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Saturday, June 15, 2019

Student Dentistry







By Thom Nickels
Wed, May 22, 2019
Philadelphia Free Press

Going to the dentist has become an extremely expensive proposition, so it’s no wonder that people who struggle financially have problem teeth. Dentists are abhorrently expensive and few people have dental insurance.

I go to Temple Dental, a clinic run and staffed by Temple Dental School in Philadelphia. Temple Dental was fairly economical ten years ago but the prices there are now approaching normal dentist prices. As for “normal” non-clinic dentists, I’ve had my share of them when I lived in Center City. They charged “Center City” prices and those prices are not cheap.

It’s important to take care of your teeth. That’s why I brush three times a day and floss regularly but all of this attention doesn’t seem to matter when your family’s dental genes point to problematic teeth whether you floss, get your teeth cleaned four times a year, gargle 100 times a day and avoid sweets. Bad dental genes will do you in every time.

It’s no wonder that some people just give up.

My otherwise perfectly charming Center City dentist had to become history when a friend of mine suggested Temple Dental. Still, I was reluctant to give a dental clinic a chance because the idea of having students work on your teeth seemed suspect and scary.

Would the instruments used at a clinic be as good as the instruments used in the office of a downtown dentist? After all, I had heard horror stories: A woman friend told me that at one student clinic she visited a drill broke in her mouth. Imagine that! Apparently, the student dentist couldn’t get a proper hold on the instrument—dainty hands? --and the drill slipped.

On another occasion, a dental student cut himself while working on her teeth and blood from his wound ended up in her mouth. My super cautious friend followed up with a Hep C and HIV test, both of which were negative.

While a dentist has never broken a drill in my mouth, I’ve had to suffer through marathon sessions in the chair as an especially slow and methodical student worked in slow motion, stopping every so often to have an instructor examine the work. In many ways, I’ve been lucky because the treatment I’ve received at Temple Dental has matched or even surpassed my downtown dental experiences, and when I got the bill it was radically cheaper.

But dentists are human, however, and mistakes happen.

Jonathan Beck, in an article entitled, “Should I go to a dental school to have my teeth fixed?” writes that a friend of his once described her dentist as having butterfly hands. “By that standard,” he continues, “mine has rhinoceros feet. Case in point: My week-four visit was the day the fillings started. After about 20 minutes or so of painful drilling on a lower molar, my student called over a faculty member to check the progress—to see whether the tooth was ready to be filled. Not quite, so a few more minutes of drilling, then another supervisor came over to check again. This one looked at the tooth, turned to my student, and informed him that he would have received an automatic failure on the drilling section of the dental exam. “

The best student dentists at Temple seem to be Mormons from Utah or other parts of the West. I don’t know why Mormon guys are attracted to the world of dentistry but I noticed this trend years ago when I asked one student dentist where he was from and he said Utah. When I then asked him if he was Mormon, he said that he was. (By the way, there are no references to Mormons and dentistry in the current hit, The Book of Mormon).

Conventional wisdom dictates that you can “spot” a Mormon student dentist because they are so nice. Mormon student dentists have the copyright on “nice.” This does not mean that non-Mormon dentists are not nice, but the Mormons, mysteriously, seem nicer than the average student dentist. They tend to smile a lot.

One Mormon student dentist was shocked when I told him that I had read No Man Knows My History: The Life of Joseph Smith which is a 1945 book by Fawn McKay Brodie while still in high school. When I rattled off a lot of other Mormon trivia —in between the insertion of cotton swabs, cherry flavored Q-tip probes and needles--he was bold enough to suggest that I might be interested in going to the Convention Center to hear the current LDS church president speak at an open forum. While I thanked him for the invite, I told him that I was quite happy with my own religion. “But,” I added, “that cross country Brigham Young Mormon wagon train story gets me every time.”

I’ve never had a Mormon female student dentist, at least as far as I know, and that’s probably because female student dentists are less forthcoming when it comes to sharing personal information. Foreign female student dentists tend to be very secretive and remote when it comes to casual chattiness. They are the first to address you as “Mister Nickels,” as well. This is a cultural thing, of course, as nothing off-putting is meant by never calling you by your first name, despite the fact that dentistry is so amazingly body intimate. Dentists, after all, not only put their fingers in your mouth, but they stretch your lips, sideline your tongue, and peer into your mouth as only a lover should.

Once I had a very strong Cuban student dentist who didn’t know the power of his arms. He would drill with such gusto and depth that the residual pain afterwards was the most intense I’ve ever experienced. And it was due to his muscular hands and the power of his arms.

Last year, a Jewish female dentist from New York kept me talking and laughing so much that other student dentists would look over into our cubical and ask what all the commotion was about. Some assumed that we were longtime friends.

Having a different student dentist every year (when the students graduate you are assigned a new dentist) gives you a good window into the types of people who make up the world of dentistry. A recent student dentist, who hailed from India, was initially very formal and decidedly un-chatty. She called me “Mr. Nickels” so many times that I began to think of my father when he wore those crush and fold fedora hats with one of his architect’s suits.

“Mr. Nickels, what will it be, a porcelain or gold crown?”

If you were to ask a child this, they would almost always respond, “A gold crown,” but gold, while it lasts longer in the mouth, could be an object of veneration by thieves and muggers if you’ve no money to give when accosted in some dark city alley and if, God forbid, they discover that the only valuable stuff you own is in your mouth. I’ve heard of grave robbers going into coffins and taking out gold fillings in order to be able to do the gold for cash thing. “I choose porcelain,” I told my student dentist, “not because of thieves but because porcelain looks like a real tooth.” After all, a gold tooth can flash on and off like a neon sign when you open your mouth.

“Most people choose porcelain,” my student dentist said.

Dental veneers are all the rage. Just open an issue of Philadelphia Style magazine and you’ll lose count of all the blinding white fake smiles, so bright they could break glass. Veneer mania has spread throughout society like the Mormon plague of locusts. It started with Hollywood celebrities then worked its way down to politicians, lawyers and real estate agents (the real estate profession has become so “glamorous” one would think that the average realtor moonlights as a model). Contractors and plumbers are now getting into the act, and even yours truly was sucked into the veneer vortex, although what most dentists neglect to tell you is that these marvelous too white teeth only last about a decade.

I once told a friend that I felt exposed and imperfect after a student dentist has spent hours peering into my mouth and poked through the maze of intricate crevices.

This got me thinking about the relationship between student dentist and patient, and whether or not those relationships could ever evolve into something special, such as a romance. As unlikely as this seems, stranger things have happened in life, although with dentistry it’s more than likely that the horrible condition of a patient’s mouth would get in the way of a deeper personal connection even if a powerful personal attraction was there.

It is still true, however, that the intense physical intimacy of dentistry, such as peering closely into a mouthful of flawed teeth and gums, might be said to rival the intimacy of the French kiss.

From the student dentist’s point of view, there must be many mouths they’d rather not explore. These are the mouths, after all, that we hear everyday in the subway or the El or on the road to City Hall, the same mouths that cry up or cry down, use the F word, curse perceived slights on the highway or that say a gentle ‘Thank you’ after a door has been held open for them.

These are also the mouths that have spoken words of love, slandered their neighbor, and in some cases, haven’t seen the bristles of a toothbrush in years.