BUILDING A BETTER SMILE; NEW GENERATION OF DENTAL WHITENERS DAZZLES MARKET.

Byline: Ben Sullivan Daily News Staff Writer

Over the years, the quest for a gleaming smile has led Americans down a tortuous path.

In the 1800s, concoctions of ammonia, chlorine and even cyanide were used to lighten the color of people's teeth. And as recently as the 1950s, dentists basted patients' choppers in concentrated hydrogen peroxide - before baking them under a heat lamp - to remove stains.

Beyond the physical discomfort involved, such methods were expensive, limiting their popularity.

Today a bevy of gentler and more affordable options has made whitening a common practice, satisfying both Americans' quest for an appealing smile, and dentists' desire for more profits in an age of managed care.

According to Santa Maria-based Den-Mat Corp., which markets the Rembrandt line of over-the-counter toothpastes and mouthwashes, Americans last year spent more than $250 million to bleach, zap, cap or otherwise whiten their smiles, and the amount is expected to grow steadily in coming years.

``It's a win-win situation,'' for patients and dentists alike, said Los Angeles dentist William Dorfman.

Dorfman developed and markets one of the most popular dentist-dispensed whitening agents, a hydrogen peroxide-based gel called NightWhite. This fall Dorfman's Discus Dental Inc. will release a follow-up product, DayWhite, that bleaches faster, requiring patients to wear the peroxide goo on their teeth for just one hour a day - 30 minutes in the morning and 30 at night - as opposed to the overnight treatment currently in favor.

Like most at-home treatments, both of Dorfman's products require a patient to wear a specially-fitted mouth guard that holds a peroxide gel against the teeth surface every day for up to two weeks.

Simple peroxide bleaching is the most popular and one of the cheapest forms of professional whitening, according to Jeffrey Lissot, a partner in Woodland Hills-based Aesthetic Dentistry Associates. But even with peroxide treatment, the price tag can range from $200 to $500 or more, he said, ``Depending on whether you go to Woodland Hills or Beverly Hills.''

Less common is laser bleaching, an in-office treatment that uses laser light to activate a peroxide-based gel applied to the teeth. The benefit of the laser method is speed: What can be achieved in a week or more of wearing a mouth guard every night can be accomplished in one sitting with a properly trained and equipped dentist, according to Irving Arons, president of Boston-based Spectrum Consulting, which tracks the laser medical device market.

Though still expensive, generally $100 or more per tooth, the technique ``is going to grow because the process is so much faster and easier than doing it at home,'' Arons said. And as more dentists invest in the lasers, which cost upward of $9,000, the price for treatment should come down, Arons said.

While bleaching is a so-called ``reversible'' process - stains will eventually return to the tooth's surface - ceramic veneers have emerged as an alternative to caps, as a permanent way to achieve a glamorous grin.

In the process, which costs $500 to $800 per tooth, a thin ceramic cover is essentially glued to the surface of the tooth, providing a more appealing color, and in some cases correcting irregularities in the shape of the underlying tooth.

Because of the price, ceramic veneers remain largely a treatment for the wealthy or for entertainment professionals who rely on their beauty for work, Lissot said.

Except in the case of veneers, where treatment may be necessary to repair a tooth chipped in an accident, most teeth whitening procedures are considered cosmetic and as such are not covered by dental insurance.

While disappointing to patients, that is a plus for dentists. Money made performing elective services is the dentist's to keep, while covered procedures are often reimbursed at only a percentage of their actual cost.

``There's no question that elective services like whitening are going to be a real good thing as far as building a practice in an age of managed care,'' said dentist Tom Orent, a former editor of the Journal of the American Academy of Cosmetic Dentistry.

CAPTION(S):

Photo

Photo: (Color) Dr. William Dorfman, who has a Century City dental practice, developed and markets a popular whitening agent.

Myung J. Chun/Daily News