At the push of a button, the backrest of the dark-colored dental chair reclines. The patient – a man with black and gold-colored earrings – looks a bit tense. It may hurt a little, the dentist says.
“Don’t be alarmed.”
A mild convulsion follows. The rotten wisdom tooth that caused pain for months was pried loose within a few minutes. The man can eat normally again. Just do his best not to smoke until the anesthesia has worn off.
That was another one. There is no time to stand still: behind the door the waiting room is full. The pressure is high, time is limited. “Is there anyone who can make prints? I really have to keep going,” comes the voice from treatment room 2. A room further on, the dental surgeon is needed for an extraction. Patients come and go.
This is how it goes all Saturday at Tandarts West in the Rotterdam Bospolder-Tussendijken district. Today, a team of dentists, oral surgeons and dental hygienists helps people with acute dental complaints free of charge. About thirty patients are expected there. Despite their complaints, most have not been to the dentist for months or years.
Worse and worse
On this day the problems surface: broken front teeth, cracking toothache and neglected teeth. Semra Genc (36), dentist and chairman of the Rotterdam Dental Association, is no longer shocked by it. “There is still a very large group of people who cannot afford the dentist. As a result, the problems in their mouth actually only get worse and worse.”
Nearly a third of the people treated on Saturday have not seen a dentist for more than three years. The reasons range from lack of money to shame. 65 percent have cavities, almost half have broken molars or teeth.
The stories are harrowing. A mother of three children who did not have enough money for a root canal treatment and therefore took more painkillers than was medically justified. A young woman who could not eat normally for months because of her molar. Her teeth deteriorated during two pregnancies. “They all have a backpack,” says Genc. “And they often don’t know the ways to get help. This day is intended for that group.”
Logistics operation
It is the fourth year in a row that the Anders Foundation has taken the initiative for the Rotterdam Dentist Day. The fact that there is demand is evident from the number of registrations. In total, more than six hundred people registered using a questionnaire. There is not room for everyone – just over half of them are being treated today, in fifteen dental practices spread across the city. If the patient cannot be helped in one clinic, he will be referred to another. It is a huge logistical operation.
Oral surgeon Britt Pluijmers normally works at the Ikazia Hospital on the south bank of the city, but today he flew in together with a dental prosthetist and several students to help. She sees many social problems. “Poverty, stress, addiction. There are people who do not have the money to come for an annual check-up. If it costs 25 euros, you might be more likely to choose to do something fun with your child. What you then see is that people do not come to the inspections.”
Sanne Donders
The consequences are great. “A hole is then not noticed in time. That hole is getting worse, worse and worse. So bad that you can get inflammation of your nerve. Then a root canal treatment would actually be necessary, but that is too expensive for many people. I meet plenty of people who say: pull out all my teeth, because I don’t have the money for it. Then I say that it is not the best option, but you do want to help someone.”
Basic package
Something has to change – everyone here agrees. Since the health care system was overhauled in 2006, oral care is no longer part of insured basic care. Adults – children do receive free dental care – must either take out additional dental insurance or pay the dentist themselves.
A majority of the House of Representatives wants to include the dentist in the basic package. However, then Minister of Health (D66) Ernst Kuipers called this in a parliamentary debate a “fairly rough measure with major financial consequences”. According to him, inclusion in the basic package is no guarantee that people will go to the dentist: even when the health insurance fund still existed, according to him, almost a million people did not go to the dentist every year.
We have been trying to address this for a number of years, says Genc. “But no one really takes responsibility for actually doing something with it. It worries me that everyone keeps pointing fingers at each other.” This, she also knows, is not a structural solution. “We are now really trying to help as many people as possible. But you can’t do that every day.”
The group of people being treated on Saturday is the tip of the iceberg, Pluijmers thinks. Usually the problems pile up. “Children from a somewhat lower socio-economic background have often not had braces. If your teeth are crooked, it is also more difficult to keep them clean. It all adds up. So that’s what I call poverty.”