Rotting Teeth, Rotten System: What Your Smile Says About Inequality in America

This carve-out entrenches inequality, as oral health is directly tied to overall health. Gum disease is linked to heart disease and diabetes, untreated abscesses can be life-threatening, and tooth loss impacts nutrition. But our system treats teeth like accessories, not organs.

Compare that to other countries. In the UK, the National Health Service provides heavily subsidized dental care, though not without its flaws. In Canada, dental care is not entirely universal, but most provinces offer children and low-income residents significant coverage. In many European countries, oral health is treated as an integral part of public health.

America’s choice to carve teeth out of the body politic was deliberate. The result: millions of citizens left to fend for themselves, and a healthcare landscape where pain relief is a privilege, not a right.

 

The Hidden Cost of a Smile

The average dental cleaning costs between $75 and $200. Root canals run between $700 and $1,500 per tooth. Full-mouth reconstruction can reach six figures. It’s no wonder people avoid care until it’s too late.

Skipping the dentist doesn’t save money in the long run. It creates a vicious cycle. A cavity left untreated turns into a root canal. Gum inflammation, often ignored for years, can lead to bone loss.

Emergency rooms fill up with dental patients. In fact, one 2019 study found that U.S. hospitals see over two million ER visits each year for preventable dental issues. Those visits cost billions, straining an already broken healthcare system.

And sometimes, the results are deadly. In 2007, a 12-year-old boy in Maryland, Deamonte Driver, died after a tooth infection spread to his brain. His mother couldn’t afford the $80 extraction that might have saved his life. His story is extreme, but it’s not unique.

Dental neglect isn’t just an inconvenience. It’s a public health crisis.

In response, more clinics have started offering dental payment plans and financing programs to spread the costs into smaller monthly installments. These programs, from CareCredit to newer options like Cherry, are lifelines for some patients, letting them fix what’s broken without emptying a savings account.

But let’s be clear: their very existence is a symptom of the disease, not the cure. The fact that Americans need financing tools to afford basic dental care shows how far gone the system is. Payment plans can help individuals, yes. But they don’t address why the system is structured to make dental health unaffordable in the first place.

The cultural consequences of this divide are brutal, too. Studies show that people with visibly poor teeth are less likely to be hired, more likely to be judged as uneducated, and more likely to face social isolation. The irony is that those who most need access to care are the ones punished for not having it.

Meanwhile, the “good teeth” club functions as a gatekeeper to middle-class respectability. Job interviews, first dates, even jury duty — your smile becomes shorthand for your worth. It’s not just vanity. It’s survival.

 

The Political Silence

Despite how obvious the crisis is, dental care rarely comes up in political debates. Candidates debate endlessly about medical insurance, yet oral health is left out of the conversation. Have you ever heard a presidential debate question about gum disease?

The silence benefits those who profit. The American Dental Association has long resisted attempts to expand public coverage. Keeping care private ensures a steady flow of paying patients. Millions of Americans continue to sit at home with untreated toothaches.

The neglect at the political level mirrors the neglect at the dental level. Both are preventable. Both are ignored.

 

The Bigger Picture

Dental care is not optional. It is healthcare. And the fact that millions of people are shut out of it is a national disgrace. Teeth are not just cosmetic. They are tools for eating, speaking, and living. They are part of the body. Yet in the United States, they are treated as extras.

This was not inevitable. It is the result of deliberate decisions and decades of lobbying. When Medicare excluded teeth, lawmakers signaled that oral health was a luxury. When Medicaid left coverage to the states, it created a lottery of access. Private insurance picked up the scraps, and corporations stepped in to profit.

The damage is plain to see. Children in low-income families often miss school due to tooth pain. Adults lose jobs or avoid interviews because they know their smile will count against them. Seniors skip cleanings because they live on fixed incomes. Inequality is written into enamel.

Meanwhile, the cosmetic industry thrives. While one group hides their mouths, another pays thousands for veneers and whitening treatments. Dental payment plans are promoted like car loans. They are helpful for some, but they also serve as a reminder that we have normalized debt as the price of health.

Imagine a country where every child had equal access to preventive care. Where losing a tooth at thirty did not mean losing your chance at work. Where dental health was part of Medicare and Medicaid, and where no parent had to choose between groceries and a filling for their child. This is not impossible. Other nations have done it. The United States simply refuses.

What does it say about us that we accept this? What does it say that we shrug when people live in pain or die from infections because care was too expensive? What does it say that we laugh about “bad teeth” as though they are proof of laziness, when really they are proof of systemic cruelty?

If you want to know America’s values, do not look at Wall Street or Capitol Hill. Look at its people. Look at who covers their mouth when they smile. Look at who gets left behind.

Until we decide that teeth count, the country will remain divided into two Americas. One where a smile is a privilege, and another where it is a reminder of everything that has been denied.

 

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The Splinter editorial staff was not involved in the creation of this content.