Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America

by Mary Otto

Overview

An NPR Best Book of 2017 that exposes our oral health crisis and the astonishing role that teeth and oral health play in our society

In this brilliant debut book, hailed by the New York Times Book Review as "a call for sweeping, radical change," veteran health journalist Mary Otto looks inside America's mouth, revealing unsettling truths about our unequal society.

Teeth takes readers on a disturbing journey into the role teeth play in our health and our social mobility. Otto "doesn't just dwell on the numbers," according to NPR, "she makes what could have been a turgid health policy tome spark with outrage over the stories of people who have suffered." Her subjects include the pioneering dentist who made Shirley Temple and Judy Garland's teeth sparkle on the silver screen; an up-and-coming beauty queen awarded thousands of dollars of free cosmetic dental care; and Deamonte Driver, a young Baltimore boy whose death from an abscessed tooth sparked congressional hearings.

Offering "an astute examination of the complex, insular business of oral health care" (Kirkus Reviews), Otto combines searing critique with forward-looking proposals for reform, "sympathetically explor[ing] a range of ideas for improving the current system" (New Republic). Muckraking and paradigm-shifting, Teeth exposes for the first time the extent and meaning of our oral health crisis.

Product Details

ISBN-13:	9781620974827
Publisher:	New Press, The
Publication date:	06/04/2019
Pages:	304
Sales rank:	238,861
Product dimensions:	5.40(w) x 8.40(h) x 0.90(d)

About the Author

Mary Otto is the oral health topic leader for the Association of Health Care Journalists. She began writing about oral health at the Washington Post, where she worked for eight years covering social issues including health care and poverty. She lives in Washington, DC.

Table of Contents

Preface v

Part I Bad Teeth

1 Beauty 3

2 Suffering 30

3 Emergencies 51

4 The World Beneath Our Noses 65

Part II The Dental Art

5 The Birth of American Dentistry 93

6 Separate Lives 113

7 Adventurers and Auxiliaries 133

8 The System 162

9 Color Lines 181

Part III A Sentinel Event

10 Deamonte's World 203

11 Riding into the Epidemic 223

12 Sons and Daughters of Chapin Harris 246

Acknowledgments 261

Notes 263

Index 281

Editorial Reviews

The problem of oral health in America is, Otto argues, part of the larger debate about health…At the moment, our broader health care system at least tenuously operates on the belief that no one should be denied health care because of ability to pay. But dental care is still associated in our minds with cosmetic practices, with beauty and privilege. It is simultaneously frivolous, a luxury for those who can waste money, and a personal responsibility that one is harshly judged for neglecting. In this context, Teeth becomes more than an exploration of a two-tiered system—it is a call for sweeping, radical change.

The New York Times Book Review - Sarah Jaffe

01/09/2017
This full-length debut from Otto, a health journalist who writes for the Washington Post, takes a hard-hitting look at the current state of oral health in a beauty-obsessed America. She highlights access disparities, poorly addressed by our national support networks, that can have lifelong devastating, or even fatal, effects. Otto’s complex history of dentistry depicts dental care as a field on the fringes of modern medicine. She begins in 1840 with the founding of the Baltimore College of Dental Surgery, elevating dentistry from a trade to a profession, and traces its evolution perpetually in isolation from the rest of America’s health care system. More moving are the book’s portraits of the effects of neglected dental health care in poor communities: chronic pain is a given, the stigma of missing teeth hinders job prospects, untreated infections lead to emergency room visits, and traveling clinics are left to pull teeth too rotted to repair. Otto highlights the case of 12-year-old Deamonte Driver’s death from complications of an untreated abscessed tooth, which eventually led to the 2009 expansion of the Children’s Health Insurance Program. With many adults still uninsured, children’s dental care far from universal, and the future of government-supported health care unclear, Otto’s sobering report should not go unheeded. (Mar.)

Publishers Weekly

Praise for Teeth:

An NPR Best Book of 2017

Winner of the Studs and Ida Terkel Prize

"Mary Otto, a former Washington Post reporter, doesn't just dwell on the numbers—she makes what could have been a turgid health policy tome spark with outrage over the stories of people who have suffered."
—NPR

"[Teeth is] . . . more than an exploration of a two-tiered system—it is a call for sweeping, radical change."
—New York Times Book Review

[Otto infuses] what could be a mundane topic with quirky history, heart-wrenching real-life stories, and prose that is . . . poetic . . . this harrowing book pulls at the heartstrings. It’s a must-read for anyone who cares about public health policy."
—Newsday

"With many adults still uninsured, children’s dental care far from universal, and the future of government-supported health care unclear, Otto’s sobering report should not go unheeded."
—Publishers Weekly

"Otto’s well-reported and important book will arouse concern over the fact that dental health, which is so essential to our well-being, gets such short shrift, and, hopefully, help instigate reform."
—Booklist

"An astute examination of the complex, insular business of oral health care."
—Kirkus Reviews

"Mary Otto hits us right in the face—our teeth—with this important book. The lack of dental care for millions of Americans is a national shame. Teeth breaks new ground in the canon of books about poverty. It should be read by anyone concerned about the class divide in the U.S."
—Dale Maharidge, author of And Their Children After Them, winner of the 1990 nonfiction Pulitzer Prize

"I can't remember the last time I read a book that so brilliantly yokes physiological, political and cultural systems. Rife with discovery, and a spur to social action, Mary Otto's book is a beautifully readable and essential testament for these times."
—Mary Cappello, author of Swallow: Foreign Bodies, Their Ingestion, Inspiration, and the Curious Doctor Who Extracted Them

"Mary Otto brings history, policy and painful personal realities together in this compelling and engaging book about our nation's highly preventable epidemic of oral disease. Teeth should be read by every policy maker and health professional who believes we can and must act to reduce the current barriers to dental care."
—Louis W. Sullivan, MD, U.S. Secretary of Health and Human Services, 1989-1993, and chairman of the Sullivan Alliance to Transform the Health Professions

"Who eats too much sugar, leading to dental trauma? Primarily the poor. Who cannot sleep because of continuing dental pain and no available dental care? Primarily the poor. Even with Medicare and Medicaid, dental care has remained a stepchild—and these programs are in jeopardy now. 'The teeth are no match for . . . a life of poverty,' Otto says. More teeth failure and its consequences are on their way."
—Peter Edelman

"Here's a book that will enlighten you, upset you, and give you hope. I highly recommend it."
—Bob Herbert, Distinguished Senior Fellow at Demos and former op-ed columnist for the New York Times

"Mesmerizing and important. Mary Otto's unflinching work on the miserable state of oral health in America gnaws at you like a toothache."
—Congressman Jamie Raskin (MD-8)

From the Publisher

★ 02/01/2017
Former Washington Post reporter Otto, oral health topic leader for the Association of Health Care Journalists, writes compellingly about the integral role of oral health in overall wellness and how seldom dental care is available to low-income families, Medicaid patients, and nursing home residents. Surgeon General David Satcher's 2000 report, "Oral Health in America," warned of a "silent epidemic." While the biological understanding of oral health continues to evolve, access to dental care remains uneven, subject to the vagaries of state funding and "dental deserts." Tooth decay, largely preventable, remains the most prevalent chronic disease in America. Residents who live in rural areas are particularly subject to dental health disparities. Lack of access to routine dental care led to the 2007 death of 12-year-old Deamonte Driver, of Baltimore, who suffered from a brain infection caused by an infected tooth, which could have been prevented by an $80 extraction. His death led to Congressional hearings. This eye-opening look at the abyss between medicine and dentistry, between the mouth and the rest of the body, is not just about dentistry. It is about public health and health-care economics. VERDICT Timely and highly recommended for all readers concerned about public wellness, health-care disparities and outcomes, and the rising costs of treatment.—Mary Chitty, Cambridge Healthtech, Needham, MA

Library Journal

2017-01-10
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.

Kirkus Reviews