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No Pain, No Gain

by Frank Trinh

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Teeth and Hair

I don't remember exactly how many times I've visited The Netherlands. I vaguely recollect that it would be at least five times. Three times out of England, once out of the USA and this last time, out of Australia. These visits cover a period of over 20 years. Each time that I went it was to visit friends whom I sorely missed.

Visiting people is my main priority, whilst sight-seeing takes second place. This way of travelling costs us less, but gains us more, much like in the early days of being Vietnamese refugees. However, this last time, on my arrival in Amsterdam, apart from seeing friends and sight-seeing, I also had to do something which was to me far more advantageous--that is to attend to my teeth. This trip was about a patient seeking a dental doctor, and looking for a private clinic for a period of two weeks, free of charge.

Looking back at the history of my dental problems, I remember that since my adolescence, which is a time when young adults like to preen themselves in front of the mirror, apart from looking after my hair with shiny brillantine, I still liked baring my teeth and beaming a big smile when I looked in the mirror. "Oh how beautiful is a set of teeth!" They are fantastically fresh and pearly-white! The only problem is that I had two front "tombstone teeth", which were big and very pronounced. Worse still, they were not closely aligned but had a gap of about the thickness of a toothpick between them.

My father, who was an amateur fortune-teller, told me that the gap between my teeth signified someone who was slack and lazy. Luckily for me, the gap between the teeth only lasted for a few years, before it closed over.

A fish on the chopping board

Van Ba dragged me off to his surgery one day in the weekend and took five X-rays of my teeth during the initial consultation using the very latest 'Siemens' X-ray equipment.

I played tennis on Sunday morning, and on Sunday afternoon I was sitting in an 'electric chair'. Van Ba, the dentist, with Dung his daughter as his assistant, also a dentist, gave me a few anaesthetic injections into the gums, and after about five minutes the gums became numb. He filled five holes in my lower right molars. I must add that, whilst sitting in the dental chair, a patient might consider himself as leaving his fate in the hands of the dentist and feeling vulnerable and helpless, lost in the middle of nowhere. This was especially so when the head of the chair is lower than the bottom part, your feet are raised up in the air and your body is arched upwards and downwards. In the meantime you feel groggy and see stars caused by the bright light shining in your eyes. The patient at this time becomes aware that he is like a fish lying exposed on the chopping board.

I thought that it would be the end of a day's work after having my teeth filled, but I found out that my dentist friend was going to take advantage of my situation, when he started giving me more anaesthetic injections, even though he said it was only one. This he said was to make me feel less scared in order to pull out a decayed molar in my left upper jaw. He said there was no way of using his dentistry skills to save it, and if it was left there it would become infected and make my face swollen. Perhaps it is because of this tooth that at times I felt acute pain in my jaw and in my temples, and regularly took Paracetamol tablets to help reduce the pain I felt.

Van Ba was very pleased and considered it lucky when he pulled the molar out intact without breaking the root or having it stick to the gums. If the root had become stuck it should have required time-consuming surgery which would have been most painful. The whole procedure was completed satisfactorily and the newly extracted tooth was wrapped up and put in a pinkish plastic container as a souvenir.

The gums stopped bleeding one hour after the extraction so there was no need to replace the swabs needed to absorb the blood. To prevent the gums from becoming painful after the anaesthetic wore off, Van Ba gave me one pain-killing tablet only. Shortly before midnight, he woke me up to give me some beef curry with vermicelli which his wife, who was also a dental assistant, had cooked. The food was soft and easy to swallow.

There were also four teeth in the upper jaw that had been previously symmetrically extracted, including two canine teeth for which a frame made with high-quality metal hooks would have to be made. He told me this was more successful than using a bridge, because the teeth next to those teeth would not be stable enough to hold the inserted teeth together. He also said that it would not last long if the teeth were not stabilised.

With regard to one front tooth in my lower jaw, it was possible to make a bridge using metal. This extracted tooth, which had been done a year ago, was stuck with resin between two teeth to fill the gap. I had bitten into a chicken bone and this tooth had fallen out. Van Ba also cleaned and ground down the two bottom teeth which were next to the damaged tooth so that the metal bridge would adhere better.

Soft at first, hard later

The surgery had two chairs. The dentist (in Dutch 'tandarts') and his daughter take turns in doing their dental work. Van Ba worked a full day on Tuesday, Wednesday and Thursday. As for the other weekdays he worked half-a-day in the mornings in a School dental clinic treating school children.

One afternoon I went with him to his surgery in order for him to take a mould of my mouth (in Dutch it is called 'lepel', meaning the ‘spoon'). He used a substance called 'alginate impression material'. It is malleable and soft at first, but after putting it in the mouth to make an impression by pressing and moulding against the teeth and gums, in less than a minute the malleable substance hardens.

After this, Van Ba gave me a lift in his BMW and took me to Amsterdam's Dental Laboratory. It was about 10 minute drive and at the Lab they did two things: Assessing the colour of the teeth and measuring the mould as a means of making an accurate cast for the next one. This type of work, ie. taking a patient to the Lab, is normally not carried out personally by a dentist, but since I was regarded as a special patient, I was given priority treatment and taken everywhere.

I had the chance to meet a Dutch dentist, tall with 'salt and pepper' hair. He was babbling in Dutch with my friend for some time. Afterwards I was taken into a room complete with a dental chair to wait for a minute. Out came an Asian girl with a bright shining face and wearing glasses and a clean white uniform. She was vivacious and polite and babbled in Dutch so much so that I felt like 'a duck listening to thunder' because it all sounded Greek to me. I got the impression that she spoke fluent and precise Dutch. Later, I found out that she had an Indonesian background and was probably born in Holland. Indonesia was formerly a Dutch colony. No wonder! I could understand a little of what she said: "If you are Vietnamese you came from the same region which is Asia". She was the laboratory technician who was there to assess the tooth colour.

I went to the surgery at 1 pm one afternoon for the dentist to make the second mould of my mouth, after the Lab had finished making the casts for my jaw--roughly called 'a convex plaster cast'. The value of this moulding is that from this the Lab made two semi-circular casts for my jaw. It's not hard to understand why this semi-circular mould is called 'lepel' in Dutch, meaning 'the spoon'. From this mould the dentist uses the alginate impression material to make a perfect cast. Dr. Van Ba always had a local blonde-haired assistant about 20-odd years of age, who busied herself doing this and that and chitter-chattering incessantly. Hearing the Dutch language used between the two of them and constantly bombarding my ears, I being of Vietnamese extraction, immediately interrupted them and tried to speak with a proper Dutch accent, asking the big buxom Dutch dental assistant whether she knew who Pieter van den Hoogenband and Inge de Bruijn were? With a big smile, the dental assistant repeated the names of these Dutch swimmers who were well-known for the Gold Medals they won at the Sydney Olympics 2000.

The process of having a second cast involved putting the malleable substance into the mould and then pressing it into the mouth, using the fingers hard enough to make an impression onto the jaw and making sure each and every tooth was covered. This created a concave cast. The mould taken from the Lab was put into my mouth and was a tighter fit to avoid cutting into the gum. It would hurt the gums if the semi-circular mould was too small, or if it was too large. It would mean the cast was not made properly. The malleable substance used this time was pink in colour, and when it hardens it is difficult to extract. This is so true, for when my dentist friend pulled it out I had a feeling that my whole upper jaw was also being pulled out. As for the malleable substance used for the lower jaw, it was a mossy-green colour known as 'elastic rubber substance'. When it hardens, it is easy to remove the mould, and when it is used to mould the cast, it is more precise.

Cop it sweet

This less-cost, more-gain trip took me on a journey to have my teeth attended to in Holland over a period of two weeks. It was all my dentist friend’s labour of love. However, I had to 'cop it sweet' and pay the Lab costs for the labour and the dental work, which amounted to the equivalent of 100 Big Macs with French Fries and a large Coke. After all, who else was there to foot the bill?

Frank Trinh
Amsterdam 2001

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