“Seriously?” asks Weekly Playboy (July 11). “Is Japan a ‘country of bad teeth?'” To the point of requiring political intervention?
Prime Minister Fumio Kishida last month unveiled his government’s intention to introduce mandatory dental checks – for the entire population; not just, as now, for children aged one and a half to three, junior and senior high school students, and workers handling certain dangerous chemicals.
It’s a reflection of the sad state worldwide of freedom under checked and balanced governments if the first thought to occur is of a coup d’état via the people’s mouths. It’s not that – though those seized with convulsive fear at the prospect of visiting a dentist (there are many, it seems) may disagree. Still, the underlying issues raised by Playboy have moral shadings. Is the motivation medical? Political? Economic? Even psychology seems involved, relative to dentists’ alleged chronic inferiority complex vis-à-vis doctors of more respected parts of the body than the mouth happens to be.
The reform is pushed, Playboy claims, by politicians with close ties to the Japan Dental Association (JDA), whose clout of late is rising. This is a tale in itself. Traditionally, political influence has lain securely in the lap of the Japan Medical Association (JMA). Generous donations to governing Liberal Democratic Party election coffers have been rewarded, it is alleged, by more generous treatment under the national health insurance plan than dentists enjoy. The overall picture is of doctors awash in power, respect and money, while dentists, though routinely addressed as “Doctor,” hover as poor relatives on the fringes of the medical profession.
Enter, as in so many contemporary dramas, COVID-19. The JMA over the past three years has been critical of the government’s handling of the epidemic. The government has not taken this kindly. Relations have cooled. The JDA saw in this an opening. Cautiously, it placed a foot in the door.
That’s one hypothetical explanation for Kishida’s announcement. One fact seems to support a contention that considerations other than medical are at the fore: the steady drop in the number of cavities among Japanese children. Twenty years ago, the average 12-year-old showed up for a dental check with 4.8 cavities – down now to 0.84. Why, then, move so boldly to solve a problem that seems to be solving itself?
The answer is that cavities are not the main issue. More crucial by far is the gum infection known as periodontitis. Untreated, it can knock your teeth out. Worse, it can spread, causing or aggravating heart disease, hardening of the arteries and diabetes. In pregnant women it can trigger premature birth. And Japan, says Playboy, owing apparently to poor dental hygiene, is “a periodontitis superpower.” Two adults in three are said to be at risk.
Bad teeth are a threat to the whole body. And healthy teeth promote overall health. Few political motives are pure, and some of the ones in play here may not pass moral scrutiny; still, Playboy takes a generally positive view.
But dentists have an image problem. It’s not their fault. The patient lies helpless on the chair, mouth open, staring up into a face that, under the circumstances and in the glare of the characteristic dental lighting, can only look ghoulish – to say nothing of the instruments wielded and the sounds produced. We’re lucky to live in an age of anesthetics – at the vanguard of which, by the way, stands a dentist, the American Horace Wells (1815-1848). Unanesthetized dentistry must have been excruciating.
It’s merely uncomfortable now, but Playboy introduces individuals who would rather – and in fact do – live with the agony of rotting teeth than submit to treatment. One 36-year-old man suffered for decades. He made dental appointments, cancelled them, made them again, failed to show – until finally, strange to say, the pain vanished. He feels vindicated. Perhaps he’ll live to discover that his victory is hollow. Disease has its mysterious ways, playing mysterious games, fooling us into lowering our defenses and then returning, not in fun this time.
Michael Hoffman is the author of “Fuji, Sinai, Olympos.”© Japan Today