It was only after we tried a two-week course of Crest Whitestrips ($65), a tooth whitening product which has been available in the U.S. for a year but only recently hit shelves in Canada, that we realized that we had been less than perfect.

The strips were our first experience with tooth-whitening products, and we were a little skeptical at first. We didn’t think we needed it. But our newsroom neighbour, TV columnist Antonia Zerbisias was lusting after the sample box of Whitestrips sent to us by Crest. Instead of giving it to her, Counter Culture selfishly locked it up. We wouldn’t want our neighbour to have whiter teeth than us, would we?

Zerb wasn’t the only interested passerby. Seems everybody’s talking about these things, maybe because they’ve seen recent ads for White-strips on television alongside images of wholesome Canadian skating heroes Jamie Sale and David Pelletier, who are sponsored by Crest.

So feeling a little guilty, we called Crest requesting another sample for Zerb, who has always been a good girlfriend, particularly that time she slid us four new episodes of Sex And The City on videotape, long before they even aired in Canada.

When they arrived, we both went at it, and found them both easy to use and very effective, proving that all the hype about Whitestrips isn’t unfounded.

Whitestrips use the same whitening ingredient as most of the other similar products currently on the market in North America – peroxide, which penetrates the tooth to remove stains below the enamel. What sets White-strips apart is in how the peroxide is delivered.

Most other whitening kits include bulky trays, which, when filled with gel and placed in the mouth, are ugly, uncomfortable and messy. But with Whitestrips, you just stick a piece of transparent plastic covered in a gel containing peroxide to your teeth. The strips are nearly invisible, don’t drip, and are easy to ignore.

"I’ve been raving about these to all my friends," wrote Zerb in a recent e-mail to Counter Culture.

"I can’t believe what a difference they have made to my smile. Look at me, I’m grinning like a fool.

"Years of drinking red wine, coffee and tea, smoking a few cigarettes a day, and, most important, eating pomegranates when in season and getting a daily fix of fresh blueberries (for the cancer- fighting bioflavanoids) both yellowed and dulled my teeth, which, admittedly, have always been in excellent shape. (Look ma! No cavities!)

"I’ve tried all the whitening tooth- pastes, brushing with pastes made of peroxide and baking soda, chewed whitening gum and, 10 years ago, paid nearly $400 to have a mold made of my teeth by my dentist who supplied special bleach. My teeth got no whiter – just more sensitive.

"But now, for the first time since my early teens when I started drinking coffee and smoking, they’re almost Chiclet white."

Counter Culture must admit, we were delinquent when it came to consistency. Though the box recommends using the strips for 30 minutes twice a day for optimum effect, we often found ourselves sort of, you know – occupied – at bedtime. So we sometimes applied them only once a day. Still, our teeth were definitely whiter than before.

Frankly, after experiencing such dramatic effect, Zerb and Counter Culture had a few questions about the safety of this product. So, being the good journalists we are, we called up Crest.

We talked to Win Sakdinan, the company’s director of public affairs, to get the dirt.

First off, he told us feedback to the product has been really positive in the U.S., where Crest had more than $100 million (U.S.) in sales last year alone. That adds up to about 2.8 million boxes.

But are there any possible negative side effects of Whitestrips?

Other than short-term sensitivity, no, says Sakdinan, noting that they employ the same active ingredient as professional kits one might use under the supervision of a dentist.

"When you use a product like this, the peroxide takes away some of the water and the oxygen from the tooth, and that can cause sensitivity," he explained, "but it goes away one or two hours after you remove the strip."

(Zerb, by the way, noticed only "very mild sensitivity" the first day she used the strips, and Counter Culture didn’t notice any.) And what about sensitivity of the tongue, gums and other mushy bits in the mouth?

It didn’t turn up in tests, Sakdinan says. "The strip can easily conform to the teeth, so we’re hoping this delivery system keeps it on the teeth instead of spilling on the gums and soft tissue," he says.

Indeed, we noticed that very little of the peroxide goop ended up in our mouths, but wanted to know if swallowing it was potentially poisonous. It’s just like toothpaste, Sakdinan says. One wouldn’t want to do it deliberately, but tests showed it to be relatively harmless when ingested accidentally.

We also wanted to know if White- strips will work for everyone.

"They’re sometimes not as effective for people who were born with stains or who get them when they are young or ill. But the most common reason for staining is what people eat and drink and Whitestrips work really well for that," he says.

To get a second opinion, Counter Culture called a dentist who specializes in this area, Dr. Edward Philips at the Studio For Aesthetic Dentistry.

"I’m happy Crest came out with these because it’s affordable," says Philips, who often does professional whitening for his patients.

"So if someone can’t afford a professional job, then this is the best alternative."

He notes that he doesn’t think 14 days of use is enough, explaining that Crest’s professional Whitestrip kits, which the company sells only through dentists, contain a higher percentage of peroxide but recommend 21 days of use.

He said using a box and a half of the consumer Whitestrips would probably be most effective and wouldn’t cause damage, but he questions whether people will be willing to commit to three weeks of use.

Philips also notes that dentist-administered whitening trays work better than Whitestrips because they form a hermetic seal around the tooth, preventing oxygen from interfering with the chemical reaction that causes whitening. Professional kits cost between $300 and $1,000 and require five to 10 days of use.

Remember, whiteners don’t change the colour of caps or crowns or veneers, so your mouth might look like a multi- coloured patchwork quilt if you have such things in visible places.

Zerb wanted to know if she could apply the strips every four months, say, rather than every six months, for extra- white teeth and to counteract her high- stain lifestyle.

No problem, says Sakdinan. "It won’t cause damage.

"Some of my colleagues apply them every two months," he says. "But those are the Ross Gellar types," he says, referring to that episode of Friends, in which dorky Ross whitens his teeth alittle too much, goes to a club under a black light, and blinds everyone in the vicinity.

So, now, a few weeks later, Zerb and I are busily smiling at bike couriers, interns and anyone else who happens by our desks in the deepest corner of the newsroom. She plans to apply White- strips for three weeks every three months, and now, so must we.

Your mouth might look like a multi-coloured patchwork quilt if you have caps or crowns in visible places.

You see, we find ourselves peering critically into the mirror following every major awards show. All the starlets seem to have such perfect pearly whites. And we want to be just like them, don’t you know. (Well, with the exception of Angelina Jolie, maybe. Even though she does fine in the dental department, she drinks her husband’s blood before dinner. So déclassé.)

We can’t help but notice the proliferation of teeth whitening products at the drugstore, and we have several friends who have forked out a few hundred dollars to their dentists in the name of sparkly incisors. We wouldn’t want our readers to be left behind in the ever-advancing frontier of beauty. We wouldn’t want to be left out of it ourselves either, so we resolved to find out more.

We consulted a Yorkville dentist, Dr. Ed Philips of the Centre for Aesthetic Dentistry and president of the Toronto Dental Society.

He’s been making people more beautiful in the bouche for about 20 years and he’s noticed that, recently, an increasing number of patients are approaching him for the specific purpose of whitening their teeth.

"Right now, it’s the most common procedure that people ask for," says Philips, noting that there’s actually a social reason for the growing interest in aesthetic dentistry.

Baby boomers, he says, are just now becoming concerned about how their teeth look, after having spent much of their lives dealing with the more pressing problem of cavities and decay.

When they were children, cavity- preventing fluoride was not added to Canada’s water, as it is now. Nor was there a variety of brushing education programs in schools. As well, a shortage of dentists following the war meant that kids didn’t visit as often as they should have. So their teeth suffered, and they’ve spent much of their adulthood fixing the problems.

"They’re cleaned up now and they don’t have tonnes of problems anymore," says Philips. "So, they’re taking it one step further."

Some of his clients are referred to him for teeth whitening and other types of aesthetic dentistry by cosmetic surgeons who want to help their clients with their overall appearance.

Tooth whitening is an often-overlooked way to achieve a younger look, says Philips. But it’s not all about vanity. Aesthetic dentistry is part of a natural evolution in people’s expectations of their teeth. While teeth were once weapons used by cavemen to fight off an intruder, as well as functional tools used to shred raw meat, they now have more of a social function.

"In our society," says Philips, "we don’t want to keep people away. We want to get along with people. It makes sense that we want a beautiful smile."

Philips says tooth discolouration is simply part of aging. "It should be called re-whitening, not whitening, because it’s just a process of returning the teeth to their original colour," he says, adding that heredity is also a factor, and can affect the end result.

He says that dentist-dispensed whitening procedures are designed to address intrinsic stains – stains which occur within the pulp of the tooth, underneath the surface enamel.

"As the tooth ages, it leaves behind certain waste products," he says, explaining that most dentists use teeth whitening products containing carbamide peroxide, which goes right inside the tooth to dissolve the by-product of aging.

"People think we’re opening up the tooth and putting a white colour in, but we don’t put artificial colour in. We just dissolve the yellow."

Here’s what to expect when you visit a dentist for tooth whitening:

First, your dentist will examine your teeth and help you decide whether the process will result in the changes you’re looking for.

Philips says that not all tooth discoloration is a result of the aging process, and he doesn’t always advise people to go this route. In cases where the stains are visible – on the enamel of the tooth – a good cleaning at your dentist’s office is the best course.

These stains can result from, frequent consumption of red wine, coffee, tea, tobacco products and other substances, as well as from the glue used to adhere braces to teeth. (Whitening toothpastes are designed to address extrinsic stains, but more on that later.)

After the assessment, your dentist will create a mould of your mouth, which he uses to make custom-fitted trays for you to take home, and gives you a carbamide peroxide gel to put in the tray.

Then, you wear the tray in your mouth for a few hours or overnight for a week or more, depending on the degree of whitening you want.

If you’re looking for a faster solution, some dentists will kick-start the process by doing an in-office treatment with carbamide peroxide and applying a laser to help activate it.

"It’s a good solution if you have a wedding coming up on the weekend," says Philips, but adds it should be supplemented by the at-home program for a longer-lasting whitening effect.

Philips touches up his own smile every three months, but advises his clients to whiten about once a year.

He allows his teenaged daughters to whiten their teeth, but suggests that children younger than age 13 shouldn’t have their teeth whitened.

The only reported side effect is that some people experience tooth sensitivity following the process, but it passes quickly, says Philips.

The process ranges in price from about $250-$700 depending on the dentist and the degree of whitening contemplated, Philips says. Laser treatment can cost between $1,200 and $1,900 and includes a kit for whitening at home.

Philips also notes that whiteners don’t affect caps, fillings and crowns – made to match the colour of the rest of your teeth – so using a kit could trigger the need for replacements. You may have to factor that into the cost.

Counter Culture has decided to forego the dentist-dispensed procedure for now (we can’t bear the thought of wearing those trays around the house), though we’ll keep it in mind for later.

In the meantime, we’re going to switch to toothpaste with whitening qualities, as we came across a clinical study on the Internet, which found that whitening toothpastes reduced extrinsic staining by about 40 per cent.

The array of products available at the drugstores these days is overwhelming. We counted as many as 30 whitening products on the shelf during a recent trip to Shopper’s Drug Mart. But we also found several studies comparing different brands of whitening toothpastes, and Colgate products seemed to fare better than others.

As for the whitening kits that are available for between $14 and $40 and claim to address intrinsic stains, we’re doubtful. The kits available in Canada contain a lower concentration of whitening agent than dentist- dispensed programs. They may also cause irritation to the gums and mouth because the mouth trays aren’t custom fitted and the gel can ooze out.

We don’t like irritation.

Plus, the supervision of a dentist is always a good thing. For example, Philips says quitting a whitening program too soon can create a spotted look because some stains are removed faster than others. And a dentist can help you decide when you’ve reached a natural but sufficiently bright shade of white.

So one month ago, she decided to spend $1,000 for a laser whitening treatment, a relatively new method of lightening teeth that takes about three hours and is, for the most part, painless.

"I deal with a lot of people, so my smile is important to me," said Buzzanca, who is an office manager.

The treatment, which has been used in Canada for about two years, is the newest development in whitening. While heralded by some, others urge caution because of potential risks.

laser whitening works like this: A protective covering (usually a rubber dam, wax or cotton rolls) is placed so that it covers the gums, tongue and cheeks, and the teeth are then painted with a special whitening gel. The laser, which looks like a pen, is then held in front of each tooth for about three minutes, and this is repeated about six or seven times per tooth.

"It is time consuming," admits Dr. Ed Philips, of The Studio For Aesthetic Dentistiy in the Ontario Hydro building at University Ave. and College St. Philips teaches cosmetic dentistry at University of Toronto.

"I usually book a patient in for the entire morning."

There’s no freezing involved, and the only side effect reported is a bit of sensitivity for a few hours afterward.

Following the laser treatment, patients should try to cut back on the main teeth stainers – coffee, tea, red wine and smoking – advises Andrea Radman of The Perfect Smile, a salons on Yonge St. just north of St. Clair Ave. that has had about 100 laser clients since it opened four months ago.

She’s what’s called a laser certified technician, which means she’s taken the two-day course required by the manufacturer for those who operate the laser.

Her background is in dental administration. The salon has two other certified technicians, one who’s a dental hygienist and the other a dental assistant.

To maintain the look, patients rely on at-home whitening kits, which can be used instead of the laser treatment to whiten stained teeth. The at-home kits have been used in Canada since the early ’90s, according to the Canadian Dental Association. They cost anywhere from $250 to $500.

A mold of the patient’s mouth is taken and plastic "trays" that have a vacuum-like seal are custom-made to fit over the teeth. All the patient has to do is put the whitening gel (usually carbamide peroxide) into the mold and then wear the mold for a few hours a day, as often as recommended.

Someone who’s had the laser whitening may only have to do this once or twice a year.

Penny Freedom, co-owner of The Smile Salon on Bay St. and Cumberland Ave., said her clients are anywhere from 32 to 70 years old.

"It’s not the rich who get this done, it’s very average people who don’t like their smile," she said.

Freedom, who’s been a dental hygienist for more than 30 years, said her salon has seen more than 200 patients since it opened in 1996. She’s found that the treatment is popular, especially among men.

"They want instant gratification. They don’t like the mess (of at-home kits). Women are used to cosmetics, we’ll do anything to help improve us. This is one thing men can do to change their look."

In general, "people like the technology" of laser whitening, "they like the long-lasting effect and generally don’t want to put solutions in their mouths more than they have to."

She said studies have indicated that teeth, after any type of laser treatment, are more resistant to decay and less sensitive.

While laser whitening maybe faster – the at-home treatments can take two weeks – and easier, the whitening gels are a concern for the Canadian Dental Association.

It has lobbied Health Canada since 1990 to regulate the oxidizing gels and liquids as "drugs" rather than "cosmetics" for stricter controls.

The association is concerned because there have been no long-term safety studies and warns that temporary damage can be done to soft tissue, and to the pulp of the teeth. It advises people use whiteners "selectively and carefully" and only under consultation with a dentist.

The treatment is hot right now because lasers are very hyped, he said, but he only uses it in a couple of cases: when patients have stubborn stains (such as those from medications) that just won’t come off with home whitening kits or when they need their teeth whitened quickly – "they come in and say, I know I should have done this months ago, but I’m getting married this Saturday."

Philips has done about 1,000 whitenings over the past four years. About 150 of those were done with laser, and he’s never had any problems with it, though he does warn that it is "more caustic, more powerful" and could cause damage if not done properly.

He also finds that "rebound" time- the time it takes before teeth naturally darken again, which will happen no matter what treatment is used – is much sooner with laser treatments, sometimes in as little as three months.

Radman at The Perfect Smile said results can last three to five years, and clients have a touch-up kit to fix any discolouration.

The total cost for laser whitening, including the at-home kits, runs from $900 to about $1200.

"We’ve been doing it for about six weeks," he says from his practice at University Ave. and College St. "That’s how new it is."

Philips compares the process to taking a piece of fabric and leaving it in the sun. "After a while, the fabric lightens. Pigment is broken down by high- intensity light."

A laser beam, he explains, is shone for five or six minutes on each tooth.

"We can do a full upper set in about an hour. In general, it runs between $800 and $1,100 per treatment.

"Calling it bleaching is a misnomer. It’s not like a hair salon where the salon person takes all the pigment out of the hair, all the color and then puts whatever color they want in. We’re taking color out and putting white in.

"We’re able to break down the byproduct yellow pigment that naturally forms as the tooth breathes and lives. It’s a residue that’s yellower in some people than others."

Philips believes the procedure is only being done by two or three dental offices in Canada.

The process uses a "hot" laser, either argon or sealed- tube.

"I like the argon laser," Philips says. "It’s not as intense. The sealed-tube laser builds up more heat."

He also uses a "cold" laser for a different purpose. "Another important use. I did a treatment the other day on a woman who came in from France and had developed very painful mouth ulcers. She couldn’t talk or swallow.

"The cold laser speeds up the metabolism, you give enough energy to the cells and if the healing process is already going on, this speeds up the recovery.

"We gave this woman a laser treatment and it almost instantly took away the pain.

"The next day, I got to the office and there was a big bouquet of flowers waiting."

Got a tooth problem? Fax it to your dentist.

"Okay, okay, I know it sounds outlandish but I really do think that this is the wave of the future," says Dr. Edward Philips, a dental surgeon who specializes in cosmetic techniques.

"This" is the array of gently beeping technological devices crowding Philips’ downtown Toronto consulting rooms.

"Look at this, this is great, every home should have one" he enthuses, picking up the handset of an AT&T Picasso-C Still Image phone.

The state-of-the-art device can transmit images over the telephone line on to a video monitor, and can store up to 32 pictures.

"If you had one of these at home, you could plug your video camera into it and send me a picture of your teeth. Then I could send you back some options on what you could have done to make your smile look better," says Philips.

Welcome to the brave new world of interactive technology, where dentists put their money where your mouth is by investing in a variety of high-tech toys aimed at giving patients something to smile about.

"This is cutting edge technology right now, but it will be the way all dentistry is done soon, I’m absolutely sure about that," says Philips who envisions a dazzling future of cyber-smiles.

While Philips is somewhat of a pioneer in embracing technology of this sort in Canada, it’s a small but growing trend.

About 5 per cent of dental offices here are currently using this kind of technology, while in the U.S., it’s 20 per cent, says George Osterbauer of the dental supply company Ash, Temple Ltd.

"It’s been a growing market during the ’90s, and it’s just starting to really take off," he says.

Markham dentist George Freedman likes to take his patients "for a magical mystery tour of the mouth" with an intra-oral camera.

The camera, which is small enough to fit behind the last tooth in the mouth, has a strong light attached to it and is hooked up to a video screen the patient can watch.

"That way, they can really see the gums they’re not talcing care of, the cavities starting on the side they miss with the brush, and they see it all magnified on the big screen," he says.

Freedman believes his office was the first in Canada to use interactive imaging for diagnosis and patient information. Using the intra-oral camera and a computer, patient and dentist experiment with different treatments and cosmetic techniques, seeing the results on the screen.

The computer digitalizes the photo images of the patient’s real teeth, and the dentist can then play with those images.

Want to see how you’d look with whiter teeth? With straighter or more even teeth through bonding or veneers? With that gap filled in or those long eyeteeth smoothed down? The digital world knows.

The pictures can also be stored on videotape and taken home for further study.

For Toronto businessman Allan Dew, the imaging system helped make a difficult decision easier.

At age 52, he was self-conscious about his dingy, filling-laden teeth. Previous dental work had yellowed and cracked, adding to the problem.

"1 had spent a lot of years in the dentist’s chair and it was something I dreaded. I had to be sure I would open my mouth and like what I saw after it was done," says Dew, who runs a color separation business and is familiar with computer imaging technology.

He spent $12,000 to have his mouth renovated. Old fillings, crowns, and a partial plate were removed and replaced, and his lower teeth were filed and shaped.

"Everybody thinks I look just great, and while it took me about four days to get used to the new guy in the mirror, I’m really pleased," he says.

Freedman, noting "a more informed patient makes for better dentistry," also uses laser disc teaching programs in his office for patient education.

As well, he says, processing insurance claims with technology such as the Picasso phone could save time and money.

In the case of a broken tooth, for instance, an image of the tooth could be sent over the phone line to a dental adjudicator while the patient is in the chair. With an immediate go-ahead the work could be done right then.

The whole idea behind interactive technology, according to Philips, is to get information out to potential customers in the easiest most comfortable way possible.

"Here’s something I really use a lot," he says, hefting a Sharp Viewcamteleport. He uses the audiovisual device – essentially a camcorder attached to a playback screen – to send pictures of a patient’s teeth to the ceramic lab where porcelain veneers and crowns are made.

It streamlines the procedure for dentist, lab and patient.

"We send Images of teeth back and forth with it and I can work with the dentist when he’s in the dental office and I’m in the lab," says Tom Williams of the Krest ceramic laboratory.

Philips sees a "huge market’s for cosmetic dentistry which is increasingly replacing the dentist’s traditional work of drilling and filling, thanks to fluoridation, better brushing, flossing and dental hygiene.

Most of his cosmetic dentistry clients, he says, are "everyday people, housewives, secretaries, business people.

"1 like to say, we used to fix your teeth, now we fix your smile."

Ed Trelford remembers all too vividly his early dental experiences during World War 11 when he had several teeth extracted without anesthetic.

“The pain was horrific and nobody gave a damn,” he recalls with perfect clarity.

So on his latest visit to his North York dentist, Trelford, 69, was particularly bemused and delighted to discover he could spend his visit wrapped in a form of virtual reality glasses watching a film about eagles.

The dentist froze the appropriate area inside Trelford’s mouth and installed a new crown. Sincere assistants hovered and helped, asking Trelford if everything was to his liking. Trelford spent the hour bird-watching.

“It was really most interesting and I learned all sorts of things about eagles,” the Orillia resident says. “I was quite taken with it I never gave a thought to what they were doing to my tooth and it sure beat sitting there mindlessly waiting for the procedure to be finished.

“I like it when the dentists bring out their new toys.”

Many Metro-area dentists are introducing various high-tech “new toys” to help patients relax and forget their dental troubles and anxieties. Some dentists have televisions or visual games hanging from the ceiling. Others give out headsets and a choice of musical selections. A few have taken up the new kind of glasses Trelford used, which show films on a tiny screen in front of the right eye.

One dentist even offers electronic goggles that use the combination of a light show and musical interlude punctuated by beeps to induce a kind of meditative trance in the patient.

Some U.S. dentists offer patients the chance to play computer games hooked up to headsets while their molars are mended and word is that future dental developments will include the laser drill and a dental chair with built-in massager.

While there are no specific Canadian studies on the subject, American research suggests 40 per cent of people won’t go to the dentist unless they are in pain and 10 per cent wouldn’t go to a dentist no matter what Studies clearly show that older people are considerably more dental phobic than younger folks.

People now in their 40s and older sometimes have nightmarish childhood memories of more primitive treatments from the days of very low-tech dentistry.

Children of the last 20 years, growing up in the days of fluoridated water and tooth sealants, have no idea why their parents and grandparents associate dentists with chilling early experiences of drilling, filling and yanking, sometimes without anesthetic.

Some people are afraid of having trouble breathing in the dentist’s chair. Others feel claustrophobic or helpless. Some are afraid of nausea and those prone to dizziness can fear having it triggered by the motion of the chair or by their position.

A 1988 Canadian Dental Association poll showed that 42 per cent of people still associate a visit to the dentist with pain, although their number is shrinking and their fears are not necessarily founded in fact.

But one of the most powerful elements in dental aversion is a sense that the whole experience is a form of human indignity that makes the patient feel like a hapless cartoon character.

“They’re up in the air with their legs

Just wanna be loved by you…

Dentists just want to be loved.

“The media often present dentists as sadistic, uncaring people just interested in getting the job done – the Little Shop of Horrors kind of thing,” complains North York dentist Ron Weintraub.

“That’s the exact opposite of the truth. You need to present the helping, caring side of dentistry.

“Your dentist is a surgeon, a radiologist, an anesthetist, a cosmetician: there’s a great dogree of difficulty to the work. It’s a very demanding profession. But you will find that it is very important to the dentist to offer information and comfort to the patient”

Weintraub says some patients want to be participants in the treatment, to be kept abreast of each detail and to make decisions about aspects of the treatment He offers these people educational videos on everything from root canal to gum disease and the opportunity to watch their treatment on a screen, thanks to a mini-camera.

“Other people say: ‘Please don’t show me anything, just do what you have to do then I’ll leave,” Weintraub notes.

“We find out from the patients what their needs are, then we focus on the needs of the individual patient”

Faced with rising costs, competition from an increasing number of dentists and fewer patients needing fillings and restorative work, dentists are turning to a new frontier in search of business: cosmetic dentistry.

“Prevention has been so successful that restorative work isn’t there,” says Dr. George Sweetman, a Lindsay dentist who heads the Ontario Dental Association.

He says the focus is still on prevention but acknowledges the elective or cosmetic side is growing.

“Now that people are keeping their teeth for a lifetime, they’re very concerned about their appearance,” says Sweetman.

And dentists say they’re finding many who want to improve what their genes gave them.

Costs put bite on dentists

These days, dentists can use bleach to whiten teeth, adhesives to lengthen them, fill in gaps, or realign a bite, then finish with a few coats of porcelain veneer.

Patients can even choose from a variety of veneers, deciding just how dazzling they want their smile to be.

“Where we’re heading with dentistry is as new to dentists as it is to the public,” says Dr. Ed Philips, who operates a dental practice at Hydro Place doing regular and cosmetic work.

“We can make teeth look younger, we can make teeth look more elegant, we can make teeth look more corporate.”

The Ontario Dental Association is launching a $700,000 billboard and TV campaign this spring that focuses on the new techniques.

One billboard shows the word “gap,” with a large space between the G and A. “Fixing it is easier than you think,” the copy says, “ask your dentist.”

Recent technological improvements mean much of the work can be done in one or two visits, without resorting to orthodontic wires and tracks, or expensive caps.

The cost of these procedures range from a few hundred dollars for bleaching that can be done at home, to $5,000 for major work.

Most dental programs don’t cover cosmetic services, which means dentists are forced to compete with a myriad other products to capture a chunk of their patient’s disposable income.

Even if you don’t have a dentist, or yours hasn’t mentioned these services, you’ve probably seen others advertising these options on the back of K mart cash slips, or on flyers in other junk mail.

“I’ve always had healthy teeth, but somehow I’ve never had a great smile,” says clothing store owner Pepe Appugliese, who recently decided to alter his smile.

Philips changed Appugliese’s smile by filling in a gap at the front and reshaping a few teeth. Most cosmetic work involves these relatively subtle changes.

There are more than 5,700 dentists Ontario and that number has been growing, despite a cut in enrolment at dental schools, because dentists trained elsewhere have been coming here to work.

A survey found 63 per cent of dentists who had been practising for fewer than 10 years would like more work and 46 per cent of all dentists would like to be busier.

Dentists who rank near the top of the income scale, with average earnings of $99,280 in 1991, are touchy about suggestions they are turning to new services in an effort to bolster declining incomes.

Philips argues that if they are properly informed, patients won’t be talked into something they don’t want.

The high cost of setting up an office is one factor driving dentists into uncharted areas.

A new dentist will shell out $160,000 to $200,000 to set up a one-chair office, says John Caise, operations and equipment manager for dental supplier Ash Temple Ltd.

New graduates usually can’t afford the latest laser machines and video-imaging equipment that could add another $60.000 to their start-up costs.

As part of his approach, Philips uses separate rooms to discuss cosmetic procedures, realizing patients can’t feel comfortable deciding whether to spend several thousand dollars on improving their smile if they are lying in a dental chair with their feet tipped up.

Patients get a plaster model they can take away to show other dentists and before and after pictures that use video-imaging techniques.

Sometimes patients take the proposal away and come back a year or two later when they are financially, or psychologically, ready.

Dr. Allan Jeffries and his traditional practice Scarborough’s Cliffcrest Plaza illustrates the trend.

A few months ago, Jeffuies sent out his first flyer, promoting new cosmetic dental techniques and touting ways to improve smiles.

The response was not great, but many of his patients asked about the methods and directed a few new patients his way.

This fits with Philips’ advice in his lectures. Start your marketing internally with your own patients, then branch out.

“Most of my patients just want teeth that stand the test of time and look decent,” Jeffries says. “They don’t want to look like movie stars.”

Philips offers his patients a written guarantee that the work will last from two to five years, depending on the procedure.

In many ways, Karen was your typical teen. Her appearance meant a lot to her and there was a lot about her appearance she didn’t like.

She hated her double chin and felt utterly miserable in shorts or a bathing suit.

But unlike most teens, Karen’s desire to look better didn’t end with diet and exercise.

Not quite 16, and accompanied by a reluctant mother, she took her less than model perfect body to a plastic surgeon.

Over the next three years – and with the help of a loan from her parents – Karen spent more than $4,500 to have the fat permanently removed from her neck, then her thighs, hips and stomach.

“I was frustrated because I felt I had done all I could,” to slim down, says Karen, who is now in her 20s. “I wasn’t happy, I wasn’t satisfied with the way I looked.”

Perfect bod, perfect face, perfect teeth. For a growing number of teens it’s makeup and designer clothing at 13, cosmetic surgery by 20.

For decades, young people have flocked to surgeons for less noticeable noses and to dentists for straighter smiles.

Today, the options are much greater. Breasts can be resized, up or down. Saddlebags a worry, tummy too flabby? There’s liposuction. Chin or cheeks too hollow? There are implants.

The world of cosmetic surgery is just a consultation away. But the procedures themselves don’t come cheap. Body contouring, for example, can cost anywhere from $1,000 to $4,000 and beyond. A new porcelain veneer smile, $500 plus per tooth.

And yet it’s not just rich kids who are turning to cosmetic procedures. Some young patients gladly work nights, weekends and summers to cover all or part of the cost, surgeons say.

Young people like Bruce. At 17 he had a $3,000 nose job. Just last month, he returned to have his nose reshaping refined – and for $3000 worth of implants for his cheeks and chin.

“I guess I’m my own worst critic,” says Bruce, a high school student who delivered fast food for nearly three years to pay his surgical bills.

But why surgery and why so young?

“I wanted to be more photogenic,” he says. “I wanted to be as perfect as I could be… ..I guess I’m kind of stubborn, that’s all”

Plastic surgery, says Dr. Michael Bederman, has gone mainstream. Since 1990 he’s seen a surge in interest from teens, who now make up about 15 per cent of his practice.

He doesn’t think teenagers are any more self-conscious or under any more peer pressure than in the past. They’re simply responding to greater social acceptance of all sorts of cosmetic procedures.

There can even be advantages to being young, he says. Because young skin has more elasticity, the younger you do liposuction the better the results.

Procedures most commonly sought by teens include breast reduction, nose reshaping, liposuction, chin augmentation and the pinning back of ears.

Not all youngsters qualify for all procedures. Breast augmentation, for example, isn’t usually done before age 16.

Bederman says he doesn’t hesitate to turn clients away. One 15-year-old wanted her breasts enlarged because her mother and grandmother were “flat” and she feared she’d be the same. He suggested she let nature take its course and come back in a year.

Like just about everyone else, young people “are keen to look their best,” says Dr. Wayne Cannan, a fellow plastic surgeon.

Young people make up roughly 10 per cent of Carman’s practice and provide “a steady, slow stream” of new business.

Teens are well aware that cosmetic procedures are available and not just to the most wealthy, he says.

“There’s a tremendous desire on the part of these girls to look like models,” notes Dr. Earl Farber, another local plastic surgeon. “They want to look like somebody maybe they’re not They want that image.”

The look? Large full lips, rolled out lips – even if it takes more than one try to get them full enough; a “natural” nose, not the pinched little nose that used to be a dead giveaway.

Braces? Sure, some teenagers still get braces. But the real rage is cosmetic dentistry – porcelain and plastic veneers, and bleaching.

Teen clients are a sign of the times, says Dr. Edward Philips.

“These are important years to them and they aren’t willing to put their lives on hold,” he says. “More and more kids are doing this. It’s a snowballing effect”

A designer smile can cost anywhere from a few hundred dollars to several thousand dollars.

For her birthday Christine Hanke had a choice between a car and a new smile. She chose the smile.

Her teeth made her self-conscious and unsure of herself she says. The work, done over several sessions, completely transformed her badly misshapen and discolored smile. The cost to her gift-giver? A handsome $8,500.

“It wasn’t an overnight decision,” says Hanke, 16. “I’d always had it in the back of my mind. As a child I’d modelled a bit and thought if I wanted to model through university my teeth might be limiting. I’m extremely happy (with the results).”

Philips describes his patients, most of whom come in without a parent, as “generally outgoing and self-confident people. They like themselves, as long as they’re not smiling.”

A new smile may be just part of the picture. Several of Philips’ patients have also had a nose job or a chin augmentation or liposuction.

But is society’s emphasis on appearance putting too much pressure on teens to both perform and conform? Carla Rice, a consultant with the

Woman and Body Image Program at Women’s College Hospital, thinks so.

The teen years, she says, are often a time of profound insecurity, when youngsters are “struggling to define themselves and where they fit in the world.

“There’s a myth in our society that if only you can look good, you’ll feel good as well,” says Rice, “that if you’re physically beautiful and have a particular body size or shape things will be good for you, you’ll get what you want, you’ll have success and happiness.”

Many no doubt do end up feeling better about themselves, she says. Others may find that, just like losing weight or getting a new hairstyle, plastic surgery is not a magic bullet.

Was Karen’s liposuction worth it? Karen believes so. She says it gave her confidence a boost and made it easier for her to wear a greater variety of clothes.

But she has this advice.

“If you’re going to have it (plastic surgery) don’t do it for anybody but yourself.

“Don’t do it for your boyfriend or because of pressure from your friends. Think long and hard about it, and ask yourself is it really going to make you happy.”

The pictures say it all.

With yellow, worn and chipped teeth, Karen Wilson had nothing to smile about. Three dental appointments later, she had a dazzling designer smile that not only transformed her appearance, but changed her life.

“When I was meeting people for the first time, I used to bring my hand up to my mouth or turn my head,” recalls Wilson, a dog groomer in her 20s. “When it came to meeting men, it was the hardest. They could see I wasn’t happy about myself.”

But now, just over a year since the dental work was done, “I can talk with people; I’m happier. And I smile a lot. People say I’m more confident.”

Wilson’s winning smile is the work of Dr. Edward Philips, a Toronto dental surgeon who’s given hundreds of people more to smile about.

Cosmetic dentistry, in fact, has given Philips something to sink his teeth into, especially when he sees the difference it can make to people’s manner and self-esteem.

“The impact is absolutely incredible. When they come back (after treatment), they just seem to have pulled themselves together. They look better, fashionably, because they’re wearing better colors, hair and makeup.”

Others respond differently, too. Billie Jo Sabo, Philips’s clinic director, tells the story about a CEO with a major bank who was so self-conscious about his poorly spaced teeth he never smiled.

“During meetings, people thought he was unfriendly and intimidating because they perceived this man with a scowl.”

But after his 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.”

Philips often works with hair stylists and makeup artists to help clients maximize their looks.

“With the right combination of work on one’s hair, makeup and teeth, the results can be astounding,” says Santo Della Corte, owner of Yorkville’s La Corte Salon, who gave Wilson a new hairstyle to go with her new smile.

Cosmetic dentistry can involve a number of procedures that vary in cost, complexity and recuperative time. A gingevectomy (cutting back the gums) will “lengthen” small teeth to create a fuller smile. Composite resin or porcelain veneers can be bonded to the teeth to correct shape, spacing and color imperfections. Yellow or discolored teeth can also be bleached.

The cost can range from $100 or $200 to several thousand, depending on how many teeth need work and what procedures are required. Bleaching, for example, costs about $500 and is done by wearing a small gel-filled tray over the teeth at night for a week.

In Karen Wilson’s case, a major dental makeover was required. Weak enamel had caused her teeth to chip and wear down to the point where even eating an egg sandwich caused them to flake, she says. Excess gum tissue covered much of what was left of her teeth.

A gingevectomy and porcelain veneers gave Wilson full, even, white teeth that not only look 100 per cent better but are stronger and more functional, according to Philips.

Wilson’s case was an extreme one, he notes. But often a perceived problem can be corrected simply and quickly. In one case, a woman who complained about her “crooked teeth” and anticipated major dental work, just needed excess gum tissue tnmmed away. A one-hour appointment and about $600 or $700 later, she was all smiles.

A smile, says Philips, is a science. The ‘perfect smile” is one in which the upper edge of the teeth follow the upward curve of the lower lip line. It is also defined by measurements and proportions in relation to the other facial features.

But most people don’t want the “perfect Hollywood Chiclet smile,” says Sabo. “They want some individual characteristics left.”

An initial half-hour consultation, which costs $85 and is covered by most dental plans, is done to identify the problems, determine what can be done and for how much. Later, before-and-after computer images and molds of the mouth might be made to show what the dental makeover would look like.

Philips, who trained at the Hospital for Sick Children’s cranio-facial 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,” notes Philips, who gives public talks and has appeared on radio and television.

Dr. George Freedman, an author and dental surgeon who runs a “high-tech practice” in Markham, says it’s important to shop around to find a competent dentist who’s trained in the latest techniques.

“Anyone can call themselves a cosmetic dentist,” he says, noting that elective cosmetic dentistry is not taught in dental schools. Only two post-graduate programs exist and they’re in the U.S.

Freedman, who’s the past president of the American Academy of Cosmetic Dentistry, suggests that patients ask a dentist about training over the last two years to see if he or she has kept up with new techniques. The best way to fmd someone, he says, is by personal references from satisfied patients.

Word of mouth, you might say.

Back in February I decided to have “the conversation” about where the relationship was going (we’re both 27). He told me he really likes me but wasn’t interested in a commitment. He said I was the only one he wanted to see, but he’d be leading me on if I thought he wanted anything serious. I said I did want something serious, so we broke up.

DEAR CHRISTINE: I think that if there were a bureau of the Telephone Police, you’d do well to turn yourself in and surrender your cell phone before you do something you’ll regret.

Joy Hunter, who specializes in couples and individual therapy, believes it’s possible for two people to be having the same (yet fundamentally different) relationship. It’s fun to be romantic and coupleish and playing at being in love; without having “the conversation,” a pair could go on billing and cooing indefinitely. Just be glad he didn’t lead you on selfishly with a half-hearted “love you too, baby” and a quick change of topic.

Hunter points out the guy was as upfront and honest about his expectations as you were about yours. Credit where credit is due – don’t you go changing now in an effort to get him back.

It’s hard to hear the truth some times, particularly when it’s one that not only points out an unhappy reality, but dashes future hopes as well.

But now you know. If you’re clear about what you want from the start (though you needn’t feel compelled to list “marriage, a house in the suburbs and two children – twins” on a first date), you’ll waste a lot less time dating people who will disappoint.

So don’t call. Save your quarter – and your caring – for someone who will appreciate it.

DEAR JANE: I hate my teeth.
I’ve always had wide gaps between my top four front teeth, but what was somewhat cute as a kid is making me increasingly uncomfortable as the years go by. I finally thought “enough!” but when I told my husband, he told me he loves me just the way I am and reminded me we’ve been saving to put a new deck on the house! We always said we’d both have to agree to any large expenditure.
What can I say to convince him this isn’t just a vain whim?