As a Chinese saying goes, dental pain is not an illness but it can almost kill.

Visiting a dentist thus becomes a must for most Chinese only when painkillers don't do the trick.

But Chinese dentists and experts are calling on all the Chinese to go for regular dental check-ups and treatment.

The quest to get more patients to properly care for their teeth is even more urgent today as most Chinese adults suffer from dental ailments and many lack awareness about dental care.

However, overcoming the universal phobia of the dentist's ear-piercing drill will be like pulling teeth. Crowded public dental clinics, the stigma associating dentists with pain, and the distrust surrounding the private dental clinics cropping up in China are just some of the roadblocks to coaxing more patients to take better care of their pearly whites.

Until recently, the specialized public dental hospitals or departments were the only places patients could turn to. Today, most people who go for dental services complain of long queues and crowds in the public hospitals.

That's why Wang Haipeng, who runs a private dental clinic in Beijing, hopes the mushrooming private dental clinics may provide convenient services for more people. With more people recognizing their dental skills and better service, the number of private dentists in Beijing have already equalled or even exceeded the number in the hospitals.

Dentists said another step to encouraging patients to visit their dentist is they have been trying to push Chinese dentistry to attain international standards.

More than 90 percent of the Chinese adults suffer from such dental diseases as periodontitis, or the inflammation in the membrane attaching a tooth to the bone of the jaw, according to Professor Zhang Boxue, leader of the technical team for the national survey on oral and dental epidemiology.

Professor Zhang warned that people with dental ailments are more susceptible to diseases in the heart, the lung and the stomach. They are more likely to develop diabetes as well.

The World Health Organization lists dental ailments as the third most serious common disease in the world, Professor Feng Xiping of Shanghai Institute of Stomatology emphasized.

Dr Wang, who runs a private dental clinic, also observed: "Most Chinese visit me with fears. It seems to be deeply rooted in their mind that dentists brought them pains."

He often encountered such an awkward situation when he was talking to some people. The moment he said that he was a dentist, the easygoing atmosphere quickly turned cold and people got nervous.

By comparison, many foreigners in Beijing working in the embassy would often take their children to Wang's clinic to have a regular check-up for their teeth. Though quite young, they seemed to have no fear at all. They would sit on the chair at ease and fiddle with their fingers.

Wang pinpointed two main reasons for the Chinese's aversion to dentists.

First, many Chinese have not developed a regular oral healthcare habit because little was available in the past. Many people turn to a dentist only as last resort when they couldn't bear the excruciating pain.

"At such a stage, despite our efforts, patients still feel pain during the treatment," Wang said. "So there develops a vicious circle and the painful experience makes them more afraid of coming to a dentist."

Secondly, some dentists should take the blame for their cold attitude towards their patients, making the patients more nervous and more sensitive to pain.

But in recent years, especially in Beijing and Shanghai, the dental philosophy of some private dentists is quickly keeping in line with those professionals in Western countries.

What Wang does in his clinic may break the ice between the dentists and their patients, he said.

He tries to persuade his patients to go for regular check-ups and early treatment to help avoid more painful visits as their condition worsens. He is also pleasant and smiling while talking to patients to help relieve their jitters. What's more, he administers anaesthetics with thinner needles to reduce their fears and pain.

Some people who go for some of the private services discover differences between the public specialized hospitals and private dental clinics.

Take Jia Zetao, a company worker, for example. Jia often had problems with her teeth. In the past, she went to public dental hospitals. Each time she had to queue for a long time.

One of her friends recommended a private dentist to her, but she was doubtful about his dentistry skills and hygiene.

Jia said she was lucky to meet Wang at the clinic. Wang had made what she described as perfect porcelain crowns for her. She found the quality of Wang's dental practice was the same as the dentists she'd seen in hospitals, she said. Also, the cost there was similar to that in the hospital.

But she said the service was far more convenient and friendlier.

Wang's dental clinic is situated in the Chaoyangmen central business district in Beijing. The deco and furniture are of lively green and light yellow and the equipment brand new. Pleasant music relaxed patients, making them quickly forget they were in a dental clinic.

Before starting each treatment, Wang would suggest a full-oral examination for the patients and then give them a clear understanding of what was to be done and what to expect as the outcome.

"Good dentists take a personal interest in patients and their health," Wang said. "They are prevention-oriented."

Crusader for Quality Control

Ten years ago after graduating from Capital University of Medical Sciences, Wang surprised his supervisors and classmates and chose to join a private clinic. At that time, not more than 10 private dental clinics were found in Beijing, which got far less acceptance back then.

"It is a risky choice," he said.

"But dentistry demands more personal efforts to gain the professional proficiency. Staying in private clinics gave me more time and freedom to learn the most advanced techniques."

Not as many patients came to the private clinics as in the hospitals. Wang commonly just saw two patients a day. So it allowed a sufficient time for him to prepare for each patient and work out specific treatment strategies, he said.

When he finished each treatment, he would evaluate which parts of the treatment he did well or needed to improve on. In this way, he felt his dentistry technique was quickly enhanced.

"High-quality dentistry cannot be done in assembly-line style which was often the case in crowded hospitals; it takes time and meticulous attention to detail," he said. "The low-quality work may fall out or decay in a few years."

Wang said he felt that private dentists are keener to learn new dental techniques. "Private dentists depend on the introduction of new techniques to attract the clients," he explained. "If their dental skills lag behind, the income would decrease."

So as long as there were lectures concerning dentistry, Wang wouldn't hesitate to pay to participate. At those lectures, he said he often recognized many of the familiar faces of other private dentists.

It is generally much easier to introduce the most advanced medical equipment and materials in the private clinics compared to the hospitals, Wang said. He believed it also contributed to the faster technical innovation in private dental practice.

Dental Care Awareness

Different from the regular practice a decade ago when dentists only cared about treating diseases, today they pay more attention to attaining an aesthetic effect for the teeth. Going beyond the level of simply applying dental technologies, dentists today aim to give the patients natural-looking and beautiful teeth.

"At such a stage, practising dentistry was not a dull drudgery any more, but a really pleasant thing," he said.

The fears about dentists may not be dispelled in a short time, but some believe that more and more people are starting to become more aware about dental care.

Five years ago, upon hearing the advice of his brother returning from abroad, Qi Sheng, an IT worker, started to visit dentists regularly to have his teeth examined and cleaned.

"Detect the problems earlier, and there are no pains at all for a treatment," he said. "It also saves money because when there is a toothache, it commonly costs much more to care for it."

While professors Zhang and Feng work in the public domain, Wang, in his private capacity, has also tried to make the fundamentals of dental care and dental practice known to the public in his own website.

He has tried to establish the credibility of private dental clinics with his own efforts. After all, the general public are still mistrustful of those clinics. Last year, the media reported that some private clinics in a bid to save money, allegedly didn't follow strict disinfection procedures, even though they run the risks of cross-infection.

In his website, Wang tells people to be cautious. He hoped the patients could also become an expert and could better choose a dentist.

"The medical skills and morals of doctors in private clinics are in serious polarization," he said. "Driven by economic gains, some advise the patients to receive some unnecessary items of treatment. There are a lot of medical traps not easily identified by common patients."

In Western countries, special dentist associations exist to strictly supervise the practice of the clinics.

In China, however, it is the government department that undertakes the role. Due to the lack of professional knowledge about dentistry, the supervision is not strong enough.

"The only thing I could do was to help more common people know about these problems, whether writing articles online or delivering lectures," he said. "I hope the private clinics could have a healthy development and the dentists could win more respect."

(China Daily October 12, 2005)