The Transformation Test Drive: How to Increase Your Cosmetic Case Acceptance

Dentistry Today


If you’re interested in increasing the number of cosmetic cases you’re currently treating, bear this in mind. The next time you have a patient that is considering changing his or her smile, look for the opportunity to do a “transformation test drive.”

I have a friend who was interested in purchasing a luxury sports car, but wasn’t sure if the timing was right. So, he decided to visit the local dealership, do some research, and investigate his options. After a brief interview in a first-class environment, the well-dressed, professional salesperson simply tossed my friend the keys to a $65,000 sports car. He invited him to drive the car over the weekend and said he would call on Monday or Tuesday either to pick up the car or to have the paperwork ready to sign.

What do you think happened? Of course, he bought the car. But the more important question is why. Why is it that salespeople know if you take the car home the sale is virtually closed? First, they know if you spend enough time behind the wheel, you begin to realize that you deserve a car like this and you’re worth it. Secondly, the spouse and the kids love it. How could you possibly disappoint them after seeing their excitement? Also, comments of “you look good in that” and “it’s really you” offered by your friends and colleagues further affirm your decision. And, don’t forget that haunting thought of having to crawl back behind the wheel of the old car. It is no longer a question of whether or not you want to purchase it, it’s a question of how to make it work. From here, it’s just a matter of making comfortable financial arrangements.

I already know what you’re thinking…the last thing we want to be compared to is a car salesman. It’s virtually every dentist’s and staff’s biggest fear in case presentation. But I think there’s something to be learned here. As a matter of fact, other businesses have incorporated this technique into their daily practices.

My wife shopped at a nice furniture store and made an appointment for the designer to visit our house. After surveying the room for which we bought 2 chairs, the designer asked if the store could send out a few items with the furniture. She assured us we could keep them a couple of weeks, and the store would send the truck back to pick up the items. Nothing was returned, and we ended up with additional end tables, a coffee table, and even a magazine rack.

In sales, they have a name for this. It’s called the “puppy dog” close; if you send the puppy home from the pet store, it’s not coming back. Wouldn’t it be nice if our patients could actually test drive a smile transformation? The patient would have a chance to feel the life-changing benefits: an increase in self-esteem, experiencing the excitement of their family and friends, and knowing that they don’t have to crawl back behind that old smile.

Obviously, digital enhancement of a patient’s smile is a powerful visual tool, but often there is a better response to the physical enhancement of a chairside mock-up. The patient’s biggest disappointment at the mock-up is always when he or she is informed that we are unable to leave the composite on the teeth. Patients want to show others how great their teeth look.

My favorite part of the mock-up is to hand the patient a mirror in order for them to observe the removal of the composite. It still amazes me how accustomed our eyes get to the mock-up in just a few short minutes, and how drastic the contrast is between the patient’s mock-up smile and the old smile.

We’re excited that we now have a method that addresses these shortcomings of the mock-up. We begin by taking photographs and impressions and then reappointing the patient for a consultation. Our photos are limited to a full facial shot and a smile. We use one model for the wax-up and keep the other for the original. The wax-up is completed, and a stint is made extending several teeth on each side of the waxed teeth.

At the consultation, the photographs are displayed as well as the before and after models. After discussing the smile analysis and having the patient physically handle the models and photos, we inform them that we have an exciting method of previewing the final result.

We recline the patient, place a separating medium on the anterior teeth and express temporary material into the stint, and firmly hold the stint in place for 2 minutes. Upon removing the stint, the acrylic either comes out with the stint or is carefully removed from the teeth. It requires minimal trimming that is accomplished in 2 to 3 minutes. The acrylic can now be placed back into the mouth, and if the shade is correct, will “disappear” once fully seated. The transformation has begun—physically and psychologically.

We purposefully leave it in several minutes while we discuss the benefits of treatment and have the patient watch in the mirror as we remove the acrylic. Just as in the mock-up, the contrast is extreme. Now the patient has something they can take with them to show friends and family and receive encouragement to follow through with treatment.



An aesthetic-conscious team will look for opportunities to perform these transformation test drives, for they are laced throughout our daily schedule. Do this, and your patients and your practice will never be the same.


Dr. McKamie is a professional speaker for Pinnacle Practices, one of the largest in-office dental consulting firms in the Southwest, located in Dallas. He has had a private dental practice for more than 21 years in Bethany, Okla, specializing in advanced aesthetic and restorative dentistry. He has studied at the Las Vegas Institute and the Pankey Institute as well as with Dr. Pete Dawson. He has worked as a part-time clinical instructor at the University of Oklahoma College of Dentistry and is a member of the American Dental Association, Oklahoma Dental Association, and American Academy of Cosmetic Dentistry. He can be reached at (405) 789-7893 or