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9/14/2003

A better bite

By Pam Mellskog
The Daily Times-Call

LONGMONT — Confidence may be priceless. But these days, upgrading one signature sign of it — a broad smile — is not.

Cosmetic procedures, which include tooth whitening, bonding, veneers, crown lengthening and full mouth reconstruction, range from $300 to $30,000 at Smile Designers, 920 S. Hover St., said owner Dr. Cliff Rogge.

That was good news for one 22-year-old man with deeply stained teeth.

He initially asked Rogge to pull every tooth and replace them with dentures so as to escape constant comments from others to brush his teeth.

Another patient, who scoops ice cream for a living, underwent a cosmetic procedure after a 5-year-old customer innocently asked her when the Tooth Fairy was going to visit.

Instead of living with frustration or hurt feelings, both of these individuals took advantage of the options offered at Smile Designers and many dentists’ offices across the country.

“We’re excited about it,” said Dr. Kim Harms, a Minneapolis-based spokeswoman for the American Dental Association. “It’s a fun and important part of our practice that most dentists are doing to one degree or another because it makes our patients happy.”

Rogge’s shift to conducting 80 percent traditional and 20 percent cosmetic dentistry is magnified at the national level.

Since 1996, cosmetic procedures have made triple-digit gains — 200-plus percent , according to reports issued by the Milwaukee, Wisc.-based American Academy of Cosmetic Dentistry, a nonprofit accrediting institution.

Neither AACD or the ADA could provide profit margin statistics between traditional and cosmetic dentistry procedures.

However, this margin appears anecdotally plumper for a number of reasons.

First, since many cosmetic procedures can be completed in two visits or fewer, this form of dentistry reflects greater productivity, according to AACD president, Dr. Mike Malone.

Marketing-wise, it is a snap see-it-and-believe-it sell. Word-of-mouth means more, after all, when spoken with a flash of freshly minted pearly whites.

Finally, dentists who become expert in cosmetic techniques can do that business instead of handing it off, Rogge added.

The booming niche, therefore, has a get-rich-quick feel. However, dentists have said the draw goes well beyond business ambition.

“This kind of stuff has made dentistry fun for me again,” Rogge said.

The fun factor, combined with the challenge of mastering the ever-improving technologies, prompted him to pursue more than 200 hours of continuing education last year — far more than the 30 hours required by the Colorado Dental Association Trust, he said.

There’s also unexpected emotional rewards, he explained.

“Most of the time you ask patients how they’re doing and they say, ‘Good, until I came here,’” Rogge said.

Cosmetic dentistry turns that attitude on its heel. Patients once ashamed to smile have returned to his office with bottles of wine and showers of “thank yous,” post procedure, he said.

Modern dental adhesive technology first hit the market in 1955, with the advent of a product called Buonocore.

Since then, however, technology has ripped along to give people with broken, decayed, misshapen and stained teeth far more options with the benefit of a natural look, said Dr. Mark Birnbach, owner of BoulderSmiles in Boulder.

For instance, crowns once required a metal substructure that both created a dark line at the gum and reflected light so much as to cause an artificial looking, chalky white coloration.

New adhesive and porcelain technology, he continued, now allow dentists to discard the metal substructure to create more realistic translucence in doctored teeth.

Birnbach finds the difference immediately appreciable, as do his patients, he explained. That is what justifies the cost difference to both.

“There are Cadillacs, and there are Volkswagons. I can get a crown done for $29, but I wouldn’t put it in my worst enemy’s mouth,” he said.

Top-end procedures, he added, typically increase the cost by a factor of 10.

But patients who buy into cosmetic dentistry have said it’s worth every penny. If vanity plays a role, so what? For those self-conscious enough to cup their hand over their mouth when speaking, the difference could be felt in everything from dating to job interviewing, Birnbach explained.

Still, cost blocks some from benefiting from the new wonder-working technologies and techniques.

The best insurance policies, according to Rogge, typically cap traditional coverage at $1,500.

Those dollars occasionally underwrite cosmetic procedures, but only if they intertwine with a functional one, he added.

So, the target market — approximately two-thirds of it composed by women — has to have money.

According to AACD, 48 percent of patients earn $50,000 annually.

More than 50 percent of them have also celebrated their 40th birthday — 27 percent are between 40 and 49 years of age, and more than 25 percent are age 50 or older.

Despite the aging demographic of the bulk of patients, the relatively young niche could not have a brighter future, thanks to their youth-lust, according to Mike Gergen, spokesman at the Las Vegas Institute, one of more than a dozen cosmetic dentistry continuing education schools.

“The growth is based on patient demand. They don’t want — they expect for it to look natural,” he said. “Ten years ago, patients could say, ‘I want a beautiful white smile.’ Now, they say, ‘I want a beautiful white smile that looks natural, like when I was in high school.’”

Pam Mellskog can be reached at 303-776-2244, Ext. 224, or by e-mail at pmellskog@times-call.com.