The Chinese View of Dentistry

 Recently, I was traveling with goods friends of mine, John and Cindy Cancelliere. John is a dentist extraordinaire and he was on his way to Spain for discussions on cutting-edge developments in dental implants. Despite my gentle ribbing that holding the class in Spain was because the dental techniques he’d learn there had actually been practiced during the Spanish Inquisition, our discussion soon turned into how the Chinese view dentistry.

Dentists in China have an image problem. The Chinese, as a whole, just don’t like to go to dentists. Not that they differ, in that respect, from people in other parts of the world. And I’m one of those. It’s a close toss-up whether I’d take an IRS audit over a trip to the dentist with the later just marginally edging out the IRS.

In China, many beliefs are passed down generationally. A majority of Chinese, for example, believe as their parents did, that it’s natural to lose all your teeth with age. Furthermore, that even with dental care, it’s unlikely that one can retain their original teeth. This view is especially prevalent with older people. Older Chinese seldom place much value on look of one’s teeth. It’s expected that one’s teeth will yellow, darken, and eventually become lost with age. In addition, many are taught by their parents that a dental cleaning, such as that performed by Western dentists, will eventually wear down your teeth and that flossing, for those that have even heard of floss, will eventually create gaps between your teeth.

Because of these beliefs, and the subsequent lack of focus on dental hygiene, it’s projected that half the population of China have dental cavities. This figure is even higher in children. According to 80% of urban children and 60% of rural children are thought to have cavities. Moreover, 97.1% of children suffering from cavities do not get them fixed. Part of the reason for this is that parents will only take themselves, and their children, to dentists when there’s pain. Therefore, according to the Journal of Dental Research, 23% of middle-aged and 24% of the elderly had visited a dentist within the preceding year with most of these visits due to existing pain. Furthermore, government educational programs have been limited with only 10% of Chinese schools teaching dental hygiene to children.

In the past the government has not placed much emphasis on dental care and has therefore provided only a small number of dental clinics relative to China’s population. According to a March, 2013 article in the South China Morning Post, even in Hong Kong people sometimes queue at 5 AM to get into one of the limited number of dental clinics in the city. Others may stand in long lines at a hospital for similar dental treatment. Moreover, this is the only option available to a majority of China’s population. Private dental care is beyond the financial reach of most Chinese. Western-style dental clinics are even more expensive for the average Chinese and are usually found only in larger cities.

The Chinese government is trying to change this and improve both dental care and dental awareness. In 1989, for example, it launched National Love Your Teeth Day, celebrated on September 20th. In addition, they’re increasing the construction of dental clinics. There’s also an increased emphasis on teaching children dental hygiene and to brush twice a day and to not consume as much candy (good luck with that). Even so, dental hygiene seems to be practiced more among the higher socio-economic classes within China who pay more attention to their appearance and their teeth. As China becomes more internationalized, and this socio-economic class interacts with the outside world, dental appearance becomes more important and is also used as a reflection of one’s social status.

For older people, and those lower on the social stratum, particularly in rural China, the care of one’s teeth is not a priority and a visit to a dentist costs money. Therefore, dental visits are made after the pain has reached a point where a procedure, such as an extraction, is necessary to relieve this pain. It’s still not unusual in some remote rural areas for dentistry to be practiced with home-grown techniques such as pumping a treadle drill by foot and the use of pliers for extractions.

In addition to increased government efforts, and increased dental hygiene as a result of rising socio-economic wealth, dental awareness is also improving in China because the young. Young people want to look good and have bright smiles. They see movie stars, television personalities, and other entertainers all smiling brightly and they want to emulate this. Therefore, younger people in China are tending to gradually move away from traditional biases and adopting more Westernized approaches to dental care.

Alan Refkin

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