Of the many thousands of U.S. dentists who do cosmetic work, fewer than 400 have achieved accreditation by the American Academy of Cosmetic Dentists. Dr. Steven Andreaus of Raleigh, is one of that elite group.

“Earning accreditation is a demanding process that certainly serves the interests of patients,” the doctor notes. “It requires a minimum of three years to become certified. Central to the process, the candidate has to present five near-perfect cases, representing different cosmetic and dental challenges. Each case has to grade out at basically 98 out of 100—recognizing that this is an art as well as a science. There are five examiners for each case, who may, for example, not all respond to the same image or same shape in exactly the same way—so they build in a small margin of error.”

In achieving accreditation, notes Dr. Andreaus, “there is more than beauty on trial. The examiners review before-and-after radiographs of each case, the materials used, and challenge every choice made by the dentist. It's much like sitting for a doctoral thesis. A key concern is the health of the gums—they must be free of bleeding, redness, and discoloration—and they must look natural and healthy.

“If a case fails to achieve the required level of excellence, the dentist-candidate is informed and given the specifics related to the failure. The candidate must then make corrections or start from scratch with a new case. Only about half of the cases submitted meet the requirements and pass muster. The entire process is a thoughtful, constructive evaluation of effort and skill.”

With his long association with the Academy, Dr. Andreaus has for some time been asked to assist in evaluating the cosmetic/aesthetic work of other dentists seeking accreditation.