Is Cosmetic Dentistry Dying?

Jim

I’m not at all surprised that cosmetic dentistry is on the decline and, in fact, I’ve been saying this for at least 3 or 4 years. The manner in which dentistry embraced the need for everyone to have white, straight teeth as a life changing necessity reminded me of the economic bubbles which have lead to catastrophic financial decline. Tooth whitening booths staffed by non-professionals seem to be legal and now abound in shopping malls advertising their services with statements like “Why pay dentists hundreds of dollars when…” Will prep-free veneers be the next service available “over-the-counter?”

Every dentist became a “cosmetic specialist.” Fees went out of control. Stories of $2000+ veneers with an extra charge for the dentist’s monogram abounded. And with the cosmetic dentistry craze (much like the Botox and Restyln craze in medicine) dentistry lost sight of the fact that it is, after all, a health profession. We stopped attending to our patient’s health needs and emphasized appearance as the cure-all for social and work-related problems. (I know I’m going to anger some by saying this.) Dental practice web sites abounded with photographs of before and after cases which often did not represent the dentist’s own work but were purchased from photographic gallery sources – the same patient smiles were often seen on dozens of web sites all intimating that they were the site owner’s own successful treatments.

Now the pendulum is beginning to swing the other way – fortunately for the PROFESSION. We have too long been the step child of medicine – the public and the profession readily accept the phraseology “Doctors and Dentists” when dentistry should be insisting on the terminology “Physicians and Dentists.” Physicians always have tended to trivialize dentists and dentistry and we, as a profession, have done little to counter that feeling. In fact in a survey that I once read – a large proportion of responding dentists said that they would be happy to accept the title “Dentist Jones” as opposed to “Doctor Jones”.

The importance of dentistry as a HEALTH profession has recently been emphasized with research linking periodontal disease to inflammation and endothelial dysfunction. My primary interest – dentistry’s role in the recognition and management of sleep breathing disorders – finally brings dentistry into a collegial relationship with physicians.

Now that the economy is officially in a recession and with the difficulty of getting loans, the ability of most people to spend $20,000 – $30,000 to veneer multiple teeth is over. Please understand that I am not adverse to providing esthetic dental enhancement where needed, I did practice dentistry for 40 years and did my share of cosmetic dentistry (before it became a fad) but I still feel we went way overboard.

But, just maybe, we are at a point where dentists will return to our health profession roots and once again start providing services that affect not only the appearance of our patients but their general health as well.

Larry Barsh, DMD
Founder, SnoringIsntSexy.com

aren’t you loosing a portion of your profit by using care credit, more than if they would just use a credit card

Interestingly, these economic times are causing people to reassess needs and wants in their lives. Many of the so-called “needs” in our society are indeed “wants” and could be easily done without. Since cosmetic dentistry is paid for with discretionary dollars- often borrowed through credit cards at high interest- slightly discolored, crooked, or otherwise imperfect teeth suddenly don’t seem so bad. This actually may be a good thing as dentistry returns its focus to the true needs of America’s oral health problems.

It’s now time to begin phase II of the cosmetic revolution-”Esthetic Prosthetics”. Andrews bars-sleeves enable ridge replicating pink acrylic to posture denture teeth for cosmetics, function and enable known, desired cosmetic out-comes. Acrylic “tissue” obtains complete,evenly distributed ridge support. This enables fewer weaker abutments to serve and endure. Most partials “replaceable” by “bridges” with no unnatural bulk. Shape-size of attachments fits them within tooth-tissue contours for look-feel of “natural”.

Jim, We have met at DOCS meetings in NYC and discussed this reality 2004…I have always felt that the insane emphasis on cosmetics in dentistry was like so many other things in our society driven by greed, and a bubble that had to burst. Why?…Simple…There are a large but finite number of people who would like to look better, there are many fewer people who can afford it, and even less who are willing to pay what it takes. The number of dentist doing the procedures has increased dramatically, and we can do much more per appointment. The younger population needs less cosmetic improvement, and it is more simply accomplished, and the larger pool of older folks has been significantly exhausted…..end result…much less demand. Dentistry needs to get back to the basics of ethical, health based, care…not be driven by technologically based procedures that create need. I agree with your perspective that people are looking more…but I beleive the reason they are researching more is because…one, they can via the internet, and two, trust is down and they want to make sure they are getting the right procedures at the right prices…..in short…it is very much like shopping for any other retail item for them ….and unfortunately, since we have becomedue to philosophy and advertising, increasingly a retail business, the ideals that originally drew many of us to Dentistry are becoming untenable in this “new” marketplace……Bob Meisner

I’d also be curious to know what sort of trends denture and elderly dental procedures are seeing at this point in the economy. With business such as Aspen Dental and other dental chains specializing in denture procedures, it seems like the industry is doing pretty well. But similarly to cosmetic dentistry, the procedures can be pretty pricey.

In our practice,I find the opposite in these decreased cosmetic dentistry trends that you state…especially in those over forty. In our office, these internet stats and trends you espouse do not match with our observations.

Granted maintenace of the integrity of the entire dental oral system is the basis of practicing good dental medicine. However, the psycological and life changing potential of cosmetic and various dental smile makeovers is priceless especially how it relates to a persons total health and wellbeing.

If we are true members of the healthcare team and not just dental mechanics… cosmetics should be part of the modern Dental Office protocol. We owe this to our patients. If not we fall short of doing the best for our patients.

Offer all the best services dentistry has to offer and let the patients decide. It is their choice what dental and psychological standard they want to live and where they want to be. It is not our final decision. Not to teach and offer our best options and services, although not malpractice , is in my humble opinion substandard dental practice.

I just got myself a good SEO and my practice has done well. I have a more optimistic view and refuse to participate in the recession.

I don’t get it. Is this seriously what we’ve come down to…Oral Cancer Screenings as a “revenue stream”? I’ve always done a screening, because it’s my responsibility – my patients count on me. But buying a device that shines a light so that I can charge all my patients just seems wrong. A local “academic” colleague told me that VELscope placed a unit with him and it missed cancer. How does that protect me…or my patients.

The US Dental Services Industry, the darling of the dental profession worldwide, has started to collapse. The dramatic events just recently published in the gold-standard, blue-ribbon federal study that is the “bible” of the economic evolution of the health care establishment tells the grim tale. The industry broke two records: it reached yet another record high in revenues–$102 billion in annual revenues–and the bubble burst. The second record it broke is astounding.

After growing robustly for four decades the industry suffered the worst implosion in a critical factor in the history of the American economy. The implosion was equivalent to forty-three 1929 stock market crashes, or about 500% in a single year. This event, a classic, textbook event, plunged the industry into the decline stage of its life cycle. If this predicament is not reversed immediately, the industry will suffer a dramatic collapse as it plunges into the Nemesis Vortex or the “meat-grinder.” If this is the first you are hearing of this spectacular event, it’s because of the 100-year knowledge gap on the business and management side of the industry.

Fortunately, there is good news; visit the definitive authority on the health care crisis: the Right Moves Project at: http//:rightmovesproject.com and also http//:dental.rightmovesproject.com.

Or you can call me directly in San Diego at 858-278-5050. The project produced the first scientific explanation of the predicament based on a mathematical law and the first and only legitimate time line. So the claim that time is rapidly running out is not metaphor, but 100% valid.

There is a strong historical precedence for what just happened. The entire health care establishment is “teetering” of the verge of collapse because of the same, exact (mathematically homologous) phenomenon that caused the recent failure of the US Housing Industry and the domino-effect shock waves that have caused the financial “meltdown” cited as the worst debacle since the Great Depression.

Frank Toto
Director, since 1982 of the Right Moves Project