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Open Collection of Student Writing (OCSW)


The book, Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America was a thought provoking, unexpected, and powerful book written by Mary Otto.  At first glance, when beginning the first chapter the author describes a situation where the reader follows along with the life of a beauty queen named, Adjei.  She goes on to win the Miss Maryland pageant and wins, “10,000 worth of smile enhancement” (Otto, 2019 pg 6).

The author continues to describe Adjei’s experience as she gets the dental treatment done. I assumed the storyline would remain about Adjei and her life.  I was not expecting the book to contain multiple story lines about the oral healthcare system in America.

While reading this book I was overcome with a surmount of emotions.  The inequality and injustice within these stories made my heart ache. For example, in the chapter: Separate Lives, Mary Otto discusses the power of a dentist. She mentions the lack of empathy towards those who need Medicaid in order to pay for their treatment.  As well as the attitude towards those who are racially and ethnically diverse. Parents of Medicaid-beneficiary children made the comment that, “The dentists seemed reluctant to see or touch their children because they are dirty…the dental receptionists made negative comments about their Medicaid status, handling their benefit cards with disdain and treating them differently than other patients (Otto, 2019 pg122).

This brought attention to the challenges that I noticed with Medicaid when I worked at a dental office.  We would often have calls asking if we take Medicaid and the front office would say we do not accept that form of insurance. However, this office had the ability to work with Medicaid, but it was too difficult to manage so they avoided it.  This is upsetting thinking about the people that could have benefitted from care.  Because these low-income families cannot afford dental care does not mean they should be treated any different or denied care. They are human and deserve to be treated with respect no matter their race or economic status.

A boy named Deamonte Driver was mentioned within the book.  His mother, Alyce Driver was struggling to find a dentist that accepted Medicaid for Deamonte’s brother, DeShawn who had a toothache.  By the time she was able to get his brother in for an appointment, Deamonte had died from a toothache himself.  The infection from the toothache had spread to his brain.  It was disheartening to know that a simple extraction may have saved this young boy, but because the family was uninsured at the time, proper care was not provided no matter the urgency.

In honor of Deamonte Driver, a mobile clinic was created that offered dental care to school children.  It is disappointing to see that the death of a young boy caused recognition to the injustice of the situation. In order for something to be resolved and for people to see the inefficient care being provided a life had to be lost.  Mobile clinics are a great way to help those young children that are in need of dental care.  It is beneficial for a child to be educated on oral hygiene at a young age so that they can have these skills to take care of their oral cavity throughout their lives.  Mobile clinics are valuable to children like Deamonte or DeShawn who need their oral health to be acknowledged.

It was stated that, “Hundreds of thousands of times each year, people with toothaches show up in emergency rooms. These visits cost hundreds of millions of dollars annually. Still, the patients’ needs are met” (Otto, 2019 pg 51).  These patients go to the emergency room because they know they are not going to be turned down.  The problem with this is that these doctors are often not specialized on the mouth specifically.  An antibiotic may be used to control the pain, but that is not a long-term solution.  Physician David Satcher stated, “oral health is integral to general health.” (Otto, 2019 pg 182).  The mouth is the gateway to the rest of the body, it can often be the first sign of infection.  That is why regularly attending dental appointments can be highly advantageous to a patient’s health.  However, if these patients do not have the understanding or resources for proper dental care, a solution cannot be met, and people will suffer from oral infection.

Personally, I have never experienced a toothache before.  I have been fortunate to have dental care my whole life. I cannot imagine the pain these people go through because they are unable to seek care to resolve their toothaches.  It was brought to my attention how much I have taken dental care for granted in the past.  It is so simple for me to call up my dentist to get an exam if I feel anything out of the ordinary. For those who are not as fortunate, they go years in pain and delay appointments because of the expense. In many scenarios listed in the book these individuals eventually pass away because their toothache was more than just a toothache. It was an abscess that spread infection to the brain and throughout their entire body.

The United Stated Health Care system is not perfect. This book brought to my attention the lives that are lost because of the lack of resources available for the underserved populations.  This book created a passion inside of me I did not know existed.  Because of the stories I read and the knowledge I have, I am more devoted to serve the community whenever I can. This book changed my perceptions of the Health Care system and I gained empathy for those who are uninsured, homeless or underinsured. I am going to take the opportunity to use my skills as a future dental hygienist and put them to good use to help serve the community and educate those around me.


Otto, M. (2019). Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America. The New Press.

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