Cosmetic dentistry is no longer the wave of the future. In fact, cosmetic dental procedures are the foundation of many practices. Patients’ increasing desire for a whiter, more esthetically pleasing smile has been a driving force in what is now a $40 billion industry. A 2004 study found that the request for cosmetic treatments such as whitening, implants, and veneers increased an average of 12.5 percent over five years, with some practices reaching as much as a 40 percent increase. So what does this mean for prosthodontics? While implants may be an option for a percentage of your patients, dentures still represent a viable solution for many patients. Many patients do not have the necessary insurance coverage or cannot afford the procedure, while others may simply prefer dentures over invasive implant procedures. There currently is a huge market for those who just want new, better-looking dentures. These facts, along with the aging Baby Boomer generation, are a few of the reasons dentures continue to have relevance to your practice.
Figure 1 - Notice how the new denture fills out the buccal corridors and increases the vertical dimension to slenderize the facial appearance.
But let’s talk business. This article will detail how providing denture-related services can be a profitable addition to your practice and discuss why these procedures should be viewed as part of your practice’s complete cosmetic dentistry offering. Beyond cosmetics, this article will highlight the importance of educating denture patients about visiting an oral health-care provider at least once or twice a year to ensure cleanliness, fit, and function. Finally, this article addresses building business with denture patients through recurring treatments such as cleanings, relining, repairs, and oral cancer screenings.
Dentures as cosmetic dentistry?
Cosmetic dentistry is often discussed in terms of implants, veneers, and whitening treatments. However, both partial and full dentures should be included in the cosmetics category as well. While dentures typically address function rather than esthetics, they provide improvements in physical appearance that often go well beyond just repairing a patient’s smile. Dentures often assist in smoothing out facial wrinkles and filling out sunken cheeks, both of which can greatly enhance a patient’s appearance and self-esteem (Figure 1).
Cosmetic dentistry is on the rise, and along with it, better oral care. Cosmetic dentistry expert Dr. William Dorfman recently noted that when whitening procedures became popular, it didn’t just increase whitening procedure occasions, but also cleanings and preventive treatments. Thinking about denture patients’ general health and cosmetic needs will ensure you are not only providing the most comprehensive treatment, but also increasing your profitability in each area. Financially speaking, patients with a variety of oral health needs are spending more per visit - some nearly $400 per visit. At this rate, if you practiced 20 days per month and treated eight patients per day, your revenue could approach $800,000!
So should dentures be considered part of the cosmetic sector simply because of the price point? Certainly not. Technology allows for modern dentures to be just as esthetically pleasing as implants, veneers, or real teeth. And, by involving your patient in the entire denture-making process, you can ensure the patient is comfortable with his or her new teeth and excited about the improvements to his or her appearance. Surveys indicate that patients are interested in setting the parameters for optimal tooth color, shape, and positioning. When introducing dentures as a treatment option, the patient should be empowered to provide input on these variables. For example, a recent denture trends survey noted that denture labs reported increased requests for lighter shades of dentures. It is clear the growing desire for whiter teeth does not reside only with those who have retained their natural teeth. Keep in mind that doing a smile-makeover on a denture patient requires more work and “try-ins,” and your fees should be revamped accordingly.
Regular visits make a difference
Denture patients need regular dental visits! Although this is not news to practitioners, it may be a surprise to your denture patients. Studies indicate that the majority of denture wearers are failing to keep their dentures clean. Educating your patients about how to care for their dentures is critical to both their oral and systemic health.
Not surprisingly, proper care includes regular professional cleanings. When a denture patient visits for a cleaning, dentures may be examined for proper fit, function, and alignment. If regular use, wear, or some type of accident has damaged the denture, repairs and relining may be necessary. Just today, as I’m finishing this article, a patient who I placed immediate dentures on 28 years ago came in and said that after I ground on his lowers and he healed, the denture was a little loose! He then said they have been getting worse for 15 years! This is an example of a patient not receiving proper education.
In addition to professional cleanings, we also like to do an oral cancer screening, which can be performed in just a few minutes. This is appropriate and is something all patients (particularly those over 40) should receive regularly. With regular visits, your denture patients can be profitable for your practice.
Along with professional cleanings, at-home treatments are an essential element in denture cleanliness. Recommending daily brushing along with the use of effervescent treatments (such as Polident, which I use in my practice) can assist patients in preventing the build-up of odor-causing bacteria. A new patient I saw today had been soaking her dentures in plain water! They were covered in tartar and stain. A few years back, one of my patients soaked her brand new beautiful partials in Clorox! The metal was etched so badly, I had to polish them for a long time and never got all the etching out! We prefer to send them home with a nice denture case, Polident, and instructions about what not to use when cleaning dentures.
Talking to your patients about the importance of proper oral hygiene helps them feel more comfortable with their treatment plan. In addition, they may be more likely to comply with recommended at-home care. Particularly with edentulous patients, daily homecare is essential. Your patients know you and your staff are busy, but taking 10 to 15 minutes to educate them about necessary daily care is a valuable investment in retaining him or her as a satisfied patient. If treated properly, a denture patient can become a patient for life. In addition to follow-up visits, patients may require replacement dentures several times during their lifetime. While dentures last an average of five to 10 years, a patient who first transitions to dentures at age 55 would likely need a new set by age 60 to 65.
The financial benefit of providing quality denture care is an important consideration, and may not be top of mind for many practitioners. As alternative prosthodontic procedures continue to grow in popularity, it is important to keep in mind that dentures are a viable option for many patients and a smart addition to general and cosmetic practices alike. We must also keep in mind that as dentists we are not only health-care providers, but also business owners. Finding new ways to promote our practices - such as offering additional services - is vital to continued business growth.
Editor’s Note: References available upon request
Dr. Ronald E. Groba operates a private practice in Friendswood, Texas, specializing in smile makeovers. He graduated from the University of Texas Dental Branch in 1974 with honors in prosthodontics and periodontics. He has been a practicing dentist for more than 30 years, and has lectured internationally on all aspects of smile makeovers - from bleaching to full cosmetic veneers. Dr. Groba can be contacted through his Web site, www.smileshouston.com.
Denture Usage Projected to Rise
Despite improved oral hygiene in past decades, the total number of patients requiring complete dentures is rising. This increased demand can be partly explained by demographics. Consider the following:
- In 2000, 12.4 percent of the U.S. population was over age 65. This figure will increase to 16 percent by 2020 and 21 percent by 2050.
- According to the Centers for Disease Control, 33.6 million individuals needed one or two complete dentures in 1991. In 2020, this number is expected to reach 37.9 million.
- Thirty percent of Americans aged 65 and over are edentulous.
A rising elderly population isn’t the only reason for the increase in denture cases. Compared to their predecessors, today’s older Americans have a markedly different perspective on aging. In the quest to look younger, they are requesting dentures for esthetic as well as functional reasons. Esthetic benefits of dentures include:
- Filling out sunken cheeks
- Reducing the appearance of wrinkles
- Allowing patients to select tooth shade, shape and positioning
As the baby boomer population approaches retirement, dental professionals will be faced with a greater number of older Americans in need of oral care that fits their lifestyle and budget. Professionals who view dentures and denture care products as a future investment, rather than a thing of the past, are poised to build their business and generate additional revenue from this new generation of elderly patients.