Try it — you'll like it!

Aug. 1, 2003
You've spoken to your patient about porcelain veneers and given them brochures about what porcelain veneers are. However, the patient still has one big question: "How will these look on me?

By Louis Malmacher

You've spoken to your patient about porcelain veneers and given them brochures about what porcelain veneers are. However, the patient still has one big question: "How will these look on me? What will my teeth look like with the spaces closed?" If patients could only visualize what their teeth would look like when their dental work was completed, they would be ready to move ahead. Today, there are three good ways to make this happen. One involves high technology, one uses what I call "medium technology," and the third involves low technology.

The high-technology method is simply this — Have a digital image made of the patient with the teeth changed to show what his or her smile will look like with the veneers in place. If you have such a system in your office, you are ready to go with this option. If not, there are a number of services that offer digital-imaging. The advantage is that patients can visualize what they would look like with treatment. The disadvantage is that what patients look like in the digital image you create and what they look like at the conclusion of treatment may or may not match.

The "medium" technology way to do this is with a traditional diagnostic wax-up on study models. The casts are sent to your laboratory, which will then "wax up" the case in white wax. You then show these wax-ups to your patients, who will get a reasonable idea of what they will look like when the work is performed. But, once again, there is still the question of how close the actual dental work will match your wax-up models.

That leaves us with one last technique. The third alternative is a decidedly low-tech approach that is simple and easy to do in every dental office. Indeed, I have used this method for years, and feel it is the most effective way to demonstrate to patients what they can expect after cosmetic treatment.

All of us have what I call the "junk closet." I am sure you have some old composite resin in this closet. Take the lighter shades of composite resin that you are not using on a regular basis, and put them in your treatment room and the hygiene room.

Now, as an example, let's say Mrs. Jones comes in for hygiene and she has a diastema between her two front teeth. You've spoken to her in the past about porcelain veneers and she never really understood what could be accomplished. You take a lighter shade of composite resin and, without any etching or bonding, fill up the diastema between her teeth, shape it so it looks good, and then cure it with a fast curing light. Then, hand her a mirror and her initial reaction will be, "Wow! What happened to the space between my front teeth?"

The next step is probably the most important step in this mock-up process. While the patient is watching in the mirror, you pop off the little mock-up so that he or she goes from a closed space back to the original open space.

We have found this to be a very powerful tool in motivating patients to accept treatment. The in-mouth diagnostic mock-up is an invaluable teaching lesson for you, too. When you do the actual final case, you can incorporate some of the lessons that you learned from the mock-up.

Spending just a few extra minutes doing an in-mouth mock-up will go a long way toward achieving patient acceptance of cosmetic services. A bonus to all this is that patients appreciate the attention and extra special service.

Let your patients try it on .... you know they will like it!

Dr. Louis Malcmacher is an international lecturer and author, known for hiscomprehensive and entertaining style.An evaluator for Clinical Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For close to two decades, Dr. Malcmacher has inspired his audiences to truly enjoy practicing dentistry by providing the knowledge necessary for excellent clinical and practice-management skills. His group dental practice has maintained a 45 percent overhead since 1988.For details about his speaking schedule, Dr. Malcmacher can be reached at (440) 892-1810 or via email at [email protected].

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