October 24, 2014

Health

I hadn’t really looked at my teeth since my braces were removed 20 years ago. I brush in the dark. I hardly ever floss. The one time I used a whitening rinse, the hydrogen peroxide made my mouth foam up like a rabid dog’s.

Don’t get me wrong: I’m not above vanity. I’m just neurotic about other things. Besides, I thought my teeth were already perfect.

Maybe they were—in the ’80s. But the definition of perfect teeth has evolved as much as dentistry since then. Porcelain fillings have replaced silver fillings. Porcelain veneers have replaced natural enamel. And if you want your teeth to gleam even more, there are accessories.

"I’ve been asked to do grills [and] diamonds. One patient wanted their entire top row of teeth to be gold," says Dr. Thomas Hale of Advanced Cosmetic Dentistry in Naples.

For readers not familiar with hip-hop culture, grills are custom-fitted metal overlays, generally gold, silver or platinum, in which jewels can be set. They give literal meaning to the saying, "Put your money where your mouth is," though these contraptions can be as inexpensive as a few hundred bucks apiece, crafted at "dentist" kiosks in malls across America.

"I tell patients, I can do anything you want. But if you’re going to get that, don’t tell anyone I’m your dentist," Hale says. "That" refers to mouth bling as well as unusually white veneers. Hale says he wants his work to be "cosmetic," meaning, ironically, natural-looking.

Of course, changing one’s natural appearance is the goal of cosmetic dentistry, and, as with plastic surgery, this niche is on the rise. From 2005 to 2006, cosmetic dentistry revenues grew 15 percent, and the total number of patients grew nearly 13 percent, according to a 2007 American Academy of Cosmetic Dentistry (AACD) survey.

Bonita Springs-based dentist Dr. Brian Olitsky, like many of his colleagues in the area, says the most common cosmetic request in his office is for veneers. To get them, your teeth are reduced in size before the porcelain material, in a shade selected by the patient, is permanently bonded to the front. The cost per tooth ranges from about $750 to $2,100.

Maureen Ritenour, who lives in Pennsylvania, was recommended to Olitsky by her local periodontist. Ritenour flew to Southwest Florida several times for a full-mouth rehabilitation, which included Invisalign braces (the ones that look like shrink-wrap over your teeth and cost $5,000 and up), aesthetic improvement of tooth implants and veneers. "[Olitsky] did such a good job at making [my teeth] look natural. Some guy just stopped an entire conversation and said to me, ‘I just can’t stand it anymore. You have the most beautiful smile. What did you do?’" says Ritenour, a 64-year-old retiree. "I turned purple. At my age, I don’t get many compliments like that."

As I spoke with more patients who have veneers and love them, I started to wonder about my own teeth. I pulled out a 5X magnifying mirror and had a good, long look. My eye teeth are yellow. And when did that front tooth start to protrude?

Horrified, I put down the 5X and examined my choppers in a regular mirror. It was kinder to me, certainly, but the truth is that my teeth aren’t terrific anymore. Wondering what I could do to improve them—without filing them down to nubs—I called another Bonita Springs dentist, Dr. Melanie Pugh. She told me about "no prep" veneers, sold under such brand names as DuraThins and Lumineers.

"They’re probably the hottest trend. They’re a very thin shell of porcelain that goes over the top of your natural teeth," Pugh says. The process involves minimal tooth reduction, so if you want to get rid of the porcelain, you won’t look like a jack-o-lantern.

Hale, who also offers no-prep veneers, wonders how reversible they really are. After all, some teeth have to be filed a bit, and surface enamel might be scarred from the bond.

For low-commitment improvement, he says, try whitening. It takes about an hour in the dentist’s chair, or your dentist can create trays for you to fill with a hydrogen peroxide gel at home. Depending on the patient’s needs, professional whitening ranges from around $500 to more than $1,000. At the least, you’ll end up with a brighter smile.

You might even make a few new friends. An AACD study about the link between teeth and personality attributes found that "people with smiles altered by cosmetic dentistry are regarded as … more interesting, intelligent, happy, etc. than those with their original smiles."

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