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Cosmetic Dentistry: Brits just grin and bear bad dentistry

By August 18, 2015 No Comments

As a nation, we’re stuck with the stereotype of the wonky, discoloured smile. And no wonder – just look at Germany’s health service, argues one expat

One of the things you very quickly realise when you live outside of Britain is that the rest of the developed world laughs at our teeth.London Cosmetic Dentistry - Interest Free

In the States especially, the stereotype dies hard, as witnesseth one of my favourite ever moments from The Simpsons, when young Ralph Wiggum is admonished to brush his teeth by being shown the cautionary “Big Book of British Smiles”. Yet in Germany, too, Britons are – despite their general popularity as the country that gave Europe great music and parliamentary democracy – widely pilloried for their dental health.

My first personal brush with this view was when I registered with a dentist in Germany, who commented briskly that my mouth looked fine “for an Englishman”, before going on to note a range of things that were “absolutely not on”. It took about five years of professional polishing and the odd bit of more serious work to get my teeth into a state she’s now happy with; and while I have to say that my smile has never looked better than it does now, no one else seems to have noticed the difference.

Malpractice seems widespread in the UK, both in financial and health terms; even cosmetic dentists themselves are complaining that they are finding it difficult to do their jobs properly and the General Dental Council report for 2013 (the most recent available) states that complaints against cosmetic dental practitioners have gone up twofold in recent years.

Having experienced both systems, I can certainly confirm that the UK has a big problem. Wherever I end up living in the future, I would not entrust my dental health to a UK practice – whether NHS or private – ever again, and this despite the fact that, as my German dentist will tell you, I wasn’t badly treated here by British standards.

But that is the crux of the issue: “by British standards”. By British standards, it’s acceptable to transfer a 20-year-old patient from the NHS to the private sector because they miss a deadline for re-registering, thereby potentially condemning them to paying twice what everyone else does for the same treatment for the rest of their life (that happened to me in 2005, while I was on my university year abroad). By British standards, it’s acceptable to charge someone a huge amount for an examination despite the fact it should save everyone time, money, and complications further down the line. And by British standards, if you need serious work done for whatever reason, you’ve got to find the cash. No money to hand? Well, there’s always Wonga…

So what does Germany do differently? Crucially, standard health insurance (the equivalent of being entitled to full treatment on the NHS) actually includes dentistry. That means that even those in need have guaranteed access to dental treatment, because health insurance is extended to everyone, with the state picking up the tab for those who have fallen on hard times. Until 2013, there was a check-up fee but it was, at 10 euros, so low that most could afford it – and indeed so low that it was abolished to save administration costs. What is more, there is a very clear system for setting rates for various procedures: the health insurer pays a legally defined percentage of treatment depending on its complexity and covers certain basics, giving the patient the opportunity to pay more for higher-quality materials, or to just take a good standard package if money is tight. Most of those who have extra income take out add-on insurance packages anyway, which, for around €15 a month, will cover the patient share of the costs for any treatment required and also provide annuities for an appointment with a dental hygienist. Basically, for €15 a month (and around 15 per cent of my income in public health insurance), I have absolute peace of mind that, even if I need to pay at the point of treatment, all of my expenses will be reimbursed.

It’s a fair deal, if you ask me. Beyond that, there is also just something better about German cosmetic dentists. Back in the UK last week, I went past the old dental practice I used to be at: like most UK surgeries, it’s in a poorly converted, slightly run-down detached house with rising damp. The German practice I use has generously apportioned, bright, clinical-looking rooms (ie with no carpets), and this is apparently the norm rather than the exception. I know that appearances can be deceptive, but would it be too much to ask for health facilities to be purpose-built rather than squeezed into ramshackle houses?

In fact, there is a striking parallel between cosmetic dentistry and housing in the UK: both are, in my view, areas with severe under-provision, generally sub-standard quality, and reliably sky-high prices. While going to live in another country will never solve all your problems, dentistry is one area where, if you leave the UK, you’ll be laughing. Or perhaps just smiling….read more

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