Adventures in Cosmetic Dentistry, or, How I Learned to Stop Worrying and Love the Drill

By Kathleen Warren

Of all the things I ever thought I’d find myself researching, writing about and ultimately experiencing, cosmetic dentistry would have to be dead last. But life takes us funny places sometimes, and what I learned about the new wave in dentistry - full mouth reconstruction, dental implants and veneers, the kind of stunning transformations we now have the art and science to accomplish - took me on a journey that seems worth sharing.

Let me explain how I came to be here. I am a reporter for an Ohio newspaper and also do some limited freelance writing. The journalist part makes the freelance part sticky sometimes. I don’t mind writing articles promoting something but it has to be interesting to me and it has to be true or I feel conflicted. It’s simply not worth it to me to write what I don’t feel good about for a few extra bucks.

About 18 months ago, I was assigned a series of articles and perspectives on cosmetic dentistry, including some about Dr. Mike Golpa, a cosmetic dentist in Las Vegas. His marketing person (marketing, shudder) was actually wonderful to work with and seemed genuine in her insistence that he really was one of the most gifted cosmetic dentists in the United States. She said he was one of the very few dentists nationally, if not the only one, who did both the surgical and reconstructive aspects of dental implants, making him quite the expert in that area. He had placed over 25,000 restorations with porcelain veneers and crowns.

She was equally insistent that the work he did, particularly smile makeovers and full mouth reconstructions, was transformative for his patients.

I certainly hoped so, because dentistry isn’t cheap and cosmetic dentistry surely isn’t - a full mouth reconstruction can easily run upwards of $50,000. That isn’t spare change and I would hate to think of people spending it for anything that doesn’t fully live up to expectations.

I told her I would want to interview actual patients about their experience and use their quotes because I don’t make up testimonials, and that if I felt at all uncomfortable with their sincerity, I wouldn’t be able to proceed. I knew they would likely give me the names and numbers of happy patients but I also knew I would get the truth my own way if I talked to enough people and did extensive independent research. Not only did she not balk at this, she seemed happy to take this approach, which I found heartening. Apparently she wasn’t too worried about anything I might find.

It probably would have been more work than it was even worth for my fee, but I had a personal reason for wanting to know more about what cosmetic dentistry could really deliver. Fresh off a difficult period in my life that included divorce, financial problems, and a time without dental or medical insurance, my own mouth was a mess. People still found my smile appealing but I knew what was going on in there and it worried me to death. It seemed important to correct but with so many things to deal with as I put my life back on track, I wasn’t sure how important. I had already done research that indicated to me I needed dental implants and possibly a full mouth reconstruction to set things right. I knew people who had had similar work done and weren’t happy or who experienced pain and time off work, all things I could not afford. Was a dazzling smile really worth it?

What I found out, after countless hours of research and talking to over a dozen different patients of Dr. Golpa’s, his staff, and the man himself, almost upset me. I think I secretly hoped I would find out extensive cosmetic dentistry wasn’t worth the time, money or trouble and I could forget about even wanting to do it myself. I certainly didn’t want to find out that not all cosmetic dentists are equal and the only one I would want to do my own work was 2,000 miles away. But I did. What happened next is the story of how a freelance writing assignment unfolded into an adventure in cosmetic dentistry.

Beauty is Only Skin Deep, But Cosmetic Dentistry Goes Below the Surface

In many ways, the term “cosmetic dentistry” is a misnomer. Yes, a cosmetic dentist with a real flair for aesthetics is able to give you a gorgeous smile. But the term “cosmetic” is usually taken to mean something that is a surface cover-up, not extending beyond appearance to function. Cosmetic dentistry, done properly, always has to be about the health and functioning of the entire mouth, including a properly aligned bite.

Take dental implants, for instance. Dental implants are often performed as part of a whole mouth reconstruction plan, and while they are not “cosmetic” per se, other than replacing a tooth, which is something that can be accomplished with a bridge, they can be an important adjunct to cosmetic dentistry where appropriate.

Long before I met Dr. Golpa or starting learning about cosmetic dentistry, I did a little preliminary research on my case. I had four pre-molars where my permanent teeth never formed. While I was fortunate to hold on to those teeth, which are only designed to last for a few years, much longer than expected, I did lose one in my 20’s, another in my 30’s, and a third in my 40’s.

What I learned about the loss of teeth is the importance of the root in the jaw. Without the root, the jaw begins to lose bone, which can help contribute to early facial aging and movement of the remaining teeth. So while a dental implant may culminate in a pretty white tooth where one was missing, what’s going on beneath the gum is even more important. The titanium posts hold the place of the missing root, supporting the jaw’s structure and preventing further bone loss.

If you’ve ever seen a picture of somebody with dentures, especially with those dentures removed, you have an idea of how the facial structure can “collapse” without a properly aligned bite and a healthy jaw to support them. So in many ways, the health of the mouth and jaw are the foundation for the entire face, something for even the vain to seriously contemplate.

Back when I lost my second tooth, I read about bone loss and asked for a dental implant. I was told then that it could not be done - that being an upper tooth, it was too close to the sinus and there could be problems. I took the recommended bridge instead, and when I lost the third tooth, I was without the resources to do anything about it.

When I finally found myself in Dr. Golpa’s chair, looking at x-rays, the effect of having a bridge on that upper tooth rather than an implant was right before my very eyes, and my heart sank. It was clearly noticeable that my left sinus above the missing tooth had dropped considerably lower than the one on the right. My bone structure had literally shifted, and not in a good way.

Amazingly, Dr. Golpa felt he could remove the bridge and place an implant in that position, despite the fact the sinus was now much closer than it was for that dentist years ago - and so he did, with complete success. I had no complications and I can’t tell you how heartening it is to know that a lovely titanium post is now valiantly warding off further shifting.

Even if you don’t need or can’t have dental implants, but could use a smile makeover with porcelain veneers and/or crowns and bridges, there is another way that “cosmetic” dentistry moves beyond the tangible surface to something that’s a little more basic. What I learned during the many interviews of Dr. Golpa’s patients, is that it creates quite a perceptible shift in attitude - both your own and that of others. What patient after patient told me was that they continued to be amazed at how their beautiful new smiles, which they quite often forget they have unless looking in the mirror, “brightened up” the world around them.

For many, especially those who had serious problems or unattractive smiles, it was quite literally life-transforming - and of course, they found themselves smiling a lot more and a lot less carefully. For most, while they thought that it would improve their confidence and their aura of success and friendliness, it was still hard to comprehend just how much it really did.

I think it was the experience of these patients that did more to change the way I viewed cosmetic dentistry than anything else. Sure, it’s always great to have a dazzling smile, but it seemed the whole experience went a lot further than that and had a lot of unforeseen benefits. And Dr. Golpa’s patients consistently claimed that even the most fearful of them found that with skilled use of sedation, the process was much less traumatic and far less painful than they would have imagined.

I was a believer. Dr. Golpa was, in fact, a dentist I would be proud to write about professionally. And, he was the cosmetic dentist that I wanted to handle my own case.