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Open Collection of Student Writing (OCSW)

Community Service Reflection II

In this day in age we successfully undertake various types of organ transplants, extending the lives of individuals who would otherwise have a shortened life expectancy. What about teeth transplants to extend the life of a natural smile? Tooth transplantation is one of the various subjects that I found compelling in the book, Teeth, by Mary Otto. I had no idea that it was ever even attempted, but it has become a part of dental history. This book discusses the beauty of teeth, the inequality surrounding dental care, and the controversy dental professionals face, in attempt to improve the oral health care and education of Americans.

While we may all be aware that a great smile is at the forefront of a great first impression, we may not realize the length that people go to, in effort to showcase a great smile. This book discussed a time when a dentist would perform teeth implants. People with less than fortunate financial circumstances would have their teeth extracted and sell them to people in better financial situations that were looking to replace a lost tooth with an implanted tooth. The risks did not outweigh the benefits, and diseases were transferred from one patient to the other, discontinuing the trend of tooth transplantation. Perhaps, this previous trend of tooth transplantation properly illustrates, both the deep desire to obtain beautiful teeth, and the unfortunate truth of dental care inequality.

While dental care inequality and oral hygiene education barriers have been a long-standing problem facing many, there have been advancements made in the dental profession. Dentists are no longer the only dental professionals treating patients and providing oral hygiene education. Dental hygienists are now employed for complete preventative care and oral hygiene maintenance. Dental Therapists are now opening their own practices and providing comprehensive dental care in certain states. Dental professionals have expanded beyond the traditional dental office setting, in effort to reach those who would otherwise not have access to care. Providers are removing access to care barriers by taking their expertise to nursing care facilities and schools to provide necessary treatment and oral hygiene education. These advancements have evolved through efforts of dental professionals with a passion to increase the overall health of our nation, those who understand the connection between overall health and oral health. These individuals have made great personal sacrifices in their hope to limit the oral disease epidemic and aid in relief of dental inequality.

Amongst the individuals who have battled to gain ground in extending dental hygiene care and education to those who may not otherwise have access to care are Dr. Alfred Fones and dental hygienist Tammi Byrd. Dr. Fones, a Connecticut dentist who established the first dental hygiene school in 1913, was a true pioneer for the dental hygiene world.  He recognized the demanding need for help as a busy practitioner. Fones fought the state legislature to get his graduated hygienists working in the state, and for the public schools to hire hygienists to clean their students’ teeth while providing oral health education.  “Fones acknowledged that he could not have picked a more challenging time to proceed with his school hygiene program. Still at the end of five years, he had successful outcomes to show for the effort. Cavities were reduced by one-third across the schools where hygienists had been working, and school performance had improved, Fones reported. During the same period, the city saw a drop in diphtheria, measles, and scarlet fever and weathered a great post-war flu epidemic better than most other cities (Otto, 2017).

Tammi Byrd was a dental hygienist of fortunate circumstances. She quit her full-time job, sacrificed much of her comfort, and started a business. The mission of this business was to extend dental hygiene care and oral hygiene education to the elderly in nursing care facilities, as well as underprivileged schools. She endured the enormous opposition received from dentists who assembled, against her cause, claiming this would provide patients with inadequate care.

Today, hygienists are providing excellent dental hygiene care beyond the traditional dental office setting, while continuing to preserve the laws that allow it. There is still opposition in this cause, although tremendous improvement has been made by these expansion efforts.

A desire for beautiful teeth, some degree of dental inequality, and opposition of efforts to expand access of care may always be a part of the dental profession, but history has shown radical movement in the efforts to diminish the extent of suffering that accompanies the poor oral health epidemic. This book has provided me with greater understanding and insight into the demanding needs of Americans, specifically the poor, in obtaining better access to affordable oral healthcare. These needs are essential, considering the connection between oral health and overall health of individuals and communities.


Otto, M. (2017). Teeth: the untold story of beauty, inequality, and the struggle for oral health in America. New York: New Press.


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