Treatment planning for success in the esthetic practice

• Published in: Oral health Vol. 91; no. 4; p. 27
• Main Author: Narcisi, Edward
• Format: Magazine Article
• Language: English
• Published: Montréal Newcom Media Inc 01.04.2001
• Subjects: Cosmetic dentistry
• ISSN: 0030-4204

Several practice experiences need to occur prior to the treatment-planning phase. First and for most, the patient needs to present themselves to the practice. This occurs subsequent to either a referral (patient referred or professionally referred) or a stimulated external marketing effort (phonebook or advertising piece etc...). Once contact has been made the patient is typically scheduled for a consultation appointment. Please do not under-estimate the importance of this visit. The introduction to the practice and the consultation are essential foundation builders for the up coming diagnosis and treatment planning components. It is not the intent of this article to explore the fine details of the consultation process; however, certain principles should be referenced to understand the dynamics that are responsible in building the momentum of patient management in the esthetic practice. The consultation is intended to introduce the patient to the practice and vice verse. The dental professional "gets to know the patient" at this appointment. Through simple conversation and listening skills the dentist gains insight to the patient's personality and background, call it a basic personal profile. This conversation easily allows for the segue into the patient's dental interests-- chief complaints, esthetic concerns, previous experiences, expectations, perceptions, attitudes and degree of motivation. Equally important, and so often underestimated, is the process of the patient "getting to know the dentist". The patient starts to generate an impression as early as the first telephone conversation. The consultation process, however, is when the patient starts to critically evaluate the practice and in particular the doctor. The facility, staff and doctor are all critiqued on appearance and personality. The mood has to be warm, friendly, and efficient. The doctor has to exude confidence and enthusiasm. The confidence and enthusiasm will begin to positively impact the patient, allowing the patient to relax and be more able to assimilate and comprehend the subject of their visit. Every dentist should give intent thought in treatment planning to maximize the esthetic outcome of the case. Smile design plays a significant role in the planning process. Each element of smile design should be carefully evaluated and included in the planning process. Modality selection as well as material selection is paramount to achieving the best esthetic out-come. When should all-ceramic and resin materials be used, or would more traditional porcelain fused to metal or gold modalities serve the case better? Laboratory selection, cost and time need to enter the treatment equation. Will the case warrant a diagnostic wax-up, surgical stents, lab processed provisionals, occlusal splints, implant parts, attachments, or treatment partial dentures. Realizing that each of these tools impacts the cost of the case. Scheduling efficiency becomes a serious process in both patient management as well as practice financial management. The patient needs to understand clearly the time involved in treatment whether it's two visits or two years. The clinician has to realistically, and as carefully as possible, determine the intended goals for each clinical session. If the case takes a significantly greater amount of clinical time the economics of the practice will suffer.