Promoting metal-free restorations

Nov. 1, 2004
My husband, Dr. John Jameson, and I recently had the privilege of being invited to lecture for and with Dr. Gordon Christensen at the Academy of LDS Dentists' Conference in Provo, Utah.

Cathy Jameson, PhD

My husband, Dr. John Jameson, and I recently had the privilege of being invited to lecture for and with Dr. Gordon Christensen at the Academy of LDS Dentists' Conference in Provo, Utah. During one of Dr. Christensen's thorough and thought-provoking presentations, he stated that he believes that metal restorations are on the way out. He referred to appropriate research on the subject, much of it relating to the allergic reactions to metal that so many people have.

No doubt you have studied the literature, the research, and the opinions regarding metal-free restorations. You may have decided to establish — or you may be committed to maintaining — a metal-free practice. If you have made that decision, you now may be wondering how to address your decision to your patients.

What follows are some suggested ways to educate your patients about your decision:

1) Have team meetings to provide appropriate education to all team members so that they are clear and comfortable with your decision.

2) Practice the verbal and communication skills necessary to not only present the decision to your patients, but also to handle any questions and/or objections presented. Think of all the possible objections that a patient might present to you and come to a consensus agreement on how you will answer them. Do some practice exercises to make sure that everyone on the team is comfortable. It is better to prepare with each other than to prepare (and possibly mess up) with patients.

Over time, revisit this subject at upcoming team meetings. If anyone expresses questions or concerns that have not been discussed by the team, bring these up at future meetings and work on those issues.

3) Read professionally-written articles on the subject or write an article(s) yourself. They should serve as the scientifically-oriented information to explain the research. Make sure the articles are patient-friendly and appropriately documented.

4) Write another article or personalized letter to explain your decision. Make sure you present your decision in a way that not only outlines your personal motivation, but also outlines the benefits of your decision to the patients themselves. Remember, all behavior is driven by "What's in this for me?" Your patients are going to want to know what the end results or benefits of this decision will have on their health, their well-being, and their pocketbook.

5) Make sure you explain the metal-free aspect of your care when you consult with your patients about any necessary treatment.

6); Prepare before and after photographs, intraoral camera images, or digital images of metal restorations versus metal-free restorations. Most of you probably have had patients tell you about a situation where an allergic reaction to metal has impacted the gum tissue, led to recession, or contributed to other gingival problems. Hopefully, you are taking before and after photographs of all your cases. More than likely, you will have photographs of problematic situations. Show these to patients and discuss both the benefits and risks of metal-free restorations.

7) Discuss the differences in your fees for metal and nonmetal restorations. You may charge more for nonmetal procedures than for metal ones. If so, you need to discuss the difference in your fees with your patients. Stress that you feel strongly that you are providing the very best in long-term, total health care. If you do, most will understand the fee difference. You can make a stronger case by showing them visual documentation to support your decision. This will help them understand the reason for the change in the procedure and the fee.

8) Provide comfortable financing for your patients' treatment. Offer them what you consider to be the best possible treatment option, and make the financing as easy as possible. Then, get out of the way and let the patient have a chance to say "yes" to the very best.

If you have established and maintained excellent relationships with your patients and they know that your decisions are always based on your commitment to quality care, they will trust you and have confidence in you to do what is best for them.

Dr. Cathy Jameson is president and CEO of Jameson Management, Inc., an international dental practice-management consulting, lecturing, seminar, and product provider. An accomplished speaker, writer, and workshop leader, Cathy earned a doctorate in organizational psychology, focusing her studies on effective stress-controlled management. Cathy's books, Great Communication = Great Production and Collect What You Produce are top sellers for PennWell Books. You may reach her toll-free at (877) 369-5558, email her at [email protected], or visit her Web site at

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