Austin Powers bites back: a cross sectional comparison of US and English national oral health surveys
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6543 (Published 16 December 2015) Cite this as: BMJ 2015;351:h6543
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It no longer surprises me that some of my fellow U.S. citizens will find offense in almost anything--even in what seems a somewhat light-hearted skewering of national stereotypes.
To the respondent protesting that the index of missing teeth differences were unimpressive, and to the writer pointing out that we Americans at least aren't missing their front teeth, I would point out the second finding of the study--that there is far greater variation in dental health status among American citizens than among the British.
This is (quite self-evidently) due the efforts of your NHS and the healthcare workers laboring within it.
Yes, I know that many of your citizens love to hate the NHS; that it has huge problems operationally. I'm sure there are.
But the lack of a centrally-administered, federally-mandated and comprehensive plan for healthcare for all our citizens should make us (among other reasons) the laughingstocks of the Western world. And the unavailability of basic health care, and our abysmal healthcare metrics are our national shame.
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Living in the US I am used to seeing people without or few teeth. This is obviously a sign of poverty and the lack of a national health system. This spring I travelled through the UK and noticed missing teeth, but in the mouth of our bus drivers and local tour guides. They are obviously not of the same social strata as the Americans and I am puzzled.
Competing interests: No competing interests
In the US, it was for several recent decades (and may still be) common dental practice to recommend the removal of the "wisdom teeth" or final molars on the excuses of not enough room in the jawbones or "You can't clean them properly way back there and you'll just have to have them pulled later anyway" or other dubious assertions.
Did the study correct for this? Did it correct for comprehensive extractions to accommodate dentures? (No, I have no information whether such practices are more or less prevalent in Great Britain; do you?)
I wonder why the authors call the numerical difference in tooth counts "significant" anyway. A full complement of teeth being 28, the difference between the Brit and US counts is .34 tooth, a third of a tooth or 1.2%. Is that outside standard deviation? (Public opinion polls in media reports are often disclaimed that a 4% difference is not statistically significant.)
The pervasive marketing and normalization of straight, brilliantly white, uninterrupted dental presentations have much to do with Americans' toothy hubris re: Brits.
I don't know whether Brits are anywhere near as likely to torture their children with dental "braces" to re-align their teeth but failure to do so for a child with severe misalignments is almost considered child abuse here.
And visibly missing teeth are considered a mark of near poverty and a great embarrassment for many in the US so are quickly refilled via bridges or implants.
Many of us are also so obsessed with polishing off any discoloration that tooth polishes had to be reformulated with less-aggressive grits because enamel was being worn away.
Anyway, this study was NOT really one to determine which nation could boast the better dentition, it merely documented tooth counts.
Competing interests: No competing interests
Dear British Medical Journal
What your jaded study is missing is that British people are actually MISSING teeth in the front of their mouths which means a gaping hole when we look at many British peoples' mouths.
Your "study" is rubbish from my perspective and is just a bunch of yap yap aimed at hiding from the reality that generally speaking, British people have very dark yellow stained teeth with often missing front teeth. I honestly don't see how this can even be compared with Americans' teeth situation.
I invite you to send a clarifying statement to your study reminding readers that this study does NOT take into account missing front teeth.
Thank you and Sincerely,
Nick
Competing interests: No competing interests
The Tooth of the Matter
Contradicting a popular stereotype that Brits have ugly teeth compared to the perfectly straight sparklers of the US, the study from Guarnizo-Herreño et al. reveals that the oral health of Americans is no better than that of the English. [1]
Recent statistics show that on pure oral health rather than appearance, the UK does far better than the US. The last figures for the Organisation for Economic Co-operation and Development (OECD) countries put the UK top for the average number of decayed, missing or filled teeth (DMFT) for 12-year-olds, which is now 0.7. In the US it is 1.3. Britain not only did better than the US, it did better than all the other OECD countries that reported data that year. [2]
Almost all OECD countries were able to meet the World Health Organization target of no more than three DMFT by the year 2000. [3] However, there is cause for concern among some countries such as Australia, Austria and the US, which have seen a slowing of the decline, or even an increase in DMFT in recent years. [2]
Rather than mocking the English for bad teeth, perhaps the Americans should be looking in the mirror and asking why they cannot take better care of their own.
[1] Guarnizo-Herreño CC, Tsakos G, Sheiham A, Marmot MG, Kawachi I, Watt RG. Austin Powers bite back: a cross sectional comparison of US and English national oral health surveys. BMJ 2015;351: h6543.
[2] OECD. Dental health among children. In: OECD. Health at a Glance 2009: OECD Indicators. Paris: OECD Publishing, 2009.
http://dx.doi.org/10.1787/health_glance-2009-12-en
[3] Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31 Suppl 1: 3-23.
Competing interests: No competing interests