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Confessions of a former cosmetic dentist

Aug. 11, 2010
Michael Zuk, DDS, boldly talks about risks involved in extreme smile makeovers.
By Michael Zuk, DDSIn the 1990s I wanted to be a cosmetic dentist and make people more attractive. The speakers were motivating and exciting, and the big name heavy hitters of the time included Dickerson, Rosenthal, and Hornbrook. One even said “porcelain was better than enamel.” That got me a little suspicious and added to the fact that I didn’t like the drilling that usually left the teeth a shadow of their former selves.Nevertheless I continued my studies and attended an esthetic continuum at UCLA and heard about more ways to make teeth attractive. The best speakers there were Spear and Chiche. Some even hinted that some orthodontics may be a good idea, and one guy told us a story about how a young girl’s teeth were mutilated by a veneer makeover. I was getting a little gun shy about this whole veneer makeover thing.The group practice I was in had a partner who was doing orthodontics. I was terrified that if something happened to him, the liability would be huge and the six-month list of orthodontic patients would instantly sink us like an iceberg into our haul. I decided to combine my cosmetic training and add orthodontics to create a hybrid. I borrowed the idea of a different standard based on perceptions of esthetics from Kokich, and started a style of braces under the trade name “High Speed Braces.”The partner who was practicing orthodontics was horrified, the competitors were alarmed, but the patients came in droves. I was referring more patients than usual to the orthodontists and treating the mild cases with what is now called “Shorter Term Orthodontics.” While it has become a buzzword, the first doctors to offer this may want to brace themselves for a little resistance.In my case, competitors ran a negative radio ad, told patients I was wrecking their teeth, told them “faster braces damage the roots,” attempted to interfere with my access to dental supplies, solicited my staff, and even threatened them with an anonymous phone call. Recently they even tried to interfere with the courses I was taking. I retaliated with things I can’t even share with you ... I can be ruthless when cornered.What was surprising to me was cosmetic dentists were “wrecking healthy teeth” and the orthodontists bit their cheeks but they raised hell when alternative straightening programs became available. Times are tough for many dental practitioners, and l was only trying to carve out my own niche. I decided to write a book to describe my position on the whole cosmetic and orthodontic fields.
“Confessions of a Former Cosmetic Dentist” was my attempt to educate the public about alternative esthetic dental treatment. It has been described as “brutally honest” and certainly would be upsetting to any dental professional who is pigeonholed into a single style of treatment. My premise is you can’t always trust a cosmetic dentist, because all too often the doctor is hyped up on selling veneer makeovers.Unlike the author of the “The Daughter’s Test” (written for dental professionals), I feel cosmetic dentists can’t even be trusted with their own family, their own staff, and even their own teeth. After cosmetic training many dentists are encouraged to veneer their teeth to help sell treatment. While this may help gain the patient’s trust, I feel rampant use of veneers needs to be stopped.When I asked another former cosmetic dentist what he would do if a dentist talked his daughter into a veneer makeover to treat her slightly crooked teeth, he replied, “There’d be hell to pay!” This was in front of an audience of cosmetic dentists at a lecture I was giving, and I was shocked he was so honest. I am on a crusade and capable of almost anything when it comes to sabotaging the Extreme Makeover Movement if it involves using veneers as the first line of treatment.Cosmetic dentists are in a high liability position if they don’t show people the graphic pictures of what will be done to their teeth, the long-term costs, and the risks of shortcuts. If they were to invest half as much money into learning orthodontics, they would have their eyes opened wide with the possibilities. The new age of conservative cosmetic dentistry will be much different, and the cosmetic dentist who says “I just do a ton of veneers” will be considered a Veneer Nazi.The Veneer Nazi is not a professional with integrity. He/she is programmed to make peoples’ smiles whiter, straighter, longer, and wider, curing wrinkles, headaches, and TMJ problems in one giant swoosh of the high-speed drill. The teeth are clear-cut and reforested with expensive ceramic. They overreact to mild variations in peoples’ smiles and over-treat like a physician ordering chemo for the common cold.On the other side is the cosmetic patient who has become a groupie. I coined the term “Smilorexia” as the condition where a person desires the mythical PERFECT SMILE. The patient inevitably ends up in the cosmetic dentist’s office after seeing their fancy magazine ad and signs up for the Extreme Smile Makeover. It’s like taking candy from a baby and while they often pay cash, these patients may be the ones who come back to haunt the cosmetic dentist, because for some reason there is always something that is not quite right.Nobody likes a whistle-blower, but after years of seeing little change from the finger wagging of esteemed dentists like Christensen, I decided to go public with our profession’s dirty little secret. We have let our education become hijacked by courses sponsored by dental labs and manufacturers. We have stopped cross-training and decided to join big organizations that seem to make it OK to do whatever they tell us to do. Do you think the public can really trust the average cosmetic dentist to encourage them to first consider affordable and conservative alternatives to porcelain veneers? Would they spend much time and effort convincing them NOT to have an extreme smile makeover? I don’t think so.Michael Zuk, DDS, is a general dentist with a special interest in conservative cosmetic dental care and marketing. He has lectured on these topics in Cambridge and provides marketing input to several dental companies including The High Speed Braces Company. The terms “Veneer Nazi” and “Smilorexia” are copyrighted and included in Dr. Zuk’s book “Confessions of a Former Cosmetic Dentist,” which is available on This article was written exclusively for this publication and may not be duplicated in whole/part without the expressed written permission of the author.