"A nation of people with bad teeth" was how George Orwell caricatured the United Kingdom in 1940. Nor was he unique in poking fun at the fruits of British dentistry; since then, everyone from Austin Powers to The Simpsons remember the Big Book of British Smiles? has had some mean observation about our molars. But it's a caricature as false as the teeth of many a British granny of yore.
Sloppy diets and buckets of sugary tea might once have been unkind to the nation's gums, but England now shines in international rankings of top teeth. The introduction of fluoride toothpaste 30 years ago has helped England reduce levels of tooth decay among 12-year-olds to among the lowest in Europe. (Kids in Poland, Hungary and Slovakia have five times as many cavities as those in England.) Even Gordon Brown, Britain's new Prime Minister, swapped his own grubby gnashers for pearly whites a couple of years ago.
But there's a new smudge on Britain's winning smile: the do-it-yourself dentist. In a survey of thousands of English dental patients and hundreds of dentists published this month by the government-backed Commission for Patient and Public Involvement in Health, 6% of English patients fessed up to administering their own treatments. One admitted to yanking out 14 of his teeth with pliers; another had used Super Glue to repair a crown. Paul Rowland, a warehouse worker from Derby, in central England, was at least smart enough to take "a good swig of whisky for the pain," before using pliers and thread to pull out his own troublesome back tooth last month, he says. "It hurt like hell for a couple of seconds," 52-year-old Rowland recalls. His post-op pain relief? "Another swig of whisky."
Rowland insists he's suffered no ill effects. And it's only the second tooth he's ever lost as an adult. But why take fangs into your own hands? Like most of those surveyed who owned up to self-treatment, Rowland has found it difficult getting professional treatment, because of a shortage of dentists offering services through Britain's decades-old, taxpayer-funded National Health Service (NHS). There were 21,000 dentists available to NHS patients in England in March this year, almost a quarter more than the number drilling and filling a decade ago although around 500 less than a year ago. Hundreds of dentists quit the NHS for more lucrative private work before revamped NHS working arrangements came into force in April last year.
Nor does today's total reflect the fact that a rising number of NHS dentists work part-time, says Dan Berry, senior policy officer at the British Dental Association. And it doesn't take into account the amount of time NHS dentists are now allocating to private punters. (Dentists are free to do both public and private work.) All told, some 44% of English patients didn't make it to an NHS practice in the last two years, many of them unable to afford private care. "That," says Berry, "is the real gap." The government insists the shakeup of the NHS system in April 2006 which handed local public health trusts the power (and cash) to decide where demand for a new practice is most acute is confronting that problem.
But for now, many prefer to fend for themselves rather than live with pain while they wait for treatment. Dentanurse, a central England-based purveyor of dental products, says sales of its First Aid Kit for Teeth complete with "specially formulated temporary cement" for your own running repairs have doubled in the last five years, thanks in part to patients' problems getting treatment via the NHS. The kit was good enough to keep one woman's four-tooth bridge in place for five months while she waited for an appointment with a dentist, says Jenny Lees, Dentanurse's managing director.
As for pliers-man Rowland, his hunt for a local NHS dental practice continues. When one did open for business a couple of years ago, it drew a line of prospective patients a mile long. "When I saw the queue, I thought no chance." Rowland says. "But," he adds, "I will always try."