their fellow country-persons can’t afford them, anymore than we can afford ours, but our cashed up bogans (whose kids will never get through the quotas into dentistry or medicine because foreign fee paying students got there first), can, sometimes.

Back to cost.  Late last year I made the first of a few visits to the Museum of Dentistry at the Dental Hospital.  An eye opener.  You can do it pretty quick because in 3000 years there aint that much history.  Plates, dentures, bridges, even implants were all thought of (they are all blindingly obvious solutions) way back.  Great stories about those who hunted through the battlefields ripping the intact looking teeth from the corpses.  We didn’t invent recycling in the 20th century you know.  This was for the wealthy only but if its any consolation the recycled teeth usually rotted in their gums.  Perhaps they waited too long or not long enough.  Perhaps they hadn’t yet caught on to the transmission of germs.  It was still the days of rampant childbirth related fever in hospitals, such as they were, and home births were the safest option if you wanted the baby to live.  It was still the days of cholera and the Broad Street pump. We had to wait for modern infection control, hygiene, hand washing and titanium.

My point is that you are not paying for Research and Development in dentistry.  There hasn’t been much. Sure there have been changes and improvements in materials technology and industrial design which dentists have utilized, as  do we all.  As for R and D in Dentistry, apart from creative accounting I doubt there has been much creative thought for 3000 years.  It doesn’t look like it at the Museum anyhow although its a fascinating and worthwhile collection.

I’ll keep looking though because I don’t claim omniscience.  I got plenty more to say but I wont say it all today.  Next time I plan to tell yousall about my fun times trying to use the (old) new government dental plan. circa 2012.


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