Home > Focus on Japan 2003 > The Four-Visit Teeth Cleaning

The Four-Visit Teeth Cleaning

July 23rd, 2003

For foreigners living in Japan, visiting the doctor or the dentist can be a stressful experience. Frankly, the quality of medical services seems substandard, especially for such an advanced nation. This is not all due to the insurance system–the fact is, many doctors, and especially dentists, seem to lack sufficient training, or are far too overworked, or perhaps just don’t really care too much about what level of service they provide.

A dentist I visited in my neighborhood is a prime example. I went to that office simply because it was close and convenient. Boy, do I regret that. I lost my second molar on my lower left side, and had to get a bridge because I was not discerning enough. I had gone to that office for minor treatment before and things went fine enough, so when I needed more important work done, I trusted them. But the doctor screwed up, and how. He was supposed to just replace a crown. While removing the prior dental work, he exerted a startling amount of force on the tooth, pushing, pulling, yanking and so forth; but I took it in stride, trusting he knew what he was doing. Some doctors and dentists will do that kind of thing, in my experience. Then he told me to come back after the weekend for the second visit, and gave me a temporary crown, and warned me not to bite down on that tooth.

Over that weekend, I took extreme care to not exert pressure on the tooth. I say this not in pride but in admission to being somewhat neurotic about such things. I chewed only on my right side, and would stop whenever any food migrated to the left side. I did not touch that tooth with anything. But when I visited the dentist on Monday, he told me that the tooth was broken, and scolded me for biting with it. I was rather upset, considering (a) the care I had taken with it, and (b) the violence he had exerted on it the previous Friday. But there was nothing to do about it–he showed me with a mirror, and lo, the tooth was split. I had no choice but to let him yank it.

He asked me when I would make an appointment for him to make a bridge to cover the tooth. I gave him a look, left, and never went back. I got the bridge at a different, reputable dentist (one who speaks English well, by the way).

Dentists in Japan have a bad rep with most foreigners for reasons more than just this. I hardly know anyone who doesn’t have a bad-dentist story or two to tell. An Australian woman I worked with in the countryside told me of a dentist who filled a cavity so badly, the filling actually fell out, and she had to come back to get it refilled. When we visited a restaurant later that week, the proprietor, who enjoyed chatting with customers, sat down at our table and told us the story of a dentist who had come in earlier and told a lamentable story. Apparently, he had done poor dental work on this Australian woman, and had told the restaurant owner that it was because during the first visit, he was so preoccupied looking down the woman’s shirt, he did not do a good job on her teeth. Predictably, my friend was not amused.

I had another nightmare experience of my own a few years back. I went to an office that I had visited during a previous stay in Japan, as it had dentists who spoke English and did a good job. It was a modern office in a Shinjuku high-rise. When I visited again later, however, the dentists were different and did not speak English well, but I decided to give them a try.

I should have been tipped off when the dentist, trying to explain what he would do to me, pointed at my ailing tooth and said loudly, “TOOTH… NERVE… DESTRUCTION!” Knowing the language difficulties many Japanese have, I again took it in stride. But this one, apparently, did not know how to anesthetize very well. Although I insisted to him that I could still feel in the tooth he was trying to do root canal on, he pooh-poohed my objections and carried on. A few moments later, I experienced pain like I had never experienced it before. It was so intense that I literally could not stop screaming for more than a minute. Luckily for them, I had a late appointment and no other patients were in the office. Naturally, I never went there again, either.

One of the more annoying (but far less painful) idiosyncrasies of dental work in Japan is the multiple-visit syndrome. This is also true for doctors sometimes, but dentists are renowned for it. Most patients who come in will have the Kokumin Hoken (National Health Insurance), which has a somewhat convoluted payment system. One way for medical practitioners to milk the insurance system is to require patients to make multiple visits; the more visits you make, the more money they can collect.

In the past, this has resulted in my having to visit the dentist a rather obscene number of times. Root canal, which can be dealt with in three or four visits maximum back home, takes as many as a dozen separate visits here in Japan. Once I just wanted to get my teeth cleaned, and they scheduled me for no less than four separate visits–one for each quadrant of my teeth.

Some sound advice: ask your dentist, in advance, how many visits the work will require. If they tell you it will take any more visits than are necessary (in your past experience), then leave and see another dentist.

But this is not limited to dentists. Recently I had a small bump on my finger and went to a recommended dermatologist in Shinjuku to have it taken care of. They did an excellent job in removing it, but the biopsy results they got back from the lab they used were less than conclusive. So I asked to get the biopsy sample, so I could take it to Keio Hospital, where I trusted their results on that kind of thing better. The dermatologist’s office called me and told me the biopsy sample was ready, so I went over to pick it up–and was annoyed to find that I would have to wait half an hour to see the doctor. I insisted that I was just picking up an envelope, I did not need to see the doctor–but they insisted. Fuming, I sat down and waited. As I expected, when my name was called, I went to the doctor’s office, and all he did was hand me the envelope. As I left, they stopped me, and told me to wait for the calculation of the bill. Well, that was a bit too much for me. It was clear that there was absolutely no reason for me to have waited, and all they were doing was trying to get a consultation fee out of me when no consultation was required–it was a package pickup, fer cryin’ out loud! It wouldn’t have costed me much–410 yen I think it was–but I was already indignant and refused. I told them that I got no medical treatment, and was made to wait for half an hour needlessly, and I was damned if I was going to pay them for that! The receptionist, probably aware that I had them to rights, let up and told me that they would let me go “this time.” Well, they’re not going to get away with it next time, either.

In case you were wondering, the dentist I use now is Dr. Nishibori, 1-30-8 Sendagaya, Shibuya-ku, phone number (03) 3403-8885 / 8886. They’re practically right across the street from Sendagaya Station on the Sobu Line, and they take National Insurance. I got a full checkup and a bridge made there, with only a few small blips; they seem like a good outfit. For example, when it came to doing some root canal work, they referred me to another dentist when they easily could have done it themselves; it was a slightly unusual job, though, and needed special care.

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  1. November 20th, 2003 at 23:22 | #1

    Check out baddentist.com for some REAL dental horror stories about so-called “celebrity” dentist Larry Rosenthal!

  2. Daniel
    February 13th, 2007 at 11:11 | #2

    I have been living in Japan for awhile and think most Japanese doctors and dentist only care about money. What is even more scary here is the doctors and dentist that think that multiple visit are the way it has to be done and don’t even realize they are cheating patients and the insurance system. I don’t think the multiple visit practice will be going on much longer though as the Japanese health care system keeps spiraling further into debt and the government starts putting more and more limitation on doctors as the government finally starts to face up to the fact that doctors are cheating the system.

    I have seen better health care in developing countries than what I have seen here in Japan.

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