Most dentists want to do more comprehensive or cosmetic dentistry but hit barriers that stop them from reaching their potential. 

The most common barriers include thoughts like:

  • “my insurance won’t cover this”
  • “I don’t have the skills”
  • “I hesitate to present these types of cases”
  • “my staff won’t discuss this type of dentistry”
  • “my patients can’t afford this”
  • “my patients won’t want this”

And so on.

But when you really think about it, these aren’t barriers; these are excuses that you or your patients use because they, or you, don’t see the true benefits of this type of dentistry.  And let’s face it, when you hear “no” over and over and over again, you become just a little bit frustrated, and tired of trying to talk about a more comprehensive approach.  So you settle for the “crown of the year” presentation because you know at least that will be accepted. 

What many dentists don’t realize, however, is that when you hesitate to present comprehensive treatment to your patients, that creates a chain reaction in your staff.  When you start to hesitate, when you stop to present these types of cases, your staff will stop talking about them as well.  And when your staff stops talking to your patients about cosmetic options, about implants, about restoring their full mouth, your patients become even more resistant to this type of dentistry.  So when you finally do get the courage to present to someone, it comes across like you don’t do this type of dentistry routinely, and as a result, the patient turns you down. 

In many cases, I have seen hesitation on the part of the dentist drive the patient to another office to get this type of dentistry done, only to return to their original dentist for “cleanings”!  That happened to me, once, and it will never happen again! 

The challenge lies in your mindset – what you believe about yourself and your ability; and what you believe your dentistry can do for your patients.  When you truly believe that what you do is a life-changer, that they must have it, that they deserve to have you do this type of dentistry, and that they are better when you provide it for them, you will come across very differently than when you are scared, hesitant, or lack the skills to do it.  But how do you go from one crown to a full mouth?  The answer is: baby steps.  You need to get your skills up first.  Once you have the clinical skills to do these types of cases, you need to get comfortable presenting them.  So if you are doing one crown at a time now, maybe start by presenting full quadrant dentistry where the patient needs a lot of work.  Or start with a smile makeover (maybe 6-10 veneers).  Discuss possibilities with your patients in a consultation appointment using their photos.  Show them what’s possible.  When you believe in your ability to do this and do this well, people will eventually pick up on that. 

So what about insurance?  Let’s face it.  Comprehensive dentistry is never covered by insurance.  Insurance maximums don’t allow for a proper restoration of someone’s mouth if they have more than one thing going on.  So it comes down to your belief system.  Do you believe in your service?  Do you believe you change people’s lives for the better?

If the dentist strongly believes in his/her skills, staff will ultimately follow.  And for the odd time it doesn’t, you have a major problem to deal with, and quickly. 

What works for me in my office is daily “sales” meetings, or for those of you who don’t like the word sales, you can call them “case presentation” meetings.  After lunch, before we start with our afternoon patients, we all gather for 30 minutes and discuss one case.  We discuss WHY I would do a certain type of treatment, what the benefits for the patient are, what the consequences are if I don’t do it now, and I ask the team to contribute and ask questions.  When they understand what is going through my mind and why I would do a full arch, for example, rather than a couple of teeth at a time, they become incredibly skilled at talking to their patients about this type of dentistry and its benefits. 

Presenting cases is a skill set and you must continue to learn and improve.  And if you are not used to it or not comfortable with it, it’s going to feel awkward at first.  Kind of like learning to write with your non-dominant hand: you may stumble at first, and mess up at times, but if you keep it up, keep trying, keep practicing, role playing and most of all, keep presenting, you will ultimately gain the confidence you need to get cases accepted and that will take you fast up the ladder to higher confidence and success.  And most importantly, for the cases that say “no”, don’t give up.  Learn from them, ask yourself what you could have done better, and do it next time.  There is always a next time, so believe in yourself and your ability to reach your ultimate potential. 

For more information on this topic, or on how to improve your Case Presentation, check us out on

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