One Russian dentist described the recent dental hygiene of the younger generation as a craze that has become a fad. Yekaterina Tkalenko brushes her teeth three to four times a day, has her teeth cleaned professionally twice a year, and carries fl oss with her. "When I look at a person the fi rst thing I notice is their teeth" said the Moscow resident who works in the tourism industry, "When I see good teeth, I think this person has more chances in life, and he'll be more successful than a person who has bad teeth."

But just a short generation ago, going to a dentist for oral care was when a tooth hurt. Families shared toothbrushes, dental fl oss was a curiosity, and oral hygiene was a fad. Soviet-era teeth were bad in 1991 when the average 35-year-old had 12-14 cavities, fi llings, or missing teeth, noted Dr. Vladimir Sadovsky, Vice President of the Russian Dental Association. Toothpaste was whatever was available at the time. Toothbrushes had hard bristles that cut the gums. The 1990 crowned Miss USSR was sent to Philadelphia right after winning the title to have her cavities fi lled and the front diastema closed.

But in recent years the dental market has taken off. Private dental clinics in large cities like Moscow have new equipment surpassing the quality of the under-funded municipal clinics. These new clinics are springing up everywhere. Pharmacy shelves are fi lled with the latest brands of Colgate, Aquafresh, and Crest, as well as yogurt-based paste in various fl avors like Jazz of Lemon Mint. Anti-plaque rinses, mouth fresheners, fl ossing devices, whitening gels that run as much as $14 a tube for Rembrandt, are the rage. Oral hygiene product there have doubled since 2000. More of the population is willing to purchase high-end dental products such as electric tooth brushes.

The reason for all this has been attributed to an educational campaign in the school system. Often we read of dental personnel going into remote areas and teaching oral hygiene and how to brush one's teeth. We think that this is redundant as everyone since Howdy Doody in the 50's should know how to brush their teeth. But that is not fact. If no one has ever demonstrated how to brush, how to use a toothbrush, and stress the reasons for doing so, then a generation of children are lost to dental decay.

Fluoride in the water is still viewed with some skepticism. After all the John Birch Society as late as the 60's claimed fl uoride in the drinking water was a Communist plot against America to weaken the population. Some Russian dentists claim that fluoride makes their teeth turn brown. But the government funds the fl uoridation of milk.

In Voronezh, Moscow, and other municipalities in 1994 a 12-year-old had an average of four cavities. Since the fl uoride campaign there, Dr. Sadovsky has noted that in 2004 the number of cavities has dropped to 1.5.

In the United States in comparison, has nearly 60% of those aged 6 to 19 who have never had a cavity. Dr. Giovanni Favero, an American dentist from California founded the American-Russian Dental Centre in central Moscow, in 1995 recalls seeing a Russian exchange student in his California practice that had 21 cavities. Editor Brophy treated a pair of Russian students in their late teens who had similar situations. He pulled a tooth on emergency and was paid with a bottle of Russian vodka. The rest of the fi llings on the two were done gratis before they had to return home.

Many Russian clinics are not owned by dentists but by entrepreneurs looking to make a profi t from the recent craze. And top shelf dentistry is still only in the reach of the money crowd. But the concept of healthier mouths is becoming a widespread desire of the younger population. Thus Russian dentistry is being dragged into the 21st century.