Going to the dentist is never a welcome task, but for Russians living under the sanctions imposed by the West on their country for its invasion of Ukraine, it is now even more difficult to bear.
The Russian dental industry is almost entirely dependent on European and American imports of equipment and materials, and now, faced with a virtually frozen supply chain, dentists are scrambling to weigh potentially inferior treatment alternatives for patients – and should raise prices.
“Getting your teeth fixed has always been a luxury, and now even more so,” says Inna, owner of a dental clinic in the Siberian city of Krasnoyarsk. “No matter how much you care about your patients, it’s impossible to maintain the same prices.”
Inna says every piece of dental equipment and materials at her clinic is imported “without exception,” listing fillings, implants, dentures, crowns and cement, among other essential items. Whereas previously these would have been ordered from European suppliers, many in Germany and Italy, the supply chain has now all but dried up. Any chance of getting their hands on the supplies they’ve relied on for so long is now forcing dentists to pay exorbitant prices, but in many cases that’s just not possible.
Some dentists were able to stockpile supplies in early March before many Western sanctions took effect. The Inna clinic has purchased equipment for the coming year.
“If we hadn’t done that, I don’t even know what we would be doing now,” she says. “Now you can only buy quality materials if someone has leftovers, and their prices are on average three times higher than before the war.”
She gives the example of an American filler called Filtek, which in February cost 1,800 rubles ($33). “Now you can’t find it for less than 4,300 ($79),” she says. “But the demand is still there.”
Other dentists point out that storage cannot go that far.
“Medical equipment has a shelf life of about a year,” says Igor Rodin, an orthopedist, chief physician and owner of a network of dental clinics in Tyumen. He says their supplies are now four times more expensive than before. “First, the cost of consumables – which are needed on a daily basis – has increased. Paper is more expensive, as are aprons and saliva ejectors,” to name a few.
“We cannot refuse patients”
On the beneficiary side, patients now find themselves with surprisingly high bills. Lidia, a resident of Tyumen, says she has been taking her son to an orthodontist near Chelyuskintsev for several years.
“Before, a first appointment cost 700 rubles ($13) and a follow-up cost 500 rubles ($9),” she says. “Now they’re asking 1,000 ($18) for follow-up – prices have doubled.”
Inna says most of the patients she’s seen have been “sympathetic” about the price increases, particularly because her clinic has stockpiled equipment and has therefore been able to increase prices gradually.
“Anesthesia at the beginning of the year cost 700 rubles ($13); now it’s 950 ($17.50). A root canal now costs 12,000 ($220) instead of pre-Crisis 8,000 ($147).
“We understand that people are out of money and for many it is expensive, but what can we do? We cannot work at a loss,” she says.
Probably the most expensive service provided by dental clinics in Russia is prosthetics, especially implants. The field of implantology is totally dependent on imports and is today on the verge of bankruptcy.
“I have always preferred to work with German, Swedish and American materials,” says Ilya Shumakov, implantologist and orthopedic dentist from Novosibirsk. “Premium implants use titanium compounds, with minimal impurities.
“It’s not something you can skimp on,” he adds, saying many materials have simply disappeared from the Russian market.
“Manufacturers don’t want to work with our state,” he says. “You can’t buy half of what you need.”
Rodin says his dental clinics fell into the red in the first quarter of 2022.
“The most difficult are the insurance companies. They make annual contracts that say I can’t raise prices,” he says. “Today we are following the 2020 rate of [Russian insurance company] SOGAZ. And we cannot refuse patients.
He says they had to resort to delaying patients.
“Yes, we started stretching them, telling them everything was busy – call back in a week. We play dirty, but SOGAZ also plays dirty.
Russian roulette, only worse
Without the quality equipment and materials they and patients rely on, dentists are cautiously looking for alternatives made in other countries. They are adamant, however, not to use domestic products, citing poor quality and limited choice.
“We looked at what we could find in Russia. To be honest, there is no comparison with foreign materials,” says Inna from Krasnoyarsk. “We don’t want the client to come back to us in a week, for example, with a filling that has fallen off. We will lose more than we gain. »
She says there was a level of confidence in supplies from Europe and the United States that is lacking when it comes to Russian counterparts.
“With ours so far, it’s Russian roulette,” she says. “And not with a bullet in the drum but vice versa, when there is only one empty chamber.”
Suppliers in China have been keen to fill the void in the Russian market. Inna says she has had representatives write and call her directly, but she remains unsure.
“As a last resort, we will have to go to China. They now have a unique position to occupy the Russian market. But there are doubts whether we will benefit from it,” she says. “The cost is comparable to European equipment, but the quality will have to be seen.
Shumakov has also seen Chinese companies seek to replace importers who have pulled out.
“The American 3M, for example, has completely left Russia. Now the Chinese are trying to take their place,” he says. “We looked at the implants offered by China. Sounds good on paper, but I don’t know what will happen in practice. And there’s no one to ask. All others have worked with imports from Europe or the USA, so cannot advise on which is best.
There are a handful of dental materials manufactured and available in the country, but the idea of using them is a Soviet “nightmare”.
“I know very well what quality it is,” says Shumakov. “Sometimes I have used our materials, but only for intermediate work. They are suitable for placing a temporary, but not permanent filling. Impression materials, cements, filling materials — all of these are not as good as they should be.
What about Russian anesthetics?
“No self-respecting dentist would use them. It’s a nightmare going back to lidocaine in big 5cc syringes with thick needles. I hope it doesn’t come to that,” Shumakov said.
For patients, too, the thought of reverting to shoddy Soviet-era dental treatment — when dentists had a limited choice of materials and lacked modern equipment and oversight — is a terrifying prospect.
“I don’t want to get to the point where we have to use [Russian implants for my treatment]“says Olga Kerimova, a resident of Krasnoyarsk. “I still remember what Soviet dentistry is like. I remember those yellow fillings and those iron teeth. No thanks. I don’t want to go back to the USSR”
“Do everything now”
Regardless of prices, people who need a dentist cannot postpone treatment indefinitely. Inna encourages people to have their teeth checked before more serious problems arise – and cost even more.
“Prices will continue to rise, so it’s better to do everything now,” she says. “People are not stupid. They know how to count, especially in times of crisis. They know that a cavity will not go away on its own. If you do not put a seal on it for 7,000 rubles, you will have to process the channels later for more than 12,000. ”
Shumakov says his clinic saw an influx of people in March who wanted their teeth fixed for the old prices, and even now there is no shortage of patients.
“Hopefully the supply issues will be resolved and we’ll have something to work with,” he says.