Take a random survey of your friends here at UW-Madison and it is likely that you will run into a few of them who have not seen a dentist in two or three years and yet are at least vaguely aware that they might have cavities or other significant dental health problems. As Malcolm Gladwell pointed out in the New Yorker last month, \The Moral Hazard Myth,"" poor people have much the same problem, as they sometimes cannot afford to pay for the seeming ""luxury"" of healthy teeth.
College students, with debt and minimum wage jobs, quite often live in conditions that are somewhat congruent to poverty. The difference is, unlike the endemic poor, we students will mostly go on to join the middle class. In other words, if we have bad teeth, it is a problem that will fade with employment and a dental plan.
Of the two groups, the endemic poor should probably concern us more, precisely because their problems are more persistent. If our cavities will be filled in the near future, a poor woman with no health coverage will often be reduced to wiggling her bad molar out while she watches late-night TV. The book ""Uninsured in America"" by Rushika Fernandopulle and Susan Starr Sered documents such cases of do-it-yourself health care.
Of all the immensely useful physical anatomy we most take for granted, teeth rank in importance with big toes, eyeballs and thumbs. However, poverty won't lead you to lose your thumbs. And while it may or may not cause you to lose your sight, long-term poverty is a virtual guarantee that you will lose some teeth.
It is telling that ill dental health, a seemingly small problem on its face, is such a big problem for poor people. Painful teeth can cause people to avoid fruits and vegetables and look to alcohol for relief-a dietary substitution of the worst for the best. Bad teeth keep the poverty cycle going, too, as bad teeth can cause employers to think twice about giving poor people service jobs that require face-to-face interaction. Fernandopulle and Sered show how this exacerbates the economic problems that poor people already face. Poverty magnifies and compounds the day-to-day problems of life in America so that those problems appear overwhelming.
Now it might seem odd to say that bad teeth would hurt a man or woman's chances for gainful employment. But just think about President Bush. Would you have voted for him if during his ""debates"" with the equally hygienic Senator John Kerry he had gnashed some empty-socket gums whenever he tried to speak?
This points towards a larger issue. Lack of adequate health coverage can actually cause poor people to look physically different than people who are better off and medically insured. To a degree, teeth are a sign of status.
Paul Wall, a rapper from northwest Houston, has a line in his song ""Sittin' Sideways"" that demonstrates, in a nutty way, how teeth are a sign of status. He says he's got ""more carats"" in his mouth ""than Bugs Bunny's lunch."" Mr. Wall has diamond teeth. However ridiculous, it is a metaphor of status that translates to other people who have ""made it."" Actors, politicians, news anchors-people with capped, if not diamond, teeth. It is also a sign of middle class prosperity to have pearly whites. These de facto marks of status sadly point to the economic and social problems that constitute the gap between America's classes.
Though Jesus told his disciples that ""you always have the poor with you,"" the line should not be taken to mean that the poor always have to be uninsured. Whatever we take it to mean, though, we can't rightly deny that it is in the interests of a civic-spirited, equality valuing democracy to spare its less privileged members from the ugliness of the very system which stands on their backs.
