We British need not have bad teeth: The American way

These days people in North America mostly look almost the same as people here in Britain. Once there were subtle differences in how people dressed, but these are fading quickly as popular culture becomes more and more globalised. There are more overweight people across the Atlantic, but even that difference is disappearing as Americans become more conscious of health issues.

But a difference quickly appears when people smile. For one thing, Americans smile much more often than we British do. Whenever you meet someone in the States you see a flash of white teeth. Not so here in England: a blank expression or a frown is more common. And when you do see a rare smile, it is usually not even and white but crooked and yellow. Even our celebrities have less than perfect smiles:

American (L) and British (R) smiles: From top left, by row, Missy Elliot, Jessica Simpson, Ricky Gervais, Tony Blair, John Travolta, Sarah Michelle Gellar, Matt Lucas, Victoria Beckham, Kate Bosworth, Brandon Routh, David Walliams, Elton John, Tom Cruise, Megan Gale, Mick Jagger and Robbie Williams

American (L) and British (R) smiles: From top left, by row, Missy Elliot, Jessica Simpson, Ricky Gervais, Tony Blair, John Travolta, Sarah Michelle Gellar, Matt Lucas, Victoria Beckham, Kate Bosworth, Brandon Routh, David Walliams, Elton John, Tom Cruise, Megan Gale, Mick Jagger and Robbie Williams

Yes, the biggest difference between the British and the Americans is in their teeth.

In the 1st century AD the Roman author Martial wrote [1]:

Thais has black, Laecania white teeth; what is the reason? Thais has her own, Laecania bought ones.

We can see the same contrast today, at least if we replace “black” with “yellow” or “grey”, with Thais being typical of us British and Laecania of Americans. And the reason is the same: the American Laecanias are paying good money for their good teeth.

This is surely something to do with the British mentality of the last half century. We have been brought up to expect the government to look after our health, including our teeth, through the National Health Service. We resent having to pay £16.50 for a check-up and £45.60 for a whole course of fillings [2]. The private dental sector has been growing rapidly over the last few decades, now treating 27% of adults [3], but the standards of treatment offered by the NHS are still considered the rule.

There are strict limits to which dental treatments are available on the NHS [4]:

Dental implants and orthodontic treatment, such as braces, are available on the NHS, but only if there’s a medical need for the treatment. …

NHS dental treatment does not include cosmetic treatments that are not clinically necessary, such as teeth whitening or veneers.

In addition, NHS fillings and crowns are metallic, not white like real teeth. So, while the health of British teeth has improved rapidly over the last few decades, their outward appearance has not. If anything appearances have got worse, because not so many people have lost all their teeth and so are wearing full dentures.

By contrast, most North Americans expect to spend hundreds or thousands of dollars on dental treatment. Total dental care expenditure in the USA is around $100 billion per year, or more than $300 per person per year. A comparable figure for the UK, including NHS expenditure, is around £7 billion or a little over £100 per person per year. But NHS patients in England only pay only about £600 million, so less than £20 per year for each person not using a private dentist [5].

So the Americans are copying Laecania by buying teeth. What are they spending their money on? Fillings and crowns are of course white by default. Even slightly crooked teeth are corrected with braces and other orthodontic procedures. But the main difference from British dentistry is surely in the regular use of two kinds of procedure, dental implants and teeth whitening.

All of these procedures are available here in the UK. And they don’t have to cost a fortune. Follow the links below to find out more about what can be done.

  • Dental implants (in preparation)
  • Teeth whitening (in preparation)

Some people might wonder whether it is right to spend money on cosmetic dentistry of this kind. Of course it would not be good to put this above the necessities of family life, or above generous giving to good causes. Nor should anyone go into significant debt just to get their teeth looking nice. Also it is not good to be obsessive about these matters. But surely it is just as valid a choice for people who do have some spare money as spending that cash on luxury holidays or cars.

In addition, cosmetic dentistry can be really useful for some people. It can greatly boost their self-esteem. It can help them to get jobs for which appearances are important. Also it can put a smile in their heart and give them the confidence to express it with their lips. A few more smiles all round will help to make Britain a better place!

[1] Epigrams Book 5, XLIII, translation from Bohn’s Classical Library (1897) adapted by Roger Pearse.
[2] These are the current NHS dental charges in England. Under 18’s and some others pay nothing.
[3] Figure for 2009, for adults with some teeth, from the official Adult Dental Health Survey 2009.
[4] NHS web page Which dental treatments are available on the NHS?
[5] National Dental Care Expenditures 1960-2007 (USA); Total spending on UK dentistry increased by 4% to £6965 million and NHS Dental Statistics for England: 2009/10 (UK).

44 thoughts on “We British need not have bad teeth: The American way

  1. I read with interest your comment about what the NHS will and will not cover, and that those standards pretty much determine what your teeth look like.

    Here in the US, we have recently passed something commonly called Obamacare. It is supposed to give us better, cheaper medical care of all kinds. Many of us are hoping, praying, and working to get this monstrosity repealed.

    I expect you have heard about this before now, but just wanted to post it fyi in case you are wondering about this subject across the pond.

  2. Galveston, I have heard about “Obamacare”. Indeed I welcomed last year in a post Congratulations, USA, on healthcare reform. Since then I have learned more about the weaknesses of the specific scheme and understand the need to reform and improve it. However, I would consider it a complete blasphemy against the Christian God for anyone to PRAY(!) for repeal and so a return to “the scandal of the poor dying uncared for at the rich man’s gate”.

  3. You have been poorly informed.

    Over here, no one has been deprived of needed medical attention. There are various sources of help and if all else fails, no hospital can refuse to treat anyone, even illegal immigrants. Obamacare is scheduled to take $500 billion out of Medicare (seniors medical care) and transfer it to Medicade in an effort to put everyone on a single-payer system. There are horrible provisions in this bill, including various taxes that have nothing to do with medical care. Perhaps the most frightening thing is that doctors will have their pay severely cut, and many have already said they will retire or change professions. We barely have enough doctors for the patient load now. When we lose the (expected) 40% of doctors and add millions to the patient load, it will become impossible for some patients to receive treatment.

    And finally, we are broke and cannot afford the trillions this will cost this country. Our health system needs reforming, but Obamacare is not the answer. So I think it is OK to pray for its repeal.

  4. Well, Galveston, I hardly expected you to agree with me. But as I understand it “no one has been deprived of needed medical attention” used to apply only to emergency room care, not to care for life-threatening diseases like cancer. I would be happy to pray with you for reform of Obamacare, to overcome its weaknesses, but not for its repeal.

  5. I don’t know what your news source over there, but if it is telling you that Obamacare is a good law, then my gentle suggestion is that you incorporate some different news sources into the mix.

    Obamacare was written in secret without any input from Republicans who were excluded from the process. The only reason it passed was Democrat majorities in both houses. It is 2200+ pages long, and Speaker of the House (at the time), Nancy Pelosi said “We have to pass it so we can find out what is in it.” Unfortunately, that is not a joke, I heard her say it. As it stands, it will cost trillions of dollars that cannot be found, it will place the government in control of all health care, decide who gets treatment or not and reduce the number of doctors. Our old system did not decide whether grandma gets cancer treatment or not based on her age. Obamacare does.

    I realize that you live in a country that is already pretty socialistic, so may not think it is a big deal.

    There is one provision that imposes a 15% tax (I think that is the %) on your home when you sell it. What does that have to do with health care?

    I have heard that you have long wait times for many procedures over there. So far, over here, you can be seen in a timely manner.

    Trust me, no one here has been dying in the streets because no health care is available to them.

    Poor people have Medicade and SSI. Consider adding Fox News to your input.

    Blessings, and Maranatha

  6. Galveston, as I said, I would be very happy for the bill to be revised, and for the result truly to be as rosy as Fox News says the old system was like.

    Your old system decided whether grandma got her cancer care based on her bank balance and her luck with insurance companies. Is that more fair?

    Our system is not perfect either. But the long waits are only for non-urgent treatment, and are much shorter than they were a few years ago.

  7. Well, I’ve never heard Fox news personalities describe current health care as “rosy”, but Obamacare will cost unbelievable amounts of money without helping the situation. Both my father and my wife’s father died of colorectal cancer. Neither were wealthy and both got care under medicare. It didn’t save their lives though. Dad was 81 and my father-in-law was 83.

    Those praying for repeal of Obamacare are convinced that there are far better ways to overhaul the system, and in fact, candidates vying for the Republican nomination have advanced more than one plan to do that without nationalizing health care or breaking the bank. Obamacare is opposed by the majority of Americans. Stay tuned for further developments.


  8. Galveston, as I have said before, if a new President can put forward a better plan to replace Obamacare, I would be all in favour. What I oppose is a simple repeal of Obamacare and a return to the previous unsatisfactory situation.

    By the way I don’t trust Fox News. There is good evidence that News Corporation has a worldwide agenda which is threatened by Obama. And here in the UK its newspapers have been caught out using illegal telephone tapping to forward that agenda.

  9. According to a report in by Newsmax, the American College of Emergency Physicians (ACEP) found that 97% of doctors treat medicade patients every day in their emergency departments because the patients can not find a doctor who will treat them for what medicade pays. They further state that Obamacare will result in more, not fewer emergency room visits.

    I have watched for decades as the news media in this country lied to us. They did not tell us lies, they just didn’t tell us the facts. They lied by omission. Fox news is the best we have here, all the others have forsaken honest journalism.

  10. Galveston, I don’t think I would trust any of the news media on an issue like this. They are all pursuing one agenda or another. But there must be another way to treat chronically ill patients than for them to visit the ER regularly. If Obamacare makes this problem worse, then it needs replacing with something that makes this problem better.

  11. I read the evolution vs creation blog. Same old never-ending argument there.
    I’m not too savvy on some of these posting things, yet. What did you want me to post where?

  12. If you doubt what I said about fluroide, do a web search on it. It is poison to the human body. The ONLY tooth benefit is when it is applied topically. I have read up on it because I have low thyroid function. I know one man who grew up in west Texas and his teeth are mottled by natural fluroide in the water. I seriously doubt if there is ANY safe level of this substance.

  13. Well, my dentist *** would say, “All they need to do is brush their teeth properly!”. Seriously, fluoride in the water and dental education is going to do a lot more good than the aftercare.

  14. H, are you aware that fluoride is a thyroid suppressant? We dump thyroid suppressant into the drinking water and then wonder why there is so much obesity. Check it out.

  15. Oh dear, that is weighing into a huge debate. The one thing any dentist will tell you though is that the volume of empirical evidence is hugely on the side of having a dose of fluoride in the water supplies. There are some studies against fluoride but scientifically these have been debunked. Sorry, you’re talking to a girl with perfect teeth due to fluoride tabs and a *** who is a dentist who had to research the subject.

  16. I am really sick of this type of article/debate, as it is just a stereotype! I know nobody will look at the links or believe them as it ruins the sense of superiority!




    Look at the above links as they are based on actual scientific fact rather than outdated racial stereotypes.

    British teeth were bad, but more for people born before 1960. In fact America’s children have nearly DOUBLE the rate of missing, decayed or filled teeth than British children.

    I know USA is a very vapid, image obsessed society where no celebrity on TV appears with any imperfection. However they are not representative of real society. Please watch old British sitcoms from the 1960’s in order to retain a sense of dental superiority.

    p.s. fluoridating the water is not necessary since there is enough in toothpaste already. After many European countries stopped fluoridating the water, decay rates remained stable.

    It is obvious Americans will have worse teeth as on average, you drink too many fizzy drinks and eat too poor a diet. This is why African rates of tooth decay are pretty low (despite them not going to see their dentist every 2 weeks at $1000 dollars a pop or whatever exorbitant prices are paid)!

    Also too many of you whiten your teeth beyond levels possible in nature. This is why you see normal teeth as unhealthy. This is what happens when you have privatised healthcare where big money is the goal. Dentists in USA tell people their teeth are terrible and need whitening etc to make more money, often when they do not even need the work.

  17. Simon, thank you for your interesting perspective on this. But it doesn’t actually contradict what I wrote. Yes, Americans’ teeth decay more than British ones, and I’m sure their diet is largely responsible. But the statistics show that, on average, they spend a lot more than Brits on repairing, replacing and whitening those bad teeth. And I would not dispute your suggestion that much of that spending is because dentists sell unnecessary work for their own profit.

  18. Dear Galveston,

    American politics never cease to amuse us Canadians. You envy our public health system and yet when your government tries to implement something similar, you brand it as socialist and fight tooth and nail against it. Die hard American capatilism has kept you in the dark ages; everything that to us is humane and a basic necessity is to you socialist and a luxury.


    Metric rules! Imperial drools.

  19. People fly in to Houston Medical Center every day from all over the world. Why would they do that? Could it be that the care there (and at other US cities as well) is superior to what they can get in their own countries, even though it may be free there?
    Obamacare is breaking down right now. I think it will be impossible to implement. I keep hearing doctors who will not accept its low payments and now there are hospitals that will not accept it.

    Enrollment in the plan is really low. Maybe it will get more numbers if (and that’s a big if) this incompetent government can ever get the web site working.

  20. Galveston, I’m sure no one would deny that the best of American medical care is very good (and very expensive), just as they would not deny that the richest of Americans are very rich. But the issue measured by statistics is the average medical care, the kind which the ordinary person can expect to enjoy. And, just as the average income of Americans is not the highest in the world, the average health care of Americans is not the best, but is in fact a long way down the list.

    The reason for that is simple. In the UK, for example, if people have a medical issue, they go to the doctor or the hospital, without worrying about what it will cost. It is not always free, but will never cost people more than they can afford, and it is free to the poor. In the USA, however, everyone first has to count the cost, and very many choose not to get treatment because they cannot afford it. That applies not only to those without insurance, but also to those with quite good insurance policies (Obamacare silver level and above) which still have substantial deductibles and co-pays. As a result many more people suffer from treatable but untreated sicknesses.

  21. We have not yet addressed the biggest problem with socialized medicine in our discussion. COST.
    Those who wrote that 2,000+ page monstrosity just assumed that young, healthy Americans would sign up and support the program, covering the gap that older people would pay vs what their care cost.
    It ain’t workin’! I was just listening to numbers, and people are flocking to stay away from Obamacare. If this trend does not change massively, even the nearly trillion dollars that the plan takes away from Medicare (what I am on) will not be enough to pay the bill.
    What then? More tax increases to make up the difference?
    We are looking at a shortage of doctors at the present level of population, not to speak of adding maybe 12 million illegals that will be covered.
    The train wreck will be spectacular. Keep watching.

  22. Galveston, I am not going to pretend that there are not massive problems with Obamacare. Many of them are to do with its cost, and many of them are the result of massive lobbying by the medical and insurance industries, whose short term advantage is in keeping the costs high.

    As for “people are flocking to stay away from Obamacare”, I suspect that it is more that people are waiting, at least until the website bugs are fixed and for many until the last moment, before the mandate kicks in. After all, whatever they think of it, most people believe in obeying the law.

    I know some of you are hoping for a spectacular train wreck on this and other aspects of Obama’s policies, just to spite a President you don’t like and have been trying to undermine ever since he was elected. Is the color of his skin anything to do with that? You don’t even consider how that train wreck will be just as disastrous for yourselves and for the whole of the country you profess to love. Instead, if you call yourself a Christian, shouldn’t you be praying for your President and seeking the best for him?

  23. I will answer your question last. I do pray for Obama every morning, along with several others. I pray that God will save their souls from Hell. I then pray that if they cannot give up their destructive agenda, that God will send them confusion, delusions, dissentions, discouragement and despondency. I further pray for the collapse of the Democrat Party, the defeat of them in the halls of Congress and at the polls.
    Now, lest you think me harsh, go online and read the platform of the Democrat Party. You will find it is positively anti-Christ. God was actually booed at their last convention.
    As to Obamacare, I think the number quoted as being without health insurance was about 15 million. We could have simply created something to help them get insured without disrupting our healt care system and at a fraction of the costs of Obamacare.
    Obamacare is like a Rube Goldberg arrangement. You remember? When a simple tube could roll a ball into a container, Goldberg designed whimsical machines that would do the same thing, only with a dozen or more ridiculous steps.
    You say you are a Christian. Would you vote Democrat if you were eligible? Would you vote for the murder of babies, the sodomization of this country and the forced redistribution of wealth? If so, you need to ask Jesus about that.

  24. Galveston, shame on you for praying “confusion, delusions, dissentions, discouragement and despondency” on your President! I am disgusted and appalled! Yes, pray for changes of policy if you like. But how you as a Christian should be praying for those in authority is outlined in 1 Timothy 2:1-4, where the “kings” mentioned are despotic dictators far worse than any American president. Where are we told to pray for “confusion, delusions, dissentions, discouragement and despondency” on those in authority? If this is the kind of prayer which is coming up from so many of those who are charged with interceding for our leaders, then no wonder the country is in such a mess!

    So you would have preferred a simple extension of Medicaid and/or Medicare to cover all the uninsured, paid for from taxes? So would I – perhaps with tax breaks for the insured so that people don’t give up their existing insurance. But, from what I understand, it was the health industry which wouldn’t allow that one. Who designed the Rube Goldberg machine? Not Obama. But actually Obamacare is not all that complicated. If you don’t want to use the bug-ridden website, go to your local pharmacy and you can buy your choice of compliant policy there, from any company which chooses to sell them.

    Meanwhile, if I had a vote, I would not use it on a party which perpetuates war, allows convicted criminals and known psychopaths to buy weapons of mass murder, and promotes policies which make the rich richer and the poor poorer. But I might vote for a party whose agenda aligns with the divine one:

    He has brought down rulers from their thrones
    but has lifted up the humble.
    53 He has filled the hungry with good things
    but has sent the rich away empty.
    Luke 1:52-53 (NIV)

  25. Paul tells us we war against princpalities. That means governments. Do you know that the Communist Party USA hasn’t fielded a candidate for several years now? The reason? The Democrats have incorporated all their issues in the DNC platform!
    I notice that you did not say you would vote Democrat. From your statement, you could not vote either Democrat or Republican.
    I am pleased to see that you COULD support a TEA Party candidate. Welcome to my world!

  26. I forgot to mention something.
    Obama is neither king nor dictator (I hope!). He is OUR EMLOYEE, and he is either monumentally incompetent or treasonous. Either way, he has no business being president of a free country. Was he elected by “we the people”? That is debatable. There was a lot of fraud by Dems in swing states. Some have even been prosecuted for it. If God in His Wisdom allowed Hussein to move into the Oval office, it was to bring His Church to prayer. Well, it is working.
    Please note that my first statement is that I pray daily for ALL these people that they will be saved.

  27. Galveston, I don’t know whether to laugh or cry at your ignorance about communism, how totally different it is from Obama’s agenda.

    Roman emperors were also supposed to be elected and the servants of the people. Of course their elections were far less free and fair than any American one. But it would be very hard to find a significant difference of principle between their roles and that of a US President.

    No need to pray for Obama to be saved, he is already a baptized and genuinely believing Christian.

    I CERTAINLY could not support any Tea Party candidate, with anyone whose agenda is to fill the rich with good things but to send the hungry away empty. See this description of where their policies would lead: Haiti should not be the model for America’s future.

  28. ” If this is the kind of prayer which is coming up from so many of those who are charged with interceding for our leaders, then no wonder the country is in such a mess!” You DO realize that you are saying that God would honor an unrighteous prayer don’t you?

    How do you find these off-the-charts blog sites? Haiti a model for TEA partiers? You mean the Haiti dedicated to Satan?
    Wherever you are getting your information about the TEA party patriots, you need to change channels, because your view of us is as wrong as it can possibly be. We only want to get back to the principles spelled out in the US Constituion (in plain English) that made this country the envy of the whole world. For your information, the SCOTUS is supposed to check new laws to see if they conform to the Constitution, not “interpet” it. Maybe Jefferson should have written it in Latin? Like legal papers and prescriptions, you know, in a dead language? I hope no one will “interpet” any prescription of mine!

    The Bible tells me that all liars will have their part in the Lake of Fire, and Mr. Obama has proven over the past 5 years or so that he is a serial liar, water baptism notwithstanding. Why don’t you read his books to see what he really is?

  29. Yes, Galveston, I do believe that God sometimes honors unrighteous prayers, sometimes for the judgment of the people praying them. Remember Numbers 11, when God provided the meat that the people were craving for, but it also brought them a plague. If sinful people call down disaster on themselves, why should God not oblige? But this issue goes well off topic for this thread, which is supposed to be about health, not God.

    Beyond that, if this thread is coming down to calling people liars and predicting that they will not be saved, it is time to call a halt to it.

  30. Peter Kirk please excuse my fellow American Galvenston. People like him were silent during the 8 years that really ruined us and our reputation, yet went rabid once Obama set foot in office.

  31. There is only one real difference between British and American teeth and it has to do with attitude. The British think what’s in the grey matter in the head is infinitely more important than what shows when one opens one’s mouth; in other words the British prefer a head full of thought to a empty head and only care that the teeth do the jobs for which they are designed – bite and chew. The British also believe caring for one’s feet – hence the ease with which one can find a really good chiropodist (pedicurist) in Britain is more important than fiddling about with one’s teeth unnecessarily. Teeth can be replaced – feet can’t. The British on the whole prefer to spend time browsing in a bookstore or library or going for a long walk than sitting in a dentist’s chair.

  32. I was raised on a small farm eating what the land produced, drinking milk and river water.. The first time I used toothpaste and toothbrush was when I moved to the U.S. at age fourteen. (Galveston, don’t worry I am here legally.) The first time I visited a dentist was here in U.S. at age 15. The dentist was surprised that I had such a healthy set of teeth: no cavities or yellow teeth.

    I believe our diet plays a very important role. No matter where we live if we have healthy eating habits, we will have healthy teeth.

    For me, a healthy diet includes staying away from News Corporations.

  33. Olivia, thank you. That makes sense. I agree about news corporations but I feel much the same about food corporations, it’s the food they produce that rots our teeth and the rest of our bodies.

  34. seriously are you actually British, because you are just reinforcing negative perceptions about your own country. Rarely do British people ever smile just a frown or a blank expression, but americans are always smiling …….sure?. I’m trying to understand what your purpose of writing this article was. Are you bitter about something. Most of your other posts seem to say your a christian. So why then did you feel the desire to post this. It’s not religion related at all. I’m thinking maybe you should leave your homeland, if your so appalled by your fellow citizen’s, supposed yellow crooked teeth. We all know America is a country full of people with perfectly straight white teeth no yellow or crooked teeth there. Even regular nobodies have hollywood smiles that they flash constantly. You have an extremely shallow view of your own country and the world which is surprising but …. kind of isn’t considering you call yourself a christian.

  35. Lazereyez, yes, I am a Christian, and British. That doesn’t mean that I am allowed to blog only about issues related to my faith, or for that matter only positively about my compatriots. I write here about what I choose. I had my reasons for posting this, which was intended as the start of a series which I never continued.

    Of course there is much more to a country than what teeth look like. Indeed one of my issues with Americans is that they are too concerned with appearances rather than deeper matters. But this page is intended to explain why appearances are also important.

    Anyway, your wish has already been granted: since writing this, I have moved from the UK to the USA.

  36. Hi,

    My Grandmother is from Ireland and I’ve been to many different countries
    in Europe and the one thing I couldn’t stop thinking of was, why do so many
    people have teeth problems??? Thank you for writing your post, it was very informative and the best answer I have seen so far. You are very frank and honest about the facts which I appreciate.

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