When you hear the words “class struggle”, do you reach for your toothbrush? You should. According to a report on adult dental health released this week by the NHS, one adult in 10 in Wales has none of their own teeth left. Not one. The figures are slightly better for England and Northern Ireland – the report was ominously silent about Scotland – but the average British mouth is still missing upwards of six teeth.
As an American, I should be laughing at this. We are famous for our dazzling choppers. The British are not; I have heard a fellow American describe an unwelcome suitor as having “British teeth”. There’s even a website that displays pictures of dentally challenged British celebs.
And although you may sneer at me – through yellow, decayed, gappy teeth – for peddling stereotypes, you may consider it a small recompense for the years of having to admit that a majority of Americans did vote for that idiot in the White House – at least the second time round.
Yet I’m not smiling – maybe because, like a lot of less wealthy Americans, I never went to a dentist as a child. I vaguely remember being examined by a visiting dentist at school.
Many of my friends endured the torment of braces. My own overbite, my parents assured me, was charming. In our family a visit to the dentist was for emergencies, such as my father’s root canal or my brother’s impacted wisdom teeth.
Our tap water was fluoridated (in Britain only 10% get fluoridated water) and we were encouraged to brush often, which may be why I still have all my teeth. But I recall the embarrassment when, as an undergraduate covered by the student health plan, I went to the university clinic and had to have 10 fillings in one go.
So I wasn’t surprised to read, lower down in the survey: “There was a clear socioeconomic gradient in the proportion of adults who had 21 or more natural teeth, ranging from 91% of adults from managerial and professional occupation households to 79% of adults from routine and manual-occupation households.” And this is in a country where dentistry is still officially part of the National Health Service.
The US probably has the best dentists in the world (ask Martin Amis). But all that artistry doesn’t come cheap (ditto). The US is also pretty far ahead in making a visit to the dentist less of a test of courage – at least in New York, where my friends are often offered a choice of drugs (laughing gas is popular, with Percodan for afterwards) and entertainment that wouldn’t shame a first-class cabin.
Some British dentists are catching up – I watched Gladiator in a dentist’s chair here a couple of years ago. But that was at a private dentist; I had spent my first 10 years in London being looked after by an excellent NHS practice but it didn’t have a hygienist, and at 50 keeping my own teeth did not seem like a luxury.
In the US, as in the UK, a person’s class is etched in their teeth. In his 1991 classic, Savage Inequalities, author Jonathan Kozol wrote: “Bleeding gums, impacted teeth and rotting teeth are routine matters for the children I have interviewed in the south Bronx.”
A report by the US National Institute of Health says poor children today are far more likely to suffer from severe baby-tooth decay “caused by frequent or prolonged use of baby bottles that contain milk, sugared water, fruit juice or other sugary beverages”. The US has more celebs with perfect teeth simply because it has more celebs (and maybe more rigid standards of celebrity appearance).
But US government statistics still show deep racial differences in dental health, and just as steep a class divide as Britain. That, rather than the space between our incisors, is a gap we should all mind.
DD Guttenplan
Guardian UK