Creating the “Want” for Better Smiles In Your Patients By: David Ouellet, DDS

In today’s world, people pay for what they want—not for what they need. In your office, you must be able to educate and create “want” from your patients. Most consumers want whiter and straighter teeth. The toothpaste manufacturers have created this “want” using advertising that focuses on people’s appearances and the fact that everyone wants to look better.

Restaurants provide menus to educate diners about the foods they offer. Dentists should take advantage of this concept and offer dental menus, for example, the Smile Portfolio. The Smile Portfolio is a book that contains “before and after” photos of patients. These full-faced photos are of patients who have Rembrandt® Veneers made of Cerinate® Porcelain. The photos are a great tool for educating patients and creating the “want” for better smiles. More patients also express a “want” when the transformation does not require “shots” for removal of sensitive tooth structure.

Dentists can also identify the “want” through the use of the Rembrandt Smile Evaluation. This is a questionnaire located on the back of the medical history form. The evaluation contains questions asking patients what part of their smile or teeth they do not like. This is an easy method for your patients to tell you what they “want.” After identifying potential veneer patients, our office prepares mock-ups using composite. (Virtuoso® Flowable and Universal restoratives are most frequently used because they give the most realistic appearance.) Without etching, bonding, or prepping, the composite is contoured quickly on the teeth. We then give the patients mirrors and allow them to examine the rough mock-up. After seeing their potential new smiles, the “want” is there for veneer procedures.

The following cases illustrate how Rembrandt Veneers made of Cerinate Porcelain fulfill the “wants” of the patients wishing better smiles:

Case 1
This dentist was interested in improving his smile without too much sacrifice of his tooth structure. He elected to be a “patient” at a Cerinate Chairside Course (Fig. 1). The evaluation of arch contour (Fig. 2) dictated the prominent PFM be removed, the lingual laterals built out, and the canines recontoured. Simplistically, anything lingual is brought forward, anything prominent is prepped or recontoured. The lower teeth were bleached using the Rembrandt® One-Hour Smile Whitening

Program with the Rembrandt Sapphire® PAC Light. The metal post under the PFM was removed and a Den-Mat esthetic fiber post was bonded in place with tooth-colored Core Paste. The preparation for this combination case can be seen in figure 3 and the final result in figure 4. The Cerinate Laboratory created an excellent match with this difficult combination case, building in much translucency. The Rembrandt® Lightning Plus bleaching gel bleached the lower arch to blend the finished restoration and smile together.

Figure 1		Figure 2
Figure 3		Figure 4

Case 2
This patient (Fig. 5) presented with an anterior open bite, diastemas, and severe tooth discoloration. Alternative treatment plans included orthodontics or veneers combined with tooth whitening. We decided to lighten the teeth using the Rembrandt One-Hour Smile Whitening Program. We then took impressions without preparation of the maxillary anterior teeth. The maxillary teeth were brought slightly forward and down to provide better articulation. The patient desired slightly whiter teeth, but with a natural appearance for his age. Prepless Rembrandt Veneers were ordered and then bonded with Tenure® Uni-Bond®, and Ultra-Bond® (Fig. 6) without any post-operative sensitivity. As you can see in the patient’s “before and after” photos, his appearance changed dramatically (Figs. 7, 8). When the patient returned for a follow-up visit, he stated that he could now bite sandwiches and even eat pizza better.

Figure 5		Figure 6
Figure 7		Figure 8

Conclusion
The two cases clearly show how Rembrandt Veneers made of Cerinate Porcelain satisfied the “want” for better smiles. Each case was unique, and both were able to use the “little to no tooth reduction” technique obtainable with Rembrandt Veneers. These techniques, using live patient demonstrations, are routinely taught during courses offered at Den-Mat Corporation.

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David Ouellet, DDS is a native of Boston and graduate of Georgetown University Dental School. He has conducted clinical research for placement and evaluation of composite resin and is a consultant for Den-Mat. David has published numerous clinical and research oriented papers and is an accredited member of the American Academy of Cosmetic Dentistry. David is in private practice, where he specializes in adhesive cosmetic dentistry. He has conducted lectures and hands-on workshops on aesthetic materials and techniques throughout the United States and overseas. You can contact Dr. Ouellet at DrO123@aol.com or 805-925-8767.