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 Best Doctors
The Great White Hope
It was time to bite the bullet and find a cosmetic dentist. One man's search for the perfect smile.
 
BY CHRISTOPHER BONANOS
 

<<Cosmetic Surgery Guide










It was a painful first date that finally pushed me over the line. It was 2:30 in the morning; I really liked the woman; I'd had a drink or three; she'd had several more. She looked across the bistro table and asked, her voice a bit blurry, "Were you by any chance given tetracycline as a small child?"

Ugh. No, but I knew what she meant. Two decades ago, I had a broken front tooth repaired with cosmetic bonding. While he was at it, the dentist worked on the surrounding teeth, to match the color and fill the small gaps I had between them. It looked pretty good, in 1983. The years were unkind, however; my four front teeth had darkened, badly, taking on a stain like the gray that tetracycline-in-childhood causes.

For the record: I spent the second date with Bistro Girl trying not to smile. There was no third date.

In any case, I knew it was time for a dental overhaul. And, I quickly found, cosmetic dentistry has vastly improved since my last go-round. There are options galore, and the results are as natural-looking as anyone could ask for, only whiter. And that vogue for whiteness has been a bonanza for cosmetic dentists. Whitening treatments are hugely popular, and quite benign — a matter of less than an hour in the chair, as often as you deem it necessary.

The dental vogue now, in cases like mine, is for porcelain laminates, also called veneers —- paper-thin sheets of ceramic that are glued to the front teeth, which are ground down slightly to accept them. It's a very fast process, sometimes done overnight, and an expensive one. Being a comparison-shopper by nature, I spent a few weeks consulting with New York's top cosmetic dentists.

Larry Rosenthal has been doing veneers since the early eighties; his celebrity list is huge, from Donald Trump to Kathie Lee Gifford. (Though he volunteers, "I did not do Regis Philbin.") I precede Miss Russia in the chair. At one point, Rosenthal pulls out a cast of someone's teeth to illustrate a point, and as it hits the desk, we both notice the label: C. BRINKLEY. Christie has — had, I guess — gaps, just like me.

Rosenthal is a big, tanned, intense guy who talks really fast. He shows me piles of impressive before-and-after photos. He's like a Mercedes dealer, but in a good way: enthusiastic about his luxe product, and comfortable with wealthy and demanding people. He says his work is especially controllable, because he has a staff ceramicist. (Most dentists send the work to outside labs.) Don't let him talk you into getting the undercoating package, I think.

For me, he has a couple of ideas. He wants to put in veneers all the way across my uppers for consistency — eight altogether. He also says my teeth are too short, so he'll make the veneers a little longer than my natural teeth, and laser-cut away a little sliver of the gums above them to make room. Finally, he'll do a bleaching on my lower teeth, which are sound but mildly stained. His business manager, Jackie Pastore-Tavolilla, is all the while doing a computer rendering: She photographs me, then digitally inserts new, white, straight choppers. I am impressed.

Rosenthal takes a poke at my gums with a dental pick, to make sure they're healthy enough to stand some trimming. "Oh, baby!" he shouts. "These are great!"

Rosenthal charges $2,200 per veneer, not out of line but clearly at the top of the range. Jackie quotes me a final price of $17,600. I note that Rosenthal's teeth look good. "His partner did his," Jackie tells me. "He had awful teeth. Much too small. Plus he's a grinder." I bet.

On to Irwin Smigel. Smigel is a white-haired granddad, in practice for about 40 years, and he peppers his pitch with iterations of "I invented that." (He developed cosmetic bonding, among other things.) Smigel's office is full of photos of celebrities, all grinning like mad: Steve Martin, Calvin Klein, Carol Burnett. He, too, talks up his ceramicist.

Smigel is rather high-handed as he shows me his before-and-afters; when I mention one of the other dentists I plan to meet, he sneers, "Ah, he's nothing!" But he says a number of things that seem smart. For starters, he insists on getting me out of the chair. "Stand up!" he says. "You can't do cosmetic work on someone who's lying down! The whole shape of the face changes." Smigel also talks extensively about his work's effect on the shape of one's face -- thickening the upper parts of the veneers on older patients, for example, to plump up the lips and produce a younger-looking mouth. When it comes to me, he says he wants to do only four veneers plus the gum work, and a little bonding on one bottom tooth that's askew. "Minimally invasive," he says. "Your face has good lines. And I don't want to mess with so many healthy teeth." At his top-dollar $2,300 per veneer, plus $1,000 for the extras, that's $10,200.

I continue to Mal Braverman, who's got a somewhat less celebrity-studded practice but a very snappy Website (www.drbraverman.com). He's friendly, and seems more down-to-earth than the other two guys. (He's a touch catty only when I mention Rosenthal. "I gave him his start!" he says. "I hired him when he couldn't get arrested!") He shows me a video and his before-and-after book. I like him. The day I'm there, one patient is having a mouthful of veneers put in — she was a tetracycline kid — and I watch the procedure, which goes quickly and is remarkably unscary. His prices are lower, too. "I try to keep them down, because I do a lot of working actors," he says.

Braverman, too, praises his ceramicist, Adrian Jurim, at great length, noting that he holds a patent on porcelain laminates. "Larry doesn't have him on staff because he can't afford him," he says. "This guy makes as much as he does."

That may be because Braverman plans to turn my mouth into a construction site to rival Columbus Circle. Ten veneers across the top, four on the bottom, bleaching everywhere else, and reducing the gums. Even at just $1,050 per veneer, the whole thing adds up to $16,800. It's definitely a full set of china.

Last up is Jeffrey Golub-Evans, who works out of two floors of a townhouse he calls the Dental Duplex. As I flip through the inevitable before-and-after book, I'm suddenly face to face with . . . Regis Philbin. I delicately say, "He's kind of the poster boy for white-white-white." One of the office staff nods. "It's what he wanted!" she says quietly. "He went home with temporaries, and he called up and said, 'I want 'em whiter. I want them to look like a million dollars.' "

Golub-Evans asks more questions about what I want than the other guys do. He explains that people come in with wildly varied expectations; a certain sort of New Yorker with unlimited income might demand different results from what I want. (I think this is his polite way of saying "I know writers don't make squat.")

Golub-Evans has his aide, Stephanie, do a computer simulation, and then he does one thing nobody else has: a quick mock-up, in pliable white wax, right on my own teeth. I'm taken aback at the improvement, even with this crude simulation.

For me, he suggests two options: gimme-the-works and a more restrained plan. The former is familiar: eight or ten veneers across the top, a little bonding on the bottom, laser gum reshaping, and several bleaching treatments. I can even go for veneers on the bottom if I'm so inclined. The total varies with the precise list of options, topping out around fifteen grand.

But the less invasive option grabs me more. Bleach everything, trim the gums, and do six veneers on top. The total comes to $10,200. He, like Smigel, says less work is more for me, given my age (32) and my face. And, he notes, "I can tell — you probably don't want to do the whole thing. It's all about your expectations." And, I decide, this is my guy.

A few weeks later, I'm in for the first of the appointments. Today, Golub-Evans and his assistant will remove all the old bonding and take impressions, then lay in a temporary repair, to keep me chewing while the laminates are made; at the second, a week or so later, the temporaries come off and the porcelain goes on.

The whole thing is less unpleasant than I expect. I'm novocained up, and though the drilling's not exactly fun, it's not painful. In the two and a half hours I'm in the chair, the only off-putting moment is when Golub-Evans begins to cut away some gum tissue with his laser. I don't like the smell, which evokes Peter Luger.

As he works, Golub-Evans launches into a story about Wayne Newton, who came in after admiring Regis, and asked for white-white-white. When Philbin's name came up, Newton asked, "Well, can we go one step whiter than that?" He went on to explain that he wants even the last row of his audience to see his smile.

My temporary work — which, mercifully, nobody will be able to see from the back row — is made of composite bonding material, and even this looks worlds better than what I had. A week later, at the second appointment, Golub-Evans grinds it off, then, just for fitting, sets the veneers in place. I am shocked at their whiteness — I fight the urge to croon "Danke Schön" — and I must sound agitated, because Golub-Evans immediately jumps in. "We can adjust," he explains. "The final color is made up of three layers — your natural enamel, the color of the porcelain, and the adhesive between them. We can go two shades lighter than we've got here, or two shades darker." He tries a couple of adhesives in different shades, and we settle on one that darkens the veneers only slightly.

After some polishing and tidying up, we're done. I've been there about two hours, I feel just a mild ache as the novocaine wears off, and the only restriction is that I'm to stay away from dark liquids (red wine, coffee, soy sauce) for two days, until the adhesive cures.

That first afternoon, I feel as though I'm tripping over my words, but friends say they can't hear it, and in any case I recover within a day or so. I also notice a couple of slightly rough spots, which Golub-Evans will polish away at my follow-up appointment. Back at my office, an editor asks me point-blank, the moment I sit down across the desk from her, "Did you get your teeth fixed?" More than one colleague quietly pulls me aside to compare notes — a surprising number of people have had the same kind of work. Few others say anything, but I find out later, when I mention it in passing to a friend, that there have been discussions. "We all approve," says one colleague, smiling. For once, I smile back.
 
   
Photo by Jay Gullixson
From the May 27, 2002 issue of New York Magazine.