Bad British teeth

The article on this subject in the BBC news magazine* on the 27th of May was interesting. It questions whether the label about ‘lousy British teeth’ is fair? Well … yes and no.

Bad British teeth
Bad British teeth: myth or reality?

I have been in general practice, albeit in quite ‘high end’ areas in both Sydney and London, as well as having worked in (a wealthy suburb of ) Tel Aviv, Israel and spent two years doing postgraduate study in Central Chicago, USA. So, I do have experience and opinions.

The real differences between Britain and often much of the rest of the ‘western’ world, in relation to dentistry actually, surprisingly, is fairly Classless. The English upper classes (of a certain age), don’t have much better-looking teeth than those traditionally ‘further down the ladder’.

So what really is the state of the British smiles Vis a Vis the North American or European and what are the main differences based on? It seems the roots are socio-economic and educational in nature and not just based on money or affordability.

Take, for example, one group: the middle-class, educated, professional, white-collar type of people (mainly Londoners). In Britain, the elderly, over their seventies, simply expected to lose their teeth by their fifties, and indeed, it became a self-fulfilling prophecy for many. They were brought up on the concept of post-war NHS, where everyone is entitled to their NHS dentistry irrespective of whether it is of good enough quality or not.

For some it may be better not to know. So, many people lost their teeth and in fact they still feel that they can live without them (so long as they are not the upper front six).

The young, those generally under thirty five, have straight, healthy good looking teeth, much like their North American or West European counterparts. They have benefitted from a more sensible diet, better oral hygiene, generally improved professional dental care (often ‘private’) and the increased use of orthodontics (‘braces’).

The biggest differences still seen are in the middle-aged… forty-five to seventy-year-olds. They are likely to have been exposed to good quality, and so relatively expensive dentistry as mature adults after, often having experienced the ravages of ‘tons of fillings’ from when they were kids, poor quality or an absence of tooth straightening orthodontics, and parents who themselves didn’t have high expectations of tooth retention and aesthetics.

I am still surprised by how many middle aged educated, comfortably off professionals are resistant to ‘fixing their own smiles’.

These people, including the relative affluent professionals such as bankers, lawyers, accountants, doctors and even dentists themselves, accept what their West European, but particularly their North American counterparts, would consider ‘ugly’ teeth. They often don’t seem to mind showing the odd black hole (missing tooth), as long as it isn’t right in the front. They don’t mind having crooked, yellowed teeth, often with unaesthetic obvious dentistry, visible.

When confronted, they often will say that they won’t pander to the ‘Hollywood standard’. Their appearance is not a priority, they have neither the time nor the money nor need to expend on, often perceived to be expensive, extensive dentistry. Moreover, they are, they claim, quite apprehensive of going to the dentist, recounting horror stories of NHS dentistry from their distant youth. They give all the reasons for sweeping the issue of smile aesthetics under the carpet.

One good way of seeing comparisons, as they are more often ‘in the public eye’ is to look at politicians from different countries. It’s quite funny how it hits the headlines in the UK press when a political leader has had their smiles fixed … Maggie Thatcher, Rishi Sunak etc.  It actually makes news here!

I have been working in the heart of the UK financial district, the City of London for almost two decades. I am still surprised by how many middle aged educated, comfortably off professionals are resistant to ‘fixing their own smiles’. These are the same people who often made sure their own children had lovely straight teeth.

So, having said that, these views are a generalisation, but they still hold true today. Over time as the mature younger adults do become middle aged, the British attitudes to smile aesthetics will change and the ‘ugly British teeth’ will become more of a ‘historical’ myth.

Reference: Justin Parkinson, BBC News Magazine, The myth of bad British teeth.

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