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. Last Updated: 07/27/2016

Your Next Visit to the Dentist Won't Hurt a Bit

Root canals, cavities and crowns: the frightening words that remind people to brush, floss and schedule regular dental checkups.

Nevertheless, to see a dentist, you first need to pick one, which is not as easy as you might expect. Upon opening the telephone book, you will find hundreds of clinics and advertisements, most bearing pictures of shiny, smiling teeth.

Look a little bit closer and you will see that you're not just choosing a dentist, you're choosing a nationality. Many of the capital's clinics boast names like the Russian American Dental Center or the German Dental Clinic. The Bely Nosorog clinic goes a step further, with German equipment and Swiss expertise.

If you want to try California-style tooth care, for example, you might head to the Russian American Dental Clinic near Sokolniki metro station.

The American head of the clinic, Giovanni Fevaro said his clinic offers "modern dentistry set up like in the western United States." Fevaro has 30 years of dental experience under his belt, including seven years in Russia.

"The European clinics have separate rooms [for each patient]. They say this is more comfortable, but this takes more time," said Vladimir Nikitiuk, a Russian dentist at the clinic who has studied in France. "The American approach is about efficiency."

Alternatively, you might go to the German Dental Clinic near Baumenskaya metro station. The clinic — a relative newcomer to the capital, having received its license in January 2001 — claims to have the latest German technology at its disposal. The slightly more cosmopolitan-sounding European Dental Center, with a staff of French dentists, is another option.

Dentistry is international, said Phillipe Dacremone, the center's chief dentist, who left a practice in Cannes to come to Moscow. He said his clinic, which has been in Moscow since 1989, takes the best aspects of dentistry from all over the world. The Japanese and German clinics are quite good, Dacremone said, and the Americans have the best cleaning instruments.

Dacremone said the abundance of foreign clinics might simply be the result of dental wanderlust. "It's not normal for a dentist to stay in one place for too long. It's better to travel," he said.

Alexander Herdt said he came to the German Dental Clinic to fill a gap in local dentistry. "There was a need for Western specialists," Herdt said, adding that there are quite a few German firms in Moscow. But Germans aren't his only clients. Herdt said his patients come to the clinic from all over Russia.

The German clinic receives financial support from Sinora, a subsidiary of Germany's Siemens AG, which specializes in dental equipment. The clinic has all the company's latest gadgets, including laser tooth-bleaching apparatus, a top-of-the-line X-ray machine and a state-of-the-art surgery room.

"When people choose a dentist, they look at the equipment … but you could have good equipment and a doctor who doesn't know about anatomy," said Nikitiuk.

Imagine however, doing a root canal without an X-ray machine. Leave Moscow to have the work done, and a good imagination is not necessary.

"Outside of Moscow, they would think you were crazy if you asked for an X-ray for a root canal," Nikitiuk said. When doing the procedure, "they start and they're not sure where they are going. And even when regional dentists have X-ray machines, they're usually from the '60s or '70s," he said.

Outdated equipment is not the only thing left over from Soviet days — bad memories still linger from a cruder era of dentistry. "A lot of people were terrorized by Soviet dentistry. Dentists did not care whether a patient felt pain or not," Nikitiuk said. "They extracted teeth without [pain killers]."

Dentists had little incentive to care about the patient since the patients had no choice over which doctor to see. "There was a prescription system, you could only go to a fixed clinic. And if the dentist didn't like you, you were in trouble," Nikitiuk said.

A malfunctioning dental system leads to bad hygiene as well. Russians generally only visit the dentist when they feel pain, Nikitiuk said. By the time they show up at the office it is too late.

"It's much easier to prevent dental disease than to fix it after it's already taken its toll," Nikitiuk said. "People don't know how to maintain teeth. They know how to take care of their Mercedes, but they don't know that you have to have a checkup every six months so that they have something to eat with."

The problems with Soviet dentistry may explain the influx of foreigners when the market opened in the early 1990s. To differentiate their practices from Soviet dental care, clinics stress their dentists' nationalities in their marketing. "Everyone wants to be European," Dacremone said.

Fevaro said a practice is built on word of mouth. "In America, most dentists own their own clinics … so they build up their reputation," he said.

Referrals also send the European Dental Center most of its clients. "Most of our patients hear about us from other patients," Dacremone said.

So, what keeps these he-men of hygiene toiling in Moscow? Strange as it may seem, the challenges of the Russian mouth are hard to resist. "There's a lot of work to do here," Fevaro said.

"It's really interesting when someone comes in with a lot of complicated problems," Dacremone said. "It's very challenging."