The choices are...

Giving patients treatment options can make the difference between a successful practice and a struggling one.

Ronald D. Jackson, DDS, FAACD

I know that veneers are the razzle-dazzle of esthetic dentistry, but esthetic alternatives to the zillions of failing amalgams are the everyday, bread-and-butter, esthetic procedures. I`m referring to the posterior direct-resin restorations, and esthetic inlays and onlays. Some dentists are quick to say that, since those procedures cost more and many insurance companies deny payment for them, their patients won`t have them done.

People given the choice when buying a car, I believe would choose electric windows over wind-up windows, electric seats over manually adjusted ones, quadraphonic sound over regular sound, etc. No third-party offers payment for these options either. So why, then, are patients frequently offered only amalgams? Why do so many dentists assume that`s what everyone wants?

Do you remember the presidential campaign slogan: "It`s the economy, stupid." Well, in our society today, "it`s value and choice, stupid." In fact, patients have the moral right to be able to choose bonded, sealed, tooth-reinforcing esthetic restorations that allow more conservative preparation if that aligns with their values.

Although some patients today become aware of these procedures by reading magazines, most are not aware of these options. They rely on their dentist or the dental staff for advice. If, after being offered the best in terms they can understand, patients still choose the cheapest treatment that their plan will pay for, then fine. They`ve made their value decision. However, you also have a value choice to make. If placing amalgams are economically sound and you feel good about the service being provided, then great. There`s a match, and you and the patient will have a good, long-term relationship. If amalgams aren`t economically sound for your practice or if performing this service doesn`t give you fulfillment, refer the patient. Some practitioners are comfortable doing all different levels of procedures and that also is OK.

There is no categorically right or wrong answer here. However, there is a right or wrong answer for you. When you are providing services that you enjoy doing, for people you like, and these procedures are economically rewarding, then, in my opinion, that?s the definition of success and a thriving practice will be the result.

Constantly compromising your own value or trying to bully the patients into changing theirs will not lead to success and happiness. A struggling practice and a desire to retire as soon as possible usually are the results.

So, the next time you diagnose a failed amalgam, think of the car dealer who merely asks, ODo you want electric windows or manual, Mrs. Jones?O

Offer your patients the best. At the very least, everyone deserves the choice. It?s the American way.