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 Patients want to improve their smiles, and the range of options for doing that is wider than ever. Most of our readers are increasing their cosmetic caseload and expect the growth to continue. by Stan Goff The times, they are a-changin’. Patients and their needs have changed. So have dentists and their services. In no area of dentistry has this change been greater than in the field of cosmetic dentistry. Dr. Mickey Bernstein of Germantown, Tenn., the President Elect of the American Academy of Cosmetic Dentistry (www.aacd.com), recalls how “cosmetics” and dentistry were viewed together three decades ago. Dr.Bernstein, one of the first to embrace cosmetic dentistry, also takes a look at DPR’s Exclusive Cosmetic Dentistry Survey (see “About this survey,” page 72) and shares his thoughts on the current state of the booming cosmetic dentistry business. The beginning “As a 1975 graduate of the University of Tennessee College of Dentistry, it quickly became apparent to me that, in that era, cosmetic dentistry was regarded by the conservative leaders of dental organizations as inappropriate treatment for any patient,” Dr. Bernstein said. “At that time, conventional wisdom said to treat only fractured, decayed, or missing teeth. To perform dentistry only to enhance the beauty of any patient was considered by many as heresy. Even I refused to treat a Miss America finalist who wanted her existing attractive smile made whiter by placing multiple crowns.” (Back then, tooth-whitening procedures and prepless veneers were not viable options as they are today.) Certainly, Dr. Bernstein is not alone when it comes to cosmetic dentists who were ahead of their time. Esthetic dentistry pioneers like Drs. Irwin Smigel, Ronald Goldstein, and K. William (“Buddy”) Mopper each told similar stories in the Esquires of Dentistry section of DPR’s 40th anniversary issue (September 2007). Like Dr. Bernstein, they were each faced with obstacles from colleagues and patients in terms of perceptions surrounding dentists and cosmetic services. But these are different times, as evidenced by the large number of GPs who report increases in both patient inquiries about elective cosmetic dentistry procedures and their caseloads. Eighty-four percent of our readers report an increase in such patient inquiries over the past five years, while 73% report a caseload increase for cosmetic procedures (see “Cosmetic comparisons,” below). Additionally, more than one-fifth of the DPR survey respondents (21%) devote 5-10 hours each week to any aspect of cosmetic dentistry (see “Caseload,” page 69). Forty-four percent spend 2 to 5 hours a week on cosmetic dentistry.
“Times have changed,” Dr. Bernstein said. “Tanning bed businesses perform well year round. Appointments for top hair stylists are difficult to obtain. Plastic surgery is commonplace. And, at long last, the public and the dental profession also have come to the conclusion that self-improvement (even if slightly invasive) is acceptable and desirable, as the DPR survey statistics show. As a result, manufacturers and educators have developed a large number of products and procedures to help people feel better about their smiles.” Initially, most of the people seeking–and able to afford–cosmetic dental procedures were the wealthy, oftentimes those who needed a great smile to enhance their appearance on television or in movies. This too has changed greatly. Now there are numerous options for patients looking to improve their smile, and people of all ages and backgrounds are asking about and receiving such services. “In the early 80s, as cosmetic dentistry was emerging, the majority of people seeking those services were celebrities, the very wealthy, or pretty young girls wanting to be prettier,” Dr. Bernstein said. “Cosmetic organizations began to evolve, such as the American Academy of Cosmetic Dentistry (AACD), thanks to the vision and commitment of Drs. Jack Kammer, Jeff Morley, Bill Strupp, and others, resulting in the spread of knowledge and expertise. “In recent years, the media has focused on cosmetic dentistry in magazines, newspapers, radio, and television shows ranging from ‘The Today Show’ to ‘Extreme Makeover.’ The public is very aware of the techniques that are available to them from their neighborhood dentist to big city practitioners that focus solely on cosmetic enhancement.”
The word has long since been spread. Dentists no longer just repair damaged teeth. They can make your smile look a whole lot better. Organizations like the AACD and the American Society for Dental Aesthetics (www.asdatoday.com) are thriving as more dentists want to learn how to provide the best esthetic services.
They need to be able to meet the changing expectations and demands of today’s patient. “In recent years, the profile of patients seeking cosmetic care has drastically changed,” Dr. Bernstein said. “People with congenitally defective teeth, dark tetracycline-stained teeth, unattractive spacing and crowding, and a multiplicity of genuine issues that keep them from getting a promotion or getting a date, are arriving at dental offices seeking the restorative care that they have been made aware of by the media.” More than eight in 10 GPs plan to pursue continuing education specifically intended to enhance their ability to provide cosmetic dental services (see “Keeping up with education,” page 72). Almost three-quarters of our readers who plan to take CE will do so through association-sponsored programs (73%), with study clubs (47%) the second most popular choice. More than one-third will go to private teaching institutes, universities, or to manufacturers for their CE, according to the survey. “One of the most effective approaches to developing a high level of skill in cosmetic dentistry is investing time and energy in the journey through accreditation in the AACD,” Dr. Bernstein said. “The real winners are the patients whom you serve.” (Continued on Page 2)
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