Alyssa Picard . Making the American Mouth: Dentists and Public Health in the Twentieth Century . (Critical Issues in Health and Medicine.) New Brunswick : Rutgers University Press . 2009 . Pp. xii, 226. $45.95.

Abstract

Americans seem obsessed with their teeth. Many commercials, movies, and other media reinforce the desirability of blazingly bright teeth. Alyssa Picard's intriguing social history of American dentistry demonstrates how that fixation symbolizes the evolution of the profession from a social commitment to improving dental health to the cosmetic focus of today. She effectively uses professional literature, limited archival resources, and the popular press to weave a series of thematic chapters into a conclusion that the profession has become less committed to broad access to its services, more conservative and status conscious, and effective in defending itself from government interference. We have come a long way from dentists' hope of improving on the World War II minimum requirement for service that a recruit's six top teeth make contact with six lower teeth (p. 128). Picard covers a great deal of ground as she analyzes a century of dentistry. The book's chapters discuss the early commitment to social dentistry through industrial and school clinics, the connection to the eugenics movement, the resistance to insurance plans and government programs, the campaign to add fluoride to America's drinking water, and eventually the rise of cosmetic dentistry and the diminishment of social dentistry. Picard connects the profession's evolution to broader social issues. For instance, in her chapter on eugenics she describes leading dentists' supportive positions regarding contemporary social views of racial differences and their impact on oral health. That “primitive peoples” sometimes had healthier teeth was explained by correlating advanced civilizations and declining oral health due to greater mental exertion (p. 45). That some dentists embraced eugenics is not surprising, but the profession's refusal to reject such concepts even as evidence mounted regarding the role of diet in oral health is distressing.