Monday, 8 December 2014
Gnashers and fangs: biting the bullet
Not many people are blessed with strong, white, perfectly-aligned teeth in middle age or older. Once beyond your thirties, you're very, very lucky to reveal a stunning row of tombstones, with no obvious flaws, when you smile. I've known people who have avoided smiling or laughing, just in case someone sees how bad their teeth are. And by 'bad' I don't mean 'clearly rotten beyond redemption'. Any noticeable discolouration, any crookedness, and obviously any gaps, can be a source of serious personal embarrassment.
And such things can and do undermine one's self-confidence. I don't think this should be pooh-poohed. Even though dental defects are a fact of life for most adults, to the sensitive their own defects are gross, something to hide, and they will not accept reassurances that their teeth are no worse than anyone else's. I'm not inclined to make light of their feelings.
Perhaps this is why dental treatment on the NHS addresses dental health only, and ignores the cosmetic element. The hit to the NHS budget would be colossal if it were possible to have free enhancements to the appearance of one's teeth. So very many would want them. Cosmetic treatment will therefore never be free. One must have it done 'privately' and pay. For those who are convinced that they have unattractive teeth, but haven't got the cash to sort them out, this must be pretty awful.
Did I say that if it's a simply matter of dental health, the NHS will pick up the bill? Well, of course, that must be heavily qualified. Some sections of the country's population can indeed get free treatment - chiefly children. Everyone entitled to free treatment is listed on the NHS Choices website - see http://www.nhs.uk/chq/Pages/1786.aspx?CategoryID=74. The rest of us must pay something. And it isn't peanuts.
Today I committed my entire after-tax State Pension for December (a cool £405) on having a crown put on one of my molars - it was Upper Left, number 5. The decision to go ahead with a crown was taken way back in September. Over the years, this tooth had been hollowed out by drilling, and filled as much as it could take. Further fillings could not be guaranteed to stay in; and if the tooth cracked, it might well fall apart. My dentist Nina had put in another filling as a temporary holding measure - at no charge - in order to take me to the end of the year, when we would consider whether to go ahead with a crown. I was frank with her: I couldn't afford the cost of a crown until my State Pension kicked in.
Now we were at the end of the year. The temporary filling had held, and was perfectly comfortable. But for how much longer? It was never meant to be a permanent solution. It might continue to hold, or it might not.
I was going to step up my caravanning in 2015, and didn't want a tooth suddenly breaking apart when far from home. Besides, it was awkward not being able to chew with complete confidence. So, despite the cost, I felt that fitting a crown was the most sensible course. So I said yes, let's go ahead.
The £405 mentioned above was the 'private' cost. In fact it was the less expensive of two types of private crown, the other sort costing £500 or so. I wondered what one got for so much, but didn't pursue it. Second-best at £405 would do. I'd get a lovely ceramic crown, perfectly colour-matched to the teeth next to it. Perfectly good enough.
Nina was assiduous in running through the options and the risks of treatment (all medical professionals seem to do this now). I was, strictly speaking, an NHS patient and a less expensive, no-frills NHS option was available to me. But it still cost a princely (or princessly) £290. Ye gods! Definitely not peanuts. Was the price perhaps set this high so that a person who wasn't too worried about having a full set of gnashers would prefer a free extraction of the tooth instead? It was actually so expensive that I felt entirely willing to go the whole hog, and enjoy whatever extra finesse the difference between £290 and £405 would bring me.
Nina is a very good dentist, and after a long but completely painless incremental drilling session, Upper Left number 5 was ready for a temporary crown. Seven hours later, with the anaesthetic worn off, this feels fine. I paid £200 on account. I go back on 19 December for the real thing to be fitted, paying the balance of £205 then. After that I will offer guided tours of my mouth, charging £10 to each lucky tourist who wants to admire my spectacular new molar. Roll up! Roll up! See the Amazing Ceramic Wonder! Thrill to its Colour-Matching! Marvel at its Biting Power! Nothing like it seen since the Pyramids of Ancient Egypt were built!
As a matter of interest - to me, anyway - the last crown I had fitted (actually it was two crowns at the same time) was in May 2005, almost a decade ago. They were, as now, the 'private' option, and cost £331 each. If you use the Consumer Price Index to calculate what in December 2014 would be the cost of something priced at £331 in May 2005, you come up with £420. So actually the £405 I'm paying is a little less than might be expected.
Small comfort just before Christmas, though! But teeth are very important. They are a priority. I'd hate to think of how it would be if I didn't possess a good, functioning set of fangs. So the cost of maintenance has to be borne. In short, one must bite the bullet and pay whatever it takes.