Cosmetic Dentistry

“It’s what you wear from ear to ear, and not from head to toe …”

If that rings familiar to you, so may the rest of it, which goes, “You’re never fully dressed without a SMILE.”

So sang the passel of lovable orphans in the musical “Annie.” And it’s a tune that is being hummed by more and more dentists today.

“When you correct the smile, you see the face differently. It’s about beauty, it’s about self-esteem, it’s about feeling confident about yourself. Who has the right to tell you that you shouldn’t have those things?” said Dr. Ronald Goldstein, DDS, who is just the one to pose that question.

A prolific author — one of his several books, “Change Your Smile” (Quintessence Books) is in its third edition — and pioneer in the field of cosmetic dentistry, Goldstein is a champion for sparkling ivories. “Patients will say to me after we’ve done a procedure, ‘People think I’ve had a facelift.’ That’s the best.”

“It’s true. My friends all thought I had a facelift, but I didn’t,” laughed Sandra Cape in a soft, rolling accent reflective of her home in Atlanta, Ga. The 58-year old made the decision to have a series of procedures done five years ago by Goldstein, including adding porcelain laminates on her upper teeth, braces to help straighten others, replacement of crowns and tooth bleaching. While Cape always loved her smile — “I do have to say, I have always had a nice smile,”– there was one but: a darkened, discolored front tooth that bothered her for years.

“I have to admit I was very self-conscious about this. It just didn’t seem to go with the rest of my mouth,” she said. On a visit to Goldstein’s private practice — Goldstein, Garber, Salama & Gribble L.L.C in downtown Atlanta — the veteran dentist with 40-plus years experience used computer imaging to show Cape what she would look like with the changes.

“I don’t think of myself as a vain person. But when I saw the difference, well, it was like when you see a wonderful antique or piece of art that you absolutely love. You have to have it,” she recalled, adding the entire procedure cost her around $40,000.

Cape is just one of the hundreds of thousands of Americans moving toward extensive cosmetic dentistry to not only improve their looks, but enhance their oral hygiene and lengthen the life of their teeth.

“I don’t differentiate. All dentistry is cosmetic dentistry,” said Dr. Richard Price, consumer adviser for the American Dental Association (ADA) and president of the Newton Dental Associates in Newton, Mass. “Brushing your teeth, flossing, changing a filling, getting rid of a stain — is all cosmetic. Of course, the only one who thought a silver filling was beautiful was a dentist. But to me, it all enhances your teeth.”

While that may be true, Price is quick to point out that the options available now are so varied and sophisticated that virtually no one has to live with bad teeth, or a lousy smile.

“This is almost 100 percent true, because even if all is lost, we have implants. We can virtually replace dentures with gorgeous implants,” said Price, who has been practicing since the mid-1960s. “I am 59 years old and probably the first in my generation since Adam that has my own teeth. It is all too common for us to have parents who had full dentures. That is almost obsolete.”

Coupled with the changes in technology that have led to such things as resins, porcelain laminates and tooth-colored fillings to replace the old silver amalgams, there is evolving aesthetics of the art of dentistry.

“You are sculpting teeth, matching colors, designing bite. It takes skill and precision,” said Goldstein. And the public appreciates it. According to a recent survey conducted by the American Academy of Cosmetic Dentistry, 9 out of 10 people think that an attractive smile is a huge asset, two-thirds believe that an unattractive one hurts your chances at success, and almost 90 percent always remember someone with a great smile.

According to Rob Johnston, he is one of the unforgettable.

“I am not kidding when I tell you that for six months after I had all my work done, I did not encounter one person who didn’t comment on my teeth. That includes strangers,” said the gregarious 52-year old president of the Pinnacle Company, an Atlanta-based apartment management firm. “Now, nine years later, it’s what I’m known for.”

To get those pearly whites, Johnston had to endure two years of wearing braces — “I was the only one in the orthodontist’s office over 15″ — and had to give up something else. “This was instead of the Porsche I really wanted. He took my darn car.”

Goldstein also straightened his top teeth, and “basically enhanced every tooth in my mouth.” After years of feeling self conscious of his smile because of poor dental work, Johnston was eager to pay the cost, which turned out to be $45,000.

But the moral of the story is that Johnston still ended up with his Porsche, albeit several years later, and has a renewed sense of self-confidence.

“People want to be around happy people. A smile is the best way to manifest that. A smile eases people’s defenses, and just makes really good business sense,” he said.

While oral hygiene and tooth-longevity are some of the sensible reasons, proponents point to self-esteem as one of the most important.

“Absolutely. This is no joke. When someone leaves the chair in my office with tears in their eyes, it’s not because of pain,” added. Dr. Price.

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