John Adams' misplaced celebration of America's dental achievements.

Health and medicine explained.
March 17 2008 2:36 PM

For Teeth and for Country

John Adams' misplaced celebration of America's dental achievements.

John Adams. Click image to expand.
Sean McKenzie and Tom Wilkinson in John Adams

In John Adams, HBO's seven-part miniseries about America's second president, the producers have rendered each scene with as much historical accuracy as time and money will allow. The cottages have small windows and low chimneys; the lamps and fires glow with era-appropriate candlepower; the horses bear the saddles of the period; the food looks as scary as 18th-century farm vittles should; and the costumes are American Girl-worthy. Everywhere you look, it's award-winning verisimilitude. Except for one wee oversight.

Teeth. All of the actors have glorious 21st-century show-biz teeth.

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This problem, of course, is a familiar one: All of Hollywood has significant unresolved dental issues. Famous actors are eager to embrace all manner of abuse. They gain weight, they lose weight, they smoke cigarettes, they sport awful hairdos or shave their heads. And yet on TV and in the movies, an actor must never be asked to traverse the Dental Curtain: The pearly whites must never be scuffed or dented. Hollywood's systematic denial of dental reality is an example of its elevation of glamour over truth, thrill over drab.

Perhaps, though, something more is at play in John Adams. Maybe the faux dental presentation is a deliberate extension of the patriotism implicit in the miniseries. In the 21st century, even as the United States' status as a world power is wobbling and our cultural and moral authority erodes, we can still be proud of our dental heritage. Our teeth stand tall compared with those of our friends in the European Union (and Asia and South America and everywhere that is heartlessly crushing our dollar). Our molars are better than their molars.

The anachronism of the John Adams dentistry, however, is particularly striking because the miniseries features prominently the beloved and edentulous father of our country. The actor who plays George Washington, David Morse, is fitted handsomely with replica uniform, balding pate, faint (Scottish?) accent, appropriately soaring height—and standard-issue blinding California chompers. Yet George Washington's bad teeth are almost as legendary as his Delaware crossing. You can see the consequences on the dollar bill in your wallet, courtesy of Gilbert Stuart's portrait. Look closely at Washington's jowls. Keep in mind that he was a tall, gangly guy, not a pudge—yet these are the cheeks you'd expect on Babe Ruth or Jackie Gleason. A comparison of the dollar-bill image with the original Stuart portrait shows an even more swollen and dentally discomfited first president.

Washington's cheeks are swollen because, due to his rotten teeth, he developed the predictable lymph-node swelling that occurs in response to any chronic infection. This gives him that unsettling chipmunk look. (Physician disclaimer: Mine is a Sen. Frist-style eyeball diagnosis—I personally never have examined Mr. Washington.) Washington's teeth reportedly began to fall out when he was a young man. By the time he finished his presidency, he had only one remaining. The rumor that his replacement teeth were wooden, by the way, is false. Rather, the First Dentures were made of "hippopotamus and elephant ivory, held together with gold springs. The hippo ivory was used for the plate, into which real human teeth and also bits of horses and donkeys teeth were inserted." (The intrepid can visit a part of his dentures.)

In the centuries since, American dentists have taken us far from those bad old days. Their European counterparts have not been as stalwart. Those suave Europeans just don't get it. Teeth, after all, are more than a cosmetic attribute—they are essential to human nutrition. What is the difference between a Green Bay Packers lineman and a fleet-footed wing on an EU soccer field? I mean, besides the steroids and the personal trainers and weight-gain shakes? Teeth. Our guys can chew anything. Teeth are what give us American muscles, if not American muscle.

Consider this: During World War I and World War II, bad teeth were among the most common reasons for exclusion from the U.S. military. According to one study, about 15 percent of men seeking to enlist were turned away for dental reasons. The military viewed good teeth as such a necessity that enlistees were required to have 12 opposable teeth arranged as follows: "a minimum of 3 serviceable natural masticating teeth above the gum and 3 below opposing; and 3 serviceable natural incisors above and 3 below opposing. Therefore the minimum requirements consist of 6 masticating teeth and of 6 incisor teeth." Our boys needed to chew, to eat, in order to stay alive.

Soon after the end of World War II, the country's public-health experts persuaded most states to adopt routine fluoridation of water, an intervention that resulted in a 68 percent reduction in cavities and other types of decay. This achievement is so highly regarded that, in 1999, when the CDC listed the 10 greatest public-health achievements of the 20th century, fluoridation of water was right up there with standard favorites like vaccination and seatbelts.

It's inexplicable that the heroes of this great American triumph—the dentists—remain consigned to the sidelines and punch lines of history. Perhaps we have forgotten our snaggletoothed past because we're too busy seething at that dentist who gave us a lousy filling or painful implant. And perhaps the effort expended to pump up one dull overlooked hero, John Adams, so exhausted the show's producers that they can be forgiven their failure to promote another dull virtue: the value of dentists, flossing, and brushing after meals.

Kent Sepkowitz is a physician in New York City who writes about medicine.

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