Getting great cosmetic results with your dentistry often means expanding your patients vision, so that they are able to see the bigger picture and choose a more comprehensive treatment plan.
Your patient asks you, “what can be done about this ugly crown? I had it done 22-25 years ago, by the best dentist on Harley Street, but its starting to look tired… Can we change this?
Obviously, the answer is yes. If you can do a crown, then you can do this.
Let me walk you through the thought process with this case, and show you why this patient increased his treatment plan by almost 5X.
Understand The Problem
Quite often when your patient is asking you to sort out one tooth, you need to have a conversation about the smile as a whole.
Often there are other teeth that are contributing to the "disharmony" of the smile, and the patient is focussed on the one, most obvious tooth.
In this case, we decised to do the front 4 teeth, but there is something that needs addressing before we can do anything.
Something that will put you in jail if you ignore (not literally)
The Gums.
Before any cosmetics, we need to get to perfect health.
So that's what we did. Stage 1 was to replace the ugly Crown (which has a massive overhang), to a temporary crown, then it was off to the periodontist to sort the gums out!
This is what it looks like with the gums healthy... and big black triangles that have developed.
Imagine if we didn't take photos, and the patient blamed us for these!? If you have pre op photos, its a lot easier to explain to the patient (again) that they had gum disease, and this is to be expected.
Its a good thing we agreed on 4 restorations before the gum work!
Stage 2 is to prepare the teeth and take lots of photos
These photos are so important because it lets your lab see the colour difference in the stumps.
We are using a stump shade guide here, this accurately allows the lab to choose the correct porcelains to compensate to the shade of the stump.
Next, upload everything to Dental Notebox, and make sure you are connected with your dental lab.
Then click send, and you’re done.
Dental labs are like dental practices, the vast majority are NHS, and say that they do cosmetics. But in reality, they are winging it a little, to do the highly cosmetic stuff means that they need to invest in a lot of tech and get a lot of practice with clinicians that do a lot of this high demanding stuff.
In reality it will take time for dentists to grow into that person who gets amazing results for their patients all the time.
The same is true for labs… So in short, use one who has an excellent track record – they will be more expensive – but you want someone who takes you seriously when you are asking for a certain level of tooth texture and want to curve the distal incisal edge a little more!
Make Excellent Temps
With anything cosmetic, I would suggest making temps (either from a waxup or freehand) to let the patient approve the look.
Once this is done, you can take a scan, or detailed impression of the temps, and this will be the template for the lab to copy.
The Fit
At this stage, you have done all the hard work.
Your lab (who is good at aesthetics), will have copied your temps - all you need to do is fit them in position!
Yes, they are a little white, the patient was expecting this, and is whitening the rest of the teeth after the fit.
Undoubtedly, taking good photos of the stages will let you get a better result.
In addition, you can use these photos in the future to “tell the story” of this case, if its to another patient in your chair, or used for online marketing.
If you are serious about improving the quality of your dentistry, and photography – do the online photography course, and get someone to help you and guide you on your next steps.
We have several online courses to help you with increasing your volume of cosmetic dentistry, and you can access them all for a monthly fee of about £200, and you can cancel whenever you want.
You can find out more about them here.
In addition you will get regular video updates from me, where we talk about business skills, marketing, and anything that my students are struggling with.
Just click the link below to look at the easiest and quickest way that you can progress to being a top cosmetic dentist.
If you want to increase the amount of cosmetic care you provide, see more complex cases, and enjoy more free time while stressing less about your income click the button below. Our mentoring programme is designed to give you the tools you need to built a successful list of patients.
