Illustration by Brittany England

How we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

The night after my dentist formally recommended me for braces, I went cold turkey on sleeping with my right index finger in my mouth. I was 14. The nighttime habit was a holdover from my childhood that came from my mom’s side. My 33-year-old cousin still does it, and my mom did it longer than most kids.

The habit was also a likely culprit in making my overbite worse than genetics alone would have. After my mom died, I’d do anything to get a good night’s sleep, even if it meant sleeping with my finger in my mouth.

Stopping was extremely hard at first, but I really wanted braces — and I wanted them to work so I’d never be ashamed of my crooked teeth again.

When I finally lost all my baby teeth, I was almost 14 — older than most of my friends who started with braces in middle school. Some even began high school with completely straight teeth. I couldn't get braces any earlier because I was poor and had to wait for the dentist’s recommendation.

When you’re poor, a lot of things come down to the visible markers of poverty

Kmart and Walmart clothing, off-brand shoes from Payless, haircuts from Supercuts instead of the bougie salon downtown, the cheap glasses that public health insurance will cover.

Another marker? “Bad” teeth. It’s one of America’s universal signs of poverty.

“[‘Bad’ teeth are] seen as a kind of decency and often equated with morality, like people with messed up teeth are degenerates,” says David Clover, a writer and parent living in Detroit. He went around 10 years without any kind of dental care due to a lack of insurance.

The average price of braces in 2014 was anywhere from $3,000 to $7,000 — which would have been completely unaffordable for us.

We also have negative associations with smiles that are missing teeth or aren’t perfectly straight or white. According to research by Kelton for Invisalign, Americans perceive people with straight teeth as 58 percent more likely to be successful. They’re also more likely to be perceived as happy, healthy, and smart.

As a middle schooler whose parent can’t afford out-of-pocket orthodontic or dental treatments, it’s hard when you’re up against statistics like that.

According to the National Association of Dental Plans, in 2016, 77 percent of Americans had dental insurance. Two-thirds of Americans with insurance had private dental insurance, which is typically employer-funded or paid for out-of-pocket. This often isn't an option for poor people.

Laura Kiesel, a freelance writer from the Boston area, paid out-of-pocket to have her wisdom teeth extracted and went without anesthesia because she couldn’t afford the extra $500. “It was traumatic to be awake for this procedure because my wisdom teeth were heavily impacted in bone that they had to crack open and it was very bloody,” remembers Kiesel.

A lack of dental insurance can also lead to medical debt and if you’re unable to pay, your bill could be sent to collections agencies and can negatively impact your credit score for years.

“The dental procedures I’ve had to undergo have taken nearly a decade to pay off,” says Lillian Cohen-Moore, a writer and editor from Seattle. “I finished the last of the dental debt last year.”

My dentist reassured my dad that MassHealth, the Massachusetts state expanded universal healthcare that the Affordable Care Act was based on, would “definitely approve me” because of how bad my teeth were. He wouldn’t have to worry about any copays. (Since my mom’s death, my dad had been a single parent and a cab driver struggling in the years after the recession. His job didn’t come with a 401(k) or company-sponsored health insurance.)

And I knew copays would make my braces unaffordable, because we were already months late on every bill we had — rent, the car, cable and internet.

A few weeks later, we got news just that my insurance wouldn’t pay for braces

They had deemed my teeth not bad enough. All I could think about was the dental mold that the orthodontist took of my mouth during my evaluation. Blue putty shaped into my overbite, crooked molars, and crowding from the four extra teeth they’d planned to extract that I now couldn’t afford to have taken out of my mouth.

I still had a chip on my front tooth from when I fell as a kid while I was running.

“You’re better off appealing insurance, and waiting until after you’ve had braces to get the chip fixed,” my dentist explained.

There are no records of my smile from my high school years.

That’s when my teeth officially became a symbol that I wasn’t wealthy or even middle class. Changing your appearance is a privilege that requires money, resources, and time. The average price of braces runs between $3,000 to $7,000 — which was completely unaffordable for us.

My dad picked me up from school in his cab or I walked home because we couldn’t afford a car. My sneakers weren’t Converse, they were the knock-offs that look almost like Converse without the recognizable star logo. And my teeth weren’t straight, even though everyone around me was visiting the orthodontist monthly for regular adjustments.

So, in photos, I kept my mouth shut and my lips closed. There are no records of my smile from my high school years. I also stopped sucking my finger at night after my orthodontist’s first recommendation, even when I missed my mom’s snoring. A part of me always hoped that someday I’d be able to get braces.

Once, after I kissed a girl, I started panicking about whether my crooked teeth would “get in the way” and whether my bad teeth were making me a bad kisser. She’d had braces in middle school and hers were already perfectly straight.

Still in many ways, I was privileged

Years before the ACA, I had access to quality dental care. I saw dentists for routine cleanings every six months on the dot without a copay (my dentist only charged $25 if you missed three appointments in a row without cancelling, which is fair).

Any time I had a cavity, I could get a filling. Meanwhile, my dad went 15 years without seeing a dentist during a period when MassHealth chose not to cover dental for adults.

Then, when I was 17, my dentist and orthodontist finally appealed my public health insurance to cover my treatment — just in time, since after age 18, this would no longer be an option on MassHealth.

I had braces put on in August before my senior year of high school and asked the orthodontist to use elastic bands in an alternating rainbow pattern, because I wanted people to notice my braces when I smiled: They were my way of announcing that I’d soon no longer have visibly poor teeth.

After my four extra teeth were extracted, my smile relaxed significantly and each tooth began slowly shifting into place.

The worst of my overbite was gone, and at Thanksgiving, my cousin told me how beautiful I looked. I took my first selfie with visible teeth in almost 10 years.

It took five years to get the braces off, compared to typical length for orthodontic care.

I’m climbing into the middle class now, and I’m more concerned with changing people’s perceptions of poor people than I am with changing myself to fit into a classist ideal by whitening my teeth or refusing to clothing shop at stores like Walmart or Payless.

A year or so into my treatment, the orthodontist began subtly shaming me for not coming in for regular appointments. But my college was over two hours away and my dad didn’t have a car. I would’ve lost insurance coverage if I switched care to another practice.

Delaying my orthodontic treatment ended up costing me years of my time, because I would have been able to come in for regular appointments while I was a high school student living at home.

The day they finally came off, I was grateful not to have to sit in the waiting room among kids and teenagers anymore — and that people would no longer ask why I had braces at 22.

I’m angry that healthy teeth and dental care isn’t a privilege everyone has access to

A few months ago, when my partner and I took our engagement photos, I smiled when I saw the ones of me open-mouthed, laughing at her jokes. I’m more comfortable with my own smile and appearance. But while I was able to fight to get my health insurance to cover the treatment, many people don’t even have access to basic health or dental insurance.

My teeth still aren’t perfectly white and when I look closely, I can tell they’re a little yellowed. I’ve seen signs for professional whitening at my dentist’s office and thought about paying to have them whitened before my wedding, but it doesn’t feel urgent. It’s not the desperate emotion straightening my teeth inspired when I was an insecure teenager just learning that basic needs often require wealth and money.

I’m climbing into the middle class now, and I’m more concerned with changing people’s perceptions of poor people than I am with changing myself to fit into a classist ideal by whitening my teeth or refusing to clothing shop at stores like Walmart or Payless.

Besides, that girl I was nervous about kissing with crooked teeth years ago? She’s going to be my wife. And she loves me with or without a straight white smile.


Alaina Leary is an editor, social media manager, and writer from Boston, Massachusetts. She's currently the assistant editor of Equally Wed Magazine and a social media editor for the nonprofit We Need Diverse Books.