In Kentucky’s Teeth, Poverty and Neglect Take Toll - NY Times

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BARBOURVILLE, Ky. — In the 18 years he has been visiting nursing homes, seeing patients in his private practice and, more recently, driving his mobile dental clinic through Appalachian hills and hollows, Dr. Edwin E. Smith has seen the extremes of neglect.

He has seen the shame of a 14-year-old girl who would not lift her head because she had lost most of her teeth from malnutrition, and the do-it-yourself pride of an elderly mountain man who, unable to afford a dentist, pulled his own infected teeth with a pair of pliers and a swig of peroxide.

He has seen the brutal result of angry husbands hitting their wives and the end game of pill-poppers who crack healthy teeth, one by one, to get dentists to prescribe pain medications.

But mostly he has seen everyday people who are too busy putting food on the table to worry about oral hygiene. Many of them savor their sweets, drink well water without fluoride and long ago started ruining their teeth by chewing tobacco and smoking.

http://www.nytimes.com/2007/12/24/us/24kentucky.html?th&emc=th