Oral Health Group

Developing a Cosmetic/Esthetic Practice

April 2, 2018
by Debra Engelhardt-Nash

With the increase in awareness and popularity of cosmetic dental procedures, most general practices are offering some level of cosmetic and esthetic treatment to patients. There are many possibilities; from teeth whitening to cosmetic bonding and porcelain veneers; as well as minor orthodontic procedures, tissue re-contouring and more. Patient demand has fueled the attention to cosmetic and esthetic dentistry. In many instances, patients are requesting these types of services with little or no provocation from the dental office. In fact, some patients seek cosmetic attention before pursuing important dental health treatment.

It is not a question of whether these procedures should be provided. The question is how does a practice increase opportunities to present this type of care to new patients and patients of record? In order to shift the practice toward a more cosmetic/esthetic focus, new skills must be acquired.


“Whether You Believe You Can or You Can’t – You’re Right”
The basic foundation of increasing cosmetic care is Doctor’s desire to provide this level of treatment in their practice. A shift in mindset might also be required. Thoughts such as, “our patients aren’t interested” or “cosmetic dentistry is only sought by wealthy patients in prominent areas” must be eliminated. Patients of all types, with all socio-economic status are looking to enhance their smiles through cosmetic dentistry. What oftentimes holds a practice back from doing more cosmetic and esthetic treatment is the opinion that “our patients are not interested” or “if insurance doesn’t pay for it, our patients won’t do it”. Patients will never choose your care if it is never offered. How this level of care is being presented is a skill that must be learned.

The doctor must be confident that he/she can deliver the type of treatment results they promise. This may require exploration of treatment possibilities that may be offered to patients and further clinical training to achieve outstanding results. There are many post-graduate training programs to learn cosmetic and esthetic procedures, as well as sponsored education through manufacturers and dental laboratories. Determine what services you wish to offer your patients and seek the appropriate training that will serve them well. Investing in continuing education, new materials and technology may be required to bring the practice up-to-date.

The additional training in the types of cosmetic and esthetic treatment you offer should be highlighted through your social media sources, your patient information packet and in conversations with patients.

“If You Keep On Doing What You’ve Always Done, You’ll Keep On Getting What You’ve Always Got” – Zig Ziglar

The doctor’s clinical pursuit directs team training. With a renewed practice vision and new patient treatment objectives added, the dental team must be re-aligned. The practice culture needs to be re-defined and shared with a discussion of each Team Member’s role.

Howard Schultz, Chairman and CEO of Starbucks writes, “If people relate to the company that they work for, they will form an emotional tie to it, buy into its dreams, and they will pour their hearts into making it better”.

Be certain your team has an opportunity to learn WHY your practice is moving in a cosmetic and esthetic focused direction and help them understand their specific roles in ensuring practice success. The responsibility of the doctor is to encourage and drive the team to achieve. Help them understand that “There is No Try – Only Do” and take time to give each role attention to learn critical patient communication skills and new behaviors.

The team will need to learn about treatment options, and acquire the skills to assist in these new treatment modalities. Involve all team members in training protocols for new procedures so they have an excellent understanding of the benefits of treatment. The more your receptionist and financial coordinator know about the clinical requirements of the services you provide, the better their discussion with patients.

A Facility Consistent with the Care You Provide
Does the appearance of your office reflect the quality of care you seek to provide? Sit in your reception room and look around. When was your last update in paint color and office décor? If everything looks dated or “tired” – it may be sending the wrong message. Visit your patient lavatory to determine if it has esthetic appeal. If your practice is going to tout cosmetic and esthetic procedures, the facility must be congruent. The patient seeking this type of state of the art care will expect a facility that has the look that can suggest the type of care they are seeking will be delivered. A modest update may be all that is required.

Utilizing patient education systems in the reception room and operatories creates patient awareness and generates interest. The patient reviews photo books that illustrate and describes cosmetic procedures during treatment discussion with the team member and/or the doctor. These books are interactive and will incite conversation when they are presented by a team member, rather than left on a table in the reception area. Some offices may alter their reception area to create patient learning opportunities. A children’s entertainment area may be replaced by a cosmetic education center. Generic consumer publications may lose their position to esthetic focused periodicals.

In addition to patient education, dental photography is also an important component in facility décor. Illustrations of beautiful smiles should be prominent in the office to increase awareness and encourage patient interest. The walls of the reception room and operatories are excellent locations to display beautiful smiles. Surrounding patients with examples of cosmetic dentistry puts them in the mood to talk about their own treatment possibilities.

Put Your Best Faces Forward
Most patients are visual learners. Illustrations of doctors’ work and photographs of results of procedures help patients visualize their desired treatment results. Digital photography and image storage has enhanced the efficiency of this technology. It continues to be a critical component of developing a cosmetic practice.

An exceptional way to show the level of cosmetic care the office provides is through team dentistry. The team is given the opportunity to enhance the appearance of their own teeth and smiles through cosmetic treatment. They are live examples of treatment possibilities and in-office testimonials of doctor’s care. In fact, if the doctor wants to talk to patients about cosmetic and esthetic dentistry, he or she should have the level of care being described. In other words, do you “practice what you preach?”

Make the First Seconds Count
With few exceptions, the moment the patient calls your office they have chosen your care. It may have come even sooner. When the patient dials your office number; they have made the decision to seek a change in their dental health or appearance; and they are seeking YOU to make that change. Something inspired that person to call your office TODAY and that reason needs to be discovered. Your patient expects you to take them to a better place in their dental health and appearance. That’s why they called.

The responsibility of the receptionist is to engage the patient and start building a relationship within moments of patient contact. The telephone introduction should welcome the patient to the practice. Asking about insurance coverage and launching into the rules and regulations of scheduling an appointment or providing the list of procedures that will be performed at the first visit does not set the office apart in customer service. Avoid touting the rules and regulations of becoming a patient in your practice. Engage the patient in a conversation about how they learned about the office and the type of care they are pursuing. Let them tell you their story and listen in an unhurried manner. Document what is learned during this call so the entire team is aware of the patient’s motivation for seeking care.

The receptionist has only a few moments to make the right first impression and differentiate your practice from other offices that may provide similar services. What makes your practice exceptional? How is that being described and demonstrated? What does your team appreciate about your training and abilities and chairside manner? This is information critical for patients to hear. Appeal to the human side of doing business with the patient, and when it’s time to review your office standards, such as payment protocols and insurance processes, they will be more accepting and more compliant.

If the patient has to be placed on hold, find out who the caller is and the nature of the call before pressing the “hold” button. Tranquil music and information about the practice helps patients learn more about the office. The recorded message should address the types of cosmetic treatment available in your office. It may also include information about how the patient should expect to be treated. A bit of doctor’s professional background and credentials help patients appreciate the exceptional experience of doctor and team.

At the Chair
Eighty percent of the reason why patients choose your care is based on the relationship that is developed with them. Everyone on the team should be able to provide a brief, personal synopsis of the practice mission or philosophy and endorse the doctor. Let’s face it – most doctors (if any) walk into an operatory and say, “I’m a really good dentist and I’m nice, too!” It is the team that introduces the talents, clinical abilities and caring nature of the doctor to patients.

Whether the practice has a treatment coordinator initiate the new patient experience, or a hygienist or chairside assistant, cosmetic and esthetic treatment and team members should introduce the quality of care provided for all procedures in the office.

When the hygienist seats their recare patient, a conversation about the new procedures being offered in the practice precedes radiographs and prophylaxis or periodontal maintenance. “May I tell you about some of the new procedures we are now offering our patients?” is a good way to introduce new treatment modalities. Another way is to offer this: “So many of our patients have asked about ___________, we are now providing this type of care in our office”.

This conversation happens at the beginning of the visit, not at the end when the patient is ready to go and mechanics of pre-appointing, collecting fees and coordinating insurance diverts patients’ time and attention. Starting with the topic of these procedures allows the patient time to think about what was discussed during their visit.

Once again, avoid the assumption that the patient doesn’t want to hear the information, or is not a candidate for cosmetic or esthetic procedures. They may not be – but they may have friends or family who may be interested. Give your patients something to talk about to their friends.

Appointment times may have to be slightly adjusted to integrate treatment discussion into regularly scheduled visits. It should be treated as a standard and important part of the patient visit, rather than an “add-on” while waiting for the doctor or only when time permits. This is important for the new patient experience in your office as well as the patient recare appointments. Give the patient the time and attention they deserve when you are presenting services that are “above usual and customary”. In other words, if you are going to ask your patients to pay above the usual and customary fees associated with insurance, your practice must behave in “above usual and customary” ways.

Financing Considerations
Financial strain or hardship is not an atmosphere conducive to patients feeling positive about treatment results. Establish a financial protocol that is consistent with the nature of elective treatment. When the patient wants the treatment, they will find a way to pay for it. Outside financial resources are helpful in helping patients afford elective care.

Standard dental insurance coverage usually does not participate in reimbursement at a level that promotes or encourages cosmetic dentistry. A conversation about the level of care for this type of work is important. Instead of seeing insurance restrictions as an unbeatable obstacle to gaining patient treatment acceptance, view it as an opportunity to distinguish services provided.

External Marketing and Social Media
A dental practice should budget 4% to 8% of office overhead to practice development. The doctor should be prepared to allocate the maximum amount to attract patients to the practice. Community exposure about the practice’s special focus provides the potential for the doctor to become a “brand” and be known for his or her cosmetic services.

Ninety-seven percent of the population utilizes the Internet and 85 percent choose their health care providers based on initial exposure through social media markets.

Is it time for a social media tune-up by a professional company? Are important key words related to cosmetic and esthetic dentistry prominent on your web site and social media pages? Do you use a professional company such as Revenue Well, Lighthouse, or Solution Reach to keep your patients informed of your services and treatment advancements?

Consider incorporating testimonials from satisfied patients on your site. Solicit posted reviews to create an exceptional practice image.

If you want a “jump start” on doing more cosmetic and esthetic cases, consider offering complimentary cosmetic consultations to existing patients, which may include photo simulations. Some dentists have this technology in their own office or subscribe to a company that offers digital simulations.

If You Wait for the Perfect Moment, You’ll Wait Forever
Most dental practices already have cosmetic and esthetic patients in their practice ranks. Begin honing your skills right away with your patients of record. If you are waiting for the perfect cosmetic and esthetic patients to walk through your office door, you may be waiting a long time. Create the opportunities as often as possible and soon you will have built a strong cosmetic and esthetic segment in your practice.

Learn the clinical skills required. Create the mindset and the practice culture that will reinforce your desire to provide this level of care to your patients. Update and enhance your practice image. Train the team in advanced patient care protocols and communication skills and establish internal behaviors that set your practice apart. Introduce cosmetic and esthetic treatment to patients routinely. Modify patient appointments and office systems to support your new direction. Review your external marketing strategies to insure they are providing the exposure you desire.
Eliminate outdated bias and objections that prevent you from providing the quality of care that will give you professional satisfaction and increased practice productivity. Become the change you seek and the results will follow.

A Few Suggestions on Communications

  • Telephone shoppers. These aren’t bad people and they may not be shopping for the least expensive office. When they ask you how much you charge for a procedure, reply by saying, “I would be happy to discuss our fees with you. Before I do, may I ask you a few questions?” Find out how the caller chose your office – why did they pick you?
  • Explaining fees. When patients mention that dentistry is expensive, agree.
  • “It is expensive, isn’t it? We base our fees on three things: the skill required to do it well, the time it takes to do it right and the materials we use so your restorations will endure.”
  • Discussing outstanding treatment. Approach the patient by asking, “Tell me what has prevented you from having your treatment completed?”
  • Insurance limitations. “We offer a standard of care that isn’t restricted by the limitations, exceptions or exclusions of any particular plan. We will do our best to help you utilize the dental allowance that has been provided for you.” OH

Oral Health welcomes this original article.

About the Author
Debra Engelhardt-Nash has been in dentistry since the early 80’s and a speaker/consultant for over 30 years. She has presented workshops nationally and internationally for numerous study groups and organizations and has written for a number of dental publications including two oral hygiene magazines. She has been honored twice as author of the year for her contributions to dental journals. Debra is co-founder and instructor for The Nash Institute for Dental Learning, located in Huntersville, NC. Debra is a founding member and served two terms as President of the National Academy of Dental Management Consultants and is the first recipient of the Charles Kidd Meritorious Service Award presented by the ADMC. She is once again their acting President. Debra is also a member of the American Academy of Dental Practice Administration, Speakers Consulting Network and a fellow in the International Academy of Dental Facial Esthetics. Because of her contributions to the industry of dentistry, Debra received the Kay Moser Distinguished Service Award given by the American Dental Assistants Association in 2008. This is her twelfth year being recognized by Dentistry Today as a top consultant and speaker. She is the 2015 recipient of the Chicago Dental Society Gordon Christensen Outstanding Lecturer Recognition Award. She continues to work in the “real world” of dentistry – when she is not consulting or speaking, she is working with an amazing Team in a fee for service practice in the Charlotte area.

Print this page


Have your say:

Your email address will not be published.