06 April 2009

My Weak Teeth and Russian Dentistry

Most Russian dentists have good training, excellent equipment, and make way more money than doctors. As with medical doctors, most are women. In the early years after my arrival, I would go to a government clinic where many patients received treatment in one room. Once I was enrolled in the Russian medical insurance plan, I could get free treatment if I was willing to wait for hours.

Its easier and quicker to go to one of the new платна, pronounced platna, pay clinics. I am very happy with Oksana, my dentist, and Victoria, my hygienist for they are skillful, gentle and kind.  The new dental clinics also have a set up that is unique to Russia.

Mud, rack and ruin...

It is a typical Russian business attitude to not worry much about the exterior appearance of a building in which they work, nor how it looks when approached by a customer. My dentist is in a structure that looks like a bomb hit it on one side, has a field of mud leading to the door, and advertises a late night bar on the third floor. It's exterior is worn and grungy.

Бхилы Mandatory!

You must put blue plastic covers... pronounced ba-heel-y... on your shoes in the reception area. This practice keeps the floor clean... especially important in wet sandy St Petersburg.

My kingdom for a tooth!

After seeing a recent photo, I realized I needed a tooth cleaning. Larissa said that her daughter's dentist only charges 70 rubles a tooth, a sensible yet surprising way to calculate the bill! We called my dental office and the receptionist quoted 80 rubles. The question remained... how many teeth are we talking about?

I counted 20 teeth in the mirror, Larissa said 19. In fact, each tooth was 100 rubles because the office added 20 rubles a tooth for a cosmetic protective coating... but my hygienist Victoria, said she would only count the upper teeth in the bill... such a deal... 20 teeth for the price of 11!

Maybe I could save money if she only cleaned the lower part of my top teeth. As long as I limited myself to a conservative smile the visible teeth would look good.

I pictured myself walking around to other dental offices... there are many... and asking, "What's your best price for cleaning each tooth?" or, "How much will you charge for cleaning and coating just this one tooth?"

When my hygienist finished the cleaning and was putting away items, I grabbed a little mirror which was lying on the shelf next to me. It had been upside down and all I saw was black... I said in Russian Oh my God! What's happened to my teeth? She really enjoyed that kidding and her laugh was music to my ears, and teeth.
Unit pricing, but not in the supermarkets where we need it!

This mentality is consistent with other pricing in St Petersburg. It's possible to buy one or two cigarettes from a kiosk, or one battery from a pack of three at a prorated amount. You learn quickly that prices are quoted for one item even when you point to a package of three.

All I want is water!

I have been treated in six Russian dental offices over the past ten years, one of them in Brooklyn. None of them had a working fountain or cuspidor for the patient.

The cuspidor is often wrapped in plastic or has a dish on top of the drain. You are supposed to spit into the plastic or dish. Often you only get a drink of water if you ask.

I stopped in at two other dental offices the other day and asked to see their dental chairs and equipment. They thought the request strange and were concerned that I put on бахилы. The first dentist turned a few valves, one of which required lifting a panel in the floor, and on the second attempt, got the water running in the cuspidor, even though it was wrapped in plastic at first. The other used the dish method. Dentists and patients in St Petersburg don't expect a running fountain for the patient, and don't think it necessary. Perhaps clinic owners don't want to pay for the initial plumbing or for the daily water use.

Sell your skill as a commodity!

Dental offices have the latest equipment, and do tooth coating, which made my old teeth look young again! But they seem unconvinced that making the client a little more comfortable with a clear walkway and working fountain would help grow their business.

Practice-enhancing ideas such as appointment cards... my next appointment was just scribbled on the back of the bill... referral requests, and little gifts for children would be good. How about a cheerful waiting room with magazines and music? Diplomas should be displayed.

Medicine still isn't viewed as a marketable business even if платна, and Russians often do not like to make the first move in social interchanges. The Russian idea of pride and their unwillingness to be outgoing hurts their business. Only once did a dental secretary call me in St Petersburg to say that it was time for my six month check up. What lost opportunities!

If I were younger, a dental clinic would be a good investment. I enjoy marketing, and feel I could help any quality dental business quickly have a loyal client base. Then the profitable clinic could be sold, and the money reinvested in a larger one with good potential.

So, going to the dentist in St Petersburg is a little strange. You and I just have to get around our own cultural hangups and be willing to speak up when it may help improve things. Remember, it can be just as safe to get your teeth fixed in Russia as in America, and you'll save some money as well!


  1. I love the idea of a bar on the ground floor and paying per tooth. I have just had a course of dental treatment here. My dentist has just moved and setup her own new surgery - all very 'mod cons' with the obligatory piped music. I took my new eReader (to blend in with surroundings) because the appointments always run late.

  2. Yes, pay per tooth is great for those of us who lose one or two a year... an offset for inflation!

    The bar before and after adds to the pleasant anesthetic effect.

    Please write about your eReader in one of your top articles from Spain, http://robinnis.wordpress.com/

  3. I went to a dentist in Moscow for emergency treatment after a trauma in 1992 and the conditions were absolutely horrid. Dentist did not wear protective gloves, blood from other patients in cuspidors - even the dental chair was ripped. I can't for the life of me understand why any American would visit a Russian dentist for a tooth cleaning. Go to Finland for goodness sake!


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