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Nothing But the Tooth

Nothing But the Tooth
Now that she's had her teeth whitened, Sonora Chase notices that casting directors take her more seriously. "It may be subconscious on their part, but there's a certain look that puts you in the employment category," she says. "Before I got my teeth whitened, they made comments suggesting that I was not going to be on TV. That has changed."

Chase initially tried an at-home whitening kit, but she found it too much of a hassle and had her dentist do it instead.  She's utterly delighted with the results and does her own touch-ups. Other actors who've had their teeth whitened, or who've opted for more-radical cosmetic dentistry, such as veneers, are equally pleased. They feel less self-conscious and more confident, and that, they say, leads to better auditions and performances.

Jessica Delfino, a comic and singer, broke one of her front teeth as a youngster. "The missing piece was filled in by the town quack dentist with a chunk of tooth putty three shades darker than my actual tooth," she says. "It was humiliating and a cause of much insecurity for years." When the wretched two-toned tooth was finally replaced with a quality veneer, she says, her life changed: She now had the confidence to launch a performing career.

"No one notices the tooth is not real," Delfino explains. "It was made in Sweden at some special tooth factory that generated it from a copy of my old tooth and made it out of a porcelainlike material that even refracts light the same way a real tooth would. I know that if I still had a half-brown tooth, it would be too distracting for the perfection-loving media and the audience they've helped to create. No one would give little Ms. Brown Tooth the time of day."

Bright, even teeth won't guarantee a successful career, of course, but many actors think they can help. Here's the lowdown on the most common procedures, their costs, and what you need to consider.

No More Chiclet Smile

Cosmetic dentistry was once synonymous with the unnaturally white, toothy smile of certain TV personalities, but that's no longer the case, say dentists, who talk of customizing their work for each patient, ensuring that color, brightness, size, and shape are natural and aesthetically pleasing. But in the end it's the patient's choice. Whatever the procedure, "patients can see simulations on the computer," says New York dentist Dr. Jay Neuhaus. "They can see the whole sequence of how teeth will move and how they'll look. These are full facial shots and close-ups."

Another New York dentist, Dr. Harvey Perlow, emphasizes the importance of looking at more than just the mouth. "What you do with your teeth impacts your entire face," he says. "It's not about smiles but about faces. If you give long teeth to a tall, thin person with a long face, you accentuate the long face. If you have a patient in his 50s or 60s with a round face who may have ground down the teeth, you may want to make the teeth a little longer."

Even with whitening, thought must be given to the shape of the teeth, Perlow says. If they're misshapen, whitening will accentuate the problem, drawing unwanted attention to the mouth. Citing Ron Howard's photo on the cover of the June issue of AARP Magazine, he says the director's whitened smile only exaggerates "his little rat teeth."

"If a person has facial harmony, you look at the eyes," Perlow explains. "It's chin, mouth, nose, and eyes. If that flow is interrupted, there's a loss of balance. You look for balance." When it's not there, he says, the audience may not know what's wrong, just that something about the actor's face isn't working. He calls Erik Estrada's too-white teeth the perfect example.

Dr. Armen Terteryan, a dentist in Woodland Hills, Calif., says he's getting more patients asking for "character in their teeth. Some actually want flaws, like a chip in a tooth or even slightly overlapped teeth, though that's more common in men than women." But when a patient comes in with a photo of a celebrity whose smile he or she wants, that raises a red flag for Terteryan. Those teeth might not work for the patient, or "the patient's perception of the picture may be off," he says. "There is no way of knowing if the shape and color of the teeth have been airbrushed."

The Great Whitening Hope

The most common cosmetic dental procedure is whitening. The good news is that do-it-yourself whitening works to a certain extent, and it's less expensive than a trip to the dentist. The bad news: It can be a chore, and the whitening agent used is less potent than you'll get from a dentist. (See the sidebar for some home whitening dos and don'ts).

In the dentist's office, the first order of business is usually a full cleaning and possibly a checkup. If your teeth are in good shape, the whitening begins. First the gums and lips are protected with a barrier; then the teeth that are visible when you smile are covered with a bleaching gel. The gel stays on for 15 to 30 minutes, followed by one or more 15- to 30-minute applications. In some procedures, an intense light is focused on the teeth at the same time to activate the gel, though some dentists think it's unnecessary and others suggest that the possibility of ultraviolet rays makes it dangerous.

"Most patients don't have any side effect, short of a little sensitivity maybe six hours later, which can be taken care of with Advil," says Neuhaus. "Men can't take pain. They are far worse patients than women."

For 24 hours after office bleaching, patients should avoid eating or drinking anything that stains, such as chocolate, coffee, grape soda, or red meat. "Stick to turkey, chicken, and cheese," Neuhaus says. "There are plenty of foods and drinks that are white or clear-colored."

A return visit to the dentist is usually not necessary for at least three years, and many patients go far longer. The dentist may also provide an at-home touch-up kit involving special trays and gels. On average the cost is $250 to $500 for office whitening (plus $200–$300 for a touch-up tray), and insurance doesn't cover it.

First, Brace Yourself

Beyond simple whitening, cosmetic dentistry is serious business and shouldn't be approached casually. A full dental and periodontal (gum) exam beforehand is also recommended.

"If you have gums that bleed easily upon brushing, do you realize that your appearance could look worse if you don't treat that problem prior to getting any cosmetic procedure?" asks Dr. Ken Ross, a dentist in Burbank, Calif. "What happens if you spend all your available cash on a few front teeth and can't afford to fix back teeth that might be decaying now? If you can't afford to fix them, how would it look if they needed to be extracted? Be smart. Get a complete checkup first and have a game plan in place to correct any unanticipated tooth problems."

Neuhaus emphasizes the importance of a good bite before getting a cosmetic procedure. If your bite is off—the teeth of the upper and lower jaws don't align properly—then veneers placed on the teeth could break. A patient with major bite problems may be referred to an orthodontist. In other cases the dentist can use a product such as Invisalign: clear braces that are removed for meals, brushing, and flossing.

Correcting a faulty bite may take three to four months, depending on the severity of the problem, but there are no risks or side effects short of some slight discomfort, says Neuhaus. Some dental insurance policies cover adult orthodontics, and the price ranges from $2,000 to $6,000, he says. Actor Rachel Diamond says braces corrected her crooked teeth and the gaps between them and she's satisfied with the work.

A Perfect Smile Is Veneer at Hand

Porcelain veneers, which are bonded to the teeth with resin cement, are the most durable, attractive option for improving your smile, according to the dentists interviewed. The number of teeth involved is one factor determining how long you'll spend in the dentist's chair: Neuhaus says eight to 10 teeth is average (though it may be six, and sometimes only one tooth needs to be addressed), and the procedure usually takes two visits of two to four hours each.

Part of the treatment involves tooth reduction, especially if your teeth are large and protruding, and some patients require a shot of Novocain. Veneers, it should be noted, are not caps. Caps require major tooth reduction—and sometimes more than one pain-killing injection—and are often affixed to save a tooth.

Veneers are usually created at a special lab, based on an impression of the patient's teeth that the dentist takes during the first visit. After the teeth have been reduced, temporary veneers are installed and remain in place until the permanent ones are ready. Those are affixed at the second visit, and follow-up adjustments may be necessary.

According to Ross, if you're thinking of getting veneers and whitening, the latter should come first. "It's very unlikely that anyone will be able to precisely bleach your teeth to match the veneer," he says. "It's much easier to have your teeth bleached first, and then the dentist can try to match veneers to that new color."

Veneers may cost $700–$3,000 per tooth, and most insurance policies don't cover them. A less expensive, less durable option is bonding, which involves a composite usually used to treat small chips or discoloration on a tooth. The cost is $300–$600 per tooth.

Chicago actor Danon Dastugue spent $10,000 on her veneers, but she doesn't regret it. "I was moving from New Orleans to Chicago and sold my home, so I had the money," she says. "I moved to Chicago to be able to audition more frequently, and I have." Though she doesn't credit her teeth for that, she says she's more self-assured in all aspects of her life. The only drawback is that flossing is more difficult.

By contrast, Christina Cuenca of Los Angeles is not happy with her veneers; she doesn't think they look natural. "It's adjusted the size of my face, so I've had to relearn my expressions," she says. "Also, every time I eat ice cream or anything cold, it's uncomfortable. If I could redo it, I'd go with braces or Invisalign—anything less invasive. Maybe I should have had more than one meeting with the dentist. But the dental work was a $20,000 prize package I won in a beauty competition. I didn't get to choose my doctor. When I get my first big paycheck, I'm going to go to a dentist and tell him to give me what I had before."

Finding a Good Cosmetic Dentist

A personal recommendation is always a good starting point when looking for a cosmetic dentist. "An agent, business manager, photographer, makeup artist, director, producer, etc., are often people you trust and who have experience with those who've had successful cosmetic dentistry," says Ross. "If you truly don't know anyone who can give a great referral, then consider telephoning a local dental school for names of instructors or former instructors in your area."

Before and after pictures can be useful, whether of friends or colleagues or from the dentist's portfolio—it's perfectly acceptable to ask to see them. So is asking whether the dentist has special training; the Dawson Center in Florida and the Las Vegas Institute both offer advanced training in cosmetic dentistry, though some dentists we spoke with aren't impressed with either school. Most agree that your dentist should be a member of the American Academy of Cosmetic Dentistry, which they say is notable for its rigid requirements. And any dentist you consider should be a member of the American Dental Association.

Two final caveats: If a dentist makes unrealistic promises about how beautiful you'll look and how your life and career will change, steer clear. And beware of prices far below the going rate. As the saying goes, if it sounds too good to be true, it probably is.    

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