What’s in a Grin? – A Petition for Oral Health

Our oral health and overall health are heavily interconnected, perhaps in ways we don't yet realize.

Our dental health and overall health are heavily interconnected, perhaps in ways we don’t yet realize. Photo by Anna Shvets on Pexels.

Subconscious Scares

We’ve all had those dreams where our curtain of awareness goes up on a particularly stressful scenario— we can’t run up the stairs fast enough to escape what’s lurking in the dark, we’re left without shelter facing an incoming tornado or tidal wave, we materialize in our high school homeroom without clothes on. I could go on. The point is our stress subconsciously manifests in myriad ways. However, the most common dream imagery I’ve come to associate with stress has to do with losing my teeth. I’ll be doing something mid-dream, and suddenly, I’m coughing up brown, hole-pocked molars and dissolving incisors. Too many for my hands to hold, and all rotten beyond saving. No matter how many times I have this dream, it never gets easier to brave.

I’m not alone in this either. Studies show that one of the most common nightmares humans experience is one where their teeth rot and fall from their mouths. It’s a widely understood stress response– a nocturnal notice from our brains that we feel powerless and overwhelmed.

It’s that notice that I mean to investigate. If our teeth are so important that nearly 40% of us wake up in a cold sweat having dreamt of losing them, what value can we assume we’ve assigned to our smiles? How can something so small and seemingly innocuous as our ‘food-chewers’ impact us so much? What’s in a grin?

Oral Health and the Body

As it turns out, our teeth are much more important than we realize. Oral health impacts our body’s function in major ways and imposes significant influence over the foods we eat, the microorganisms we harbor, and how comfortably we live our everyday lives. If overlooked, our teeth can be the impetus for a slew of dangerous diseases such as cancer and type two diabetes, just to name a few. But I’m getting ahead of myself. I’ll start small and keep things localized. According to this article published by the CDC, neglecting basic dental hygiene is the direct cause of tooth decay (cavities), oral cancers, and gum disease, all of which are preventable and present with only mild symptoms, provided that countermeasure resources are widely available. However, if proper hygiene and routine dental care are not accessible, even the smallest cavity, left sitting for too long, can become abscessed. Rotting teeth are painful and make it difficult to eat, drink, smile, express emotions, and live fully as a human being. Furthermore, the abscess infection can spread from there, leading to serious and even fatal sepsis.

If the chance for serious (even fatal) infection isn’t enough to alert you, ponder that modern researchers are discovering there are more links between our oral health and our overall health than we currently understand. In some cases of gum disease, the bacteria left to colonize the mouth can spread to the bloodstream, which produces a protein that inflames blood vessels, increasing one’s risk of heart attack and stroke. Additionally, Dr. Keiko Watanabe, professor of periodontics and researcher at the UIC College of Dentistry, has recently added a new challenge to this scuffle. In a series of scientific studies examining the connection between oral disease and the development of neurological conditions, she and her team discovered that exposing mice to common gum-disease bacteria led to the development of “inflammation, neurodegeneration, and senile plaque formation” similar to those found in humans suffering from Alzheimer’s disease. Their control groups continued living as normal.

What’s more, with this growing body of research has come an abundance of data supporting the hypothesis that oral health impacts the individual and affects their progeny. According to the University of Sydney, having even mild cases of gingivitis (gum inflammation) during pregnancy “releases inflammatory markers and bacteria into the systemic bloodstream, which may reach the placenta and induce poor pregnancy outcomes such as preterm delivery…”

To round off this point, according to the World Health Organization (WHO), “untreated tooth decay in permanent teeth is the most common [disease]” in the world. They estimate that over 3.5 billion people are currently suffering from untreated dental maladies, which is just under half of the global population. To rephrase, we are currently in the middle of a dental health crisis that well exceeds the definition of a pandemic. Even in countries with universal health care, dental health does not typically fall within the scope of that coverage.

Oral Health and the Brain

It’s astonishing that more people are not aware of just how dire health outcomes skew when dentistry is overlooked (hence this article). And the picture gets bigger. Where health outcomes are significant, I believe that mental health outcomes are just as strongly linked, if not more so, to the state of our smiles.

Oral care plays a massive role in our psychology. Psychologist Dr. Susan Albers put it aptly: “When your oral health is suffering, it can decrease the quality of your life or exacerbate mental health issues. If you feel embarrassed about the health of your teeth, you may notice that this triggers some social anxiety. You may withdraw. Or it may hurt your self-esteem…” Which can then, of course, make everything worse. People who withdraw out of embarrassment or shame naturally opt out of receiving treatment, and the cycle perpetuates itself.

But why? Where does all this smile shame come from? It comes from us. We— collectively, as humans— have hinged so much undue importance on having “good teeth” that we have inadvertently made it more difficult for those without dental care to succeed. People without the genetics or the funds to correct and protect their smiles with orthodontia and routine dentistry suffer from this standard. “The Chicago Tribune reports that 74 percent of those surveyed believe a smile with discolored or broken teeth can inhibit your career success…”

Such was the experience of Ryanne Jones, a woman who suffered for decades because of a childhood accident that broke her two front teeth. When her parents were unable to pay for her corrective procedure, she worked for years to save the proper funds. As an adult, she trained and interviewed for jobs where Ryanne knew she would receive enough compensation to finally fix her teeth. She went to interview after interview, objectively overqualified and confident, only to not be chosen.

After dozens of failed interviews, she asked a friend to set her up with an interview at her place of work. She also wasn’t chosen for that job, but this time, she enlisted that friend to find out why. When questioned, Ryanne’s interviewer responded by saying, “She’s really thin, and have you seen her teeth?” As it turns out, despite her efforts to present well in every category, they thought that Ryanne was a meth addict because of her low weight and shattered smile, things she could not change without the money the job could give her. What people don’t realize about having “bad teeth,” Ryanne told NPR, is “how much it can keep you poor.”

There are further studies on this too. The American Dental Association found that “nearly one in three low-income adults say that their teeth make it hard to interview for jobs.”

The Invisalign Smile Survey pulled similar figures. Sampling a size of 1,000 diverse Americans, they discovered that 75% of them believed that having a traditionally beautiful smile was important for succeeding at work, 85% believed that it was necessary to have straight, white teeth to land a date with their ideal partner, 71% believed that having “good teeth” was necessary for meeting new people and making friends, and over one-third of participants agreed that having “bad teeth” overshadowed the rest of their qualities.

Examining all of this, it’s no wonder that a significant portion of the population wakes up in a huff having dreamed of losing their teeth. It’s no wonder we stress— our smiles play a key role in our overall health, protect us from what society deems as a failure, open doors, generate opportunities, and incur the judgment of the world around us. In many ways, our smiles are our second faces— labels of enamel we wear that not only communicate how we feel but who we are.

In Ryanne’s case, and presumably in many others, her appearance permitted others to make assumptions about her worth as a human being. She was no longer the bright and hopeful woman seeking a way out of her lifelong predicament but someone who deserved to stay there. Unfortunately, we live in a society that equates whitened, altered, and pristine grins with moral uprightness, beauty, and trustworthiness.

Until that changes, it’s clear that there is no health without oral health.

If you’d like to read more about how you can keep your teeth as healthy as possible, check out this article!

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About Cristin Dickey

Born in Maryland, raised in Texas, and educated in Utah, Cristin is a purveyor of stories from all widths and walks of life.  With a background in filmmaking and a staunch passion for literature, she aspires to give digital spaces a uniquely human touch.

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