That was then.

More and more, the paper-white glow of artificially lightened teeth is becoming the new standard for one of America's most-noticed physical attributes.

A 2004 survey conducted by the American Academy of Cosmetic Dentistry found that virtually all Americans consider a smile an important social asset, and 96 percent of adults surveyed said an attractive smile makes a person more appealing to the opposite sex. With so much emphasis on teeth, it's not hard to believe the number of people who whitened theirs between 1996 and 2000 jumped 300 percent, according to an AACD survey. "Teeth whitening is far and away the most requested and performed cosmetic dental procedure," said Eric Nelson, director of public relations for the Wisconsin-based AACD. Nelson said new data suggests the trend may be leveling off, but the convenience and affordability of various whitening procedures often persuades those considering an oral overhaul. Buzbee Dental Clinic in Springfield performs roughly eight in-office whitening procedures per month, but Dr. Tyler Buzbee said that number doesn't show the full range of patients who are brightening their smiles: Many opt for less-expensive, over-the-counter treatments like Crest Whitestrips.

"I always tell patients, 'If you're interested in lightening and you don't want to pay a lot, try the Whitestrips,'" Buzbee said. "See how it works. " Since Whitestrips were introduced in May 2001, more than 20 million people have tried them. Last year, Crest sold 9 million boxes, which retail for about $25 apiece.

Strips worn for 30 minutes twice a day for seven days can whiten teeth for up to six months.

But there are certain disadvantages to the do-it-yourself approach, Buzbee said. The strips aren't as effective as in-office whitening procedures, and patients with misaligned teeth or limited dexterity run the risk of an uneven bleach job.

Dr. Chanin Ropka with the Parkcrest Dental Group in Springfield likened Whitestrips to bleach-coated Band-Aids."If your teeth aren't straight, it's not going to stick in the nooks and crannies," she explained.If strips don't cut it, Buzbee usually points patients to custom-fitted bleaching trays, which cost $400. Patients who go that route relax while a gel-filled biteguard does the work. Most dental clinics also offer take-home kits that enable patients to bleach their teeth further by wearing the guard for a short period during the day or overnight.Hydrogen peroxide is the active ingredient in both over-the-counter and in-office whitening treatments, but bleach products applied at the dentist's office have higher concentrations of the oxidizing agent. Gum sensitivity is the most common side-effect, but most patients say the discomfort is short-lived.Many dental clinics also offer a light-activated whitening process, which takes more than an hour but can lighten teeth several shades.

Locally, the procedure costs somewhere in the neighborhood of $500, and no, insurance won't pony up.While bleaching typically achieves the desired results, dentists know better than to guarantee the outcome of whitening sessions. "Everyone's teeth are different," Buzbee said. "Some people who have a grayer hue aren't going to get that super-bright white. You can tell right away if they're going to get better results than others." Dentists don't usually recommend whitening treatments for people with tooth-colored fillings, crowns or porcelain veneers. They say those who have managed to escape significant restorative work are the best candidates for whitening.

When it comes to perpetrators known for discoloring smiles, the lineup includes the usual suspects: coffee, tea, cigarettes, chewing tobacco, soda and red wine.But strangely enough, dentists said, patients with mouths full of tainted teeth aren't typically the ones interested in brightening up."To tell the truth, it's usually the people who don't need their teeth bleached that want it," Buzbee said.Buzbee said he often discourages patients from excessively bleaching their teeth and reminds them of the "Friends" episode when Ross left the whitening gel on his teeth a little too long.

"Sometimes — for whatever reason — they think they should look like Ross on 'Friends,'" he said. Ropka said in-office whitening procedures seem to be most popular with women between the ages of 30 and 50 on a quest for that gleaming white smile. "They want it paper-white, and natural teeth are yellow," Ropka said, adding that she sees the best results in baby-boomers."It takes 10, 15 years off some people."

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