Friday, November 04, 2011

Going to the Dentist in Japan

Today: the dentist (歯科 shika).

Despite the fact that the Japanese seems to suffer from a rather high case yaeba (double or indented teeth), cosmetic dentistry is still much less common when compared to Western countries.

However, there are plenty of dental clinics all over the country. In today's guide we will cover all the important differences and points of interest regarding the Japanese dental establishment.

Finding a Dentist and Making an Appointment
In Japan, dentistry is considered part of the basic medical establishment (see our previous article on medical specialties for details) and all the basic rules of Japanese health insurance apply to a dentist office (i.e. paying 30 percent of expenses up front, out-of-pocket expense limits, etc.). However, there is one important difference, which is that dentists almost always require appointments. 

The waiting list for dentists varies greatly depending on the size of the clinic, staffing, time, and general popularity of the dentist. Like regular doctors, dentists generally keep a split schedule with morning and afternoon hours. In this author's experience, wait times for non-emergency peak hours are generally 1 to 3 weeks depending on the dentist.

Dentists are plentiful and, like doctors, are often family establishments passed down through from parent to child. You can use websites like or to find all the various clinics in your local area as well as their specialties and office hours.

Dental Visits and Follow-Ups
Dental clinics (歯科医院 shika iin or 歯科クリニック shika kurinikku) are generally private practice establishments, however almost every doctor employees a few dental hygienists (歯科衛生士 shika eiseishi) to help with his or her duties. Chances are, unless you are getting a tooth drilled or braces put on, you will mainly be seeing the hygienist. 

One common complaint about Japanese dentists is that they rarely do everything in one sitting. Many dentists offices are quite small and, like doctors, the insurance system encourages seeing as many patients per day as possible. It's quite possible that you will get x-rays one day, come back for brushing and gum checks the next and then get your teeth cleaned over a series of appointments. 

Some people have complained that dentists schedule unnecessary follow ups simply to milk you for insurance money and, while that may be the case, my experience has largely been positive.

Check-ups and Cosmetic Dentistry
After your initial check up, dentist offices will generally send you out yearly post cards to remind you to come in for your annual appointment.

Keep in mind that insurance only covers necessary treatments like cleanings, check ups, treating broken teeth, cavities and so on. Elective treatment (選択医療 sentakuiryo) must be paid totally by the patient and for the most part these procedures are not cost controlled. 

In the case of dentistry, elective treatment includes aesthetic dentistry (審美歯科 shinbi shika) and corrective dentistry (矯正歯科 kyosei shika). This covers tooth whitening, specialized tooth cleaning, braces, customized implants, and high quality fillings. If you get a cavity filled, insurance will only cover the most basic type of filling and cap. Implants are generally considered an extra as well. Unlike other countries, braces are never considered to be a medical necessity, even in the case of extreme tooth deformation.

As it's where the money lies, dentists aren't shy about pushing for braces and extra cleaning. Generally speaking, braces are still considered a luxury in Japan and they are generally significantly more expensive when compared to the US.

A few last things to keep in mind are that if you are looking for more invasive dentistry (surgery, gum work, etc.), make sure you find a clinic that specializes in oral surgery (口腔外科 koku geka). Like a doctor's office, its a good idea to bring a Japanese speaker along to fill out forms and explain your symptoms in detail. Luckily, many younger dentists have a fair comprehension of written English and basic medical terminology so its not impossible to communicate.

And that's a wrap. If you have any personal experiences or advice you want to share, please feel free to add comments. Also, check back to our health insurance, medical specialties and doctors office articles if you have other any burning medical questions.

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