As published in The Times of Trenton
15 August 2004
In 1975, when Melvin Babad opened his dental practice, yellow-toothed patients suffered true agony for a (marginally) whiter smile. The treatments, which took hours, required toxic bleach, blazing heat and blinding light.
Today, thanks to better treatments, a chain-smoking coffee addict can walk into Babad’s Hamilton Township office in Mercer County and emerge an hour later with a movie star’s smile, a mild mint aftertaste and an un-scarred psyche.
Speedy bleaches, along with other new technologies, have transformed cosmetic dentistry from a tiny niche to a booming business.
These days, dentists like Babad, who once worried that science would put them out of business, owe much of their livelihood to breakthroughs in chemistry and computers.
“When I first started practicing, cosmetic procedures probably accounted for 10 percent of my business, if that. These days, I’d guess that 75 percent of the work I do qualifies as cosmetic in one way or another,” Babad said.
“I credit much of the change to baby boomers, who worry more about their looks than any previous generation. Television shows like ‘Extreme Makeover’ have also been helpful because they have greatly reduced the stigma that most Americans once associated with cosmetic medicine. Still, none of that would matter if the technology had not improved the way it has.”
Until recently, many dentists regarded technology not as an ally but as a menace.
In the days before fluoride appeared in toothpaste and drinking water, most Americans acquired more than a dozen cavities (and a dozen fillings) before they reached adulthood.
Then, for the next several decades, they continued to get new fillings and to need repair work on old fillings. Finally, in their later years, disease struck their gums, their teeth began to fall out, and they required dentures.
In other words, dentists had plenty of work.
Things began to change in the early years of the last century, when scientists investigated why miners in parts of Texas and Colorado had oddly-stained teeth and why those teeth seemed nearly impervious to cavities.
Those scientists soon traced both the stains and the strength to fluoride in the miners’ water.
Even after that discovery, the intentional use of fluoride to prevent tooth decay caught on slowly, but its popularity finally exploded in the 1960s and 1970s, with dire effects for dentists.
The addition of fluoride to drinking water typically reduces a community’s cavities 50 to 70 percent. Worse still, at least for dental business, children who drink fluoridated water and brush properly with fluoridated toothpaste rarely develop any cavities at all.
Shortly after fluoride’s spread, new treatments for gum disease, like antibiotics that dentists inject straight into the mouth, transformed serious tooth loss from an inevitable by-product of age to a regrettable by-product of car crashes and other violent accidents.
Finally, the dentists took another blow from toothpaste makers during the 1990s, when the big brands introduced tartar control and whitening formulas.
Things looked dire.
“We still do a fair amount of work on people who grew up before fluoride, people who have a couple dozen fillings that need periodic repair. But when you talk about the youngsters of today, forget it. Most of them don’t have any tooth decay,” Babad said.
“Once the baby boomers start dying off and taking all of their cavities with them, tooth decay will become a rare finding. Fortunately for us, the demand for cosmetic procedures has been growing steadily for years now.”
Indeed, in the years after technology brought such horrors as fluoride and tartar control, it began bestowing presents on dentists that range from computerized breath monitors to invisible systems for straightening teeth.
Even treatments that sound simple, like covering dental problems with tooth-colored bonds, have benefited greatly from technology.
For example, dentists began using white porcelain to cover caps and fill chips during the early 1970s. Sadly, the ceramics they used back then bore far more resemblance to bathtub enamel than tooth enamel.
Either a patient had to settle for two-toned teeth, or the dentist had to cover every visible surface in a single gleaming white—an option that appealed to television personalities and beauty contestants but not the general public.
Today, patients have much better options.
Dentists can mix porcelains together to match almost any tooth color.
“Just a few years ago, matching colors could be difficult in some cases because porcelain technicians had only a few colors to work with,” said Paul Kost, a dentist at Franklin Corner Dental Associates in Lawrence Township.
“Today, they can mix different colors together like an artist using a palette, so they can match almost any color perfectly.”
“In the future,” Kost continued, “we will be even more accurate because a computer will make a match rather than a person. Our computers will work like the ones they have in the paint stores now, where you can come in with a color sample and the computer can make a perfect match for you.”
Although computerized color matching systems have yet to move from the laboratory to the store, Kost expects them to start popping up some time during the next couple of years.
Further down the road, after color-matching machines start looking like old hat, he hopes to see some truly revolutionary technology.
“Some of the work that scientists are doing right now has raised the possibility that we may be able to re-grow missing teeth some day,” said Kost, who estimates that cosmetic procedures account for 80 percent of his business.
“Stuff like that is a long way off, of course, but I think it is coming. I think some absolutely amazing stuff is coming down the road, stuff that we can hardly even dream of now.”
Of course, if technology becomes too advanced, it could end up fulfilling its original promise: making dentists obsolete.
Still, dentists today worry little about nightmare scenarios like the possibility of genetically engineered supermen who need no dental care.
The nation’s 169,000 dentists still make good money—averaging around $175,000 a year for general practitioners and $280,000 a year for specialists—and the 4,500 members of the New Jersey Dental Association do even better than that.
A recent study from the American Dental Association in Chicago showed that 65 percent of America’s 300 million people had seen a dentist in the past six months and that 83 percent of the country had seen a dentist in the past year.
Frank Graham, the president of the NJDA, believes that such numbers demonstrate the nation’s changing attitude toward dentistry.
“People used to go to the dentist when their teeth began hurting. These days, they go to dentists more for preventive medicine than to treat acute ills,” he said. “This change, along with advances in technology, has improved the nation’s dental health enormously during the past few decades, and I think we will see that trend continue.”
“Many people do come to dentists because they want their teeth to look better, but oddly, a lot of treatments that improve the way teeth look improve the way they work as well,” Graham said.
“To give you an example,” he continued, “people today tend to fix chipped teeth, rather than living with them like their parents did because they hate the look.
“As it turns out, this improves their dental health because having a chipped tooth makes it easier for bacteria to attack your tooth and getting the chip fixed makes it harder.
“In other words, people may think they are just being vain when they fix problems like that or when they straighten crooked teeth, but they are actually making smart choices.
“Aside from whitening, which really does not have any medical value, most of these so-called cosmetic procedures will reduce problems down the road. It’s a win-win situation.”Return to Marketing Ideas For the Halimeter® Dentist