At first glance, what follows sounds trivial — or at least very low down on the list of reasons why some kids succeed in going from high school to college, and some don’t. But it’s not.

A few years ago, a colleague and I noticed that one of our students had extraordinarily white teeth. They were so very, very white — like a refrigerator, or like the newly fallen snow, or like Moby Dick seemed to be to Ahab — so brilliantly white that it was next to impossible to look away from them whenever the student opened her mouth to smile or speak.

It was obvious to me that the student in question had overdosed on teeth-whitener, whitening her teeth way beyond the max. In aiming for the perfect smile, she’d unknowingly overshot her mark and ended up with a set of choppers that were so startling in their whiteness as to look fake.

Although I never encountered another student who overdosed quite this dramatically on teeth-whitener, my encounter with this one super-white-toothed student caused me to begin consciously observing the teeth of college kids, practically everywhere I went. I’ve concluded what should have been obvious to me in the first place: Colleges never have students with bad teeth — teeth that are severely crooked, stained, decayed, or missing.

According to the government (cited in an article, in 2007, in The Washington Post), despite the introduction of fluoride in almost all of our town drinking water, tooth decay is the most common illness of American children. Surprisingly, it’s five times more common than asthma.

Whereas 8 million children have no health care, 25 million have no dental care. Poor children, who are twice as likely to get cavities than children who are above the poverty level, are also far less apt to get treatment. Their dental treatment is supposedly covered by Medicaid, but there aren’t enough dentists willing to treat them. Many dentists, in fact, refuse to participate in Medicaid because reimbursement is often so minimal that it actually costs them money to participate. When poor children do get treatment, it’s rarely prophylactic care. The usual treatment is to pull the tooth.

It’s sobering to realize that the problem of dental care isn’t restricted to the very poor. A third of Americans have no dental insurance. People who fear the “moral hazard” consequences of insurance (i.e., that having insurance makes you go to the dentist or doctor more frequently than you really need to go, thus driving up costs) probably approve our low level of dental insurance coverage. In practical terms, however, since half of all dental procedures are paid for out of pocket, many people who are neither ignorant nor poor delay going to the dentist until the only treatment possible is tooth extraction.

As the artist Willem de Kooning demonstrated in his famous Women paintings (a series of paintings made in the early 1950s), the perfect smile, marked by perfect, even white teeth, helps define Americans. In his paintings, the smile symbolized not just happiness and success, but also an ominous and scary side to our culture. Its artificiality—even in the 1950s, long before the introduction of teeth-whiteners—shocked Europeans especially. Having been through the Second World War, many, of course, had teeth that were either decayed or gone.

In some cultures, stained, rotten, or missing teeth are no big deal, even today. If you travel around Britain, for example, you see plenty of pretty ugly teeth, as well as mouths with gaping holes where teeth used to reside. But in America, our visual tolerance — defined as it is by advertising, movies and television — for people with rotten or missing teeth, is exceedingly low. Who hires the person with rotten or missing teeth, even if it’s only to work the checkout line?

It’s not surprising, then, that American college kids always have great teeth. It’s not that we require great teeth to get into college, but that college kids come from a select and privileged group within the middle class who grew up with good dental care. Kids ending up with bad teeth, on the other hand, come from families who skipped dental care for them. They were weeded out of the college pool long before they could ever even know what “college pool” meant — not by intelligence tests, or subject-mastery test scores, or high school grades, but by having to spend their K-12 years in constant, bitter pain.

Comments

1. My father is a district court judge and former lawyer who graduated at the top 4% of his class.

   He bought his first toothbrush at the age of 8 with money he earned selling ears of corn door to door. Aside from that, the only dental care he ever had prior to becoming a lawyer was in the U.S. Air Force.

   My husband got his first serious dental care in the U.S. Army at the age of 21. He is now a professor of English, an author, and a translator of literature.

   I think Americans, in general, expect far more than is possible in the white-teeth department, but maybe its in our genes. A survey of single colonial American men revealed that the most desirable asset in a woman was not her charm or her figure, but a full set of teeth! No kidding!

   — Pinkster · Sep 4, 10:50 PM · #

2. Many Americans also have bad diets which contributes to tooth decay. The Pepsi generation is raising their children on fruit loops and pop tarts. Those who can afford dentistry can get their cavity-riddled teeth fixed.
   But low-income Americans can’t afford dentistry AND can’t afford healthy foods. Fresh produce is often unavailable in poorer neighborhoods. And children’s hungry bellies are quieted with cheap chips and soda.

   What’s really criminal is that the very politically powerful and rich American Dental Association and its constituent groups won’t allow any other viable group to fix teeth. They like it this way because dentists have become very rich and very powerful themselves in their communities due to their ability to fund political campaigns.

   Dental Health Aide Therapists are two year trained individuals who can do non-complicated dental work. They have worked for decades in other developed countries. The first ones are working in rural Alaska where no dentist would go and where people pulled out their own teeth when it got bad enough.

   The ADA sued Alaska and the DHATs costing the ADA a million dollars. Thank goodness they were unsuccessful because DHATs are doing wonderful
   work in Alaska.

   Organized dentistry is using their political might and money to sto DHATs from being accepted in the rest of the country. Instead they focus on water fluoridation which gives the illusion they are doing something about the dental health crisis occuring in the US which has caused people to die from untreated tooth decay

   Organized dentistry wants government off their backs because they fear they will be mandated to tret more Medicaid patients. Instead the mandate government onto our backs in the form of water fluoridation even though federal statistics show our children are over-fluoridated with up to 48% of US school children sporting dental fluorosis – white spotted,yellow, brown and/or pitted enamel – which actually puts more money into dentists pockets because, as you describe, people who can afford to will make their teeth appear perfect.

   Take action to end fluoridation here:
   http://congress.FluorideAction.Net

   — nyscof · Sep 5, 07:07 AM · #

3. This is an excellent posting, but it doesn’t go far enough. Those lovely smiles are indeed a sign of middle to upper class membership because not only has decay been kept at bay and whiteness enshrined but orthodontics has also played a major role. In fact, one of my teachers a few decades back told me of an upper-lower “inter-class marriage” that was called off once the rich, prospective in-laws saw the potential bride’s crooked teeth.

   In fact, the correctness of the bite is far more important than the color of the enamel, for it can have a life-long effect on nutrition as well as social mobility. Ergo, orthodontics work is often called for yet remains a very expensive proposition.

   McCain perhaps said more than he knew when, last night in his party nomination acceptance speech, he referred to education as “the greatest civil rights issue of our time”. As the blog posting suggests, checking teeth is a relatively easy assessment of economic class background and access to education.

   — Anti-hypocrisy advocate · Sep 5, 11:45 AM · #

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