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Health Communication
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The American Dental Dream
Nathan Hodges
a
a
Department of Communication, University of South Florida
Published online: 25 Sep 2014.
To cite this article: Nathan Hodges (2014): The American Dental Dream, Health Communication, DOI:
10.1080/10410236.2014.914621
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Health Communication, 00: 1–8, 2014
Copyright © Taylor & Francis Group, LLC
ISSN: 1041-0236 print / 1532-7027 online
DOI: 10.1080/10410236.2014.914621
The American Dental Dream
Nathan Hodges
Downloaded by [University of South Florida] at 00:08 26 September 2014
Department of Communication
University of South Florida
The American Dental Dream—the cultural desire for straight, white teeth—is difficult, if
not impossible, for poor and working-class people to achieve. Using ethnographic fiction,
autoethnography, poetry, and qualitative interviewing, I brush away the taken-for-granted
assumptions about teeth. I explore the personal, relational, and structural consequences of
this cultural desire, and show how social class writes itself on our bodies. I write these
culture-centered teeth tales to show how one might cope with their teeth.
Movies, TV commercials, billboards, magazines, professors,
doctors, lawyers, my friends, my friend’s families, my students, my colleagues, professional athletes, President Obama
. . . it seems everywhere I look I see straight, white teeth.
Well, not everywhere. All I have to do is go home and chat
with my family or almost any poor or working-class family in America to find teeth that our culture says are not
worth smiling about. The American Dental Dream, the desire
for teeth whiter than the bald eagle’s head and stronger
and straighter than the white picket fence surrounding the
dream home, is a national ethos as difficult to achieve for
the working poor as the other American Dream. And just
like the other American Dream, it is a story of social mobility built on appearances. As George Carlin (2005) said, “It’s
called the American Dream because you have to be asleep to
believe it.”
My mom and I grew up in working-poor families, unable
to afford the dental care needed for straight, white teeth.
Every one of her crooked, decayed teeth was replaced with
dentures at the age of 42. Only her family and close friends
know her teeth are made of acrylic resins, not calcium.
To others, she has achieved the American Dental Dream.
Her teeth might be fake, but her smile is real. I also know
what it feels like to be embarrassed by my teeth: a crowded,
crooked mouthful with a rebellious snaggletooth. No matter how often I brush, I can’t scrub away my working-class
roots.
Dentists and dental researchers tend to focus on predicting and controlling patients’ individual behaviors, ignoring
how cultures, identities, and structures intersect to influence decisions concerning teeth (Amin & Harrison, 2009;
Anderson, Noar, & Rogers, 2013; Loignon, Landry, Allison,
Richard, & Bedos, 2012). The stories written here are culture centered (Dutta & Basu, 2011), trying to understand
oral health inequalities from my mom’s and my workingpoor perspective. What is important to us about dental
health? How do we make sense of cultural messages about
teeth? How do we challenge and work within structural constraints that keep us from having healthier, straighter, and
whiter teeth? Through conversations with my mom a different story emerged than the dentist–patient compliance
story that condemns us for poor personal choices (Dutta
& Basu, 2011). The stories we shared are about our culture’s emphasis on straight, white teeth as a marker of
social status and the high cost of paying for teeth like
this.
Being culture-centered means recognizing the intersections of culture, structure, and agency (Dutta & Basu, 2011).
Culture is created in the day-to-day practices of cultural
members and influences beliefs, attitudes, and values, providing the social scripts for how to act and what to think.
We live in a culture telling us daily that our teeth should
be straight and white. In a 1966 study, researchers provided
1,862 Americans the following scenario:
Correspondence should be addressed to Nathan Hodges, University
of South Florida, Department of Communication, 4202 E. Fowler Ave.,
CIS 1040, Tampa, FL 33620. E-mail: nlhodges@mail.usf.edu or post a
discussion thread on CRTNET
The Green family had been saving money for a long time to
buy their house. They have finally found one they like and
can afford. But their thirteen year-old son has begun to be
self-conscious because his teeth are so crooked. When they
go to see the dentist, he says that the teeth can and should
2
HODGES
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be straightened. This would use most of their savings and
they could not meet the down payment on their house. (Linn,
p. 290)
What would you do?
Eighty percent of participants chose to straighten the kid’s
teeth. The American Dental Dream over the American dream
home. Participants who had the lowest amount of education
were most likely to say they would straighten the child’s
teeth because of appearance (Linn, 1966, p. 292), perhaps to
have the child pass as not poor by “communicating in ways
that hide or deny [their] identity” (Orbe, 2013, p. 203), since
teeth have become another socially constructed category for
demarcating the poor from the rich (Toner, 1998). This is a
1966 study, too. Only a few generations ago, people expected
to lose their teeth, and dentures were the norm, especially for
the working class. Now more Americans are keeping their
natural teeth into old age (Douglass & Sheets, 2000).
Structures reflect cultural beliefs, values, and meanings and become systems that enable and constrain certain
choices (Dutta & Basu, 2011). Economic structures created
by our capitalist culture make it difficult for the working poor to achieve the American Dental Dream. More
than 4 in 10 Americans pay their dental bills themselves
(Florida, 2011), compared to only about 1 in 10 paying
physician costs out-of-pocket (Thomas, 2009). Most dental insurance requires costly co-payments and usually is
not really insurance at all, but more like a membership
that allows people to have a discounted fee at the dentist
(Thomas, 2009). Medicare does not cover any dental costs,
except under unusual circumstances, and only about 20%
of practicing dentists accept Medicaid (U.S. Department of
Health and Human Services Health Resources and Services
Administration, 2013). Even fewer devote a substantial part
of their practices to working with poor and low-income
patients. Braces can cost anywhere from $3,500 to $10,000
(Oral-B, 2013) and are not typically covered by insurance
since they are generally associated with cosmetic procedures. Dental health and dental aesthetics are different ideas,
but aesthetically pleasing teeth have material consequences.
Being hired for a job where you make enough money to
achieve the American Dental Dream can be tied to whether
you already have straight, white teeth. As the American
Association of Orthodontists website reads, “We live in a
competitive world and a great smile can give you an edge.”
The same subtle advantages providing access to schools
with well-paid teachers and superior physical facilities also
result in mouths with dazzling white, perfectly straight teeth
(Oldfield, 2007).
Agency is the capacity for individuals and communities to challenge and work within structures that constrain them (Dutta & Basu, 2011). “As social agents
constrained but not controlled by culture [we] live stories that show the dazzling human capacity to remake
and reform cultural narratives” (Ellis & Bochner, 1998,
p. 7). By sharing these teeth tales, I am an agent
for renewed understanding and change. My mom tells
me how she copes with economic structures that inhibited us from achieving the American straight and white
ideal:
Growing up,
Grammaw just didn’t have the money
to fix my teeth.
She had five kids to support
and utilities
and food
came first.
She done what she could.
The dentist told me
you and your brother both needed braces
but I didn’t have the money.
Me and your dad were both struggling
to make ends meet.
Although I do my best to describe the ways my mom
made sense of her experiences, I am ultimately the author.
I create meaning for these experiences through storytelling.
There will always be discontinuity between our lived experiences and the stories we tell about them because of the
inadequacies of language and memory. We never can seem to
find the right words, can we? We remember the past through
the lens of the present and we are not the same people we
were when the experience happened (see Bochner & Riggs,
2014). Therefore, I am less concerned with “what actually
happened” and more concerned with what the experience
means and how it can be used by others, what Bochner
(2001, 2002) labels narrative truth.
Good stories offer us a different sort of knowledge
than knowing how or knowing what. They help us know
what it is like (Goodall, 2008). They bring readers into
the scene to help them “experience an experience” without actually being that person (Ellis, 1993). I agree with
Bochner (1997), who tells us “there is nothing as theoretical as a good story (p. 435)” when we think with a
story (Frank, 1995) rather than think about a story, “trying to stay with the story, letting ourselves resonate with
the moral dilemmas it may pose, understanding its ambiguities, examining its contradictions, feeling its nuances . . .
We ask what kind of person we are becoming when we take
the story in and consider how we can use it for our own
purposes” (Bochner, 1997, p. 436). Our personal stories are
also cultural stories. Through vulnerable, reflexive personal
storytelling we can learn how identity, culture, and relationships are interconnected (Boylorn & Orbe, 2013; Ellis,
2004; Hodges, 2014). I also use poetry to communicate the
feeling-world of our experiences in ways prose sometimes
cannot. Richardson (1994) says “Poetry’s rhythms, silences,
THE AMERICAN DENTAL DREAM
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spaces, breath points, alliterations, meter, cadence, assonance, rhyme, and off-rhyme engages the listener’s body,
even when the mind resists and denies it” (p. 522).
The way we understand, describe, and treat teeth is symbolic of our identity and society. Ben Myers (2008) writes
about being socialized into and performing straight and
white identity using the metaphor of straight, white teeth.
He beautifully shows how teeth tell a story in America about
a society that normalizes whiteness and heterosexuality. He
says, “My braces shaped my teeth to be straight while simultaneously reflecting my desire to be straight” (Myers, 2008,
p. 164). “Every time I brush my teeth, I enact the politics of
whiteness. Every ounce of mouthwash that rinses over my
teeth works to reinforce the hegemony of my white teeth”
(Myers, 2008, p. 168). But white privilege does not necessarily mean the privilege of having a straight, white smile.
Beautiful, jaw-dropping smiles inhabit the mouths of all
races and sexual orientations. How many poor or workingclass people do you see with straight, white smiles? Myers’s
social class is influential in him having straight, white teeth:
My parents made sure I grew up straight by spending thousands of dollars to provide me orthodontic care and the
proper medical equipment to pull teeth and attach braces and
rubber bands and retainers to make sure that my teeth came
out straight. (Myers, 2008, p. 163)
When you smile, you are letting us know who you are
and where you come from—what sort of advantages you
do and do not have. Social class is about more than money.
Social class writes itself on our bodies, influencing how we
talk and walk, and what we look and feel like. “In a country in denial about class divisions, a mangled mouth is the
clearest indication of second-class citizenship” (Thompson,
2009). My body reveals clues about social structures and cultural ideals. My teeth are a “cultural billboard” (Spry, 2001,
p. 719) composed of calcium, money, family, education, my
past and projected future (see Myers, 2008, p. 168).
I write as a blue-collar scholar (see Dews & Law, 1995;
Orbe, 2013). Similar to Orbe, “I’m not trying to advance past
my poor, working-class background” (p. 205) and I don’t
“desire to move beyond class or strive for social mobility”
(pp. 205–206). I carry my past with me, and its presence
shapes who I am and who I can be. Despite being a doctoral student, working-poor is still written on my body.
My teeth tell the story of being unable to afford orthodontic care. I write these stories to open understandings of
social class beyond stereotypical, exclusive categories, and
embrace ambiguous, nonbinary identities (Boylorn & Orbe,
2013).
3
“Damn! Wished I didn’t hafta work tomorrow,” my stepbrother Caleb sighs, thinking about his night shift loading
paper into a printing press. “Shouldn’t we at least get a day
off after Christmas?”
“At least yer bringin’ in holiday pay,” Jeff replies.
My stepdad spends his nights stacking blocks of packaged
cheese on wood pallets. “Bein’ an adult sucks dudn’t it?”
“What sucks is this TV show,” says my brother Nick.
“Turn it to the football game.”
As my family sits around the living room opening
presents, the show Lost plays in the background, detailing
how survivors of a plane crash slowly uncover secrets about
the island they’re stuck on. Sawyer, one of the main characters, is on screen smiling, revealing his movie-star teeth
despite the fact he’s been on a deserted island for months.
“Sis, open that damn present already, I’m starvin’ to
death!” Aunt Brenda complains. She had all her teeth
removed and replaced with dentures only a few days ago so
eating solid food is out of the question.
“Sorry, we don’t have any baby food,” Nick teases.
“You little smartass!” she laughs, turning her attention
back to the last present under the tree. “C’mon, I wanna’
see what Dad gotchya,’” Brenda tells my mom.
Meanwhile, Jeff and Uncle Steve’s eyes are glued to the
TV where a gorgeous sideline reporter with teeth brighter
than the white stripes of the referee’s uniform is holding a
microphone to the face of Green Bay Packers quarterback
Aaron Rodgers. She asks him a question about his game plan
but when he talks I can’t take my eyes off his immaculate
teeth.
Like nested dolls, Mom opens box after box before she
gets to one about the size of her open mouth.
“Dad, what the heck is this?’ Mom asks as she struggles
with the tape.
“Hell yer’ crazy if ya didn’t think I’s gonna make ya’
work for it!” Papaw says grinning. There is a gap in the bottom half of his mouth where his teeth used to be, leaving no
place for his top row of dentures to rest.
“Help her get that tape off,” I say to Nick.
“How ’bout you tape your mouth shut?” he says.
“You’re about to get the snaggler in the skull,” I say,
snarling my upper right canine at him. The jagged, vampirelike tooth rests high in my gums and juts out in front of
another tooth, ready to attack.
“The snaggler’s ’bout to be on the floor,” he says making
a fist.
It wouldn’t be the first time one of us had teeth, or pieces
of teeth, knocked out. Our mouths are more chipped than the
pavement street my mom lives on, and Nick is missing half
of his front left tooth.
I help her with the tape and she opens the box to find
a useless five-stick pack of Winterfresh gum. Because she
received a full mouth of dentures at 42, she is unable to
chew it.
“I thought it’d give ya’ somethin’ to do with your mouth
besides talk,” Papaw teases.
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4
HODGES
“Dad, don’t make me take my teeth out and come over
there. I won’t have nothin’ to lose then.”
My younger cousin Hayden sprints down the hallway
wearing yellow, rubber Billy Bob teeth, a present from Santa
this morning. He bumps into an end table and knocks off a
picture of Uncle Tommy.
Uncle Tommy didn’t make it to family Christmas this
year. I pick up the picture and stare at his red-scabbed
face, gaunt frame, and scraggly hair. He stares back at
me with a rare grin on his face, revealing a mouth that
looks like it’s been smashed with a hammer and tarred. The
few teeth that are left are corroded markers of the addiction that kept him awake during his night shift factory job.
I place the 5 × 7 back on the end table, reminiscing about
the old Tommy. Things would’ve been different if he had
money.
“Alright, I want a picture of everyone,” mom says. The
groaning starts.
“You may have to take two to get all of me in the frame,”
Jeff says, rubbing his belly after a Santa-sized portion of
turkey and noodles. We make our way to the front of the
tree.
“Smile on three,” mom says, holding the camera in front
of her face.
“Mom, the camera’s not zoomed in to the right place,”
Nick points at his face, posed like a model.
She laughs and focuses the camera on the family.
“One.”
I push my cheeks out a little, letting the ends of my lips
curl up without opening my mouth. Without baring my teeth
the forced smile makes it look like I’m plotting something
devilish.
“Two.”
On the TV, a Wal-Mart commercial plays showing several
Wal-Mart clerks turning their checkout lights on and off to
the tune of Christmas music, all smiling with straight, snowy
white teeth.
“Three.”
Click. I’m not smiling.
Wal-Mart considered her [Caroline] for customer service
manager and then promoted someone else . . . The people
who got promotions tended to have something that Caroline
did not. They had teeth. Her teeth had succumbed to poverty,
to the years when she could not afford a dentist. Most of
them decayed and abscessed, and when she lived on welfare
in Florida, she had them all pulled in a grueling two-hour
session that left her looking bruised and beaten . . . No
employer would ever admit to passing her over because she
was missing that radiant, tooth-filled smile that Americans
have been taught to prize as highly as their right to vote.
Caroline had learned to smile with her whole face, a sweet
look that didn’t show her gums, yet it came across as wistful,
something less than the thousand-watt beam of friendly
delight that the culture requires. (Shipler, 2004, pp. 52–54)
Growing up, I went to The Kids’ Dentist twice a year. The
dentist office was a mixture of pleasure and pain. Usually a
dentist appointment meant I was missing school (pleasure),
but missing school to have sharp metal objects shoved in my
mouth (pain).
Stretching my mouth like silly putty, Dr. Winn and her
assistants stick their hands of knowledge and power into my
working-poor mouth and poke at my teeth with sharp metal
toothpicks, spoons, and Captain Hook tools.
“Open wide,” she says, wedging a sharp metal drill in my
mouth.
The spinning steel screeches against my teeth, attacking
cavities embedded in my molars.
Then they wedge floss in between my crowded teeth, cutting the waxed filaments into my gums until I taste blood.
Not being a vampire, I am happy when the taste of my
own blood is sucked up through plastic hoses. Next, flavored toothpaste is rubbed on a chewy retainer and put on
my teeth for cleaning. I choose French vanilla from a menu
of delicious flavors: bubble gum, cherry cheesecake, chocolate, banana split, and other flavors that taste like the same
sugary stuff supposedly giving me cavities.
The pain is short-lived and intense, the metal tickling
sensitive nerves in my mouth. The pain experience taps
into several of my senses: the burning smell of teeth being
grinded; the taste of tooth dust being sprayed in my mouth;
the sound of a buzzsaw screeching through sheet metal.
Every time I visit the dentist I vow to never have a cavity
or filling again. I brush fanatically, up to five or six times a
day. But every time I go to the dentist I have new cavities.
As Kenneth Oldfield (2007), who grew up in a workingclass family, says, “If you had weak teeth, no matter how
often you brushed, they still decayed and had to be extracted”
(pp. 5–6).
I pick up my pink-and-white toothbrush from the smileyfaced toothbrush holder my mom bought me before I moved
away for graduate school. The bristles on my $2 Colgate
toothbrush are fraying in all directions.
I hold the brush in my mouth and grab my scrunched up
tube of Colgate Total whitening toothpaste. I unscrew the lid,
revealing little dried chunks crusted onto the grooved end,
and squeeze the tube from the bottom up with my thumb and
index finger. I take the toothbrush out and squeeze a big goop
onto the frayed bristles. I brush softly over my bottom back
right molars since they have been sensitive lately. Most of
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THE AMERICAN DENTAL DREAM
them have amalgam fillings, a mixture of different types of
metal and liquid mercury that fill in the hole where the dentist
dug out a cavity. The working-poor are often left choosing
between amalgam or no fillings at all because alternative fillings are not covered by Medicaid. Despite being used for
more than 150 years, the fillings continue to be criticized
about their potential for adverse health effects because of the
mercury (see McGrath, 2013).
I keep scrubbing my front teeth, trying to scrub away the
plaque I know is there but can’t see, like an ugly by-product
of social class, invisible and destructive. As I continue brushing I think about the lengths I have gone to brighten my
smile. During my high school years, my hometown WalMart Supercenter oral health care aisle took quite a hit.
I made sure to take all the whitening strips out of the box
and shove them in my pocket so I did not set off an alarm as
I walked out the automatic doors.
I snarl my upper lip to continue the last part of my brushing ritual: cleaning the snaggletooth. Resting high in my
gums, this tooth bullies its way in front of my upper right
incisor. The incisor tries to hide behind the canine like a
toddler in hide and seek, leaving half its body exposed. The
tooth is exposed and vulnerable, like those living at the edge
of poverty. I spit into the sink and glance at my teeth in the
mirror. My bottom teeth cannot stand in a straight line for the
life of them—just a misbehaving, zig-zaggity mess. Some of
my teeth form a broad U-shape, where the middle has been
ground down from other teeth. My left front tooth contains a
partial veneer, with a slightly longer left corner than the rest
of the tooth creating a downward slope. There are gaps in
the back of my mouth where teeth used to be. The last time
I went to the dentist, several years ago, I had my wisdom
teeth removed without general anesthetic in order to save
money.
There are health repercussions for those unable to
straighten out their teeth. Crowded, crooked teeth inhibit
good brushing and flossing, making it harder to keep teeth
and gums healthy. Over time, this can lead to tooth decay,
gum disease, and potentially tooth loss. Also, an over- or
underbite can wear tooth enamel and lead to jaw problems (American Dental Association, 2007). Tooth problems
can inhibit chewing, affecting nutrition choices, which are
important to maintaining oral health. Researchers argue periodontal disease increases the risk of other chronic illnesses,
including diabetes and cardiovascular disease (Metcalf,
Northridge, & Lamster, 2011). There are other less documented health risks too. During a high school wrestling
match, my snaggletooth pierced through my lip to the other
side of my face, requiring stitches and leaving a permanent
scar.
5
As I watch my friend Jerrod presenting a paper to colleagues, my attention is not focused on the words he is
saying but instead the beautiful white barriers those words
are escaping through. I envy his teeth. He radiates confidence and warmth, and surely his teeth are the inspiration
for clichés like “his smile lights up a room.”
Henson et al. (2011) showed 221 teenagers pictures of
10 volunteers’ smiles. Each volunteer is shown two photos: an arrangement of teeth considered “ideal” and another
considered “not ideal.” “Ideal” arrangement referred to the
American cultural desire: straight, not chipped, crowded, or
crooked. The researchers then asked the teenagers to answer
questions based on these photos. Those with culturally ideal
smiles were perceived by teenagers as more athletic, social,
and better leaders.
“I think people look at you differently when you have bad
teeth or at least you feel like they do,” my mom tells me on
the phone. She continues:
I hated my teeth growing up
I had absolutely no confidence
because of my teeth.
I was embarrassed to talk to people
because you know how they look at you
when you have a cold sore—
they’re lookin’ at your cold sore,
not you.
That’s how I felt.
My mom felt stigmatized because of her teeth. Ellis
(1998) says minor bodily stigmas are “involuntary characteristics perceived by self and/or others as undesirable.
Sometimes people are born with minor bodily stigmas, other
times these attributes are acquired later in life” (p. 524). My
mom thought others viewed her teeth undesirably (whether
they did or not), which has an impact on how she lives her
life. Sparkes (2012) discusses the shame and anxiety his
father felt about his dentures, and about the stigma of having
teeth that marks himself as working-class:
His teeth were a source of deep anxiety and ongoing degradation. It was not long before he was wearing a full set of
dentures that became a constant reminder to him of his poor
background and a source of deep vulnerability and shame
in terms of what was already a fragile sense of masculinity.
(p. 176)
My snaggletooth has been the biggest source of shame
and embarrassment. I try to keep the snaggletooth hidden
beneath my lip but occasionally in a fit of laughter or a forced
smile, it will emerge, a photo bomb for any picture it is in.
My snaggletooth haunts my smile.
6
HODGES
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Occasionally, I will bare my teeth for a straight-on camera
shot, so as not to get a good angle on the snaggler. I have an
overbite so bad it seems like every time I close my mouth the
top half is going to eat the bottom half. When I am forced to
open my mouth for the person insistent on a serious smile,
I make sure to extend the bottom half of my jaw forward
so I can stack my teeth. Organized photos, often a source of
fun and pleasure for others, are an anxious time for me. One
photo in particular sticks out:
Lacey has my high school libido
dancing fast during slow songs.
Bright, pink Prom dress
snug against her bronze Venezuelan curves.
“Smile,” says the photographer.
Her moonlight smile
casts a shadow on my closed mouth.
Weeks later in the lunchroom,
she’s walking toward me frowning,
photos in hand.
She unloads:
“Why do you look upset? Are you angry? Are you not
happy with me?”
She’s upset I look upset,
insecurely assuming
something must be wrong with her.
I’m too embarrassed to explain
why the ends of my lips look too heavy to lift.
We break up a few days later.
My mom had photo anxiety, too. She tells me:
Any picture you see me in before my senior pictures,
I did not smile with my mouth open.
Not one picture.
You see my pictures now.
I’m always smiling
Everybody says how beautiful my teeth are now.
I smile without hesitation.
Nobody at work knows I got fake teeth.
Everybody thinks these are my real teeth.
It lets me be the person I wanted to be.
I rinse my toothbrush, put it back in the holder, and dry
my hands on the towel hanging over my shower curtain.
I grab my bottom left incisor and wiggle it, noticing it felt
a bit tender when I was brushing.
As a child I would try my hardest to pry my teeth out
so I could collect money from the Tooth Fairy. I would wait
excitedly in bed with my tooth under the pillow and my parents would say, “He won’t come if you’re still awake.” In
typical American fashion, the Tooth Fairy came for a business deal: a few bucks for a piece of my docile body. It is
a cultural myth based on the idea of capitalistic exchange.
I wonder though, what did the Tooth Fairy do with all of
those teeth? Did he deposit them in a tooth bank where
they collected interest and made him rich, like the orthodontists who removed my mom’s teeth, averaging more than
$300,000 annually (Berenson, 2007)?
According to the latest Delta Dental Tooth Fairy Poll,
90% of American homes are visited by the Tooth Fairy and
the average payment per tooth is $2.42, a 15% gain since last
year (Delta Dental, 2013). Adjusting for inflation, that nighttime tooth-napper still owes me at least $10, and if broken
pieces of teeth are accepted for half-price, then a lot more.
This may sound like a fairy tale, but the ideology has materialized in America: We pay a price for our teeth. And if you
are a member of the working-poor, the price is too high.
“If I won the first thing I’d do is fix my teeth,” my brother
says as he scratches off a lottery ticket.
“Me too,” I reply, scratching off my $5 Hoosier
Millionaire with a penny.
We both lose.
Standing in front of the bathroom mirror, I run my tongue
along the back of my crowded bottom teeth, and prepare to
present “The American Dental Dream.” My hands tremble
as I get ready to talk to a group of “serious” academics about
the Tooth Fairy and a snaggletooth, but I hope my vulnerability will invite others to share their teeth tales. Stories have
a funny way of leading to more stories.
The article has been through months of revisions following feedback from journal reviewers, colleagues, my
girlfriend, and my mom. Most of the people I have talked to
about the article acknowledge they have never noticed anything “wrong” with my teeth and a few mentioned how they
love my smile. Hearing these comments about my teeth has
at times, left me “feeling ashamed for feeling ashamed about
a seemingly trivial blemish” (Ellis, 1998, p. 526). I also wonder if in my writing I have made the issue “bigger than
life,” about a “blemish so small that [I] shouldn’t care; at
the same time, it is so big that it prevents [me] from measuring up to the images of perfection [I am] encouraged to
seek” (pp. 526–527).
As much as I would like to see immediate structural
and cultural changes, I am not getting my hopes up. Dental
care is not high on the health care policymakers’ list of
concerns, as it represents less than 5% of all health care
spending (Thomas, 2009). This is partially because those in
Washington who make decisions that impact working-poor
teeth “tend to come from the segment of the population that
has not experienced [these] type[s] of problem[s]. And if
you’ve never had a toothache, you’ve never had a toothache”
(Thomas, 2009). It is hard to understand how teeth can
strongly impact a person’s life, when you are in a position to take your teeth for granted. And even though most
public health dentists say that dialing back the obsession
with aesthetics would allow them to better serve a broader
population, about 50% of a dentist’s annual income is from
elective aesthetic procedures, so dentists profit from the
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THE AMERICAN DENTAL DREAM
vanity and anxiety most Americans have about their teeth
(Thomas, 2009). So, how do my mom and I cope with
crooked, crowded teeth, paradoxically turning them into
something to be valued (Ellis, 1998)? What agency do we
have when we are unable or unwilling to buy into the
American Dental Dream?
Bud Goodall (2005) says, “A comic perspective helps. Or
at least it has helped me. It’s not so much a cure for the past
as it is an attitude toward it. And attitude can help get you
through the night by not taking yourself and your own misery so seriously” (p. 509). Even before writing this article, I
was comfortable discussing my teeth, through reframing the
narrative (Kiesinger, 2002) I tell about them by using humor.
During my high school years, I began treating my snaggletooth as a separate entity, naming it “The Boston Snaggler”
(named after the infamous Boston Strangler). I would tease
friends, and sometimes strangers, that The Snaggler had a
mind of his own, as I snarled the tooth at them. I externalized the embarrassing tooth, “objectifying and personifying
the problem in [my] life that [I] experience[d] as painful
and oppressive” (Kiesinger, 2002, p. 108). This shift from a
tragic teeth tale that constructs me as a victim, to an empowered teeth tale, makes people laugh and projects me as unique
and confident. I inherited this comic perspective from my
mother, who has also been able to reframe the stories she
tells about her teeth as seen in the family Christmas narrative. Just this morning she was walking around our house
singing without her dentures in.
In externalizing the story I tell about my teeth, I can view
it with some emotional distance. Bergson (1911) tells us
comedy requires “a momentary anesthesia of the heart” and
encourages us to “look upon life as a disinterested spectator:
many a drama will turn into comedy” (p. 5). However, this
reframing is an emotionally dynamic process and at times,
especially when I am supposed to give a “serious” smile for
the camera, these feelings of embarrassment return. A tragic
frame is one in which we forget that we are looking at the
world through a frame. We associate our frame of the experience as the experience. We feel stuck, hopeless. Agency
means being able to reframe the cultural narratives we are
given about teeth. A comic corrective (Burke, 1984) allows
us to take charge of our own story again (Parry, 1991) and
“presents a world without pain . . . an abstraction from the
tragic dimension of human existence” (Berger, 1997, p. 210).
I check my phone to see the time. Two minutes until the
presentation. I look at the mirror, smile, and grab my school
ID from the counter. A closed-mouth photo stares back at
me from the plastic card. I slide the card into my pocket as
I enter the conference room. When it is my turn to present
I walk to the front of the room and look around at all the
straight-faced academics. I reach into my bag and pull out
7
a handmade sign—a piece of paper taped to a toothbrush—
holding it up for the audience to see. Their lips curl up as
they read it: SMILE.
ACKNOWLEDGMENTS
I thank Art Bochner, Ambar Basu, Mariaelena Bartesaghi,
Heather Zoller, and two anonymous reviewers for sinking
their teeth into my article and giving me a lot of ideas to chew
on. Thank you, Krystal Bresnahan, for giving me reasons
to smile and for the incredible suggestions on the article,
too! Thank you, Mom, for sharing your story and for always
loving my smile no matter what.
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