About one in three U.S. adults say they did not visit the dentist at some point in the past 12 months. The 64.7% in 2013 who said they did visit the dentist at least once in the previous year is essentially unchanged from the rate found in 2008. Women are more likely than men to report visiting the dentist annually.

These findings are based on interviews with 178,072 American adults conducted during 2013 and with 354,645 adults conducted during 2008 as part of the Gallup-Healthways Well-Being Index. Respondents were asked whether they had visited the dentist in the previous 12 months. Results for all years between 2008 and 2013 are similar.

The American Dental Association recommends that adults develop a plan for dental visits with their dentist, but say even those at low risk of oral disease benefit from at least annual cleanings. Thus, one in three American adults do not meet this minimum level of dental care.

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Photo Credit: AP / Carol Tapanila

“We the people….” declared the script inside her U.S. passport — now with four holes punched through it from cover to cover. Her departure from life as an American was stamped final on the same page: “Bearer Expatriated Self.”

With the envelope’s arrival, Tapanila, a native of upstate New York who has lived in Canada since 1969, joined a largely overlooked surge of Americans rejecting what is, to millions, a highly sought prize: U.S. citizenship. Last year, the U.S. government reported a record 2,999 people renounced citizenship or terminated permanent residency; most are widely assumed to be driven by a desire to avoid paying taxes on hidden wealth.

The reality, though, is more complicated. The government’s pursuit of tax evaders among Americans living abroad is indeed driving the jump in abandoned citizenship, experts say. But renouncers — whose ranks have swelled more than five-fold from a decade ago — often contradict the stereotype of the financial scoundrel. Many are from very ordinary economic circumstances.

Some call themselves “accidental Americans,” who recall little of life in the U.S., but long ago happened to be born in it. Others say they renounced because of politics, family or personal identity. Some say signing away citizenship was a huge relief. Others recall being sickened by the decision.

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Photo Credit: Politico

When the president, a reformed smoker himself, lands in Kuala Lumpur this weekend for his third stop in a weeklong Asia swing, he’ll be visiting one of the other 12 Pacific Rim countries hoping to close the Trans-Pacific Partnership, a free-trade agreement that American and Asian businesses see as worth billions in sales into new markets.

But Malaysia is smarting that Obama’s negotiators won’t back the country’s efforts to take a strict anti-tobacco approach in the trade deal.

Malaysia’s fear is that it will suffer the same fate that Uruguay, Australia and Thailand have in other trade deals: dragged into an expensive, years-long international legal fight over its right to block cigarette companies from advertising.

When Malaysia’s trade negotiators have pushed to carve tobacco out of a section of the deal that would otherwise allow businesses to challenge whether a country’s laws and regulations meet its international trade obligations before an independent panel, the United States has balked and instead called for an approach that Malaysian officials believe would leave their country exposed.

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