In the 1980s, the emergence of composites created an entirely new field of esthetic dentistry that allowed dentists to begin providing a broad scope of elective procedures for smile enhancement. Whether we are referring to bonding, porcelain laminate veneers or dental implants, dentistry now has an entire discipline based on patient desire rather than specific need.
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THE CHALLENGE OF ESTHETIC, ELECTIVE DENTISTRY
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This paradigm shift is not an easy one for dentists to comprehend fully. For one thing, there is no model from the medical field that can be emulated directly. Unlike medicine, in which 80 percent of physicians are specialists, we do not have specialists in certain areas of elective dentistry. In medicine, there are specific specialties dedicated to fields such as facial plastic surgery and breast implants. While several specialties may participate in any one procedure, most internal medicine or family practice physicians will not be providing these services.
In dentistry, the role of the general practitioner is different. The general dentist not only is the first line of diagnosis, but he or she often treats a broad array of need-based and elective procedures as well. Most esthetic dental treatment, for example, is provided by general dentists who were trained to diagnose and treat need, but now have the added responsibility of being proficient in other treatment areas that are of interest to patients. A majority of dentists have experience with a whitening, bonding or porcelain laminate veneer esthetic-only case, whether it is matching the color of a single tooth or placing six anterior porcelain laminate veneers.
The general dentist not only is the first line of diagnosis, but he or she often treats a broad array of need-based and elective procedures as well.
Despite the exposure to esthetic and elective procedures, most dentists still are focused on specifically needed procedures. While the line between what patients want and need sometimes is blurred, the truth is that most dentists are trained primarily to provide for need-based procedures.
In addition to clinical excellence, a dentist’s training includes patient education and communication. Dentists who believe that this training transfers easily to esthetic and elective services are in for something of a shock. Being able to educate and communicate with patients concerning need-based procedures is not a guarantee that these skills will translate into successful case presentation for elective services. Although most dentists have received some level of clinical training in elective procedures, education and communication skills need to be honed.
In need-based dentistry, patients understand when they have a need, owing to visual identification of a problem, discomfort of some type or radiographic evidence. On the other hand, the decision to pursue elective dentistry largely is due to emotion. If an esthetic case presentation does not strike an emotional chord with the patient, it is unlikely he or she will accept the treatment.
Technology is a key way to help patients understand procedures and see the benefits that can be obtained from treatment. Dentists who are not greatly involved in esthetic and elective procedures may have difficulty fully appreciating the need for technological assistance because it typically is less critical in their need-based dental procedures. However, intraoral cameras, software education and even high-end models all have been incorporated successfully in case presentations so that patients can better appreciate esthetic and elective services.
Today, dentistry is undergoing an evolution. New materials and products have advanced the dental profession far beyond dentistry in my father’s and grandfather’s days. However, the next step is for dentists to understand that the education and communication must advance as well. While plastic surgeons in the medical field have used their motivational skills with patients to create a huge demand for their clinical skills, general dentists’ use of patient education and communication still is evolving. With so many areas of responsibility, it is no surprise that dentists’ ability to shift gears in this area has been gradual.
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SUMMARY
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Many dentists would like to increase the number of esthetic and elective procedures they perform. What may be holding them back is the ability to communicate with, educate and motivate patients in the area of esthetic and elective dentistry. While implants, esthetic dentistry or elective dentistry is not for every patient, each of these areas has improved the quality of many people’s lives, allowing the dental profession to continue to serve the public in the broadest possible way
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THE CHALLENGE OF ESTHETIC,...
SUMMARY
