Our Town: May the smile be with you

Publication Date: Wednesday Jul 28, 1999

Our Town: May the smile be with you

by Vicky Anning

I screwed up the courage to go to the dentist last month for the first time in years.

I've always had healthy, shiny white teeth. I brush them twice a day. I floss them, whenever I remember. And they've never given me any trouble. I just don't like going to the dentist. They scare me to death.

As I reclined in the cold black leather chair at the Middlefield Road office, I remembered why. The high-pitched whine of drills and the smell of antiseptic mouth rinse brought back traumatic childhood memories. Even the television set playing CNN over my head couldn't distract me as the man in the white coat bore down on me with a battery of instruments.

And then it came out of the ether. "How do you feel about your teeth?" he asked, flashing his own pearly whites in my direction.

I almost gagged on the instrument sucking water from my gums.

"How do I feel about my teeth?" I gasped. "Errr ... I've really never thought about it."

All right, so I have one slightly crooked lower tooth. And my aging fillings wince occasionally when I eat ice cream. But on the whole, my teeth are doing just fine. Or so I thought.

By the time I left the cold black chair, I wasn't so sure anymore.

"We could straighten that tooth out for you, no problem," my dentist said, pointing to my crooked incisor. "And we could replace all those metal fillings with tooth-colored crowns."


"How much would that cost?" I asked, when he finally removed the instruments from my mouth.

"Oh, we could do the whole lot for about $5,000," he said, flashing that smile again.

Gulp. It was like going to the doctor for an annual exam and being told I need a tummy tuck.

As I left the office clutching a payment plan, I felt as if the smile had been permanently wiped from my face. I didn't even pay $5,000 for my car. Then I started to rationalize. Perhaps my insurance would cover the costs. A couple of phone calls later, it was clear they wouldn't.

It was about that time that I started noticing ads for cosmetic dentistry everywhere I looked.

"Get brilliant white teeth in less than one hour," they promised. "We can create a new, beautiful, natural-looking smile in two visits."

It seemed to be part of a conspiracy designed to make me feel even worse about my mouth. Then I started asking questions. And my worst fears were confirmed. It was part of a conspiracy--a dental conspiracy to promote cosmetic dentistry.

According to Welch Road dentist David Love--yes, Dr. Love!--the old-style drill, fill and bill dentistry is giving way to more aesthetically pleasing techniques. In fact, Love doesn't use metal fillings at all any more--just porcelain.

"There's more money to be made with this new technique than with the old insurance-based dentistry," said Love, who offers laser tooth whitening, porcelain veneers and other "metal free" dentistry not covered by most insurers. "For patients to want this type of dentistry, they have to pay more money."

And pay they do. According to Nanette Bernstein, who heads the Midpeninsula Dental Society, half of the society's 250 member dentists-- from Menlo Park to Mountain View--offer some kind of cosmetic dentistry. And the number is growing.

"I have seen a trend, especially in this area," Bernstein said. "People are seeking this as they would cosmetic surgery."

Dentists claim the fad is being fueled by increasingly image-conscious patients. Others are not so charitable, pointing out that dentists are seeking new revenue streams as they find less demand for traditional dentistry.

"Over the years, our general oral health is always improving," Bernstein said. "So this is another avenue for dentists."

Cosmetic dentistry isn't yet recognized as a specialty by the American Dental Association, and the techniques are typically taught in career development seminars rather than at dental schools. But Frank Grimaldi, a dental professor at the University of California at San Francisco, predicts cosmetic dentistry will eventually integrate itself into general dental practice. It's a philosophy, Grimaldi says.

"You need to interview the patient and find out what element of their smile they don't like," he said.

For a few hundred dollars, those who don't like the color of their teeth can whiten their smiles by several shades. More elaborate treatment--such as porcelain veneers and inlays--can set you back several thousand dollars.

As for my dental dilemma, I decided to ditch the payment plan. Call me old-fashioned, but I don't feel strongly enough about my teeth to shell out $5,000.

Vicky Anning is a staff writer at the Weekly.

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