Friday, May 29, 2009
In some California counties, finding a dentist is like pulling teeth
Have a toothache in Alpine County? Tough luck. There are no active dentists there, making it the most underserved dental population in California, according to a report released Thursday by the UCLA Center for Health Policy Research.
The 700-square-mile mountainous region is one of several counties with severe dentist shortages. San Benito and Inyo counties have less than one dentist per 5,000 people; Imperial and Colusa counties have less than one dentist per 4,000. Even some poorer parts of Los Angeles County are considered underserved, said Nadereh Pourat, director of research planning at the UCLA School of Public Health and the report's primary author.
"In some areas, particularly when they're rural, you're talking about having to travel a long way before you can find a dentist," Pourat said. "And if you don't have dental insurance, you have to pay out of pocket in order to find a dentist willing to accommodate you."
In Hollister -- located in San Benito County, where the UCLA data show only five working dentists serving nearly 58,000 residents -- Dr. Mark Stephens said he's been able to handle the demands on his practice, so far.
"If someone calls with a toothache, we try to see them the same day, but some offices don't see them for a week or two," Stephens said. "If I have to work through lunch or stay late, I will."
Stephens said he thought there were more than a handful of dentists still practicing locally, but added that in the last several months, his brother, who is also a dentist, sold his practice and another dentist died.
Like many dentists, Stephens does not accept Denti-Cal, the state's dental insurance for the poor. He said he knows of only one dentist in Hollister who does.
The shortage situation may worsen in some already-underserved areas because new dentists are not keeping pace with those retiring.
Because dentists often leave school with between $200,000 and $300,000 in loans, setting up practice in areas where patients rely on government-sponsored insurance that pays only 30 to 40 cents on the dollar can be hard, said Cathy Mudge, chief administrative officer of the California Dental Assn.
"They need to be able to repay that loan," she said.
To encourage new dentists to move to needy areas, Mudge said, the association's foundation offers a loan repayment program. In exchange for a three-year commitment in an underserved population, the foundation covers their loan payments during that time.
For Dr. James Forester, who works at La Clinica de Tolosa in Paso Robles, that equals about $35,000 a year in loan payback -- a hefty sum, particularly when he's working at a clinic that pays significantly less than what he could be making elsewhere.
"For me to be able to work in a population where people really need me is ideal," he said. "Who else would be here if I wasn't here? It's a great opportunity, but also a responsibility. These people are here. They need care too."
Source: http://www.latimes.com/news/local/la-me-dentists29-2009may29,0,6945696.story
Wednesday, September 17, 2008
Dentist Claims Device Enhances Athletic Performance
A local neuromuscular dentist has joined a network of more than 200 dentists nationwide who offer the Pure Power mouth guard, a device they claim can improve athletic performance.
Dr. Etienne van Zyl, a sole practitioner in Germantown, said the device works by allowing the jaw and neck muscles to relax completely, which in turn opens athletes’ airways. The result is improved strength, balance and flexibility, he said.
“What we’ve found is that the muscles of the head have two functions,” van Zyl said. “The first one is to be able to chew … and the other job that they have that people tend to overlook is that they’re also responsible for positioning the jaw so that when you swallow, your teeth come together.”
Even though the teeth come together, it doesn’t mean the muscles will be in a relaxed state, van Zyl said. But by placing the mouth guard between the teeth, it helps achieve relaxation.
About 90 percent of people don’t have a complete alignment of the jaw, van Zyl said.
“It’s almost like the rein on a horse,” he said. “The muscles that sit in your temples – the two muscles that bulge when people chew gum – are responsible for reigning the lower jaw in like you would do with a horse, with the rein.
“When the jaw relaxes, the muscles in the neck and other core muscles don’t fight each other anymore because they’re bracing … and now you have better flexibility, and of course, better balance. All that stuff comes instantly with a piece of plastic that goes in between the teeth.”
Jury’s out
So far, the only testimonials for the device have come from athletes who say they wear the mouth guard.
Canada-based Pure Power Athletics Inc. markets the mouth guard, and on its Web site Milwaukee Bucks basketball player Michael Redd is shown demonstrating the device.
“I’m Michael Redd, entering my ninth season in the NBA,” he says while working out. He goes on to say how he heard about the product from his trainer. “I found out this mouth guard is really serious and it’s been wonderful as far as my flexibility.”
Several other videos feature professionals from other sports making similar claims.
Paul Fitzgerald, director of public relations for Pure Power Athletics Group, said the results of a scientific study should be out in the next few weeks proving the claims being made about the mouth guard.
“(The study is) being done at one of the United States’ biggest research universities,” Fitzgerald said, declining to give the name of the university. “Everything’s being kept sort of confidential, the subjects know they’re being tested about this device, but we just haven’t released any details in order to not interfere with any part of the research. But I can say confidently that we’ve gotten some results back and they look fantastic.”
Fitzgerald added the company has testimonials from more than 1,000 collegiate and amateur and 200 professional athletes.
Marketing vs. evidence
Dr. Anil Makkar, a Canadian-based neuromuscular dentist, invented the mouth guard after attending classes at the Las Vegas Institute for Advanced Dentistry.
“It’s an institute that teaches dentists how to treat people and reposition their jaw so their jaw muscles are calm,” van Zyl said. “And then the headaches, and the neck aches and the backaches, all that stuff goes away. Because the pain is directly attributed to muscle tension in the head.”
Van Zyl said more than 40 years of research supports the effectiveness of the mouth guard.
The device actually is similar to one that was supposed to offer the same results.
The MORA (mandibular orthopedic repositioning appliance) was all the rage during the early 1980s. After reports that the device could enhance athletes’ performance, the American Dental Association conducted strength tests on 14 Louisville football players. At the conclusion of the study, the ADA found the MORA had no effect on muscular strength.
Source: http://www.memphisdailynews.com/editorial/Article.aspx?id=38630
Dentist Claims Device Enhances Athletic Performance
A local neuromuscular dentist has joined a network of more than 200 dentists nationwide who offer the Pure Power mouth guard, a device they claim can improve athletic performance.
Dr. Etienne van Zyl, a sole practitioner in Germantown, said the device works by allowing the jaw and neck muscles to relax completely, which in turn opens athletes’ airways. The result is improved strength, balance and flexibility, he said.
“What we’ve found is that the muscles of the head have two functions,” van Zyl said. “The first one is to be able to chew … and the other job that they have that people tend to overlook is that they’re also responsible for positioning the jaw so that when you swallow, your teeth come together.”
Even though the teeth come together, it doesn’t mean the muscles will be in a relaxed state, van Zyl said. But by placing the mouth guard between the teeth, it helps achieve relaxation.
About 90 percent of people don’t have a complete alignment of the jaw, van Zyl said.
“It’s almost like the rein on a horse,” he said. “The muscles that sit in your temples – the two muscles that bulge when people chew gum – are responsible for reigning the lower jaw in like you would do with a horse, with the rein.
“When the jaw relaxes, the muscles in the neck and other core muscles don’t fight each other anymore because they’re bracing … and now you have better flexibility, and of course, better balance. All that stuff comes instantly with a piece of plastic that goes in between the teeth.”
Jury’s out
So far, the only testimonials for the device have come from athletes who say they wear the mouth guard.
Canada-based Pure Power Athletics Inc. markets the mouth guard, and on its Web site Milwaukee Bucks basketball player Michael Redd is shown demonstrating the device.
“I’m Michael Redd, entering my ninth season in the NBA,” he says while working out. He goes on to say how he heard about the product from his trainer. “I found out this mouth guard is really serious and it’s been wonderful as far as my flexibility.”
Several other videos feature professionals from other sports making similar claims.
Paul Fitzgerald, director of public relations for Pure Power Athletics Group, said the results of a scientific study should be out in the next few weeks proving the claims being made about the mouth guard.
“(The study is) being done at one of the United States’ biggest research universities,” Fitzgerald said, declining to give the name of the university. “Everything’s being kept sort of confidential, the subjects know they’re being tested about this device, but we just haven’t released any details in order to not interfere with any part of the research. But I can say confidently that we’ve gotten some results back and they look fantastic.”
Fitzgerald added the company has testimonials from more than 1,000 collegiate and amateur and 200 professional athletes.
Marketing vs. evidence
Dr. Anil Makkar, a Canadian-based neuromuscular dentist, invented the mouth guard after attending classes at the Las Vegas Institute for Advanced Dentistry.
“It’s an institute that teaches dentists how to treat people and reposition their jaw so their jaw muscles are calm,” van Zyl said. “And then the headaches, and the neck aches and the backaches, all that stuff goes away. Because the pain is directly attributed to muscle tension in the head.”
Van Zyl said more than 40 years of research supports the effectiveness of the mouth guard.
The device actually is similar to one that was supposed to offer the same results.
The MORA (mandibular orthopedic repositioning appliance) was all the rage during the early 1980s. After reports that the device could enhance athletes’ performance, the American Dental Association conducted strength tests on 14 Louisville football players. At the conclusion of the study, the ADA found the MORA had no effect on muscular strength.
Friday, August 22, 2008
Dentist left me down in mouth
Today new English figures will reveal that dental decay in youngsters is soaring - yet it's still nowhere near as bad as in Scotland, where the estimate of obvious decay in five-year-olds is 2.16 teeth per child.
As a result the Scottish Government has established a target that 60 per cent of primary one children will have no signs of dental disease by 2010.
All very laudable – but for it to work you have to have dentists on board. That's dentists who don't decide that because you're ten minutes late for an appointment your two children won't be seen for their six-monthly check up (and nor will their mother). The kind of dentists who have already printed off a charge letter totalling £30 for the privilege of having no treatment at all.
I am still fizzing at the events in my Gorgie dental surgery last week. To be told that not only would we not be seen despite a 40-minute journey to get there thanks to heavy traffic (cue high stress levels), but that I was being charged for nothing . . . well you can imagine the gnashing of teeth that occurred.
It is understandable that dentists get peeved when people fail to turn up and don't call to cancel. But that's not what happened in this case.
Admittedly the dentist may well have decided there was no time to see me, but to send two children packing without having the chance to open wide and say "aahh", is a kick in the teeth for the Government's aims. And surely the dentist hadn't planned to conduct all three of our check-ups in just ten minutes? Where had our appointment time gone?
Then of course there's this charging business. Scotland's health service is always held up as being far superior to that south of the Border, but not in this case.
In England and Wales dentists are not allowed to charge for missed appointments, but they can refuse future treatment. It's a similar scenario in Scotland for GP surgeries – there's no charge, but three-strikes and you're out policies are not unknown.
But Scottish NHS dentists can charge whatever they like if someone fails to show (not that we did, I must stress). It is completely at their discretion. They have more freedom than banks and credit card agencies when it comes to taking money out of your pocket.
They also have patients over a barrel given that there are so few dentists taking on NHS patients these days – if you don't want to pay the fine you could end up without any dentist whatsoever. In fact in Scotland 76 per cent of people who tried to register with an NHS dentist in the last two years have found doing so difficult.
Why is dentistry treated differently to other NHS health provisions? Why are patients charged at all for treatment – never mind missed appointments – when other NHS care is free at the point of delivery? Of course it's all to do with the archaic way they are paid. If they were paid in a similar way to GPs, by the size of their patient list, then charges for missed appointments would become unnecessary.
And if that then encourages people to take their kids to the dentist, rather than putting them off because they know they'll be slapped with a fine if they're slightly late, must surely be welcomed.
Until then though, the next time I'm kept waiting past my allotted appointment, I'll just hand over an invoice for my wasted time. I'm sure the dentist will understand.
Home truth for Sean
DOES anyone really care what Sean Connery has to say about anything? He certainly seems to believe that the Scottish public dote on his every word. Someone should enlighten him.
This time the grumpy actor has waded into the debate about football and bigotry. His apparent expertise lies in the fact that he has changed his allegiance from Celtic to Rangers. Maybe it was to make dining out with David Murray in Roseburn a less fraught affair.
The real question should be why he's not a supporter of either of the two teams in his home town. He grew up not too far from Tynecastle, or given his Irish roots, Hibs would be a more obvious choice. His footballing choices certainly won't do his book sales much good in Edinburgh.
Connery is also a Sir, of course. Quite why, I'm at a loss to understand (as I am with most who get such "honours"), and for someone who is all for Scottish independence, it seems an odd status to accept.
But it seems likely that one who should be decorated, Olympian Chris Hoy, is likely to remain unadorned.
Perhaps once Edinburgh City Council has knocked down Meadowbank and the velodrome where Hoy took his first tentative turns on the track, they could remember him in some way.
Maybe with the block of apartments which will undoubtedly be built on the site – once developers are prepared to build again anyway. Chris Hoy Heights has a certain ring to it.
http://news.scotsman.com/opinion/Dentist-left-me-down-in.4412711.jp
Tuesday, August 19, 2008
Dentist isn't just interested in your teeth
Buy Photo | ||
Staff photo/Josh White - Dr. Bob Perry concentrates as he cleans the teeth of Ashley Way during an appointment at his office Saturday afternoon. |
Looking around someone's office can tell you a lot about a person - what's important to him or her, what he or she is interested in.
Looking at Dr. Bob Perry's downtown dental office, one sees the obvious dental equipment - Perry operates three stations where he sees patients. But there are also the photos - his family, his staff and his staffs' families. There are the stuffed animals for the children - a duck, cow and lamb propped on partitions, a comforting diversion for those not-so-comfortable-in-the-dentist-chair kids.
"I am a people person," Perry acknowledges. No need to tell us, Bob. We see it in your office décor.
Perry's people skills must be pretty good. His two dental assistants, Nancy and Kim, have been with the dentist for a combined 54 years. A photo collage on one of the office walls tells that story - Perry dancing with one of the assistants at her wedding; pictures of Perry and his assistants on Kansas City and Las Vegas conference trips; Halloween costumes at work. Kim and Nancy put the pictorial together to commemorate the office's 30 anniversary last year.
The Council Bluffs native set up his practice in its current 532 First Ave. location in November 1977. He graduated from Abraham Lincoln High School in 1965 and received a biology/chemistry from the University of Nebraska at Omaha. After earning his degree, Perry did medical microbiology research at Creighton University and then spent a couple years as a chemist with Mobile Oil in Omaha.
"I was debating between becoming a dentist and an optometrist," Perry said. He said the option of attending school closer to home tipped the decision to dentistry and Perry enrolled at the University of Nebraska Dental School in Lincoln where he graduated in 1977.
While he connects with people, Perry also talks dentistry. He cites the importance of good dental hygiene, noting it can help prevent heart disease, diabetes and rheumatoid arthritis. Perry said mouth bacteria and its by-products can get into the bloodstream if not removed and that can create problems. That health history he takes if you are a new patient is not just for show. Health issues can effect your dental treatment, Perry said.
Allergies, high blood pressure and other factors influence what anesthesia dentists administer to patients, so it is important to give an accurate profile and note any medications you are taking.
Since he cares about people, making them comfortable is important, Perry said. Older patients remembering the dental chair torture scene in the film "Marathon Man," people who have had bad dental experiences and young children are most apprehensive. Honesty and medication are Perry's remedies.
"It's important to be honest with people upfront and tell them what you are doing," he said. Perry walks patients through the dental experience, alerting them to a "little poke" or "you're going to feel a little sting." Numbing medications also help reduce pain, he said. And a few people get the gas.
"Nitrous oxide does not make you laugh," Perry said, referring to the mix that has been referred to as laughing gas. "It takes the edge off and helps patients relax." But, most of those sitting in the chair do fine without the extra "boost." Some of the youngsters hold the lamb or cow or duck. As far as we know, no adults have grabbed the stuffed animals while under the dental drill to help them deal with their grinding and gnashing of teeth.
Perry likes the fact dentistry is relatively safe. While patients with toothaches sometimes feel like they are dying, he notes no one has ever died from one. But, he was a little concerned when he received a call about Fritz's bad Halloween experience.
"The person said Fritz had gotten some bad candy and was not doing too well." Perry's concern increased when the caller said she had Fritz waiting outside in the back of her station wagon.
"It turned out there was another Dr. Robert Perry who lived fairly close who was a vet," he said. The person dialed the wrong Dr. Perry. "Turns out Fritz was a St. Bernard."
While Perry considered optometry, being a vet was never on his list.
The dentist has seen changes over his 30 years wearing the white coat - gold/silver fillings replaced with less glittery materials in an effort to project the perfect smile, increased interest in cosmetics and computerize record keeping that has made paper work easier. But, the people connection is a constant at this dentist's office. He has one patient who moved to Hawaii, but returns every year for his annual dental checkup.
"I'm flattered but I would prefer they fly me there," Perry said with a laugh.
http://www.zwire.com/site/news.cfm?newsid=20022080&BRD=2703&PAG=461&dept_id=555106&rfi=6
Mouthwashes Promise A Breath of Fresh Air
If you've got dragon breath, you may want something more powerful than a standard antiseptic mouthwash. A bevy of odor-neutralizing mouthwashes with special ingredients claim to eliminate bad-smelling gases and provide long-lasting breath protection. Scientists say published efficacy testing is so far scant, however rinses with zinc are likely to be effective.
Standard over-the-counter mouthwashes such as Scope and Listerine contain antiseptics designed to kill bacteria in your mouth. While they can improve breath, their effects are often short term as the bacteria grow back. Procter & Gamble's Scope, for example, kills bacteria that cause bad breath, but the company makes no claims as to how long the beneficial effect will last.
Tim Foley |
Another class of mouthwashes contains several ingredients designed to break down odiferous gases. Most of the mouthwashes contain an oxidating agent, such as sodium chlorite, which the companies say chemically neutralizes mouth gases. That chemical process releases oxygen and makes the mouth less hospitable to odor-causing bacteria, according to the companies.
Often the mouthwashes also contain zinc, an ingredient scientists say has documented laboratory activity against smelly gases. University of British Columbia scientist Ken Yaegaki says zinc has been shown by a number of scientific teams, including his own, to act against bad-breath gases.
The result of these new mouthwash formulas, the companies claim, is long-lasting protection. California dentist Harold Katz says his TheraBreath rinse, distributed through major retailers, improves breath for eight to 12 hours. Oxyfresh Worldwide Inc., of Coeur D'Alene, Idaho, which markets its rinse for sale in dentists' offices, claims up to six hours. Triumph Pharmaceuticals Inc., of St. Louis, says its SmartMouth rinse works 12 hours because positively charged zinc ions bind to bacteria to prevent biochemical processes that create smelly gases. To release the zinc ions, you mix a small amount from each of two pump bottles into a small cup.
Manufacturers recommend you rinse at least twice daily. The mouthwashes are expensive, often costing $10 to $12 a month.
One of the few rigorously designed tests of the oxidating mouthwashes is a 48-patient study on SmartMouth, published in 2004 in the Journal of Clinical Dentistry. That company-funded study found that smelly sulfur gases in the mouth were reduced by 55% during the monthlong trial, compared with no significant change for a control mouthwash. Sniff tests of saliva by judges also showed improvement.
Scientists warn that gas-reduction data in mouthwash tests, measured by a device called a halimeter, isn't always accurate. Saliva sniff tests are better, says Walter Loesche, professor emeritus of the University of Michigan School of Dentistry, but those are also subjective.
Dentists say the products are worth a try, but aren't a substitute for good oral hygiene. I don't think there is a product that is "a magic bullet to bad breath," says American Dental Association spokesman Richard Price.
In recent years, big-name companies have been adding zinc to their products. P&G in 2005 introduced zinc-containing Crest Pro-Health, which it says provides 12 hour breath protection based on its internal tests. Johnson & Johnson says the main purpose of regular Listerine is to tackle bacteria that cause plaque and gingivitis, but Advanced Listerine contains zinc for added breath protection.
• Email aches@wsj.comhttp://online.wsj.com/article/SB121909513576250887.html?mod=googlenews_wsj
Porcelain veneers could ruin your teeth, your smile... and your life
By Helena Green
Last updated at 10:51 AM on 19th August 2008
Porcelain veneers are the quick-fix route to a perfect Hollywood smile, we're told - they'll fit over your own teeth like false fingernails, hiding all manner of imperfections and giving your mouth the equivalent of a face-lift.
And with the advent of swish walk-in dental clinics offering 'lunchtime smile lifts' it's not surprising so many people are having it done.
According to market research by Mintel, the amount of money spent on cosmetic dentistry in the UK last year rocketed to £627million, from £519million in 2006 and £210million in 2005.
Veneers: What price a bright, white smile? (File picture)
At the same time, magazine articles and makeover shows such as Channel 4's 10 Years Younger help promote the idea that cosmetic dentistry is as routine and painless as having your eyebrows shaped.
The truth, as I now know, is very different. Eight weeks ago, I had ten porcelain veneers applied to my upper teeth by a top London dentist.
As an experienced fashion and beauty writer, I went into it with both eyes open.
I'd written about porcelain veneers in the past and knew that it was an invasive process that involved your own teeth being pared down first in preparation.
But my own teeth were discoloured and unlikely to improve by bleaching, so it seemed a good idea.
And I naively thought that by paying nearly £9,000 for the services of a top dentist, I would be in safe hands.
Dr Gates (not his real name for legal reasons) had been written about in glowing terms in fashion magazines.
Visiting his smart London consulting rooms, I was reassured by the prestigious address.
Cosmetic dental surgery should be taken lightly
Dr Gates was young, charismatic and enthusiastic. 'Was I a suitable candidate for veneers? I asked.
'Absolutely. You'll be stunned by the results,' he replied.
Looking back, I should have been alarmed by his gung-ho approach: he didn't even stop to take a medical questionnaire, which is standard procedure.
Instead, I returned three weeks later for a gruelling one-and-a-half hour session where he drilled back ten teeth ready for the veneers.
It felt like a physical assault. Having the enamel of healthy teeth blasted away is every bit as invasive as the surgeon's scalpel slicing into your skin.
Sitting in his chair, my mouth numbed by the anaesthetic and my lips blown up like lilos (or so it felt), I kept telling myself how thrilled I would be with my new smile.
After 90 minutes of drilling and drooling, the 'temporaries' were fitted.
Based on a wax model taken of your mouth at the first appointment, these are fixed to your poor, exposed, shaved-down teeth while the porcelain veneers are being made.
When I staggered out into the street, jaw and mouth aching, I figured the pain would pass - but it didn't.
I had to take pain-killers twice a day to deal with it and in order to sleep. But far worse was the searing pain in my back teeth that followed when the temporaries fell off a few days later.
This shouldn't happen, but chances are increased if you grind your teeth at night - which I do.
When I tried to eat hot or cold food it felt like the nerve was being gripped by tweezers. I was on holiday at the time so couldn't return to have them refitted, and lost pounds in weight because eating was such an ordeal.
I figured that the pain would go away when the porcelain veneers were fitted three weeks after the preparatory session. But it didn't.
The veneers Dr Gates fitted were significantly longer than my own teeth (something we hadn't discussed and I didn't want) and suddenly I had a lot of porcelain clanging around in my mouth, which made the pain worse.
Again, I imagined the pain would subside but it didn't - despite returning to Dr Gates twice for adjustments to my bite.
On my last visit, he became very defensive. The problems I was experiencing, he claimed, were probably there beforehand, this despite the fact I had never had jaw or tooth pain before.
He told me that in order to get rid of the pain I might need root canal treatments to remove an inflamed nerve and that I should consult my own dentist. I left the surgery in tears.
Root canal treatment is a highly specialised process under local anaesthetic, where a dentist drills into the tooth to remove the inflamed pulp tissue before sealing it to protect the root canal. It costs up to £1,500 per tooth.
The dentist I consulted told me that some of Dr Gates' veneers were too big and that my bite had been adversely affected - there was no contact between upper and lower teeth when I bit down, causing the jaw pain.
I also learnt that because I grind my teeth, something Dr Gates should have discovered, I was not an ideal candidate for veneers. I was told I would have to get my bite corrected before my dentist could assess whether I needed root canal treatment.
Then, even more alarmingly, one of my expensive veneers fell off - less than six weeks after it was fitted. Feeling like I must be a freak case - Dr Gates had said they would last ten years - I did an internet search for 'dental negligence.'
On the site of specialist law firm The Dental Law Partnership - which deals with the majority of UK claims - I found I was far from alone.
'We are seeing a 20 per cent rise in dental negligence cases year on year,' says Chris Dean, a trained dentist and partner in the law firm.
'It reflects the mass uptake of cosmetic dentistry. In the past two years, the average person in the street has become more ready to undergo cosmetic dentistry and so we are seeing a significant rise in claims.
'With veneers, the sort of problems we are seeing are failures with the way they are bonded on [they fall off], gaps between the veneers and the underlying tooth [which can allow bacteria and decay to flourish], and overhanging veneers causing problems with the bite.
'And in the worse case scenario, if the dentist removes too much tooth surface, this can cause the nerve to become inflamed or infected, the tooth can die off and the client will need root canal treatment to keep it.
'Our clients are usually angry about the fact that they are in pain, they've paid a lot of money and they are going to have to pay more to put it right,' he says.
One such client is Judith Ferguson, 47, a research scientist from North London.
'I'd read about a dentist in Harley Street who had worked on two pop stars and I thought he must be good.
'But on my second appointment there was a girl in the waiting room with veneers so big she looked like a racehorse. It should have rung alarm bells, but by that time I'd already paid half the cost of the £15,500 treatment.'
Judith had six porcelain crowns fitted to her bottom teeth in one session. 'The dentist went at my teeth hell for leather - I felt like I'd been attacked by Mike Tyson,' she recalls.
'My mouth was incredibly sore and I couldn't eat properly for a week. Next day, when the anaesthetic wore off, I could feel a lot of cracks and holes on the crowns with my tongue. When I phoned to complain, he said not to worry.
'It was only when I went to the hygienist a couple of years later and she said my teeth were not up to the expected standard, that I decided to do something.'
Judith eventually sued the dentist, winning an out-of-court settlement of £22,500.
Later, she discovered from her hygienist that 'it was well-known within the dental community that he was doing slipshod work'.
Worryingly, there is no recognised qualification for cosmetic dentistry. As Chris Dean says: 'There are highly complex activities such as implants that can be provided by any dentist out there, which is a recipe for disaster.'
Veneers should not be seen as a quick-fix and certainly not a lunchtime fix, says Dr James Goolnik, a board member of the British Academy of Cosmetic Dentistry, which was set up four years ago to try and ensure standards in the profession.
'Everything in the mouth has to be healthy before any treatment is carried out. If the underlying structure is not healthy, that's when things can go wrong.'
Dr Goolnik also advises checking what kind of aftercare and guarantee the dentist offers.
'What happens if you fall over in the street, for example, and chip them?' he says.
Some practices will guarantee veneers for five years, provided that clients come back up for annual check-ups.'
As for me, I cannot see an immediate end to the pain, and eating remains an ordeal.
Two months on, I wake up with a headache and nausea and am permanently short-tempered.
In addition to bite correction I am also paying for weekly cranial osteopathy to help with the jaw pain.
My smile makeover has turned into a painful nightmare.
Some names have been changed.http://www.dailymail.co.uk/health/article-1046622/Porcelain-veneers-ruin-teeth-smile--life.html