With all the recent advancements in cosmetic dentistry, some adults are seeking out the once-dreaded dentist’s chair to get their teeth whitened, straightened and brightened.

For the most part, there’s no tooth fairy to pick up the bill. Yet, some whose parents couldn’t afford braces when they were younger are spending the money and taking the trouble to wear them. They even have the option of wearing newer white braces that aren’t as noticeable as the traditional metal wires.

All in all, improving your smile has become less painful and time-consuming. Just ask Dr. Ed Philips, whose office credo is: "Will that be fluoride or a Cappuccino?"

Philips, a dental surgeon in Toronto for 20 years, has just opened an ultra-modern "studio for aesthetic dentistry" near the Ontario legislature, complete with a cappuccino maker, stereo and VCR.

Instead of dealing with fillings and cleanings, his new practice is limited strictly to the business of smiles.

Like every dentist, Philips sees his share of patients who for years have covered their mouths when they laugh or smile because of teeth that are horribly crooked, misshapen or stained.

In fact, problem teeth have held some of his patients back from going for a promotion, public speaking or just meeting new people because of the fear of rejection or ridicule.

"One CEO came in to get some work done because whenever he smiled he looked mean and nasty and it was really affecting his image at work, but he was actually the nicest man," said Philips, whose clients are mostly professionals and people in the entertainment industry.

The CEO acquired a softer smile after a few visits to Philips’s office, where his sharp teeth were filed down and covered with a natural-looking white porcelain veneer, fused on to teeth to improve both color and shape.

Mark Breslin, founder of the Yuk Thk’s comedy chain, used to smile with his mouth closed because of teeth he described as chipped, thin, uneven and badly discolored.

"Of all people, I should be able to smile," he said.

He found a lot has changed since he was a kid enduring "pure torture" while getting fillings at his family dentist.

"I’m very, very happy I got it done," he said after five long dental sessions. He paid $10,000 to cover his upper teeth with porcelain veneer and to get laser whitening for the bottom.

The price range for smile improvement runs between $200 and $5,000.

He could improve every one of them, boasts Dr. Bederman. Well, almost every one. New Brunswick’s premier, Frank McKenna, 48, is virtually perfect. "Unless he came in saying he really hated his nose or something, I’d leave him alone," says the doctor; who runs the Centre for Cosmetic Surgery in Toronto.

Elm Street provided official photographs of the premiers, pictures chosen to put their best faces forward. Even so, Dr. Philips, whose Toronto practice specializes in smile analysis, believes he could turn up the wattage on the smiles of several of the men. He wouldn’t bother changing Saskatchewan’s Roy Romanow; somebody, he believes, beat him to it.

Using the two experts’ know-how, plus electronic photo- manipulation software, we could have turned back the clock and made the premiers look like their high-school photos. We didn’t. "These days plastic surgery aims for subtle, natural- looking refinements that leave the patient looking refreshed," says Dr. Bederman. The goal is to soften lines, not to pull the skin so tight that the face looks permanently startled.

One word of caution. No matter how gifted the practitioner; cosmetic surgery is a mix of science and art. Computers aren’t bound by the realities of scalpel and sutures. In real life the premiers might not emerge from surgery looking as sleek as they do in our manipulated portraits. "It would be lovely if we could just say, ‘OK, let’s slim the nose by another 10 per cent,’ and have that happen," says Dr. Bederman, "but we can’t."

Still, just look at what a little electronic nip here, a digital tuck there can do to Ralph Klein’s chipmunk cheeks, to Mike Harris’s schnozz, to Brian Tobin’s ears.

Lyle details some of the most compelling scientific research which supports this belief. It is well known, for example, that the brain produces neurotransmitters which affect a person’s mood and energy level. Psychologist Robert Zajonc has postulated that when a person smiles deliberately, even when feeling blue, the brain releases neurotransmitters which can override the sadness. In essence, when people smile through their tears, the brain can be tricked into making them feel better.

Not only does smiling have a positive effect on the smiler but there’s good reason to believe that it also has a powerful influence on others. Paul Ekman, a researcher at the University of California, believes that one of the reasons people are attracted to those who smile is because smiles are infectious. Confronted by a smiling face, one smiles in response, resulting in all the positive effects on one’s autonomic system.

That is also one of the reasons why people who smile may be more successful in their careers. Many psychologists believe that people who smile tend to manage, teach and sell more effectively.

Dr. Denis Waitley, a motivational psychologist, points out in his book The Winner’s Edge, how crucial a smile can be to a person’s success in life, and to one’s abilitiy to connect with others when he says: "Winners display a simple, radiating charm. They project that warm glow that comes from the inside outwards. Most importantly, self-esteem is transmitted with a smile, which is the universal language that opens doors, melts defenses and saves a thousand words."

You may be thinking to yourself, I now know smiling is good for me but I just wish I had a nicer smile to show the world. The reality is that anyone can achieve a beautiful smile with today’s cosmetic and environmental dental techniques and solutions.

Cosmetic dentistry is not a new concept for oral beauty and has always been in the eye of the beholder. Ohaguro was the name of a tradition in old Japanese social strata for the method of staining teeth black. In Mayan culture, teeth "enhancements" included grooving and notching. Marco Polo wrote in his travels that Chinese men and women covered their teeth with thin plates of gold. Centuries later among the Kilao of southwest China, wedding day brides had two incisors broken out as a rite of beauty.

Cosmetic and environmental dentistry respects the autonomy of the client more than traditional dentistry. The patient, beyond the pain and urgency of an abscessed tooth, can calmly consider the elective procedures. Health conscious people are asking for safer dental alternatives and progressive dentists are responding by getting in step with personal and environmental concerns. Nontoxic dentistry is the dentistry of the 21St century.

If you’ve decided to pursue a new and improved smile the first step is to find a dentist you are comfortable with; one who will discuss available options including a questionnaire asking you to offer your opinions, priorities and needs. And, one who will show you before and after photos of patients who have undergone similar procedures, simulate your cosmetic changes with digital computerized equipment and give you an estimate, contract and explain all about the techniques and materials as well as their limitations.

Currently Smile Whitening has become one of the most sought after elective dental procedures for people in search of whiter brighter teeth. The consumer has two choices, either whiten at home in about a week or have your dentist perform a laser treatment in a couple of short office appointments.

Almost every will benefit from the At Home Tooth Whitening Program. It will lighten natural teeth that have been discoloured due to aging, consumption of coffee, tea, colas, smoking, trauma, tetracycline staining, excessive fluoride and nerve degeneration. It’s actually a process that lightens discolorations of enamel and dentin. The program uses a mild solution retained in a custom-fitted appliance that fits over your teeth. As the active ingredient in the solution is broken down, oxygen enters the enamel and dentin, dissolves, and removes the coloured substances. The structure of the tooth s not changed, only the tooth colour is made lighter. Results are often seen after the first. use, but normally to achieve desired results the trays are worn for three to four hours a day for about a week. The teeth will always stay lighter than they were, however most people find they like to repeat the whitening procedure for a couple of days every year to combat their lifestyle choices that contribute to the darkening of the enamel.

The process for this program is simple. A dentist will take impressions of your upper and lower teeth and have a laboratory fabricate custom-fitted trays (similar to very thin sports guards). The trays and whitening kit are taken to the patient’s home. Inside the kit, there are carpules of gel that dispense into the trays which are placed over the teeth. The trays with solution are to be worn for about four to five hours each day for about a week. The patient can decide the most convenient time to wear them. And the trays can be worn overnight during sleep.

There are many at home tooth whitening programs available, so ensure you discuss your needs with a dentist experienced in home whitening. They will either stock or specially order the best product for you. Some of the most popular product names are Nite White, Opalescence, Rembrandt and Contrast PM. The active ingredient in these products is carbamide peroxide with a neutral pH. It has been used by dentists for over 50 years as an oral-antiseptic, for cavity prevention and as a tooth whitener. The side effects, if any, will be slightly sensitive teeth while using the product. This disappears within 48 hours after the treatment ends.

Glorified toothpastes and those "as seen on products just don’t work so don’t waste your money.

In Office Laser Whitening is the newest technology in smile whitening. The laser is simply a source of concentrated, light energy. A special whitening gel is placed on the teeth, and, when activated by the laser light, works quickly and gently to whiten the areas of stained enamel. Laser tooth whitening is effective on discolouration due to aging, consumption of coffee, tea, colas, smoking, trauma, tetracycline staining, excessive fluoride and nerve degeneration, similar to the At Home Whitening Program. The major difference is that the laser whitening produces immediate results. The procedure is usually performed in one or two 90 minute office visits.

These special lasers for tooth whitening have been approved by the Food and Drug Administration and thousands of people have had their teeth whitened this way.

So what does your new, brighter whiter smile cost? The At Home Whitening Program ranges from $250 to $800, depending on the dental office and the products used. The In Office Laser Whitening fees can range from $800 to $1,500 for the complete treatment.

When inquiring about whitening services and fees you may want to ask the following questions:

Does your office take before and after 35 mm photos to compare the results?

Do you do a comparison, before and after whitening, using a dental shade guide to show how many shades your teeth actually lightened?

At the completion of treatment, if I have some stubborn stains that are still present, will you provide me with a higher concentrate gel to illuminate them? If so, is it complimentary?

Does the dentist perform the laser whitening?

Is my satisfaction guaranteed?

In today’s highly competitive world "a world in which one’s self image and the image one projects to others is so critical" more and more people of all ages are determined to present the best possible SMILE.

Eye lid surgery is particularly popular with men, he said. Other forms of facial rejuvenation, he said, are facelift, brow lift (the least popular) neck lift, chemical peel and collagen inserts, or a combination.

Miles said his rule of thumb is that facial cosmetic surgery should not be done more than three times in a lifetime and a second operation should not be done until five years have passed.

The trend is for younger and younger people to come in for cosmetic surgery and he now operates frequently on patients in their 40s, he said.

Cosmetic surgery is becoming more and more popular, he said. "Recently, I was at a cocktail party in Rosedale with about 30 people and when I was cornered and asked questions I said, ‘Six people at this party have had plastic surgery,’ That really set the cat among the pigeons."

He said it is not necessary to have a second consultation but if a patient is not comfortable, he or she should have one.

"The brow lift is the most underestimated and under-performed operation in cosmetic surgery," Miles said.

Breast augmentation, following a masectomy is the operation he does the most. "Our goal is a nice feminine form, not a big bust," Miles stated.

He advises patients who have had cosmetic surgery to wait three weeks before going public and six weeks before attending a major social event.

"Mark my words, within a few years you’ll be getting a call from your dentist to come in every few months for bleaching," said Dr. Edward S. Philips who practices dental cosmetics.

Bleaching, to whiten teeth, is one of the main changes coming in the practice of dentistry, he said. The process will involve patients letting a solution soak their teeth.

The day is not far off when computers will fashion the fillings patients need for cavities or other reasons, Philips said. And on the horizon as well are lasers to fuse fillings into place.

Unfortunately, 90 per cent of dental insurance does not cover cosmetic work, he said. One reason for the increase in dental cosmetics is that people are living longer and want their teeth to look good. Most dental bridges worn by patients are out of date in new-age dentistry, he said.

Dr. Shia B. Wolgelernter described sclerotherapy which he uses for patients with varicose and spider veins. It involves the injection of a solution, takes only 10 or 15 minutes, and has an 80 per cent success rate.

Patients don’t complain of any pain from the needles, but some do report pain from the solutions, he said.

"It is painless and safe and requires no hospitalization," he said. The larger veins are likely to recur, he added. He asks patients to wear support hose for two weeks after the procedure.

-B.R.

Why? Three reasons. The first seems to be computers and access to the Internet and the information that a web site(s) provides. Many people have learned, or are learning, that this powerful and increasingly popular source for information is an incomparable method for research. A well-done web site is educational and informative and causes a person to become knowledgeable and informed.

The second reason is money. Given the state of the weak Canadian dollar, $1.00 US is currently worth approximately $1.50 in Canada. Many medical and dental services and procedures are comparably priced in the United States and Canada, so that in Canadian funds a patient can anticipate saving anywhere from 30 – 50 percent.

And the third reason, which is the most qualified and beneficial reason, is the level of experience and expertise achieved by Physicians, clinics and hospitals in Toronto.

For example, The Studio for Aesthetic Dentistry in Toronto is the only one of its’ kind in North America, and the Shouldice Hospital, which performs only hernia procedures, is recognized worldwide for the procedure developed some 58 years ago, and at the Bochner Eye Institute, patients come from as far away as Texas and California as a result of the Canadian approved equipment utilized to perform laser eye surgery.

Toronto is recognized worldwide as a medical centre mecca for various disciplines, and teaching facilities. Many Doctors, medical researchers, Dentists and other health care specialists are frequently invited to lecture in the United States and around the world. The reputation of certain facilities and Physicians is such that American patients are often referred by their personal physicians for treatment in Toronto, and U.S. Doctors have been known themselves to come to Toronto for certain treatments.

As a result, hundreds of Americans come to Toronto annually for numerous medical and cosmetic services, which often results in satisfied patients referring friends and relatives for the same or similar procedures.

Following is a brief profile of some facilities in Toronto which have, and are, currently treating American patients:

The Institute of Cosmetic Surgery
Since commencing his practice in 1978, Dr. Lome Tarshis has become one of the most respected and popular cosmetic surgeons in the city. Trained in Toronto, and Beverly Hills at Cedars Sinai Hospital, Dr. Tarshis has had additional training and worked with some of the most renowned plastic surgeons in the US, Brazil, Italy and France. It is important to note that Dr. Tarshis is a Board Certified Fellow of the American College of Surgeons. Dr. Tarshis has become a recognized authority in his field and attends national and international symposia, either to lecture or participate in a professional exchange of information.

Dr. Tarshis has performed various procedures for over 500 American patients, one of the most recent having travelled from Missouri to Toronto. In addition to the Doctors’ skills and expertise the cost of having procedures performed in Toronto, in Canadian funds, justifies the travel expenses.

An indication of how well some people research a cosmetic surgical procedure is how often The Institutes web site is accessed – 200 times a day and from across the U.S. and as far away as England. The Institute receives 5 -10 qualified email inquires everyday.

Several new patients are referred to The Institute by former patients, some who have returned for second and third procedures. Contact The Institute of Cosmetic Surgery at 1 888 926-8122 or (416)

926-8122. The web site address is www.cosmeticscanada.com

Shouldice Hospital
This hospital, having gained a worldwide reputation for the technique of repairing hernias, (the method having been developed some 50 years ago), has treated 400 – 500 American patients a year! and many more that come from around the world. Such is the experience of the medical staff and the highly developed skills and procedure that this method of hernia repair has come to be known as "the Shouldice technique"

In fact, one of every seventy patients is a medical doctor, and of the thousands of patients treated at Shouldice every year, 57% are referred by former patients. The internet being the source of information it has become, an astounding 11% of patients come to Shouldice as a result of the comprehensive website: www.shouldice.com.

The Hospital has prepared a comprehensive and informative VHS video which a potential patient can request.

Most U.S. managed care plans such as Aetna/U.S. Health Care, Multiplan and Blue Cross/Blue Shield, will cover the cost of the procedure, which is approximately $2200.00 US, and for patients that qualify Shouldice Hospital offers a $300.00 Cdn. travel allowance. The same procedure in the United States is approximately $4500.00 US for outpatient care. Included in the fee at Shouldice is 72 hours post op care, again specifically developed for hernia patients.

It is important to note that surgeons at Shouldice are U.S. Board certified.

Statistically, the repair and failure results in Great Britain are as high as 30%, in the United States 10 – 15% and at Shouldice over the last fifty years, the rate is less than 1%.

Shouldice Hospital is so well respected and appreciated by patients for facilities provided and especially the caring staff that a patient reunion is held annually at the Royal York Hotel where some 1500 previous patients attend – and some have attended every year for the last fifty two years!

For information you can contact the Hospital at 1 800 291-7750 or (905) 889-1125, or see the website: www.shouldice.com

The Studio for Aesthetic Dentistry
This is not your typical Dentists’ office.

This is a studio designed specifically for cosmetic dentistry; in fact the only one of its’ kind in North America. The Studio is operated by Dr. Edward Philips who is also the Course Director for Cosmetic Dentistry at the University of Toronto. Dr. Philips also lectures in Canada and the United States and is an information resource for several radio and print media.

This ultra-modern, very state- of-the-art studio literally makes clients smile.. better. The purpose, and function of the studio, is to correct and improve a persons’ smile by performing any number of procedures such as bonding, capping, crowning, teeth restoration and onlays.

No appointment is necessary to stop in. In fact, the Studio encourages potential clients to visit and spend some time at a nine-screen information centre which is informative and educational. Or visit the Studios’ website which has become a popular source for information.

In the last year Dr. Philips has seen more than 50 patients from the United States, most being from the Buffalo/Cleveland/Detroit areas, and even a patient from New York City. Several patients are referred by Toronto cosmetic surgeons, or are referred by their U.S. Physicians.

An impressive fact is that Dr. Philips sees only two patients each day, which means that a patient has the Doctors’ undivided attention.

Costs of course vary, depending on the procedures required, but as rates are often higher for similar procedures in the United States, and considering the very favourable exchange rates, it is estimated that a patient can save 40 – 60% less. An average cosmetic smile improvement costs approximately $5000.00 Cdn.

The Studio for Aesthetic Dentistry is located at University and College and can be contacted at 1 888 764-5354 or (416) 597 6453 . The website address is: www.cosmeticdentistryto.com

Bochner Eye Institute
Laser eye surgery seems to be growing in popularity and the laser technology being developed and in use in Canada today is distinctly different from the first or second generation of lasers used in the U.S. The Canadian government has approved for use advanced laser technology equipment and procedures that the FDA has not as yet certified.

The Bochner Eye Institute uses the Nidek 5000 laser, developed in Japan, and as a result of performing this procedure since 1991, is now seeing 100- 150 American patients annually.

Many patients are referred by their eye care doctors or even their physicians, and have come from as far as Texas and California, (you may recognize some names) although most patients coming from the U.S. are from the border States.

The procedure takes a few hours and usually by the next day the recovery period is over. Follow up care is provided by the patients own eye care doctor.

The procedure in Canada costs approximately 30 – 40% less as a result of the advantageous exchange rate.

The Bochner Eye Institute can be contacted at 1 800 665-1987 or (416) 960-2020. The website is www.bochner.com

After a dental makeover "he came in with this big smile, saying he’d closed a big deal. Because he was smiling all the time, people saw him as being more friendly and approachable." Says Billie Jo Sabo, clinical director for Dr. Edward Philips, a dental surgeon who’s give hundreds of people something to smile about.

Cosmetic dentistry, says Philips, "is absolutely incredible. When the patients come back (after treatment) they just seem to have pulled themselves together. They look better, fashionably, because they’re wearing better colours, hair and make-up."

Philips, who trained at the Hospital for Sick Children’s craniofacial department, says new techniques have changed the face of cosmetic dentistry: "Now, many simple defects or problems can be corrected without braces, extraction or surgery that couldn’t be done 15 years ago."

Procedures vary in cost, complexity and recuperative time.

For example, a woman who complained about crooked teeth and anticipated major surgery, needed only excess gum tissue trimmed away. A one-hour appointment and about $600 later, she was all smiles.

To find out more, call Dr. Philips’ office, 700 University Ave., Hydro Place, 593-5111.

Dr. Lloyd Carlsen of Toronto, who has practised corrected and rehabilitative surgery for many years, once observed that "my happiest patients are my cosmetic patients. They look better, feel better and appreciate what I do for them."

There’s no part of your anatomy that the cosmetic surgeon can’t change – breasts, face, buttocks, tummy, legs and arms.

But, not surprisingly, most cosmetic surgery is performed on the face area because that’s the part of the body that is most prominent and visible.

Choosing the right nose

One of the most popular operations is the so-called "nose job" or rhinoplasty. There’s a good reason for it. More people are displeased by the appearance of their nose than by any other part of their body. Dr. Paul Regnault, a Montreal cosmetic surgeon says, "I sometimes get patients who want me to change their nose even though they’re in perfect proportion to their face. I refuse to operate on them."

To do a first-class nose job requires a physician who combines surgical skill with artistic talent.

"Choosing exactly the right nose for the right face is tremendously exciting," says Dr. Martin Unger, a Toronto cosmetic surgeon. "You don’t put small noses on big faces."

Also ranking high in popularity is the face lift operation, referred to by doctors as a rhytidectomy. During the three-hour procedure, the surgeon sculpts your face to make you look younger and more attractive. He removes sags by lifting the face tightly, repositions sagging layers of muscles and cuts away excess skin and fat.

But the cosmetic surgeon has several other procedures at his disposal to give your face a new look. Droopy eyelids and bags under the eyes can be corrected. Imperfections in your facial skin can be smoothed away by chemical peeling or dermabrasion, that is, sanding it away by a high-speed rotating steel brush.

Wrinkles can be eliminated by injections of silicone or collagen – a protein material derived from cattle. Some experts urge caution in the use of both these anti-wrinkle substances for healthy safety reasons.

Dentist creates designer smiles

The latest specialist to join the ranks of the "surgeons of happiness" is the cosmetic dentist.

"The cosmetic dentist aims to give you a beautiful designer smile," says Dr. Edward Philips, typical of this new breed of practitioners. Formerly on the staff of the Hospital for Sick Children, Philips is now part of a group practice, housed in a downtown Toronto office building.

Philips and his colleagues have taken great care to make their workplace appealing and non-threatening. Furnishings include a large tropical fish tank, tall floor plants, park benches, a popcorn stand, high ceilings and wall colours and lighting to create a warm, upbeat ambience.

On the first visit, Philips carefully studies your face and makes a mold of your teeth. By the second visit, he has constructed another mold which incorporates the changes necessary to improve your smile.

"Many kinds of imperfections detract from a smile," says Philips. He lists some of them: discoloured teeth, teeth which are chipped, mishapen or irregular; teeth crowded into a mouth too small to comfortably contain them; teeth which are too small to comfortably contain them; teeth which are too small to fill a large mouth.

To correct these deficiencies, the latest technology is used. "We’re having good success with home bleaching," says Philips.

The patient with discoloured teeth is given a jelly-like bleach. With the help of a plastic mouth guard, he applies it to his teeth for thirty minutes every night for a month.

Chipped and poorly shaped teeth can be given a pleasing shape by the use of porcelain veneer and other materials which can be bonded on and stay stuck. Again, by the use of new materials and bonding agents, it’s possible to repair cavities with smaller, almost invisible fillings. It’s also possible to build durable ceramic crown systems with a minimum interference with your teeth.

Electronic pain relief

"We can also reduce the discomfort of our client while he’d undergoing treatment," says Philips.

For example, there’s the Synchro-Energizer. The patient wears special glasses and earphones. He sees a flashing strobe light and listens to electronic beeping. The sound and sight are synchonized and change frequency. The purpose is to create a brainwave pattern that encourages relaxation and per-

Overall, people have healthier teeth today due to better home care and early prevention measures.

In Ontario, the average 17-year-old has one decayed tooth, compared with a dozen or more a generation ago, says Ralph Crawford, a dentist and editor of the Journal of the Canadian Dental Association.

This has created a demand for cosmetic dentistry. Since people have healthy teeth, they also want good-looking teeth, says Dr. Crawford.

Dr. Crawford says the greatest advance has been in bonding.

Whereas traditional metal fillings have to be "mechanically locked" into a tooth, bonding uses materials such as plastics which are "stuck to the tooth."

In the process, less of the actual tooth is removed. The bonded filling looks more natural and the end result is a better-looking tooth, he explains.

There are many other cosmetic techniques currently available, including porcelain veneers, crown systems and implants.

Advances have not only come in cosmetic dentistry, but also in equipment and anesthetics.

The days of sliding down into the depths of the chair while the dentist attempts to freeze your gums by giving you a shot from a rather large needle may be over.

Now, instead of the shot, you can put on special glasses and earphones that send your brain into a state of relaxation where it no longer feels pain.

The system is called Brain Wave Synchro-Energizer, or more commonly, "mind flight," says Edward Philips, dentist and vice-president of the Central Toronto Dental Society.

He says the system, which he uses in his downtown Toronto practise, uses computer-driven strobe lights and electronic beeps, picked up by the glasses and the earphones, that are in the same pattern as deep sleep. It works as an anesthetic for the brain.

Also, there is an electronic dental anesthetic which uses small electrodes attached to the gums. The electrodes send off impulses or waves that block pain.

The patient holds the controlling devices. If pain is felt, he or she can increase the intensity of the waves. The technique is commonly known as H-wave.

Dr. Philins says he has had this technique used on him. While he says it is great for basic work, he doubts it would be effective for procedures like deep drilling.

Gum work using lasers may not even require pain medication.

Lasers can cut through the gums faster than the nerves can feel the pain, says Dr. Philips.

Unfortunately, the lasers currently on the market are expensive and few dentists can afford them.

Imagine a computer that can take a pattern of your teeth, design a filling to fit a cavity, and prepare or mill that filling all while you wait in the dentist’s chair.

But not all dentists can afford the price tag of $75 ,000 or more that comes with the machine.

Dr. Crawford says this technology, a machine called CAD- CAM (short for computer- assisted design-computer- assisted machining), is in operation at a handful of dentists’ offices in Ontario.

The future could see the traditional dentist become extinct.

Dr. Crawford says work is being done to find a vaccine that will prevent tooth decay and gum disease. The vaccine would kill the bacteria that cause the two evils, he explains.

Unfortunately. the vaccine is still years away. So for now, keep visiting your dentist regularly, and open wide.

Dr. Edward Philips of Toronto works on patient Rochelle Litman, who is using the latest in pain control-"mind flight."

"I prefer tattoos and inlaid diamonds because they are flush against the tooth and are not usually problematic," explains Dr. Philips. The golden gems, on the other hand, are glued to the teeth; they sometimes slide and can lead to serious complications. "The charms may interfere with bite or collect debris and create cavities or gum problems," warns the doctor. He cautions that previous trends in mouth decor have had detrimental effects on tooth care-the frequent rattling of metal against the teeth knocked tongue piercing from hip to chip; the damage from this tooth temptation could last longer than the look.

According to Dr. Philips, tooth jewelry is just the beginning of smile style. The actual shape of teeth can also be changed to create a different look.

"Smiles can have a certain fashion-conscious look" says Dr. Philips. "We had one patient who wanted to have s smile like Julia Robert’s, and then about 2 years later she liked Madonna’s smile which is very different and has a bit of a space between her teeth, so we changed her and gave her a Madonna smile." Advances in cosmetic dentistry are creating more viable options than ever for tooth appeal, but consult your doctor about the consequences of jewelling procedures to ensure they are appropriate for you. Don’t let mouth into a fashion victim.