KERRY MACIVER: Is the search for the ‘perfect smile’ worth the cost?

Just lately, I feel like I’ve been living at the dentist. After neglecting my teeth in my 20s, I’m paying the price for it now.

I loathe the dentist. Ever since that Portakabin rolled into the Conon Bridge Primary School car park, I knew they were a thing to be dreaded. The last year has been a long haul of failing fillings, crowns, root canals and, when those failed, extractions. But it’s been interesting seeing how they do dentistry in America.

Immediately, you notice how obsessed USA dentists are with The Perfect Smile. The very first time I went to one across the pond, I was offered teeth whitening and Invisalign before I could even say ‘Cheese’. This seems at odds coming from a place where it doesn’t matter how crooked or horsey your teeth are. The health of your mouth, not appearance, is the utmost thing.

That’s not to say they don’t care about oral health in America. A trip to my dentist coincided with writing this column and I asked her about the cultural differences in dentistry. She stated: ‘In the USA, we focus on prevention. The UK focuses on sorting it when something goes wrong...I know a British person as soon as they walk through the door!’

I guess our crooked teeth gives it away.

When I got a tooth out last year, I was offered a bone graft on the spot, then asked if I preferred it to be filled with a synthetic substance, or that from a cadaver. I had no idea what a bone graft was, or the purpose of it.

Then they offered to give me an implant. Again, I had no clue. They found it strange that all I wanted was a simple extraction. It’s overwhelming and intimidating, especially if you’re not expecting it.

My Scottish dentist was a one-stop shop. Here, my dentist outsources most things. You’ll be sent to endodontics for root canals, the periodontist for gum issues, and an oral surgeon for your extractions, bone grafting and other stuff. I like it this way. Each person has their own speciality, and not a jack-of-all-trades.

Now we get to the bit people are most interested in. Money. With more money in the system, dental care is better over here, and facilities have the most up-to-date equipment. But the health and dental insurance setup is confusing, and I still don’t understand it. Insurance is through your employer, but many employers don’t offer it. 74 million (23 per cent of Americans) have no dental coverage. People who need treatment can’t access it without spending horrendous amounts of money or getting into debt. The crown I’m getting in a few weeks will cost me a thousand dollars, and that’s as well as the root canal and the two crowns I got a few weeks ago. If you can’t afford treatment, no dentist. It’s mind-boggling and extremely depressing that people here go without because they are in the wrong job or have no savings.

I’ve always been embarrassed about my horsey crooked teeth and was thrilled when face masks were mandated during Covid. The promise of a straight white smile is very alluring, but I dislike this constant pressure from dentists and American culture to have that perfect look. A gorgeous smile is a serious business with big buck potential. If a dentist suggests work, the cynic in me wonders what their motives are. Is it just a moneymaking thing for them, or do I really need the work?

I say, give me the NHS any day.

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