Zagreb Story

January 14, 2018

This story is about teeth.

This story is about complicated, stained, and broken teeth.  

This is the story of my friend Carl's teeth, teeth that stirred a village and sent us halfway across the globe.

 

 

It was early September. We sat in the waiting area of a small dental office in Belltown. Nervous energy blanketed the room. Months before, my friend Carl asked if I could come hold his hand at the dentist's office.

 

My friend went to this appointment with an encyclopedic history of gristly dental experiences. Carl had gotten kicked out of dentist's offices for panicking, had pulled his own teeth out with pliers, and had generally neglected for all of his life. As a baby, his mother left him with a bottle of kool-aid to sip on in this crib, causing him to wear a set of metallic crowns until age seven. By age eighteen, he was told that he had a dental nightmare on his hands, that his teeth wouldn't last long if he didn't immediately mold his life around them. When faced with a decision to either fix his teeth or take out student loans, he put health on hold to go to school. Carl had hidden his smile for most of his life.

 

Not many things could willingly bring my friend into a dental office, but by that September morning, his teeth had been breaking weekly. He was afraid of tough food, or dinner parties, or even brushing too harshly. There were only a handful of dental offices that accepted Apple Care (Medicaid), his most basic low-income insurance.

 

We had waited two months for this appointment.

 

The doctor asked Carl to recline back as I huddled in a chair next to him. I quickly understood that his phobia was unlike the anxiety most people feel – the moment the dentist examined him using a pick, Carl's face went hallow and pale, glazing with sweat. His hands were violently shaking.

 

The dentist turned to me when he finished, avoiding Carl's gaze. He explained that we could salvage between two and four of his teeth, but even that was a gamble. He emphasized that full extraction was the next and only step covered by insurance.

 

My friend Carl was 42 years old when he was told he needed dentures.

It was the worst news imaginable, news that hadn't even entered the realm of possibility going into this appointment with him. My mind began to race to justify how dentures couldn't possibly be that bad, how it would take an adjustment period. We began to accept the reality of painful extractions and long healing times. My friend's jawline might forever change and he might never be able to taste his favorite foods the same, but that was all we could hope for with the insurance we had.

Even with the spotlight on America's healthcare crisis, wealth inequality in the sphere of dental care rarely comes up in public discourse. In a 2016 survey conducted by FAIR Health, 20 percent of consumers in America reported that they never visit the dentist, or only do so when the need becomes critical. The dentally uninsured rate is roughly four times that of the medically uninsured rate, leaving roughly 74 million Americans with no coverage at all. Medicaid, the state-federal program for low-income Americans, is only accepted at 38 percent of dental clinics. In some states, Medicaid doesn’t cover dental work at all. This problem creates a need for individuals to purchase private dental insurance packages, many of which fail to offset the financial burden of a serious procedure.

 

On average, private dental insurance packages limit coverage to $1,500 annually, focusing on routine checkups and cleanings. The typical dental plan requires a 50% copay for complicated procedures such as crowns and bridges. Meanwhile, the average cost of a root canal in the US ranges from $511 to $1,274, the cost of a single crown is $309 to $1,450, and a single dental implant ranges from $3,000 - $4,500.

 

What is a low-income odontophobe to do?

There was a nagging voice in the back of my mind that I couldn't shake.

 

The news was heartbreaking, but our dentist's tone was blasé and indifferent. He made no eye contact, showed no signs of empathy. The devastating diagnosis came with a side of judgment  and no practical alternative. How could we trust someone parroting what an insurance company could provide without taking even a moment to hear our circumstances? This person didn't care about us. He couldn't possibly know that my friend was an artist who occasionally painted cotton-candy paletted portraits of subjects restrained by dental equipment, influenced by his nightmares about teeth. He couldn’t know the extent of Carl’s fears about this.

 

My problem wasn't that he didn't care; that wasn't his job. My problem was with how he made us feel sub-human while delivering the news, how we had already waited two months for this appointment, how this clinic told us that we couldn't start any fillings without insurance approving it first (a process that could take another 3-6 weeks).

 

Anger began to knot my stomach. What if there were other options out there? What if this was a surface judgment because of how we looked or dressed or because we had gone to a low-income clinic?

As weeks passed, I watched Carl shroud himself in a dreadful hopelessness, retreating from the world. The more I watched him retreat and accept circumstances, the more my anger boiled, turning into fuel. We had to fight this, somehow. The first step was finding a second opinion, so I reached out to handfuls of the best clinics in Seattle. Within two weeks, we met with Dr. Hasan Dbouk, who offered a free consultation. After examining Carl's x-rays, Dr. Dbouk gave his feedback.

 

“You're only 42 and your roots are strong. With the proper treatment, a series of root canals, bridges, and crowns, we can save your existing teeth. I would be very sad to see you get dentures at this stage in your life,” he explained. Dr. Dbouk was confident that a full extraction would be unnecessary, forever altering Carl's speech, appearance, and ability to eat.

 

“The bad news is, the treatment you need is costly,” Dr. Dbouk added. He went on to describe the process, which would involve between one and two years of visits and about $25,000 - $30,000 (a cost universal to most local clinics). The ray of positive news was instantly overshadowed by the unattainable cost. We felt just as lost leaving the clinic as we had been going in.

Mary Otto puts it most eloquently in her book Teeth: The Story of Beauty, Inequality, and the struggle for Oral Health in America.

 

"In the way that they disfigure the face, bad teeth depersonalize the sufferer. They confer the stigma of economic and even moral failure. People are held personally accountable for the state of their teeth in ways that they are not held accountable for many other health conditions."

 

It's more than a medical issue or a cosmetic one. Where a medical issue may be disguised, teeth make or break a first impression, highlighting an income-based struggle. The problem is propagated by more and more low-income workers seeking customer-service work; America's service-with-a smile-mentality causes fewer employment opportunities for those with inadequate dental care. Our cultural discourse portrays two extremes; the Hollywood smile and the offensive hillbilly trope. The former is lusted after, the latter mocked and ridiculed. While much of America's poorest population concentrates in rural areas, we poke fun at the most transparent evidence that the commodification of health care is a systemic problem.

As time went on, I began thinking of anecdotal stories of my immigrant friends traveling back to their home countries for affordable dentistry. Our situation felt desperate, so why not toy around with the notion of sitting on a beach in Costa Rica? I could be drinking Piña coladas out of a coconut with a twisty straw while my friend suffered in a dental chair. There would be hammocks and sand and ocean for miles. The daydream was a comfort.

 

One day, it occurred to me that my fantasy could have some legitimacy behind it. Seemingly overnight, I became an obsessive bathrobe-clad recluse glued to the internet. I found myself placing expensive calls to the Philippines, translating Bulgarian websites, and navigating time zones. Carl was questioning my sanity.

 

The problem with the research was that I had no idea what I was doing. The overflow of information was overwhelming. The prices were all over the place, or I couldn't find English-speakers, or the clinics themselves seemed dodgy. As my phone bills skyrocketed and desperation grew, I turned to a Berlin-based company called Qunomedical for advice. Qunomedical was comprised of professional researchers, customer service specialists, data analysts, and doctors – essentially, caseworkers that connected patients to clinics.

 

I spoke to Emma Allen, a health manager in Berlin. We became as inseparable  as could be over email. I scanned in Carl's x-rays, which she passed on to a series of clinics overseas. When she sent me a quote from Poliklinika Bagatin in Zagreb, I nearly cried. Suddenly, my fantasy dream escape turned into the most viable chance we had to fix Carl’s teeth affordably.

 The quote from Poliklinika Bagatin in Zagreb provided two options, and one of them was within our tiny budget. The attainable option would preserve Carl's natural teeth for a number of years, but wouldn't change the discoloration or appearance. I secretly lusted after the less attainable option for my friend, one with full ceramic crowns and bridges. I wanted to see Carl smile confidently – and to minimize potentially traumatic dental visits in his future.

 

I began exchanging emails with Tea, the head of the dental tourism department at Bagatin. I read glowing reviews from foreign patients who had traveled to Zagreb and had their lives changed. I drooled over the facilities, which appeared more modern than any stateside dental clinic I had ever seen. I was stunned, but trying to preserve a healthy degree of skepticism. 

One evening in early October, Carl and I sat down for a Skype meeting with Dr. Marin Radic, the dentist we had been consulting with. Dr. Radic spoke flawless English and sat behind a window wall overlooking a panoramic view of Zagreb. Even discussing root canals, his calming presence overshadowed the sound of the multiple invasive procedures.

 

It still felt too good to be true, but this option offered us what we needed in the span of a week. After the call, Carl and I looked at each other in dumbfounded silence before agreeing that the radical option was our only option.

Then came the question of financing. Between the two of us, Carl and I could scrounge up enough for airfare. We could potentially take on side jobs and raise the bare minimum, but there was no guarantee that his front teeth would even last longer than a month. The idea of starting a GoFundMe came up, but I railed against it. Dental campaigns were known for failing, and my pride formed an iron baricade against asking for help.

 

It was our friend Charles Holzhey who convinced me otherwise. Charles had been there for the Carl-pulling-teeth-with-pliers incident and understood the necessity of finding an alternative. Charles stepped in, writing the story from his perspective. He advised us to raise the bar for donations to be as high as the unattainable, extreme-makeover option. There was no way we could raise twelve thousand dollars, I thought, but there was no harm in trying.

The cynic in me was wrong. Donations poured in from day one.

I marveled after the first day when we reached nearly a grand.

After five days, the number was over four thousand dollars.

 

The donors were baristas and visual artists, touring musicians and video game designers,  passing acquaintances and project managers.

People who had never met Carl gave.

People who had nothing to give gave.

 

When we boarded our first flight, we were just shy of $10,000.

Carl chuckled at my early cynicism:

“You don't know who my friends are.”

When I first met Carl, one of the things he had told me was that he would never get to travel out of the country. He had never held a passport before, had never even crossed into Canada. Most of his life had been paycheck to paycheck, so Europe was just another far-off place depicted in movies.

 

My freelance work slowed in wintertime, allowing me the freedom to go with Carl for moral support (since I had grown up in Europe, it wasn't nearly as daunting). I had booked a cheap and difficult itinerary, but one that allowed us plenty of cushion in the case that anything were to wrong. We decided to forego checking luggage and brought our own food for the long flights. We refused the hotel Bagatin's guests typically stay at, opting for an AirBnB instead.

Between the GoFundMe and the first flight to LA, I had exchanged over 90 emails with Tea. I kept looking for validation and kept finding it through every immediate response and phone conversation with her. This was a person deeply devoted to their work, willing to take my late night, anxiety-ridden calls. She did as much hand holding as is possible from across the ocean.

 

“You'll be really happy, I promise. Did you know this is an amazing time to be in Zagreb? We have some of the best Christmas markets in Europe,” she assured, “the whole city is covered in lights”. We had taken to calling Tea our angel.  

 

The time leading up to this blurred in a mixture of extreme gratitude and genuine terror. The night before our flight to LA, we delivered tearful goodbyes to some of the friends who had helped raise the funds. Neither of us could sleep that night.

 

We headed to the airport before the crack of dawn on Thursday morning, from which point I documented each day in a leather-bound journal.

 

Here are the journals from our time in Zagreb.

 

DAY 1 – LA

Carl and I land in Los Angeles. We get a ride to a nearby airport hotel and check in early. We have a full day to kill, so we head to Santa Monica and take advantage of the flawlessly warm weather. We catch a sunset and grab dinner, walking the promenade until our feet can't carry us anymore. The nerves of what we've committed to are beginning to set in. This feels like madness. How did I actually convince my friend to do this with me? Why was he so easy to convince? What if something went wrong? What if the payment doesn't go through? What if one of my sketchy flights doesn't exist?

DAYS 2 & 3 – Stockholm & Zagreb

Our flight to Stockholm exists! We have nearly eleven hours in our skyseat to watch movies and binge on cheap calories. We marvel over Norwegian's dimmable windows and the vast expanse of ocean beneath us. In Stockholm, we share an espresso and wait for our flight to Zagreb. Time crawls and we try to sleep. Finally, we board and fly and descend into our new home for two weeks. It's late evening by the time we arrive and get a ride to our rented apartment.

 

Our ride takes us to a series of cement buildings, the color of stale bread and reminiscent of old Soviet tenement housing. We carry our luggage up two flights of stairs and meet up with our host, Melita. I can tell that so far, Europe is not what Carl had expected. His expression is a combination of inquisitive and alarmed.

 

Still, the apartment is small and cozy and only a short walk from the clinic. We have instant coffee and Netflix and blankets, enough creature comforts for healing.

DAY 4

Carl and I have one day to recover from the flights and figure out our surroundings before the dental work begins. We scope out the breakfast situation and walk to city center. The Christmas markets are the easiest to find; they've stretched through every major landmark and busy street. Tiny white booths shaped like houses line the olden square, vending mulled wine and bratwurst and fritters. We find live performances and an outdoor ice skating rink. People huddle around heating lamps and bundled up kids run around the fire pit laughing.  “We're coming here every day, right?” Carl asks. He seems more at ease now, learning that the city is, indeed, every bit as beautiful as we had hoped.

DAY 5

Carl and I have a meet-and-greet tour and get to see Poliklinika Bagatin for the first time. We nervously walk over to the highrise building, not knowing what to expect.

 

The elevator drops us on the 10th floor and we enter into the waiting area. The receptionists take our coats and offer us espresso and fruit juice, but we can barely process what we're seeing. The entryway is immaculately decorated, with an enormous window wall showcasing a view of Zagreb.  It becomes clear that we've entered a luxury clinic, a place we wouldn't dream of having access to in America.

 

A few minutes of confounded staring later, we finally meet Tea. Tea is everything I had pictured; her warmth radiates as she asks about our flights. She introduces us to Dr. Radic, who turns out to be every bit as charming in person. They walk us through the schedule of appointments and take Carl's x-rays in the most futuristic, efficient x-ray machine I've ever seen. The clinic has a dermatological department and a second plastic surgery campus in city center. “We'll take care of you too,” Tea offers, asking me if I'd like a complimentary session with their dermatologist and a dental exam. I nod happily at the perks.

 

Carl and I walk out of the clinic, our tension lifting.

DAY 6

The difficult days begin. Carl had feared the root canals most, nearly scrapping the Zagreb option when he found out he needed eight of them. We meet Dr. Ivan (who specializes in endodontics) at 9:00 am. Dr. Ivan is young and witty and seems every bit as trust-inspiring as Dr. Radic, inviting me to take over his desk for the day. I play DJ for the morning.

 

Carl is given local anaesthesia and the canals begin. You can tell Carl's discomfort from his leg movements and eyebrow creases. The procedure is uncomfortable to watch, but not as bad as expected. Oddly, Carl doesn't show the dramatic anxiety symptoms like he did with the last two dentists.  

 

Our second appointment that day with Dr. Radic is for three full hours of teeth grinding. I had assumed that the root canals would be the hard part, with the grinding as something uncomfortable we could just get used to. Dr. Radic and his dental assistant, Sandra, get to work. They begin on Carl's upper teeth and I watch my friend sweat and stiffen. I hand him my phone for music, trying to drone out the sound of the drill. Eventually, I get used to the procedure and tune out, focusing on my book.

 

Midway, I look up and am jolted in horror. I had absolutely no idea how much would be taken off of each tooth during the grinding process. Dr. Radic explains that it's a 30 percent reduction, and the parts he is removing are not healthy. Still, the significance of the reduction is a visual shock (Carl would later refer to it as “rat teeth”). I want to document this part of the process, but I freeze completely – my impulse is to leave the room, to sit in the bathroom and sob. I had brought him here and there is no going back from this point. I hope against all hope that he doesn't run his tongue over his sanded down teeth, that he doesn't become aware of how intense this procedure is. Almost 2/3rds of the way in, Carl comes close to passing out. Dr. Radic doesn't miss a beat, lowering Carl's chair and gently lifting his legs. I want this to be over. I can't fathom the shock of sensing the jagged dents his teeth are being reduced to and thank every deity imaginable that Carl isn't handed a mirror during this process.

 

Simultaneous to the revulsion, I have all of the confidence in the world about the work Dr. Radic is doing. We are in the best hands possible for this procedure, surrounded by empathetic people who sooth, comfort, ask questions, and show curiosity.

 

Towards the end, they force a metal sphere into Carl's mouth to take a gel impression. Where the grinding was psychologically taxing, this part appears physically disquieting. I don't know how Carl feels, but I'm ready to be done watching this. Dr. Radic puts in a plastic prosthetic for Carl's upper teeth. “We can't have him running around like Dracula,” Dr. Radic jokes, lightening our solemn, terrified mood.

 

The prosthetics look bafflingly real, like a version of Carl's natural teeth, only whiter. We're sent out to return the following day for more root canals and teeth grinding.

Carl wakes up in the middle of the night in pain. Croatia doesn't allow opiates to be administered for this kind of dental work, so we have a gentler painkiller in the form of strong Ibuprofen. “Can we please get a drink somewhere?” Carl asks. I can't even bother with trying to dissuade him and we wander off into the only place shady enough to be open at this hour, a largely vacant casino two blocks away. Carl gets lost in conversation with the bartender, who speaks perfect English and entertains us with stories late into the morning. He grows animated talking about his life and what brought us here. We tip heavily, meandering home to prepare for our second appointment.

 

DAY 7

Three hours of teeth grinding to begin at noon. Carl tunes into his zen place, drowning out the drill with Gorillaz and Beastie Boys. A few minutes into the grinding, Tea pulls me out of the room.

 

“I hear yesterday was pretty emotional,” she says. I tell her that the visual shock was heavy on both of us. She relates with how it felt watching her father go through the same procedure. We sit and talk for a while. I instantly feel comfortable sharing anything with her, like catching a close friend on lunch break.  I come back into the room and Carl takes out his phone. “Look what I did,” he says, proudly. He shows off a Nosferatu-selfie baring all of his ground down teeth. It's the most gruesome, ghastly photo I've ever seen of him.

 

“That's just great,” I mutter, thinking about how my attempts of keeping him away from mirrors have been entirely futile.

 

“When else am I going to be able to do this?” he shrugs nonchalantly. I'm confused that the man who couldn't handle a dental pick back in September is taking a selfie of his living nightmare, but I also take it as a positive sign.

 

Compared to the grinding, the 3:00 pm root canal doesn't seem so bad. The sun glows in a grandiose ember of sunset as Dr. Ivan tunnels through my friend's teeth. At home, I cook gnocchi that Carl can't eat. We fall asleep by 7:00 pm, still jetlagged.

 

DAY 8

The longest days are over at this point. We have a final root canal with Dr. Ivan, but by now we know that root canals are the cakewalk of our dental story. I visit with the dermatologist, not understanding anything that is done to me but feeling pampered. The doctor removes some keratosis from my skin with a tiny lazer and I marvel at how this is a little thing I never would have done for myself. In America, this bonus would have cost me at least a grand that I would never have to spare.

DAY 9

“We found your artwork, by the way,” Sandra tells Carl when we meet for the final appointment of the week, “it's very beautiful”. Dr. Radic agrees and it occurs to me that they must have grown curious about him, finding his website on their own time. There's something touching and fundamentally human about this small gesture.

 

This is supposed to be the easy day, the day before a full weekend away from dental work. We walk into the office and see a set of metal crowns on Dr. Radic's table. I promptly gather that there are no easy days in the world of dramatic-makeover dentistry. Carl's prosthetics fight coming off, requiring a series of hard pulls. The metal cuts and pushes uncomfortably against his gums. Nothing about it is pleasant to go through or watch, but at least the appointment is short.  

 

As we leave, Tea introduces us to her executive assistant Daria, joking that the two are work-wives. The two offer us champagne, “for our guests and for the holidays”. The absurd indulgence of drinking champagne at a dental clinic makes us giggle in the elevator.

DAY 10 + 11

Carl is in the normal amount of pain, once again bearable. He no longer wakes up in the middle of the night. We visit the hotel restaurant that morning, where we've managed to bond with the entire staff. Our newest friend brings us a warm infusion he concocted, “on the house”. Carl unabashedly befriends everyone we meet in this country, just like he does back home.

 

We wander toward the old city and window shop and buy little trinkets for our friends. Eventually, we find the Museum of Illusions and spend a few hours getting lost in the oddities and mirrors. Most of our time over the weekend is taken by the Christmas markets, the magic of which has yet to fade. We wander through the Zagreb Cathedral and Kaptol, one of the large hills overlooking the city. I catch myself obsessively hoarding foods to try, more food that Carl can't eat.

DAY 12

The dental work resumes with the first fitting of porcelain ceramic crowns. Carl goes ghostly white when Dr. Radic puts the new teeth in, beads of sweat lining his eyebrows.He later posits that the fitting feels like “a chainsaw on your gums”. *

 

Pain aside, the teeth look exceptional. Dr. Radic thinks we should adjust the balance a bit, but the form mimics Carl's old teeth and feels at least somewhat familiar. The doctor asks about color, offering an option for a slight stain which “appears natural with age” and keeps the teeth from being a creepy-Hollywood white. Carl notes to Radic, “can we make them look a little like yours, or like someone my age who takes great care of their teeth?”. We all nod in agreement, discarding the Hollywood-glow option.

 

*I should note here that Carl was offered lots of sedation options from the beginning of this process, including full anesthesia and nitrous oxide. He opted for the less intensive generalized anesthesia option, due to not wanting to prolong the process or drive up costs.

 

DAY 13

This day turns out to be the most unexpectedly brutal of all. We have two hours scheduled for cementing. The time passes quickly and without complications until the very end. Dr. Radic warns, “you may feel a little discomfort as the cement reacts with your gums.”

 

I watch Carl's face stiffen. He doesn't look at himself in the mirror to see the final result, only mutters, “need to leave”. This is so unlike his code of politeness that I understand the pain must be bad - Carl walks so slowly that I consider getting him a taxi to go the three blocks. When we get back into the apartment, he sits in the dark, head folded in his hands at the kitchen table.

 

“I need you to go away,” he says, hovering in the corner of the room to face the wall. It's brutal to watch and even harder to leave. I head to our usual restaurant alone, finding an empathetic ear and a complimentary drink from Alexander, one of our newest friends at the hotel. An hour passes when Carl texts me to come back. I find him in the corner cafe chatting with a regular. He turns to me, apologizing and explaining “that was some of the worst pain I've felt in my life.” He explains that the cement had reacted with the nerve endings in his teeth, which was brutal. He talks with a lisp now, adding to my list of concerns. 

 

That night, I go to sleep with my heart heavy.

DAY 14

Carl still feels some pain from the cementing but it's a dramatic improvement from the day before. He is able to eat a soft McDonalds burger, a victory considering he hasn't eaten in nearly 24 hours. Along with the many perks thrown in with Carl's treatment, Tea scheduled a complimentary, private city tour for us for the morning.

 

We meet our guide, Damjan, in the city center. I can tell that Tea found the best match for us; veils drop at introduction and we immediately feel at ease around him. We talk about Zagreb history and childhoods and the current political climate. Damjan walks us through Saint Mark's Church, Dolac Market, and Kaptol. We finish the tour at our regular spot at the Christmas markets and he asks if we want to sit down for a drink. It's an unexpectedly warm afternoon. Damjan joins us for tea and it occurs to me that our tour had been over for thirty minutes now, we’ve just enjoyed each other’s company too much to notice.

 

Later, we wander up and down Ul Ivana Tkalcica (a stretch of hipsterish bars and restaurants) marveling at how people prefer to eat outdoors even in the winter. We end the night hanging out with Alexander, who bonds with Carl over comic books and comps our drinks.

DAY 15

We have a final checkup at the clinic. Carl is feeling much more like himself and we walk in, relieved that nothing invasive will happen from this point on. Dr. Radic examines Carl's teeth and gives him a mouth guard to sleep in. He files a couple of his teeth down for a more natural shape, but at this point Carl doesn't need anesthesia at all. We say our goodbyes, overcome with gratitude.

 

Tea finds us in the lobby, offering us small gifts from Zagreb as going away presents. I'm at a loss for words with how to thank her, but I can tell she knows that her job changes lives. We hug and promise to keep in contact.

DAYS 16 + 17

We don't make plans for our final days in Zagreb, other than splitting up to explore the city independently. Carl finds a subculture hostel and I look at some art at the Mimara. We meet up in the evening and I buy us pizza, which Carl still can't eat. I notice that Carl's lisp is completely gone. I have a hard time concentrating when he talks now because the transformation is so staggering that I catch myself staring. It's like the dental work unwound five years, bringing a youthfulness to his face that I can't quite accept for reality.

 

On Sunday, we pack our things and get ready for the final leg of the adventure, Copenhagen.

DAY 18

We fly into CPH at 10:00 am. The overcast makes us feel at home and we catch a ride to our hostel, Urban House. We examine our surroundings on Google and Carl finds that we're only three blocks away from Tivoli Gardens, the second oldest amusement park in Europe. Since we only have a day and a half, we decide to spend it there to celebrate.

 

Tivoli doesn't disappoint. It feels like a Christmas wonderland and we decide to go on all of the rides, sudden drops and rollercoasters and all. We take a midday break and celebrate with sushi before returning to see the park lit up at night. We drink mulled wine in a pirate ship and watch the city spin from the Star Flyer, the tallest carousel in Northern Europe. It's perfection.

 

This portion of the trip feels surreal, disjointed from the hard days in the dentist chair. We allow ourselves room to play as a reward, but experiencing Copenhagen as tourists reads with a stark contrast from the rest of our trip. Carl and I have gotten so used to having to think about teeth that a day without teeth is a new kind of strange.

 

We enjoy it nevertheless.

DAY 19

Waking up early, we pay too much for coffee at the hostel and set out to explore the city. Copenhagen has its own Christmas markets and we feel at home. We stroll through Nyhavn and climb inside the Round Tower and gawk at the palaces.

 

The trip back is a long one. We have a 13 hour layover in the UK and sneak out of the airport to go watch the new Star Wars movie in Crawley, which is worth it just for the passport stamp. We go through security again, catching a few winks of sleep while seated upright. Finally, Carl and I board our flight back to Seattle.

 

The thought of returning back home after this adventure brings a mixed bag of emotions. It feels like we had just pulled off a heist, but the adrenaline of the experience remains with us. Integrating back into the day-to-day after four dental-obsessed months of planning and executing is strangely daunting. That said, we’re ready to see our friends.

EPILOGUE

Carl and I had to leave America in order to get a higher level of care. We only pulled it off because of the generosity of our friends. Most of all, we got exceptionally lucky. We were lucky to have Charles and Emma and Tea and Dr. Radic. We got lucky that Carl had so many people step in and bear the financial burden. We got lucky that this was an option for us.

 

The US has a long-standing history of class dynamics and elitism when it comes to teeth – it became personal when I saw my friend hurting. We talk about medicine as political issue, but this is a basic human right. Dental health dramatically influences overall health. Gum disease is linked with heart disease, respiratory illness, diabetes, and osteoporosis; people with gum disease are three times as likely to have a stroke and twice as likely to die from a heart attack. As the humiliating divide between rich and poor soars, millions of Americans rely on charity clinics, fundraisers, and hospital ERs to treat neglected teeth while better-off Americans spend over 1 billion each year in whitening services alone. The bifurcation of dental health and medical health is accepted as a the norm, but brings no benefit to the public. The people desperately needing care the most end up suffering instead. 

 

I could preach the virtues of Croatian dentistry all day, but Croatia's health care system isn't immune to wealth-based hierarchy either. Not everyone in Zagreb can afford Poliklinika Bagatin, although the country has universal health care. The American Dental Association has no official warning about traveling abroad for dental care, though not all clinics are held to the same standards as in the US. Countries popular with medical and dental tourism have varying economic levels, so taking advantage of lower costs could turn exploitative.

 

What we experienced was still marked by privilege.

 

Ultimately, our situation left us with a difficult choice to make and the dental tourism option gave my friend a chance for a fresh start, avoiding two years of scraping together money between dental appointments. Intensive as it may have been, the opportunity to do this bought him freedom.

One week after returning, Carl observed that strangers treat him differently. Where before, he had learned to compensate for his appearance with upbeat politeness, Carl no longer had the obstacle of a first impression hindered by his smile.

 

The reactions from friends and family brought a swell of happiness to watch. Carl began to eat more or less normally, braving steak and potatoes. These days, he gets addressed as “sir”, which feels novel and unfamiliar. Grocery store clerks and service workers seem more at ease around him. The world feels like a friendlier place.

 

The change in Carl’s disposition is far from subtle.

My friend Carl smiles a lot more these days.

Credits: 

Qunomedical

Poliklinika Bagatin

Special thanks to Emma Mincks for feedback and edits on this piece. 

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