Years without dental insurance took a terrible toll on more than Katelyn Bowden’s teeth.
Her worsening oral health affected all aspects of her life — her mental health, relationships, job prospects and overall well-being. Small problems like cavities became big problems that required visits to the emergency room.
So when Bowden finally had access to dental insurance and received proper dental care, she was proud to be finished with treatment in January and proclaimed on social media: “I’m a 37 year old with dentures.”
Her tweet has received tens of thousands of likes and hundreds of comments from people also struggling with bad teeth.
“It was something that I’ve been going through for years and wishing that more people talked about it because it really felt alone to be that self-conscious about smiling,” Bowden, an artist who lives in Huntsville, Alabama, tells TODAY.com.
“I would see the changes in people’s faces. Once they realized that I had bad teeth, their attitude and their opinion of me changed drastically.”
Bowden has none of her natural teeth left. She wears full dentures on the top and bottom jaw.
'Teeth should not be rich people bones'
Before she had the work done and people saw her missing teeth, some assumed Bowden did drugs, but she says she has never even tried drugs that would cause tooth problems. She explains she was just “dirt poor” for most of her adult life.
Bowden was covered by dental insurance as a child and had a nice smile for a while. But things “went downhill very, very quickly” when she turned 18, she recalls.
As a high school graduate, she worked in service industry jobs such as bartending. None offered dental insurance. She couldn’t afford to get regular dental checkups and fillings for cavities.
One-third of U.S. adults don’t have dental benefits coverage, according to the American Dental Association. A quarter of U.S. adults have untreated tooth decay, the Centers for Disease Control and Prevention notes.
Medicaid covers dental care for children, but adults may only be covered for emergency dental services depending on the state.
Teeth should not be “rich people bones,” and dental care should be accessible and affordable to everyone, Bowden says.
“I didn’t have Medicaid until after I had my kids. So by the time any dentist was able to look into my mouth, they said, ‘Well, there’s too much work. So we’re just going to pull the ones that are problematic,’” Bowden recalls.
When cavities in her teeth got deeper, they caused abscesses in her face that required emergency room visits. One abscess was so severe that it swelled her eyes shut. Bowden couldn’t chew without pain and had toothaches for months on end.
A man she dated broke up with her and told her it was because he didn’t want to be seen with someone with bad teeth. She developed anxiety about her appearance, and experienced shame and isolation. She felt her job options were becoming more limited.
“It was miserable,” Bowden says. “Add to that the mental health toll that it takes on you, where you’re afraid to smile, where people are judging you… there is a lot of stigma that comes with having bad teeth.”
Dentures have been 'life-changing'
Everything changed when she met her husband, TC Johnson, through Twitter. She told him about her teeth during their first phone call and he was not bothered.
He later worked his good dental insurance into his marriage proposal noting Bowden could finally get good dental care.
Bowden began going to her husband’s dentist in 2020. Her upper dentures were in place within a year. Her lower dentures required three implants in her jaw to support them, so they took longer.
Now that everything is in place, Bowden is enjoying foods she once couldn’t eat because of her painful and missing teeth.
“It’s been a life-changing event,” she says. “I got to eat steak in the past month and it’s fantastic. It felt really good to finally be able to chew a lot of foods that I have been missing. I’ve gained weight, which is great, I needed to.”
Dr. Terri Alani, a dentist in Houston, Texas, who is not treating Bowden, says she has never seen any patients in their 30s need full dentures in her 40 years of practice.
All the preventative care put in place over the last decades — including fluoride, sealants and patient education — means Alani sees less decay and fewer comprehensive procedures needed on young patients.
“Most of the people I see that are in need of dire dental work are probably in their 50s,” Alani tells TODAY.com.
“(But) nowadays, because of all the preventive measures, I have patients in their 90s who have all their teeth.”
Dentists and periodontists try to keep a patient’s natural teeth in place whenever possible, but there comes a point when they’re not salvageable — if the bone loss in the mouth is too much, the teeth are very mobile, there’s a lot of decay present or there are medical issues, Alani says.
In those cases, full dentures may be needed. Implant supported dentures that don’t require the palate to be covered are a popular option now, she notes. But to avoid getting to that stage, Alani urges people to keep up with regular checkups and cleanings as much as possible to prevent major problems.
Bowden says that after the posted her tweet, some people told her she inspired them to make an appointment with a dentist.
“That made me feel really good,” she says.