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Inside Dentistry
April 2019
Volume 15, Issue 4

Training Your Patients’ Eyes

Joyce L. Bassett, DDS

Although roughly 75% of the US population desires pearly white teeth, dental professionals only initiate a discussion about whitening approximately 15% of the time. Patients may simply forget to ask, or they may have a preconceived notion that whitening is expensive or painful. They may also be embarrassed to bring up their desire for a whiter smile. Oftentimes, dental professionals miss the opportunity to speak about whitening because they believe that they do not have the chair time or lack simple systems to start the whitening conversation. All patients who have teeth are potential candidates for whitening. Color is one of the most important factors in dentofacial treatment planning and is the easiest parameter to enhance. Dentists and their teams should discuss the available treatments and explain how whitening works in terms that patients understand. With proper engagement, we can motivate them to achieve their proper tooth color, which can then be followed by a whiter shade that they deserve and desire and believe looks best for their face.

How do we add this step to a busy practice? We must optimize the time that we have by adding systems to our existing daily protocols.

First, update your medical history form by adding a few questions, such as the following:

• If you could change your smile, what would you change?

• Have you ever whitened your teeth? If so, what did you use, and how did it work? How are you currently maintaining your whiter smile?

• Have you ever tried a power whitening treatment in the dental office?

Next, assign a staff member to record each patient's tooth shade in detail using a shade guide. The patient actively assists in this step by holding the mirror and helping choose the color that best matches his or her teeth. This allows the patient to see all of the shade possibilities but specifically the bleaching tooth shades. During recare appointments, a hygienist can easily accomplish this task, and for new patients, it can be done by a dental assistant during the new-patient exam. A smartphone can be used to take a photograph that includes the shade tab that best matches the patient's current shade as well as all of the shade tabs that are whiter than his or her teeth. In this manner, patients can clearly see what whitening could accomplish for them. With permission, you can text this photograph to patients so that they can continue to evaluate it after the appointment.

Once they see the possibilities for whitening their own smiles, the whitening conversation can begin with an explanation of how the process works and the whitening options that are available to them. When patients choose the color for their final smiles, they become more engaged and feel that their chief concerns are at the center of your treatment plan. As trust is built, patients become more motivated to evaluate their teeth. Then, they begin to pick out all of the imperfections (eg, divots, discolored fillings, worn edges) and feel empowered to ask the dental team how they can be fixed.

The patient's desires drive the treatment planning, and the dentist revisits all of the possible treatment options, which can range from composite resin restorations to a full arch of bonded porcelain restorations. The difference with this approach is that now patients see their smile potential and own their transformation. There is no sense that they are being "sold" anything.

Whitening is often an entry point for future restorative work. Many pa-tients who are reluctant to accept a comprehensive treatment plan become more willing after they have successfully completed an easy, visible improvement in their smiles.

In addition to helping patients achieve pearly white smiles and boosting their confidence levels, these techniques can also increase a practice's net income. Whitening is one of the largest untapped revenue sources for a dental practice, and some practices using these systems have experienced a 10% increase.

When we develop office systems that train our patients to see their smiles like we do and make whitening a routine part of our practices, both patients and practices benefit.

About the Author

Joyce L. Bassett, DDS, is an accredited fellow and past president (2015-16) of the American Academy of Cosmetic Dentistry, a diplomate of the American Board of Aesthetic Dentistry, and a clinical instructor at the Kois Center.

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