In the next few years, more dentists may set aside their drills and chisels and zap their patients' mouths with laser beams, high-pressure streams of metal particles and radio waves.
They'll also spend more time trying to make people look good by whitening and sculpting smiles, and less time treating disease or repairing damage.
"That's where we're getting pushed, because we don't have the decay we had in the past," said Dr. Paul Bussman, chairman of the public information council of the Academy of General Dentistry. The academy is holding its annual meeting in Baltimore this week.
Dr. Jeffrey A. Sherman of Dix Hills, on Long Island, said dentists are increasingly in the beauty business. Plastic surgeons are even referring their patients to dentists for cosmetic work.
"They tell their patients, 'My face lift is not going to be any good if you still have those crummy teeth,' " he said.
Almost 2,000 members of the academy have gathered at the Convention Center, where they're talking about such topics as dental drugs and counseling patients to quit smoking, to promote oral health. They also came to hear sales pitches for some of the advanced technology filtering into dental offices.
Kreativ Inc. of Albany, N.Y., demonstrated its $10,000 machines for removing cavities by sandblasting them with ultra-fine grains of aluminum oxide, traveling four times the speed of sound. A bonded resin filling is then inserted, and cured within a few seconds with a laser beam.
While the basic "air-abrasion" technology has been around for more than 50 years, Kreativ Inc. claims to have perfected its as an alternative to the traditional drill.
A May 1994 article in the Journal of the American Dental Association reported that air-abrasion didn't work well in preparing teeth to accept metal fillings back in the 1950s. But, the article said, the technique is "suited" to use with new bonded resin filling materials. It also removes less enamel.
The manufacturer says the machine produces less heat, vibration and bone-conducted noise than drilling, reducing the need for novocaine.
Dr. Bussman said strides are being made in metal implants sunk into the jaw bone for holding prosthetic teeth in place. But their cost remains very high: from $750 to $1,200 per post, or more.
Dentures, which are removable false teeth, also are improving, he said. But the demand for them may not grow significantly. "People aren't losing their teeth as much anymore," he said. "Ten or 15 years ago, if you had a toothache, the dentist would take it out."
Now, dentists are performing root canals more frequently, and using advanced tools, such as lasers, to clean out the infected canal. "We're saving a lot more teeth that we classified as hopeless before," he said.
The traditional tools of the dental trade also were on display yesterday: dental chairs, drills, and those tiny binocular-style devices dentists put on their glasses when they're peering into your mouth.
Ken Zoll of Zoll Dental, a Glenview, Ill., manufacturer of dental instruments, stood behind a display of about 500 stainless steel dental chisels, pliers, picks, probes and other finely crafted but wicked-looking implements.
"Some of these can be a little painful," he chuckled. While he was setting up his display, he said, someone came along and commented: "Oh look, it's the torture device guy."
Dr. Sherman, the Long Island dentist, held a daylong seminar yesterday on the use of radio waves to cut and cauterize the gums of patients. The technique, he said, can be used to remove excess gum from the front of the teeth of some patients, or for cutting a small muscle between the upper lip and gum that sometimes creates a gap between a patient's two upper front teeth.
The pen-shaped radiosurgery device also can be used to heat peroxide solution placed on the teeth, to help bleach away stubborn stains.