You'll need to be more specific. I have a feeling you're not comparing identical procedures. It wasn't too long ago that dentists were applying inlays with a mallot. (And the dentist who did it might not have been wearing gloves.) lol "Buy an inlay, get one dead or inflamed root free." Even the way crowns are done has changed. There's a whole lot more precision, training, and equipment/ materials that goes into dental work today. And, you often get what you paid for. Yes, you can find a family dentist who can do some cosmetic work, but there are only so many hours a doctor can apply to advanced training. As a family dentist, a doctor is going to spend his time improving the meat and potatoes of his practice- crowns, fillings, and root canals... perhaps even implants. Porcelain veneers and full-mouth reconstructions? Not so much, unless he changes the model of his practice. Out here, I think the dentists only did veneers every few months. I loved those guys- wonderful, honest, caring doctors. But, if I needed cosmetic work... Nuh uh. I'm going to the dentist who has spent his continuing education hours on cosmetic dentistry and does it all the time. Up goes the price tag.
At the same time, there are lots of ways to improve aesthetics. It doesn't have to be high-end. If you want the movie star smile, sure... veneers all the way, but even in veneers, there are lots of techniques, materials, and brands. Chairside, lab-made, in-office milling? Porcelain, zirconia, composite, lithium-disilicate? ... I'll stop now. :)
Guessing, cost of the technology. Once, as I was having a routine cleaning, the dremmel ceased functioning. He pulled out a spare and continued his work. My dentist said it would cost $3,000 to buy a new one and it would only last 2 years.
