Son Be a Dentist! You'll Be A Success!

You're never fully dressed without a smile. That is how the song lyrics go in the musical Annie. This is especially true in western culture where teeth are highly cared for and are considered beauty markers. If you want to be more beautiful, then you need straight white teeth. Most teenagers in the USA wear braces or retainers, whitening strips, kits, and pastes are sold everywhere from Walmart to Instagram. You want to look good? Fix your teeth and get them whiter than a page of paper! Personally, I have worn braces and have two sets of permanent retainers currently. 

This does not translate over to other countries specifically China. 

I was aghast when I came to China and I kid you not, half of my first grade students have teeth rotting out of their heads. They smile at your with their cute little faces and then you see a row of black and green teeth. Or in many cases, no teeth. I literally do mean that their teeth are rotting out of their heads. We have a student in the third grade who doesn't have any top teeth because they all rotted out but since they didn't fall out naturally his permanent teeth still don't feel the need to grow in yet. Teachers are confused as to what they should do with him as his pronunciation of Chinese and English words are wrong-but are they wrong because he has a lisp or are they wrong because he doesn't have teeth?

The student's mouth. Yep, all gums and no teeth. 

Many of the Chinese adults I have seen don't have any teeth or if they do, they are deeply discolored or crooked. At my old gym I had a trainer who had the straightest and whitest teeth and he was the only person I met in months who actually took care of his teeth. 

But why?

What I found in my research is that the biggest deterrent of dentistry is cost. Hardly any Chinese insurance companies will pay for oral health and about 85% of all the costs are paid by the client (Zhou, et al., 2018). What about those who can afford it? They go overseas to get their teeth fixed while the poor suffer. The only times people would go to the dentist is if they were in great pain (Ruggles Media, 2016). In one study in Shaanxi, China they interviewed 207 four to six years old children and 501 twelve to fifteen years old children and found that in 88% of them said that oral care was important to them but only 5% knew how to take care of their teeth. The same study found 67% of the those four to six year old children had missing teeth due to lack of oral care. The reason education was so low is that this area is poor and doesn't have access to oral education, while richer areas did (Gao, et al., 2014). 

There seems to be a lot of dentists in the country but why is no one using them? According to the article Oral Health in China: From Vision to Action they aren't actually trained that well and not all of them have certificates. The Chinese government wants to change this by 2020 by requiring all doctors to have a bachelor's degree and then a specialty degree above that. There is supposed to be a written set of criteria that dentists' offices will follow by 2030. On top of this, most of the tools that dentists use in China currently are developed and made by western countries which China hopes to change. The reason they are buying overseas is that the dentistry tools are considered, "high-tech, high-end, and high-price items."(Zhou, et al., 2018) These items include dental lasers, CT scanners, dental implants, and microscopes (Zhou, et al., 2018). 

Traditional Chinese Medicine or TCM has also been listed as a cause. As mentioned in a previous blog post, many locals prefer to use TCM than "western" medicine. However, it was found that if a person were to have oral issues, TCM doesn't have a lot of remedies for it. Since TCM wasn't studied in-depth scientifically, there doesn't seem to be much evidence that it actually works(Zhou, et al., 2018). Most locals will still try to use TCM first when there is a problem and will only go to the dentist when the home-made remedies don't work (Ruggles Media, 2016). 

As of right now, China is working on changing how its people care for their teeth. My elementary school has a "Love Your Teeth Day" and my supermarket just had free teeth check-ups for children. I have also seen a huge surge in tooth products available like mouthwash, toothpaste, and toothbrushes in the last six months. 

I would say that if you want to get your teeth checked and you are a foreigner, wait until you back to your home country. Come back in 2030 when everything is fixed up. 

I think in the future, Chinese dentists will make a lot of money once people care about their oral health so to end on another song, "Son, be a dentist. You'll be a success!" *

*I know the idea is totally different but I still like the song. 

References

Gao, J., Ruan, J., Zhao, L., Zhou, H., Huang, R., & Tian, J. (2014). Oral Health Status and Oral Health Knowledge, Attitudes and Behavior Among Rural Children in Shaanzi, Western China. BMC Oral Health.

Ruggles Media. (2016, December 17). How Chinese Differ from Westerners in Oral Health. Retrieved from NorthEastern.edu: http://www.northeastern.edu/rugglesmedia/2016/12/17/how-chinese-differ-from-westerners-in-oral-health/

Zhou, X., Xu, X., Li, J., Hu, D., Hu, T., Yin, W., & Fan, Y. &. (2018). Oral Health in China: From Vision to Action. International Journal of Oral Science.