Dentist – Consultation – Consult Process

Cosmetic (Invisalign, Porcelain Veneers, Composite)

  • Go through their main concerns again and get them to articulate and point out areas of concerns

Have Discovery sheet in front of you

COMPUTER SCREEN SETUP:

Education: discuss 5 key factors in a nice smile. 

  1. size and shape
  2. color of teeth
  3. width of smile
  4. alignment of teeth
  5. smile line

Options

  • When discussing the option you think is most suitable go with DISADVANTAGES FIRST
  • Go through the option you want to start with at the end (second)
  • Younger patients under 23 discuss Composite

Based on your concerns and my observation, there are 2 options for you

Orthodontics (Braces or Invisalign) –Basically moving teeth to ideal position

Pros

Able to correct width of smile, alignment and smile line

Keep things natural

May need less veneers, however if size, shape and or color a concern, will not help. Will still need veneers on those teeth

Cons

May take up to 1.5 to 2 years to correct

Cannot correct size, shape and color of teeth

Will still need veneers at the end

Only helps with 3 out of the 5 concerns we are facing

VENEERS

Porcelain Pros

Helps with all 5 key factors: size, shape, color, smile line, width and alignment

Start to finish in 2-4 weeks.

Porcelain Cons

Trimming of teeth of 0.3mm

Longevity: Will last a long time but not forever. It will be around 15-20 years. Nothing man-made will last forever. God has given you a set of teeth which were meant to last for life, and in a lot of cases, even that does not happen.

If any risks go through with them! ie RCT

COMPOSITE Pros

Cost 1/3 of cost

Less Trimming

trial for porcelain upgrade later on

Composite Cons

Chipping/Breakage/Stain

Short term option More like a trial

General Treatment

  1. How I would approach your concerns by laying a foundation first, like a pyramid, we will build our way upwards.
  2. I understand that you may have some aesthetic concerns, which we will deal with later, after laying the foundation right. Your aesthetic concerns could be easily dealt with whitening etc etc. 
  3. Focus on Damaging Results of Preexisting Conditions (DREC) for each scenario.
  4. Health:
    1. Gums: healthy vs gingivitis vs perio
      1. Deep clean and description – metaphor barnacles on the jetty. Cant see them but everything present under the water.
      2. Link perio to health
      3. Very important to check in when was last dental clean/ visit – helps avoid appearing “dumb”. Example: Last hygiene done 10 years ago but you advised that teeth look clean and healthy OR last hygiene 2 months ago and you criticise how dirty teeth are – need to understand patients’ mindset and what will go through their mind – can be a trust buster
    2. Teeth: Cracks, Extent of decay
  5. Bite: Link to DREC and any pre-existing issues. 

Cosmetics: Do not touch too much on cosmetics as this group of patients is often not ready, despite patients saying they want to hear the options. Go through options very briefly i.e. veneers, whitening but advise  that foundation needs to be set right first. Deflect this part as best as you can and focus on phase 1

HEALTH PYRAMID

Damaging Results of Existing Conditions (DREC)

Most of these patients need to go through “phases” of health, bite and cosmetics due to costs.

Often patients would ask for all the options and the total costs. There’s a big risk by giving them a “full” treatment plan as you do not know their expectations of treatment and cost.


Analogy (cost deflection)

Deflect by giving the renovation analogy to assist patient in understanding the need for phasing treatment out for best outcome:

It’s like a builder going into your home. Your initial concern was just the bathroom as it looks dated, but when the builder came in, he started recommending changing the living room as the floorboards are outdated and the kitchen cabinetry could look better. 

However, your concern is just the bathroom. From here on, you have a few options: 1) Follow the advise of the builder and fix the remaining parts of the home at the same time understanding that the costs will go up

2) Stick to your budget and fix just the bathroom. and you can always revisit the living room and kitchen in the future 

My advice to you is XXX

  1. Analogy (If pt. insists on finding out full cost)

If patients insist on the full cost, find out what their budget is.

Hole in the wall analogy:

There are so many ways to fix a problem. For example, if there’s a hole in the wall, you can either just put a picture to cover the hole, patch the hole up or rebuild the wall if the hole is too large. Sometimes in certain situations, a patch up is fine. For me to be able to assist you better, I am going to ask you a question. Do you have a budget in mind?   That way, I can give you the most value for your money by maximizing the amount of treatment that should be done. Is that ok?

PLEASE NOTE:

  • Do not jump into next session without confirming what patient wants.
  • Keep Discussion light hearted
  • Pause to check in that everything makes sense PAUSE
  • What are your thoughts PAUSE
  • The LAST THING that you say to the patient is what sticks
    • this is the reason you present the “preferred” treatment option last and also why you do disadvantage then advantages for this last treatment option
    • Patient will then have: Preferred option + advantages in their mind

DECISION MUST BE MADE BEFORE PROCEEDING (circle option)


Next Step – Invisalign

For these steps write out how long it will take for each appointments (as written bellow) for Invisalign ideally after scan-> 1 week for clincheck-> 4 weeks for Start

  1. 3D scan + smile design 5mins
  2. Review your smile before we even start your tx (show them clincheck of a pt similar to them) Starting the preview of clincheck allows you to visualize how it will look – so you can envision exactly what they may look at the end.  30mins
  3. Start treatment – virtual care 60mins

Point of difference – cosmetic focus / outcome is different from one dentist to another


Next step – Cosmetic

  1. mould / scan of your teeth and smile design 5mins
  2. prep, trial smile, gum recontouring, teeth whitening
  3. Final teeth position assessment
  4. Cementation – trial first and permanent cementation later

Our process may be slightly different as we incorporate multiple contact points. This is to ensure that you will always leave here with a spectacular smile. Not one of our patients should ever leave with a smile that they are not proud of. And to do that, it starts off by designing your smile well. 

  1. I will be the one designing your smile and with that smile design, we will do a trial smile on your second visit together with the rest of your treatment such as the gum recontouring and preparation of your teeth.
  2. I will then get you back in the next day to review your smile. During this time we will assess the length, size, shape and overall smile. The reason why we want to do this only the next day is because it will give you a chance to review the smile by yourself and with your friends and family. They can then give you input and may say your smile looks amazing or they may be too long, too white, too short etc. We will then make all the necessary changes based on your feedback. The other reason is that on the day of preparation, you will be quite numb. So by giving a day, it will allow the numbness to go away as well. Any adjustments that I am making immediately after the preparation will not be accurate and precise enough due to the numbness.

Does this make sense?

  1. After the review of your smile, we will move on to the next stage. We will try on your real veneers with temporary cement. We will then assess the exact shade and colour, size and shape of your smile. If you are happy with them, we will cement them in. If not, we will make all the adjustments on the spot as our veneers are with our lab. We will try it with multiple cements to either bring the colour warmer or brighter. We can make the veneers shorter, longer, rounder, squarer, whatever you need and want.

Our process will ensure that by the time we cement your veneers in, you will be absolutely certain that this is the smile you are looking for and you will leave here with a spectacular smile.

Does this make sense to you?

Next step – General Health

Next step – Questions

2 common questions:

COST? – Deflect question first

Amazing, Cost is something that I definitely will go through with you, in fact I will definitely go through with you in detail but before we go into the cost I want to find out from you the number of veneers we need to do first and then we can work backwards to the cost.

We want patient to be educated about full extent of work and we can adjust cost down the track.

HOW MANY DO I NEED?/WHAT WOULD YOU RECCOMEND?

Look at photos

go through main concerns

I am biased with my decision because I am a dentist, I will go for perfection however I understand every one of us has got concerns or constraints, budget/finance and the needs and concerns that you come in for.

Ask questions ie.

  • If it was going to take 2 years to move them would that be an issue for you
  • Look if were to fix up the 6 front teeth without adding to the width of the smile would that be a concern for you.

If you have done your job well, the patient will ask you what’s next.

Need to keep some silent time for patients to digest information and think.

If not,

“Now, I am guided by you on what to do next.” “Where do you want to start”? 

“You don’t have to go with my recommendations”.

Our job is to give you the gold standard, but we need to take things into consideration and do what you want to do.



Next step – Price List

We have 2 options from here: (VERY IMPORTANT TO GIVE BOTH OPTIONS!!!)

As mentioned, all we have to do from here is the mould of your teeth to start the process.

The 1st option is to go home, think about your options, discuss with your friends and family and if you still feel that we are the right place for you, come back to us. We will then spend 5 minutes taking the scans for the smile design. The only thing is that you will need to travel back here. Where do you live? You may have to travel back for 2-3 hours just for 5 min.

Alternatively, we can take the scans for you today. It’s really up to you on what you want us to do. The cost for the scan is $65 X 2. 

If patient says yes:

Perfect. I am so excited for you and I can really see how I will be able to achieve a stunning smile for you (anything similar)

Have a sit back on the chair. We’ll get this sorted in a few minutes. Hayley (DA) will be assisting with this and while she’s doing the scans/ impressions, I will be writing out the treatment plan.

If patient says no:

Perfect. What we will do next is if you can sit outside at the reception area and give me 5 minutes to write up a tentative plan. From there, I will introduce you to our PC

Next step – PC Handover

Now I’m going to introduce you to our consult because He/ she is your point of contact , like your PA for everything about your treatment. He will also go through the logistics of your treatment, the appointment time, when to come in, final costs and payment options. Because we have a team of 150 people, we would like you to be able to speak to only 1 person and have a point of contact. Instead of calling the clinic and having to repeat your questions every single time, he will be your PA. If there is anything clinical that he cannot answer, I will come back to you and look after you from there.

Next step – Summary

Things to keep in mind:

  • Sit close to the patient
  • Keep Discovery sheet between you and patient
  • try and keep patient as involved as possible
  • Change patient’s body language
  • Consult structure should be the same every time
  • Decide early if it is a Cosmetic or General consult
    • Cosmetic go through 5 key factors
    • General got Through pyramid and phasing
  • Do not skip out on options
  • Ask questions and double down
  • Let patient guide you on where to go but make sure you are involved in the process
  • At the end make sure patient has the option to do scans today or another day
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