Russians Rush to Brush Up Long-Neglected Teeth

An old clich? about Soviet Russia was that no one here smiled. But one of the secrets long hidden behind the Iron Curtain was the millions of gapped, iron-toothed mouths, mauled by the most basic of dentistry techniques and the most primitive of Warsaw Pact equipment.


Now Russians, growing self-assured as their lives begin to stabilize after years of political and economic upheaval, are finding time and money to rectify the situation. Suddenly, they want to make their post-Soviet smiles the gleaming white of omnipresent Western toothpaste.


"Foreign companies that produce and sell toothpaste and hygiene products are seriously interested in the Russian consumer market and are very active in placing ads," said Victor Kolomiyets of Media-Service, a branch of the Video International advertising company. "Four or five years ago, there wasn't a single toothpaste ad on television. Now you see them on every channel."


The ads are working.


Tanya Nesterova, 50, decided last spring that it was time to have her entire mouth seen to. The teacher turned housekeeper, a mother of two who recently separated from her husband, paid 8 million rubles ($1,500) to have ceramic crowns put on all her upper and lower teeth. In the United States, the cost of a single crown ranges from $500 to $1,000, but the average wage is much higher.


The once-shy Nesterova, who used to hide her mouth behind a cautious hand whenever she laughed, said she was transformed by the month of dental visits, in which her old teeth were filed down to dark brown stumps before the crowns were slotted into place.


"When I was young, I used to be terrified of the dentist. I never used to go, and that was where the problem started. I got my first false tooth when my daughters were born, when I was 34, and after that it was downhill all the way," Nesterova said. ``Finally, I decided it was time for a fresh start."


It would have been impossible for her to have the work done four or five years ago, she said, when the Soviet Union had recently collapsed and Russia was in the grip of galloping inflation that hit 2,500 percent in 1992.


Nesterova, who earns $400 a month from two part-time jobs and did not have the entire sum to pay the dentist upfront, had no trouble finding friends who would lend her half the money without worrying that the ruble would tumble in value before they are repaid.


To cope with the new demand for dentists, private clinics have sprung up around Moscow. The Moscow Dentistry Institute is the overbooked destination of choice for students hoping to get rich in their profession.


The new clinics add choices for patients who grew up going to the dentist at state medical centers but grew tired of the long waiting lists and delays at the cash-strapped facilities. The clinics have also gone some way toward replacing the dental offices in huge Soviet factories that once gave their workers free care. (Factory workers today are lucky to get their wages, never mind dental care.)


But not everyone is happy with the changes.


"There's too much competition nowadays," said Irina Shinkarenko, who has been head dentist at central Moscow's run-down Clinic No. 3 for more than a decade.


"In the good old days, people used to get in line at 6 a.m. to see us. But now, people come less. To persuade them to turn up here, we have to do things we'd never have dreamed of doing before -- like giving out free advertising calendars with our name and address on the back.


"Our problem is that we don't have the most modern of technology," Shinkarenko added. "Our equipment isn't bad -- our drills are Czech -- but they're not the top-of-the-range Western stuff that would attract wealthy customers."


In the long, bleak corridors of her clinic, mostly elderly people wait stoically, either standing or perched on scruffy chairs. Several clutch white handkerchiefs to swollen mouths. Everyone is silent.


The typed price list taped to the glass partition at Clinic No. 3's chilly reception area focuses almost exclusively on remedial work: fillings, false teeth and crowns.


The price of an ordinary checkup is not listed because the idea of preventive dentistry is still little-respected in Russia.


Educating people to look after their teeth before they rot is one of the goals of the new private clinics.


"Whether or not you choose our clinic, we strongly advise you not to wait for the critical moment but to visit a dentist not less than twice a year," exhorts the glossy promotion leaflet of the Radix clinic, a favorite of Russia's super-rich.


Coffee brews in a corner at Radix, the clinic Aslan Kanukoyev opened more than two years ago. Marble floors gleam. A dental hygienist has a corner salon, and nurses slip in and out of surgical rooms equipped with high-tech drills and chairs. Clients can forget their worries during their examinations by slipping on electronic eye masks inside which they can watch movies.