Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SATURDAY, April 21, 1990 TAG: 9004210070
SECTION: EXTRA PAGE: E-1 EDITION: METRO
SOURCE: MARY J. PITZER LOS ANGELES DAILY NEWS
DATELINE: LENGTH: Medium
"We Cater to Cowards," it reads. It shows a shaking man huddled behind a dentist's chair.
"A lot of patients are fearful of coming," said the dentist who placed the ad, Dr. Edward Reifman of Encino in Los Angeles' San Fernando Valley. "But we have a lot of supreme cowards here."
No doubt about it, dentistry is a tough business. But in the last decade dentists have had to deal with bigger problems than patients who are afraid of the needle and drill.
Largely because of fluoride treatments, dentists virtually have eliminated much of their traditional reason for being - cavities. Coupled with a flood of new dentists in the late '70s that increased competition, some observers warned that the profession was headed for decay.
But instead dentistry changed with the times.
Dentists began hustling for business with ads, referral services and direct mail. They changed from filling teeth and fitting dentures to treating the total health of patients. And they are using new techniques and technologies to meet patients' demands to look better.
In the end dentistry is changing from a reserved and stuffy profession to a dynamic and at times flamboyant business. Dental insurance is bringing more people through the door. Doctors who scrambled for patients in the early 1980s are likely to feel competition ease as dental schools graduate fewer students.
Dentists' incomes, which took a hit for a few years because of fewer patients and the advent of prepaid plans, are looking more robust than ever.
Some $32.8 billion was spent on dental services in 1987, the most recent year for which figures are available, according to the federal Health Care Financing Administration. That was an 11 percent increase from 1986.
Independent dentists, who make up most of the nation's 183,000 practicing dentists, had average net earnings of $85,690 in 1988, a 19 percent increase since 1985, according to the American Dental Association.
"The outlook for the profession, dentists and patients, is just excellent," said Long Beach dentist Dr. Richard Lewis, president of the California Dental Association. "There will be better treatment, and dentists will do better."
In fact, many dentists have drastically changed the way they approach their patients. Many focus on overall physical and emotional needs.
"The mouth is representative of the whole body," said Dr. Beth Settle of Woodland Hills in the San Fernando Valley. "A lot of people are starting to take a holistic approach."
Dentists are often the first to discover that patients have AIDS, leukemia, vitamin deficiencies and too much stress.
Settle thoroughly examines her patients' heads and necks for cancer and gum and joint problems. Dr. Howard Bleicher, whose office is in nearby Sherman Oaks, counsels his patients on how proper nutrition affects the health of mouth and body. And Reifman uses hypnosis to relax some of his cowardly patients.
The patients, too, are changing, causing dentists to switch to different procedures. As the population ages, dentists are helping people keep their teeth longer and healthier.
"Teeth were never meant to last that long." Reifman said.
Prevention of gum disease has replaced fighting tooth decay. Dentists are treating problems such as cavities on the roots of teeth, which appear in elderly patients as their gums recede.
And with the health and fitness craze, patients are fussier about how they look. That is fueling demand for cosmetic dentistry.
The profession, in turn, is keeping pace with improvements on a host of treatments. Dentists can bleach teeth to erase coffee and cigarette stains. Instead of a crown for up to $700, dentists can bond a tooth to repair chips for $200 to $500. For $400 to $700 they can fit the teeth with porcelain veneers that will keep them white and strong.
And they are implanting teeth at $800 to $1,500 apiece to save patients from bridges and dentures, which can cost from $400 to $1,000 for a full mouth. The success rate for that procedure has risen from 50 percent to about 90 percent in the last five years, said CDA's Lewis.
More adults also are wearing braces, once confined to metal-mouth teen-agers. Encino orthodontist Dr. Charles Gross estimates that more than 50 percent of his patients are adults.
Part of the reason is that new materials for braces, such as plastic and porcelain, are hardly noticeable in a person's mouth. The porcelain braces, said Gross, "look like little jewels."
Even if patients opt for older materials, curiosity about new ones brings them into the office, said Dr. Jerald Medway.
by CNB