All Predictions Wrong

All Predictions Wrong

America’s hidden class divide – dental care

Bad teeth pretty much bar you from good schools and good jobs

Gregg Easterbrook's avatar
Gregg Easterbrook
Jul 05, 2024
∙ Paid

Think of the people you know personally – friends, family. How many wear dentures?

Perhaps an older person, or one who suffered a gum disease. The total won’t be large. If you are in the cohort of readers – and you are, else you wouldn’t lurk on Substack – chances are your friends and family have nice teeth.

We know there were no dentures, tooth gaps or crooked smiles in the past. We know this from BBC period dramas and Game of Thrones. On them everyone has perfect teeth! In addition to clean clothes and just-styled hair.

The fantasy world doesn’t need dentists and orthodontists. Our world does.

A hidden class distinction in American life involves dental care and dental insurance. From the middle class on up, the situation is good. For working families and the poor, the situation is not good.

Persons in the bottom quintile of American society are far more likely than others to have tooth and gum problems, as well lack dental insurance.

a dentist chair in a room with a painting on the wall
Photo by Ozkan Guner on Unsplash

They are also more likely to put off needed care, not because they fear dentistry, because they can’t afford it – either the sticker price or the copay. When you put off needed dental care, the situation always gets worse: leading to pain, lost teeth that could have been saved, implants and dentures that could have been avoided.

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