Are We in need of an Extreme Makeover?

As I watch the excitement fueled by the television show Extreme Make-over(tm), and the deluge of "cosmetic" advertising that has followed, I am reminded of a story told to me by a fellow dentist of a time when advertising was tightly regulated.

As I watch the excitement fueled by the television show Extreme Make-over(tm), and the deluge of "cosmetic" advertising that has followed, I am reminded of a story told to me by a fellow dentist of a time when advertising was tightly regulated. In 1975, my colleague was forced by the State Dental Board to remove his exterior sign that displayed his name and address. The sign, shaped like a molar, crossed the line of acceptable advertising according to the Board. That same year, another dentist had his license suspended for three months because his "Family Dentistry" slogan was also deemed excessive by the Board. We have come a long way since that time - but, have we gone too far?

A new dental school graduate moves to town and inundates the market with slick ads and television spots claiming he's a cosmetic expert. He hasn't placed his first occlusal filling, yet somehow he's qualified to undertake a full-mouth rehabilitation? This is the beauty of advertising or, some would argue, the problem. A dentist, or any service provider for that matter, can create a fantasy persona, without any proof of credibility. The burden of proof lies with the consumer. Most of us realize that discerning clients will never choose their health care providers from a magazine ad, or even a well-scripted television commercial. Nevertheless, there are those less-discriminating patients who will buy the rhetoric and make the appointment with the heavily marketed dentist.

Assuming everything goes well for the new patient at the marketed office, and expectations are met and possibly exceeded, there is no problem. This, unfortunately, is not always the case. Oftentimes, patients leave a practice disappointed, searching for qualified dentists to redo the dentistry - and attorneys willing to pursue possible litigation. Dental boards and attorneys are busier than ever investigating these full-mouth cosmetic cases gone wrong.

Liability attorneys have long held the spotlight as the overly advertised professional, practically owning daytime television. Plastic surgeons are arguably second on that list, with cosmetic dentists quickly closing the gap. I certainly understand the competitive nature of our profession, and I applaud every dentist doing all he or she can to build a successful practice. What I fear is the public's perception of a potential down-classing of our profession.

On one hand, it is refreshing to see the diversity in advertising ranging from one office offering a routine "pulling" for $30 all the way to that other office with the snazzy $5,000 full-page magazine ad offering the "Hollywood smile." Such disparity is healthy and allows us to separate ourselves from one another with unique services and individuality. On the other hand, we are in danger of giving people a bad taste in their mouths by not delivering what we proclaim we can. What makes an extraction routine, and what if bleached-white cookie-cutter teeth do not match the patient's expectations of a "Hollywood smile?" It only takes a couple of botched cosmetic makeovers to cast doubt about our profession and integrity.

What makes any dentist a "cosmetic" or "reconstructive" dentist? Is it years of additional hands-on training, or specialized postgraduate work? Is it sitting in lecture auditoriums listening to countless other dentists demonstrate how to perform such advanced dentistry? Or, is it just a lot of practice? Perhaps it is all of these. It won't come from hoping you can live up to your ad. And it certainly does not come from a weekend course.

It is important that we consign the same professional integrity and care on cosmetic work as we do on everyday restorative dentistry. Although most of the aesthetic cases are elective, they are no less important than any other health-care service we provide as doctors. Should we flood the high-style magazines and commercial spots with "makeover" promises, or should we try to maintain the decorum that has placed us high on the Most Trusted list for many years? Should we create more monikers to attach to our profession in order to convince potential patients that only "specialized" practices can provide their care, or should we raise the bar on our advertising methods and focus on providing excellent care and goodwill? Perhaps the "sedation dentists" can answer that question.

Dr. Griffin Cole maintains a private practice in Austin, Texas. He graduated from the University of Texas Health Science Center at San Antonio in 1993. Dr. Cole currently lectures on practice management and growth concepts. He may be reached at (512)472-3565, or at griffincole@yahoo.com

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