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The ideal patients are already within your practice, the question is do you know who they are?

As a dental practice management consultant, my job is to assess client's strengths and weaknesses and come up with specific solutions to get them closer to their goal. One of the most commonly complaints that I hear is, " I don't have any cosmetic cases" or " I don't have the types of patients who ask for a full set of dental implants". However, when I ask the same clients to present their cases on a weekly basis with photographs and x-rays, I notice that most dentists do not see the opportunities when present itself. Why?

The #1 reason, is most doctors are not trained well in diagnosing elective dentistry. They are trained to diagnose most functional problems but lack the skills to know , "what looks good and what could be improved?". The second reason is their lack of ability to communicate elective dentistry in a way to elicit emotional desires in patients.

Diagnosing elective dentistry requires a two-way communication with patients. In traditional dental models, dentists are trained to come up with a list of dental problems and offer treatment solutions. If the patient is in pain or have a visible problem such as broken or a missing tooth, this type of treatment planning could work. However, using the same way in diagnosing elective treatment can come across as if the dentist is trying to sell an expensive and often unnecessary dentistry. I train my dentist clients in the art of questioning rather than simply prescribing treatment recommendations that often faces resistance by patients. This all starts with first the dentist and the team to become good in diagnosis of normal conditions vs. ideal conditions followed by showing patients their dental photos and simply ask their opinion about various scenarios. Here is an example:

During a clinical examination, it is discovered that the patient has generalized gingival recession that is affecting the esthetics of the teeth by making them look elongated. Instead of recommending the patient various treatment solutions and risking to lose the patient because of the complexity of the treatment or the cost, I recommend interviewing the patient in the following manner to gauge patient's interest in committing to an elective cosmetic-perio treatment:

Q. Have you noticed your gums have receded ( pulled away ) throughout your mouth?

Q: What do you think has caused these recessions?

Q: Are you concerned for them to recede more?

Q: Do you see any advantage in protecting them from further recession?

Q: Is the fact that the teeth are looking longer and longer is that a concern:

Q: Has anyone discussed the various treatment options available to you to treat this condition?

Q: Would you like me to come up with a treatment plan that addresses your concern ( Repeat what concerns the patient may have listed )

I have made this quite simple for the purpose of writing this blog but in real life coaching, we role play different scenarios of questions and answers. The bottom line is, in elective dentistry, you cannot tell a patient what they need but you need to learn to ask good questions and if the patient shows the desires and wants to perform elective dentistry, they will tell you. If they show no desire, then you have at least brought up the subject for possible future consideration by the patient but most importantly, you don't treatment plan for something that the patient does not want which can make you look like a salesperson trying to sell a treatment they don't think they need.

Dr. Allen Nazeri DDS MBA is a dental practice management consultant helping dentists to develop, scale and exit from their businesses successfully. Dr. Allen offers specific coaching solutions for dentists. With two offices in Las Vegas and Bangkok, Dr. Allen is able to help dentists across the globe. For more information or register for one of Dr. Allen's coaching programs, please visit www. or email

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