The White Touch
By Stacey Okun
It's true that Dr. Irwin Smigel, a pioneer in the field of cosmetic dentistry, can be credited with the invention of bonding (in which synthetic tooth-colored material is fused onto stained, chipped, widely spaced or misshapen teeth and molded into whatever new shape is desired) as well as porcelain veneers (caps of porcelain, which can cover a multitude of sins). But his real passion is making teeth white - marshmallow white. To that end, Dr. Smigel has greatly improved the technique of bleaching, a procedure usually done at home by patients over the course of two to four weeks during which discolored teeth are soaked in molds filled with a hydrogen-peroxide solution prepared by a dentist. The results can last from one to three years.
This quest for white has earned Dr. Smigel much acclaim; models and movie stars too glamorous to mention (primarily because they want you to think their teeth are naturally that white) have flocked to his Madison Avenue offices for the kind of extra help you can't get from a whitening toothpaste (more on this later). But still, this world-renowned smile doctor - considered the "grandfather" of many top cosmetic dentists in this country - hasn't been satisfied. "I'd always hoped to find a method that would get teeth even whiter and last even longer," he says. "I wanted to find help for the people who have severe nicotine stains or discoloration from using tetracycline as children. We haven't been able to make these stains go away completely or permanently with hydrogen peroxide alone."
Until now. 'He's tried chemicals, he's tried synthetics; now, Dr. Smigel has turned to lasers-the hottest equipment in modern medicine-and as usual, he's the first dentist to tread in this ultranew territory. Working with Dr. David Yarborough, another renowned cosmetic dentist, and Ion Laser Technology (a company that manufactures lasers for medical use), Dr. Smigel has been able to "reach the next level of whiteness," he says. "Lasers work quicker, better, deeper and safer than any other technique."
How exactly does it work? First (and perhaps most important), gum tissue,is coated with a wax barrier and protective gels to shield it from the lasers. Teeth are then coated with Dr. Yarborough and Dr. Smigel's own ("top-secret") bleaching chemicals (called catalysts), and a blue light argon laser is held near each tooth for between twenty and thirty seconds to expedite the bleaching process. Then the second set of bleaching chemicals is applied, and a heat-producing C02 laser is used to focus on persnickety stains. (Both steps are performed three times each.) Finally, a fluoride sealant is applied with the C02 laser to glaze the teeth and preserve the bleaching effects. The entire process should take just one or two visits, and the procedure is supposed to last (with proper maintenance) longer than regular bleaching, maybe even permanently provided, of course, that the patient stays away from what Dr. Smigel calls "bad habits": coffee, tea, red wine, soy sauce, blueberries and nicotine.
Though the laser technique is still in its early stages (it has received FDA approval, but the American Dental Association has yet to evaluate it), the results have been dramatic. Dr. Smigel's guinea pigs - a few of whom I met personally really do have sparkling smiles. But the very fact that the technique is still so new kept me from having it done myself. lasers are incredibly powerful, and I am incredibly cautious.
Patients can now make their own decisions, because Dr. Smigel has been training dentists throughout the country to do the procedure; it costs between $75 and $150 per tooth, depending on where you live. (Call 800-454-ASDA for a participating dentist near you.) Or, you can still get the old-fashioned bleaching from any dentist in the country.
If it were up to Dr. Smigel, of course, everyone would have his teeth professionally whitened. "Without a doubt, white teeth make you look younger, more energetic and, frankly, more sensual," he says. The smile doctor is not joking.