Helping patients ask for your best stuff

Feb. 1, 2011
How do you help patients value something they don't know they need and have never been told they could have?

Frank M. Spear, DDS, MSD

For more on this topic, go to and search using the following key words: interaction, norm, conversation, appearance, observations, best stuff, Dr. Frank Spear.

How do you help patients value something they don't know they need and have never been told they could have? One of the first steps is the interaction that occurs in the examination. Just as important, though, is how we communicate the exam findings - and possibilities - to the patient.

The norm - and why it does not work

The tendency in many practices is to outline the findings and necessary therapies for the patient at the "treatment presentation." If we stop there, however, the patient does not really understand why the findings matter in the first place; they do not "own" their conditions and the consequences of taking no action. When we merely tell patients what the issue is and how we will fix it, they are not invested in the process. Simply put, treatment plans can scare patients away.

Having the conversation

Rather than present a clinical treatment monologue, I engage patients in conversations about their dental possibilities. Discussions and photographs give life to their options and show them "what could be." Relaying exam findings and the consequences of not treating those findings are vital aspects of the conversation, helping patients own their issues and build their concerns. And concerns are the genesis of questions.

Begin with appearance. If patients are completely happy with the appearance of their teeth (just ask them), steer the discussion directly to function. Use photography to reinforce findings and show the contrast between their reality and the ideal. "See this crack? It probably happened because these teeth are acting against each other. At some point, this crack will become a fracture, a broken tooth." Create the pause, and then let the patient consider whether or not he or she wants to have that crack.

Guide the conversation through structural and biological issues, continuing to make observations about conditions, potential consequences, and health. Again, photography makes the disparities between the conditions and ideal possibilities obvious for the patient.

For example, gingival recession and loss of attachment are far more impactful when seen through a direct comparison with a photo of a healthy gingival apparatus. Showing before-and-after photos of a successfully treated patient with the same type of wear will illustrate the potential of today's dentistry far better than a lengthy conversation.

Involving your team

People tend to support what they help to create. If you want to create a consistent message and passion in your practice, empower your team to help construct the changes you envision. The simplest way to energize your team members about dentistry? Show them that your best stuff is something they value and want for themselves. Let them experience a conversation with you about what you see in their mouths, and the consequences of not acting. In other words, arm them with the experience that helps them walk patients through the process of realization, understanding, and questions that lead to your best stuff.

What if they still say no?

We often remember only the patients who decline our offerings, which can prevent us from making those offers to others. Keep in mind, though, that not every patient will want to come with us. Part of the beauty of approaching treatment "presentation" as a conversation is freedom from rejection; we can let go of the memory of those who decline. The conversations may not always progress beyond what we see and the consequences of not treating things. That's okay. We are having conversations. Some conversations lead to questions, and that leads to answers.

As the founder and director of Spear Education, Dr. Frank Spear continues to be recognized as one of the premier educators in esthetic and restorative dentistry in the world. He and long-time practice partner, Dr. Greggory Kinzer, maintain a private practice in Seattle limited to esthetics and fixed prosthodontics. Dr. Spear can be reached through

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