What our teeth reveal about the growing gap between rich and poor

Teeth have increasingly become a visible symbol of inequality, exposing how structural disadvantages show up in people’s bodies long before policymakers acknowledge them. Dental health now sits at the intersection of class, public policy and stigma – and the divide between those who can afford regular care and those who cannot continues to widen. 

In an essay for Aeon, US journalist Sarah Smarsh described the concept of “poor teeth”. She wrote, "Often, bad teeth are blamed solely on the habits and choices of their owners, and for the poor therein lies an undue shaming […] Poor teeth […] beget not just shame but more poorness: people with bad teeth have a harder time getting jobs and other opportunities."

Her words resonate more today than ever, as “whitened, straightened, veneered smiles” become a cultural norm.

A system that excludes dental care

Australia’s dental crisis is not new. When Medicare’s precursor was established in the 1970s, it specifically excluded dental care – a decision that continues to shape outcomes.

Public support expanded slightly in 2014 through the Child Dental Benefits Schedule, which allows eligible children to access free care at many private clinics. During the 2025 federal election campaign, the Greens pushed for “Dental into Medicare”, prompting a national conversation about the cost of dental treatment and who gets left behind.

Yet the Grattan Institute warned in 2024 that more than two million Australians avoid the dentist because they cannot afford it, and over 40% of adults wait more than a year to be seen.

Peter Breadon, the institute’s health program director, has argued the public dental system is “underfunded” and “overwhelmed”.

Years-long waits for care

Around one-third of Australians qualify for free or low-cost public dental services, according to ABC reporting in July 2025. These services rely on Commonwealth support but are run by states and territories.

Access, however, is far from guaranteed. The ABC obtained data showing wait times can stretch into years in some regions. Untreated dental problems often escalate into emergencies, pushing patients into hospital – or worse, leaving them to manage pain alone.

One account from the United Kingdom underscores the stakes. A recent book documenting deaths linked to the UK’s strict “work capability assessment” includes the case of a 57-year-old man whose family found two large molars and a pair of pliers in a shoebox lid in his cupboard.

Lived experience as testimony

Stories about dental inequality frequently emerge from those who have lived it. Linda Tirado’s 2014 book Hand to Mouth grew out of a viral online post responding to the question: “Why do poor people do things that seem so self-destructive?”

Tirado’s writing – candid, sharp and often darkly funny – chronicles the realities of low-wage work, parenting on the edge of poverty and the daily compromises she and her husband made. The title of her book plays on the fragility of day-to-day survival and the instinct to cover one’s mouth to hide damaged teeth.

Barbara Ehrenreich, who wrote the foreword, called Tirado’s account the authentic version of the poverty she had attempted to document in Nickel and Dimed. Ehrenreich wrote that she had been “waiting for this book” and ultimately conceded: "But let me get out of the way now. She can tell this story better than I can."

This shift – from reportage to direct testimony – is growing. Digital platforms have enabled people living in poverty to bypass traditional gatekeepers and speak for themselves, highlighting local struggles and systemic failures.

Teeth as symbols in Australian storytelling

This evolution appears again in Povo, a 2024 collection featuring writers from Western Sydney who developed their work through the Sweatshop Literacy Movement. One of its standout pieces centres on tooth gems, described in the line, "Plot twist! Got them at a salon… right after Mum and Dad kicked me out. Four of them. Two on the top canines. Two on each incisor. Crystal Swarovski. USD 150 all up. Each gem will help me manifest my dreams."

The narrator’s bright gems clash with the surrounding hardships, underscoring how dental aesthetics can carry personal, cultural and economic meaning.

At a protest outside Prime Minister Anthony Albanese’s electorate office in 2023, speakers on JobSeeker and the Disability Support Pension described life on payments still below the poverty line. One JobSeeker recipient – likely in her late fifties or early sixties – recounted spending two days a week kneeling in the bush pulling weeds to meet “mutual obligation” requirements.

Her handmade sign read: “welfare not warfare”. In the photo taken that day, her mouth is firmly closed. The chipped teeth she kept hidden told their own story. (The Conversation)