LOUISA, Ky. — Thomas Reed’s daughter won an award for the prettiest smile at her Louisa, Ky., school.Reed admits he would never win such an honor. He hasn’t been to a dentist since he was a boy. He never flosses his teeth, seldom brushes. He has chronic gum disease.“We’re going to do a full mouth extraction today,” Dr. Dan Brody informed Reed after having a quick look in his mouth at a Valley Health dental clinic in Wayne County, just across the river from Louisa.Dreama Jordan, who also lives in Louisa, has been walking the floor in pain the past two nights.“I have a plate, but I couldn’t get it in my mouth today, it was swollen so bad,” said Jordan, who has 10 teeth left.Poor oral health isn’t a problem exclusive to West Virginia.Reed and Jordan, both 45, live in Kentucky, a state that had the highest proportion of people without teeth in 2002.West Virginia surpassed Kentucky in 2004, the last year the Centers for Disease Control and Prevention has collected data on tooth loss.Oral disease seems to be most prevalent in Appalachian states. Kentucky has the second highest rate of tooth loss among older adults, followed by Tennessee.In the Deep South, Alabama, Louisiana and Mississippi also have high rates of oral disease. Oklahoma is another state with few people going to the dentist and large numbers without teeth.Hawaii and Connecticut typically have residents with the best oral health.Reed said he grinds his teeth at night. He sometimes wakes up and spits out teeth. He said he has tried to pull some of his own teeth, but they broke off.Brody pulled six of Reed’s teeth during a visit last January.“Some people, if they’re really hurting, we’ll do 10 to 15 teeth in a day,” Brody said. “If they have a widespread oral infection going on, you’ve got to get the infection out, so the body can start healing. It’s a different kind of dentistry here.”Jordan had 10 teeth removed — the last of her remaining teeth.Jordan has no dental insurance or medical card. Her husband, a former coal dock worker, is trying to qualify for disability payments. Jordan has been cleaning houses.“It’s the only money we have right now,” she said.With the last of her teeth gone, she went to check out.“Today’s charge is $175,” the receptionist said.The total charge actually was $700, but Jordan qualified for a 75 percent discount.She pulled a wad of bills from her pocket and handed them over. A $10 bill and nine $1 bills. Nineteen dollars. That’s all she had.The receptionist told Jordan to pay the remaining amount within 30 days.“Anything’s better than suffering with a toothache,” she said.To contact staff writer Eric Eyre, use e-mail or call 348-4869.