Open Writing

Whenever I see smiling faces on TV, and in magazines and newspapers, if the smiler has Caucasian features I can usually guess whether they are American or not. My clue is their teeth, which in most Americans approaches perfection.

I am told by my dentist that perfect teeth and healthy gums are necessary for good health. Well I would agree that diseased gums are not much of an asset, if for no other reason than bad breath, but I question the importance of a perfect bite. England, the country of my birth has a substantially healthy citizenry, but is renowned for its snaggled smiles, sometimes with as many gaps as teeth.

My own dental history is fairly typical for my generation. As a schoolchild I was subjected to the mandatory, but brutally ham-fisted municipal dentistry. Extractions were carried out under general anesthetic, using nitrous oxide, known popularly as laughing gas, though I never saw the humorous side of it. In my own case it produced lurid dreams, and left me feeling nauseated and confused.

To make matter worse, the dentists used a metal device that wedged one’s mouth open and made it almost impossible to swallow. As a result of these childhood experiences, for years after I completed my basic education I avoided dental treatment. I was well into my twenties before I was compelled by extreme pain to seek treatment. In the meantime, several teeth had broken off at the gum–line.

Pain is a great persuader, as torturers know, so I needed no encouragement to get my mouth fixed. The dentist who first saw me was horrified at what he found. He tended to my most urgent needs, and since I was living away from home at the time, recommended that I sign up with a practitioner in my home town for regular treatment, since it was going to take a number of visits before my teeth, those that were left, were restored to a healthy standard.

That visit did more than just solve my immediate problem; it revealed the advances in methods, medicines and materials that make modern dentistry a walk in the park compared to my schooldays. I never again refrained from regular visits, and not once had the pre-visit qualms of my younger days.
The only limiting factor was the cost. The National Health Insurance at the time provided for only the essential services – cleaning and extractions. Any other treatment was considered optional or cosmetic, to be paid for by the patient. I had been married just a couple of years, had a baby daughter, and no spare cash, so the basic treatment was what I could afford.

Fast forward fifteen years, and I was on my way, tooth gaps and all, to live in America, land of the perfect smile. Although my pecuniary status had improved quite a bit, and my private health insurance covered more dental options than before, what were considered to be cosmetic treatments, like the gap-filling implants I needed, were excluded.

In the US, practically any dental problem can be fixed, at a price. Young people have braces to correct their bite, or to corral their buck teeth. Older folk can have gaps filled by bridgework, implants or partial dentures. Chipped or discolored teeth can be capped. The net result is smiles that in some cases are rather eerie. Such perfection is its self an imperfection in a way.

Two ladies of my acquaintance are, if I’m generous, in their seventies, but have the smile of seventeen-year-olds. Were they wearing dentures it would not seem as incongruous, but these are their own teeth, capped, straightened and whitened.
The cost of such exotic treatments here are horrendous. Even what could be considered essential dentistry imposes a severe strain on the finances of the under or uninsured. My wife’s aunt who is in her eighties, and has not had preventive treatment for years, recently needed an extraction and antibiotic treatment for an infected tooth. In the process, the examination revealed several other problems that needed attention, with an estimated cost of $10,000! Now that’s a lot of toothache.

Many people in the US workforce have company provided medical insurance that customarily includes very basic dental coverage. If you want more than that, you have to take out your own insurance at significant cost. In my own case, I was never able to afford treatment over and above the essential cleaning and extractions, until I met my wife.

She had a very comprehensive dental plan, and generous woman that she is, shared it with me. So now, after 25 years of marriage, I’m in the curious position of having more teeth than at any time in my previous adult life, thanks to the crowns and bridgework, root canals and skills of several dentists. Better still, it didn’t break the bank.

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