Teeth

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

From a veteran Washington Post journalist, the view from inside America’s mouth—and what our teeth reveal about inequality today

“We must recognize that oral health and general health are inseparable. . . . Teeth . . . represent the very essence of our humanity.” —David Satcher, former surgeon general of the United States

“Show me your teeth,” the great naturalist Georges Cuvier is credited with saying, “and I will tell you who you are.” In this shattering new work, 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 America’s silent epidemic of oral disease, exposing the hidden connections between tooth decay and stunted job prospects, low educational achievement, social mobility, and the troubling state of our public health. Otto’s subjects include the pioneering dentist who made Shirley Temple and Judy Garland’s teeth sparkle on the silver screen and helped create the all-American image of “pearly whites”; Deamonte Driver, the young Maryland boy whose tragic death from an abscessed tooth sparked congressional hearings; and a marketing guru who offers advice to dentists on how to push new and expensive treatments and how to keep Medicaid patients at bay.

In one of its most disturbing findings, Teeth reveals that toothaches are not an occasional inconvenience, but rather a chronic reality for millions of people, including disproportionate numbers of the elderly and people of color. Many people, Otto reveals, resort to prayer to counteract the uniquely devastating effects of dental pain.

Otto also goes back in time to understand the roots of our predicament in the history of dentistry, showing how it became separated from mainstream medicine, despite a century of growing evidence that oral health and general bodily health are closely related.

Muckraking and paradigm-shifting, Teeth exposes for the first time the extent and meaning of our oral health crisis. It joins the small shelf of books that change the way we view society and ourselves—and will spark an urgent conversation about why our teeth matter.

Praise

“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)
“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
“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
“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
“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