I Grew up Too Poor to Smile

I remember the first time I tried to Photoshop a tooth into my mouth. I was trying desperately to fill the dark spot visible at the corner of my mouth. I hadn’t needed to in the past, but this most recent tooth I lost was right on the border of my smile line. I was looking at this picture of me smiling wide with pure joy and thinking, “Oh no, everyone will know.”


I didn’t always have teeth that shamed me. I didn’t have my first cavity until high school. Well, that’s not completely accurate. Chances are, I’d had that cavity for a while, but there’d been a years-long gap between my visits to the dentist. We were on a state dental plan, and my mom just couldn’t handle the looks of pity and disgust that the dental office staff gave us when she handed over our medical coupons at our annual cleanings. So we stopped going. Ultimately, I made my own appointment, got a filling, and was done with it.

For college, I moved to a town that doesn’t fluoridate its water. The measure had come up time and time again in local elections, but the hippy liberal students with full dental plans would vote it down and then move away when they graduated, leaving the poor, long-term residents to suffer the consequences. As a result, the county I went to school in saw twice the amount of untreated tooth decay in preschoolers as the rest of the state. My teeth, however, were managing to hang in there—that is, until I became pregnant.

Pregnancy is notoriously hard on teeth, and combined with the lack of fluoride in the system and my general disinterest in dental care, my teeth began to fall apart. I learned quickly that gummy candies, nuts, toffee, even certain cuts of meat, could cause one of my teeth to shatter. I’ve quietly and embarrassingly spit pieces of my teeth into my napkin while dining with friends.

My family didn’t have the money to help pay for my college, nor did they have the money to pay for my insurance. So when I became pregnant, I went back on the kind of state insurance I’d had as a kid. 

“We have to pull it. Nothing else is covered.” The dentist would say, looking at me like I should be glad to get even that bit of charity. Tears would fill my eyes as yet another tooth that could have been saved was yanked from my head. Five teeth lost in one pregnancy. I stopped eating hard food, I stopped eating crunchy foods, I stopped eating chewy foods. I became conscious of the weird movements my mouth made as I tried to manipulate food to a part of my mouth that would not hurt. 

“You chew funny,” people began telling me.

I was conscious to always cover my mouth when laughing, to never smile too widely, never sing too boisterously. I once again began avoiding the dentist, dreading those cold words, “We have to pull it.” I would rather be up all night with searing dental pain, I’d rather risk damage to my health, than to lose any more of my teeth.

Other poor friends and family members fell victim to the same identifiable curse of poverty. My brother has the smile of poverty, too—neither of us grin too widely.

We are the butts of jokes. We are the faces to pity. Our smiles are the symbol of hard-times, poor hygiene, and bad life-choices. 

And we are in pain, actual physical pain—every day. Sometimes it’s the sharp pain when chewing, sometimes it’s the dull ache that reminds you that things are likely getting worse, sometimes it’s the throbbing pain that makes you feel like you are going to lose your mind. 

When I finally got insurance and a decent-paying job after college, the first thing I did was make an appointment with a dentist. I blinked back tears as I opened my broken mouth to him and tried not to imagine what he was thinking. The dentist handed me an estimate of how much it would cost to fix my teeth—$17,000 out of pocket. My tears splashed on the page as I read it. “You’ve waited too long for any less expensive options to work,” he scolded me gently. I left feeling, once again, ashamed.

And this is where I am today—I have a full life with wonderful family and friends, a career that I love and truly believe is making a difference, a voice that carries, and a mouth that can’t open wide. Perhaps one day I’ll be privileged enough to be able to hand over $20,000 to try to make up for a lifetime of being treated like basic medical care was a luxury that I didn’t deserve. But in the meantime I, and so many other poor people across the country, will continue to try to get by in a world that judges our smiles.

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