A staple of American humor about the United Kingdom is the population's bad teeth. In one of many recent memorable parodies, when young Ralph Wiggum on "The Simpsons" admitted he did not brush his teeth, he was brought to tears by the picture of Prince Charles in his orthodontist's copy of "The Big Book of British Smiles."
Those reportedly misshapen, stained, rotten teeth are only set to get worse as 1 million people in England lose their state-financed dentist under government reforms introduced last month.
The change has produced a surge in businesses that offer dental vacations to eastern Europe or do-it-yourself kits.
No More 'Drill and Fill'
The British government is switching the way it pays the tens of thousands of dentists who are part of the free national health insurance system that covers the entire population. The new arrangement means dentists are paid a flat fee -- currently estimated to be about $150,000 a year -- instead of them billing the government for each National Health System treatment.
"We are taking dentists off the 'drill and fill' treadmill of the current pay system, as it will provide dentists with more time with patients and more time for preventive work," U.K. Health Minister Rosie Winterton told ABC News.
The country already suffers from a shortage of dentists, but officials admit 10 percent of those participating in the National Health System have not signed new contracts, meaning there will be even fewer professionals available under the public system.
Susie Sanderson, chair of the British Dental Association's executive board, said the payment switch makes it even harder for Prime Minister Tony Blair to fulfill a pledge made seven years ago that everyone who wanted it would have access to NHS dentistry.
It is now nearly impossible to find a National Health dentist. Only 10 local practices are listed on the NHS Web site for the bustling neighborhood of Hammersmith, West London. And only two of those 10 would treat National Health System patients; the rest have gone wholly or partly private.
Watkins J. and Associates, a dental office in West London, reported a jump in people seeking treatment since the new legislation went into effect. But they say they can't afford to take on new patients, because the government payment they receive every month wouldn't increase to match a bigger caseload.
Need a Filling? Do It Yourself!
As private dentistry costs have increased in the U.K., more patients are considering going abroad for dental treatment. They can save significant money by traveling to countries like Hungary or Croatia.
A private dentist in the U.K. quoted Kirsty Minas of Kent a fee of $23,000 for a procedure to improve her smile. She contacted a company in eastern Europe called Smile Savers Hungary and received an estimate of $9,000 for the same treatment.
A dentist from Hertfordshire has devised another, cheaper option, a do-it-yourself-kit. People can fill their own teeth or replace a crown. Tony Lee's kit costs $17 and includes a mirror, dental solutions and plastic tools. Since the new legislation, he has seen an increase in demand for his Dentanurse kits, and he predicts his production will increase threefold over the next year. Major pharmacy chains already stock it and it is about to appear on supermarket shelves.
Although his kit was originally designed for emergency treatment for travelers in remote areas, "it now offers those who cannot get appointments, a chance of DIY [do it yourself]. It's not a permanent solution but it will tide them over for a few days," he said.