Poverty and Poor Teeth


Posted & filed under Fluoride, Oral Health, and Access to Care.

Poor Teeth, a personal and reasoned observation of what it can mean to have bad teeth in America, gives us much to consider. Author Sarah Smarsh grew up in poverty in and around Wichita, Kansas, a city that – as she points out – did not then (and does not now) have fluoridated water.

Offering the experiences of her immediate family as representative, Smarsh connects the dots between the very real effects of “a mouthful of teeth shaped by a childhood in poverty” and “the psychological hell of having poor teeth in a rich, capitalist country: the underprivileged are priced out of the dental-treatment system yet perversely held responsible for their dental condition.”

Boy Smiling with TeethWhen community water fluoridation (CWF) is proposed or discussed as a public health intervention, opponents often embrace the kind of victim blaming that Smarsh describes so carefully above. One need only wade into the comments that follow online articles on this topic to find wagging fingers and statements like, “Why can’t those people just brush their kids’ teeth!”

Reducing health disparities is the driving force behind efforts to promote and protect CWF. A 2012 vote of the Santa Clara Valley Water District makes San Jose, California the next large city in the U.S. to implement CWF. This multi-year, multi-partner effort was undertaken in large part to address inequities in the oral health status of the County’s poorest residents.

When we talk about the preventive benefits of fluoridated water, we are talking about much more than good oral health. Fluoridation is the safest, most effective, and least expensive way we have to help break a cycle of ‘poorness’ that, for many people, is very real and begins with their teeth.