dental teknicher a.k.a ahli gigi…
2009.05.13 12:58
They might not be your regular dentist, but they could be of service for the lower-middle-class with cavities, missing teeth, and even those who want a more attractive smile.
Just look for their signs, they are all over the place. When you bump into pictures of bright white teeth resting nicely on deep red gum, there they are.
Informal ‘dentist’. Another proof of the city’s messy health service, another proof of how informality rules and how some choose to –-and probably can only afford to– seek instant and cheaper ways to obtain dental care.
Salamah was a case in sight that cloudy afternoon. The 25-year-old mother of one walked into a 4-square-meter room inside an alley in South Jakarta’s Pondok Labu with a missing tooth.
She took the large wooden chair in front of a half-body mirror, a scene similar to that in barbers. Only this time, instead of grabbing a comb and scissors, the man at her service took a set of loose acrylic teeth and Salamah opened her mouth.
“Would you like a permanent or a removable one?” asked Soleh, the middle-age informal dentist or ahli gigi (‘dental expert’) as locals referred to. He merely took a glance at the spot where the tooth was missing.
Deciding on a removable one that would be attached to neighboring teeth with a short wire, Salamah waited five minutes for Soleh to finish carving the bottom side of the chosen tooth prosthesis to fit into the position.
Meanwhile, Adnan, his younger assistant, mixed pink alginate powder with a liquid substance until they turn pink and jelly like. The mixture would serve as artificial gum where the prosthesis will sit on.
“My neighbor suggested seeing him instead of going to the dentists. And my father, too. It’s cheaper and doesn’t hurt,” said the native-Jakartan while waiting for her new tooth.
“I’m afraid of going to the dentist.”
A mere half an hour and voila! Salamah got a new molar that only cost her Rp 50,000 (around US$5). The procedure will take at least three times longer and three times more expensive if she were to consult a real dentist.
And most probably the dentist will have to pull out the remaining root of her missing molar after sticking some needles for anesthesia. A procedure that not only Salamah, but most of us too, dread.
“I have lots of customers like Salamah. That’s what we are for,” said the man who has been in the business for 10 years.
He said to have learned the art of making dental prostheses from his uncle, also an informal dentist which practice in Jl. Fatmawati, some 15-minute drive from his place “Delima, Ahli Gigi”.
Both came from East Java’s Madura island. And so is Soleh’s young assistant, Adnan, who has been under his training for the last five years, watching his uncle making gypsum molds, mixing acrylic powder and skilfully placing ready-to-use tooth prostheses.
Adnan can now handle most of his uncle’s customers, earning a shared monthly turnover of between Rp 4 to 5 million while waiting to collect Rp 20 million to start his own business.
And that’s how these ‘dental experts’ learn their business.
This kind of dental service is actually an inheritance from the Dutch era, where dentists are scarce and people go to Tandmeester.
It was first mostly Chinese that learned the skill, but these days, most of the dental experts you bump into are either Maduranese or East Javanese. An ethnicity cluster that could probably be explained by their old tradition of having golden teeth implanted as status symbol, thus it might probably easier for them to learn the skill of making prostheses.
voila! a new tooth in half an hour…
Informal as they are, these businesses are actually legally recognized. Licenses for such premises could be obtained by applying to local health agencies as long as they also include a statement that they will not curative measures like filling in cavities. Their business are supposedly limited to making prostheses.
But, as the market evolves, these ‘experts’ roams into area that they have no expertise on, such as filling cavities, placing braces and even pulling out teeth.
“I have treated two patients coming with infection after being sloppily treated by ‘dental experts’. They argued that they wanted cheaper service, but when it got ugly they had to pay more,” said Nabila Firdaus, a 30-year old dentist practicing in Depok’s Pangkalan Jati.
The first case that she treated was a cavity filled using acrylic instead of the supposed amalgam or composite.
“And the cavity had not been cleaned prior to applying the fillers,” she said, adding that such treatment led to infections.
In another case, she had to spend an hour boring a tooth prosthesis loose from the acrylic that bond it to neighboring teeth, denting the supposedly healthy teeth. This is a measure that Soleh referred to earlier as permanent prosthesis.
And as braces became a trend, these experts are also providing such services. Adnan himself proudly wear braces on his upper jaw, a work of his uncle.
Dentists actually have their own formally trained technicians to assist in making prostheses, graduates from the Dental Health Academy like one in Kebayoran Baru, South Jakarta. But, the problem is, graduates from such schools are limited and the demand is rising.
And probably the “dental experts” are merely filling in this niche market and providing services that for most are still too expensive. Services actually provided in sub-district level community health centers at a more affordable cost, but is to few. Thus, the informality rules.
Cheap services is its main attraction, especially for lower middle income families, as prices could be half or even a third of the same service from dentists. Both upper and lower jaws prosthesis cost a total of Rp 1.5 million, while at the dentist it will cost at least Rp 3 million. A set of permanent braces costs Rp 2.5 million while dentists charge at least Rp 5 million.
But, one will later on pay for choosing instant and cheaper service.
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