The Big Book of British Smiles

There are times when I'm astounded by the cultural acuity of some our 'special' relations, the Americans. Recently I came into contact with a group of US exchange students through work. We met and broke the ice by making small talk, as you do.

"How are you enjoying your stay in the UK?" I enquired. A predictable opener, but you've got to start somewhere. After commenting on the miserable weather (fair point I thought), they turned their attention to the British populace.

"Your teeth aren't as bad as I expected them to be", one of them chipped in, and the others tipped a synchronised nod of agreement.

"What was she wittering on about?" my inner voice demanded of my grey matter (it didn't have a clue incidentally). The Brits are renowned for exporting football hooliganism, underage (and overage for that matter) binge drinking and grudgingly providing a cushy refuge for a parasitic, out of touch monarchy, but I didn't know we were in any way defined by the state of our knashers.

It would also likely be news to the highly astute Swiss guy who characterised us as follows...

Being British is about driving in a German car to an Irish pub for a Belgian beer, and then travelling home, grabbing an Indian curry or a Turkish kebab on the way, to sit on Swedish furniture and watch American TV shows on a Japanese TV. And the most British thing of all? Suspicion of anything foreign.

(Swiped from an email circular I received. The original source is believed to be a British tabloid rag)

As diplomatically as possible I asked Dolly, Britney or whatever the air-head's name was what she meant. Big surprise! She couldn't tell me, despite being certain that the British somehow have 'bad teeth'. After an awkward, shifty-eyed moment or two we moved on.

Ever since I've been wracking my brains trying to come up with an explanation. In case you didn't know, the UK is part of one of the richest, most well developed continents in the world. Our health care system leaves a lot to be desired, but - believe it or not - we do have the odd qualified dentist knocking about the place (often in a luxury sports car though that's another issue). So why on earth should the teeth of British people be markedly different to those of Americans, or at least appear that way to foreigners?

My best theory so far concerns the dissemination of British history in American schools. Could it be that the Elizabethan period is the only one covered? Let me explain; it was during this time when the sugar trade spun into overdrive, having first been imported to England from the Atlantic island of Madeira in 1319. Because the availability of super-sonic jets, helicopters and speed boats was limited, any goods that had to be shipped from abroad cost a small fortune, and consequently could only be indulged by the upper classes and nobility. Said toffs got hooked on the stuff and - in the absence of sensible hygiene practices - sure enough their teeth turned black. Rotten teeth soon came to be associated with wealth, hence they were seen as a status symbol; something for the rich and poor alike to aspire to. This wacky fashion fad became so pervasive that people would actually have their teeth artificially discoloured to convey an air of sophistication. I kid you not.

In 1598 a German traveller by the name of Paul Henter popped round to Queen Elizabeth I's pad for tea. I expect he couldn't help noticing that her mouth had become a festering, abscess-filled cess pool populated with putrid stumps which presumably had once been teeth. Nevertheless he was more subtle than me (the wimp was probably fretting over losing his precious head to the blade of a guillotine) and so only cautiously pointed out that her teeth were black, "a defect the English seem subject to, from their too great use of sugar".

Could this single quotation account for the British bad teeth myth? Probably not; our propensity for sugar is apparent throughout history. For instance, Charles Dickens makes reference to it on 102 separate occasions within his collected works. Dickens' novels, which indubitably feature a statutory levy of dentally-challenged street urchins and undesirables, have since been turned into screenplays and exported to the far reaches of the globe. This can't have helped to diminish the cement-like bond between the English in particular and rotten teeth.

In any case, to make sure I wasn't missing some unique feature of the American way of life that serves to specifically protect the teeth of its inhabitants I set about comparing the World Health Organisation's oral health data for both the US and the UK (yes, it's been a very slow day). I shouldn't have been in any doubt; after all Americans consume more sugary, nutrient-deficient gunk than any other nation on the planet (their supermarkets are death-traps - I know, I've shopped in them) so why should we expect their teeth to be in superior shape? In reality they're not, evidenced by the fact that tooth decay is the second most common disease in the United States. Tooth decay is actually a huge problem globally, but that doesn't detract from the home truth that it's no less of an issue in the US.

To demonstrate this we can compare the DMFT (an indicator of the prevalence of Decayed, Missing and Filled Teeth) statistics between countries. For 12 year olds living in the UK this equates to 0.9, while the figure for 12 year olds living in the US is 1.75. The global average is a marginally healthier 1.61 (source). The significant caries index is a more recent yard stick used to assess the extent of tooth decay. The 'SiC' Index for 12 year olds living in the US is identical to that of 12 year olds living in the UK (when the figures for England, Ireland, Scotland and Wales are averaged) (source). This 'disparity' is hardly grounds for bundling us all off to Ripley's Believe It or Not! Maybe the abundance of oral cancer is a better predictor of general mouth ickiness, and the Americans run rings around us in that department. Nope, the figures don't bear this out either. The US has an incidence rate of 1.66 per 100,000 people (source), whereas the UK average is 1.035 per 100,000 people (source).

That's settled then. Americans are watching black and white period dramas set in Blighty in days of yore, and shrewdly intuiting that the closest we come to encountering modern dental care is wrenching out owie chompers with a length of string and a slammed door. Cor blimey guvnor, I think I've cracked it! Would you Adam and Eve it?

Of course we've been stereotyping the Americans for years so you could say we deserve what we get. I disagree; it's perfectly fine for us to pigeonhole them because our labels are founded on genuine observations garnered through personal experience. I won't apologise for drawing conclusions from the fact that a hefty chunk of the US electorate voted George W into office, twice!