For People Overcoming Addiction, Teeth Matter

By May Wilkerson

Unlike many of us, Brian Thompson doesn’t take his teeth for granted. After decades of dental neglect caused by drug addiction, he had his teeth pulled during an eight-year stint in prison for drug-related bank robbery. But a few years ago he bumped into someone at an AA meeting who offered him a brand new set of chompers, all expenses paid. He says it’s radically altered his life and helped keep him on the road to recovery—and as the effects of dental work are psychological as well as physical, many other people struggling with or overcoming addiction find it similarly crucial.

Brian, 52, grew up on the Lower East Side and started using alcohol and other drugs as a teen. He began smoking cocaine on “the day Richard Pryor caught fire—in 1980,” which he regularly continued for about 25 years. He eventually also got hooked on heroin, and turned to bank robbery “strictly [in order] to avoid heroin withdrawal.”

He robbed banks twice, both times in downtown Manhattan: Once at an Apple Savings bank using a fake bomb (clay with an electronic timer), and once at a Chase bank using a fake gun. “I was followed by a civilian in his private vehicle and he directed the police to the spot where I disposed of my briefcase,” he tells me. “My briefcase contained some personal items with my name an address on them…the police came to my home shortly there after.”

When Brian ended up in Schuylkill Federal Prison in 1997, his teeth were a mess from years of neglect. He says it was probably made worse by “dry mouth” caused by smoking so much cocaine: “The theory is, it stops you from producing saliva, and the saliva protects your teeth.”

“In federal prison they don’t do dental work. They just pull your teeth,” he explains. There was a denture training school at the prison, where they trained inmates to make dentures. So an on-site doctor convinced him to pull his teeth, although Thompson says “it didn’t take much convincing.” He remembers the entire process as painful and “horrible.” Seven years later, he got out and re-entered the world with “a mouth full of prison dentures that don’t fit.”

The shoddy prison dentures affected Brian’s physical appearance and his daily life. He recalls having a “pushed-in face,” which apparently irked his mom. And being a self-described “passionate person” who loves to stand up for himself and others, was “not very effective” when his teeth were prone to falling out. “I couldn’t talk in an excited manner because they would fly out!” he says. “And I love to talk in an excited manner!” He couldn’t afford to get them replaced.

Brian was out of prison—and in recovery—for six years when he met Sebastian Saville, a former executive director of, a London-based human rights organization that helps former prisoners and people fighting drug charges. They ran into each other at an AA meeting and swapped horror stories. Like Brian, Saville had lost his teeth to his addiction and was in the process of getting implants. It turns out, Saville had been trying to launch The Teeth Project—a program, sponsored by the Harm Reduction Coalition, offering free dental implants for recovering addicts—for four years. All that was lacking was a willing volunteer.

It was perfect timing: The Teeth Project flew Brian out to California where, between July 2011 and April 2012, he got his new set of teeth put in by a renowned dental surgeon, Dr. Sascha Jovanovic, and a cosmetic dentist, Dr. Eric Fugier, who has operated on high-profile clients like Bruce Willis and Diana Ross. (The Teeth Project is ongoing, but relies heavily on cash donations and on clinicians donating their work to cover the very substantial costs.)

Brian’s surgery was more invasive than expected and he even needed to have part of his jaw bone removed. But he wound up with a set of teeth perfectly suited to his personality and lifestyle. “The doctor wanted them whiter and straighter, but I said, ‘Dude, I’m going back to Manhattan. I’m not staying out here in Hollywood,’” he laughs. “But he did a really good job.”

Brian celebrated 10 years of sobriety this past weekend and—much like his teeth—his life looks very different today. He completed college and is now working towards a graduate degree in clinical rehabilitation. He also volunteers with the Covenant House and the Harm Reduction Coalition—he first went to swap needles there when he was still using heroin. And he says the implants have played a major role in helping him climb out from “the lowest percentile of the human population.”

“I have several felonies. I’m a drug addict. I’m way down there,” he says. “And I was determined to get out, somehow. These teeth I really feel made it so much easier for me to confront the fears and the obstacles that I had.”

Many people with addiction struggle with poor dental health, mainly due to a lack of proper dental hygiene and care. Kevin, a 48-year-old recovering “crack-aholic” from Brooklyn, had no teeth at all his first year of sobriety. He’d lost his teeth two-and-a-half years earlier—which he attributes to smoking crack, drinking, smoking and poor dental hygiene. He then lost his dentures to his dog, who bit them in half. ”As an addict, it wasn’t my first priority to get it replaced,” he says. He was homeless on the streets of LA and facing up to nine years in prison for drug-related crimes, when he finally kicked drugs during a stint in rehab, five years and eight months ago.

That first year without teeth was hard: “I dealt with severe inferiority, depression, loneliness,” Kevin says. “My ego wouldn’t let me approach women.” But after settling his legal issues in drug court, he was able to enroll in Medicaid, which covered a new set of dentures. Suddenly, “I got a lot of compliments. I could smile again…. and two months later, I fell in love and got a girlfriend.” Although his dentures aren’t perfect, they’re “better than no teeth—and “a real boost to my self-esteem.”

Kevin also welcomed the luxury of being able to chew and enjoy food again. “The hardest thing to eat without teeth? A fucking pickle,” he says. But though life is better now, Kevin sees that year without teeth as a gift, because it taught him self-reliance. “I had to learn to live, and to find self-worth and self-esteem through esteemable acts, not appearances,” he says.

He now works as a drug counselor and does a lot of outreach work at rehabs, detoxes and crisis centers. “I always, always make it a point to pull out my upper dentures,” Kevin says, “to remind people that I did not ride the coattails of a winning streak into recovery. Nobody gets turned away, just because you don’t have teeth and shit like that.”

Allan Clear, executive director of the Harm Reduction Coalition, says that people’s perceptions of tooth loss and decay are “another piece of the stigma” associated with addiction. The conditions also impact how people with addiction see themselves. “When you have teeth missing, or you look a certain way, or your teeth actually make you sound a certain way when you speak,” he says, “it can do horrible stuff to your self-confidence.”

Dental work can be crucial in helping people to reenter the job market and reintegrate into mainstream society. “In terms of all the strikes against you,” Clear adds, “if you have a history of drug use, addiction or prison, you really don’t want to have your physical appearance get in the way of getting back into society.”

Brian’s donated surgery would have cost about $80,000 if surgeons and dentists hadn’t donated their time. The overall reduced costs were paid for by Saville, in hopes that philanthropists would be inspired to make similar donations in the future. At a recent drug policy conference he attended, Brian says that some people were “outraged” at hearing about this use of resources. They argued that he could have gotten the procedure somewhere cheaper, like Costa Rica. But Brian says he’s determined to give back by dedicating his life to helping others: “The payoff in social capital for an investment like this is trying to fight for social justice anywhere I can.”

Today, “I look at myself every morning when I’m brushing my teeth and I think about how [the implants] changed my life,” says Brian. “Primarily, it’s changed my self-image. That’s the first thing people notice. What I notice is the confidence though,” he says. “Often times, [people with addiction are] our own worst aggressors when it comes to image, that kind of stuff. We keep ourselves down.”