Governmentality of Dental Care

The best exploration of the “at the dentist” sensibilities I’ve ever encountered is to be found in Ann Cvetkovich’s “Depression: A Public Feeling” book.

The repetitiveness of the experience, the mundane, the quotidian, the pain you are subjecting yourself to, sort of nice abrupt civil exchange of platitudes while you are in the chair, is the center of the visit to the dentist. Everything that forms this experience, what is never seen as worthy of reflecting, might be the subject of wonder.

Cvetkovich describes her battle with depression, stopping to examine attentively the episodes usually floating beyond the reach of our attention:

“In addition to his enthusiasm about my life, Dr. B was also very enthusiastic about the future of my mouth. My teeth were very worn down from a life-time of jaw clenching, that now much-publicized sign of stress that turns your dentist into your psychoanalyst (and sells another bite guard). The root canal involved multiple sessions of drilling, poking, and crown fitting, and my many hours in the dental chair that year were an experience of welcome submission. I was too bereft of agency to do more than simply show up for the appointments and let the doctor do as he deemed necessary. I would focus my gaze on his blue overhead light or beyond it to the holes of the acoustic time in the ceiling and go blank. Afterward I would return to work with my jaw completely numb,unable really to feel the difference between the frozen and unfrozen states, but with a sense that I was taking care of business.” (Cvetkovich, 2012, 48)

She shows how the routines, despite their un-noticeability, nevertheless, matter as one struggles to keep oneself afloat, sized by depression.

dentist

The experience with dentists that I had in my childhood almost exclude the possibility of viewing the dentist as a figure of familiar friendliness.

Soviet dentists were true Stoics. And so were their young patients. The children stomatological office was located right in the school. Kids were called there during the classes for regular check. Not a bad idea in itself. However, the slow drill; insufficient anesthesia; cheerful, laughing disregard and shaming in response to your complaints and moans of pain in the chair; the temporary filling with arsenic—everything was directed at developing stoicism, endurance, the resistance to hardships, and served as a clear warning about the future which awaited us. It was a tool of training for the reality into which we were born.

I received my first lesson in psychotechnics allowing to escape the thoughts about pain from my father, a military officer. The method deserves being stored in the Soviet secret agents’ golden rules collection. “Do not think about the drill, do not concentrate on your pain. Think like you are walking up and down the aisles in the toy store.” It was not uncommon that children were held by force, threatened to be treated for a cavernous tooth through their nose if they refuse to open their mouth. And, as a rule, someone among little patients cried vocally, getting in response exclusively irritated rebuffs.

As my light-eyed doctor her instruments, I thought–understanding all the petty-bourgeois commonality and incredibly oblivious privilege of even the possibility of these musings–that the drilling without anesthesia must be one of the worst torments imaginable, a Nazi-style, elaborate torture. The way dental care is institutionally structured, is definitely revealing of the type of governmentality and people-production functioning in the state.

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