The knowledge of dental practice comes from scientific research and also from close engagements with patients in poorer (underserved) communities. Many patients with healthy upper front teeth wanted these extracted, not for health-related reasons, but because, in their terms, it was fashionable. Appearance concerns and acceptance were more important than healthy tooth aesthetics. The personal beliefs and social positionality of patients in underserved communities require dentists to see patients differently, as sources of knowledge that could inform dentistry practice and the promotion of oral health. Dentists and health care professionals are obligated to educate people to realize that access to care is a human right in terms of the constitution of our country. Social and cultural mores often stand in the way within these communities. New knowledge can be generated through the precision gained from the scientific method, but it can be complemented in powerful ways by attending to the knowledge of patients in underserved communities where history, culture, economics, and tradition shaped local responses to dental care in both positive and limiting ways.