In this book, author Mary Otto reveals what could be described as an “oral health crisis” in our county, a crisis with far-reaching and often surprising health ramifications and serious social consequences. Millions of Americans lack dental care, resulting in chronic pain, periodontal disease, infection, and possible tooth loss. Increasingly, the mouth is viewed as an ecosystem; links are suspected between poor dental hygiene/periodontal disease and diabetes, inflammatory diseases such as rheumatoid arthritis, and heart disease as well as other conditions. Having bad teeth -- a condition that disproportionately affects minorities who frequently lack dental coverage or the ability to pay out-of-pocket -- can be an obstacle to employment and advancement. The rise of cosmetic dentistry has further stigmatized those lacking the means to obtain “the perfect smile.” Children and the elderly often lack access to needed dental care and there are also areas of the country that have a shortage of dentists. Otto’s startling, thought-provoking exposé casts a little-known public health emergency into high relief and will, hopefully, spur policy change with regard to provision of dental services.