The Whole Tooth / What they don't teach you at Harvard Dental School

The science of dentistry (as some of you may know) was first developed around three thousand years ago in Ancient China, where it was used as an advanced and highly stylised form of hand-to-hand combat. In those halcyon times, brave warriors would fight duels where they would vie to pull the teeth of out each other's jaws, the one to have all his teeth extracted first being said to 'lose face'. The true sign of a man's prowess, therefore, was the number of teeth he still possessed. Legend has it, for instance, that the renowned General Wang retained a full set of teeth till the day he died, with the exception of one incisor that he lost when he committed the tactical error of tasting his wife's fried rice. The fact that the Western world has chosen to use something as inherently harmless as gunpowder to fight its battles, while actively volunteering for dental work, remains one of the finest ironies of history, one that the ancient Chinese would doubtless have found amusing if they'd ever managed to take the time out from inventing all these other cool things to actually develop a sense of humour.

At any rate. One of the consequences of this noble provenance of the dental arts is that, like everything else that's imported from China, 85% of the features of dental medicine remain unused in the modern world because they all came written up in an obscure 600 page manual that no one can read because it's in Chinese. As an aid to budding dentists looking to start up their own clinics, therefore, I offer the following 10 cardinal rules of being a successful dentist, gleaned from years of careful observation of dental techniques:

1. The most important feature of a state of the art dental clinic is the presence of a large collection of woefully outdated and unspeakably boring magazines in the waiting room. Everyone knows that the skill of a dentist is inversely proportional to the readability of his waiting room periodicals, so that if you ever stumble into the waiting room of a dentist who has the current issue of Outlook lying about, you probably want to beat a hasty retreat, while if said waiting room features the 1974 issue of Auto Parts Illustrated then you KNOW that you're in sound hands, and you might as well have all your teeth taken out and replace them with dentures, because nothing God gave you could be better than what this dentist can do. If you're a young dentist setting up your own place, and don't have any great aunts who can lend you their teenage copies of Woman and Home, your best bet is to litter the place with the abstruse neuro-science journals that you used to collect before reality struck and you had to settle for being a dentist.

2. While outdated magazines are critical to setting the right ambience for your waiting room, they aren't enough. The Ministry of Silly Signs requires that you put up at least one poster showing a full set of shining teeth with the word SMILE written in large letters somewhere on it, preferably with some lame Hallmark type joke underneath. This is important. Failure to comply with this statute could result in your Blockbuster DVD membership being revoked permanently. Notice that the key issue here is smiling - other functions that teeth might conceivably serve are not officially recognised yet, so that if you're thinking about putting up a poster that says EAT, don't.

3. The next critical piece of equipment is, of course, the Chair. The purpose of the Chair is to obscure the fact that what you really do is essentially basic manual labour, only with really tiny instruments (I firmly maintain, for instance, that the only reason dentists get paid more than say, hairdressers, is that their chairs are fancier). A good state-of-the-art dentist's chair doesn't just recline and shine a light on you, to be truly modern it must be capable of playing Bach Fugues at the press of a foot-lever, able to run complex chaos theory models while the patient rinses his / her mouth, and equipped to fly the USS Enterprise should the need suddenly arise. You're unlikely to use any of these features on a regular basis, but the fact that you can tell the suction pipe from the karaoke attachment will make you feel less guilty about charging exorbitant rates for what is essentially a process of drilling holes in people's teeth and filling them up again.

4. If you are a man, becoming a successful dentist means you need to combine the Boris Karloff look with the bedside manner of Frankenstein. Only then will your patients be sufficiently intimidated by you to never refuse to come back, justifying this decision to themselves with the argument that you must be really good if you can afford to be so rude. (Fun fact: Dentist, in Transylvanian is spelled Igor, or would be, if vampires could spell)

5. If you are a woman, being a successful dentist means you have to be young, single and good looking. This is to ensure that the entire procedure is as embarassing and tortuous for your male patients as possible. After all, what could be more frustrating than the knowledge that when they finally meet a woman worth hitting on, it's in the most unromantic setting conceivable [1], that the first time a woman gently pushes them onto their backs and asks them to open their mouths for her, it's only so she can clean off their tartar deposits? After that, a mere extraction or two is hardly going to hurt.

6. Always wear a mask. This not only makes your pretense of being a real doctor more convincing, it also ensures that no one can actually see the 26 fillings you have in your own teeth.(thus retaining the molar high ground. heh.)

7. Always wait till you've got at least four different implements in your patient's mouth before you start asking them questions. There's nothing like making small talk while your mouth is being held forcibly open to make you appreciate the importance of healthy teeth.

8. Tell your patient that he / she has a condition of that kind that is lying dormant now but could suddenly come alive and prove excruciatingly painful if not actually fatal. Go on and on about how terrible this could be. Use words like inflammation and septic liberally. After you've got the patient to the point of abject panic, explain to him / her that you don't actually plan to do anything about it, except wait for it act up. Wave an X-ray at them to PROVE that there's no other way (Oh, yeah, always get an X-ray done - like your patient's teeth are hidden so deep within his / her body that you couldn't see them with the naked eye). This step has numerous advantages: a) it's more sadistic than making someone watch re-runs of Friends b) it gives you a reason to show empathy, thus enabling you to show off the bedside manner you've been practising in the mirror these last 5 years c) it means you can schedule follow-up meetings every few months, and eventually send your kid through college d) if anything does eventually go wrong with the person's teeth (and let's face it, it probably will) you can then claim you told them so [2] (this requires, of course, that the initial diagnosis be suitably veiled in medical gobbledy-gook; never say, for instance, that a piece of their third tooth bottom right got chipped off, say something like "you have an infracted sub-accidental presentation of your lower occidental incisor")

9. Make sure you prescribe a mouthwash or gum massage or some other treatment that will require hours of intense effort after every meal, meeting any whimpers from your patient about having a job / life with a look of shocked outrage. Remember to emphasise that the substances you are prescribing are not to be taken internally, not even in trace elements, because they could lead to poisoning and eventual blindness, leaving it to your patient to figure out how this is to be achieved with something that is being applied to his / her mouth.

10. If all else fails, simply tinker around randomly in person's mouth, and then show them a mirror and say something like "you can see the difference already". They almost certainly can't, but there's no way they're going to admit to you that they don't spend long periods of every day studying their teeth with a magnifying glass. If they do have the temerity to claim that they don't see an improvement, tell them you could do a more thorough cleaning, but it would require using a local anaesthetic - there's something about the idea of someone poking a needle into one's gums that will make even the most stalwart naysayers meekly capitulate.

Notes

[1] I mean seriously, can you imagine a situation less likely to lead to intimacy? How do you even begin to come on to someone who just spent the last twenty minutes staring at the undersides of your gums? Where's the magic? And what do you say exactly, "You want to catch dinner sometime? And afterwards we could go back to my place and floss?". Sheesh (and please, no jokes about filling cavities. Let's keep this clean. And pearly white).

[2] If absolutely nothing ever goes wrong with your patient's teeth, you can always fall back on Plan B - congratulating them on how lucky they are, as though this were some sort of personal achievement.