Miles for Smiles

Kimberley McGee

Thursday, Oct. 8, 1998 | 10:04 a.m.

The whine of drills and teeth grinders resonate at a new dental facility, as overlays to straighten patients' teeth are shaped.

But the patient is in Pittsburgh and his new teeth are being worked on in a lab in Las Vegas.

The cross-country procedure is not new technology, but technology that most dentists may not have had easy access to, until now.

The Las Vegas Institute (LVI) for Advanced Dental Study recently opened its $5.5 million teaching facility in Summerlin to provide an international audience of dentists with the latest information and technology via four- and eight-day courses.

The courses -- which range in price from approximately $3,900 to $7,900 -- are accredited by Baylor College of Dentistry in Dallas, a leading dentistry school. Since its August opening, the school has attracted approximately 300 professional dentists from as far away as Switzerland, Australia and Japan.

"We did (a straightening procedure of) 28 teeth on him yesterday," William Dickerson, LVI president and a local dentist, says about Ben Dyer, a Pittsburgh dentist who recently had his teeth straightened. Lifting Dyer's chin to inspect the dental work, Dickerson says, "It took three hours to place them."

This procedure, Dickerson says, is advanced cosmetic dentistry technology which many dentists likely do not know how to perform. Natural-looking porcelain is bonded directly to the reshaped tooth structure, leaving most of the original teeth intact, whereas past procedures have reduced teeth significantly.

Dyer, whose teeth had always been crooked (a genetic condition), had waited for the technology to become available, and for someone with the ability to aptly apply the procedures to his own teeth.

"I always had it in my mind to fix my teeth," he says. "I waited for my own mind to be made up and for the technology (to be made available)." He found the adhesive restoration method to be less intrusive and more aesthetically pleasing.

"My other option was to do orthodontia for a couple of years, probably lose a couple of teeth," Dyer says.

"This is much easier on the patient," he says. "This took two (appointments) in three weeks." He smiles his new smile, teeth straight and natural-looking.

Instead of grinding his crooked teeth to nubs, attaching a metal base and overlaying with porcelain (which would have required 12 office appointments, drilling and untold hours in the dentists' chair), thanks to the new technique, Dyer says he suffered minimum pain and still has all of his original teeth.

"There is a huge void in the knowledge of aesthetic dentistry," Dickerson says. He hopes to change that with his private live-patient aesthetic treatment program.

"(Dentists) can't get what they need from a one-day seminar, they need to learn hands-on."

Dickerson had been looping the lecture circuit for years, discussing the attributes of aesthetic dentistry and the latest technological advances in dentistry.

"As I went around the country ... doctors wanted to learn how to do aesthetic dentistry," he says. "They were excited about dentistry again."

This led him to start the LVI at his office on Meadows Lane in 1994.

"But we had 25 doctors to teach and five chairs" to use at his office on weekends, plus lectures at other locations, which slowed the learning process. He decided that a private school was needed.

Aesthetic dentistry is "a whole other realm of dentistry," he says. "We use materials that make the tooth look natural, but better than what nature provided" by simply extending the tooth or filling cavities.

For students,Dyer says, "it's about being in the trenches, opposed to just academic" work.

Dickerson moved to the 10-chair operating clinic at the institute in Summerlin in August. LVI also has a hands-on workshop that accommodates 24 dentists, two lecture halls and his dental practice and laboratory.

"He has built a comprehensive, state-of-the-art center," Bill Wathen, vice president for Professional Development at Baylor College of Dentistry, says.

That's good news for those looking for live-patient treatment for post-graduate credit, because Nevada requires dentists to obtain 12 hours of continuing education annually.

"Typically, continuing education has been a lecture and slide, barely scratching the surface," Wathen says. "Hands-on is the best kind of learning for dentists.

"It's like a non-traditional graduate school because they don't have to leave their practice (to attend)," he says, whereas a university may require a more rigid course schedule. "A school like Bill's is important because it helps (dentists) use this technique."

Dyer says he attended LVI last spring because he saw the opportunity to offer his patients the newest techniques in dentistry. So far, he's studied more than 120 hours this year. (Most dentists who attend the Institute acquired more than 100 hours of continuing education on their own.)

"But you can get 12 hours (of study by) going to Dental Society meetings every month," Dickerson says. "The best dentists have over 200 hours a year (of continuing education)."

"You can get away with being a 'drill-and-bill' dentist, but these people are going to be left behind," Dyer says. "Technology is exploding, you have to keep up."

He says he has learned techniques at the Institute that many of his colleagues do not know. The speed and quality of his recent 28-tooth procedure is not common, he says. "Most dentists can't comprehend (that). They are (used) to thinking, 'You can't do it that way.' "

Laurie Bloch, an associate instructor at LVI and a dentist who recently became a partner in Dickerson's private practice, agrees. She left her husband and two daughters behind in St. Helen, Ore., to begin taking classes at LVI two years ago.

She says the amount of knowledge that she realized she didn't know encouraged her to continue studying.

"Dentistry has advanced so much, dentists don't do anything they did 11 years ago because the procedures are so different," she says.

When the opportunity arose to join Dickerson in a partnership, Bloch says her husband, a certified public accountant, supported the risky decision and her belief that it was a good move.

"It was a successful practice, and a practice is not mobile, so when I came here I had no patient base," she says. "We sold the house, the practice, and I passed the board to become certified all in one year to do this."

The risk was exchanged for the excitement of being involved with a private institution "committed" to the advancement of dentistry, she says.

"It's very exciting, we have a lot of people coming through the course ... gaining from this."

The difference between attending a private "school" such as this instead of a university program is the control over the curriculum, the state-of-the-art equipment and lack of politics, Bloch says.

She expects a lot of competition as technology and dentists catch up. "Dentist schools are 10 years behind (the technology), usually," she says.

"We have dentists that have been practicing for five to 30 years that have never done a veneer (a porcelain overlay)," she says because the opportunity to learn new techniques, which are not taught in basic dentist school, have not been as readily available.

Meanwhile, Dickerson says only 2 percent of the dentists listed in the Las Vegas phone book are actually trained for "cosmetic" dentistry.

For the patients, "the issue (of aesthetic dentistry) is the quality of life," he says. "It's about health, function and appearance."

Aesthetic dentistry, however, is not usually covered by insurance. Depending on the dentist, Dickerson says the procedures can cost up to 400 percent more than a traditional metal filling or bridge.

"They (insurance companies) just want to get the cheapest thing done, that's why they go for metal," he says. "If dentists stop allowing insurance companies to dictate treatment ... patients would have better care."

(HMOs pay per patient, not procedure, he explains. Therefore, some dentists "room-hop" to see as many patients as possible using the simplest techniques. "There is no incentive to do work that costs them overhead, if anything else.")

But Bloch says that as patients learn what technology is out there, a demand will be created. "It is our obligation to tell (patients) what is available to them," she says. "They'll be smiling so much more."

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