One thing's for sure: teeth aren't just for eating anymore. Through cosmetic dentistry, consumers today have a dizzying array of tooth-enhancing options that promise to create a smile filled to the brim with perfect-looking pearly whites.
While traditional dental care aims to maintain healthy teeth and treat oral disease, cosmetic dentistry is more about helping patients achieve a more attractive look. Not all cosmetic dentistry focuses purely on aesthetics. For example, reconstruction procedures offered by a cosmetic dentist might attempt to restore functionality to teeth that have been damaged by decay or an accident, says Thomas P. Connelly, D.D.S., of Connelly General and Cosmetic Dentistry in Manchester. But modern reconstruction techniques often leave a patient looking better than he or she did before, Connelly says, and cosmetic dentists usually draw the attention of patients interested in aesthetically improving a fully functioning set of choppers.
Cosmetic dentistry is a burgeoning field, estimated to be a $2.75 billion market, according to the American Academy of Cosmetic Dentistry (AACD). Baby boomers constitute the majority of those who typically seek cosmetic dentistry services, although much younger and older patients are not uncommon. "The range of folks is all over the place," says Paul E. Thompson, D.D.S., of Thompson Smiles by Design in Manchester.
Connelly estimates that his patient make-up is about "50/50 men vs. women. A lot of the men are a little bit more subtle about it, though," he says. "They don't want people to know that they've had their teeth fixed." Connelly says that he's worked on numerous 45- to 55-year-old male CEOs or men in prominent positions who are scheduled to be on TV or to be interviewed frequently.
"I think the motivating factor's a little bit different with the men and women," Connelly says. The male CEOs "are worried about the way their teeth are going to look, how the public perceives them," while the women tend to feel the pressure of the forever-young American culture.
Advances in cosmetic dentistry during the last two decades have drawn patients in, as well, Thompson says, and have led to less-invasive techniques that rely on better materials and achieve faster results.
A quick glance at the products lining the oral healthcare shelves of any drugstore or supermarket gives a big hint as to the most popular cosmetic dentistry service: whitening. Tooth whitening is the most requested service partly "because it's minimally invasive and people can get a good shade change, maybe up to six to 10 shades lighter than their original," Thompson says.
Also, consumers are bombarded by ads for tooth whitening products, Connelly says, and the heavy marketing, along with Hollywood celebrities and media figures whose teeth are a preternatural shade of almost glow-in-the-dark white, have led increasing numbers of patients to inquire about whitening procedures.
The images of perfection tempt some patients to settle for nothing less than dazzling. Connelly and Thompson say they've encountered their share of patients whose desire to go ever-whiter knows no bounds. "It's not a common thing, but there are people that seem to think they can always get [their teeth] even whiter. But there is a point of no pigment, when the teeth are as white as you're going to get," Connelly says.
Fortunately, ultra-whitening in most cases does not appear to be overly harmful, although patients might experience increased tooth sensitivity or gum irritation. But some sensitivity is common even among conservative whitening patients, Thompson says, regardless of which product is used.
In fact, there is some risk associated with most, if not all, cosmetic dentistry procedures, Thompson says, but it is usually minimal. If you are dissatisfied with the results of a procedure, often you cannot return to what you started with. That is not true of bleaching, of course, because if you stop whitening and make no lifestyle changes, eventually your teeth will probably get stained again. But some procedures require the dentist to prepare the tooth in a way that will forever change it, however slightly.
Placing a porcelain veneer, for instance, might require a dentist to grind away two-tenths, or as much as a half of a millimeter from the front of the enamel, in order to make space for the veneer, Connelly says. That technique does slightly affect the integrity of the tooth, he says, "but what you give back to the patient in terms of self-confidence and quality of life I think far outweighs the minimal risk."
Also, the amount of risk depends on the situation, Thompson notes. If a patient's tooth is unattractively colored but has no structural problems, improving its appearance will involve minimal risk, whereas a tooth that requires a complex restoration for improved function and aesthetics might involve more risk.
How big a bite will cosmetic dental procedures take out of your wallet? It varies widely, from over-the-counter whitening products that cost about $30, to $500, on average, for a whitening package from a dentist, and then potentially on into the thousands for more involved procedures, such as veneers and multi-tooth enhancements, whose cost can soar into the tens of thousands, Connelly says. The average amount spent by cosmetic dentistry patients in 2006 was $5,640, according to the AACD.
Cosmetic dentistry has brought services once provided only to the rich and famous to flinty Granite Staters. Connelly, who has perfected the teeth of high-wattage celebrity clients in New York City, says that today he performs the same procedures right here in Manchester. Whether that leads more of us to smile during blizzards remains to be seen. NH
This article appears in the December 2008 issue of New Hampshire Magazine