Opinion: Stop Stereotyping Bad Teeth as a Sign of Drug Addiction

The image shows inside of a mouth with two front teeth with black spots and damaged enamel.Photo bySuzy Jacobson Cherry

When I studied Anthropology in college, I learned that teeth have been indicators of economic status just about forever. Archaeologists look at the teeth in ancient skeletons and know who the rich were based on their tooth decay. During the Renaissance period, it became fashionable for women to blacken their teeth to look like they were better off than they were, because the royals and aristocrats, who could afford sugar and sweets, had more rotten and missing teeth than the poor.

Things are a bit different today. Among the middle class and the rich, very few people haven’t had orthodonture, veneers, or whitening done on their teeth. Most of the actors we see on television and in the movies have perfectly straight, perfectly white teeth. Anyone who can afford it will have their teeth “fixed” to look as perfect as those we see in the media, including social media.

Those who can’t afford something like that still have natural colored teeth, if they have their own teeth. In the western world today, just about everyone can afford sweets. People who can’t afford to go to the dentist regularly tend to have more cavities and missing teeth, mainly because they can better afford to have a bad tooth pulled than they can afford to fix the tooth.

The assumptions

These days, when many people see someone with bad teeth, they tend to be quick to judge them. Sadly, when they do, they don’t judge them as possibly being poor or lower-middle class. Most often the first thing I hear people say when they see someone with bad teeth is, “I bet that person is a tweaker,” or “that person uses drugs.”

If the someone with bad teeth happens to be a child, the common assumption is that the child’s parents allow them too much candy. They say this because everyone knows that candy, methamphetamines, and other drugs cause tooth decay.

There are certain areas where these assumptions are more prevalent. People who happen to live in cities and towns that have become known for having a high incidence of drug use are often judged as users, especially if they have bad teeth.*

Our area of East Mesa and Apache Junction has a reputation as a sort of drug haven. In 2013, one poster to a Phoenix area forum wrote that they had heard that Apache Junction was just "...rednecks", meth heads, drug abusers, prostitutes, racists, excessive crime and just overall, not a good area to be in." Another wrote that "...it is not that great and the only reason I say that is because of the high concentration of tweekers and white trash."

Thirteen years later, this reputation persists, in spite of an effort toward revitalization and development. The reputation as a community of "meth heads" and "drug abusers" lends itself to the harsh judgment of those whose teeth show decay and deterioration.

Often, however, these assumptions are untrue, and the judgment is unfair.

Then what’s the problem?

Most of the time, people have bad teeth because…they have bad teeth, and they can’t afford to get them fixed.

Many things can affect tooth quality which are beyond the control of the person. Genetics, medications, presence of fluoride or lack of it in the drinking water, parental choices of food and drink for their children, nutrition, and, of course, access to dental care.

In the past, it was common practice for caregivers of bottle-fed babies to prop the baby bottles when the child was in their carrier or bed. These babies had a higher risk of tooth decay. The milk or formula would pool in the baby’s mouth, coating the teeth with bacteria and sugars. Some babies were given soda in their bottles, which will cause tooth decay as well.

These parents and caregivers were not being purposefully hurtful to their children. They didn’t realize what the results of their actions could be. Many just did what their parents had done. Most parents today know this is an issue, but not long ago, bottle propping was a regular practice.

If the child’s teeth are not cared for properly, their permanent teeth are likely to be affected, which will result in adults with bad teeth. This can be the result of medications given in childhood as well.

I come from a family with poor tooth genetics. Adding to that, I was hospitalized at the age of nine for second and third degree burns and given medications that affected the integrity of my teeth. My teeth were messed up, full of fillings, and crooked.

My mother had a full upper dental plate by the time she was twenty-six. Another family member got theirs before they were thirty and another by their mid-thirties. I was able to hold out for my dentures until I was in my late forties, when it became impossible to pull any more teeth without negatively affecting my health.

Dental care is expensive

Dental care for adults is not covered by medical insurance unless the dental problems are clearly a result of an illness. Dental insurance is usually nothing but a “discount” program, which can often leave the cost of care out of the affordable range for many. Because of this, a lot of folks simply choose to do the best they can to care for their teeth and only go to the dentist for emergencies. When faced with the choice of a root canal or pulling the tooth, many opt for extraction. That’s what I did.

I had to take out a loan to pay for my upper plate. My bottom teeth are not all there, and while I had a partial for the bottom, both anchor teeth have since gone bad, so I can’t wear it. I always hated my teeth, and I still hate my bottom teeth, but I will go down kicking and screaming before I have them pulled to accommodate a lower plate.

Ideally, I would go get implants and not have to deal with dentures. My teeth would look great. I would ask them to make my canines just a little bit longer but I’d go with a more natural color than bright, blinding white. Well, actually, ideally, I would have been born with better teeth.

But neither of those options are going to happen. Implants are far too expensive, and, well, the latter’s opportunity was lost on the day I was born.

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*In my opinion, if a person has bad teeth as a result of being a drug user, there still should be no negative judgment, but that’s another story for another time.

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Resources:

• The author's personal experience
• Anectodal stories heard over the years from friends, relatives, and others
• https://www.rmg.co.uk/stories/topics/elizabeth-i-fashion-beauty#:~:text=As%20Elizabeth%20aged%2C%20her%20legendary,teeth%20to%20mimic%20her%20appearance
• https://www.ranker.com/list/historic-connection-between-teeth-and-status/genevieve-carlton
• https://www.dentistryiq.com/dental-hygiene/public-health/article/14297423/the-role-of-social-determinants-in-oral-health
• https://www.ada.org/resources/ada-library/oral-health-topics/forensic-dentistry-and-anthropology#:~:text=Teeth%20are%20an%20integral%20part,tell%20us%20about%20past%20peoples
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676336/
• https://www.kidspot.com.au/parenting/mum-used-to-give-us-coke-in-bottles-when-we-were-sick/news-story/65965ee749b601817c335d071192d064