“This tooth is very bad. You will either have to get it out or have a root canal treatment done.”
I do not remember how many thousand times I have repeated those words and I spoke them once again in front of this girl.
“I do not want the tooth removed, doctor.”
“In that case it will be the RCT”
When it comes to root canal, my patients are always worried about pain. The words “drilling deep into the tooth”, “removing the nerves” etc, which we employ while explaining a RCT, are enough to evoke terror just by the very mention of those three letters. But most of those who choose to undergo the process will agree that it was not at all as bad as they had imagined and that it was almost painless.
But not many would agree that paying the fee was painless.
“What will be the cost doctor?”The girl came straight to the point.
I told her about the fee that I usually charge and in her case it had to be multiplied by two. She had two very bad teeth.
“Can’t you do it for less?”
I had to explain to her why it costs so much and indicate my helplessness as far as the charges were concerned. But then, she started explaining HER helplessness as far as the charges are concerned, bringing in her family conditions, their financial status, college fees etc etc for good measure. Since I had no heart to force an extraction and since I found that she was genuinely interested in retaining the teeth, I agreed to do her RCTs and accept whatever she could afford, as my fee.
The treatment went on longer than planned as she missed appointments because, as she put it “I could not arrange the money doctor,” and at one stage I told her to be regular for treatment and think of paying the fee, later. I finished the treatment three months after starting it, instead of fifteen days which it usually takes, and the last installment of my fee was paid another three months later.
I was surprised to see her once again in my waiting room. I don’t like my RCT cases back in my clinic. If the tooth is still bothering them it indicates that my treatment might be a failure. But here that was not the case. The teeth were fine.
“These fillings that you have done, Doctor,” she indicated the teeth that I had treated, “they look black. Can’t you make them look white? like that?” she pointed to her friend who was with her and who was also a patient of mine. I had filled her friend’s front teeth with the ‘natural’ looking acrylic filling material.
I told her that the material which I had used for her friend’s teeth were not suitable in her case because of various factors. I reminded her that her fillings were on the grinders at the back of the mouth and were not easily visible. I pointed out that had I not filled them myself, even I would have had difficulty in locating them.
“No doctor. Little bit of the fillings are seen when I open my mouth wide. When I laugh”
I told her not to laugh and not to be a fool. I informed her that her fillings were functioning very well, were expected to carry on like that for a long time, and were not affecting her looks at all. I said that we may not get such good results if I changed them.
“It is alright doctor. Even if they last one or two years it will do. We can do them once again if required. I want these fillings to be white. Please.”.
I really did not like the idea. Those fillings were very good. They were not black. May be they were greyish. A wee bit was visible when she opened her mouth wide. That’s all. The new light cured acrylic fillings were not indicated in her case. I wanted to avoid it. But she was insistent. She had a fixation about those fillings.
“If you don’t want to remove the whole filling, at least remove the part that is visible and fill it with that white material doctor. Please.” She almost begged.
I got an idea.
“That material is quite expensive. I can’t do it free. It will cost you a lot.” I quoted a figure higher than what we charge for a filling and hoped that at least the cost would deter her.
“It is Ok doctor, I don’t mind. Do you need an advance?”
I was flabbergasted. The same girl who had pleaded with me to reduce my fees and had delayed getting the very essential RCTs since she could not arrange even the reduced fee, was here, saying without a second thought, that she was ready to pay an almost equal sum for a treatment which was only cosmetic and which she thought was more aesthetic.
Whatever it is, it was her fillings and her feelings and I had to bow down.
She insisted on an early appointment, got the new fillings done and paid on the spot.
After it was done and the payment was received I started thinking. I used to say that it is the money that matters. But when it comes to looks, even if it is just what one thinks about himself/herself, money does not matter. I do not know how she managed to pay the fee. One part of my mind said that I should have shown the same consideration as RCTs and should have charged her bare minimum. Another part said since this was an unnecessary treatment and had to be done just because of her feeling, it was OK to charge her as I did. I don’t know. But it is no wonder that we have a booming cosmetics industry with hundreds of products pampering hundreds of feelings with promises to make one look better and no wonder that my cosmetic dentist colleagues are raking in the stuff in sackfulls.
A Saying On A Ride
5 days ago