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.