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Plenty of reasons to smile

Dr. Philips in the News…

From whitening to braces, cosmetic dentistry is growing in popularity among the fluoride generation. The top procedures and what they cost WHEN Debbie Hunter was 27 years old, she finally found the courage to smile. Since she had fallen off a swing and broken her two front teeth as a child, Ms. Hunter had endured life with a chipped, discoloured grin. But, three years ago, it occurred to the Montreal freelance marketer that her life – and her teeth – could be repaired. A couple of dentist visits later, Ms. Hunter’s teeth were bonded and veneered – two of the many cosmetic dentistry procedures that Canadians are enthusiastically sinking their teeth into. Dr. Ed Philips, a cosmetic dentist in Toronto, attributes the current popularity to the coming of age of the fluoride generation. With fewer cavities to fill, they now want their pearly whites whiter – and straighter. And they’re willing to pay for it. So what are some of these procedures for perfecting imperfect smiles? Here are the most popular and what they’ll cost you. Most of these treatments are only partially – if at all – covered by health insurance plans. In other words, expect to pay for these luxurious procedures through the teeth.

You don’t have to go to a cosmetic dentist for this one. As demand for a more glistening grin continues to grow, more and more regular dentists are providing home whitening kits for their patients. With this simple procedure, the dentist takes a mould of your teeth, and constructs a form-fitting plastic mouth guard – something like Mike Tyson might wear – to fit over them. You just take the guard home, apply whitening gel to your teeth, and fit the guard on top for two to eight hours every day for up to two weeks. You can have this procedure done at the dentist’s office, but it will cost you more in time – the trips back and forth each day – and money. Tooth whitening won’t take as well or last as long on people who are fond of coffee, tea, red wine or cigarettes. Also, if you have a mouthful of fillings and crowns, you’re not the best candidate: the whitening agent relies on a biological reaction, and doesn’t work on unnatural teeth. The procedure will cost between $600 and $1,000 for the full mouth, and you can expect to pay between $30 and $50 for annual touchups.

Porcelain veneer
This thin shell of porcelain laminate can fill teeth that are crooked, stained or chipped. The dentist grinds the tooth down a little, removes about a millimetre from its surface, and then attaches – with very strong cement a perfectly fitting veneer to match the surrounding teeth. It’s the same as gluing on an artificial fingernail, but it lasts much longer – an average of 10 years. Prices can range between $350 and $1,000 a tooth, so shop around.

The bonding procedure is similar to veneers, but instead of gluing on a panel, imperfections are smoothed out by applying a soft composite material. Bonding doesn’t look as good as a veneer and won’t last as long either – only five years. But it is much cheaper. The range is between $60 and $350 a tooth, depending on how much of the tooth is covered.

Implants have been around for 20 years, but they’ve only caught on in the past five years. Say you lose a tooth in a company hockey game. In the past, you’d be fitted with a bridge denture and would join the league of people who pay special attention to Martha Raye television commercials. Today, bridges are reserved for people who can’t withstand minor surgery, or whose jaws are too weak to support an artificial tooth anchor. The minor surgery for implants involves the dentist making a small incision into the gum and bone and inserting a titanium anchor. After a healing time of four to six months, an artificial porcelain tooth is fitted on top. You now have a permanent tooth, instead of a removable denture. The cost? Implants are expensive at $2,500 a tooth, compared with bridges, which run between $1,600 and $2,000. And if you’re a smoker, an implant may not be worth it; the nicotine and tar affects the ability of the implant to integrate into the bone.

Cosmetic contouring
So you want straight teeth but don’t want to get braces? You can have your teeth cosmetically altered so that they just look straight. The dentist uses a high-speed diamond-bit drill to judiciously shave and shape your teeth. It won’t hurt them; there’s about 1½ millimetres of enamel on each tooth that can stand to be filed down. The final touch is repolishing and reglazing the tooth. Not every case is amenable to cosmetic contouring – just minor to moderate problems. But if you qualify, Toronto dentist Dr. Arthur Rubinoff calls this procedure "the biggest bang for the buck. It’s almost like instant orthodontics." And for between $75 and $200 a tooth, it’s definitely cheaper.

Forget those old metal train tracks. Technology has opened wide to make room for more discrete, clear plastic, ceramic or porcelain braces. And older patients are biting for several reasons – vanity, health and an ability to pay that was absent during childhood. A mouthful of braces costs as much as $8,000 (the general price for metal braces, top and bottom, is $4,500 to $5,000. Ceramic or plastic brackets cost about $200 extra and lingual braces – which are placed on the inside of teeth – will run you 60 to 70 per cent more). Some insurance plans pay up to half of treatment costs, with ceilings of up to $2,000. And part of the costs can also be deducted on your taxes as a medical expense. Now that’s something to smile about. Recent technological advances have given cosmetic dentists such as Dr. Ed Philips the tools to perfect imperfect smiles.