Many patients from the Dothan area take the 90-mile drive to Thomasville for their cosmetic dentistry because of the reputation of Dr. Oppenheim. He is an Accredited Fellow with the American Academy of Cosmetic Dentistry, meaning that he has attained the highest standard of excellence in cosmetic dental care. His beautiful cosmetic dentistry is recognized across the country by his fellow cosmetic dentists-he has won gold medal and first place awards in the American Academy of Cosmetic Dentistry smile gallery competition for ten years in a row, and his work has been featured on the cover of the Journal of Cosmetic Dentistry an unprecedented eight times. Patients who recognize his skill and artistry come to him from around the world.
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Everyone that graduates from dental school is a general dentist, and most of them also claim to be cosmetic dentists. But there is a great difference, which we will explain here.
The Difference Illustrated
The best way to explain the difference is with photographs.
Below is a photograph of a case treated by an excellent general dentist. The person who reported this story to us said that the dentist “raved about his own work and thought it was gorgeous!”
The patient, however, didn’t agree. In fact, she was so unhappy that she paid thousands of dollars to have it done over. Notice the problems—The color of the teeth is flat and kind of yellow. They are opaque. They don’t sparkle. From a distance, there appear to be dark triangles between the teeth. And their shape is more like Chicklets than natural teeth.
And below is another photograph. This one is of a re-do by a highly artistic cosmetic dentist in our referral network—Dr. Thomas Oppenheim of Thomasville, Georgia.
Notice that her smile is now warm and inviting, as opposed to the cold, clinical look created by the general dentist. The teeth are translucent and natural-looking. They are whiter. They truly sparkle. They have subtleties embedded in their shapes and the coloration to make them look real.
The patient, was of course, thrilled with the results.
Click here to see more photographs of cosmetic dentistry mistakes re-done by mynewsmile network cosmetic dentists.
Here’s the basic problem: Cosmetic dentistry is not a legally recognized specialty. This means that there is no restriction on a dentist saying that he or she is a cosmetic dentist. So, many dentists take advantage of this lack of a legal definition and claim to be cosmetic dentists.
And I believe that they are usually innocent in this claim. They think that they have learned in dental school how to use composite fillings and how to do porcelain-fused-to-metal crowns which are white on the front, and they feel capable of addressing appearance concerns with patients.
Read the amazing article from the June 29, 2004 Wall Street Journal, “New Business for Dentists: Fixing Botched Cosmetic Work.”
Read letters that we have received from disappointed patients about cosmetic dentistry mistakes.
However, doing cosmetic dentistry properly requires extensive extra training that can take years. This means a heavy commitment of time, money, and energy for the dentist. And, if dentists can announce themselves as cosmetic dentists without this training, why should they go through all of that expense, travel, and time away from the office?
Besides this, there is a very different temperament and a different approach to dentistry by a true cosmetic dentist. Here are some of the fundamental differences:
- A cosmetic dentist is passionate about the appearance of the work and getting it to look as beautiful as possible. General dentists have a much lower expectation of “beauty” in dental work.
- Cosmetic dentists are very attuned to the patient’s perception of the work. General dentists are trained in dental school that they are the best judges of what is best for the patient. Cosmetic dentistry, however, is the art of addressing the self-perception of the patient. A cosmetic dentist knows that if the patient is not pleased with the appearance of the work, the case is a failure. This goes directly against the grain of dental school training. It is not uncommon, when a patient addresses cosmetic concerns with a general dentist, that the dentist will say that there is nothing wrong with the patient’s teeth, or he or she may emphasize the risks of the treatment, and really not understand the depth of the patient’s concerns. The general dentist should be applauded for his or her honesty, but the patient needs more than that.
- General dentists are trained to fix things. Cosmetic dentists are trained to create things. General dentists tend to have the mindset of a technician—giving their attention only to detail and to function. Cosmetic dentists, to be successful, also must have that great attention to detail, but must have that added spark of creativity and attention to beauty. It’s like the difference between a building contractor and an architect—it takes a completely different personality type to succeed with each dimension.
- Cosmetic dentists must dedicate themselves to extensive hours of education after dental school, knowing that it isn’t required, simply for the passion of being able to create smiles of beauty. There is a certain “fire in the belly” that they possess.
And there is a great deal they have to learn:
- The tooth-colored materials that cosmetic dentists work with have properties that are very different from the materials generally taught in dental schools. There are opaquers, tints, composites of varying translucencies and surface characteristics, complex bonding agents, various porcelains, etc., that require a great deal of training to master. There is a chemistry of bonding that they have to thoroughly understand. Different materials have different properties of texture, color, translucency, strength, and polishability, and these all have to be manipulated to produce a beautiful and natural result.
- The concept of smile design is an artistic subject that general dentists, just as a matter of personality, have great difficulty with. But cosmetic dentists learn this art, the elements of beauty in a face and in the shapes and alignment of the teeth. It is difficult to teach this subject to someone that doesn’t have the aptitude.
- It takes more than attending lectures to learn the many aspects of color that a cosmetic dentist needs to know—he or she needs some hands-on training in this subject. Tooth color is very complex. Not only are there multiple colors in one tooth, but there are many variations in depth of the color. Some tooth colors are on the surface, some are just beneath the surface, and some are deep within the tooth. Color is influenced by reflectivity and texture—how shiny a surface is changes the color perception of that surface. Even contours can alter color perception by creating lines and spots of reflection. But the most difficult issue for general dentists is translucency and opacity. Teeth transmit light besides reflecting light, and to make a tooth look natural, the dentist has to master this understanding of degrees of translucency. There are differences in translucency between one tooth and another, and even within the same tooth there are great differences, and the way tooth translucency interacts with tooth color is very complicated and takes time and effort to master.
- Finally, there is a great art of communication in great cosmetic dentistry. The dentist has to take all of this artistic and scientific knowledge and apply it to the perceptions of the patient. General dentistry is a matter of diagnosing what is wrong with the tooth—decay, infection, cracks, or other structural problems, and then simply fixing them. However, a cosmetic dentist diagnoses the self-perception of the patient and then addresses that. If a patient is satisfied with his or her smile, then there is no cosmetic dental problem. If a patient is not satisfied, then the dentist has to determine what to do to create that satisfaction and meet the patient’s needs. It’s a different level of communication, and it requires considerable training and experience to master.
How many of the dentists who claim to be cosmetic dentists actually are? It may be impossible to say, but I’ll give my best guess. From what I have seen, and from what I know of the dentists who have pursued extensive additional training in cosmetic dentistry and have shown a level of skill that I would consider acceptable, I would guess that it’s some number under 2%. That’s as close as I’d like to guess, and it’s my personal guess. Fewer than one-quarter of one percent are accredited in cosmetic dentistry.
So how do you tell if a dentist has had the proper training to be a fully qualified cosmetic dentist? It’s difficult for the consumer. Dentists may be able to cite courses that they’ve attended, but, as a patient, you would probably have no way of evaluating whether these courses are adequate to prepare the dentist. Even if they show you photographs, my experience is that most patients miss seeing the subtleties that make a smile look truly natural and beautiful. Complicating the issue for the patient is the lack of appreciation even by many dental authorities of the requirements of real cosmetic dentistry. Thus, when interviewed by The Wall Street Journal for an article about the poor quality of much cosmetic dental work that is being done by general dentists, the spokesperson from the American Dental Association disagreed with all of the cosmetic dentists who were interviewed and said that current ADA guidelines and state regulations provide “sufficient oversight for the protection of the public.” To make a statement like that he has to believe that if the dentistry is functional, then it’s acceptable. He fails even to see the problem. Cosmetic dentistry is very different from general dentistry, and, if we are to please the patient, it can’t be judged by the same standards.
—Dr. David Hall, accredited cosmetic dentist and author of this website
- See Dr. Hall’s blog postings where he answers questions from visitors about choosing and finding a cosmetic dentist.
- Click here to ask Dr. Hall a question yourself, to receive an email answer.
- Read about porcelain veneers.
- Read about all porcelain crowns and the difference between them and porcelain fused to metal crowns. Find out how you can have a crown that perfectly mimics a natural tooth.
- Find out about Invisalign invisible braces – how you can have your teeth straightened without wearing ugly, uncomfortable brackets and wires.
- Learn all about teeth whitening.
This website was created to give you authoritative information on cosmetic dentistry. It is the only cosmetic dentistry information website written by an accredited cosmetic dentist. My name is Dr. David Hall. I am the author, and I was one of the first forty dentists to become accredited by the American Academy of Cosmetic Dentistry.
The website is unique in its plain, straightforward talk. I have a strong sense of obligation to you, the visitor, and so I try to tell you the plain and unvarnished truth. Other websites on this subject matter seem governed by professional political correctness. You won’t find that here.
What is Cosmetic Dentistry?
It is a highly specialized area of dentistry that very few dentists can do well. If you ask your average dentist, they will tell you that sure, they know how to place porcelain veneers and do other esthetic procedures. While that is true in one sense—they usually know the technical procedures—they lack the passion to create truly beautiful smiles. I have a file full of e-mails from disappointed patients that demonstrate this. Check our collection of cosmetic dentistry horror stories to see for yourself. And excellent cosmetic dentists will tell you that from 25% to 40% of the esthetic work they do is re-doing other dentists’ work.
It’s actually a controversial area in dentistry. Some dentists insist that it ought to be a specialty. Most dentists, however, insist that it shouldn’t—any dentist properly trained in dental school, they claim, can do esthetic procedures just fine.
Some would attribute this discrepancy in opinion to financial self-interest. Dentists know that this is a profitable practice area and simply don’t want to give it up. While that is undoubtedly part of the reason, it is only part.
Cosmetic Dentistry Is a Blind Spot for Most Dentists
Dentists, most of them, simply don’t understand esthetics. They chose the profession because they like to fix things. They have an engineering mentality, an approach that is reinforced throughout dental school. Beautiful, to them, is perfect margins and healthy gums. And they are taught that the dentist, not the patient, is the best judge of how teeth should look.
A True Story
Let me illustrate with a true story. A few years ago a patient was looking for the best dentist available to do crowns on all her front teeth. She was recommended to a dentist whom she was told was one of the very best in her area. He did ten crowns on her front teeth. You can see the results in the photograph below. The dentist raved about this work and thought it was gorgeous. The patient, however, thought it was terrible. It looks fake. There is no sparkle to the teeth, and they have a yellow tinge.
Having been through dental school, I can tell you that this is exactly the kind of smile we would have been taught to make, and if the patient complained, we would have been taught not to listen because we were professionals and knew better.
Fortunately, this patient had enough money to have the work re-done. She went to one of the excellent cosmetic dentists in our referral network, Dr. Thomas Oppenheim of Thomasville, Georgia. He cut off all of the crowns placed by the first dentist and replaced them. You can see his work below. The patient was now thrilled with her smile. You can see that the yellow color is gone. There are no more dark triangles between the teeth. There is sparkle in her smile. Subtleties in the shape make the teeth look real. The overall appearance is warm and inviting.
You might be thinking that this beautiful work would be tremendously expensive, but it usually isn’t. While it is true that there are some very high-end cosmetic dentists who charge very high fees, most charge fees that are about the same as other dentists in their area who do technically excellent work but have no artistic ability.
Find a Cosmetic Dentist
That leads me to the main purpose of this website—helping you find a cosmetic dentist. I stick my neck out in doing this because I don’t just list these dentists, I recommend them. Each doctor recommended on this website has been personally screened by me for training credentials and artistic ability. I do have a legal disclaimer that you need to read before using this site, because it is ultimately the responsibility of the dental board of each state to insure the quality of dental care in each state, and not mine. But I can say that I have made an honest and carefully informed effort to list dentists that I believe will do beautiful work.
And no, dentists do not have to pay to be listed. They are chosen based on the quality of their work as demonstrated by photographs and on their credentials. Yes, most of the dentists listed help support the website through sponsorship, but not all of them do. On the other hand, many dentists have offered to pay in order to be listed, and we have turned them down because I didn’t feel that I could recommend them. We thank those dentists who do provide support, as well as the advertisers on the site.