Teeth

The Story of Beauty, Inequality, and the Struggle for Oral Health in America

By: Mary Otto

Narrated by: Suehyla El'Attar

Length: 9 hrs and 37 mins

Publisher's summary

"Show me your teeth," the great naturalist Georges Cuvier is credited with saying, "and I will tell you who you are." In this shattering new work, veteran health journalist Mary Otto looks inside America's mouth, revealing unsettling truths about our unequal society.

Teeth takes listeners on a disturbing journey into America's silent epidemic of oral disease, exposing the hidden connections between tooth decay and stunted job prospects, low educational achievement, social mobility, and the troubling state of our public health. Otto's subjects include the pioneering dentist who made Shirley Temple and Judy Garland's teeth sparkle on the silver screen and helped create the all-American image of "pearly whites"; Deamonte Driver, the young Maryland boy whose tragic death from an abscessed tooth sparked congressional hearings; and a marketing guru who offers advice to dentists on how to push new and expensive treatments and how to keep Medicaid patients at bay.

In one of its most disturbing findings, Teeth reveals that toothaches are not an occasional inconvenience, but rather a chronic reality for millions of people, including disproportionate numbers of the elderly and people of color. Many people, Otto reveals, resort to prayer to counteract the uniquely devastating effects of dental pain.

Otto also goes back in time to understand the roots of our predicament in the history of dentistry, showing how it became separated from mainstream medicine, despite a century of growing evidence that oral health and general bodily health are closely related.

Muckraking and paradigm-shifting, Teeth exposes for the first time the extent and meaning of our oral health crisis. It joins the small shelf of books that change the way we view society and ourselves - and will spark an urgent conversation about why our teeth matter.

©2017 Mary Otto (P)2017 Audible, Inc.

Critic reviews

"[ Teeth is]...more than an exploration of a two-tiered system - it is a call for sweeping, radical change." ( New York Times Book Review)

Content everyone should know; dismal narration

Unlike most critics of "socialist countries," I have actually lived in one that has state-run health care. My husband grew up in Europe, and although his family was quite poor, his sisters have perfect teeth thanks to regular dental care. My husband neglected his as a child, and after we were married he had a terrible toothache right before we were supposed to go on vacation. I called the dentist and asked for a same-day appointment. We drove straight there and paid the equivalent of $100 for X-rays and an immediate and painless extraction.

Otto's book is a flawed but significant exploration of the wait times and poor care, the "dental deserts" and inequality, and ultimately the lives lost because of the United States' addiction to applying free- market principles to dental care. I say the book is flawed because Otto seems to lay most of the blame at the feet of dentists themselves, and I'm not convinced that's fair. After one or two grudging admissions that dental school costs hundreds of thousands of dollars and dentists mostly have large student loans to pay, she portrays most dentists in her book as moustache-twirling profit-chasers who refuse services to children because they don't like poor people cluttering up their waiting rooms. Even If her negative depiction of American dentists is accurate, she needed to do more to justify it to the reader than to cherry-pick a few quotations--as it is, she just sounds biased.

The other main flaw is organization (or lack thereof). The book reads like a collection of articles rather than chapters that are organized to acheive some end, and thus some information is repeated and the book is unable to present a cohesive message more insightful than"the dental system in our country is broken." For all its shortcomings, though, the book taught me a lot that I didn't know, and it certainly does draw attention to a serious, dangerous inequality in a country that is supposed to believe that everyone has the right to life, liberty, and the pursuit of happiness.

I won't make excuses for the narrator, though: she's annoying. The tone of her voice is nice, but the way she reads is like the vocal equivalent of casting one's eyes heavenward in horror. And don't even get me started on the accents she fabricates for quotation.

I wish I'd read this book the old-fashioned way instead of as an audiobook because it at least draws attention to a serious problem in our country that most of us know little about. I was drawn to this book because I recently learned that a childhood teacher of mine was in the hospital because of sudden paralysis. The cause? An abscessed tooth. My hometown is in a "dental desert" where the only dentists who accept the insurance that state employees have are 70 miles away or have a wait time of months to get an appointment. It's pretty bad when the American dental system is outclassed by that of countries of the former Yugoslavia.

The Mouth--The Body, The Wallet, The Class Lines

Growing up in a family of six, a cavity would've meant violence and a six-week grounding: we simply couldn't afford anything beyond basic care for such a large family. As I grew older, lacking dental insurance, I went across the border for shoddy service, but service nonetheless. Now, I have dental insurance, but out-of-pocket expenses are mind-boggling. Over zealous brushing as a child, otc medications that cause dry mouth and require synthetic saliva, prescription medications that cause teeth grinding all come together to make continuous dental care an absolute must. I'm at the mercy of the system.
This makes Teeth a truly captivating listen as I find that I'm not alone in feeling under the gun. In the book you'll find forays into those compelled to seek cosmetic dentistry, those compelled to simply hope for the best in buying pain medication as opposed to antibiotics they can't afford.
I can see where the book might anger those who decry Socialism! Socialism! But the book's many anecdotes are harrowing, and really: You don't find the well-heeled sporting rotting teeth. I urge listening to the book as it's an eye-opener and it expands ones awareness of the world that is around us, what the masses go through (do YOU want your restaurant hostess flashing a brown smile with gaps where teeth used to be? Is that who you want welcoming you into your doctor's office or serving your food?).
Teeth could've been edited some as it can be a bit repetitive, plus it relies heavily on Maryland's practices, plus there's quite a bit on the history of dentistry that can go on a bit too long. Still, it's a definitely worthwhile listen. By the way, I gave the narration only three stars because I thought El'Attar was a tad too enthusiastic, and you can sometimes hear the booing and jeering in her voice, which I don't need if the content of the book carries it without such additions.
Worth the time, worth the credit.

Politically biased

This book is biased towards labor and the Democratic Party. It will be enjoyed only by adherents of these two political movements. The author would benefit by, and gain some political understanding from, a year spent living in a socialist country.

The Struggle is Real

Many do not understand the impact that oral health has on our country. This book provides some great perspective. I am starting dental school in July and I am glad that I read this book. My only criticism would be that at times it feels like dentists are being vilified. I would argue that the vast majority of dentists are good people who are genuinely concerned about their fellow man.

Sad, Compelling, Hopeful - A Must Read/Listen

Where do I begin? Some in the dental field may like this book, some may not. There are always two sides to a story. In the case of oral health, I am hopeful there will be continued emphasis on prevention and bringing mouth health back to the body. Thank you Mary Otto for bringing light in such a captivating manner to an issue that seems so illusive.

Biting Commentary, Outstanding Narration

I saw the audiobook version of this book as a daily deal selection. The topic was interesting and the reviews were very positive. I am familiar with a large portion of this book, having already been aware of how medical insurance and care far exceed dental care and insurance. Nearly everyone I know has had a toothache at one point or another. Most people do not have dental insurance or kid themselves that they won't need it. You will need to go, it's just a matter of time.

Still portions of this book were real eye openers. The ADA's fight against dental hygenists, the marketing guru teaching dentists how to push services that may not be needed are just a few. I was aware of the lack of dentists not participating in Medicaid because of the low reimbursement rates, how the poor go untreated and the push for coverage and care for children. The deaths of several mentioned in this book were preventable. The sad case of Deamonte Driver was used as a rallying cry for more coverage for children. A good third of this book covered children's care and the lack thereof, though improvements have been made.

Despite this, coverage for adults is virtually non existent. I would've liked to have read more about the challenges of coverage for adults. The cost of dental care is often worse than medical in some cases, even with insurance you still have to pay a growing share of fees.

A biting commentary, this book is an excellent read. I read this using Immersion Reading, while listening to the audiobook. The narrator was superb, a beautiful voice with the perfect amount of emotion. One of the finest voices I’ve had the pleasure of listening to.

Not well researched

Dentistry is an evidence based profession. The evidence of this book is very biased and one sided. If dentistry is so bad then why does the public rate it so highly. Physicians and emergency centers frequently are paid more for a 5 minute exam and writing of prescription for a dental abcess than the dentist would be paid for treatment of the patient. The system is definitely flawed but the author goes out of her way to blame the dentist. Dentistry by design is a prevention based practice. Medicine uses a disease based model and only a few practice prevention based. Dealing with the treatment and claims submitted in the Medicaid system is a nightmare. Many states actually reward the insurance companies that save the plan money denied the dentist for patients care. The parents are responsible for child care........

Eye opening

Great book, was a real eye opener to the dental industry. Narrator did a great job.

Good listen about why dental covg separate

So this is pretty academic but not dry. I for one always thought it was messed up that dental was not part of healthcare plans given (a) it’s a very important part of your body (b) dental pathology can impact other bodily systems and lead to systemic disease and infection. This book takes you through history beginning when dentists were unskilled and thought to be unsavory to the era when they became skilled medical professionals to how they took a different path from the rest of healthcare and have fought any attempts at integration. To insane protectiveness/sexism that tried to bar dental hygienists and NP from helping the poor/rural children from providing preventive care. Just crazy. But explains a lot....

EVERYONE who has teeth should listen to this.......

...........and tell their dentist, and their children’s’ dentist or orthodontist about this book.... And offer to send it to at least one of those practitioners; the others should try mightily to obtain it. Segments can be marked for dentists and hygienists to hear. It will be absolutely worth paying for a segment of any dentist’s time ( You are paying for their time, that’s all they have to sell.) to share a section of this vital, necessary story.
As a worker in an ICU for cardiac patients, many of whom have just finished heart surgery, for years I have told them that their next step was to get to a dentist. Recent research has proven that many heart related illnesses start with teeth. Not to deprive surgeons of their prime clientele, but if many of these,”Well, I don’t hold with dentists very much; last time I went was in the 50’s,” had taken better care, including all needed procedures, they might not have needed that scary heart surgery.
In short, if you are reading this you probably have questions and an interest in the subject. Read ( listen) to this and you will shortly be spreading the word as I just did! Do it!!