Bad Teeth, Bad People: How Lack of Access to Dental Care Screws the Poor

Welcome to the new class divide: Access to good dental care, or the lack thereof.

Welcome to the new class divide: good dental care, or the lack thereof.

Any parent who has taken their son or daughter to their six-month checkup — while desperately praying their child won’t need braces or other expensive procedures — knows the bitter truth: Here in America, access to dental care is a form of privilege. During the 2008 recession when my husband got laid off and we had no insurance, we were grateful that our daughter access to dental care though MediCal. But the coverage was barebones and we lived in terror of not being able to afford some procedure she needed and wrecking her entire future.

Aside from all the poking, prodding, scraping, and drilling, for many of us, the worst part about receiving dental care is the way they make you feel guilty and ashamed when they find anything wrong with your teeth. And, of course they always find something wrong with your teeth because that’s how they make their money.

Did your dentist find a new cavity? Does your child need braces? Do you need a root canal? Chances are, your dentist read you the riot act about dental hygiene, flossing, and how you and your kids haven’t been coming in often enough. Never mind that you were out of work for two years and had to wait for your new job’s dental care plan to kick in — and never mind that dentists often won’t take Medicare, payment plans, or charge discounted rates: They’ll shame you for not taking care of your teeth.

Welcome to the new class divide: good dental care, or the lack thereof. Newsweek reports a U.K. study of 6,000 people across all ages and regions finds the starkest, most dramatically visual difference between rich people and poor people is…eight teeth.

The poorest people in the UK have up to eight fewer teeth than the richest people by the time they are 70, according to the results of a study released in the Journal of Dental Health today.

Oh, you’re thinking. That’s in the U.K. where everyone’s teeth are horrible, even famous people like John Oliver’s. So what’s the big deal?

But it’s a problem in this country, too. Those Brits’ teeth may not look creepily white, straight, and gleaming, like ours do here in America, but at least their health care system ensures that dental issues don’t get so severe they impact people’s overall health.

Here in America, when your lack of access to dental care — usually in the form of missing teeth — becomes visible, you’re screwed. Back in the 20th century, comfortably affording a single-family home with two cars in the garage was the litmus test for whether or not you had made it into (or stayed in) the middle class. Nowadays, those things are barely — if at all — within reach for many of us, but we can still keep up appearances as long as we’ve got decent-looking teeth.

Dental care is a form of privilege.

In a searing personal essay, The Shame of Poor Teeth in a Rich World,  Sarah Smarsh conjures up painful memories of childhood poverty and bad teeth.

If you have a mouthful of teeth shaped by a childhood in poverty, don’t go knocking on the door of American privilege.

Smarsh relates to the snaggle-toothed character Pennsatucky from Orange is the New Black, but explains that you don’t need to get hooked on meth to have teeth like that. Smarsh’s family has been dentistry-challenged for generations:

But Pennsatucky’s teeth aren’t just ‘meth teeth.’ They are the teeth of poor folk, of the young grandma who helped to raise me and for decades worked from diner to factory line to a desk job as a probation officer for the county court system in Wichita, Kansas.

She recalls her Grandma  as a vivacious “radiant thing” attracting flirtatious comments from the guys. . . until bedtime, when her teeth came out. Grandma explained that a dentist pulled out all her teeth and gave her a set of dentures when she was still in her twenties.

I had bad teeth all my life. They were straight and looked OK, but I always had toothaches.

Likewise, Smarsh’s handsome father’s teeth looked fine when he was younger, but his lack of access to dental care caused his health to deteriorate as he aged. At one point, he mentioned, “I notice people’s teeth because mine are so bad.” Then, his dental health got so bad, Smarsh’s father’s bad teeth didn’t just make him look less attractive, they nearly killed him.

About a decade ago, at the age of 50, my dad almost died when infection from an abscessed tooth poisoned his blood and nearly stopped his heart. He has never had dental insurance and has seen a dentist only a handful of times when some malady became unbearable.

Smarsh angrily rails against a system that denies quality dental care to the poor, while punishing and ridiculing them for their bad teeth.

My family’s distress over our teeth – what food might hurt or save them, whether having them pulled was a mistake – reveals the psychological hell of having poor teeth in a rich, capitalist country: the underprivileged are priced out of the dental-treatment system yet perversely held responsible for their dental condition.

That’s right: People with bad teeth are constantly subject to ridicule on the pages of “People of Walmart,” in countless hillbilly jokes, and as redneck stereotypes on TV. In an interview with the actress who plays Pennsatucky, the ABC host chirps:

“Don’t get fooled by those mangled teeth she sports on camera! ‘Taryn Manning is one beautiful and talented actress.”

Because Manning couldn’t possibly be considered beautiful or talented if she really had Pennsatucky’s teeth.

Smarsh also astutely draws the connection between using shame to keep struggling people down while depriving the institutions that help them of funds, and then saying these public institutions don’t work and privatizing them.

It’s a familiar trick in the privatization-happy US – like, say, underfunding public education and then criticizing the institution for struggling. Often, bad teeth are blamed solely on the habits and choices of their owners, and for the poor therein lies an undue shaming.

In Smarsh’s experience, poor people’s bad teeth results from lack of dental insurance and money to pay for the dentist, not from laziness or an immoral lifestyle.

Continues on next page: How lack of dental care keeps you from getting a job.

About the Author


Leave a Reply

Your email address will not be published. Required fields are marked *