Asymmetrical Information

I have an answer for this one! I have several friends from various parts of europe and they all say the same thing, it's a matter of priorities. (yes, sadly enough I've had this conversation before).

In England, for example, the important thing was to have your teeth, not how white/straight/even they were. So while Austin Powers doesn't have pearly whites...his teeth are all there. Same is true in most european nations. Braces are not for cosmetic reasons, they're for people with really severe bite problems.

As American TV has proliferated european culture, people have become more aware of visiting the dentist for whitening/straightening etc.

The other thing you have to keep in mind is that National Health Care never covers "elective" procedures. Just as you can't go to London and require their plastic surgeons to give you a breast enhancement on the government teet, neither can you request your teeth be made prettier by the local densist. You have to pay for it yourself.

If no one else in your country cares that your teeth are brown and crooked, then why should you spend the cash?

So that's the theory I've established. Lets see what the others are.

Don't knock UK teeth. God knows why, I find British Isles' girls' teeth downright sexy. ;-)

So, uh, to answer the question: Brits keep their "natural smiles" intact for fellas like me.

Also, if I remember correctly those little bits of history that noone ever needs to know, a couple of hundred of years ago, you could tell how rich or poor a person was by their teeth. People who had money (i.e. Aristocracy) had horrible teeth, mainly because they could afford such niceties as sugar. (the stuff that really makes the teeth rotten) while the poorer people (i.e. surf, farmers, etc.) had healthy teeth because they couldn't afford sugar..even if they grew it!) Also, a little FYI, rich people rarely took baths either...covering the body odor with awful perfumes. While the poorer people were much cleaner (even though they feared water) because at least they would wash themselves down from a bucket of water and lye soap. So, I reckon that's what he was talkin' about.

I don't know what part of the US you are in, but...I grew up, fairly poor, in upstate NY. We didn't have dental insurance and couldn't afford dentist visits. My teeth suck. Now that I have insurance I'm making up for years of neglect, but your argument is absurd. Do the homeless guys, freezing on the streets of American cities have better teeth than the British middle class?

It might not be fair to compare our homeless to Britain's middle class...

Jack - Jane's arument is not absurd just because her imprission of the average dental health of Americans differs from yours. It's just a difference that is most likely based on different experiance.

I spent two years in Italy in the late 1970s. At that time, my impression was that the average Italian's dental health was quite poor compared to the American's in my home town(a rural town). Many Italians that I met had not just "natural smiles" of the kind that seem to please some of the other posters, they had teeth missing from decay. Many had lost teeth by the time they were in their early twenties. I have no idea whether this was an accurate perception nor do I know whether it would still be true today.

Homeless people have problems with health care access, but they are due less to lack of money than the mental or drug abuse problems that have landed us on the street. The homeless families I used to work with who had shelter, however, had teeth no worse than what I've viewed on your average suburban street. And my family's from Upstate New York, strictly blue collar, has no dental insurance, and yet their teeth are fine. I, on the other hand, have the kind of gap in my front teeth that they used to paint on the hillbilly character on television in the sixties. I'm perfectly open to the idea that it's observation bias, but I'm not the only person who's observed this, including one friend who grew up in Hell's Kitchen.

Speaking as an English person with an an ordainary set of English teeth [healthy, slightly crooked, off white] living in America, with 2 children with ordainary American teeth[healthy, straight, blindingly white], the difference to me is obvious. It's $10,000. Only in America have Orthodonists been able to persuade the middle classes that having a set of perfect white tombstones is 'natural'. I hear the joke about English teeth about twice a week and its just as funny after the 6000th time.

fluoridated water

:)

---How come our poor people have better teeth than Britain's middle class, when they have nationalized health care?---

Wow. That question answered itself.

I tend to think it's culturally based, as Kate mentions.

Think of many Latin American nations (Argentina and Venezuela come to mind) where the population is generally much poorer than the US yet their physical appearance (yes, based on my personal observations and preferences) is better. Even though they are poorer social pressure or preferences leads them to spend more on appearences, which includes their weight and their teeth.

Yet I would never argue that their healthcare systems are anywhere near those of the US.

Heres some more thoughts:
1. All European countries have permanently, heavily, fluoridated systems. This does massively reduce dental cavities but does stain teeth. Certain bleaching products widely available and used in the US are illegal in the EU as they contain substances only available under prescription.

2. Non Emergency Dental care is not covered under most European health systems.

2. A quick walk round your local trailer park should quickly disabuse you of the belief that the American poor have better teeth than the English middle classes.

Apart from Mark's third point, which I think is quite valid, I'm going to hazard a guess that the dentists simply haven't gotten to them like ours have.

Just think, how many of you remember lectures in school about dental hygiene? I do. (I've got awful teeth, though.) Do Europeans have the same pseudo-governmental and educational emphasis on dental hygiene? I'm guessing that Chinese society doesn't -- my Pop's had really bad teeth before he got dental religion.

What is more interesting to me in the comment is the condemnation of "indiscriminate hiring and firing". Sounds like a prescription for stasis, and eventual stagnation, to me. For some, the pipe-dream of central planning will never die.

Klug - Yes they do. I even remember television commercials from my youth about brushing teeth. I'm going to re-emphasise this. This isn't about dental hygiene, despite the relentless jokes and Austin Powers, Europeans have teeth as healthy as Americans, and generally visit dentists as often. They just haven't succumbed to the cosmetic dentistry thing, not even many television and movie stars. My wife and I always talk about David Bowie in terms of "Old Teeth" vs "New Teeth" eras. Old teeth was pre 1996 (approx) when he suddenly appeared overnight with a set of American style tombstones.

Will - This isn't a 'central planning' thing, just a reflection that in Germany, like most European countries, workers still have rights, such as grievance procedures, a reasonable termination period and compensation and that employment is a two-way contract. Despite widely-held American beliefs, Europe does have a pretty dynamic labor market [Unemployment in the UK is running at about 2% at the moment]

Well, to characterize the UK as typical of the European labor market isn't exactly accurate. Look, what you call "worker's rights" is simply the ability of one faction in society to use state power to impose it's will upon another faction which has been less successful in lobbying the state. You think this use of state power to have one faction in society force another faction to behave in a way that they would not voluntarily agree to do is a good thing. Fine. Don't pretend, however, that having the state greatly restrict the ability of private parties to find MUTUALLY suitable contracts does not represent an element of central planning, or that such a regime does not inhibit economic dynamism.

I agree that Germany is burdened by reconstruction and the economy is subdued.
On the concept of mutually suitable contracts without some state intervention, I would say that it is simply a fantasy. For most employees, the employer holds all the cards. A labor contract upheld by the state simply mitigates the disruption to society that occurs when employers cut costs through labor reduction.

Employers hold all the cards when the labor is unskilled and easily replaced. When the labor is very difficult to replace, employees hold most of the cards. Go talk to the chairman of American Airlines, a firm which has had to squander billions in stockholder value, and perch itself on the brink of bankruptcy, before it has gained any leverage with employees. You believe that the state must set the terms, in a very specific way, of employer/employee relationships, in order to have society function well. You believe in central planning, just as the supporter of agriculture price floors does. Central planning, however well intentioned, how fervent the desire for "fairness" is, inevitably inflicts costs on everyone. The costs are sometimes worth it. 100 %central planning in pursuit of national defense is unavoidable, because there isn't any alternative, and it isn't an option to not have a national defense. Some aspects of society, like transportation, are a mixed bag. The degree to which it is necessary to have the state dictate the terms of employer/employee relationships, however, is a far more debatable issue.

One word - Fluoride. Most of Europe, to my knowledge, does not have fluoride in their water. Lousy dental care on the part of Europeans have nothing to do with their economy.

I could be wrong though.....

I spent time living in Italy in 90 and 93. Dental care there is a joke. My wife went to an English dentist in Milan who was doing very well correcting the incompetent mistakes perpetrated by the state run dentists.

Doctors were just as bad. A family doctor we saw had a one room office/examining room. The waiting room was the hall. He had no nurse and no receptionist. He had to handle the paperwork.

It wasn't just the dentistry that sucked. Medical care in general was deplorable.

spot on stan, how much do the europeans pay their dentists, how competent are their dental schools.

Ignoring the teeth issue for a bit:
“Our country has not become economically strong through the law of the jungle, through indiscriminate hiring and firing.”

Didn't Ludwig Erhand, West Germany's post-WWII finance minister (or whatever the local equivalent is) manage to impose a basically market economy, thus setting off West Germany's post-war economic miracle, and meaning that West Germany became economically strong through indiscriminate hiring and firing?

Methinks someone doesn't know the history of their own country very well.

To answer Jane's question with regard to my experience, I've lived in Germany for nearly 7 years in aggregate. The German approach to dentistry (much less emphasis on prophylactic dental care from an early age) leads to poorer teeth overall and more extensive dental rectification as adults. A few comments based on personal experience:

1. Back in the 80's, I knew some American military dentists who warned against visiting German dentists b/c the quality of care was much lower. Obligatory caveats: Perhaps dismissive professional bias, and things may have changed for the better in the past 20 years;

2. Some German colleagues (financial professionals) note that their dentist 'is American-style', i.e. very good. However, this dentist sees only patients with private health insurance;

3. Germans do not drink fluoridated water. In fact, Germans rarely drink tap water, and almost universally drink bottled water (i.e. non-fluoridated) instead;

4. My girlfriend is a very bright German law student, and she thinks the dentist is someone to visit when something goes wrong. (She has fabulous teeth, which was definitely an attention-getter for me);

5. We have 'discussed' our conflicting approach to dental care, i.e. brushing, daily flossing, & regular visits to the dentist vs. brushing period;

5. Many, many Germans have caps as their dental 'cosmetics'. I take it this is the result of less emphasis on long-term, regular dental care which leads to serious dental problems as adults. (I am amazed at how many young adults - 20s - have a set of capped teeth); and

6. My recent major dental work (German dentist) has been a positive experience, but again only possible with private health insurance.

Bottom line: pay early for good teeth (US) or pay more later for worse teeth (German).

Cheers,

Mark's comment (". . . (I)n Germany . . . workers still have rights, such as grievance procedures, a reasonable termination period and compensation and that employment is a two-way contract. Despite widely-held American beliefs, Europe does have a pretty dynamic labor market . . .") is puzzling, to say the least.

German unemployment hovers at 11%, and the near-universal opinion (WSJ, Financial Times, Economist, Business Week, German financial press) is that Germany's ossified labor practices massively constrain economic growth.

Germany's annual GDP growth over the last 10 years has been the lowest among major industrialized nations, and the latest projection for this year is around 0.2%. Grievance procedures often lead to long court cases when employees dispute termination, and 'reasonable termination periods and compensation' (as a rule, 3 months notice and one month's salary per year of service plus additional termination costs) mean that businesses cannot reasonably reduce staff without incurring significant hits to the bottom line or risking extended litigation.

In short, 'widely-held American beliefs' about the lack of dynamism in Europe's labor market are entirely justified in Germany's case.

Cheers,

yeah.. euro economy is weird!!!

a former cmopany had an employee who took a job at a competitor. this person had to, by law, give 6 weeks notice, and work the weeks...

let's just say that i know very few people/companies in North america that would let someone in the next day if they were going to a competitor...

and all firings i've seen give you payment in lieu.. rather than actual notice... seems very strange that you'd actually keep a fired/laid off employee around

but then germany has "works councils" where the unions get to second guess management. lovely. not that management is always right (they're frequently idiots), but airlines show what happens when agressively incompetent & ignorant people (i.e. unions, who don't believe in customer service or profit) get to control a company. Employee ownership very good (see the old line partnerships, MS, etc) but you need people owning individually, rather than as a union...

but it's all good... europe will collapse and we wn't have to worry about german and french sniping

Um gee whiz, if you're going to use health as an indicator of well-being, why not use: number of children who die before 2 years old? Or life expectancy?

PS. Most Europeans (including many Brits) don't think much of the British National Health Service.

I'm not one to defend the German economy but simply comparing their unemployment rate to ours is misleading.

While job creation is undoubtedly stronger in the US the disparity is not as big as the unemployment numbers would suggest.

Among other things our very high incarceration rates reduce the unemployment rate. I've seen estimates that, adjusting for that, the unemployment rate is 2 to 3 points higher.

One could say, with only a little exaggeration, that in Europe the underclass is subsidized, and shows up in the unemployment rates (specially in the long-term unemployed) while in the US we jail them.

Jane -

We do have generally good dental health, but watch Jerry Springer some time and you'll get an eye-opener.

I once met a man in his forties who had perhaps three remaining natural teeth. (To give you an idea of his mental status, he insisted he was 31 years old.)

Americans do have a much higher standard for dental appearance. My teeth (at least the ones you can see) are quite straight, but I am plagued with yellow canines (my incisors are roughly the color of your background white, while the canines are about the color of the background of your blogroll). When I have enough money, I'm going to get caps for them.

I'd say that you can still estimate wealth by teeth in this country; you just have to have a really high standard.

Remember the old saying: The difference between socialism and capitalism is that under capitalism it is dog-eat-dog, while under socialism it is exactly the reverse.

GT: your 2-3% upward revision of the unemployment rate doesn't bear the smell test. The US workforce is maybe around 150mm. Incarecerated adults at most number 2mm (I think it is a bit lower than that) so how could the incarcerated raise the unemployment rate that much? More like 1-1.5% max. You also have to assume that some Europeans are incarcerated as well.

For those who are interested, Peter Cuthbertson posted a piece about dental care in the UK recently that seems to address all of the questions posed above. It's at Conservative Commentary.

I was working from memory so you may be right. My bottom number (2%) is not so different from your top one (1.5%).

Just for Jane's info:

Dental care, after age 16 (or 18), isn't covered by the NHS. After that age, you have to pay for dental care.

Care is much cheaper there, though. I remember being totally dumbfounded when a replacement bridge, which had cost me $300 in the UK, was $2000 in the US.

There's also less emphasis on flossing (almost unknown) and on plaque/tartar removal. So you don't have the armies of dental hygenists scraping tartar off teeth.

So, funnily enough, the fee-for-service system in the US led to more prophylatic (sp?) dental treatment than in the UK.

Another theory:

American teeth are better 'cos American chocolate & candy is less tasty than European.

Compared to Cadbury's (which continental europeans think is tasteless), Hershey bars are vile brown-colored wax. So, do American kids eat less candy than European kids?

Another theory:

American teeth are better 'cos American chocolate & candy is less tasty than European.

Compared to Cadbury's (which continental europeans think is tasteless), Hershey bars are vile brown-colored wax. So, do American kids eat less candy than European kids?

Jane:
I note that the posts re US vs. Euro teeth tend to fall roughly 50-50 in opinions as to both cause and effect. What might be the genetic component of the divide vs. the economic/cultural one? After all, how much of the American population is of either Anglo/Gaelic/Celtic origin, or German, for that matter? Teeth might be teeth, wherever they bite: Herr Schroder might just have been using the first simplistic analogy taht came to mind (no surprise there); but as an issue of fact, there seems to be (as yet) no agreement.
And not to get too personal, but a gap between the front teeth isn't necessarity a negative: go see what Chaucer had to say about that!
:)
JSC

first: our precious essence is polluted with flouridation and other communist schemes to weaken the national will to resist... what a price to pay for white teeth!

two: since germany is the size it is and the us is the size it is, there is a lot of local variation on levels of various health indicators in this country. anyone say: appalachians or micro urban environment of your choice?

I am in England right now and I can tell you without reservation the teeth of the average Briton are horrific. They do not have flouride (cas it is used for the strength of the tooth not the appearance). Maybe they really do not care about the appearance of their teeth. Talking to someone inevitably starts you staring at their teeth. Its embarassing but, in the land of no flouridation what's left?

"one thing you can't tell people's wealth by, in the dog-eat-dog dystopia that is America, is their teeth."

I agree with Jack. Implants can cost $3000, root canal + cap can be $1500. If someone doesn't have insurance, they can't afford that, and are forced to either get dentures or "go without." I'd suggest more and more varied observations.

Try visiting Oregon. Even in Portland, the number of ordinary, middle class Americans (the local bookstore owner, the local pub manager) had astoundingly bad teeth. I think it's a regional observation bias. Although if Euros have no braces, the overlaps are prime locations for decay to begin.

David

Mark pointed out what, in my opinion, could be the main reason, if true, for americans having better teeth than europeans: dental care is not covered under most european health systems. That remains all to a question of purchasing power, higher in the US.

At least in Spain, where I live, dentists are one of the most expensive medical specialities. People try to minimize it with private health programs.

The problem with so-called "natural smiles" is that they are anything but. As Megan pointed out the abundance of sugar in modern diets do not lead to natural smiles. Additionally, popular activities such as drinking coffee or smoking cigarettes (both of which are very popular in Europe) discolor teeth (and cause breath odor problems, but that's another issue). The excessively bright white smile is popular in the US but even if it wasn't, simply achieving a "normally white" smile would require assistance for most people.

What I think is hysterical is the amount of comments on a topic about yellow teeth. Apparently this is the topic of the day! Personally I wouldn't have allowed a pic like that to be published if my teeth looked like that, i would at least asked for an airbrush artist.

I gave a call to my local dentist who also said that some people's teeth just tend to stain moreso than others and if someone smokes, then those stains become semi-permanent. That is part of why, I think, the created products to help whiten teeth; the paint on whitener that leaves you with your mouth open for about a half an hour so that saliva doesn't wash it away and now the clear plastic strips that you stick to your teeth like post-it notes. Perhaps these products are not yet available overseas.

I have many German friends from my 8 years working for Behring Diagnostics. They all get their dental work done when they come to the states.

Jim

UK unemployment is not 2%, it is 5% (http://news.bbc.co.uk/1/hi/business/2863413.stm), which is still very good by European standards. The German rate is 11.3% (http://news.bbc.co.uk/1/hi/business/2825091.stm), a rate which if occurred in the US would have the media in a full panic. The current US unemployment rate is 5.8%, which people are complaining about. I remember when 6% was considered full employment!

When you make it very difficult to fire people, then businesses are reluctant to hire people since they'll be stuck with them if times are bad, or they turn out not to be suited for the job.

In Canada, dental work is not covered by the socialized medical scheme. Perhaps the same is true in Europe. Or it just could be generally lower standards of hygiene, which would not be surprising considering that Europe tends to be significantly poorer than the US. Per capita GDP adjusted for PPP (2001) in France was $25,700, in Germany was $26,600, and in the UK was $25,300, as compared to $36,300 in the US.

That $10,000 dollar a year difference can pay for a lot of orthodontic work...

Do you realize that in addition to fluoridating water, why there are studies underway to fluoridate salt, flour, fruit juices, soup, sugar, milk, ice cream...Ice cream, Mandrake, children's ice cream.

GT: are you saying that in Europe they don't incarcerate criminals but instead just put them on the unemployment rolls?

Or that in Europe the unemployment benefits are so good that they're effectively bribing their criminals not to commit crimes?

I don't quite get your implication. You're not suggesting that in the US most of the people in our prisons are actually innocent of breaking the law, but it looks better to throw them in prison, are you?

As a physician practicing in rural Northern California, I can tell you that many Americans have poor teeth. Two reasons: lifestyle choices and lack of access to care.

Just like the comment above about Italy, there are many Californians who have dentures in their 20s (California Medicaid will pay for dental extractions and dentures, but not much for other dental care). There are also a lot of 2-year-old kids running around with stainless steel capped teeth because their teeth rotted from excessive sugar and no hygeine.

Wow, I'm not sure what definition of 'poor' you're using, in CA, CO, AZ and NM, the poor have very bad teeth due to lack of access to dental care (those are the places I've lived in my 32 years, can't comment on the rest of the country).

My family had amazing dental care when I was growing up because of my step-fathers union membership (UFCW, an AFL-CIO union). Which is why my teeth are straight. But I have many problems now, as I've only had dental insurance for a few years of my adult life (the last 2 recessions haven't been kind to geeks).

My fiancee has had an uncapped root canal since she was 12, and now has another, and can't afford the caps (she only got the recent root canal at all because she got 'on the spot' credit approval, which mystified us, as we expected a denial...a week later they reversed the 'yes' into a 'no', and the dentist ate the charges).

I don't have a url handy, but a recent Surgeon General's report on dental care called the state of access to dental care in the US one of the worst chronic public health problems here.

i am an american who lives in Germany. The dental benefits here are not THAT great. My dental insurance in the USA was better.
Plus you pay dearly for the insurance. The premiums for health insurance are split between the employer and employee 50/50. It is a percentage of income. If your income rises, so does your premium.
In short the German social system is not as good as the Germans think it is. and the misconceptions
over here about the US are LEGION.
What? people get unemployment insurance? in AMERICA?
you got laid off and got severance? In AMERICA?
the land of social darwinism?
Schroeder says he does not want 'cowboy capitalism'. On the other hand when the economy here has bad times he blames the recession in the USA. If the 'German way' is so much better, how come they are so dependant on the USA?

i am an american who lives in Germany. The dental benefits here are not THAT great. My dental insurance in the USA was better.
Plus you pay dearly for the insurance. The premiums for health insurance are split between the employer and employee 50/50. It is a percentage of income. If your income rises, so does your premium.
In short the German social system is not as good as the Germans think it is. and the misconceptions
over here about the US are LEGION.
What? people get unemployment insurance? in AMERICA?
you got laid off and got severance? In AMERICA?
the land of social darwinism?
Schroeder says he does not want 'cowboy capitalism'. On the other hand when the economy here has bad times he blames the recession in the USA. If the 'German way' is so much better, how come they are so dependant on the USA?

I spent a summer in Denmark taking an International Business course. I lived with a Danish family, so I managed to absorb a good deal of the thought and culture of the average Danish citizen. Nationalized healthcare in Denmark did not solve anything. Rich people got tired of waiting for treatment, and private clinics sprung up that the rich would use, even though they had free medical and dental care. It's been a while, but I remember Danish teeth being fine. The Danish women were fine too. Very fine.

Shorter GT:

{ whatever } is better in Euroland, as { made up statistic } shows.

{ actual fact } doesn't tell the whole story - consider { made up statistic }.

That reminds me - which way are the brains flowing these days? What happened to the proposed US immigration preference for Euroland, esp. French, technologists? (Since Euroland is better, such a system would not hurt, right?)

"That reminds me - which way are the brains flowing these days? What happened to the proposed US immigration preference for Euroland, esp. French, technologists?"

Biggest Euro country for US immigration is the UK (maybe followed by Ireland, 'cos of the Morrison greencards). Both have labour economies more similar to the US than France or Germany (e.g. low unemployment benefits).

There's a big reason why engineers from the UK go to the US; engineers don't make shit in the UK (e.g. I got a 50% pay raise by stepping off the plane to the US). Engineers *do* do well in France & Germany; anecdotally, I'd say there's more two-way traffic between French & German technologists and the US than for UK technologists.

What's all this about dental insurance being the big difference? My family never had it growing up (self-employed dad; it was hard enough getting medical coverage), and my sister and I both had twice-yearly dental visits and braces (and she spent a lot of time in various dental appliances). We didn't have much money - my dad, though he did white-collar stuff, was certainly out-earned by our plumber - but we got private schools and straight teeth instead of nice clothes, cars, or vacations.

It's mostly a matter of priorities. My mom has horrible teeth, of which she has always been ashamed, so it was predetermined that I would not.

I've noticed before that this blog has an allergy to actual research. Come on folks, it isn't like you actually have to _walk_ down to the library anymore, you can get actual data without _any_ physical exercise.

I don't know what, aside from being whacked upside the head with a six-pound sledge (preferred by professionals 3 to 1 over two-by-fours), will get you over to who, but let's see if this works:

According to the Who summary page, Brits have 30% fewer bad teeth per mouth than Americans.

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