The cost of a perfect smile

At this clinic, it is not medical certificates that decorate the walls. It is pictures of perfect smiles, or rather perfect teeth; well-contoured and intense white.

Is a smile worth paying for? To answer this, Dr Khushil Nathwani, an aesthetic and restorative dentist, remembers a customer’s smile that perhaps will be etched in his brain.

Monica* walked into his office having lost her job after being sacked over the loss of a front tooth.

“I asked her to smile and immediately knew changing her teeth design would change her life,” says Dr Nathwani at his spacious, minimally decorated office in Westlands, Nairobi.

With advances in medicine, it means that more Kenyans who have disposable incomes and do not like their smiles can now fix them.

“Whether stained, discoloured, worn out, chipped, or misaligned, cosmetic dentistry can give you a smile makeover,” says Dr Nathwani, who graduated with a degree in Advanced Aesthetic and Restorative Dentistry from the University of California, US and from India with a Bachelor in Dental Surgery.

“Everyone wants to look better and cosmetic procedures can be used to improve the appearance of teeth, gum and bite,” says Dr Ngoru Njuguna, director of DentalAccessNairobi Clinic in Nairobi explaining the rising demand for elective teeth treatments.

But it goes much deeper than looking better. A smile is like a poster. You put up a good poster and you are almost guaranteed to get a good feedback. A bad one can be ruinous to one’s reputation. That’s what a smile does for self image.

“They are people who are struggling to find (or keep) love because of an unhealthy smile, people who cannot smile or laugh without covering their mouth, and people who cannot express themselves because they know you’ll see their teeth first before you see them,” says Dr Nathwani.

There are more women than men seeking out cosmetic surgery services, Dr Njuguna says attributing the gender gap to women being more particular than men about their appearances.

Dr Njuguna started his career at Karen Hospital before branching out on his own eight years ago. He started with one clinic. On a good month he would see 10 to 15 people. Today, his practice has expanded to two clinics attending to at least 110 clients a month.

The demand is also driven by the increased awareness of the ability of doctors in Kenya to offer bleaching, veneers, crowns and invisible braces as well as dental implant procedures.

“Teeth alignment is the most popular cosmetic dental procedure. Most clients request for braces since it is affordable. Teeth whitening due to dental fluorosis is also a much sought after service. It is the main reason most of our clients seek teeth whitening,” says Dr Njuguna.

At his clinic, clients can also have their gums recontoured especially after teeth realignment, or direct composite veneers that cost from Sh7,000 per tooth, or ceramic veneers that cost upwards from Sh30,000 per tooth.

When Dr Nathwani opened One Oak Dental Studio in 2018, the uptake was slow, so much so that he was rethinking his decision to start the clinic.

Coming from Hollywood, in the US where he did at least three big cosmetic surgeries a week, he did only three that year. However, in 2019 things turned around which made it “a very good year” for the entrepreneurial doctor.

He specialises in replacing teeth, doing dental implants, correcting misplaced teeth, jaws and bite patterns, and teeth whitening.

Among his working tools are a DSLR camera, macro lenses, and photographic studio lights which he uses to take clients photos before and after treatments and shade pictures for precise documentation. A passionate photographer, he says these are some of the perks of his work.

He talks of botched cases that he has had to redo. For instance, one woman’s teeth had been fixed so badly that she bled for 20 years.

“She would bleed profusely after touching her gums. Can you imagine living a life like that?” He poses.

Fortunately, he, together with his associate partner Dr Samra Khalid, were able to fix it.

That not many people want to travel out of the country in the middle of a pandemic has helped his business thrive.

“I receive clients, who used seek treatment abroad because it wasn’t locally available,” says Dr Nathwani.

And it is not only locals who seek his services. Last year, he fixed a patient with fluorosis. The client flew in from the US seeking his service. The doctors there did not know what to do because they had not seen nor experienced fluorosis.

His eye and hand in cosmetic dentistry have seen him conduct lectures as far as the Philippines.

Kenyan sports celebrities and news anchors were among Dr Nathwani’s first clients but that has since changed.

Dr Njuguna is thankful that unlike before, insurance companies are slowly accepting to cover some of these procedures.

Advancement in technology has also played a role in boosting the numbers. Surgeries are moving away from being invasive to the use of laser technology. Today, 3D scans have replaced 2D dental scans of yesteryears.

The One Oak Dental Studio clinic is surrounded by greenery from trees, flowers, plants, and grass he has invested in. It is all part of his strategy as nature has a way of relaxing and calming the human mind.

A typical client's experience involves conducting an aesthetic evaluation where he asks questions about how they feel about their teeth – shape, size, colour – as well as the gums and facial structure and the impact all these have had on their life.

“This enables me to understand the client's thoughts and expectations,” he says.

A plan of treatment is then drawn up. Some of the procedures take about an hour and a half but some can take weeks depending on the severity of the condition. In the case of redesigning the teeth, he works with an overseas lab to fabricate the veneers which come with a five-year guarantee.

The biggest hindrances have been affordability. Braces cost on average Sh200,000 at DentalAccessNairobi. Fixing two teeth using ceramic veneers at One Oak Dental will set one back between Sh120,000 to Sh150,000. Bleaching costs Sh50,000.

“Cosmetic dentistry is an investment whose returns cannot be quantified. The joy of confidence and the power of a smile - who can measure these?” says Dr Nathwani.