Terrie's Job Tips -- Staying Healthy, Part Three – Dental Care in Tokyo

Something that many of us as foreign parents in Japan are surprised at is the amount of candy Japanese mothers feed their kids - especially in public, such as on the trains and in supermarkets. It seems that the need to keep the kids orderly and quiet supersedes any health concerns and so at the first whine from the stroller, out comes the candy. We can only assume that what goes on in public is probably continued to some degree at home and so you have to wonder if this is setting an extremely negative diet pattern for these kids later on in life.

It’s no surprise, then, that Japanese kids have a relatively high incidence of dental caries and other tooth problems (measured as DMFT: Decayed, Missing, and Filled Teeth) as compared to other developed nations. For example, in 2005, the DMFT for Japanese 12-year olds was 1.7, compared with Australia’s 0.8. But at least the situation is getting better than it was. Back in 1987, the DMFT was 4.9 – extremely high by today’s standards. Of course, those people who were 12 in 1987 are now in their early 30’s and paying the price at the dentist.

It’s interesting that the rate of caries has come down so much, and scientists are not sure why. Although you could point to fluoridation, actually there have been very few new fluoride treatment programs launched in Japan over the last 30 years and in fact most areas of Japan are against fluoridation (although Tokyo adds 8mg/ltr of fluoride to its water supply). So the most likely reason for better teeth must be increased parent education and the advent of painless preventive dentistry.

I was reading that probably another Japan-specific reason for fewer cavities is the fall off in the habit of feeding kids from the mouths of their parents or grandparents. It has long been a Japanese tradition for the mother or grandmother to “pre-chew” a baby’s food, before popping it in to the little ones mouth. We now know through DNA testing that doing this will literally double the presence of S. mutans and S. sobrinus bacteria in the child’s mouth and thus increase the child’s likelihood of dental caries later in life.

But enough of kids, what about those of us who are working? Dental care during the day is now a lot easier because of the Japanese penchant for functional foods. Try purpose-made teeth cleaning gums, which are admittedly a bit hard to chew, or one of the newer Xylitol brands. Just don’t go too hard on the Xylitol, because it can have a laxative effect!

Back at home in the mornings and evenings, you can now buy ultrasonic tooth brushes here in Japan. The original, and best in my opinion, is the Phillips unit, which emits ultrasonic waves from the brush head to dislodge plaque around the teeth. Braun and National brand products seem reasonably good, too, although I haven’t used them. If you’re still using a manual brush, you should try an ultrasonic electric one – you’ll never go back. I was particularly pleased when a new dentist asked me where I was getting my teeth cleaned (meaning which clinic)…!

We all need to go to the dentist regularly, preferably every 6 months. While many of us put off those visits until we’re on holidays back in our own home country, the fact is that Japan is very well serviced by technically competent dentists. Indeed, in 2004 there were roughly 95,000 dentists, 230,000 dental nurses, and 73,000 dental hygienists looking after the nation's teeth. This translates into about one dentist per 1,330 people. So if you get a tooth ache in the middle of the night, you should be able to find someone in your area who can look after you.

That said, older Japanese dentists are often not so sensitive to the patients pain and fear thresholds, and if you’re like me, you’re a wimp in the dentist chair. For this reason, when I move to a new area, I look for a dentist skilled in looking after kids, because that usually means they know how to give injections painlessly and to take it easy on a deeper cavity. There are some good English-speaking dentists around as well, and you can find these on the Internet with a quick search.

A good thing to note is that dental care is covered by the Japanese health insurance, so long as you’re not using “luxury” treatments such as ceramic inlays and such like. This means you pay the first 30% of the bill, and the government pays the rest. Dentistry is technically well advanced in Japan, so they moved to modern resins and composite materials some time ago. I recently went to a new Japanese dentist for a check up and he was surprised I still had so much old amalgam in my mouth. Without hesitation, he recommended I get all my old fillings changed for a more up-to-date material, both for health reasons and aesthetically. I had thought about doing this back home but was always put off by the cost. During his consultation, I bit the bullet and said OK. Three weeks later I have no amalgam left and the bill for each resin filling was only JPY1, 500 or so – a good deal in anyone’s language.

Sometimes it’s good to live in Japan!



I agree that some older dentist are not that sensitive to their patients compared to the younger batch who seem to know how to deal with our anxiety and fear, and yes, the threshold of pain. I'd really like a dentist who is more caring and gentle and is aware that hard as tooth may be, it could really hurt sometimes.