Do You Talk About Dentistry?

You have a patient in the chair. She has an esthetic need that is obvious to anyone who has seen her smile. You're both aware of it, yet neither one of you mentions it.

Why not?

Most dentists who decline to raise the topic with patients like this will say they do it out of respect for the patient's feelings. They believe that it's their duty to address clinical health issues. If the patient wants to do something about their esthetic issues, well, they'll ask about it.

But there are real health issues at stake here – the patient's social and mental health issues tied to self-esteem – and it's sadly ironic if those issues are never explored because of social inhibitions.

When a medical doctor advises someone that they need to lose some weight it's understood that the normal social rules about commenting on another's appearance don't apply.

Similarly, there is really only one person who is qualified to speak to that patient in your chair – respectfully but candidly – about the esthetic condition of her mouth and the possibilities that exist. And you're not doing this patient any favors by withholding your advice out of a sense of social propriety.

There's also another good reason for always advising patients of their full range of options. It's a frustrating scenario that I have seen played out many times.

One day a patient decides they actually want to do something about their esthetic deficiencies and go to another practice to get the work done. When their long-time dentist asks why they didn't come to them, they get an eye-opening answer: "I didn't think you did that kind of thing."