An Irishman's Diary

My dentist retired recently, more than a decade after acquiring me as a patient. His acquisition was a profitable one, at least initially. My teeth then were a metaphor for the Ireland of the early 1990s: suffering from years of economic neglect and in serious need of investment.

The work peaked with the 1998 root canal project which, unlike many tunnelling jobs, came in on time and under budget. But once the worst of the infrastructural deficit had been addressed, I became a less frequent visitor, attending just for the odd filling or polish. Expensive crowning was always the long-term plan, to start around the same time as the airport metro.

My dentist was always obliging and his work impeccable. His dental chair faced a lovely Georgian window, which offered a mildly anaesthetic view of the garden. But perhaps what I liked most about our relationship was his relaxed approach to billing.

The extractions were very gentle, and never carried out on the premises. They would usually be initiated by a letter two or three months after the last visit. If the amount involved was painful, I would sometimes require a top-up letter, which would issue a few months later. By the time I had to part with the money, numbness had always set in.

In short, I felt I owed him something. But now that he has retired, I have been freed from that bond. Moreover, my liberty comes at the very time when a Munich dental clinic has begun advertising on Dublin Bus, tempting tourists with packages including hotel accommodation, Rolls-Royce airport transfers, and porcelain crowning, all for less than the work would cost at home.

The choice is stark. Do I make my next visit to my old dentist's successor, and risk a relationship developing? Or do exploit the hiatus and take my teeth offshore? We live in a very different country now than we did in the 1990s, when anti-competitive practices and Irish-born hotel workers were both still common. Free-market forces have since overrun the island, meeting minimal resistance, except from a few brave and fiercely committed groups: dentists, doctors, solicitors, barristers, accountants, publicans and, er, every other profession you could mention.

Courageous as the insurgency is, Brussels directives and cheaper alternatives from an expanded EU are gradually mopping up the rebels. More importantly, public attitudes have changed. In the new Ireland, customer loyalty is for losers. Even the Government encourages us to shop around. If you can have a holiday and still save money while having your teeth done, you're a fool not to.

Now that the ads have started, there will be offers more exotic than Munich. Sunny South Africa is already popular for dental holidays. And even in Europe, there are many destinations that could promise to whiten your teeth while tanning the rest of you - although there is an unspoken rule that the more romantic a country is, the less you would want to have dental work done there.

Of course you don't have to leave Ireland at all to save money. Barely an hour north of Dublin lies the Border, a permeable Berlin Wall beyond which cheap dentistry beckons to us the way Western democracy once did to East Germans. It's not exactly dental tourism: a cruise on the Ulster root canal lacks the appeal of the Rhine. But it is an option.

And yet southern dentists still have one big thing going for them: fear. Fear of what the foreign dentists might do to us, and fear of what the domestic ones will do when we get back. Irish dentists don't even need to encourage these worries. Our imagination does the work for them.

Modern dentistry is a mostly pain-free experience. But we have all had a bad toothache at some point in our lives and the memory tends to linger. Add to this our inherited lore of stories about ancestors who had teeth extracted by string-and-doorknob and we are predisposed from childhood both to fear dentists and to feel grateful to them when the experience proves painless.

The power they have over us is concentrated in their equipment, which includes several potential instruments of torture. The mere sound of a dentist's drill is enough to make you blurt: "I'll tell you anything you want to know - just don't hurt me." They could put silencers on those things if they really wanted to.

In the ideal scenario, we could have the best of both worlds: taking foreign holidays for the bigger projects, while keeping the local dentist for emergencies and routine check-ups. But you suspect that dentists all leave signatures on their work, like silversmiths and potters. And even if they don't, Irish dentists would surely recognise a foreign hand. The term "identified from dental records" has an ominous ring about it.

I'm not sure what form the punishment would take. But the worry is that if I go the foreign route, sooner or later I will have a toothache. Then I will have to turn up at my old dentist's door and introduce myself to the new man. There will be the usual pleasantries as he checks my chart. A sinister pause will follow. Then he will point me to the chair and quip, with barely disguised menace: "I think you know the drill".