Presenting Esthetic Dentistry to Patients By: Sameer Puri, DDS

Media exposure has raised the public’s awareness and helped elective esthetic dentistry become mainstream. With the evolution of adhesive bonding and all ceramic restorations, preparations of teeth have become more conservative, the contraindications fewer and the esthetics improved.

Regardless of these advancements, the age-old question arises: how do you effectively present elective cases to patients and make them aware of their esthetic options without being pushy?

I am a firm believer one should not sell esthetic elective dentistry. There are courses and books that teach dentists how to sell dentistry, but I don’t like to sell. One way to drive patients out of your practice is to tell them they are less than perfect and suggest change. I have made the mistake of trying to convince a patient that not only was his/her smile less than perfect, but for the low price of $X.XX, our office could perfect their smile with porcelain veneers, crowns or a full-mouth rehabilitation. I didn’t realize the patient was very satisfied with the appearance of their teeth and had other priorities. Needless to say, that patient is seeking care elsewhere in a less “pushy” office.

Anytime you sell, there is the possibility of forcing something on the individual they really don’t want. Would a Rolls Royce salesman try to sell a car to a person with no desire or economic means to spend $200,000? Don’t you think it would be a waste of time and risk alienating the consumer to sell them on the benefits of a Rolls when all they really want is a Toyota? The same is true for dentists trying to convince patients they need elective cosmetic dentistry when all they really want is a cleaning. A successful Rolls salesman creates the proper environment for potential buyers, answers questions, and is available for the customer to provide a pleasant purchase environment when they are ready. As an esthetic dentist, you should do the same for your patients who seek elective care.

It is essential to create an environment where patients who are interested in esthetic/elective dentistry will ask you questions about enhancing their teeth instead of you telling them. When you don’t push, you create patients who are interested and motivated. All you and your staff have to do is be proficient in providing the procedures.

Before you present elective dentistry, you must first possess the clinical skills to deliver it. There are many fine courses available to increase your skill level. Before you attempt to deliver this type of dentistry, make sure you can walk the walk and have the skills to back up your talk. There is nothing worse than promising excellence and delivering mediocrity.

Another step in creating an environment to encourage esthetic dentistry is to place pictures of completed cases in your office. If you don’t have any of your own, you can purchase completed cases. When patients walk into your office, they should know you can deliver excellent esthetic results. If you don’t let patients know what you can do for them by showing photos of completed cases, how will they ever bring up the subject of enhancement?

Next, listen to your patients for insights on how they feel about their smile. One of the most common questions asked in my practice is, “should I whiten my teeth”? This usually indicates the patient is unhappy with their smile and would like to change it. Whitening is a great way to promote esthetic dentistry. In my practice, whitenings usually evolve into veneers, or replacement of old unsightly amalgam restorations or other procedures. Once a person whitens their teeth, they find other things they want to fix. I always inform patients that whitening is the beginning. If after whitening the patient is happy, then we are finished. If whitening does not completely fulfill the patient’s desire, then we explore other options to give them the look they want.

Look for other hints on the patient health history form. Your form should include a place to ask patients how they feel about their smile. When dissatisfaction is indicated on the form, ask questions and open a dialogue. Take a digital photo of the patient’s smile and display it on a large monitor. Ask them to point out what they don’t like and then discuss possible options for change. Restore the smile of your staff. There is no better marketing than a staff’s smile.

Show PowerPoint presentations, from start to finish of your completed cases. This is excellent education for the patient and will give them a lot of insight into the procedure they’re considering.

In my office, I am adamant that we don’t try to sell every patient that expresses interest in enhancing their smile a 10-unit veneer case. When a patient expresses interest in enhancing their teeth, we briefly discuss all the different treatments available and schedule a work-up and consult. Before recommending a particular treatment, I will request a work-up, which includes taking a full set of digital photos, study models and a comprehensive exam of both hard and soft tissues. At the consult appointment, we go over the photos, models and present the patients with all their options.

I typically present a lower-priced option which might include some whitening and selective bonding, a medium-priced option that may include a few indirect restorations, and a higher-priced option that will be a complete smile makeover including veneers and crowns. One option, always included, is no treatment. Remember, this is elective dentistry and the patient should know that none of this is mandatory. If problems arise down the road, the patient cannot blame you for pushing them into treatment.

Reschedule the majority of the discussion until the consult appointment. This allows you more time to be prepared for the presentation. Taking a week or so to review the patient’s photos and explaining your recommended treatment is ten units of porcelain, will be better received than sticking your head in the operatory and making the recommendation during a hygiene check.

Transform your office into providing elective dentistry slowly. Do not abruptly change your core business principles. For example, if you are an insurance provider, do not suddenly drop all insurance and go fee-for-service and offer only cosmetic cases. If your practice currently treats mostly emergency pain patients, don’t stop seeing emergency patients and only do elective treatment. Keep your core business principles intact and gradually add elective treatment as another menu item you offer.

The final key component is making sure your dentistry fits within the patient’s budget. The cost of some aesthetic cases can be equivalent to purchasing a car. The number one thing new car buyers ask is what kind of financing is available. You must, and I repeat must, have financing options in place to offer patients. Our finance company of choice is CareCredit. Once a patient is approved for a certain amount, they can easily get additional care approved at a later date without reapplying. In my experience, patients will start one procedure, perhaps porcelain veneers to enhance the appearance of the front teeth and then after they are finished and love the results, they decide to do more, such as replace their posterior un-esthetic amalgam restorations. With CareCredit, if their credit application has already been processed and they have previously been approved for credit, they do not have to reapply. It is also very convenient for the patient because there is only one monthly statement. I consider this to be a major advantage of using CareCredit over other third-party financing companies.

Remember, don’t sell cosmetic dentistry, but be ready to go when patients ask for it.

Sameer Puri, DDS, is a graduate of the University of Southern California, School of Dentistry and the University of Tennessee. He maintains a full-time private practice emphasizing comprehensive dentistry in Tarzana, CA.

In addition to organizing the Annual DentalTown Gathering, in Las Vegas, March 25-27, he hosts a live-patient, over-the-shoulder anterior esthetics seminar to help teach the concepts of anterior esthetics.

Dr. Puri’s practice is located at 18399 Ventura Blvd. #251, Tarzana, CA 91356. Call him at 818-345-5286 or by email at drpuri@socalsmiles.com. To find out about the DentalTown Gathering, visit www.towniemeeting.com.