In the elegant World Heritage City of Luang Prabang, nestled in a tropical valley beside the Mekong River in Laos, time has stood still for centuries but worlds collide everywhere.

There’s the Buddhist past, a quiet reminder of the power of stillness as the seeds of modern life sprout into internet cafes, groovy restaurants and five star hotels pressing boisterously up against the ancient temples.

There’s the miraculous grace of Laos people, survivors of the most aggressive bombing campaign in world history during the American assault in the 60s. And there’s the usual chaos of hope and disorder as progress forces every soul toward ‘development’ and overlooks what they’ve already achieved.

And then there’s the girl on the bicycle. She’s riding home from work with a little umbrella perched over her head in a light evening drizzle.

She heads toward the river past the lively night market and just as she glides passed the ornamental roundabout, her world collides with the changing times and is altered forever.

Coming toward her through the rain, an older man on a motorbike is a little too drunk on BeerLao, a little too overwhelmed by the tensions in his life, a little too late to have any chance in the New World, and old enough to know the value of what has been lost.

Coming toward her he is happy. Full of amber relief from his worries and fears. With his bleary eyes fogged from beer and the strains of living, he navigates through raindrops sparkling with fairy lights from the market, and is blinded for just a second.

The man and the girl make a terrible collision. Metal locks jaws at the intersection and the sound of breaking glass and scraping steel bring every moving thing to a standstill. The night holds its breath. The raindrops forget their falling. Twinkling lights freeze for a moment – as if reality had called “cut!”

Slowly the girl begins to move and I can hear her sob as the world starts again, too fast and in all the wrong directions.

As usual at a crash scene, most everybody just stands there gaping. People in Sydney say this is because we’re scared to help in case we get sued. In my experience, we’re all just scared to help. But with some experience in first aid, and wishing to be useful, I rush to see what can be done.

Titi is a beautiful young woman dressed elegantly in a new tailored skirt and snappy wool-look coat. She probably bought both at the night market where locals treat themselves to Chinese-made synthetics. Her outfit cost

more than $20; a week’s wages, and it’s lucky she wore it because it has kept her out of hospital. As the motorbike is lifted off her, I see the exhaust has completely melted the side of her coat. Her eyes are stunned and frightened, she looks as bewildered as a deer hit by an arrow.

Gradually we find her injuries; both wrists are ground to the bone but nothing seems broken. Her knees are lacerated but she can stand, and pain from damage to her left arm will only register when her mind moves on from the shock. She’s all in one piece, but the worst of the damage is plain to see.

Landing face-down on the tarmac, Titi has smashed off both her front teeth. Their crooked stumps flash at wild angles under the nightlights. She feels it as her senses collect, and dashes to the crippled motorbike to check in its mirror what her tongue has already told her. Her face wet with rain and her pretty smile broken, Titi immediately knows what this means for her future, and her whimpering breaks into a heartbroken howl as she collapses against me in misery. Laos is a wonderful place to visit for traditional textiles, Buddhist art and cuisine. It’s wonderful to live here if you’re young, educated and find a good job as a waiter or clerk. But you wouldn’t want to get sick here – and you certainly wouldn’t want dental work.

Travellers are told in guide books that the first thing to do in a medical emergency is “get to Thailand”. Laos people don’t expect much in the way of modern advances; they even travel overseas to go to movies! And when it comes to cosmetic care, while neighbouring Malaysia and Thailand have boom industries in nips, tucks, botox, fillers, whiteners, veneers, crowns, canals.. you name it, Laos is like the twilight zone in health.

But it’s very much in the sites of the beauty industry. The global brands have clawed their way into the dreams and pockets of women in developing nations all over the world. The ideal they sell in Asia is even more surreal than it is in the West, where at least women are actually born white. Here they are reminded on every wall and shop window, in every store, magazine, bus, cafe and toilet that being attractive requires white skin... and white teeth. I’ve even seen men in the markets, where very poor farm women sell veggies, insects and rice dishes on blankets on the ground, giving away posters of young Asian women airbrushed to the nines, advertising beauty and therefore happiness, with skin bleaches.

Women are strongly persuaded to burn away their native honey complexions with skin whitening potions (including deodorants) and it’s such a successful campaign that if you want a moisturiser without the chemicals: good luck!

The darker your complexion in Asia, the more poor and ugly you could be considered to be. And the same goes for teeth. Despite poor access to dental care, a contaminated water supply, saturation of the food market by Nestle, Pepsi (the official drink of Laos) and the rest with sweetened everything, decayed or damaged teeth carry the same stigma as the first world and can shatter your self-image and work prospects.

For a girl like Titi the chance of having what we consider standard, necessary restorative care are practically zero. She knows full well that she will end up with a dodgy-looking pair of badly colour-matched restorations – at best. She knows full well that her teeth could now betray her. You see the results of poor dental work everywhere in Laos – it’s the reason many women hide their smiles. Ex-pats and Aid workers, however, are highly valued clients for dental work but would never shop in Laos.

When I ask one Australian how to get help for Titi, she simply scoffs,”Stay out of it.”

“She’ll never have the money to get to Chiang Mai for a proper job (about $40 by bus and perhaps $150 for the work). And if you help her she’ll smell money and rip you off. Besides, they get free dental at the hospital. Stay out of it.”

For the price of a haircut in Sydney I could get Titi gorgeous new teeth and a straight new bicycle. But is it really right to interfere? I search around town for the Dental Centre and find it rotting into the ground in an abandoned medical complex. Nobody answers the door, which is swinging off its hinges. I sit on the steps under a flowerless frangipani and set to wondering once again, was it really better to have been a writer when I could have been a dentist?