It would seem like a no-brainer that most people would much rather get a massage, a manicure/pedicure or facial than go to the dentist. But what if consumers - especially the most dentist-phobic among us - could combine all of the above?

Building a booming business out of this idea, dentists and providers of spa services have joined forces to create the latest trend in dental care: the dental spa. Touting themselves as a place where you have permission to be pampered - after all, experts recommend everyone should have a tooth cleaning twice a year, and more often for high-risk groups - as well as an atmosphere that can calm the fears of people scared of the dentist.

"Going to the dentist shouldn't be this bad thing," Dr. Kimberly Baer, founder of the Bethesda Dental Spa in Bethesda, Md., told The New York Times. "It should be like going to get your hair done."

Or where you get you hair done, as dental spas and the services they offer continue to grow. Research shows about 5% of the American Dental Association's members define themselves the dental spas, offering traditional dental services (cleanings, fillings, tooth repairs), in addition to cosmetic dentistry like tooth whitening, veneers and implants, and spa services, including massage, nail treatments and facials.

Dental spas are even decorating their facilities to look the part, soothing consumers with soft colors and music, waterfalls, candles, aromatherapy, coffee and fresh-baked cookies. (See sidebar for additional dental spa amenities EBN discovered in our research.)

Apparently the strategy is yielding converts and cash. The Academy of Cosmetic Dentistry reports that cosmetic procedures have grown 12.5% in the last five years, driven primarily by demand for tooth whitening. As such procedures are not generally covered by dental insurance, the dentists who perform them can keep all of the profits. Research shows services outside the scope of traditional dentistry - never mind spa services - can range in cost from $300 to more than $10,000. And obviously, patients who leave the dentist's chair more relaxed and satisfied will be repeat customers.

However, John Chien, co-founder of Dental Spa, the first such facility in the nation, says what matters most at dental spas is not the profit or perks, but the patient. "With the recent interest around the world about dental spas and spa dentistry, dental spas are becoming more than just a trend, but rather a concept that has earned the attention of consumers and the dental industry alike. Our clients have been very clear in articulating their needs. We are responding to demand and letting the marketplace decide."

Health benefits

Call it a gimmick, but if it takes scented candles and pedicures to get Americans to get regular dental care, so be it, some dental experts say.

According to American Dental Association, more than 20% of Americans have gone more than a year without a dental checkup. A MetLife survey shows 38% of members haven't been to the dentist in at least 18 months. When asked why, 85% said because they are healthy. However, among those, 85% to 90% acknowledged they have experienced tooth pain, bleeding gums and rough edges along their teeth - all signs of periodontal disease.

In that regard, for the dental community, beggars can't be choosers.

"Our focus is on preventive care and raising awareness about the importance of good oral health," says Jill Roman, a spokeswoman for Cigna Dental. "If one of our individual customers chooses to have their oral care done with a contracted dentist in our network, which may also happen to be a dental spa, we wouldn't even necessarily know it, as we are billed for the same procedure codes from a dental spa as we would be from a regular office. The procedure codes for dental care are the same, no matter what office it comes from."

The dental community has taken great pains to cement the link between oral health and overall health, hammering home to employers that helping employees take care of their teeth and gums should be part of their general wellness effort.

A 2000 Surgeon General's report on oral health took the first steps in establishing the healthy mouth-healthy body linkages, and the dental community has been working to bring the message to employers and the general public.

"The knowledge has been out there for a while, but now because of concerns with the rising cost of medical care, there is more discussion around the part that oral care plays [in overall wellness]," says Evelyn Ireland, executive director of the National Association of Dental Plans. "Dental plans are starting to change benefit structures to support the science, and companies are becoming more willing to invest [in dental benefits] in the hopes that chronic disease costs can be avoided."

Research shows that patients with diabetes, heart disease and high-risk pregnancies all can have better health outcomes by practicing good oral health.

In addition to health benefits from preventive dental care, some dentists have found that spa services and amenities helped relax patients so that their blood pressure no longer spiked before they underwent dental procedures, and so that they had fewer negative reactions to anesthesia.

A first-hand account

Recently, EBN Editor-in-Chief Kelley Butler - an admitted dental-phobe - visited a dental spa. Her experience and opinions - limited to this one facility - are detailed below.

As I entered, I noted the calming purple and gray walls, lined with overstuffed and very comfy-looking purple chairs across from a flat-screen HDTV. Clearly, I thought, the dental spa biz is lucrative.

A kind nurse asked me if she could get me something to drink. My nerves were a mess, but since I doubted a vodka tonic was an available beverage, I simply asked for water, please.

I filled out the traditional paperwork - name, address, brief medical and dental history, HIPAA disclosure form - then I waited, alternately wanting and not wanting to hear my name called.

When I was taken back to the exam area, the chair I sat in was quite cushy, but that's where any similarity to a spa experience ended.

The walls were stark white, and none of the staff asked me a thing - Neck massage? Facial? Pedicure? - except for my credit card, as the facility does not take my insurance.

With the finances taken care of, I then saw the doctor. She put orange plastic glasses on me (and no, they don't show episodes of "The Office," - see sidebar) and got right to work with the Cavatron - the dreaded scraper that makes noises like a drill and also sprays water. It was awful. Not painful, just loud and uncomfortable. I wished for my iPod, or at least the classical music through headphones I'd heard about during my research for this article.

When I asked about headphones - and where were the pedicures and massages, by the way? - the doctor chuckled and made note of the foot massagers in the front lobby. Seriously? What a rip-off.

I left with cleaner teeth and, since they didn't take my dental insurance, a lighter wallet.

I didn't, however, feel relaxed nor do I now hate the dentist any less. I'll try one more dental spa just as a comparison (I'll post the details of that experience on EBN's blog, the "Daily Diversion"), but I'm thinking I'll stick with the standard dentist from now on.

From sublime to silly: Dental spa amenities

• Massage treatments
• Acupuncture
• Manicures/pedicures
• Facials
• Waxing services
• Complimentary robes
• Hot towels
• Scented candles
• Scented nitrous oxide
• Cocktails
• Aromatherapy
• Fresh baked goods
• Jetted gum massage
• Catered meals
• Music and headphones
• Special glasses that allow patients to watch television during dental procedures

Dental benefits at a glance

• Dental insurance is the fifth most important benefit among all full-time employees.
• It is the second most important benefit among young singles (age 21-34), valued slightly more than vacation time.
• Working Americans who have dental insurance are more than twice as likely to visit the dentist than those without.Half of people without dental benefits will not see a dentist.
• 77% of all employers offer dental benefits, ranging from 58% of employers with two to 49 employees, and 90% for employers with 10,000 or more employees.

Source: MetLife's 6th annual Employee Benefits Trends Study