How To Provide Patients With The Optimum In Smile Enhancement, Part 2

Harvey Silverman, DMD

In the last edition of Silverman On Smiles: Cosmetic Dentistry SOS I shared a valuable technique to co-diagnose and expand your elective cosmetic dentistry practice. Let’s look at another clinical case and see how you might combine your cosmetic dentistry internal marketing and management skills that you are fine-tuning to provide this patient with her dream smile.

Case Study

In the last article, my patient was treated with noninvasive veneers back in 1987. Now let’s fast forward to 2010. This will be an easy case for you to diagnose. The patient, below, presented with an old discolored composite on her maxillary left central incisor. What simple procedure would you recommend to enhance her smile? Here’s a close-up photo of her teeth.


What elective cosmetic dentistry needs to be done

 So, what treatment does she need to have done? If you were doing a cosmetic consult with her would you suggest tooth bonding, a veneer or would you even recommend having a crown placed on her left central incisor?

Lesson No. 2—At first glance this case seems easy to diagnose. Her left central incisor needs to be restored with whatever treatment you feel is most appropriate to solve her problem. But it really isn’t quite that simple. The reason is because I used the D word instead of the C-D word. With elective cosmetic dentistry we do not diagnose until we first learn what the patient wants to have done, which leads us to co-diagnosing. Therefore, once again, as stated in the last article, the answer is you do not know until you review the answers to her smile analysis form. The form allowed her to confide in you that she wanted to brighten the discolored tooth and whiten her entire smile. Treating only the discolored tooth is analogous to only seeing the tree and not the forest.

Imagine if you did not find out that the patient wanted whiter teeth and you placed a veneer that matched the existing shade of her teeth. In a few weeks, when this patient wanted to talk about the possibility of doing whitening, you would have a dilemma.

Here is the outcome of placing one LifeLike Veneer on her left central incisor in conjunction with in-office tooth whitening:



LifeLike Veneer on her left central incisor. Note the seamless emergence profile.

A bright, white, natural-looking smile after in-office whitening and 1 LifeLike Veneer. Note how perfectly the LifeLike Veneer blends in with the adjacent teeth.

 Cosmetic dentistry done by Harvey Silverman

I hope you and your team are excited about expanding your elective cosmetic practice. If you have any questions, feel free to contact me or let me know if I can help you take your cosmetic dentistry practice to the next level. Remember to always give your patient an opportunity to share what changes he/she wants before you decide if they are a candidate for a specific elective cosmetic dentistry procedure—and then provide your patients with the optimal cosmetic dentistry to have a brighter, more self-confident smile!

Dr. Silverman has been successfully coaching dentists on how to expand their cosmetic dentistry practice since 1984. If you want to take your cosmetic practice to the next level or want more information about the Silverman Institute’s 24 Hour Cosmetic Transformation Program, please contact him at (216) 256-4599 or e-mail him at This email address is being protected from spambots. You need JavaScript enabled to view it..


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