Among the technologies Dr. Phil Smith, D.D.S., uses in his new Kingsport dental office is a digital X-ray machine, which provides clearer X-rays more quickly than traditional X-ray machines. Photo by Ned Jilton II.
KINGSPORT - J. Phillip Smith has 32-inch LCD televisions in his business, as well as the latest computers and digital photography technology.
But he doesn't run an electronics store.
Smith also has walls painted in mellow sometimes pastel tones ranging from rose to blue and burgundy, but he's not running an interior design center, either.
Dr. Smith is a dentist.
And after 27 years of dentistry, the West Tennessee native left another practice in town and is welcoming patients to a new dental office in the Colonial Heights section of Kingsport. It opened July 2.
Smith, who goes by Phil, said Gary and Ann Alexander, the building's owners, have been helpful in configuring the facility for his office, which was designed from the ground up to take advantage of modern technology. That technology includes creating a paperless office, with all charts, records and other documents on computer files.
'Live, from your mouth,' dental visits televised
However, what's most striking about Smith's office upon passing the reception area are the four flat-screen television sets serving four dental patient stations.
"A lot of [patients] turn up the TV and drown out that drill," Smith said on a recent afternoon at his office, which is finished save for installation of some new carpet and baseboards.
"They love the TV, they really do," added Elisabeth "Liz" Ashby, a hygienist for Smith. "For kids, that is the biggest thing. It relaxes them and makes them not nervous."
Angie Ball, Smith's registered dental assistant, said the TVs help relax many patients.
"One of the biggest problems we see in dentistry is the patient putting off treatment because they are scared," Smith said. "Everything is relaxing."
After catching up on the latest soap opera, news, a talk show - or in the case of young children the likes of Spongebob Squarepants or Jimmy Neutron cartoons - patients can see their digital X-rays on the TV screen, as well as an inside view of the mouth by use of an intraoral camera.
"The biggest thing that I see is probably digital X-rays and the ability to view them on computer monitors and TV screens," Smith said.
He said the digital images are quicker, sharper and the part that goes into the mouth less cumbersome.
The TVs also can be used to view educational programing about dental care or information about a root canal or other procures.
At the Kingsport dental office of Dr. David W. Foulk in Kingsport, televisions have been in place for about 10 years. He's been a dentist for 36 years.
Hygienist Mary Robinette said Foulk's patients can watch TV while numbing drugs take effect or while waiting for the dentist or hygienist; although, she said she prefers to talk with patients during cleanings and get in some dental education.
The televisions also allow patients to see the inside of their mouths, again using an intraoral camera.
"You can show them if they have a broken filling or how clean [their teeth] are," Robinette said.
She said that kids enjoy going to the dentist there because of the televisions, fish pond and herb garden. The office features a large open space with dividers marking off work areas.
However, another Tri-Cities dentist doesn't use televisions.
Dr. Janet Hatcher Rice's Bristol, Tenn., practice did research and found televisions and loud earphone music "were more disturbing to the patients than relaxing," said her husband, John Rice.
Unlike the other two practices, Rice's does not treat children but caters to adults with soothing surroundings.
Regardless of the age of the clientele, however, dental cleanings also have changed in recent years.
Smith and other area dentists are using prophy jet powder, which resembles a thick saline solution and is used to clean teeth above the gum line instead of scraping instruments.
The traditional scraping still must be done below the gum line, but Smith said the powder reduces scraping and thus stress among patients.
At Rice's dental practice, lasers have replaced mental dental instruments used to clean teeth. An erium laser is used.
"[Patients] don't feel anything. It's painless," said John Rice, who holds a doctorate in laser science.
Pain medicines have advanced, too. For patients undergoing longer procedures, Smith uses the traditional nitros oxide to put them to sleep. But the local anesthetic he uses is articaine, a descendant of novocaine.
'Full mouth' cosmetic dentistry comes of age
Another development in dentistry is the growth of cosmetic dentistry.
"Probably the other biggest change I've seen is dentists undergoing a lot of continuing education in cosmetic dentistry," Smith said, adding that it accounts for about 40 to 50 percent of his practice today.
"When I came out of medical school in 1980, it was maybe 20 percent," smith said.
He said teeth whitening, veneers and lumineers - porcelain-type tooth facing applied with no preparation required - are increasingly popular.
Rice of Bristol said she has done cosmetic dentistry throughout her career as a dentist, which began in 1985, and saw it before that when she was a dental hygienist starting in 1975.
"My father was a cosmetic dentist before they ever called it that. We called it full-mouth reconstruction," said Rice, who added cosmetic to her signs and business name about four years ago.
Even the common filling is no longer the traditional silver color; although, it is sometimes still used on back teeth.
"I do very little silver fillings. I do mostly white," Smith said. Although he has gold fillings, he said those are rarely requested nowadays.
Rice, on the other hand, said she no longer does the silver fillings at all.
Smith said the silver fillings - which are an alloy that includes mercury and has caused some health concerns - can last for decades. He said the newer materials have held up well so far and may end up being as durable or more durable.
The 2003 American Dental Association/Colgate Oral Health Trend Survey found that tooth whitening ranked as the No. 1 requested procedure, at 63.7 percent, by patients between 40 and 60 years old, according to dentists surveyed.
Fifty-eight percent of the dentists named veneers, bonding or crowns as the second most requested procedure by baby boomers.
As for the fastest-growing segment of practice, the survey found almost 27 percent of dentists selected restoring teeth with natural-colored fillings as the fastest growing segment of their practices. Tooth whitening followed as the next fastest at 21 percent.
Day spa dentistry dawns
A trend Smith has not yet adopted but that Rice has turned up in the 2003 ADA/Colgate survey. It's the day spa model, in which patients are offered massages, skin treatments and other spa-like services as part of or in conjunction with dental visits.
"I haven't considered it yet. I'm not going to say I wouldn't. I haven't had any patients ask for it yet," Smith said.
On the other hand, Rice in Bristol has provided day spa-type services for about four years and in May opened a day spa adjoining the dental practice.
The spa offers massages, facials, aromatherapy and skin tightening and wrinkle removal using lasers, which her husband designed.
"It's been unbelievable. I had to come over from my job to take over the spa," John Rice said of its success.
The prices on the spa sign include $45 for a single facial and $250 for a one-year VIP membership, which entitles the bearer to four or five services throughout the year.
On the dental office side, the Rices said aromatherapy has been used "for years" in the dental practice, which also offers relaxing music and paraffin wax treatments in gloves that soften hands.
Patients can use the spa before or after dental treatments. The spa also accepts non-patients, who often become patients, Rice said,
The ADA/Colgate survey found that about half of the surveyed dentists offer some sort of spa or office amenities to patients.
Most common, the survey found, included headphones and neck rests, followed by warm towels and complimentary snacks and beverages.
However, only 5 percent of the surveyed dentists offered amenities such as massages, facials, pedicures and manicures like those offered at Rice's practice.
Visit a dentist, staff that have patience for patients
Ultimately, Smith said, good dental care rests with patients, dentists and their staff. Patients should maintain the teeth through regular dentist visits, while dentists and their staffs must have patience and compassion for their clients.
Smith said that kind of caring about people and their teeth runs in his extended family.
A native of Friendship, Tenn., near Memphis and graduate of the University of Memphis dental school, Smith received his bachelor's of biology from Union University, a Baptist college in Jackson.
His father-in-law and two brothers-in-law are dentists, and another brother-in-law is a hygienist. And his wife was one of the original "Crest babies" used to help test the fluoridated toothpaste before its landmark endorsement by the American Dental Association.
After nearly three decades of dentistry, he said people in the area seem to be taking "much better" care of their teeth and that fluoride toothpastes and fluoridated water have also contributed to healthy teeth.
"[Fluoridated water] probably has cut down on dental fillings as much as anything," Smith said, adding that he believes it also helps that the region has a good group of dentists.
"There's a good group of dentists in this area," Smith said. "The people are lucky. They get good dental care, not just from me but most of the dentists in the area."
Smith's office is at 4260 Fort Henry Drive. For more information, call 239-6594. Foulk's office is at 2300 Memorial Blvd. For more information, call 378-4488. Rice's office is at 136 Martin Luther King Blvd. For more information, call 989-7733.
Other dentist offices in the region are listed in local phone book yellow pages or online phone books.