Q & A with Dr. Bill Dickerson

April 1, 2000
Cosmetic dentistry is presenting new opportunities for dental professionals. Our culture and the media`s fascination with youth and vitality and their connection to a beautiful smile are establishing a new class of private-pay patients. Rather than being driven into a practice by pain, patients are now coming to dentists to enhance their appearances. For the first time, "want" is replacing "need" as the primary reason many people visit a dentist.

Dr. Bill Dickerson

Cosmetic dentistry is presenting new opportunities for dental professionals. Our culture and the media`s fascination with youth and vitality and their connection to a beautiful smile are establishing a new class of private-pay patients. Rather than being driven into a practice by pain, patients are now coming to dentists to enhance their appearances. For the first time, "want" is replacing "need" as the primary reason many people visit a dentist.

How can you capitalize on this explosive trend? In this article, Susan Love talks with Dr. Bill Dickerson, the director of the Las Vegas Institute for Advanced Dental Studies, about trends in cosmetic dentistry, common misperceptions about a cosmetic-focused practice, and the team`s role in an esthetic practice.

Love: How can doctors capitalize on this trend?

Dickerson: In order to capitalize on this trend, one has to be able to deliver the steak, not just the sizzle. Many dentists make the mistake of thinking it`s all about marketing. Unfortunately, from a clinical standpoint, dentists don`t know what they don`t know, so they don`t even know that they don`t know something. I think that dentists` clinical skills need to be current before they even consider developing a cosmetic-oriented practice.

I personally believe that most things are bought on a want basis, not a need basis. As Dr. Harold Wirth said, "People have money for what they want whether they need it or not. It`s our job to make them want what they need." But in the average practice, very little time is spent on this aspect of the patient`s experience. Most dentists are so busy running a volume-oriented practice that they don`t have time to create the value of this type of treatment with the patient.

Love: What are common misperceptions about having a cosmetic-centered practice?

Dickerson: A very common misperception about having a cosmetic-oriented practice is that dentists need celebrities and wealthy people in their practices. I don`t have any celebrities. My practice was built by treating regular people. Most of my patients in my career have been teachers, businessmen, housewives, etc. I don`t even remember treating any showgirls (darn it!). The perception is that cosmetic dentistry is only wanted by young, good-looking people, but the truth is that the majority of my work is performed on more mature patients.

Although the amount the public is spending on dentistry has not been keeping up with inflation, personal health-care expenditures have been exceeding inflation. People will spend money on things that make them look younger and feel better. They just don`t know that dentistry can do that.

Dentists need to realize that it can be done anywhere. We have LVI graduates from small towns all over North America who are doing some amazing dentistry. Sure, it may be easier in locations like New York or Hollywood, but it can be done anywhere.

Love: What recommendations do you have for doctors who want to integrate cosmetics into their practices?

Dickerson: Obviously I think it`s important to obtain proper education. I`m not just talking about a one-day lecture or going to a meeting where each speaker talks for an hour or so each. That will just show you what you don`t know. You may pick up some valuable tips, but how comfortable would you have been graduating from dental school if you never worked on a patient under the direction of your instructors?

Dentists don`t think they can afford such an education, but the truth is that they can`t afford not to have that type of education. In fact, those who tell me they can`t afford it actually are telling me that they need it more than those who can afford it. The average graduate from our program increases his or her net income by 50 percent.

Love: What role do staff members play in a cosmetic-centered practice?

Dickerson: The team can make or break a cosmetic practice. I was just talking to a dentist who said that he struggled for a year because he had the wrong team. Once he changed the team, his practice took off. That`s why we put so much emphasis on our team program. We know from experience that the doctors who bring their teams are more likely to be successful with their transitions to esthetic-based practices than those who don`t. If a team member doesn`t understand the value, or believe in the doctor`s choice, of treatment, he or she can kill a practice without saying one word. Body language and demeanor say volumes. Again, that is why we strongly encourage dentists to bring their staffs to our programs.

Love: What`s the best way to make patients aware of cosmetic services?

Dickerson: Talk to them about the advances in dentistry. We have a tabletop book that shows before-and-after pictures to stir the patient`s interest. It was designed as a "photos-only book" so the patient will ask questions. These questions will allow the doctor and his or her team to talk about possible treatment with the interested patients.

Another way to create an interest in this type of treatment is to use computer imaging. Nothing is more powerful that having the patient see what he or she would look like with an improved smile. Of course I also think that practicing what you preach is the most valuable thing you can do. It would be hard for a dentist with ugly teeth to talk about the importance and value of esthetic dentistry. Dentists who have had their own mouths restored report a much higher incidence of case acceptance in their practices. I think that it`s their enthusiasm about their own mouths that creates the difference.

Love: What new advances in materials and/or techniques are on the horizon?

Dickerson: The exciting thing about dentistry is that it`s undergoing a revolutionary transformation with materials and techniques. I think one of the areas I`m most excited about in the area of products and techniques lies in the arena of neuromuscularly based occlusion and its importance in an esthetic practice. Most esthetic programs ignore or spend little time on the importance of occlusal harmony in restorative dentistry. I am so proud of our merging of esthetics and occlusion. The ability to accurately determine the ideal bite and maxillary and mandibular position is what will propel dentistry into the status of being a more respected profession.

Of course, the area of esthetics and metal-free dentistry is evolving to the point where we won`t need to use metal in dentistry. The new techniques and materials are reaching the point where it is difficult to discern between natural tooth structure and restorative materials.

Love: If there were just one piece of advice you could give dentists just starting out, what would that be?

Dickerson: I think if I had one piece of advice to give a dentist just starting out it would be to never stop learning. A dental degree should be thought of as a license to learn more about dentistry.

In dental school, instructors should teach what is necessary to pass the state boards. The truth is that I don`t do any procedures that are required on state boards. Today, I use very little of what I learned in dental school. That`s not an indictment of the schools; their purpose is to teach dentists enough to pass the license exam. If I have a criticism, it would be with the state boards.

I could study dentistry for the rest of my life and not know everything there is to know about it. I think I have learned more during the last 18 months than the prior 10 years. That makes dentistry exciting. How boring would dentistry be if we reached the point where we thought we knew it all? Unfortunately, too many dentists think they do know it all, and the learning stops. Many of the "experts" think that since they teach others, they no longer need to learn. As one of my main mentors told me years ago, "You don`t know what you don`t know!" If one adopts this philosophy, then the learning never stops. But again, that`s the good news that makes our profession interesting and exciting.

Dr. Bill Dickerson is the director of the Las Vegas Institute of Advanced Dental Studies. For more information on LVI, call (888) 584-3237 or visit www.LVILive.com.

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