With Teeth

Marker, felt tip pen on paper

Sam Paul

My mother is screaming and crying on the phone. Her voice shakes with rage. 

“You’d be so pretty if you’d fix your teeth,” she stammers. “But you don’t care about being pretty.”

She sounds ridiculous, like I imagine I sounded in the fights we had when I was a teenager—emotional and seething and somewhat incoherent. But I am crying now, too, because of course I care on some level.

Even at 36, I can’t help but care that my mother is saying that I’m not pretty, saying it so emphatically and so loudly that I can hear her when I pull the phone away from my ear without placing her on speaker.

I care that she is saying that my teeth—with their slight overbite and a less slight gap between the front two—tell everyone that I am poor, that my life has been hard. That this, unequivocally, is the first thing that people notice about me.  

I care that maybe—even though I would not consider my teeth much at all if she did not bring such constant, biting attention to them—she is, to some extent, right.


The standards we have for people’s teeth are a relatively recent development. Until the early twentieth century, it was not common to reach adulthood without some that had gone missing or become uneven.

But, in the 1930s, during the golden age of Hollywood glamour, Charles Pincus popularized a powdered plastic and porcelain mixture to form snap-on caps, known as veneers, for actors. Judy Garland and Joan Crawford were some of his notable patients.

Over time, dentists learned from Hollywood and the influence of popular women’s magazines, combined with post-war prosperity, began to redefine how women approached the care of their teeth.

As preventive dental care addressed middle- and upper-class people’s concerns, and the need for necessary invasive dental care lessened, cosmetic dentistry slowly blossomed.


From before I was born until I was in my late teens, my mother avoided the dentist. She went for years, maybe decades, without dental care. The more time passed, the more afraid she became.

“I knew I had so many problems,” she told me. “I considered killing myself instead of going.” 

My father coaxed her and coaxed her, until she could no longer deny her aching need. Since then, she’s gotten Invisalign braces twice.


In 1983, John Calamia, a professor at New York University, helped invent and popularize contemporary porcelain veneers, which last much longer than the Hollywood version. He published scores of articles to help spread the word of his invention. His innovations caught on, influencing aesthetic ideals and expanding possibilities for many people.

Enlarged and over-white, Europeans of the time made fun of the stereotypical American smile. Still, these standards for white, filed, and even teeth spilled abroad slowly. As in the US, by the 1980s, broken and discolored teeth began to be viewed as marks of poverty in Western Europe. And, as braces became more popular in the 90s, it grew uncommon to see a young person with uneven teeth.


My father was the one who took me to the dentist. Terribly and debilitatingly agoraphobic, he barely ever took me anywhere else.

We moved a lot. Another side effect of the untreated PTSD, my parents never seemed to be happy no matter where we lived.

But my father and I kept the same dentist, Dr. Schwartz, who had a tiny practice in Blairstown, New Jersey. We drove more than an hour to see him at times. I enjoyed those drives, which were the longest stretches my father and I spent together. He’d sing along to the radio, and we’d laugh.

I wish I could remember the songs and the things we talked about, but I just have flashes and wisps: going west on Route 80, getting off on exit 12, and driving the twisting, hilly roads that passed corn fields on the way to Dr. Schwartz’s. My father’s cigarette smoke and his hair both blowing in the wind.

I do remember that he was proud every time we left the office, my mouth always predictably cavity-free, and that sometimes, before he dropped me back off at school, we’d stop for McFlurries.


Teeth are potent markers of wealth and success. As people attempt to replicate the habits of celebrities, conventionally attractive smiles have become an indicator and, perhaps, a portent of prosperity.

An oft-cited study by dental clinics and Invisalign providers surveyed Americans about their perceptions of others based on their smiles. Overwhelmingly, participants equated those with straight teeth to be more successful, wealthy—and even more trustworthy.

The other side of the same coin: in Teeth, Mary Otto writes, “In the way that they disfigure the face, bad teeth depersonalize the sufferer. They confer the stigma of economic and even moral failure.”


 Something else I remember:  When I was very young, four or five, every night before bed, my father would watch me brush and floss and rinse. Then, I’d walk from the bathroom to the couch in the living room and climb onto its arm and up onto my dad’s back. It was sturdy as I pressed my face into his black and gray hair—a full head he had always been proud of—that smelled like his True menthol cigarettes. He’d take me to bed, where I slept until I woke up to brush again in the morning.

An otherwise attractive man with strong arms and unwrinkled skin, my father’s teeth were misshapen and discolored. The lack of Fluoride in the water in his youth, the coffee, the cigarettes, the three years spent in the service during Vietnam had taken their toll.

He made sure I brushed every night, that I didn’t eat much candy, and that I gargled with warm salt water every time I lost a tooth. He was invested in the care of my teeth, wanted better for my young mouth.


Reading the reviews on Goodreads for Teeth, I see one from Jessica, who gave the book two stars. “I always notice people’s teeth – it’s something I learned from my dad,” she writes. “And as Georges Cuvier is credited with saying, ‘Show me your teeth and I will tell you who you are.’”


I chipped my front tooth for the first time when I was in second or third grade. I was standing at the counter at the house we lived in in Hope, New Jersey, eating a goldfish cracker. It was not an especially meaningful or memorable experience. It didn’t hurt. I wasn’t missing an exceptionally large amount of tooth and what remained was not jagged or mangled and I am not exactly sure how or why it happened, just that I had it bonded the next time I went to Dr. Schwartz and that the bonding lasted until I was about 25.


In the late 1790s, using their molars as a point of comparison, Georges Cuvier distinguished Asian and African elephants, mastodons, and mammoths as different species for the first time.

From these teeth—with their differing ridges and textures—he was able to envision and eventually establish the existence of animals who had once and no longer walked the earth. In doing so, he pioneered the concept of extinction.


Another elephant in the room: my overbite and most likely my gap resulted from the fact that I sucked my thumb much longer than I should have. In order to conceal this, I hid my head under blankets at sleepovers and at camp. My parents covered my thumb with some solution to make it taste bad in hopes I would stop. It tasted bad, but I sucked it anyway.


Like the growth rings on trees, our teeth have microscopic lines that tell our history beginning before birth.  

In the womb and into adolescence, cells called ameloblasts secrete enamel.  Following our circadian rhythms, over a 24-hour period, they leave tracks called enamel prisms: tiny cross-striations that mark our days. Over longer periods, they create Retzius lines, which form rings around the whole tooth. You can see the period marked by Retzius lines by counting the prisms between them.

The spaces between neonatal lines in primary teeth can indicate whether a baby was born prematurely or still. They can indicate children’s rates of growth. In fossils, they have helped determine how quickly our ancestors matured.

We have all read by now that the body keeps the score. Teeth, it turns out, literally carry tally marks.


Basically everything had gone wrong by the time I was 25. After my mother left and moved to Queens, my father sold the house we’d all lived in together in New Jersey. He moved to a trailer in Nebraska and clearly wanted to come back to the east coast, but money and circumstances didn’t seem to provide any means by which he could do so. My mother was working in publishing, eking out a living.

I’d been out of college for three years, had defaulted on my student loans, and was working as a bike messenger. 

One morning at work, riding towards the Williamsburg Bridge from SoHo, I caught the wind and a crack in the pavement at just the right angle and just the right time and found myself floating over my handlebars before falling hard onto the ground. I broke my elbow and, biting down, lost the bonding I knew was never meant to last forever.


The lines in our enamel tell stories of our birth and our youths, our very formation.

As we get older, we stop making new enamel, but cementum—the hard layer of tissue that helps the ligament attach to the tooth—continues to grow. In it, we can find a record of major life events. Examining teeth alongside a subject’s life history, a team of researchers identified markers that correspond to major prolonged changes such as becoming a mother or going through menopause or significant bouts of illness. Markers even indicated changes we see as more emotionally impactful like big moves or periods of incarceration.


The year my front tooth was chipped, most of my friends were bike messengers, which is a profession that is not especially kind to teeth. Messengers are much less likely to have insurance and much more likely to have faceplanted onto the concrete recently than the general population.

Two of my best friends were missing their front teeth. Some had had multiple implants. One friend, a beautiful girl, who at one point had a particularly terrible accident, had a dental plate she would remove at parties to reveal her toothless smile.

It was a scene, one that I was thoroughly enmeshed in. And before that, I’d been into hardcore and punk music. I’ve always cared about my appearance to a degree, but maybe less about markers of class status, and I suppose this extended to my teeth.

For my 26th birthday, my mother effusively offered me the gift of the dentist, something she likely couldn’t really afford. She emailed me weekly for months to insist that I go. “You never smile in pictures,” she wrote me. “I remember when you’d always tilt your head to the side and smile your toothy grin.”

Reading those emails now, I see she offered to rent a car and drive me to Dr. Schwartz, who would have been cheaper than the dentists in the city, but I refused. She had recently been offered an apartment off of the Mitchell Llama housing connect lottery and had considered making arrangements for my father to move into it. When she saw the apartment and the neighborhood it was in and what it would cost, she didn’t follow through with the plan.

My heart was broken. I couldn’t imagine driving the hour and a half to Dr. Schwartz’s office with her, somewhere she had never driven me, the one place my father always had.

Instead, if I was going to go to a dentist, I selfishly insisted that I go to hers in the city, which turned out to be more like a Medspa on Park Avenue. He bonded my teeth and urged me to come back for a deep cleaning, an appointment I never made. His office emailed me for years about the dangers of smoking and my declining gum health and to wish me a happy birthday and to send wishes for various holidays and occasions.


Just as Cuvier determined so much about our world through the fossilized teeth he found, modern evolutionary scientists and archeologists use teeth to construct histories of individuals and humanity as a whole. 

Teeth evolve slowly, changing little over generations. They are also hearty and are some of the most likely remains to be preserved. And they have the potential to tell us so much.

Scientists have used dental remains to tell us about the earliest humans and the relationships between our species and archaic homo sapiens, homo erectus and Neanderthals, considering the ways in which these species intersected and diverged geographically and genetically, tracing their lines from Africa through Europe and Asia.

With teeth, our view of early human history continues to develop. A jawbone found in 2019 in Tibet and a molar in Laos in 2022 helped to determine the path of another one of our ancestors, the Denisovans, the population that spread to the east when Neanderthals spread to the west. These findings helped bridge decades’ old gaps in knowledge.


My father spent ten years in Nebraska. Our relationship was limited to the phone—long meandering conversations about books and history, about my present and his past. 

He was afraid to fly for many years until, one day, to my surprise, he agreed to visit.

I didn’t recognize the man who arrived. My father was strong and robust. The man who exited the black cab was old and thin. His pants sagged. Instead of the aviators I remember, he wore big, black post-cataract surgery sunglasses with panels on the side.

When he smiled, I saw that the teeth he had left were spotted and many were missing—in part, a side effect of his uncontrolled diabetes.

I had changed so much in ten years, but I expected him to remain the same.

The other changes were good ones. He was at ease as we walked through the streets and went to restaurants, able to be among people in a way he never had been before. I tried to focus on the growth and not the degradation, the fact that he was there and not the fact that it seemed like the time that he would stay felt so finite.

I only saw him one more time.


Our teeth are sensitive to our environment—so much so that scientists can use them to determine the weather a subject lived through. Studying primates’ fossils, the marks of enamel formation can show weather patterns and help determine what their world was like. The way teeth are formed can provide information about wet and dry seasons, about nearby flora and fauna, about altitude and the moisture in the air. 

Fossils of baboon’s teeth recorded drought and rainstorms, where their owners preferred to feed, and how humans influenced their landscape.


It’s funny now that, in my father’s absence, my mother has taken up the torch of my teeth—albeit in a way that he never did.

I know that her scathing insistence is also a form of care. It is a screaming care. A hurtful care. A care that makes me catch on my words midsentence if I hear the faint sound of a lisp she mentioned as a jab. But it is also a care that is massive and real and wants things for me that she didn’t have, or earlier than she got to have them. I am lucky to have had his care, and I am lucky to have hers.

What is unclear is what it means to care for myself. 


I am settled now, insured, fortunate. I take myself to the dentist, where my cleanings are covered. I do not have to navigate the twisting labyrinth that is receiving dental care while poor.

I am also white, as are 70% of dentists living in the US. 

When I was 22 and on Medicaid, I had to get my wisdom tooth removed. The dentist, a white man, told me that my provider wouldn’t cover any sort of anesthesia for the procedure. He looked at me and said he wouldn’t let someone take out his daughter’s impacted tooth without at least twilight sedation. He covered the cost for me. I know this is unspeakable privilege.


I have never known my teeth without their gap, although my mother is right in that it has widened. My teeth have never been perfect, but they have always been mine. Mine when Eric Mason, a rich, round boy I’d never met before, told me I looked like I’d never received any dental care when I was 17. Mine when my mother screams. Mine when my father taught me to tend to them and when Dr. Schwartz quietly asked if I’d started smoking. Mine when I finally quit, in part thanks to seeing my father’s ravaged smile. Mine when I care for them begrudgingly each night before bed.


This is not a Sheila Heti-style rumination on whether to get Invisalign. Because I should probably get it. I should probably fix my smile—even if I’m not sure that I will. It is hard enough to get by without adding to the deck that’s stacked against you.


Still, it’s a shame. Our teeth carry so many marks. They have the potential to show us so much about who we are, but we try so hard to make them all look the same.

Sam Paul is a writer of nonfiction, fiction, and criticism. She’s a graduate of the New School and NYU. She’s a frequent contributor to the Feminist Book Club blog and her work can be found in a variety of publications including Esquire and Fourth Genre. She lives in Brooklyn.

Artwork: “Girls Portraits” by Kateryna Bortsova

Marker, felt tip pen on paper

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