Some years ago, I received a card for a birthday. Pictured on the front was an island paradise. Written over the image was something like, “There is a place where the old are revered, youth is insignificant and the wisdom of the ages is treasured in the elders.”

On the inside of the card was additional insight about this supposed wonderland: “They also use human teeth for money.”

So much for paradise.

It is still funny every time I think about it. However, as I look around the world at the growing disparity of wealth, it makes me wonder: What would happen if riches were indeed stored as a vault of human teeth? What if money became repugnant?

Money has had a variety of markers of value. Early on, there were cows and grains. The bartering would go something like, “I will give you this cow for your 10 bushels of wheat.” If that practice had continued, banks would be filled with a lot of manure.

Then the cattle baron was born. Cattle ranches were Fort Knox. Cattle rustling was robbing the bank.

Unfortunately, there were disadvantages to trying to use cows as tender. You couldn’t insert them into pay phones or use them at laundromats. Further, the cow couldn’t be carried in any convenient purse, and change would be impossible.

That is when teeth, instead, could have entered the pockets of people around the world.

While people might have been happy about the added convenience of using human teeth, it would not exactly have been the best vehicle for growing wealth. First, when there is a chance to earn quick money, there will always be people to exploit it. Counterfeit incisors, molars and even wisdom teeth would begin to flood the money markets. Inflation would grow out of control.

For a loaf of bread, at first one would have to put down only two incisors. Almost overnight, the price would rise to a couple of molars and four incisors. Black markets would spring up. People suffering for want of the basics would begin to find rogue dentists who would pull teeth for a wisdom tooth or two.

Desperation would start to overcome the usual human restraints, and anyone with a pair of pliers would set up pulling shops in back rooms down back alleys.

As 99 percent of the population would grow thinner due to lack of buying power, they would also become hungry from the inability to chew anything that required teeth.

Being toothless would mean both poverty and starvation.

The only upside would be if the remaining 1 percent grew dissatisfied with their stockpile of old teeth. Who would want human teeth hanging around? Imagine a treasury glittering not with diamonds but with the gleam of old dentures.

Charity would then skyrocket. The wealthy would do anything to get rid of their gross, stinky stockpile. They would throw contributions at anything of social good.

Food and clothing would be shared with the disadvantaged. Teeth for student scholarships would pop up all over the nations. The means to meet basic human needs would be distributed justly among the rich and the poor.

The arts would flourish; improvements in housing, environmental projects and infrastructure would all be funded with the surplus of unwanted teeth.

Education would be augmented, and early intervention of children at risk would be supported first out of the desire to get rid of the enamel. Soon, the societal advantages would become obvious, and the giving of teeth would accelerate because everyone could feel the positive impact to the whole community.

Hoarding and speculation wouldn't be practiced. Who would want more teeth? Giving them away would feel better. Enriching the less fortunate would become the new wealth. It would be a competition toward giving, not gaining.

It would be a utopia created by everyone working for the good of his or her neighbor.

The story would be one of a paradise.

On birthday cards, there would be jokes about mythical paradises where people used plastic for money.

Joseph Cramer, M.D., is a board-certified pediatrician, fellow of the American Academy of Pediatrics, practicing physician for 30 years and a hospitalist at Primary Children's Hospital and the University of Utah. Email: [email protected]