What our teeth reveal about growing gap between rich, poor

Teeth are among the most visible markers of poverty—structural circumstances borne by individuals.

In an essay for Aeon, U.S. journalist Sarah Smarsh calls them “poor teeth.” Often, she writes, bad teeth are blamed solely on personal habits and choices, creating undue shame for those living in poverty. Yet poor teeth do more than generate stigma: they compound disadvantage. People with visibly damaged teeth face greater barriers to employment and opportunity.

In an era of “whitened, straightened, veneered smiles,” the gulf between ruined teeth associated with poverty and the healthy teeth of the wealthy continues to widen.

When Medicare’s predecessor was designed in the 1970s, dental care was excluded. Since 2014, Australia’s Child Dental Benefits Schedule has enabled children up to 17 to access free dental care at most private clinics, provided they are eligible for Medicare and part of a family receiving certain government payments.

“Dental into Medicare” became a key Greens policy during the 2025 federal election. While the proposal has sharpened public attention on dental inequality, Grattan Institute researchers reported in late 2024 that more than two million Australians avoid dental care due to cost, and more than four in ten adults wait over a year before seeing a dental professional.

Peter Breadon, the institute’s health program director, describes Australia’s public dental system as both “underfunded” and “overwhelmed.”

In July 2025, the ABC reported that about one-third of Australians are eligible for free or low-cost public dental services. Although these services receive some Commonwealth funding, they are delivered by state and territory governments. ABC data showed that while average wait times vary, some patients wait years for care.

Untreated dental problems can escalate into medical emergencies requiring hospitalisation—or worse.

The consequences of dental neglect intersect with harsh welfare regimes. In the United Kingdom, a stringent “work capability assessment” limits access to disability benefits, similar to Australia’s own assessment system. A book memorialising victims of the UK system recounts the death of a 57-year-old man found alone in his flat. In his cupboard, relatives discovered a shoebox lid containing two large molars and a pair of pliers.

Published in 2014, Linda Tirado’s Hand to Mouth documents life in poverty in the United States: unstable, low-wage work; the hidden costs of late fees; coping strategies; pleasure; and teeth. The title captures both the precarity of day-to-day survival and the shame that leads people to cover damaged teeth with a hand over the mouth.

The book began as a viral online response to the question: “Why do poor people do things that seem so self-destructive?” Tirado’s reply resonated widely, leading to a book deal.

Barbara Ehrenreich, in a generous foreword, positioned Tirado’s account as an authentic counterpoint to her own work, Nickel and Dimed. Declaring herself an outsider to contemporary poverty, Ehrenreich wrote, “But let me get out of the way now. She can tell this story better than I can.”

This principle underpins the 2024 Australian collection Povo, featuring writers who found their voices through workshops run by the Sweatshop Literacy Movement in Western Sydney. The contributors write from lived experience, and teeth emerge as a powerful motif.

In one striking piece, Victor Guan Yi Zhou recounts acquiring tooth gems, four Swarovski crystals – soon after being kicked out by his parents. The gems, he writes, help him “manifest” his dreams, reframing adornment as resilience.

Ahead of the 2023 federal budget, I attended a protest at Prime Minister Anthony Albanese’s electoral office, organised by the Australian Unemployed Workers’ Union. Speakers on JobSeeker and the Disability Support Pension described the struggle to survive on inadequate payments and the fading hope once attached to Albanese’s election.

Despite modest increases, JobSeeker payments remain below the poverty line. Researchers now describe recipients as more likely to be older women living with chronic illness or disability – far removed from the “dole bludger” stereotypes of earlier decades.

At the protest, I spoke with a woman in her late fifties or early sixties who spends two days a week kneeling in bushland, pulling weeds to meet her “mutual obligations.” I admired her hand-painted sign, which is welfare not warfare; and took a photograph.

In it, her mouth is tightly closed. I noticed her chipped teeth.