Modern dentistry is an excellent development. I would probably be a toothless crone by now if I had lived a century ago.

I am grateful to dental pioneers - along with the people who brought us vacuum cleaners, wonderbras, extruded cheese flavoured corn snacks and those absorbent tissues that soak up the blood from meat packs - welcome inventions one and all.

Nonetheless, I have some problems with the dental profession. One scary dentist of East European descent - catchcry "You VILL relax" - insisted on telling me every detail of what she was going to do and showing me the grisly pictures on a video screen. Yeuch. Sometimes informed consent can go too far. I was pregnant at the time and even more wussy than usual; I complained the anaesthetic hadn't worked. Dr Death snapped: "So, how are you going to cope vis ze pain of childbirth?" I should have said, "Better drugs." Instead, I just stopped going to see her.

Now I see a lovely dentist who "cares for cowards", plays hot jazz and gives me nitrous oxide - it's fabulous, like going to a pleasant nightclub where you can't talk or dance because someone is fiddling in your mouth. Until you get the bill. Open wide, wallet. Last time it cost $3300 for a crown and a filling.

I have tried and tried but I don't understand why dentists are so expensive. If I go privately to see another sort of medical specialist who has trained for a squillion years - a neurologist or a dermatologist, say - they are likely to charge me about $400 an hour. Even factoring in the fact that the dentist has an assistant, a whizzy chair and more technology, the difference in fees seems startling. And dentists only have to tell people to floss, not that they have a brain tumour. I imagine the difference in pricing is a result of government subsidies.

Medical care is subsidised - even privately - so the cost to the patient does not reflect the true cost of treatment. But this is perplexing too. Putting aside the argument of whether the government should be footing the bill for everyone's health - I favour the middle classes taking responsibility for their own - this seems quite inconsistent. Why is it that we are entitled to expect the state to look after our ingrown toenails or dicky tickers, but we are not entitled to have healthy fangs? Or any pegs at all? I know we used to have the murder house at school, but after that you're on your own.

And there has been a disturbing new trend among dentists. Maybe it is the influence of all those Americans on reality shows with blinding white chompers, but these days dentists aren't content to just fix the holes; they also want to muck about with your gums. And everyone seems to buy into this booming new gum industry. Why? We don't all want to turn into Martin Amis, who devoted a large part of his autobiography to his molar melodramas. It makes me long for the days of Austin Powers teeth. "All right, I get it. I have bad teeth. You have to understand in Britain in the sixties you could be a sex symbol and still have bad teeth. It didn't matter."

deborah@coneandco.com