dentists offered tooth whitening, a once-exotic procedure. Membership in the American Academy of Cosmetic Dentistry, a professional group, has doubled in five years, to 4,000.

Improved technology has expanded services from what dentists call the routine of "drill, fill and bill." Lasers can alter gum lines without sutures, or bleach yellowing teeth almost instantly. Chipped, crooked or just plain bad teeth can be concealed with fingernail-thin porcelain veneers. In the world of bionic beauty, the "smile lift" has become as familiar as the face lift. Traders in cocktail-party confidences can score points by announcing, "Larry did my teeth," referring to Dr. Larry Rosenthal, whose patients include Donald Trump, Kathie Lee Gifford and a long roster of socialites.

Dr. Rose said, "The guys who focus on discretionary services have a little bit of that old salesman-type thing, to tell people why they have to do it."

And do they ever. Seminars in "practice management" for business-minded dentists can include such nonmedical recommendations as: When presenting a patient with a treatment program, always use a Montblanc pen.

"It's no longer enough to have published in the journals," said Dr. Jeff Golub-Evans, a New York dentist and frequent contributor to professional journals. "Now people want to know if