“Madame, you can go downstairs now,” the receptionist politely orders me to go to the dentist’s area in the basement.
I have no idea where the staircase is. I apologize and also ask where in the world the staircase is.
It’s my first time to see a dentist since I’ve arrived in France, and it’s been almost 18 months since my last cleaning, so I’m way overdue.
Before I left the US, I made sure to have one last cleaning, and I asked my former dentist to email me the latest x-rays they had taken.
It was one of those things I felt I had to do before the big move.
Though after I arrived, finding a French dentist was one of the last things on my mind. What with one administrative hurdle after another, and the difficulty of getting my French socialized health care card (la carte vitale), getting my teeth cleaned didn’t seem very urgent.
And so, after all those big administrative hoops were jumped through, and after a lovely vacation in the US with my family and friends this summer, I finally figured it was time to get that tarter build-up taken care of.
But how to find a dentist?
My first thought, of course, was to ask my husband. However, he’s not one to overcomplicate life. He simply arranges to get his teeth cleaned by his childhood dentist whenever he goes home to visit his parents. Having never had to look for a new dentist (lucky guy!), he didn’t really have any advice for how I should go about this.
I asked a French friend who said to simply look in the equivalent of the yellow pages. I did a little peeking around, but the French aren’t apt to leave comments online or rate their doctors, so I didn’t find much good information on the internet.
Eventually I also ended up talking to my primary care physician about it, who had a specific dentist she recommended.
In that same conversation, she made a comment I didn’t quite grasp. Something about “Sector 1” doctors having lower rates than other Parisian doctors…
My husband didn’t know about this, so I went to Google. It turns out that some French doctors – and MOST Parisian ones – want to be paid a much higher rate for a consultation than the standard rate set by the government.
However, “Sector 1” doctors DO accept the government’s rate, which means the patient pays less out of pocket. Hm!
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I’m all about saving money, so of course I started Googling “Sector 1” doctors!
The first thing I discovered was that the dentist recommended to me by my general care physician was not a “sector 1” dentist, so I was back to square one.
However I quickly discovered that the City of Paris has set up several medical clinics all over the city that are all “Sector 1”. So, off I went to one of these Centres de Santé Médicale et Dentaire to make appointments to see the dentist and another medical specialist.
The building is old (built in the 1800’s or early 1900’s) with 20-foot ceilings, and hasn’t been renovated since the 70’s or 80’s. Perhaps the last time they painted the walls was in 2000. There are lasar-printed laminated signs everywhere to indicate which line to stand in (there are 2) and where to pay.
10 molded wood chairs line the waiting area, which look so modern compared to their surroundings.
Both times I have been to the building, there have been old people and some near my age. Some are clearly immigrants based on their clothes and the heavy accent they use when they speak to the receptionist. Some appear to be professionals like me. No one looks fancy, no one looks to have a well-paying job, no one is wearing a suit or the latest fashions.
When I made my appointment, I was able to set a date within 3 weeks of that time, and then a week before then I got a phone call reminder.
(By the way, general physicians could be seen any day of the week without an appointment.)
On D-day (or le jour J, as the French call it), I arrived 30 minutes early, and I was given a form to fill out while I waited.
I knew only 50% of the words on the sheet. It was one of those medical history charts that every doctor wants you to fill out before the visit – except of course the thing was in French!
I don’t know if I’ve had hémophilie! What the heck is that?
Tediously, I translated every one of those words with the Google Translate App. Unfortunately the app would give me English medical terminology that I didn’t know (haemophilia). So I hopped over to search Google for the layman’s terms for these medical words (fyi: haemophilia is the inability of the blood to clot).
There must have been at least 30 words I had to translate. It seemed to take forever…
The receptionist got so tired of waiting for me to give her the form back, when I was still about half-way done, she got up from her desk to return my carte vitale to me!
I asked for directions, and found the old off-white metal double-doors leading downstairs. I wound my way down a somewhat narrow concrete spiral staircase and followed the bright blue signs with arrows guiding me to the one lone room with the only dentist and her hygienist.
The room had no window, and was spacious, with a small folding table and a computer to the right, next to the metal folding chair where I was to set my purse. On the left was a counter and cabinets that wrapped around the entire left side of the room, and towards the back in the middle was the classic dental chair with all of its lights and attachments.
The dentist was a woman in her late 30’s who studied the form I had filled out and asked me a couple of follow up questions.
So far so good.
And then she instructed me to sit down and asked, “C’est pour un control?” (Or something of that nature.) And of course I had no idea what she meant. Un control? Oye vey. I could tell this might get annoying and complicated, as it had for EVERY previous visit I had had with French doctors.
My French is pretty good, but it seems to all fall apart when I visit a doctor.
When it comes to medical terminology, I lack the vocabulary I need, and the right word groupings to make grammatical sense of what I want to say. I feel like a child who wants to talk about astronomy but who has never learned simple words like “solar system” and “gravity.”
Luckily, I at least know some of the basics for French dentistry like “teeth” and “gums”, so I keep a fairly coherent conversation going.
I apologized for not having the right vocabulary for this, and I explained it was my first visit to a dentist in France. I asked what she meant by un control.
She asked her question in a different way using different French words: do you have specific problems with your teeth that you want me to look at? Ah, this question made sense! Thank goodness.
Clearly she was used to working with non-French speakers, because rewording something confusing is an advanced communication tactic that one must use when speaking a new language, or when speaking with folks who aren’t speaking their native language. This made me feel at ease.
This might not be a horrible doctors visit after all!
I explained in French that I had no specific problems. I told her that I was accustomed to getting my teeth cleaned every 6 months or a year in the US, and that since it had been 18 months, it seemed about time to get them cleaned again.
She nodded and then got started. She examined my mouth for what seemed like an eternity. I’m not sure I’ve ever had such a thorough inspection before.
She told me everything looked very good, and that I had nothing to worry about. I asked her about receding gum lines. I understood her explanation, but maybe she was talking to me as though I was a 5 year old so I would grasp what she was saying. I have no idea!
Then she used a big word again, but I could sort of deduce what she meant. She said she was going to begin the détartrage. This reminded me of “tarter” and begins with “de,” so I assumed she was going to start to clean my teeth.
But first she did a curious thing.
She had no idea that I’m an English teacher, and she stopped and asked me how we say it in English! That made me smile. I liked that she had an interest in being able to communicate in English with her patients. (Though she hadn’t bothered to speak in English with me…)
I told her that among the patients, we say “clean your teeth” or “remove the tarter from your teeth,” but I wasn’t sure how the dentists talked about it among themselves. I imagine there is more formal medical terminology for such things.
She was relieved because what she typically says in English to her patients is “clean your teeth.” I suppose she too wondered if there was a more formal way to talk about the activity.
I leaned back, and they got the lights in the right position and moved my chair up and back so they could reach all the crevices of my mouth.
And then SHE STARTED DRILLING!
Or at least that’s what it sounded like.
The unearthly screeching sounds and sharp whirring sounds like nails on a chalkboard made me hold my breath and clench my hands together. My eyebrows were slightly furrowed for the whole time and my entire body was tense.
I noticed that perhaps I should start to breathe again, so I would try to breath in during the screeching sound and breath out during the pauses. This mostly worked, but I was so stressed about the sound – and the occasional feeling of Oh My God Are You Drilling Into My Tooth? – that I still kept forgetting to breathe normally.
My American dentists had always used a manual pick to scrape the tarter from my teeth.
Back in the US, a cleaning was a mostly painless experience that I almost found meditative and pleasant.
This was not meditative in any way whatsoever!
Usually I mentally keep track of which part of the mouth the dentist has finished cleaning, and which ones they have yet to do. I did this once with a US dentist who was new to me, and discovered that he had completely ignored a whole section of my mouth! I’ve made it a point to monitor their activity ever since.
But the screeching noise made it impossible. I could barely concentrate on my own breathing, how could I possibly track the progress of the dentist?!
Finally she finished.
And I didn’t care if she had missed a whole section of my mouth or not!
I was just so relieved she had stopped!
She then whipped out the polish tool, and went about polishing my teeth. The noises were almost soothing compared to the noises of the pick.
And then it was all done. She cleaned off the bits of polish that had flung themselves across my cheeks, and the hygienist removed the bib.
Before she gave me my carte vitale back, I asked if she wanted the x-rays I had gotten from my previous dentist. She said that would be great! She seemed genuinely interested.
But when I told her I only have them as an attachment to an email, her face fell. She apologized and explained that their state-run computers have no option for receiving emails whatsoever. She recommended I print them off and bring the papers to my next visit.
I agreed and then I made what felt like a daring decision: I wanted to talk to her about the screeching pick she used.
“I’ve never had my teeth cleaned with an electronic tool before,” I said in my rusty French.
“Oh really?! What did your previous dentists use?” She was clearly very surprised. I said that every US dentist I had ever been to had used a manual tool. (I think my more exact words would translate as “a tool with the hand”.)
She was very shocked. Apparently French dentists stopped using manual picks years ago! She seemed to suggest the manual tool was antiquated.
She didn’t even have one of these tools in her office! Wow. I couldn’t get over that.
She then told me that she could tell by what she saw in my mouth that my teeth had been well taken-care of over the years, that I had had good dental care.
The way she spoke, it seemed that the idea of very good dentists still using antiquated methods was the ultimate shock of her day.
Americans are known around the world for having really nice teeth, so I imagine that in her mind, the American dentists must obviously be using the most modern methods available to produce such great results. Apparently not! (At least not the ones I’ve seen…)
I’ll bet she’s going to talk about this with her colleagues at the next dental conference she attends. This may have even marked her for life!
I wondered aloud if the difference had to do with American dentists needing to be more sales-y and to please the client (and gently suggested that the manual pick was a more pleasant experience).
Her guess was that my experience was unique. She posited that hygienists had never needed to use the electric pick with me because of the small amount of tarter on my teeth – but that folks in the US with more tarter might need the bigger machinery to get the tarter off.
Her hypothesis seemed smart to me, though I was a bit skeptical, so I later surveyed American friends on Facebook, and found that most of their dentists still used manual picks, or had only recently started using the electric picks.
But I left the French dentist with neither of us really knowing what motivated the American dentists to use (or not use) a manual pick.
Back upstairs I found the cashier and handed over my carte vitale.
I had no idea what this was about to cost, but I was pretty sure the socialized health care would cover most of it. In the end, I paid 30% of the cost, or 13 EUR, which I may get reimbursed for from my supplemental coverage. Not too shabby!
The total out-of-pocket cost for someone without government coverage would have been 43.38 EUR. (For the cleaning alone, I think it would have been only 28.92 EUR, but it must have been the polishing that cost an additional 14.46 EUR. The bill doesn’t explain this clearly.)
Had I gone to the dentist that had been recommended to me, or nearly any other non-Sector-1 dentist, I would have paid close to 90 EUR, and been reimbursed only 30 EUR!!
60 EUR out-of-pocket is not for me, thank you very much!
I could fly to Barcelona and back for that kind of money…
And I just might. 😉