Cosmetic dentistry takes on new polish
The new age of dentistry is equal parts medicine, marketing and money.
After years of preaching preventive care and promoting the use of cavity-fighting fluoride, dentists are becoming victims of their own success.
Faced with rising costs, competition from an increasing number of dentists and fewer patients needing fillings and restorative work, dentists are turning to a new frontier in search of business: cosmetic dentistry.
"Prevention has been so successful that restorative work isn't there," says Dr. George Sweetman, a Lindsay dentist who heads the Ontario Dental Association.
He says the focus is still on prevention but acknowledges the elective or cosmetic side is growing.
"Now that people are keeping their teeth for a lifetime, they're very concerned about their appearance," says Sweetman.
And dentists say they're finding many who want to improve what their genes gave them.
Costs put bite on dentists
These days, dentists can use bleach to whiten teeth, adhesives to lengthen them, fill in gaps, or realign a bite, then finish with a few coats of porcelain veneer.
Patients can even choose from a variety of veneers, deciding just how dazzling they want their smile to be.
"Where we're heading with dentistry is as new to dentists as it is to the public," says Dr. Ed Philips, who operates a dental practice at Hydro Place doing regular and cosmetic work.
"We can make teeth look younger, we can make teeth look more elegant, we can make teeth look more corporate."
The Ontario Dental Association is launching a $700,000 billboard and TV campaign this spring that focuses on the new techniques.
One billboard shows the word "gap," with a large space between the G and A. "Fixing it is easier than you think," the copy says, "ask your dentist."
Recent technological improvements mean much of the work can be done in one or two visits, without resorting to orthodontic wires and tracks, or expensive caps.
The cost of these procedures range from a few hundred dollars for bleaching that can be done at home, to $5,000 for major work.
Most dental programs don't cover cosmetic services, which means dentists are forced to compete with a myriad other products to capture a chunk of their patient's disposable income.
Even if you don't have a dentist, or yours hasn't mentioned these services, you've probably seen others advertising these options on the back of K mart cash slips, or on flyers in other junk mail.
"I've always had healthy teeth, but somehow I've never had a great smile," says clothing store owner Pepe Appugliese, who recently decided to alter his smile.
Philips changed Appugliese's smile by filling in a gap at the front and reshaping a few teeth. Most cosmetic work involves these relatively subtle changes.
There are more than 5,700 dentists Ontario and that number has been growing, despite a cut in enrolment at dental schools, because dentists trained elsewhere have been coming here to work.
A survey found 63 per cent of dentists who had been practising for fewer than 10 years would like more work and 46 per cent of all dentists would like to be busier.
Dentists who rank near the top of the income scale, with average earnings of $99,280 in 1991, are touchy about suggestions they are turning to new services in an effort to bolster declining incomes.
Philips argues that if they are properly informed, patients won't be talked into something they don't want.
The high cost of setting up an office is one factor driving dentists into uncharted areas.
A new dentist will shell out $160,000 to $200,000 to set up a one-chair office, says John Caise, operations and equipment manager for dental supplier Ash Temple Ltd.
New graduates usually can't afford the latest laser machines and video-imaging equipment that could add another $60.000 to their start-up costs.
As part of his approach, Philips uses separate rooms to discuss cosmetic procedures, realizing patients can't feel comfortable deciding whether to spend several thousand dollars on improving their smile if they are lying in a dental chair with their feet tipped up.
Patients get a plaster model they can take away to show other dentists and before and after pictures that use video-imaging techniques.
Sometimes patients take the proposal away and come back a year or two later when they are financially, or psychologically, ready.
Dr. Allan Jeffries and his traditional practice Scarborough's Cliffcrest Plaza illustrates the trend.
A few months ago, Jeffuies sent out his first flyer, promoting new cosmetic dental techniques and touting ways to improve smiles.
The response was not great, but many of his patients asked about the methods and directed a few new patients his way.
This fits with Philips' advice in his lectures. Start your marketing internally with your own patients, then branch out.
"Most of my patients just want teeth that stand the test of time and look decent," Jeffries says. "They don't want to look like movie stars."
Philips offers his patients a written guarantee that the work will last from two to five years, depending on the procedure.