Possible! 'cause most of the Nepalese people carry Gum Diseases alone with the root canal. And most Nepalese never do dental check up in life time unless it becomes serious. I know this much because my cousin, he is an Army Dentist back home. Good man! Working as A Dentist back home for the country. NOT LIKE NEPALESE DENTIST IN US...MONEY IS LIFE FOR THEM...