Small Differences: Dentistry

There are two stereotypes about teeth that we all know: Americans have big, wide mouthed smiles; British people have wonky teeth.  Studies show that there is no real difference in oral health and hygiene between Britain and America but the perception of vastly different aesthetics remains.

I have lived in America for almost four years now and still every time I visit the dentist for a check up I imagine the dentist recoiling in horror when I open my mouth and reveal my ever so British teeth.  Truth be told, my teeth are pretty skew-whiff even by British standards – perfectly healthy but very crowded and crooked.  Compared to my American peers, however, they are a complete and utter mess.  The first time the dental nurse at our American practice looked in my mouth, she asked me if I was British or Russian.  It was that obvious that my mouth was not tended to by American dentists.  I never felt self-conscious about my teeth back home in Scotland but here in America I most definitely do.  Cosmetically pristine teeth are clearly valued here and mine don’t pass muster.  I may have made it to the age of 41 and have only one filling but that doesn’t mitigate against the visual mayhem of my mouth.

I think the key to the different dental experiences may be in a different approach between the two cultures.  I cannot compare US dentistry to private dental care in the UK because I have never been to a private dentist.  For the five years when I malingered on the waiting list of an National Health Service dentist, I never had an oral emergency that compelled me to seek out a dentist and pay private fees for the privilege.  Throughout my childhood and all but those five years of my adulthood in Britain, I was treated on the NHS.  This means my dental treatment was heavily subsidised (great for the budget) but it also means that the appointments were pretty perfunctory.  In contrast, my US appointments last for an interminable amount of time even though all I am having is a check up and routine cleaning.  The hygienist actually performs the bulk of the treatment.  This involves lots of ponderous poking and prodding and then a professional cleaning that lasts so long I have to stave off panic attacks.  Only after that marathon is completed does the dentist appear to look over any xrays and give my gob a final, brief once over.

Every single time I go to my check up, either the hygienist or the dentist – and sometimes both – will comment on the overcrowding in my mouth.  It is as if they find it grimly fascinating to contemplate the abyss that is my British mouth.  My teeth are not straight, they overlap, and my lower wisdom teeth came in at right angles to my other molars (though to be fair my UK dentists always found that weird too).  Even the dental hygienist, an expert flosser, has occasionally trapped a piece of floss between my teeth because there is so little space between them.  When I first moved here, the inevitable follow up question was whether I had ever considered orthodontistry.  You can probably imagine their looks of surprise when I tell them that I had a mouth full of metal for almost six of my teenage years.  I don’t think they can comprehend that the mangled mouth they see wide open before them actually represents an improvement on what was there before.  I decline each time the subject is raised.  I have lived with my wonky teeth for enough decades now that I can just accept that this is how they are.  I have endured braces for enough years of my life and don’t need a redux.  Besides, I have to shell out a whole heap of dollars on my kids’ orthodontisty.

Sadly, yes, at least two of my children have inherited my British mouth.  Apparently I have a tiny jaw, especially the mandible, and I have transmitted that “defect” to two of my offspring.  My 10 year old is already in braces because, aside from the crowding, he also had a dramatic crossbite, and my youngest will start orthodontic treatment as soon as he has a couple more adult teeth.  In addition to all of the metal and wire work in his mouth, it has been mentioned that my 10 year old may need to have some teeth pulled to create space and will need a palate expander.  That aspect of the treatment diverges from my experience of having orthodontisry in 1980s and early ’90s Scotland.  I had no teeth pulled and certainly didn’t have my palate expanded which, therefore, means that no extra space was ever created in my apparently minuscule jaw for the relocated teeth to move into.  So, while the six years worth of metalwork pulled everything into line, as soon as all of those devices were removed, my teeth simply began to drift back – especially once my wisdom teeth came in when I was in my mid-20s.

Even with very good dental insurance, the out of pocket cost for the orthodontistry is a major expense.  Multiplied by two kids, that expense becomes eye wateringly winceable.  They need the treatment for physical reasons, not just cosmetic ones, but I also think it is important to their self-esteem that they have winning smiles that fit in here rather than having my experience of people looking quizzically at teeth that look like collapsed tombstones in a long abandoned cemetery.  I am, therefore, going to stick with my awfully British teeth so that my children’s mouths can evolve to become more American.

13 thoughts on “Small Differences: Dentistry

  1. This post really did make me chuckle Laura especially your last sentence!! I can identify totally with the British teeth thing, that’s exactly what I have. How nice it would be to have a gleaming white and perfect smile though.

    • It’s sadly one of those national stereotypes that is founded on truth. I’m trying to put a positive spin on things with the fact that two of my children don’t need orthodontistry . It may be a preference for them for cosmetic reasons but they can make that decision for themselves as adults.

  2. A tiny jaw, eh? You are the tooth martyr, sacrificing for your kids’ future lovely smiles. I agree that orthodontic prices are crazy. My son’s first round of $4000 braces were not covered by our dental insurance at all, so Round 2 has been postponed until we become millionaires. The braces that gave me perfect teeth in the 80s have now led to very crowded 40-something teeth. Whatever I eat wants to wedge itself in the crannies. And as far as your 10-yr-old, tell him my husband had to have EIGHT teeth pulled from overcrowding when he was a teen. I shudder to think what he would have looked like, had I met a man with 8 more teeth shoved in that mouth.

    • Our insurance covers part of the treatment but not very much overall. Maybe a quarter of the total cost. Thank goodness for payment plans. But that’s precisely why I’ll fund the kids who have actual physical need for braces but not the ones who’d just benefit for cosmetic reasons.

      As for my jaw, I’d never think to look at my head that I have a tiny jaw but every single dentist remarks on it so I guess it’s true. It’s nice to have something about me that’s tiny I suppose.

  3. I had four teeth pulled and good thing as my wisdom teeth came in at age 14. Yes, I got all my teeth early. Orthodontia did a lot of good for me. I also inherited my father ‘s bad teeth, I have several crowns, plus having knocked out my two front teeth at age 8, I’ve gone through three sets of crowns there. Your teeth sound strong and healthy and long may they stay so.

    True story: my father went off to WWII, two years later returning to his small Illinois hometown having of course seen no dentist for a while. Teeth were bad before and at this point rotted. Given the time and place they were all extracted and he got full dentures. At age 19. Fast forward to 2017…At this point 70+ years. Things sure have changed!

    • One of my husband’s grandfathers did the same thing. I guess dentures were regarded as the cheaper/easier option at some tipping point of oral hygiene.

      14 is very young for wisdom teeth. I know a good number of people who got them in their teens but not that young. I think I was a late bloomer in that regard.

  4. It’s interesting to me to read this. When I was living in Boston 15 years ago it was certainly my experience that the dentists were appalled by my gold cap. (I grind through everything else)
    However since I’ve been in the UP, many of the people I have met have appallingly bad teeth. It seems that there are few dentists here who will take low income clients and few people who can afford dental insurance. Having only just got mine I haven’t braved a dentist yet, but I will at least feel like I can’t be the worst they have ever seen.

    • Access to and affordability of dental care obviously play a significant role. When I couldn’t afford private dentistry in England, I just didn’t go to the dentist. Had I had less healthy teeth, I can see how that might have started an oral hygiene snowball effect.

  5. We were banned from sugar for most of my childhood (my parents learned to live without it in the war,) so the NHS did me very well until I left home with no fillings at all. Four years of Coca Cola later and I had several. I can only imagine how bad my teeth would have been with the levels of sugar in everything here in the US and no free dentistry. I actually begged my NHS dentist for braces (when I was 12) and he wouldn’t give them to me as he felt uniform teeth looked unreal and it was a vanity. Can’t imagine getting that response in the US 😉

    • I agree with you on the sugar thing. A couple of my kids have room for improvement where brushing and flossing are concerned but have no cavities and impress the dentist with their hygiene. My assumption is that it’s because we limit their sugar consumption to occasional treats.

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