Why Some Amish Have Their Teeth Pulled: Cost, Not Doctrine

Some Amish adults do have all their teeth pulled and replaced with dentures, often much younger than the rest of us would. The reason is not religious. It is the price of dentistry and the absence of insurance.

The short version

No Amish church forbids dental care. What most Amish churches do forbid — or at least strongly discourage — is commercial insurance, on the grounds that the congregation should carry its own. Medical costs are met by the community through mutual-aid arrangements rather than by a policy.

That works reasonably well for a catastrophe, which is what mutual aid was built for. It works badly for a slow accumulation of cavities in a large family, where each filling is a bill and no bill is an emergency.

Extraction is a single cost that ends the problem. A full set of dentures is a single cost that ends it permanently. Fillings, crowns and root canals are a lifetime of costs that never quite end.

Given that arithmetic, a great many people in the same position would make the same choice.

What the research actually shows

The best study is small but careful. A mobile dental unit examined 210 Amish children aged 3 to 17 in Geauga County, Ohio, between May 2011 and May 2012 (Heima, Harrison and Milgrom, Journal of Clinical and Experimental Dentistry, 2017).

The findings were stark. More than 88% of the children had untreated decay. Only 11 of them were free of cavities. Twenty-eight per cent — 54 children — had never had any dental treatment at all, and those children averaged 6.8 decayed teeth apiece.

Among the youngest group, ages 3 to 5, decay prevalence was 88.6%, against roughly 20% nationally for the same ages.

And one more finding, which is the saddest of them: 87.7% of parents rated their children’s oral health as good or very good.

That last figure is not neglect. It is what happens when a community has no basis for comparison. If every child you have ever seen has decay, decay looks like childhood.

What the rumours get wrong

Two things circulate online that deserve correcting.

That the Amish pull their own teeth. Some settlements have lay practitioners who do extractions, and this is real. But most Amish who have teeth removed go to a licensed dentist, often one in the area who has built a practice around Plain customers and charges accordingly. Cross-border dental trips also happen, for the same reason non-Amish Americans make them.

That all Amish do this. They do not. There is no single Amish practice about anything. Settlements differ enormously — an Old Order community in one county and a New Order community fifty miles away may have entirely different norms about dentistry, and about a dozen other things. Anyone who tells you what “the Amish” do is generalising across more than two thousand separate church districts.

Why dentures carry no shame

In wider American culture dentures at thirty would be read as a mark of poverty or neglect. In Plain communities they are simply a solution that many adults have, and nobody remarks on it.

This is worth sitting with rather than pitying. A community that has decided appearance is not a measure of worth has removed a genuine cruelty that the rest of us live under. That the same set of convictions also produces avoidable pain in children is the harder half of the same fact, and both halves are true at once.

What Scripture has to do with it

Very little, directly. The Bible says nothing about teeth as a matter of health, and the Amish do not claim otherwise. Their position on insurance rests on passages about bearing one another’s burdens (Galatians 6:2) and not being unequally yoked with outsiders in binding commitments (2 Corinthians 6:14), together with a long Anabaptist suspicion of worldly systems.

Those are serious readings held by serious people. They are also readings with a cost, and the children in the Ohio study are part of the cost.

The honest conclusion is not that the Amish are wrong about mutual aid. It is that any community, ours included, pays for its convictions somewhere, and the humane thing is to know where.

Frequently asked

Do the Amish believe dental care is sinful?

No. There is no Amish teaching against dentistry. The barrier is cost, distance and the absence of insurance.

Do Amish people use anaesthetic?

Licensed dentists treating Amish patients use anaesthetic as they would for anyone. Accounts of extractions without it come from lay practitioners and are not the norm.

At what age do Amish get dentures?

There is no standard age. Reports of full dentures in the twenties and thirties are credible for some settlements and would be unusual in others.

Do the Amish have any health insurance?

Most do not carry commercial insurance. Many communities operate church aid funds, which pool contributions to meet large medical bills.