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Cosmetic Dentistry: Getting to Yes

June 8, 2011
If patients understand what the problem is, how big it is, and what benefit they will get from your solution, they will accept care every time.

by Mark Wilhelm, DMD, MSD

A common complaint of practicing cosmetic dentists is that they know they have the necessary training and ability to provide the care a patient needs, but they can't get the patient to accept the needed treatment. Many dentists have paid consultants to help them with practice management and productivity issues, and yet they still feel like something is missing. The two themes I hear repeatedly from dentists about their practice are:

1) I don’t get enough new patients, and

2) My patients will not accept the treatment I’ve proposed.

Getting patients to say yes is simple to accomplish. If they understand what the problem is, how big it is, and what benefit they will get from your solution, they will accept care every time. Why is it that when they need a car they spend $15,000 to $35,000 at the drop of a hat and are excited about it, and then they turn right around and tell you that they can’t afford $2,700 for a three-unit bridge?

The answer is that they need the car, right? No, no, no! The real answer is that they want the car. All buying decisions are based on emotions which are later justified by logic. The problem here is that dentists are logically trained and present treatment in a logical manner. But this is not the way people buy!

Most dentists experience this first hand when they suddenly get a spike in production because of an increase in treatment coming from the hygiene room. Then, by coincidence, several patients call the office with emergency dental needs that require immediate attention. All this boils down to the fact that when patients perceive a problem, they want a remedy. They’ll tell you that they want that bridge for an abscessed tooth that must be extracted. This happens to every dentist, and when it does, we wish it could always be this easy.

In a recent survey, many dentists told me they believe their patients are too “blue collar” and don’t accept high-level treatments. I have data that prove otherwise. I can confidently tell you that it is common for these same “blue collar” patients to accept average cases between $10,000 and $15,000. How can this be? It all comes down to their understanding of what is wrong with their health, and their ability to connect to the value of restoring it.

Cosmetic dentists need to have established systems in place to deal with a patient from the initial phone call to the diagnosis and treatment presentation. You can spend years with consultants, books ,and videos, and just scratch the surface. What’s needed for successful case presentation is listening skills, rapport-building, communication, dynamic diagnosis, persuasion, and a host of other skills. But, when you get it right, you will notice your case acceptance rate climbs to over 85%.

The diagnosis needs to be exhaustive and it needs to be presented to patients in a manner that they will understand. Think about presenting treatment needs in terms of you (patient and Dr.) against their disease, not you against each other. This is a critical point which is often overlooked. As the doctor, you cannot approach the situation with an entrepreneurial mindset. Instead, you need to be a neutral consultant to identify the problem and point it out to them. When they understand their dental disease is a problem, they will naturally ask you or even tell you what they need. Now you will be on the same side of the fence, looking at your menu of treatment options. Once the patient is emotionally ready to buy, they will figure out where to get the money.

While the finances should never be your incentive, this approach will lead to more case conversions and therefore more productivity generating more income. If your average case is $2,500 and you can increase case acceptance by one case a month, you have added $30,000 in production to your schedule in a single year. If you can increase case acceptance by two a month or your average case is $5,000 or $10,000, then you can easily see that the numbers quickly add up.

Your bottom line boils down to case acceptance. The difference between the leading dental practices and everyone else is that the leading practices convert patient needs to case acceptance rates at levels exceeding 85%. Do you track your case acceptance percentage? Do you know what value an average case is worth to you? By examining these numbers, you can easily see the affect of increasing your case acceptance rates.
Mark Wilhelm, DMD MSD, has been in private practice in St. Paul since 1990, where he is focused on cosmetic dentistry, sedation dentistry, and advanced restorative procedures and dental implants. After graduating from the University of Illinois, Dr. Wilhelm received his Doctorate of Dental Medicine in 1985 from Southern Illinois University School of Dental Medicine. He continued his education to achieve a Masters of Science in Dentistry and completed specialty certificates in prosthodontics and maxillofacial prosthetics at Indiana University. Dr. Wilhelm is an author, consultant, mentor, and frequent speaker to dentists and the public on techniques that enhance oral health. He presents many seminars on implant dentistry and advanced restorative procedures to family and cosmetic dentists in the Minnesota area. Visit his website at