Sunday, 17 December 2017

Tooth by tooth

By Emily Prucha | Prague Daily Monitor |
9 March 2012

Having a dentist for a father had its perks. Every six months or so, usually during summer and Christmas breaks, I'd hop up in the reclining dentist's chair, open my mouth and have my teeth counted, cleaned and protected with grape-flavor liquid fluoride. I left slurping a sugar-free lollipop, pockets stuffed with rubber erasers, bouncing balls and free toothbrushes. Apart from a single occasion having broken a baby molar I came back, missing not one, but two, molars as Dad had mistakenly pulled the wrong tooth first, I can't say I ever had a reason to complain. My friends used to be surprised that my family kept a bowl of sweets in the kitchen, free for the taking, and bought Fruit Loops and Sugar Smacks cereal. We brushed our teeth twice a day with whatever toothpaste tasted best, and I never thought much about our family's dental habits, until years later, when I had kids of my own.

For several years while living in Prague, I waited until our annual visits to Virginia for the children's and my own dental care. They adored going to my Dad's office, just as I had as a child, riding up and down in the dental chair and coming home with fancy Princess or Cars-themed toothbrushes. But when more than six months began to elapse between our visits home, I decided it was time find dental care in Prague. I'm an information-gatherer by nature, so I asked around to figure out where my friends went to the dentist. When we had searched for a pediatrician, location was a prime factor, but as going to the dentist usually happens only a few times a year, I decided anywhere within the city limits was an option. From talking to friends, finding a dentist who was still accepting patients might be a hard task to accomplish. With dentists on the decline in the Czech Republic, many of our friends continued going to dentists that they didn't particularly care for, just to avoid being without.

In the US, dental insurance is typically a separate policy from health insurance, making it an expense that people sometimes choose to go without. However, in the Czech Republic dental care comes with socialized health care. Basic dental care is provided for free, although such services as routine cleanings are paid for directly by the patient since they are considered "preventative" and optional, not essential care. I was surprised that the system would pay for me to have a cavity filled but not for a routine cleaning that might prevent the cavity's onset. Nonetheless, even paying out of pocket for cleanings are a good deal compared to average dental costs in the US. Cosmetic dentistry and advanced treatments are also offered at a price that's typically less out of pocket than a similar procedure in the US or UK.

If you haven't yet searched for a dentist in Czech, you may be as surprised as I was to learn that stomatolog is the technical term for dentist in Czech. When I arrived at the first children's dental office I'd been referred to by my neighbor, I found the doctor's name on the door with stomatolog printed just below. Instantly annoyed, I called Radek to tell him he'd sent me to the wrong doctor before realizing my own mistake. Once inside the office, I was shocked to find a one-room operatory, no assistant and antiquated equipment. The utensils looked like the ones my dad used to bring home from the office for us to play around with. When the dentist pulled Anna's wiggly tooth without gloves or even much warning and sent us away without cleaning either child's teeth, which had been my primary motivation for making the appointment, I decided to keep looking for someone else.

One American friend, who'd had major dental work a few years ago, including implants and braces, recommended a private dental clinic in Prague called American Dental that used to boast the only ADA accreditation in Prague. My friend paid out of pocket for the services, but felt it was worth it to get quality care. I was skeptical if a company with such an extensive English website would accept our basic VZP (Czech state insurance) and have reasonable out of pocket fees, although they do say that they honor VZP. Radek and I have a general understanding that we try to find our health care providers within the scope of our VZP insurance whenever we can find an acceptable standard of care. Since I'm able to communicate in Czech it's not necessary to pay more simply for an English-speaking doctor or dentist. We wanted to find a family dentist who would see everyone and who wouldn't tag on exorbitant costs for basic procedures.

When another friend recommended her dentist, who was originally from Radek's hometown and now practiced at a clinic near Vršovické náměstí, we decided to see if she'd be a good fit. The clinic's building wasn't anything special and the waiting room was just a bench down the hall a few meters from her door, I'd already seen plenty of well-equipped medical facilities hidden under scruffy exteriors in the Czech Republic. Still, I was impressed when we walked into the operatory. The dentist's spiffy chair held all her tools and equipment, except for the special head light she wore during the examinations. It was as fancy a setup as any I'd seen in my Dad's office growing up, if the space was a bit more confined. The dentist's demeanor was professional and thorough. One by one we took our turn in the chair. I was surprised when she insisted that the baby Samuel, at barely one-year sit in the chair with me to have his teeth counted, and then shocked when she finished examining Anna Lee and Oliver just by counting their teeth. When I offered to pay for a cleaning, she said that wasn't necessary for children as long as we came regularly and had their teeth examined. She pointed out one spot on Oliver's front tooth to watch and referred us to an orthodontist for Anna Lee's permanent molar that wasn't erupting properly.

When I checked back with my friend recently, she hadn't been at American Dental for all that long and had instead followed her individual specialists throughout the city as they branched out and established their own private practices. In recent years a plethora of private dental practices have sprung up in Prague. I may have to consider visiting one if I want to get the kids' teeth cleaned before all of their permanent teeth come in, although fortunately, they can do that back in Virginia for free. There's also a fairly competitive market for dental tourism in the Czech Republic. I found a website promising a combination of top-quality dental treatments with a chance to sightsee in the heart of Central Europe. Interestingly, commentary from an online US dental website remarked that Budapest, with the Czech Republic close behind, were popular destinations for the increasingly appealing practice of combining cheap dental care with a holiday abroad.

Overall, many of the high-level services that are offered here do seem on par with the best of services in the US, and the price is usually better. Although Radek and I were bemoaning the 3500 CZK that we'd need to pay for Anna's six-month temporary braces to position the molar correctly, my father said we were getting a steal. The alternative, a free treatment, would involved putting metal bands around her back molars for up to 3 or more years, an approach which seemed antiquated and unnecessarily lengthy. Even the Invisalign treatment (clear removable braces) that my brother, also a dentist, recently began offering in Virginia is also available in Prague at a competitive price.

In 2005 and again in 2007, Radio Praha reported that the Czech Republic will soon face an acute shortage of dentists when the current wave of 50-54 year-old dentists retire. There are not enough emerging dentists to replace the retirees and in recent years, many young Czech dentists have been attracted to careers abroad for better wages and conditions. I couldn't find any more recent dental update to determine whether the predicted crisis had struck or not, but if you're thinking about finding a dentist, there's probably no reason to wait.

My dad jokes that he'll relocate to the Czech Republic when he retires and offer his services to help balance out the shortage. If you like a dentist who's not bothered if you eat candy and choose your toothpaste based on its taste then he may just be the one you need.

Emily Prucha is a Life Section columnist for the Monitor. She likes writing about bilingual and multicultural families.
You can reach her at emily@praguemonitor.com. You can read more of her stories here.