For those practitioners providing services in elective cosmetic dentistry, the subject of consultation fees for a new patient of record for their initial office visit is a hot issue. Some seem to suggest that free consultations are an indication of low self-esteem by our profession. I suggest the reality of the situation is not so clear cut.
Organized dentistry has not done a great job of educating the general public as to what elective cosmetic procedures are available in dentistry or the positive impact these procedures can have on a person’s life. Our focus has been on promoting preventive measures and probably rightly so. We are only recently aware that the ‘bonding’ technology of the last 15 years is predictable in its longevity. We can now successfully mimic the natural tooth while conserving tooth structure. A specialty of cosmetic dentistry may be emerging, but as it is not yet recognized in Canada as a separate entity, it has no way to set standards within the profession and has no organized voice to inform the public in what it can offer. Where does the lay public go to get topical information on this subject?
Many of us have access to the World Wide Web but the traditional printed material is still more ‘user-friendly’ for people. A search of the keywords ‘cosmetic surgery’ at the Internet-based bookstore, Amazon.com produced 225 books for sale on the subject. A similar search of ‘cosmetic dentistry’ produced four titles; two of which are no longer available, one is a procedure manual aimed at dental professionals and the other a glossary of terms for journalists. The best information available to most people comes from the office of the family dental practitioner. If that practitioner does not offer cosmetic services, there are few other places to turn. Indeed, according to Levin,1 a poll of practitioners across the United States indicate that on average, only about seven percent of their billings are from elective services. He suggests that we need to educate the public patient by patient.
As the interested cosmetic patient has limited resources to refer to for information, I advocate a complimentary ‘screening’ exam. My staff are trained to take intraoral photographs of these patients and to show them before and after photographs in order to begin a dialogue as to their wants and needs. I feel this is an important step as it educates the new patient as to what services are available. Unlike our medical counterparts, we may not promote ourselves as ‘specialists’ in this field but the new patient needs to feel we can meet their expectations of treatment.
I then take a cursory look in order to triage those patients who may not be good candidates for cosmetic procedures and the reasons why they may not be are explained (i.e. half of my ‘screened’ patients go on to orthodontic referral). Those patients who may benefit from cosmetic services are invited to book for comprehensive diagnostic records for which they are charged a fee. Only after these records are gathered and studied are case fees discussed.
When we are successful in providing a patient with a beautiful result, we rely on word of mouth referral of their friends who might be interested in the same treatment. Still, the average referral has little information other than the result that their friend presents with. Until organized dentistry provides the public more widespread information as to the choices in elective dental procedures available, it is up to the general practitioner to educate our patients one by one.
1.Levin,RP. Increasing Patient Cosmetic Motivation. JCD vol 16. No.3. p.45-47.