When it comes to cosmetic dentistry, the dentist’s job really is to recognize what the patients want because the success or failure of the case depends not on how the dentist feels about it, but on how the patient feels about the final result. This is what differentiates cosmetic dentistry from general dentistry. In general dentistry the dentist is the one who judges whether his treatment restoration meets the criteria of success in general dentistry. In cosmetic dentistry, however, if the patient is not satisfied with the end result, there is a failure no matter how technically skilled the treatment is.
We usually start out by showing the patients some pictures of beautiful smiles, and we ask the patients to rate these smiles on a scale of 1 to 10. We then ask these patients where they want to be on this scale. Not everyone feels the need to be a 10. Millions of people who are embarrassed by their smiles, rating them a 4 or lower, simply may want to reach a 7 so that they can smile without being uncomfortable, inhibited, or self-conscious.
During this treatment discussion patients may change their minds about wanting to have a “10” smile. When they realize what treatment would entail, or how long it would take, or the costs involved, they often discover they could be happy with a smile that is a 7 or 8. If we decide on crowns or veneers, we can have a wax model made to show what the final result will look like. After the patients approve this model, we shape the teeth so that we can make the temporary crowns or veneers.
We then have a “review” of the temporaries, and we painlessly modify their shape, color, or length, without Novocaine, so that we can see the natural drape of the lips. When we achieve a result that is mutually agreed upon, we send a model of those temporaries to the dental lab so that we maintain control of the end result.
When the crowns or veneers arrive from the lab, we insert them, and only after our patients’ written approval, we cement these final restorations. We deliver our warranty, and schedule our happy patient in one week for any final tweaking.
In our office we do not believe in pressuring our patients to extend themselves either in terms of treatment or in terms of costs beyond their comfort level. It is our job to help them focus on realistic expectations so they can achieve their goals, so they are happy with their new smiles, so they feel their teeth look natural, and so they are happy with us and will refer their families and friends.