Smashing stereotypes

17 December 2015
Volume 31 · Issue 6

A new study has smashed the cultural stereotype that people in England have terrible teeth compared to their American counterparts.

In fact, the research – the first analytical study ever to compare levels of oral health and oral health inequalities between England and the US – suggests there are consistently wider educational and income inequalities in oral health in the US compared with England.

Additionally, the mean number of missing teeth was significantly higher in the States.

The English population has long had an international reputation for having poor oral health and rotten smiles, much mocked within US culture.

Examples include Hollywood character, Austin Powers, and his discoloured, crooked smile and an episode of The Simpsons, in which a dentist scares a young patient into better oral hygiene by exposing him to a horrific publication called The Big Book of British Smiles.

But, the research team – based both in the UK and the US – assessed oral health measures and socioeconomic indicators, using data from the English Adult Dental Health Survey (ADHS), and the US National Health and Nutrition Examination Survey (NHANES).

The study – published in the Christmas issue of the BMJ – showed that the mean number of missing teeth was significantly higher in the US (7.31) than in England (6.97), while reporting of oral impacts on daily life was higher in England.

There was strong evidence of significant socioeconomic inequalities in oral health in both countries, but these inequalities were consistently higher in the US than in England for all the measures assessed.

President of the British Association of Dental Therapists, Fiona Sandom, said: “Whilst welcoming this new study that destroys the reputation we have for poor dental health and confirms that it has come on in leaps and bounds recently, there does remain major inequalities across the country.

“The Marmot Review into health inequalities in England highlighted the social gradient of such health inequalities, which are obviously largely preventable. We now need a joined-up approach to securing further improvements to the nation's dental health and the BADT will continue to add support to the numerous campaigns aimed at improving children’s tooth decay figures, especially in those areas of deprivation.”

According to figures from the British Dental Health Foundation, 61 per cent of adults in England now attend the dentists regularly – in 1978, this was just 44 per cent.

To read the full report, visit http://www.bmj.com/cgi/doi/10.1136/bmj.h6543