Tuesday, March 29, 2011

Seeing a Dentist in Ukraine

During the past year I developed a tooth cavity that needed filling. Never having set up a dentist visit on my own, I didn't know how to go about doing it. I talked to a couple friends and asked for recommendations, but didn't get any specific advice. So, after waffling for a few weeks I finally just went to the state dental clinic on the corner.

It was a lot like any Ukrainian state clinic or hospital. The interior was dilapidated, with rickety seat rows in the open areas for people to wait. Middle-aged women walked around in white robes, and information was posted near the entrance behind a glass screen. I looked at the prices for various dental procedures, and it seemed too low to be true (15 UAH for a filling, for example — that's just $2 USD). It turns out the actual prices are higher.

I asked the administrator (in Russian) how to go about seeing a dentist to get a filling (поставить пломбу) and have plaque removed (снятие налёта). I was worried that I would only be able to obtain services if I was a registered resident of the local district. The lady asked me when I wanted to see the dentist — "now" or "later." I said, "how about tomorrow?" "What time?" she asked. (This is a typical situation in Ukraine. You ask a general question, and they respond by asking you a specific question. Most people don't like to answer general questions.)

Apparently my registration, or lack thereof, made no difference. The lady took down my last name and gave me a scrap of paper with the appointment time, room number, and dentist's last name on it. The next day I came in for a filling and was in and out of the clinic in just under 20 minutes, paying 195 UAH ($24 USD) for the procedure.

The dentist was working in a large room with 4 dentists total and 4 dental chairs that appeared adequately equipped. She took a look at the cavity and told me it would cost about 200 UAH for a "good filling" and that the price could be lower for a lower-quality filling substance. I opted for the better filling.

The procedure didn't require anaesthesia, and she worked quickly and seemed to do a good job. In less than 15 minutes it was over. She told me to go to the administrator to pay, then bring her back the pay slip. I did so and arranged for a teeth cleaning directly with the dentist, and she wrote me out a note with the time and place. And that was that.

A few days later, I returned for the teeth cleaning (plaque removal), which took under 10 minutes and cost 70 UAH ($9 USD). This time I paid the dentist directly. Don't quite understand how that works.

The really interesting part was when I shocked our house guest from the U.S. by returning home in just 20 minutes after leaving to get my filling. Apparently getting a filling is a far more complicated procedure where she is from in the U.S. and takes no less than an hour. After telling her what my visit was like and how much it cost, she began to wonder whether all the procedures performed at her clinic were really justified and whether they might have been making things more complicated than necessary to jack up the cost.

I don't know the answer to that question, but I do know that getting a filling in Kiev involved about 1 minute of paperwork (giving my name and signing up), almost no wait, and a bare-bones, but efficient procedure that took about 10 minutes.


  1. RE: "This time I paid the dentist directly. Don't quite understand how that works." - The dentist simply bypassed the clinic and put the money in her own pocket. Sadly, this is common in state-run enterprises.

    Thanks for a great blog, it's very interesting to read about your experiences here in Ukraine.

  2. This is what I have learned about cavities and dental fillings.

    All types of dental fillings are harmful to health. There is no such thing as a 'good' dental filling material. Each type of filling causes different symptoms. Some types are slightly better than other types.

    Some people have symptoms caused by dental fillings, but they are not aware that they have symptoms or that the symptoms are caused by their fillings. I myself got my first dental filling when I was about 14 or 15, and at that time in my life, I did not know how to observe my own symptoms and connect them with their causes. So I did not notice symptoms caused by the filling at that time. I also had symptoms that were caused by my orthodontic braces and my plastic retainer, but again, I was not aware until much later that those things were causing the symptoms.

    Plastic fillings and retainers can cause: breast pain which might be diagnosed as fibrocystitis; headaches; mood swings; erectile dysfunction (impotence or its female equivalent - I don't know what they call it when it happens to females - perhaps anorgasmia); a reduction in mental ability, and other symptoms. These symptoms are caused by bisphenol-A (BPA), a chemical that leaches out of the plastic. I experienced all of these things myself whenever I got my first plastic fillings a couple years ago.

    Metal fillings can cause a different group of symptoms. I haven't read about it in a while so I might have a hard time remembering, but I personally experienced constant nausea in my stomach when I had the metal filling, before I had it removed. I always felt sick. However, the sickness was interpreted as a bad mood, not just as nausea. So I always felt like I was in a very negative mood. Low-level mercury poisoning from fillings can cause bizarre and eccentric behavior. My behavior might seem weird enough nowadays, but it was even weirder back when I had the metal filling. My mood and attitude improved greatly when I had the metal filling removed and replaced with a plastic one, but unfortunately I then experienced all the plastic-induced symptoms.

    I concluded that all types of fillings are bad, and that the best policy is to leave cavities alone, to simply stay away from the dentist and avoid getting any cavities drilled and filled.

    I tried to get the dentist to remove both of my fillings (which are now plastic), and just leave the cavities open and unfilled, but he said that he couldn't do that because it was unethical. So I am going to remove the fillings myself, by hand, using a drill, in the future after I get on a special diet that is meant to protect the teeth.

    I learned about remineralizing teeth. The Weston Price diet claims that it can strengthen teeth, however I have not been able to try the diet yet because, for a variety of reasons, I am not able to cook for myself at this time (partly because I am living in my car, and partly because of other problems going on). However, every time I mention the Weston Price diet I must give the disclaimer that some of the foods described in that diet can cause extremely severe food poisoning and other problems, and I've mentioned that before. So the diet needs more research and troubleshooting.

    Cavities can be caused by grains. Grains contain phytic acid, which you probably already know, because you learned about soaking grains and because you chose buckwheat as your grain, and they say that buckwheat contains a relatively low level of the phytic acid. It's possible that alcoholic beverages can cause cavities, particularly if the alcohol comes from grain. Phytic acid tends to cause loss of minerals in the body and the teeth.

  3. Anyway I've noticed that my own constant bad mood and sick feeling greatly improved whenever I had the metallic filling removed and replaced with a plastic one. The plastic ones are still bad, but they might possibly be better than the metal ones. Ideally, it would be best to remove the fillings and leave the cavities open and unfilled, but dentists won't do that.

  4. A small comment on the dental situation in the States. In the current medical industry in the US, there is an overwhelming view in the populace that if the doctor (or dentist) were to miss something, and the missed problem shows itself later, that the doctor is to blame. And because people are sue-happy, doctors cover themselves by doing tests an procedures that aren't really needed, but protect the doctor from malpractice lawsuits.

    Due to government health insurance and the prevalence of private insurance, doctors feel justified in doing this, since the patient doesn't end up paying for it. And patients in this case also couldn't care less, unless they have no insurance.

    But in cases of doctors and dentists that don't take insurance at all and rather treat their services like say, a mechanic treats his services, the cost are dramatically lower. The Patient has all the say in what procedures are done, and the dentist is happy to do anything the patient is willing to pay for, (and since he takes no insurance, his prices must be low, or no one will use him). This is the basic experience you had.

  5. I had a bad case of gum infection while traveling in Eastern Europe last year. I had to see a dentist in Vilnius, Lithuania. I was pleasantly surprised to see they had modern equipment and very capable dentists in one of their government clinics. They did an amazing job on my gums.