Doughty J, MacDonald M E, Muirhead V, Freeman R. Oral health-related stigma: Describing and defining a ubiquitous phenomenon. Community Dent Oral Epidemiol 2023; DOI: 10.1111/cdoe.12893.

Otherness leads to health inequalties.

Straight, white teeth have become a social norm in western societies. Oral health status which is markedly different from this can attract stigma - an othering in which the stigmatised are seen and judged, resulting in status loss, discrimination and shame. The consequence is a loss of power, leaving the victim open to exploitation, control and exclusion.

Deviations away from perceptions of oral health norms are linked to lower intelligence, poverty, ill health and old age, and loss of teeth is linked to a declining of a sense of self. Being highly visible (unlike, for instance, HIV infection), poor oral health may more easily trigger stigma. Whilst this can happen at any age, 'in older age, (the stigma of) poorer oral health and tooth loss may lead to limited social interaction, and lowered self-esteem, perpetuating loneliness and isolation.' Halitosis, for instance, may be interpreted as a sign of oral disease and provoke disgust.