It happens every day and usually more than once: When a person wishes to signify greetings, gratitude, admiration, or otherwise good or chill vibes, they peel back their lips and reveal two rows of about 32 mineral-coated nerve fibers, embedded in pink tissue, strung with sparkling threads of saliva.
Made up mostly of hydroxyapatite, a relatively weak gemstone, teeth begin to rise from gummy ridges inside the mouth when a baby is around six months old. Those teeth hang on until about the first grade, when they start getting replaced by larger, forever teeth. In various cultures, baby teeth are alternately buried, thrown, or exchanged by spirits for money.
Things just get more challenging from there. Human teeth grow jagged and yellow with time and use, but contemporary beauty standards favor teeth that are neatly arranged and in a shade of white. I know it seems like I am writing from the perspective of some kind of alien robot, but precision is very important in cosmetic dentistry. A leader in the field once told me that he could tweak the masculine-feminine interpretations of my genealogy just by changing the shape of my canine teeth. I thought about this for days. And then I called more dentists. I learned that America is the number-one exporter of smiles in the world — smiles typified by bigness and whiteness and straightness.
Humans have had teeth for as long as they can remember and have been whitening them for just as long using basically whatever objects were lying around, probably to emulate optimum health. There is a reproductive survival argument for white teeth, perhaps, but we’re not going to get into that right now.
We're here to talk about "good teeth," a concept born in the years before and after World War II. That's when Hollywood dentist Charles Pincus popularized tooth caps for movie stars like Judy Garland (whose smile was dotted with gaps) and James Dean (who lost two front teeth reportedly after a "trapeze accident"). Pincus made a transitional set for Shirley Temple between the loss of her baby teeth and the arrival of her adult teeth to avoid costly filming delays. Walt Disney and Bob Hope were Pincus clients, as was Joan Crawford, who renovated her face in the 1930s by adding a set of Pincus's caps. Her new teeth "made her lips look fuller, her teeth longer and whiter, and helped give her a 'femme fatale' smile," according to dentist Timothy Gogan, who studied under Pincus.
Pincus's veneers, a mix of powdered plastic and porcelain, snapped onto the teeth of his clients and clung there for anywhere from a few hours to a few days before requiring replacement. Then, in 1983, John Calamia, a cosmetic dentist at New York University, helped invent the contemporary veneer by creating a better fit that could reliably stay put for many years: the snowflake-precise, etched porcelain veneer technique. This, plus his extensive body of published work on the topic, probably turned custom veneers into an economy of scale, and the straight, white, American smile into a bankable commodity.
Now 37 years old, etched porcelain veneers are one of the youngest art forms on earth. (At 37, etched porcelain veneers are also, technically, millennials.) And like many art forms, they've needed time to evolve. The fake smiles of the late '80s and early '90s skewed large and impossibly white. "It was kind of like shoulder pads," says Jon Marashi, a cosmetic dentist in Los Angeles and a former student of Calamia's at NYU. "A bad fashion choice."
Marashi is an emphatic speaker, and his every word is underlined by the sharpest jawline known to man. Last winter, at a conference room in lower Manhattan, he reached into a Louis Vuitton duffel bag and produced a white and gold box labeled "The Marashi Collection" in beaming letters and containing six shades of premium porcelain: Sassy Smile reflects the worn-in ideal of a wellness scion who formerly chain-smoked; Undeniably White, well, is. It is as if when Charles Pincus died in the mid-'80s, his restless spirit of aesthetic innovation haunted the streets of Los Angeles until it found a host in Marashi. His work reflects the cosmetic dentistry zeitgeist through the Hollywood lens, with the charmingly perfect smiles of Ben Affleck and Renée Zellweger, and perhaps many other celebrities you did not realize had the very best in dental renovation. Marashi originally fixed Joaquin Phoenix's teeth, unfixed them for his role in 2019's Joker, and then refixed them for the press tour. His clientele also includes people who have not won Oscars, plus a robust international contingent, who will make the pilgrimage to Los Angeles for the opportunity to smile like they just won one.
Marashi doesn't love the stereotypical Hollywood smile. Don't get him wrong — some people love it, and those people are beautiful and special in their own way. But the cosmetic dentistry vanguard is obsessed with toiling in secrecy on teeth that look like they could have sprung forth from the mouth of their wearer, even if they were placed there by hand.
Stephanie Dumanian is a fashion-y New York City dentist in a rising class of fashion-y dentists who retain publicists and fastidiously maintain a presence on Instagram. She describes this as a more "East Coast" approach to teeth design, using words like "natural" and "harmonious." In the 21st century, it is no longer fashionable to appear as though you've had cosmetic dental work done, presumably because it would anger the American proletariat.
"People want to have a healthy smile, but realistically, you don't need your teeth in order to survive."
The big, straight, white American smile is as much an indicator of good oral hygiene as a tiny waist is of digestive health. "People want to have a healthy smile," Dumanian says. "But realistically, you don't need your teeth in order to survive." A healthy smile could look fleshy, wet, and pink, to indicate good circulation, but it is not the look most people are going for. Instead, a smile is a beacon of economic power, another thing for the Haves to have that the Have-Nots have not. Even among American adults with private health insurance, only half have dental coverage for basic oral hygiene appointments; in a recent survey, one-third of Americans had not seen a dentist in the past year. It's not always easy to tell who those Americans are, until the moment they open their mouth, and then it becomes very easy. Because orthodontia, regular cleanings, and the occasional whitening only result in teeth that look unmemorable and basically fine.
A casual sleuth could estimate an American family's economic caste simply by looking at their teeth in photos: The average set of braces costs more than a Fendi bag, but nevertheless is a painful rite of maturity for many children of the American middle class, an investment in their personal and professional futures. Parents might choose to finance the several-thousand-dollar hope that nobody pay too much attention to their kids' perfectly average mouths.
And then there are teeth that you might notice, but in the most positive way. "Think about the best-looking people in our society: your Beyoncés, your Julia Robertses," says Rhonda Kalasho, a cosmetic dentist in Los Angeles. "They don't look like they have giant white teeth. They have smiles that fit their faces." And for that, we are no longer talking about the cost of a Fendi bag, but the cost of reupholstering your bones in gorgeous Italian calfskin.
"Let's say I'm watching the Oscars," I ask Dumanian. "What percentage of all-natural teeth am I seeing?"
Dumanian closes her gold-dusted eyes for five ponderous seconds before offering her estimate: "I would say… 20 percent?"
That is much higher than I'd thought. I turn on my television and see nothing but the brilliant pottery of manufactured smiles reflected back at me. It is amazing that the HBO series Game of Thrones takes place in a quasi-medieval fantasy universe, but concubines and kings alike sport two tidy rows of plaqueless white teeth. The cool teens of Euphoria must have all undergone serious orthodontia in middle school — they arrive at the events of season one with heartbreaking smiles.
It's a fun game to play while scrolling through Instagram, browsing on Netflix, or otherwise visiting the natural habitats of those who are paid to look good: How many people have gorgeous smiles? How many people have straight, white teeth? And now that I'm thinking about it: What are the odds that their teeth naturally look this good, their lips hovering just so above the gumline? That their teeth naturally appear to be displayed on shelves, rather than suggesting that they break down food into ingestible bits before it can begin a path through the human digestive system?
The odds are extremely low. Over the past few decades, an aesthetic dissonance has grown between humans seen in the corridors of our daily lives, i.e., at the check-out counter and the kitchen table, and the ones who live in our televisions and smartphones. Some people have nice teeth thanks to a genetic win or, far more likely, thanks to the superhuman discipline required to continuously wear a retainer from age 16 until death. Most people, though, have just fine or somewhat crooked or otherwise unremarkable natural teeth, which is probably why uncrooked, better-than-fine teeth have become mythologized to represent success. Cardi B famously bought a bag and fixed her teeth; Congresswoman Alexandria Ocasio-Cortez did too. The 45th president of the United States has some of the most recognizable teeth of the era: Two rows of searing pearl that leap forth from a jerkied complexion. False teeth are so entrenched in the lore of the American presidency that children are taught in school about George Washington's wooden set. (The wood thing is a myth; his dentures were composed from a serial killer’s grab bag that included loose metals and a combination of human, and probably cow and horse, teeth.)
Teeth and imagery have been inextricably linked since 1840, when the first dental college in America was established in Maryland, and also when the first camera was patented — by a dentist. "Photography and professional dentistry were born at precisely the same moment in history," writes journalist Mary Otto in Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America. Otto traces the American smile through the advent of the photograph — and the newfangled capability of capturing a "permanent self" — to the office of Charles Pincus, to the silver screen, to the hearts and minds of Americans. "And dentists would learn from Hollywood, Pincus predicted," Otto writes. "They would shape the American smile."
Pincus died in 1986, at which point the concept of good teeth had grown into a society-wide demand for them. A dental care market that began in the 1950s, borne out of the invention of toothpaste that contained fluoride, a mineral discovered to have miraculous potential for preventing cavities, has now mushroomed to include far less studied innovations like CBD toothpastes, charcoal flosses, and other things people hope will make them feel good, but more importantly, look good.
After speaking with dozens of cosmetic dentists, I've noticed something that sets them apart from other professionals: So many of them are quick to describe their work as uniquely, intensely, almost magically gratifying, in a way that ER nurses and firefighters — and even, in my experience, dermatologists and plastic surgeons — simply do not. "I am redefining how my patients see themselves; I am giving them confidence; my patient did not love himself until today; she was ugly until I made her beautiful; I am changing lives, not for the better, but for the best."
I wish they were being hyperbolic, because that would be funnier to me personally, but unfortunately they are not. Among the first things you notice about a person are the contents of their mouth. It happens every day and usually more than once: A person smiles, displaying two sets of teeth, and so much more.
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