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DENTAL NEWS ARCHIVES 191

MSNBC Health

Million Dollar Smile

Pretty pearlies: Cosmetic procedures are on the rise
Alex Nabaum for Newsweek
Pretty pearlies: Cosmetic procedures are on the rise

By Karen Springen

Newsweek

March 7, 2005 - Kendall Ramirez, 34, always felt self-conscious about her teeth, which she thought were too wide and masculine-looking. So before her wedding five years ago, the Dallas marketing consultant splurged on MAC veneers, paying about $15,000 to cover her 10 top front teeth with porcelain. She was so happy with the results that, last year, she went back and had her bottom set bleached. The result: a bright, rounded, more feminine smile. "It was worth every penny," she says.

Ramirez is part of a new era in dentistry that goes far beyond fighting cavities. With the vast majority of celebrities sporting blinding-white smiles, and shows like "Extreme Makeover" bringing da Vinci veneers to Everyman, Americans have grown tooth-obsessed. As a result, dentists are performing about twice as many cosmetic procedures as they were just three years ago, estimates Cleveland dentist Matthew Messina, the American Dental Association's consumer adviser. And companies have sprung up to offer special financing for those who'd like to remodel their mouths. Tempted? Here's a primer on the most popular procedures:

Veneers. At $1,000 to $2,000 per tooth, it's the most expensive option but the best way to improve the shape of your teeth. (One downside: veneers may need to be replaced every 10 years or so.) A dentist typically grinds down your tooth enamel, then glues on a custom-made porcelain shell. To save money, you can buy veneers for just the top six to 10 "smile zone" teeth and bond or bleach the rest. Don't go too white or you'll end up looking like Wayne Newton, who had a special color made so his audience could see his mouth from the back of the concert hall. To avoid the horse look, tell your dentist explicitly that you don't want big teeth, and ask for "temporaries"—resin mock-ups that mimic the smile you'll end up with.

Bonding. This technique involves a plasticlike resin instead of porcelain, and dentists perform it "freehand" in the mouth. It's excellent for smaller work, such as fixing a chip. But, unlike veneers, it can't be used to reshape or whiten a broad surface. It also costs a comparatively low $300 to $700 per tooth.

Bleaching. A good option for people who don't need to straighten or reshape their teeth. Peroxide bubbles out some—but not all—stains that collect within tooth enamel. (Ask your dentist ahead of time if bleaching will fix a particular blemish you're concerned about.) Typically, custom-molded bleaching trays—worn at home for an hour a day for two weeks—cost $300 to $500 and can get your teeth five to eight shades whiter.

Those in need of instant gratification can turn to "power whitening," which takes only one hour in the dentist's office and uses a light-activated peroxide gel. The treatment—under brand names like Brite-Smile, Zoom! and Rembrandt—typically costs $600 to $1,000 and can get patients 10 to 12 shades lighter, says Messina. Over-the-counter products like Crest Whitestrips Premium (seven-day treatment course for $34.99) are a good place to start when you're trying to decide if professional bleaching is for you. But be wary of store-bought bleaching trays, which can make it tricky to keep the gel spread evenly.

Before you jump into the dentist's chair, do your homework. Not all practitioners are equally trained in esthetic techniques, so check their credentials, which may include membership in an association like the American Academy of Cosmetic Dentistry (aacd.org). Ask to see before-and-after photos of their patients—not generic ones of another dentist's work. And think about payment. Companies like Enhance Patient Financing (enhancefinance.com) offer loans for cosmetic dentistry similar to car loans, except that interest rates are higher because there's no collateral. (You can't repossess dental work.) And remember, a little bit can go a long way. "Not everyone needs an extreme makeover," says Messina. "Small changes may make a big difference."

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