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All sorts of people tell us that nowadays don't they? You go clothes shopping, perhaps for a pair of trousers or a top or something that seems to be a straightforward purchase. Selecting it from the shelf is not too bad but getting embroiled with an assistant will almost certainly result in the need for further choices. He or she will soon be talking images and awareness and perceptions so that the simple garment you thought you'd choose actually turns into a lifestyle decision about the way you want to look for the rest of your days.

And of course patients are after the same results. They want their little bit of perception too. They've been reading swanky magazines or surfing the net or glancing over someone's shoulder on the bus and caught sight of an article in the paper about how to get your teeth whitened and straightened. And they want that because the perception is that it will make them look just fab, the bee's knees. They will be Tom Cruise, Halle Berry, Madonna, whoever. They will now no longer look and feel shabby and down at heel but with white teeth they will be able to walk tall, look the world in the eye and be successful. It will change their lives at a stroke, and an easy one too.

So that, when they say 'I'd like my teeth whitened' how can you possibly say 'no'. Of course, you can say no, at least in theory, on clinical grounds or some such pretence but you know very well that it's going to cut no ice. If you say no they'll just go round the corner and have it done somewhere else instead. Which is not only irritating and rather galling, but also, more importantly, a serious loss of business.

Despite this, there are occasions on which, or at least patients to whom, you're very tempted to say, 'well frankly if I were you, slightly off-white teeth are the very least of your problems just now. I mean look at yourself. White teeth, pah! Get real, wake up and smell the coffee. I really wouldn't waste your time and money.' But how can you be so brutally honest? You'd crush every last atom of hope that they had that they could ever aspire to be famous and glamorous and just the most gorgeous person in Hartlepool, or wherever.

Ironically, in the 'old days' we used to do everything we could to persuade people to have 'darker' teeth. Interesting though how colour itself never used to come into the conversation. Old ladies would grab your wrist as you approached them with the prosthetics shade guide and arm-wrestle you to the floor until you agreed to make their new full-fulls with A1 teeth. It was mainly so that they could beam at their peers, then wait for the chorus of recognition that they had got 'new dentures' and the following acclaim at how wonderfully white they were. So, in the mistaken belief that 'the more mature' patient would wish to disguise the fact that they needed dentures, we used to suggest a slightly 'darker' shade. Never yellow, always less bright.

If Mandy's worth her salt she'll have the potential patient sat down next to the sculpture created from a mock East India Company tea chest. . .

No point now. Since everyone can have bleached white enamel for ever no one will know how old anyone is anymore. It has become the reverse snobbery that dictates that cars with sunroofs, once the perception to which to aspire, are now only for poor people who have to use fresh air instead of being able to afford the far superior air-conditioned variety. Darhling, white is the new yellow. But does this lead down a slippery slope? Do we just become extensions of beauty salons? Well maybe. With falling caries, improving perio and non-existent dentures what is there left except straightening and whitening. In the same way that clothes shops are busy selling their perceptions maybe we have to do the same. Gone will be the waiting room with familiar comfy chairs and slightly dog-eared but reassuringly predictable magazines. Instead, in will come the adornments of retail outlets that offer the sophisticated allure of lifestyle choices.

For reasons best known to clever designers who clearly frequent rummage sales and old people's cellars, the walls will be decked, with discoloured tennis rackets, faded hockey sticks, bits of sack with 'top class flour' printed in white and leaves nailed in autumn patterns.

Sepia pictures of dead people's grandparents in village brass bands, or skating on frozen lakes wearing Edwardian mufflers will replace the rather more homely watercolours of the Algarve that you lovingly brought back in your hand luggage to prevent them getting damaged.

PCDs will be rebranded as amelogenesis image advisory consultants and wear badges with customer-friendly mottos like 'Hi, I'm Mandy, here to help'. OK Mandy, let's start with this tooth whitening thing.

It's time to talk brass tacks, is it worth the cash or can I do it at home just as easily and a lot more cheaply with domestic bleach? If Mandy's worth her salt she'll have the potential patient sat down next to the sculpture created from a mock East India Company tea chest and a 1940's vacuum cleaner and be talking perceptions before he realises that he's chanced off the shopping mall and into a surgery. You see, that's the beauty of perception, no one sees it until it's too late.