In the 2018 movie Bohemian Rhapsody, young Freddie Mercury tells his fellow musicians that he’d like to join their band. “Not with those teeth, mate,” they laugh. The shame on Freddie’s face hit me in the gut.
My friends who saw the film barely remembered that moment. Nor did they notice how the adolescent Freddie was constantly pulling his top lip over his teeth or covering his mouth with his hand. For me, that was the story. My story.
It took me back to ninth grade on Long Island, when I heard giggling as I walked onto the school bus. I bounced into my usual seat and asked a classmate what was so funny. Nodding toward a group of the seniors, she whispered, “They were laughing about your teeth.” I felt I could barely breathe, that the world was in on a sneaky secret: my smile was gross. I felt like a freak.
My father, an Italian immigrant knife sharpener, earned just enough for a home in a blue-collar neighborhood and Catholic-school tuition. Our dentist was a sole practitioner who pulled teeth and filled cavities from his home office three blocks from my school. There was no dental insurance. My parents paid cash. When I asked about braces, my mother said, “When you get married, your husband can pay for it.”
When I asked about braces, my mother said, “When you get married, your husband can pay for it.”
Unlike Freddie, I didn’t have four extra incisors. I had what is known as a “high protruding cuspid.” It was a long pointy tooth just off center, aka an eye tooth, canine or, as kids liked to tease, a fang. Cuspids emerge in middle school. Similar to wisdom teeth, they can be impacted if there aren’t braces holding the space open. My two front teeth also overlapped in an overbite, but it was the Dracula tooth that mortified me.
Over the years, I’d practice smiling without showing my teeth. My mother would remark at how my two younger sisters were more photogenic. Their little choppers weren’t perfect, but they had no need to hide. I was the only one with a grotesque tooth sticking out.
After college, earning a paycheck, I didn’t look into braces right away. As much as I hated my gargantuan eye tooth, I was afraid a mouth full of metal would make it harder to be taken seriously on the job as a cub reporter at an upstate newspaper.
Once, during a dental checkup, I asked about a new method involving tiny invisible braces that clipped to the inside. The dentist warned it might not work with my teeth, and when he told me the price was $1,700, I knew I couldn’t roll the dice on three months’ take-home pay.
In my mid-20s, my fiancé’s upper-middle-class parents threw us an engagement party at their home. A dentist they invited told me, “You’re such a pretty girl; I’d love to see you do something about your teeth.” I was hoping he would offer to do it inexpensively, but he didn’t. In our wedding pictures, I have a Mona Lisa smile that looks fake.
During our marriage, my husband’s term of endearment for me was “Snaggle Tooth.” He thought it was funny. I thought it was cruel. With a mortgage and his small salary as a young lawyer, the cost of braces was a year’s preschool tuition for our two children.
When my son and daughter reached middle school, I took them to the orthodontist. As a mom, I was determined to do better for my kids than my parents had done for me.
By this time, I was separated, soon to be divorced. While I wasn’t rolling in cash, I had a full-time job in publishing and my ex was paying for half the kids’ braces. Maybe it was my turn, I thought. Was it too late?
To my astonishment, the orthodontist took me on and extended a family discount.
But before taking the leap, a friend recommended veneers, “only” $500 a pop at that time. Extravagant, yes, but the prospect of trading two years of metal for a few hours in a dental chair was tantalizing. I thought of it as a “cut the line” fee at Disney World. I went to her dentist, who shook his head and said that laminates could only even out minor irregularities. He couldn’t chisel a whole new mouth.
I returned to the orthodontist, where finally, at age 42, I was fitted with a full set of the latest clear, plastic braces for about $2,200 from my own savings. Dipping my toes into the dating scene, I of course assumed this would be a deal breaker. Romance would have to wait.
Instead, I found myself to be an object of curiosity. People at work, on the checkout line, everywhere, seemed to be in awe, as though I’d done something incredibly brave, like skydiving or joining the military. It didn’t seem to stop men. Kissing a woman with braces wasn’t a deterrent after all.
Yet, there was one setback.
During our marriage, my husband’s term of endearment for me was “Snaggle Tooth.”
While I was prepared for the added humiliation of adult braces, I had not counted on the pain. Not the psychic kind, which I’d grown accustomed to, but physical agony from the sharp gizmos chafing against my front lip and the regular “adjustments,” which felt like a medieval rack tightening inside my mouth, turn by turn.
My kids had rarely complained that their braces hurt. Then again, they’d run outside wearing shorts in the middle of winter. I should have known.
Once, the throbbing in my lower jaw was so unbearable that I took the painkillers prescribed and woke up in the middle of the next day. My unsympathetic boss threatened to fire me if it happened again.
When the braces finally came off, I ran my tongue across the smooth straightness of my front teeth and held my new retainer like a purple heart in its pink plastic case. When I went for drinks with a cute guy from work, and when I sheepishly asked if he noticed anything different, he seemed stumped. When I mentioned “braces off,” he admitted he’d stopped noticing them.
Then the contractor I’d hired to work at my house told me I had a “million dollar smile.” This time, my face tingled with surprise, not shame.
I’ve since heard comments like that many times over, and not just from men. Yet, sometimes I still have to remind myself that it’s okay to grin proudly in pictures.
There is a photo of me at 30, holding my firstborn, dreamily happy with my daughter, with a half-smile showing The Tooth. It was a picture I loved for the memory of the moment, but did not put on display. The fang overshadowed my silky hair, trim body, and sparkling young eyes.
While I love my teeth now, I regret having been defined by the bullies on the bus.
In Bohemian Rhapsody, it is only after Freddie sings that, awed by the power of his voice, his new bandmates overlook his massive teeth. Recently, Cute Little Fangs have become such a popular trope with anime that many Japanese adolescents have capped their cuspids into points.
But life is not like the movies, and without Freddie’s chutzpah, it took a bold step at 42, for myself and by myself, to let my true self shine.
Five years after her braces came off, Ruth Bonapace adopted a child from Hanoi, Vietnam, as a single parent, and they all smile proudly in family portraits.
Featured image: Tooth or consequences: As a teen with pointy cuspids (“fangs” to her classmates), the author recalled feeling “like a freak.” (Shutterstock)
This article is featured in the September/October 2020 issue of The Saturday Evening Post. Subscribe to the magazine for more art, inspiring stories, fiction, humor, and features from our archives.
Question: Baxter, my 5-year-old retriever mix, broke a tooth while gnawing on a bone, and the vet said his enamel was badly worn, probably from chewing on tennis balls. Can you suggest safer chew toys?
Answer: The nylon fuzz on tennis balls damages enamel in two ways: It’s abrasive even when clean, and it picks up dirt that acts like sandpaper on teeth. The lesson: Anything harder than teeth breaks teeth. The list includes natural and nylon bones, dried pig ears, hard plastic chew toys, and even ice cubes. Safe chew toys, the rubber kind, have some “give.” (Kong black toys are good for power chewers.) Offer Baxter a twisted rope toy and some dental chews. Also, increase his physical activity to tire him out before he settles down for a chew.
This article is featured in the July/August 2020 issue of The Saturday Evening Post. Subscribe to the magazine for more art, inspiring stories, fiction, humor, and features from our archives.
Featured image: Photology1971 / Shutterstock
In the 17th century, a barber surgeon ministered to the dental needs of the Plymouth Colony. In the 18th century, goldsmith and ivory turner Paul Revere, a hero of the American Revolution, constructed false teeth in Boston. Tooth decay and toothaches were seen as inevitable parts of life, and care of the teeth was widely considered a mechanical concern.
By the turn of the 19th century, science and specialization were transforming many aspects of Western medicine. A growing emphasis upon clinical observation and an increasing array of instruments — stethoscopes, bronchoscopes, laryngoscopes, endoscopes — brought a sharper and narrower focus to the study of disease. Physicians and surgeons, increasingly working together, developed new approaches to treating specific ailments of the heart, the lungs, the larynx, the stomach, the bowel.
They left teeth to the tradesmen.
But Chapin Harris, who began his career as an itinerant dental practitioner, led the effort to elevate his trade to a profession. Within the span of a year, between 1839 and 1840, Harris worked with a small group of others, including Horace Hayden, a Baltimore colleague, to establish
dentistry’s first scientific journal, a national dental organization, and the world’s first college of dentistry.
Dental students learned the mechanics of drilling and filling teeth and constructing dentures. They learned to perform extractions. Then they went out to practice in the villages, towns, and cities of a growing nation.
In 1880, Ohio dentist Willoughby D. Miller traveled to Germany to work in the laboratory of physician and scientist Robert Koch. Koch had traced the cause of anthrax to a specific bacterium. In two more years, he would present his discovery of the microbe responsible for tuberculosis, a killer of millions. Koch helped transform the study of disease.
Willoughby Miller studied oral bacteria on a microscopic level and began to see the mouth as the vector for all manner of human suffering. Bacteria invaded the bodies of people and animals by way of their mouths, causing deadly epidemics such as cholera and anthrax. But the mouth was not just a passive portal for illness. Miller saw it as an active reservoir for disease, a dark, wet incubator where virulent pathogens were able to multiply.
Leading American and British physicians concurred: The human mouth was a veritable cesspool. Aching teeth and inflamed tonsils were teeming with newly discovered germs. Physicians ordered dental extractions, tonsillectomies, and the removal of other suspect organs for the treatment of disorders ranging from hiccups to madness — for arthritis, angina, cancer, endocarditis, pancreatitis, melancholia, phobias, insomnia, hypertension, Hodgkin’s disease, polio, ulcers, dementia, and flu.
Vaccines were sometimes concocted and administered in concert with dental extractions in the belief that they would counter the effect of the germs that were released from the roots of the teeth. The English writer Virginia Woolf was preparing for such an ordeal in May 1922 when she wrote to her friend Janet Case. “The dr. now thinks that my influenza germs may have collected at the roots of 3 teeth. So I’m having them out, and preparing for the escape of microbes by having 65 million dead ones injected into my arm daily. It sounds to me to be too vague to be very hopeful — but one must, I suppose, do what they say,” she wrote.
In the United States, the physician Charles Mayo, of the Mayo Foundation in Rochester, Minnesota, acknowledged that some of his patients had complained about being left toothless. But he was convinced that the oral cavity was the seat of most illness. “In children the tonsils and mouth probably carry 80 percent of the infective diseases that cause so much trouble in later life,” he noted.
“Total clearance,” the removal of all the teeth, remained widely recommended.
In the face of the mass extractions, dentist and dental x‑ray innovator C. Edmund Kells stood up for tooth preservation. In an address in 1920 before a national dental meeting held in his hometown, New Orleans, Kells denounced the sacrifice of teeth “on the altar of ignorance.” He demonstrated the usefulness of his x-ray machine in examining teeth and the power it gave dentists to offer second opinions and to resist the orders of physicians to extract teeth needlessly. Kells urged “exodontists” to “refuse to operate upon physicians’ instructions.” And he contended “that the time has come when each medical college should have a regular graduate dentist upon its staff to teach its medical students what they should know about the oral cavity.”
But it could be difficult for dentists to defy physicians. The two professions not only distrusted each other — they inhabited separate worlds. The tensions and lack of communication hurt patients, concluded the respected biological chemist William J. Gies in his major 1926 report on dental education in the United States and Canada for the Carnegie Foundation. Gies was troubled by the entrenched disdain for dentistry he found among medical professionals. “Even research in dental fields is regarded, in important schools of medicine, as something inferior,” wrote Gies, who himself had been deeply immersed in the study of oral disease at Columbia University.
Gies firmly believed that dentistry should be considered an essential part of the healthcare system. He called for the reform of dental education, for closer ties between dental and medical schools and between the two professions.
“Dentists and physicians should be able to cooperate intimately and effectively — they should stand on a plane of intellectual equality,” Gies noted in a speech to the American Dental Association. “Dentistry can no longer be accepted as mere tooth technology.”
The mass extractions and surgeries continued through the 1930s. As microbiology advanced, however, the research underlying them was held up for closer scrutiny. Untold millions of teeth had been extracted, and the diseases the extractions were intended to cure persisted.
The growing availability of antibiotics in the 1940s offered new tools for fighting infections. But Gies’ calls for closer ties between dental schools and medical schools met with resistance. Many dentists rejected the idea. In 1945, an effort to integrate the faculties of the dental and medical schools at Gies’ own institution, Columbia University, was strongly opposed by the dental faculty. The dentists’ act of defiance was applauded by the editors of the Journal of the American Dental Association. “The views of the majority of dentists in the country cannot be misunderstood on the question of autonomy. The profession has fought for, secured, and maintained its autonomy in education and practice for too many decades to submit now to arbitrary domination and imperialism by any group,” they wrote.
Today, nearly all American dental and medical schools remain separate.
In addition, cooperation has also been complicated by another disjoint between the two professions: the fact that dentistry has historically lacked a commonly accepted system of diagnostic terms. Treatment codes have long been used in dentistry for billing purposes and for keeping patient records, but the long absence of a standardized diagnostic coding system for dental conditions has inhibited the understanding of the workings of oral disease, some researchers have said.
A uniform, commonly accepted diagnostic coding system would represent a major shift of emphasis in dentistry, “a move from treatment-centric to diagnostic-centric” care, said UCSF dentist Elsbeth Kalenderian, who spearheaded a dental coding initiative as a professor at Harvard. Efforts are now underway to put such a system into place. The integration of medical and dental records will become increasingly important as researchers such as Robert Genco, from the University of Buffalo, continue with their work. Over the past three decades, Genco has focused upon periodontal disease and its relationships with wider health conditions.
Years of study have led Genco and his team to a sense that obesity, periodontal disease, and diabetes are all “syndemically” bound by inflammation. Other researchers are more conservative in their assessments. The diseases are deeply complex. But the clues of biology will eventually bring oral health into the larger understanding of health, and dental care into the wider healthcare system, Genco has predicted. The gap between oral healthcare providers and medical care providers will need to be bridged, he said in an interview. “We all have the same common basic sciences. We all train in a similar fashion. But still the professions are separate. We dentists don’t look too much at the rest of the body, and the physicians don’t look at the mouth.”
Science has become a leading force in integration, Genco explained. “It’s getting us to look together at the patient as a whole. It’s a two-way street. Physicians and dentists really have to integrate in their management of the patient. So it is bringing the professions together. Putting the mouth into the body.”
This article appears in the March/April 2018 issue of The Saturday Evening Post. Subscribe to the magazine for more art, inspiring stories, fiction, humor, and features from our archives.
Copyright © 2017 by Mary Otto. This excerpt originally appeared in Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America, published by The New Press Reprinted here with permission.