When was the last time you went to the dentist? Be honest. A year ago? Two? Five? Have you been since your mum stopped booking your appointments for you? It’s fine, this is a circle of trust.
I’ll go first: I didn’t go to the dentist between the ages of 18, when I left home to go to uni, and 24, when yelping in agony every time I bit into a slice of toast stopped being cute. I finally dragged myself along; I needed two fillings. ‘Ah well,’ you might think, ‘lesson learned’. But no! Because after that, I didn’t go again for another five years. And only then because I’d been chewing on the left side of my mouth for so long I was worried my jaw muscles were going to start to look unbalanced. “I can fill this tooth again now, but you will need more work in the future,” warned my dentist. “Make sure you come back in six months.”
“I can fill this tooth now, but tralalalalalaaaa,” I heard, and rewarded myself with a brownie.
For the next two years, I ghosted her. Every time a reminder text about a check-up arrived, I ignored the growing throb in my gum and batted it away with an easy excuse. "When I’m less busy... after I've moved house... after I’ve been paid… when I’ve fully processed the last Fleabag and feel ready for further emotional onslaught." Time passed, I found more pressing things to do. Like painting each fingernail a different colour, or staring blankly at the wall.
Then one day in March, I woke up with toothache so bad that it left me in tears on the phone to 111. Several emergency appointments, one nerve extraction, one root canal, one unpleasant surprise in a mouthful of sandwich, two temporary crowns and £800 later, here I am to grin sheepishly and say: kids, I regret putting it off for so long. But I can’t promise I wouldn’t do the same again.
For all our talk of wellness, there is nothing like bringing up the dentist to make a room of millennials wince. Reportedly the 18-34 age group has the lowest frequency of dental visits, and according to research by Bupa, a third of us haven't been to the dentist in over a year – despite the same proportion using whitening teeth treatments once a week. In fact, more people under 34 are now having cosmetic procedures than normal check-ups. It’s the stuff scathing tabloid headlines are made of: young people care more about the pearly whiteness of their teeth than their strength or condition! We’ll coo over the perfecting potential of an Invisalign brace but let our molars rot away to stumps – because, lol, you can’t see molars in a selfie!
In an informal Twitter poll I just carried out, 55% of my followers had been to the dentist in the past year, 22% within the last three years, and 23% chose the third option: “shut up you’re not my mum.” My DMs, meanwhile, are overflowing with dentist-avoiders keen to absolve themselves. Some haven’t been for five years, some 10 years. Some haven’t been this side of the millennium. Most fall into two camps – the cautionary tales (“When I finally went, I had a wisdom tooth growing into my cheek”) and the proud cynics (“I had a temporary cap put on at least three years ago, under strict instructions to get a crown within six months. I have not done that.”). It’s comforting and worrying in equal measure. But why, in a world of commodified ‘self-kindness’, where everything from buying a £40 candle to bunking off your friend’s birthday to having a wank in the bath can now be dressed up as a radical act of personal nourishment, are we neglecting to look after ourselves in this most basic of ways?
That was a rhetorical question, because of course we all know the answers. 1) Money. 2) Fear. 3) Time. 4) That vague, indefinable paralysis that stops us being able to complete straightforward life admin even though we know we should, and could, and would feel better if we did. The email we should have replied to six weeks ago. The phone call we can’t quite find the energy to make. The chores perpetually bumped down our to-do list, filed away in a mental folder marked “I just can’t right now” for no real reason except… agh.
“This is what I observe in my own practice: young people are busy, and may have many life changes which will take priority – new jobs, moving out, having children, etc,” says Lauren Harrhy, vice chair of the British Dental Association’s young dentists’ committee. She gets it. “They may have been used to parents making appointments for them, but when that stops it’s easy for life to get in the way, so they forget,” she says. “Because they often don’t have obvious problems, thanks to the widespread use of fluoride toothpaste (success!), they may not realise the importance of getting checked regularly for gum problems and cancer, as well as decay.”
For plenty of people, fear is still reason enough to stay away. Although the modern reality of dental treatment is mercifully far from the ‘Steve Martin in the Little Shop of Horrors’-style sadism many of us hype up in our heads, odontophobia is a very real condition, often triggered by a bad experience in childhood. Anxiety UK explains: “Some people have their fear triggered by the sound of the drill, or the thought of needles in sensitive areas of their mouth. For some it is the loss of control which is most feared, for others it is the fear of pain.”
“I’ve always been terrified of the dentist. I don’t know why,” says Megan, 35. “Had avoided going for five years, and then last year one of my teeth just fell apart when I was eating some crumpets one Sunday morning. I ended up having some very expensive treatment, cried my way through the entire thing. And even though I know it’s wrong to avoid it, I still really struggle making that appointment.”
As with so many bodily complaints, there’s also a certain level of shame attached to our oral hygiene that can actually make people more reluctant to talk about our teeth – even to a professional who has seen it all.
“One of the hard things about dental stuff is feeling so ashamed for avoiding the dentist for so long, even though it’s really common,” says Jane, for whom traumatic and painful experiences with dentists in her teens led her to skipping appointments from the age of 19 to 35. “There’s a weird morality attached to it – like if you don’t have those gleaming straight American teeth, you’re a disgusting dirtbag.” Many of us would rather endure great personal inconvenience than the indignity of being scolded by another adult for the way we treat our own bodies; especially one we’re paying for the pleasure. It’s the same reason I cut my own hair for nearly a decade.
After 16 years, a toothache eventually prompted Jane to confront her fear and get checked out, which led to a tooth extraction and referral to a dental hospital for a chronic condition. “It was super stressful but I’m glad to have it under control now,” she says, her fears now balanced by a much better experience with a dentist who came highly recommended by friends. “The treatment was really manageable because they put so much emphasis on patient experience and dignity.”
Personally, I’m not afraid of the dentist so much as resentful – and broke. Grateful though I am for the NHS, and I truly am, I find it hard to square the idea of regular dental work with that other painful cavity: my overdraft. Reading that research by Mintel in 2017 found one in five Brits only visit the dentist “when they think they have a problem with their teeth”, a figure I think we’re supposed to be horrified by, only baffled me further. What are the other 80% going for? The scenery?
But prevention is better than cure, and the annoying truth is it could be cheaper too. Professor Damien Walmsley, scientific advisor to the British Dental Association, explains: “The concern about avoiding regular checks ups is that people may be storing up problems that could end up being more costly to fix in the long run,” he says. “You may be surprised how regular advice will reduce those costs.” The official recommendation from the National Institute for Health and Care Excellence is to have a dental check-up (which should cost a not-too-painful £22.70) at least once every two years – although you could need them as often as every three months, depending on your risk of tooth decay or gum disease.
If fear is keeping you from getting treatment, there’s help available – you can search for NHS dentists who specialise in treating anxious patients, or even be referred to a sedation clinic. Or if cost is the main deterrent, it’s helpful to know you can get free or heavily discounted treatment by signing up to be treated by student dentists, all safely supervised (find your local scheme here). Just try not to think about Josie from Fresh Meat drilling through that woman’s cheek that time. And if you’re on low income support, pregnant or have recently given birth, you’re entitled to free dentistry. Although telling a woman with toothache to “just have a baby, you’ll get it free!” is punishable by floss throttle.
Unsurprisingly, going DIY is a bad idea. “There is a problem with fake news in dentistry, such as charcoal in toothpaste,” says Professor Walmsley. “There is no evidence that this works and as it’s abrasive it can damage the enamel on teeth over time. If these don’t contain fluoride, people will also miss out on the benefits of protecting their teeth.”
“We’d also advise people to be cautious about buying teeth whitening products online or over-the-counter, as these are often ineffective or can damage teeth and gums depending on the chemicals used,” he adds. “The UK has tight regulations on the use of hydrogen peroxide for good reason. High-level bleaching gels can, and do, cause mouth infections, blistering and burns to gums, damage to nerves and tooth enamel and gum-shrinking, as a recent study in the British Dental Journal suggests.” Suddenly those megawatt Love Island smiles look less sexy.
Maybe what we need to do is reframe the dentist, psychologically. We need to see those regular check-ups for what they are: an act of self-care in the most genuine sense of the term. My root canal, when I finally had it, was so impressively painless that I found myself almost enjoying the chance to lie down and zone out for an hour and a half. I’m not saying it was exactly a spa break, but I’ve definitely had worse afternoons – and the results, I’m assured, will last longer.
So if the nagging texts from your dentist won’t compel you to book an appointment, let me give you the prod instead. Go, open wide, congratulate yourself on a feat of personal caretaking. Bite the bullet, while you still can.
And this isn’t dentist-approved, but get yourself a brownie afterwards.