The global cosmetic dental market is a multi-billion dollar industry showing unprecedented growth. Dr. Michael Apa is the pioneering New York dentist at the forefront of this burgeoning phenomenon. Nick Rice meets the man leading a new generation of dentists.

That long, reclining chair in the bright white room has rarely been a place to settle into and get comfortable. Too many childhood tears may have rendered the dentist’s chair a place that many people seldom like to return to. However, this is certainly not the case with the chair of Dr. Michael Apa DDS. He has a waiting list of well-heeled candidates from all over the world – royalty, celebrities and business leaders – all of them eager to get some time in that seat.

His international renown and high demand status is down not only to his expertise as an aesthetic and restorative cosmetic dentist, but due to the pioneering new direction he is forging within the industry. 

For the last three decades cosmetic dentistry has been based on the precise mathematical principles developed by the ancient Greeks, known as the golden proportion or golden ratio. Leonardo Da Vinci painted the Mona Lisa according to the Pythagorean theorem and intellectuals from all fields have been fascinated by this formula and its dimensional relationships. Yet however intriguing it is, when applied to the creation of porcelain veneers that are seamlessly attached to teeth to improve a smile, you won’t always get the desired beautiful result. “We were taught a certain length and width for the front teeth, the side teeth, the canines – there were formulas. It wasn’t artistic as much as scientific. Beauty is symmetry. With any arrangement, whether in nature or manmade, people think it’s beautiful it it’s symmetrical. But we were taking something symmetrical and plunking it into people’s faces – everybody was getting the same set of teeth.”

This adherence to the unquestioned norm in the field created teeth that didn’t’ always suit a patients face and the overall effect was distinctly false.

Dr. Apa, who trained as a medical dentist at New York University and lobbied for aesthetic dentistry to be included in the curriculum, was carefully taking note of the trends and practices in cosmetic dentistry. After successfully convincing The American Academy of Dentistry to integrate cosmetic dentistry in to NYU’s medical dentistry curriculum, founding NYU’s Aesthetic Dental Society, receiving awards in Aesthetic Dentistry and, upon graduation, joining one of New York’s most respected (cosmetic) dental practices – he was well placed to address the ‘one-size-fits all’ issue and develop his Facial Aesthetic Design technique. 

“Facial aesthetic design came to me after so much learning of ‘smile design’, which was taught as the cosmetic dental ‘golden standard’ but which only takes into account the parameters of the mouth. After assessing smile design, I found that it was creating the same smile for every patient almost, and it was almost impossible to say that we were making ‘customised’ or ‘natural’ smiles because patients were all getting the same smile. So I started researching orthodontic journals, looking at principles of art and facial art and came up with facial aesthetic design, which truly designs each smile based upon the facial features of each patient. The idea is that most people are asymmetrical, and beauty, by definition is symmetry. So the idea was to create symmetry with facial features by building a smile into the proper framework of the face. If this is done properly, it can take a canted nose and make it look straight, or a canted chin and bring it into the proper plane of face, making people appear more symmetrical, hence more beautiful. And all the while giving them a glamorous smile that ties everything together.”

Although deliberate alteration of teeth, including tooth extraction, notching, filing and drilling, has been documented in human groups worldwide, never has it been so deeply ingrained in the collective conscience.

This attention paid to our teeth has led to multi-billion dollar industries dedicated to teeth whitening, corrective treatment and smile enhancement.

According to a new market research report by Report Linker, the total value of the global market for cosmetic surgery services is forecast to reach the $40 billion mark by the year 2013.

There are now so many treatments available and at every level of affordability, that lavishing some attention on your teeth is becoming almost as common as a routine trip to the hairdresser to smarten up. 

Dr. Apa ascribes the booming success of cosmetic dentistry to the fact that treatment is no longer just the privilege of the rich and famous. “People are starting to realise the power of what a smile says. A great smile communicates health and beauty. If done properly it is the highest level of couture one can attain. People spend so much on the newest handbag or a well-tailored suite but all of these things are temporary. A smile you can wake up with, and the only thing you have to do to show it off is, smile.”

However, Dr. Apa is quick to warn against casual decisions and maintains that people should consider very carefully the procedures they desire. “People from all different economic backgrounds can get cosmetic enhancement of their smile, but there is a warning on the label. This is a permanent procedure. It should always be looked at as a high-end procedure because so much detail goes into each creation.  No ‘assembly line’ can manufacture a great smile. The beauty is that it can be done in less than a week with little or no discomfort. We have two locations, in Dubai and New York, in either of which we can transform your entire appearance with little to no downtime.”

The minimal discomfort and quick recovery periods have also contributed to the growth of the industry and people are now looking initially at dental treatment before invasive plastic surgery or a face lift, as the dental work itself can have a transformative effect on the face, hence the term ‘smile lift’ which Dr. Apa describes as having “much more to do with creating balance within the facial features rather than just having a nice smile. This is what allows things to look natural. Taking focus away from just your smile and allowing the facial features to present in harmony by re-creating the lower third of the face with a new smile.”

With all this devotion to perfection it is very reassuring that Dr. Apa agrees that there is much beauty to be found in our slight imperfections – the tiny flaws that give us character and charm. His Facial Aesthetic Design technique eschews the traditional creation of too-perfect teeth at an exact size and instead focuses on each individual in great detail, observing all aspects of the patients face, mouth, teeth, speech and bite, eventually creating a detailed photographic case study.

Dr. Apa can then make the desired improvements while preserving a hint of these personal quirks, so that the patient doesn’t appear to have had any obvious artificial treatment. 

“After teaching facial aesthetics to more than 5,000 dentists worldwide and talking to the public about it, I think that the ‘imperfect perfection’ has started to catch on. It’s a way of creating a smile based on facial features and facial tones that will only enhance appearance, rather than make the teeth stand out as ‘fake smile’. Beauty exists within each patients face, you just have to find it and bring it to life.”

Dr. Apa says that his aim in treating his patients is to take away any physical insecurity and inspire confidence in them. Using a highly specialised integration of exacting science and a keen artistic eye, the key to his craft is maintaining the delicate balance between microscopic precision and artistic vision. It is a simple, if incredibly skilled, objective. 

“I provide art for the face, my medium is teeth, it’s like wearing the most beautiful painting every day of your life – something that was made just for you, that enhances the way you live your life. This is what wakes me up every day and puts a smile on my face.”

With his partner, Dr. Larry Rosenthal, the Rosenthal/Apa group operates in New York and Dubai and Dr. Apa divides his time between treating patients, lecturing students and teaching his art to practicing dentists all over the world.

Dr. Apa has teamed up with Dr. Michael Formenius in Dubai. Dr. Formenius is the founder of two Dental Health Centres in Dubai that have been the leading providers of dental excellence in the UAE. Established in 1997 in the heart of Jumeirah, known as the ‘Harley Street of Dubai’, Dr. Formenius’ clinics provide the perfect space and technology to train visiting dentists and offer procedures to customers in the region. As a renowned ‘dentist to the stars’ Dr. Apa will bring his team from the US, including Jason Kim – widely regarded as one of the world’s foremost ceramists  – and see a limited amount of patients from the region. 

Dr. Apa may have a stream of patients from all over the world visiting him, but language is never a problem – as the saying goes, “There are hundreds of languages in the world, but a smile speaks them all.” And everyone wants a winning one.