London may not be the only city known for bad teeth.

Lubbock, too, is gaining a similar distinction.

The Hub City was ranked as having the worst teeth in the nation in the April 2008 issue of Men’s Health magazine.

And the high level of fluoride in Lubbock’s water, as well as the cost of dental care, may be to blame.

The study ranked 100 large cities in America, with Lubbock finishing last. El Paso, San Antonio and Dallas were not far ahead.

The analysis used statistics from the Centers for Disease Control and Prevention on the number of people who annually visit the dentist, the number of canceled appointments, the number of people who floss on a regular basis, as well as the number of households using fluoride. Denny Watkins, the reporter who wrote the article in Men’s Health, said he also used Mediamark Research to gather information used to compute the rankings.

And some say fluoride is the source of the problem.

“For years, we’ve had such high fluoride levels,” said Randell Johnson, a local dentist. “It’s the local well water that’s so bad.”

Too much fluoride in the water may cause the enamel on teeth to become rough, leaving brown or white stains, dentists say.

Well water alone contains too much fluoride, said Gaylyn Chapman, the city’s water utilities customer service supervisor. But Lubbock’s water supply is diluted with water from Lake Meredith, she added.

And according to the city’s Water Quality Report for 2006, the city’s water meets state requirements.

Despite the water, Johnson said the quality of his patients’ oral health is extremely high, and the population sample the study used may not be an accurate reflection of the whole city.

John Epperson, another local dentist, said some people take excellent care of their teeth and some don’t.

“My expectation is people in Lubbock are like people around the country,” he said.

Johnson and Epperson have practiced dentistry in Lubbock for about 30 years.

But flouride may not be the only issue to blame.

Some Lubbock dentists and residents blame high insurance rates for Lubbock’s low ranking.

The amount of Medicaid patients in the area, who tend to have less dental hygiene education, could be why statistics for Lubbock’s oral care are low, said William Nash, a local dentist.

“I do a lot of Medicaid work,” Nash said. “Notoriously, they have poorer teeth than the normal population.”

Other Lubbock residents agree.

“Dental insurance is kind of high, so a lot of people can’t afford it,” said Jeremiah Flores.

But Flores said his mother works in the dentistry field, so he makes frequent trips to the dentist.

Not having dental insurance is no excuse for Tim Vega.

Before he started getting health benefits through his job, Vega said he still made trips to the dentist.

“I don’t think (not having insurance) is a reason,” he said, adding he currently has dental insurance and had a checkup just three months ago.

Candice Lofton, who works at The Candy Wrapper in South Plains Mall, said many people don’t brush and floss their teeth like they should. Having worked as a dental assistant, Lofton reminds kids who buy candy to always brush their teeth.

“I’m like, Brush your teeth after you eat that,'” she said. “And their moms will laugh.”

Lubbock resident Aimee Galicia said she has not visited the dentist since she was a child.

“It’s been a long time,” she said. “I have five children – I take them.”

But Alex Lopez said he visited the dentist just six months ago.

“I try to take pretty good care (of my teeth),” he said.

And Barbara Deason does, too. She said she visits the dentist regularly for cleanings.

“I floss. I brush my teeth. And I drink a lot of water,” she said.