I was born in the Year of the Rabbit. In theory that should have nothing to do with personality, but I’m also the kind of person who insists on being logical, so when I saw a big bag of carrots at the supermarket earlier this year, I had a vague feeling that I must be the sort of person who likes carrots. Into the cart they went.

A Costco-sized bag of carrots is not subtle. Before leaving the store, I decided to eat one on the spot, because if I’m already there, I’m obviously also getting the standard cheap hot dog and soda combo. So there I was: a bite of hot dog, a sip of soda, then a bite of carrot—followed immediately by a sharp reminder that this had been a terrible idea.

My tooth.

That bag of carrots then sat in my fridge for two or three months, untouched, until I noticed a greenish mold creeping through the plastic and threw the whole thing out. As for the tooth—more precisely, a crooked, decayed wisdom tooth—it has since been cut into two pieces and now rests peacefully somewhere in a medical waste facility in Zibo. Meanwhile, I’ve also made yet another trip back to China within six months. My flight mileage this year has reached 70,000 kilometers. At the start of the year I was joking that I had just finished circling the globe; now I’m practically working on a second lap around the equator.

How a carrot turned into an all-night dental emergency

What probably happened that day was simple enough: the carrot pressed against the decayed wisdom tooth, and the irritation radiated through the nerves on one side of my face. The result was immediate and very clear. I did not sleep at all that night.

I spent the whole time in pain, stubbornly refusing to take painkillers. This was not bravery. It was because I didn’t happen to have any at home, and since I don’t drive, I was too lazy to go out and buy them. So I just rolled around in bed all night. There’s a big difference between a quick clean blow and prolonged dull pain; one is over fast, the other is psychologically exhausting. After a full night of that, I made a dental appointment the next day.

The earliest slot was a week away.

At that point, I went and bought painkillers.

To be fair, they worked. In fact, they worked a little too well: not only did they stop the pain, they produced a faint sense of cheerful clarity that made me immediately suspicious. I stopped taking them after two days. “This feels great” is exactly the kind of thought that belongs at the beginning of a dependency problem.

The consultation that convinced me to walk out

A week later, I took time off and went to the dental clinic. The front desk led me into a room, a dentist looked at the scans, and within a very short time I was told that all my wisdom teeth needed to come out, under general anesthesia, and that I would need someone to drive me home afterward. The surgery could be scheduled for about a month later.

I asked the obvious question: the scan showed only one impacted tooth, so why were all four wisdom teeth being removed?

The answer was even better than I expected. Not four, I was told—first the four wisdom teeth, and then, at a later appointment, the molar next to the crooked one.

That actually made me laugh. Apparently once we start extracting teeth, we might as well commit to the lifestyle.

Then I asked why general anesthesia was necessary at all. Wouldn’t local anesthesia be enough?

This time the dentist’s attitude changed. I was told that because of my age, I was in a high-risk group; the tooth was impacted; general anesthesia would make the procedure easier.

I was in my thirties.

So now I was hearing that being in my thirties made me “high risk.” That naturally raised several follow-up questions. If I’m already high risk now, does that mean someone in their sixties is untreatable? And if this is such a risk-sensitive situation, why wait a month? The response was essentially: I’m the expert, do what I say, don’t question it.

Unfortunately for everyone involved, questioning things is a professional habit of mine.

So I said no and left. On the way out, the front desk informed me that the consultation fee would be billed to my insurance company. In other words, I got to pay for the privilege of being irritated.

What I learned after checking for myself

Back home, I put large language models to work and cross-checked the issue. The conclusion was not that the dentist was entirely wrong, but that the recommendation had been inflated.

Yes, the horizontally impacted wisdom tooth did need to come out. If left alone, it could eventually damage the adjacent molar, and since the wisdom tooth itself was decayed, it could keep triggering exactly the kind of pain episode I had just experienced. But the other wisdom teeth, the ones that were not impacted, did not obviously need to be removed immediately.

That should have solved the problem. Instead it revealed another one.

Because of the way dental care works in the United States, I could not find a clinic willing to remove just that one tooth. Everywhere I checked pushed the same package: remove all of them, do it under general anesthesia.

The incentive structure is not hard to spot. More teeth means a bigger procedure. General anesthesia creates more billable work, and insurance often covers only part of it, which means more money can be collected elsewhere. I could have paid for it if necessary; the bigger issue was the absurdity of being required to arrange for someone to pick me up afterward for an anesthesia plan I didn’t even think I needed. It wasn’t that I had no one to ask. It was that bothering someone else just to comply with an unnecessary protocol struck me as ridiculous.

Why I chose to have the tooth pulled in China

Eventually I decided that if I was going to spend money and suffer anyway, I might as well direct the money toward my hometown.

I was already scheduled to return to China in late July for a conference. After the meeting, I went back home, rested one night, and the next day went to a dental hospital. No appointment was needed. I found a doctor on the spot, showed the X-rays taken in the U.S., and said I wanted that single wisdom tooth removed under local anesthesia.

The doctor looked slightly puzzled and said they had never used general anesthesia for wisdom tooth extraction there.

That alone was reassuring.

I paid, picked up the anesthetic, and within five minutes of entering the hospital I was lying on the operating table. About fifteen minutes later, the tooth was out. They put in a few stitches to help healing. I bit down on gauze for forty minutes afterward, and there was indeed quite a bit of bleeding. I was prescribed one box of cephalexin and one box of metronidazole, told not to eat hard food for 24 hours, and to swallow rather than spit saliva.

I took the medication for three days. I never felt pain. On the morning of the fourth day, I went back to have the stitches removed, and that same evening I flew back to the United States.

The cost difference was almost comical

Without any Chinese insurance coverage, the entire procedure cost me less than 900 RMB.

In the U.S., even after insurance paid its share, I likely still would have owed several hundred dollars.

This is why I keep saying the American medical system is deeply flawed. You pay well over a hundred dollars a month, sometimes close to two hundred, for insurance, and then when you actually use the system, you still get hit with bills in the hundreds.

What makes it especially strange is that uninsured patients are often presented with absurd list prices that are not even the real price. If the hospital sends the bill to collections, it is often possible to negotiate the amount down to something comparable to—or only slightly higher than—what an insured patient would effectively pay. That’s because the hospital and the insurance company are already operating on negotiated numbers anyway, and those same numbers often become the basis for what outside collectors pursue.

At some level, the whole system could function as a straightforward commercial service system without insurance sitting in the middle of everything. Add insurance, and one of the biggest winners seems to be the insurance industry itself. The structure ends up binding doctors and insurers into a shared interest bloc. I’m not against health insurance in principle, but the rules here have clearly been bent and hollowed out by people who profit from the complexity.

Dentistry seems especially vulnerable to overtreatment

When it comes specifically to dentists, the pattern often feels like overtreatment by default. Every recommendation gets pushed toward the maximum intervention: more extraction, more sedation, more procedures. And if you ask why, the answer is often some version of “because I’m the professional.”

But the world does not contain only American dentists. Cases like this are common enough elsewhere that it’s easy to compare approaches. Wisdom tooth extraction is supposed to reduce risk, but from where I stand, the risk of general anesthesia outweighed the benefit of removing a tooth that could be handled under local anesthesia. I still don’t understand why American dentists seem so determined to use general anesthesia in cases like this.

As for the upper wisdom tooth, the doctor in China also suggested removing it eventually. But I checked the literature and did not find what I considered strong enough evidence. It’s true that wisdom teeth don’t play much of a role in chewing. Still, “it isn’t useful” is not, by itself, a convincing medical reason to eliminate it as a preventive measure. I’d rather make that judgment after seeing an actual problem than accept the logic that every nonessential body part is just pre-risk waiting to happen.

There’s plenty of junk in the human genome too, and nobody thinks the answer is to keep only the exons.

The business model behind the expert voice

To be fair, dentists in the U.S. are also operating under serious economic pressure. Dental school is expensive. Many dentists open clinics with loans and need years of high earnings before a practice becomes truly profitable. But once a clinic does become profitable, the margins can be substantial.

That is exactly how a strong interest group forms: high barriers to entry, delayed but impressive financial rewards, and a professional culture that filters out people looking for quick money while also preserving high incomes within the circle. Because the field relies on specialized knowledge, it also creates a kind of knowledge monopoly.

The problem is that this monopoly weakens the moment you compare it internationally. Once you do that, a lot of what is presented as professional necessity starts looking more like profit-maximizing industry custom wrapped in expert language. It has a lot in common with guild monopolies that have existed in one form or another since the medieval period. You often don’t notice how strange the system is until you step outside of it.

Whether experts should be trusted at all

My own view is fairly simple: a genuine expert educated through a modern academic system should be able to explain the reasoning in a way that an educated non-specialist can broadly follow. If they understand it well enough to believe it themselves, they should be able to communicate at least the outline of that reasoning.

If the explanation makes sense, I’m happy to listen.

If it doesn’t, then “just trust me” is not good enough.

Blind belief belongs to an older, more feudal model of authority. If you don’t want to explain, I don’t feel obligated to obey. I can accept a risky treatment if the rationale is clear. What I will not accept is an order issued in the name of expertise alone.

And if you believe four years of undergraduate education is enough to start producing experts, then you should also believe the resulting knowledge system is not so unfathomably complex that it cannot be explained in ordinary language. Anyone who has done research knows that many conclusions that look absolutely settled from the outside were arrived at through methods and assumptions that are much messier than they appear. History is full of once-respectable treatments—bloodletting, astrology-based medicine, faith healing—that later turned out to be nonsense. The doctor who relies only on authority is usually the one least able to defend the reasoning.

Isn’t it exhausting to live like this, constantly questioning? Not really. After a while, it becomes very easy to recognize the people who don’t actually know why they are giving orders. They repeat instructions the way a machine repeats a script, and insecurity has a very recognizable texture.

For now, at least, the tooth situation is resolved. But when I got back into my home, I was hit by a wave of damp air. Quite a few things inside had started growing mold.

That, however, is a different story—one involving a leaking bathroom pipe. So apparently this little blood-soaked saga is not over yet.