Dental case presentation: present the PROBLEMS not the treatment!

Dr. Chris Bowman looks at case presentation in a whole new way. While we would all would like more patients to say YES to ideal treatment recommendations, he believes we should NOT try to present treatment or gain acceptance of our cases. He says the problem with focusing on “presenting treatment” or “closing the case” is that most patients simply do not realize that they have the PROBLEMS that require the recommended treatment in the first place! He suggests that dentists and team members NOT present treatment, but instead present the problems.

Jan 19th, 2014
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World famous speaker, author, and philosopher Earl Nightingale once said, If you’re in a situation and you don’t have any clear way forward and want for clear advice, look around and see what everyone else is doing and do the opposite.

These words are so wise, and they apply to countless principles in any business, including dentistry. I mention this now because all too often dentists find themselves asking, “What would most dentists do (in a certain situation)?” Or, “What would most coaches/consultants advise me to do?” Well, since many dentists are not ultra-successful …and most coaches/consultants offer the same old, tired advice … either question will usually not get you to the best answers!

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Here’s a key example. How many times have you sought or received advice on “case acceptance” or “presenting treatment”? Chances are a ton! While I acknowledge that all dentists would like more of their patients to say YES to the most ideal treatment recommendations, I contend that we actually should NOT be trying to present treatment or gain acceptance of “the case.” After all, how many people really want dental treatment? How many want fillings, crowns, root canals, veneers, etc., in or on their teeth? In short … most dentists are presenting the WRONG thing!

The problem with focusing on “presenting treatment” or “closing the case” is that most patients simply do not realize that they have the PROBLEMS that require the recommended treatment! Very, very few people realize the extent of any existing dental problems they may have. In fact, most dental patients with significant dental needs are completely without noticeable symptoms. In essence they are fairly comfortable with how they are right now, except for any potential cosmetic goals they may have.

When you couple this fact with the unpleasant thoughts of receiving dental treatment, it’s no wonder why dentists and team members have so much trouble getting patients to say YES to recommeded treatment to fix their problems. In reality, if patients are not uncomfortable with their problems, they aren’t seeking solutions for those problems … plain and simple … so why would they move forward with treatment that they perceive to be so uncomfortable and inconvenient?

On the other hand, consider the emergency patient — someone who is in your office because a tooth is broken, hurting, or both. Is it easier or more difficult to motivate that patient to accept restorative care than a symptom-free patient? Easier, of course, in almost all cases!

In fact, an emergency patient can often be heard saying, “I don’t care how much it costs, what time the appointment is … I’ll get through my fears … I just want to get this fixed NOW!”

Why? Because they know that they need to get something done about the problem! And, because they’re UNCOMFORTABLE with the way things are now. Other barriers such as cost, time, and fear are cast aside to a great extent and often eliminated completely in order to deal with the problem and get it fixed.

Conversely, patients who are relatively comfortable, with no symptoms, are much less likely to be motivated to getting anything fixed, especially when they don’t think anything is wrong! When presented with treatment that they don’t think they need, the cost, time commitment, and anxiety become BIGGER issues, making them more resistant to take action.

So now that we fully understand this concept, what can we do about it? How can we overcome it and get our otherwise “comfortable” patients to understand their treatment needs in such a way that they are highly motivated to do something about it?

The answer lies just as much in what we shouldn’t do as it does in what we should do!

Don’t present “treatment” (yet). Instead, present the problems!

I know what you’re thinking. THIS GUY’S CRAZY!! “I thought proper ‘case presentation’ techniques were the way to go. I have my system for ‘presenting treatment.’ You’re telling me that I’m not supposed to do that?”

Well, YES and NO. There will be a time when it’s important to present treatment options for your patients, with special emphasis on the most ideal choices. But it shouldn’t be the FOCUS of the conversation.

Instead, the most critical part of the conversation with a patient concerning his or her treatment needs must be your thorough explanation of the PROBLEMS! I’ve given this concept a new name: Problem presentation.

You must be able to present the existing problems to each patient in a way that compels him or her to request a solution. When the patient understands that he or she has dental problems, only then will he or she potentially be inclined to do something about them.

Once you learn to present the problems using the right simple techniques, then gaining acceptance for the treatment becomes virtually automatic. Your “case acceptance” becomes a slam dunk!

Instead of YOU trying to convince your patients that they need the treatment you’re recommending, THEY will be convincing YOU to do something now!

Ever since I became aware of this phenomenon and implemented the appropriate changes, I have enjoyed truly stellar levels of case acceptance in my practice, even beyond my expectations. Of course it’s not just me; my team actually drives the whole process. Truth is, any doctor and team can get the same results! It seems too simple to believe, but it’s true.

Consider working backwards from the dental procedures you perform to clarify the particular problems you should be presenting. Here’s a small list of examples:

TreatmentProblems to present to patients
FillingsNew cavities, recurrent decay, old smaller broken-down fillings, etc.
CrownsOld larger fillings, cracked teeth, broken teeth, worn teeth, etc.
Perio therapy
Periodontal disease (gum infection), bleeding gums, excessive tartar, pus, etc.
OrthodonticsCrooked teeth, spaced teeth, uneven smile, poorly fitting bite, etc.
VeneersUnattractive smile, "aging" smile, discolored, misshaped teeth, etc.

See what I mean? After bringing up, showing (with digital photos), and describing your patients’ problems to them in plain language, plus demonstrating the fact that the direction those problems are heading is not the direction that suits their dental goals, your ability to gain acceptance of recommended treatment increases exponentially!

Patients don’t want “treatment.” They only want solutions to the problems they know they have. By employing problem presentation in your practice, you’ll enjoy better end results:

  • More treatment scheduled
  • Healthier, happier patients who’ll be more likely to refer their friends and family
  • Bigger bottom-line profits for your practice and you!

Chris Bowman, DDS, is a full-time practicing dentist, speaker, author, and dental coach/consultant from Charlotte, NC. He has lectured nationally and internationally on topics such as practice management, marketing, and advanced dental communications. Also a Six Month Smiles clinical instructor, Dr. Bowman’s mission is to empower dentists to be more successful. For more information on maximizing phone skills in practice and other resources, go to

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