Some people opt for new boobs. Some want a shock of tansplanted hair. Others want their lipo immediately suctioned.  Judith Hantin? She wanted a fresh smile. No, she needed a fresh smile. It was either that of a ventriloquist, because Hantin had become so self-conscious about her teeth that she’d developed a habit of covering her mouth when she spoke.  She hated that habit. She hated her teeth. But she also hated the thought of her unsightly smile replaced by huge, bright caps that serve as a billboard: Hey, Check Out My Fake Teeth!

"I had always wanted to do it, but I never liked how the teeth looked afterward," Hantin says about cosmetic dental surgery. "I thought it made them look like they had big pieces of Chiclets for the caps."  Still, she had to do something. As a vice president of the Nathan Adelson Hospice, Hantin communicates with the public, pitches donors and works with volunteers. She certainly couldn’t continue covering her mouth to hide her dental flaws.

So she asked Dr. Patrick Simone, her family dentist, about the state of cosmetic dentistry. Simone, who has an office in Green Valley, has eased into aesthetics during the past 12 years and is now one of the most respected cosmetic dentists in the Valley.  "[Simone] showed me what the alternative was to the big Chiclet teeth without looking phony," Hantin, 52, says. "He showed me [photos of] other patients that he had done and how beautiful they looked."  Hantin wanted that look. She needed that look. Thanks to Simone and a set of porcelain laminate veneers, she got that look.

"When you see people, one of the first things you look at is their mouth. Now I notice their teeth," Hantin says. "And I’m not the greatest dental patient on the planet, but I was comfortable in this procedure. I’m thrilled to be able to have done this. It makes you more self-assured…Now people say, What beautiful teeth."  Luckily for Hantin, her dentist went through extensive cosmetic training and acquired state-of-the-art tools. Not every cosmetic dentist can make that claim.  

It’s not enough to do general exams and fillings anymore. For a lot of doctors, the money – and job satisfaction – is in cosmetics. Today, Simone is one of about 500 Southern Nevada dentists who promote their practices by using the words "cosmetic dentistry." Sure, busts and new hairlines remain the cosmetic industry’s big sellers, but teeth are making their mark.

"We’re definitely working our way up," Simone, 41 says. "Some people want big breasts. My clients tell me they want their smile. Baby boomers are using their smile to regain their youth."

How is it possible? Well, as with most everything else, technological advancements have given dentists more tools with which to shape smiles. They include bonding agents, bleaching gels, titanium posts that bind teeth to the jaw and laser surgeries on gummy smiles.

Some popular procedures include:  Porcelain laminate veneers.  Hantin’s experience involved the placement of porcelain veneers, which resemble press-on finger nails, over her existing teeth.  Teeth replacement surgery. Surgical-grade titanium posts are placed in the jawbone to hold sections of teeth securely. New "teeth" are screwed into place, and the patients is free to eat anything shortly thereafter. Specialists are used to insert the posts.  Filling replacement surgery. Silver or black fillings are replaced with porcelain ones. This more common procedure has been enhanced by better bonding agents.

Teeth whitening or bleaching. Several options are available, including the patented Bright Smile technique. This involves the use of a bleaching gel and a gas plasma lamp, which combine to make teeth up to 10 times brighter in 90 minutes.

By far the most popular cosmetic procedure, whitening is a $600 million industry that has grown 15-20 percent in recent years, according to the American Academy of Cosmetic Dentistry. The academy also states that bleaching services in dental offices have increased 300 percent in the last five years, veneers 200 percent and bondings 100 percent.  These advancements are not only giving patients plenty of reason to smile, but longtime dentists are grinning from ear to ear, too.

I’m a different dentist than I was five years ago, much less that 30 years ago," says Dr. Cal Evans, 63, "I have every toy invented-lasers, computers. We now have instant orthodontics with pieces of porcelain to change their smile. There’s been a revolution in equipment."

Which has led to a revolution in the high-stress dental field. Ten years ago, most dentists were forced to grind out a weekly living filling cavities, scraping away plaque and scolding patients for not flossing. Then, in the late 1980s, when cosmetics began to gain in popularity, dentists were presented an alternative; seek continuing education and enter the aesthetics world, where you treat one or two patients a day-patients who volunteer to see you, not ones who dread your very existence. No wonder dentists young and old are eager to learn the trade. "A lot of my friends are burned out, and I’m still going to school," Evans says. "I graduated from dental school in 1966, and most of my peers are retired. I’m having so much fun, and it’s so rewarding. I don’t know when I’ll ever quit."

Change is rarely easy to accept. So it’s hardly a surprise that a lot of dentists initially frowned on cosmetics. "Many said it wouldn’t work and wouldn’t last," Now everyone wants to be a cosmetic dentist, and you don’t see an ad without the word "cosmetic" in it.  Not that that’s entirely a good thing. The American Dental Association doesn’t recognize cosmetic dentistry as a specialty. Therefore, there are no additional guidelines or educational standards.

"Just because you stick your name under a sign doesn’t mean you’re a cosmetic dentist," says Dr. Samuel Pick, 59, who went to dental school with Evans and has been examining mouths for more than 30 years. "There’s a lot more to it than putting six veneers on their six front teeth-there’s the facial structure, lips and gums to look at. …A true cosmetic dentist has a lot of extra training.

Says Simone: "Some guys take a weekend course, then on Monday morning, they hang a sign outside their office that says cosmetic dentistry. …There is no way to say that one has more training than another, not in cosmetics. If there are 500 dentists here, then 450 call themselves cosmetic dentists."

Simone, who’s worked as a dentist since 1985, started taking cosmetic classes in 1989, but didn’t start using the word "cosmetic" in his practice until 1996.  "I did things a little differently. I got the training first," he says. "As soon as I felt comfortable and knew that what I was doing, I was doing correctly, and I was going to give my patients a good result for their investment, then I decided to put cosmetics after my name."  

Since it’s difficult to determine which cosmetic dentists are at the top of their game, the key is to do research, inquire about a dentist’s credentials and request referrals to other patients. Also, when interviewing dentists, ask if specialists are involved; if your procedure involves a laser, ask if it was manufactured in the past three years, during which time lasers have been significantly refined.

If you do put your mouth in incapable hands, there are recourses. The Southern Nevada Dental Society’s Peer Review Committee, of which Simone is a member, hears patient complaints, and if it believes a dentist was negligent, it can refer the patient to the state’s ultimate dental police, the Board of Dental Examiners. The 10-member board, which includes Pick, licenses every dentist in the state and can take action (including the suspension or revocation of a license) if a dentist is found to be in violation of state law.  There is some soothing information, though: The state board has received very few patient complaints about cosmetic dentists and has never had to mete out punishment.  "If people have had problems, we’re the place they would complain," says Valonne Harmon, the board’s executive director. "For the most part, [cosmetic dentists] do a very good job.

The good news for patients in the valley-and really, patients all over the world-is that dentists can attend classes and learn the latest industry tricks right here in town. The Las Vegas Institute for Advanced Dental Studies, located in Summerlin, was founded by Dr. William Dickerson and welcomes as many 1,000 dentists a year. "There’s none like it," says Evans, a graduate of and instructor at the institute . "For a while we were going to Baylor University [in Texas}. Their facility wasn’t as up-to-date as it should be. Ours is the only private one with a hands-on facility. We can do the latest and the newest." The Las Vegas Institute has welcomed dentists from all over the North America, as well as Australia, New Zealand, Japan and England. It’s so popular Dickerson, 48, is expanding the facility to include an additional complex that will house new lecture halls and labs. It will be "the world’s premier post-graduate dental teaching center," Dickerson says.  Classes at the institute can enhance a dentist’s skills-they work on actual patients-and boost their confidence. Still, some dentists view such classes as a hassle. Dickerson would like to see that attitude change "Very few dentists understand cosmetics," he says. "You can’t get it from a one-day school. If someone hasn’t been to a program, I don’t think I could recommend them because they don’t grasp the technicalities that are important. You can give anybody white teeth and they are happy, but that doesn’t mean you couldn’t have done it better to make [the teeth] functionally stronger so they don’t break."

With all of the technological and educational advancements-not to mention the sparkling results of patients-there’s only one reason why somebody uncomfortable with their smile wouldn’t do something about it; money. Like any cosmetic procedure, elective dental work can be costly. And don’t bother call your insurance carrier, because cosmetic dental work isn’t covered-unless you’re involved in an accident, in which case your medical insurance would take over.

So how much are we talking about here? The least expensive option is teeth whitening or bleaching, which costs about $500. (After the initial treatment, patients usually will need touch-up work, which can be done at home or at the dentists’ office-every one to two years). Want to replace those ugly black fillings? Be prepared to fork over anywhere from $150 to $1,000 per tooth. Porcelain veneers $600 to $1,500 per tooth.

"It’s all about priorities," Simone says. "Guys making just over minimum wage can be driving a Mercedes."

Experienced cosmetic dentists like the ones mentioned in this story tend to be situated more toward the higher end of the pricing chart. But before you go shopping for a bargain, remember the comments by Simone, Pick and Dickerson about dentists who take a weekend course, slap "cosmetic dentist" on their office door, then dive into your mouth Monday morning. There’s something to be said for experience.

Of course, for some, you can’t put a price on a perfect smile. Just ask Judith Hantin. "It was something," she says, "I couldn’t afford not to do."

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This article was reproduced for this web site
from Las Vegas Life, June 2001