Feature

"The spa environment is the dental office of the future." That's the confident prediction of E. John Moreno, D.M.D., the owner of the Cosmetic and Biological Dental Spa in San Clemente, California. An increasing amount of evidence says he's right. As many as 5 percent of the American Dental Association's more than 152,000 members have declared their offices "spas," and these members say they regularly receive calls from colleagues inquiring about their expanded setups. (The International Medical Spa Association reports a similar rate of spa-dentistry inquiries.) About half the respondents to a recent American Dental Association/Colgate Oral Health Trend survey said they offer patients some type of spa or related amenities--though these can be as simple as headphones or neck rests. And when Lynn Watanabe, D.D.S., one of the field's pioneers (see "Filling the Gap" on page 148), lectured on the topic earlier this year at the University of the Pacific dental school in San Francisco, there were 175 students in attendance, nearly double the number who turned up in 2004. "I'm absolutely seeing spa dentistry growing," says Irwin Smigel, D.D.S., a trailblazer in aesthetic dentistry. "The spa effect is tremendous."

The roots of the dental-spa movement lie in the profession's attempts to make going to the dentist a more pleasant experience. An estimated 23 percent of American adults skip visits to the dentist out of fear, the severity of which was codified in the 1960s in Dr. N. L. Corah's widely used Dental Anxiety Scale (DAS). During that decade, jokes about going to the dentist were a staple of TV variety shows. In the 1970s, advocates of holistic dentistry began to connect the body-to-mind dots; from its founding in 1978, the Holistic Dental Association has advocated "dental care as it relates to the entire person." In the 1980s, the movement got a big push from an unlikely source, cosmetic dentistry, for an unlikely reason: Because those procedures kept patients in the office for longer stretches, many dentists began providing spaces and activities for the downtime. Ronald Goldstein, D.D.S., a cosmetic dentist and noted author in Atlanta (see "Wisdom Teeth" on page 147.), for example, serves patients lunch during such a break. The final step occurred in the 1990s, when America awakened to spas. The stage was set for the spa sensibility to ease its way into the dentist's office. "Dentists felt people are going to spas," says Dr. Smigel, "so why not create a dental spa?"

No one can say exactly when the first dental spa opened, and there's yet to be a consensus on just what constitutes one. The American Dental Association doesn't even have an official position on spa dentistry. The International Medical Spa Association and the Day Spa Association offer a definition--practices in which "both traditional and nontraditional dental and spa treatments" are offered--that is accurate but broad enough to include offices that have aromatherapy candles along with ones doing advanced cosmetic dentistry. The IMSA's guidelines also call for dental spas to be run "under the strict supervision of a licensed dentist."

For this installment of Spa Rx, Luxury SpaFinder surveyed the field, focusing on how dental spas use the idea of spa. From that research we've divided dental spas into three categories: atmospheric, cosmetic, and holistic. The first creates a spa ambience and may offer some basic spa treatments to allay patient anxiety. The second offers spa services along with an emphasis on cosmetic dentistry. And the third is using dentistry in the service of overall wellness. These dental spas employ some quite advanced diagnostic techniques, including digital X-rays, which reduce radiation exposure, and devices such as the Wand, a computerized instrument that measures the precise amount of anesthetic needed, thus reducing the pain of an injection and the amount of anesthetic the body is given. Holistic practices also offer a more advanced spa menu that might include acupuncture and nutrition counseling. We even turned up one office that offers permanent makeup (a.k.a. tattooing). (See "Baer Essentials" on page 146.) To be sure, these categories aren't hard and fast--some dental spas have elements of all three--but they help make this burgeoning field comprehensible.

Atmospherics

At the most basic level, any dentist who places an aromatherapy candle beside the coat rack has ventured into spa territory. What these dentists realize is that taking the anxiety out of having a checkup is the first step in getting the patient to come to the office regularly. It may sound like a gimmick, but listen to the effect it had on Michael Mazek, a Washington, D.C., international-trade specialist. He hadn't been to the dentist since his freshman year in college--he's now 27--when he went to the Bethesda Dental Spa.

"I had to get a lot of work done on my teeth growing up, and when you walked into the dentist's office, all you heard were drills," he recalls. At Bethesda, Mazek was pleasantly surprised by the sound of a waterfall and New Age music. A paraffin hand treatment, a facial, and a teeth cleaning later, Mazek's childhood memories were distant. "They balanced out a bad experience with a good one," he says. "You walk in there and the lighting is inviting and so are the people. I have to go back for more work, and I never thought I'd actually look forward to going to the dentist."

"This is blissful," says patient Lynn Michaels, enjoying a foot massage as part of a cleaning at Dentaspa in New York City, run by Eda Ellis, D.D.S. "You're not even aware you're having dental work done." That, of course, is the point. Dental spas, according to those in the field, are not aiming to turn dental patients into spa clients, but spa services are certainly gaining favor as a complement to dental work.