Friday, March 28, 2008

Der Zahnarzt

This morning I had my first experience at the dentist in Germany. On my sister's first night here, I chipped a front tooth while eating ice cream (only a klutz like myself could manage this). We found a dental office with English speakers and made an appointment.

I was quite nervous because the appointment happened to occur at the same time as a horrible cold sore outbreak. It popped up on vacation and it was Easter Monday, so we never came across an open Apotheke, and I had forgotten my trusty Abreva. Hence, I got the worst cold sore in recent memory because it went untreated for about 24 hours. On top of that I have a little spot of gingivitis in the back that flares up 2-3 times a year, and happened to start to flare up last night. So, I expected all kinds of lectures on the horrors of HSV-1 and gingivitis, as I have received from previous dentists in the US.

Thankfully, they were quite nice and focused on the matter at hand. No lecturing about how my teeth are crooked and I need braces, on the evils of herpes, or on the "pockets" in my gums that will lead to my inevitable downfall. He fixed up the cracked tooth, looked at the other teeth, and recommended only a filling for a very small cavity, and a minor cleaning. However, the filling isn't covered by insurance and costs 30 EUR. I asked about this, and it's because my insurance only covers the silver-colored amalgam fillings, and this dentist doesn't do those type of fillings. He only does the tooth-colored ones. The assistant tried to tell me the tooth-colored ones are better, but I remember the dentist in Boston telling me that the cheaper silver-colored ones are actually better and last longer. So, perhaps I found myself a good, but posh, dentist, who wants to get more money by not doing the things insurance covers. I guess I should look elsewhere for that filling. It's in the back, so it doesn't really matter what color it is. The cleaning will also be 40 EUR. Does anyone have experience on insurance in Germany covering those? Forty EUR is not bad - cleanings at my dentist in Boston cost $99, but I never had to pay because insurance completely covered 2 cleanings per year.

In other fun at the dentist, I had to fill in the standard patient questionnaire with demographic info and medical history. It had been translated into English for dummies like me with poor German. The title of the page read, "Anamnesis elbow for the patients of dentistry". Hee hee! Anamnesis is an overly medical word for patient history - I had to look that up - but it's correct. Elbow, however, is pretty funny. I know from work and class that the German word for questionnaire is Fragebogen. The word for elbow is Ellbogen. Rainbow is Regenbogen. So, Fragebogen, directly into English, is kind of like Questionbow. Somehow they translated it to elbow. That is kind of awesome.

It's in the nature of Germans to correct things like this. They love to help you and inform you, as off-putting as it might seem to Americans (we tend to be quite sensitive, I think). I debated for a while about whether to tell them about the mistake. In the end, I just couldn't do it. My German is terrible and I don't feel that I have a right to correct anyone's English at the risk of making them feel stupid. They probably wouldn't feel stupid, given they are used to correcting and being corrected with each other. But, I still couldn't do it.

Lots of photos of our last vacation coming soon! I'm dealing with a lot of administrative stuff and class stuff right now, but I'm working on the vacation stuff here and there.


  1. Cleaning - depends (heavily) on the insurance company. Some pay one per year, some two, most don't pay any at all. TK for example (as the biggest insurance company) doesn't pay anything.

    They also don't cost the same anywhere, some dentists take a set amount, some per time, some per tooth.

    Btw, if you have stuff that has such extra costs like that filling, and feel... errmm, adventurous... you could try the [i]Kopfklinik[/i] in Neuenheimer Feld. They do some of this stuff for free, however you'll have to let [i]students[/i] work on you for everything except emergency stuff (with professional supervision of course).
    With the risk that they mess it up and you'll have to sit there for them to fix it again.

  2. Elbow - I love it!

    Germans are not known for having good teeth so it's pretty hard to shock a German dentist. The whole dentistry thing here is set up to happily fix what's broken but not to prevent it happening in the first place. That's why prophylactic measures like a good cleaning are rarely paid for by insurance. EUR 40 is a really good deal, though. I think my dentist charges between EUR 75 and 90 and many go waaay beyond that. Seems to be an individual thing.

    Also, there's a lot of contoversy in this country about silver amalgam filling and whether they give off harmful mercury vapours. I don't really buy into the panic and still have some amalgam fillings, but a lot of people are having them removed (and subsequently getting themselves entgiftet, because Germans are really big on Engtiftung) and replaced by the plastic ones. Your dentist may just be on the amalgam bandwagon.

  3. My cleanings cost around 80 euro and they are never covered by insurance. After informing me of this fact, my dentist always tells me what strong and healthy teeth I have compared to his usual patients. I'm not sure if he is trying to be ironic.

  4. Kato, is the Kopfklinik the same thing as the Poliklinik? A friend told me about the Poliklinik and I tried to go there first, because I figured they would be unlikely to recommend unnecessary work. They weren't taking any new patients, though.
    You called it - I have TK.

    Christina, yeah, the mercury is stable and I have absolutely no worries about that. It doesn't surprise me that there's a large segment of Germans worried about it, though!

    Blythe: Maybe I should stick with this guy since two people now have said their cleanings cost more!
    I got a kick out of them telling me today I had great teeth, because I heard the opposite in the US for years. Americans, we thrive on fear, and our dentists seem to have that figured out...they can get $$ by instilling in us the fear of having terrible teeth.

  5. questionbowwwwwwwww!

    i can't believe you're just NOW going to the dentist! it's been like forevar. but even more miserable is the damn cold sore! damn! i hate them!

    um, we haven't skyped in far too long. i have music to send you!

  6. Poliklinik just means they do a variety of stuff, the Kopfklinik contains like 15 Poliklinik departments by itsel ;-)

    Just looked it up, according to their website, they "transformed to a intensive-research center". Pity. Well, ok, not that their work was all that good really. I transferred to a "real" dentist after a series of visits there.

    I actually know a case of mercury poisoning, stemming from (presumed back then) pieces of a broken amalgam filling entering the bloodstream through a tiny wound in the mouth. Bad luck i guess. Was rather severe though, temporarily paralyzed facial muscles and all that, wouldn't want anyone to experience that.
    I still have my own amalgam fillings btw.

  7. My US dentist once asked me to rate my smile between 1 and 10. He was obviously setting up to sell me some cosmetic treatments. (I gave myself a 10 - out of sheer orneriness more than anything else.)

  8. I work at a dental office and just wanted to say that you are RIGHT! Silver/amalgam fillings last longer and are more durable than white composite fillings. The composite fillings slight shrink after curing, which allows bacteria to "sneak" underneath the filling and decay. Also, composite fillings have been know to be more sensitive than the amalgams. I live here in Orange County (CA) and it seems that dentists have been marketing the new composites are the "better" filling, but in reality, unless the cavity is visible in the front, the dentist is just interested in the extra $ from the composite filling. The mercury scare has been largely documented and I think JADA and ADA have articles online.

    Hope this helps :)

  9. Sara: My teeth were fine, so no need! :) Although if my insurance bugged me about it like they did in the US, and paid for it, I would have had about four German cleanings by now!

    Mary: That is hilarious. Right on with the 10. :)

    Emily: Thanks for the confirmation! I'm trying to decide how much worse composite is now...because I don't have to find another dentist if I just accept it....argh!


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