My teeth really aren’t that crooked, crowded, gappy, or grungy but the fact that Americans—upon hearing my English accent—are often expecting me to have a mouth like a bag of fries makes me feel unduly self-conscious.
For years, I’ve pushed back when people take it upon themselves to peer into my mouth and cheerfully remark that doesn’t resemble a pink sock full of smashed beige china. “That’s a pretty outdated stereotype,” I say, and to a certain extent, I think that’s true. After all, the British celebrities with dodgy choppers who are partly responsible for these stereotypes have long ago gotten them fixed, bitten the dust, or are so figuratively long in the tooth that they cease to exist in the public imagination. Yet the stereotype endures.
I have a few theories for why the British have a reputation for having less than stellar smiles. Firstly, less than 10 percent of the UK population has drinking water that is optimally fluoridated. Compare this with the US; it’s close to 70 percent. Then there are the realities of having the popular but permanently cash-strapped National Health Service which prioritizes the treatment of more serious conditions—something advocates of the American health “system” are wont to point out to US voters at every opportunity. And talking of Anglo-American distinctions, let’s not forget that most of the bashing of British teeth comes from the US, which has been understandably fond of ribbing its previous management about anything it can for at least the last 242 years.
Then there’s cultural stuff. The English are famously fond of tea which, due to the higher concentrations of tannins, actually stains teeth more readily than coffee. Furthermore, up until very recently, enlisting a medical professional's help to enhance your appearance was also considered extremely vain and therefore rather gauche. Another cultural factor worth chewing on is that having nice teeth isn’t so much of a priority when big toothy smiles are meted out more stingily than in the US. Despite all of these factors, the UK smile situation—much like the similarly maligned cuisine and weather—seems to be steadily improving.
Ashley Dé, head of communications at the British Dental Association directs me to a landmark Harvard-University of London study which showed that US adults don’t fare much better than their British contemporaries. The research, conducted in 2015, found that the average American is missing 7.31 teeth—significantly higher than the British figure of 6.97. Of course, having too many teeth can disrupt smile symmetry as much, if not more, than having too few but it’s an interesting data point nevertheless.
“In Britain […] it’s older generations that usually have the worst teeth. Stateside, those most likely to have no teeth are working-age adults,” Dé says.
His take is that this difference is largely driven by socio-economic factors, and what he calls “the near total lack of access to affordable dental care in US.” “British dentistry continues to provide better quality comprehensive care for the many, not just Hollywood smiles for the few,” he says in a way that’s rather supercilious and therefore quintessentially English.
As for the basis of the myth around bad British teeth, Dé suggests that at least part of the reputation could be chalked up to the fact that over 30 million dentures were ordered in first nine months after the launch of Britain's National Health Service. At the time—July, 1948—the population of the UK was a little over 50 million.
All the statistics in the world don’t change the fact that I want to have a smile that’s as incongruent with my origin story as my tan skin and circumcised penis. And that’s where cosmetic dentist Victoria Veytsman comes in. I happened upon her website in the wake of yet another person telling me that my teeth “aren’t that bad considering.” Upon seeing an impressive gallery of her work, I dropped in on her for a consultation in her New York office. I was particularly interested in how she packages a suite of interventions together into what she promotes as a “bridal makeover.”
I can’t go on without telling you that Dr. V—as she's known by patients whose reviews she uses on her website—is a riot and possessed of a star power that’s exceedingly rare among people generally, let alone dentists. In between the fun, she gives me a couple of options for how my smile could be improved but only after remarking that for British teeth, they really “aren’t that bad.”
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“One option would be veneers which would be the most dramatic transformation, that Hollywood look,” she says, explaining that veneers are a thin layer of material that is pre-made in a lab then bonded to the natural tooth. “A significant amount of natural tooth structure has to be removed to add the veneers so, it’s definitely something that you have to be sure about because I can’t put that structure back. And you really do have nice, healthy teeth to begin with.”
While I’m pretty fastidious about oral hygiene, I’ve always thought that my top two front teeth were too long and incidentally, so did a few of my schoolmates who enjoyed calling me “Bugs Bunny” once they tired of making fun of my athletic acumen, sexual inexperience, or voiced intention to someday leave the little town in which I was raised. Additionally, some of my teeth are slightly chipped, there’s some asymmetry here and there, plus a fang-like canine I don’t particularly care for. All this I relay to the good doctor. Since making the appointment with her I’d been envisioning myself with a smile with less character, allowing mine to show up differently.
Though a “perfect” smile that wouldn’t look out of place in a Colgate commercial certainly appeals to me, Dr. V quickly gets me on board with a less-involved, two-step procedure that she offers to people looking to enhance their smile before a red-carpet event, photoshoot, or indeed, a wedding. The first step, she tells me, is a laser whitening which would lighten my teeth by several shades.
In a second session, she would recontour my teeth with something like a miniature sanding belt. This, she said, would remove chipped enamel and shorten my too-long front teeth. In other areas she would be adding material with a composite, color-matched to my newly whitened teeth. This composite is actually a veneer of sorts but one that is added in the mouth in real time and not premade by a ceramist. The reason that the whitening and the reshaping don’t take place in the same session says Dr. V, is that newly whitened teeth don’t have a surface that’s optimal for the composite to stick to.
“The recontouring would be the more conservative option,” she says explaining that I could try out my new smile for a bit and then decide whether I want to go the full monty. Another difference between the two strategies is the price which, had I been paying, would have been a deciding factor to say the least. In Veytsman’s practice, re-contouring and bonding ranges between $500 and $700 per tooth whereas a premade veneer would be closer to $3k per tooth. The whitening alone carries a $750 price tag.
The night before my whitening I drew a diagram of my teeth, making notes about areas for aesthetic improvement—most of which Dr. V had already highlighted in our consult. It was more to articulate to myself what I was looking for but I brought the diagram along anyway and she seemed to get a kick out of it.
The whitening process is pretty straight forward. A hydrogen peroxide gel, in conjunction with a special light, is used to penetrate the teeth and break up the stains and discoloration. I feel some sensitivity during the procedure and am told that it could last for up to 24 hours. The results are pretty dramatic however and I manage to make it to the following day’s session having obeyed Dr. V’s rules about what I can eat and drink. Basically, if it’s all white it’s all right.
“I was up all night studying your diagram,” Dr. V says jokingly before going over its finer points with me. She gets to work and after around 90 minutes, hands me a mirror to see my revitalized smile. It’s more symmetrical, the chipped edges are all gone and of course, it’s whiter. The two bunny teeth however, are still a little longer than I’d like.
“I thought you’d say that,” she says—she was erring on the side of caution given that once the enamel has gone, it’s gone for good. She takes off a hair more enamel in my attempt to look less like a hare and urges me to slow my roll when I ask her to reduce their length just a little more.
She explains that not only are the front supposed to be slightly longer than their neighbors, the more she takes away enamel, the greater the likelihood of experiencing tooth sensitivity. “Why don’t you take ‘em for a spin and see how you feel in a couple of weeks,” she says. “You can come back in and I’ll make any adjustments then.”
Dr. V tells me that it’s not terribly uncommon for patients to come back in to have rough areas on composite material buffed out but that the mere act of eating and drinking tends to do the trick after a week or so.
Indeed, the roughness I felt on the edges of my teeth has all but disappeared after less than a week of regular use and I’m glad that we went with what she described as a more conservative approach. It’s still very much my smile. But now it’s whiter, brighter, straighter, and—minus the various imperfections that a casual observer might attribute to my nationality—I’m exponentially more eager to bust it out.
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