Drill, Fill and Facial

We know readers will find this difficult to believe, but prior to 1950 A.D., providers of that era (originally referred to as "dentists"), did their work while standing upright. Or as nearly upright as they could manage because after years of attempting to negotiate procedures in the darkened recesses of the mouth, their right shoulders typically were four inches lower than their left. Unless, of course, they were left-handed or, worse yet, ambidextrous. Tired of being called "Quasimodo" behind their backs, many turned to barbering, a proud profession whose members still operate while standing today, acknowledging that the cutting of hair is less arduous than the cutting of teeth.

In March of 1951, brothers Wilber and Orville Wong of San Francisco deferred to their varicosities and tried to operate in a sitting position. Even though the patient’s head was a good 10 inches higher than the brothers’ heads in this position, the comfort factor was not to be denied. Several months later, smiting their foreheads in unison, they came up with the idea of lowering the chair and tilting it back as far it would go. "Wow! This changes everything!" they cried.

Thus was born the concept of "four-handed dentistry." It was also the birth of the high-speed vacuum and the demise of the saliva ejector except as an obligatory prop in comical cinematic portrayals of dental offices.

In the halcyon years following the introduction of four-handed dentistry, many enthusiastic practitioners experimented with six- and even eight-handed dentistry until the operatories resembled Grand Central Station during peak hours. This was the result of dentists watching too many emergency room scenes on television where multiple surgeons and their auxiliaries stood four deep around the patient in tense moments of high drama. Eventually the dentists’ accountants pointed out that the revenue from an MOD restoration did not support an assisting staff of 10, particularly those who insisted on being paid on a regular basis. The innovative "preventive nurse," whose job it was to teach people for a fee how to brush their teeth; the "nutrition nurse" who gave detailed advice on proper diets; and the "rover nurse," who filled in when one of the others was busy or indisposed, all quietly faded away.

Thus it has been for the past 35 years -- the dentist and his assistant, a hygienist, and the front office people doing what they had to do, coping with insurance companies and governmental intrusions.

This included experimental forays into providing soothing music via earphones, ceiling-mounted televisions and a tsunami of marketing ploys designed to lull the patient into forgetting that she was a captive audience at her most vulnerable, flat on her back with her mouth wide open.

Exit polls indicated patients, although appreciative of all this programmed TLC, still had one overriding emotion expressed as "hurry up and get this over with and let me get the hell out!"

According to a recent story in the Los Angeles Times, the status quo is in for another crack at patient pacification. A California dentist predicts it will become the cutting edge of this new century. It has been named "The Dental Spa."

"This business joins a handful of practices in New York and Texas that have begun serving up paraffin baths and reflexology -- even Botox injections," reports the Times. Reflexology, for the uninitiated, is the study and interpretation of behavior in terms of simple and complex reflexes. Reflexologists are in short supply as confirmed by the Yellow Pages. High school counselors, take note.

The Holistic Dental Association, based in Durango, Colo., was founded in 1978 by a handful of dentists wishing to explore and effectively utilize the mind-body connection they perceived to be an important and little-understood or little-used modality in dental treatment.

They believed that the patient should be provided with choices that will enhance personal health and wellness while feeling loved, accepted and understood, similar to the feeling you get from flashing an American Express Platinum card.

With that credo, the Dental Spa was born and conventional dentists are observing it carefully to see if full-body massages ought to be combined with tooth whitening at an introductory fee of $350.

If so, it is not too early to place a help wanted ad in the local paper for a qualified "esthetician massage therapist." Forward-looking dentists who believe the future lies ahead are saying, "Forget the ’60s, that was then, this is now!"

When entering the Dental Spa, patients are aware of a new kind of dental office. Strains of "spa music" normally heard in salons catering to the pampered and plucked waft gently through air perfumed by delicate scents of tangerine and lavender. Mesmerized patients are invited to forego the old "exam and prophy" routine momentarily; and, while sipping a glass of pure water with lime and lemon slices, they peruse a menu that includes massage therapy, aromatherapy, facials, cosmetology services, chairside massages (hands or feet). It dawns on them they are not in Kansas anymore.

A satisfied Dental Spa patient is quoted as saying she was pleasantly distracted from the real business of having her teeth cleaned when a heated cushion filled with flax seeds was placed under her neck. As she surrendered her shoes, she was further pampered with a lotion-enhanced foot massage and a hand massage with a salt scrub, followed by a steaming towel.

Dental students who feel their education at $40,000 per year is sadly lacking in the essentials necessary to make it in today’s "feel good" environment, are well-advised to address their concerns to the curriculum committee before it’s too late and they discover they are ill-prepared to do anything but basic dental services upon graduation.

As for the rest of us, if we are interested in joining the 21st century, we should keep our eyes open for franchise opportunities. The Medical Spa Association is a newly formed subgroup of the 8-year-old Day Spa Association. The way things are going, this could be bigger than anything Painless Parker could have imagined on his best day.