Fact vs. Fiction

March 2007 Special Sections

In the age of on-demand information, consumers are becoming instant “experts” on all their purchasing decisions. Cosmetic dentists see this trend every day from their patients. Most of the time, dentists say, people are well-educated about the topic. But every once in a while, falsehoods—either from misguided sources or a patient’s own fears—slip into the mix. Cosmetic dentists share some of the most common myths they hear in their offices, and the truth behind the misinformation.

Myth: I never got braces as a teenager, and now I’m too old to wear a mouth full of metal. I guess I’ll just resign myself to a life of crooked smiles.

Reality: Chances are pretty good that you won't be called "Brace Face" in adulthood, but in case you're worried, there are other alternatives available. Ceramic braces mimic tooth color and are less noticeable than the traditional bracket-and-wire braces. Another option for some patients is Invisalign, says John Cretzmeyer, a dentist in Fridley. "Invisalign is a series of clear plastic trays that fit over your teeth and gradually move them into a more pleasing position," he says. "They are hardly visible, and normal speech and public appearance are not an issue."

Myth: I saw an ad that says I can now get veneers the same day I go to the dentist, rather than having to get work done on my teeth and wait for my new smile.

Reality: Although some cosmetic dental product companies are actively marketing their veneers as prepless, this is more the exception than the norm. “For most people, if they would like to have an ideal, natural, beautiful smile, some preparation will be required on their teeth,” says Marc Montgomery, a dentist in Woodbury. “When you do not prepare a tooth, it will look like false fingernails. People who have fairly straight teeth that are tipped in a bit tend to be good candidates for the prepless veneers.”

A similar trend is happening with CAD/CAM technology, which allows dentists to prepare a same-day crown using computer design, versus the traditional method of creating a temporary and employing a ceramist to build a permanent crown over the course of several weeks. “These can be very functional restorations for some practices,” says Ned Windmiller, a Stillwater-based dentist. “But you can’t build the color, and you have less control over shape and translucency. The artistic aspect is lacking.”

Myth: Doctor, I am pretty sure this is the worst smile you have ever seen.

Reality: “There are some people who believe nothing can be done for their smile,” says Walter Palmer of River Bluff Dental in Bloomington. “They are self-conscious and have a self-defeating attitude.” However, with teeth whitening, veneers, crowns, implants, and orthodontics, nearly everybody should be able to find a fix through cosmetic dentistry, assures Palmer. 

Myth: When it comes to teeth whitening, the whiter the better.

Reality: A menagerie of whitening options exists today: over-the-counter whitening strips, tray bleaching, in-office bleaching, and even veneers. A responsible dentist should first educate himself or herself on the principles of tooth color, then use that knowledge to keep teeth whitening under control for the patient, says Frank Milnar, a dentist who practices in St. Paul. “Our culture is mandating that we create ungodly white teeth, either through bleaching or dental procedures. It’s up to the dentist . . . to advise the patient when their desires become unnatural.”

Teeth whitening is a step-by-step process. It often involves four cycles. “If you don’t want your teeth to be paper white, you can stop after the first or second cycle,” says Edgar Jimenez, a ceramist who owns Jimenez Dental Studio in North Oaks.

Myth: Veneers always look fake.

Reality: Although porcelain veneers have been around for the last two decades, the technology behind them has improved significantly, Jimenez says. “It used to be hard for us to make something very pretty and natural-looking,” he says. “You’ve got to have a good eye to build a highly aesthetic, natural tooth. It’s an art to make one of these teeth. Porcelains are the closest thing that there might be out there to natural teeth.”

Myth: Once you give me the perfect smile, I’ll never have to see you again.

Reality: Dentistry is not permanent. “It is important for the consumer to realize that once the dentist and patient decide to remove tooth structure, it won’t grow back,” Milnar says. “The more times the tooth is prepared, the vitality or the overall health of the pulp or nerve can come into question.” Milnar advises that the patient and dentist work together to create a conservative treatment plan to ensure that tooth structure is left for the next round of dental work.

Myth: Any dentist can be a cosmetic dentist. Isn’t it just really a title, anyway?

Reality: As of now, the American Dental Association does not recognize cosmetic dentistry as a specialty, which puts more of a burden on the consumer to find a dentist who can create the best aesthetic results. Montgomery suggests that people ask to see before-and-after photography of similar procedures the dentist has performed in the past. “People who are passionate about cosmetic dentistry do a lot of photography,” he says. “It is a way we analyze our work.”

Patients may also want to inquire about a dentist’s accreditation with the American Academy of Cosmetic Dentistry. “It’s very tough to become accredited,” Windmiller says. “You have to present five cases of patients before and after, along with photos of the procedure and how you went about it. This shows the level of knowledge and expertise to the board of examiners, who evaluate and determine if the dentistry is of the quality to become accredited.”

Myth: I’ll have to tap into my 401(k) to pay for all of this.

Reality: “These procedures aren’t just for the rich and famous,” Cretzmeyer says. “We accomplish these things on the whole spectrum of the population.” Some procedures to repair damaged teeth may even be covered by insurance. In the end, as Cretzmeyer says, “It becomes a matter of priorities, how we’re going to spend our money.”