An astute examination of the complex, insular business of oral health care.
Former Washington Post journalist Otto recognizes poor oral hygiene and maintenance as a major public health problem, and she adroitly probes the ramifications of this persistent “silent epidemic of oral disease.” While those in disadvantaged communities cite affordability, accessibility, and shame as factors in their lack of dental care, the opposite can be said for more privileged socio-economic groups, in which vanity and self-consciousness inspire an obsession with teeth bleaching, porcelain veneers, and spatial alignment. “Bad teeth depersonalize the sufferer,” writes the author. “They confer the stigma of economic and even moral failure.” Aside from economic variances, Otto charts the history of American dentistry, including the astronomical educational debt of dental school students and, consequently, why more progressive dental offices are often established within wealthier enclaves. The author meticulously examines the inexplicable fragmentation of oral health from established American health care systems, the increase in emergency room dental visits by uninsured patients, and how unregulated costs, a shortage of free clinics, and plans like Medicaid further isolate poorer populations from obtaining dental care. She also addresses the widely debated medical claim directly connecting oral health to overall health. Otto presents several case studies reflecting the state of the industry, including a young Miss USA pageant contestant’s pursuit of the “Hollywood smile” and the shocking deaths of two young men from untreated dental abscesses. Though the situation is certainly a grim national concern, Otto presents hope via radical initiatives to stave off the flow of dental demand. Still, she implores, prevention and upkeep are paramount, as “people are held personally accountable for the state of their teeth in ways that they are not held accountable for many other health conditions.”
A focused, well-researched depiction of the dental industry’s social and cultural relevance and its dire need for reform.