How to Offer Patients the Best Elective Cosmetic Dentistry



Harvey Silverman, DMD

How many patients do you and your hygienist see in a day? Ten, 15, more—whatever that number happens to be, stop right now and count how many elective cosmetic cases you did yesterday. Be honest. Was it one? Two? Three? Or none.

If you are like many dentists, the answer may sadly be none. I recently gave a presentation to a dental society and asked the dentists in attendance to let me know how many cosmetic cases they did for the entire week. I started with zero and to my surprise every dentist in the room raised their hand. No one had done a single elective cosmetic dentistry case. That’s when I knew it was time to roll up my sleeves and get to work.

Elective cosmetic dentistry is one of the few opportunities where dentists can use their artistic talents to create beautiful smiles patients choose to treat. Today nearly every dentist performs elective cosmetic dentistry. Some of us do more cosmetic dentistry than others, but it is rare to find a dentist who does not enjoy offering cosmetic services to their patients.

The reason why elective cosmetic dentistry continues to be in great demand is apparent. Cosmetic dentistry taps into our creative skills, it is actually enjoyable to do and benefits patients with solutions to problems that may have had a negative psychological impact on their life. In contrast to many functional restorative services, patients typically look forward to their cosmetic dentistry appointments.

How To Develop New Diagnostic Skills

As patients seek more affordable, less complicated ways to revitalize their smile, dentists are looking for professional, ethical management systems to fill that need. Team members also want to function as an integral member and be more effective when discussing cosmetic dentistry with patients.

However, many members of the dental profession feel uncomfortable doing internal marketing for cosmetic dentistry. Dentists and team members often worry how to bring up cosmetic treatment options without offending their patient. Other dentists have a challenge diagnosing cosmetic dental needs. It’s not always so obvious as determining dental decay or periodontal disease. The good news is that it’s not difficult to do once you make a minor mindset adjustment and incorporate the following suggestion in your daily routine.

Here’s the solution to this problem: first, if you are in your office right now, grab a copy of your health history form. Go ahead and bring back a copy. If you are not in your office, do it first thing tomorrow morning.

Now review the form and find the section where you ask patients to provide you with input about their cosmetic dental needs. If you are like many of your colleagues, your form probably includes a section that says something as follows: “Do you like the appearance of your teeth? ___Yes ___No. If no, please explain________”

Here’s the problem with that format: patients don’t always feel comfortable admitting to vanity concerns. Want proof? Just think of the song, You’re So Vain. People do not want to be thought of as being vain and often shy away from admitting that they have any vanity concerns. Just the same, the beauty industry sells billions of dollars in cosmetics every year based upon consumer vanity concerns and the desire to feel more self-confident about their appearance.

Through years of experience as a coach to cosmetic dentists I have observed that while patients do not always want to admit vanity concerns, nearly every patient wants to have a radiant, self-confident smile. So the question is how do you help your patients confide in you about their cosmetic dental concerns without feeling vain or self-conscious?

Clinical dilemma: should you address cosmetic issues you observe with your patient?  If so, how do you maintain professionalism and approach your patient about cosmetic changes that are possible?

The solution: allow your patients an opportunity to feel comfortable sharing any dental enhancements they would like to have done. Sounds simple enough. But from being in the trenches every day, you already know that it isn’t this simple.

In the next edition of Silverman On Smiles: Cosmetic Dentistry SOS I will share with you a simple form to help you provide one additional elective cosmetic case each day. This is the same form used when I do on-site coaching to help dentists expand their cosmetic dentistry practice—it will cost you nothing and best of all it works! Until then feel free to let me know if you have any questions or if I can help you take your cosmetic practice to the next level.

Dr. Silverman has been successfully coaching dentists on how to expand their cosmetic dentistry practice since 1984. If you want to take your cosmetic practice to the next level or want more information about the Silverman Institute’s 24 Hour Cosmetic Transformation Program, please contact him at (216) 256-4599 or e-mail him at