“Some people want to look super hot and sexy and white and opaque, and some people just want to look super natural, and everything in between,” Sands told me. “Everyone looks different. A 20 year old woman is not going to have the same teeth as a 50 year old man. The difference between me and the guy next door is that most dentists just send their stuff to the same dental lab, their standard dental lab, and most of their teeth look exactly the same. But mine are very tailor-made for each customer.”
On the second day I visited his practice, I settled in behind the reception desk while Sands holed up in his office for a call with a plastic surgeon who wanted him to work at a clinic in Dubai. Somehow, while Aro ordered sandwiches for the staff lunch and her colleague Jasmine booked a date for actor John Goodman, our conversation turned to breast augmentation surgery—the defining cosmetic surgery of my teenage years of the ’90s, with a bow that heralded the rise of veneers and a clientele that skews rich and feminine. (Seventy percent of patients seeking cosmetic dentistry are women.)
Like the veneers of the 1980s and 1990s, when the practice first spread beyond the realm of experimentation, the first mass-market bust jobs were widely associated with the obvious and extreme. the fake was a defining characteristic. The limitations of the procedure dictate a certain aesthetic—breasts that are hard to the touch and stick out, teeth that look bigger and whiter than they should—that endure until those limitations are overcome. Once overcome, a second wave of patients heralds a new and more natural aesthetic, which in turn can cause a backlash against the old look. The loop closes when early adopters start returning to the process to have fixed smaller work.
“A lot of the clients we’ve had, at least in the two years I’ve been here, are the natural look that people want to achieve and they couldn’t achieve the first time,” Aro told me.
One of those clients was a female patient who flew from Miami to have Sands replace a set of veneers that had been done a decade earlier by a different dentist. The job had never pleased her, and since Sands had a good reputation among her fellow plastic surgeons, she didn’t mind that he was “much more expensive” than other candidates for the job. Hearing this comment, Sands pointed to his patient’s Birkin bag and said, “She spent $100,000 on her bag, she can afford it!” That kind of humor is a kind of lubricant, I’ve learned, for the kind of direct conversation required in these situations. Before long, Sands and his patient were debating whether her smile was behind too much Botox or too much lip filler. “I want to show more teeth,” she told him.
They then decided on the shape of her new veneers, which they agreed would be whiter than her already very white old ones. But this took me a while to figure out because the patient had come to believe that she would look better with a straighter smile, meaning that she believed her two front teeth should be no longer than the ones on either side of them. Sands strongly disagreed with her on this point. “You make the side teeth a little shorter, always,” he told her. “Otherwise it looks masculine. It looks like dentures.”
She seemed to understand this, and yet insisted that there was a trend towards straighter, squarer veneers, particularly among younger women. Before accepting the expert’s opinion, she wanted to reassure herself that this beauty trend wasn’t going to become the next beauty standard. Most of all, I felt, she just didn’t want to look old. I later learned that this was not unusual and that these patients, like everyone else dealing with their dentist, often needed to hear the same advice over and over again before they could accept it.
