A Voice in the Arena: Champion What Your Patients Want by Dr. Chad Foster

A Voice in the Arena: Champion What Your Patients Want 

by Chad Foster, DDS, MS, editorial director

Every day during new-patient exams, we educate about and preach the benefits of orthodontic treatment. The most important among these, and rightly so, are occlusal function and long-term dental health. For any mouth that makes an appearance on the big screen in our exam rooms, there is little doubt that we tooth nerds could spend the entirety of the appointment on these important subjects.

That being said, the best available literature on orthodontic patient motivation is quite clear: The vast majority of those sitting across the table in the exam room want us to help them look better! The desire for aesthetic enhancement brought them into your office.

Let’s quickly reference the literature: Orthodontics is mainly done for psychosocial and aesthetic reasons.1 People with ideal smiles are considered more intelligent and have a greater chance of finding a job.2 Furthermore, those with good alignment or occlusion are seen in a more positive light in affective/romantic relationships.3

I’d like to share how I mishandled aesthetics in the exam room during my first six years in practice. When a new patient would come in, I generally understood that most were there for aesthetic improvement. To me, that was a given. I operated under the assumption that the patient was already well aware of the aesthetic benefit of straight teeth and a nice smile. This benefit would of course be reviewed in the exam room, but I thought I should spend more time educating them about the benefits that I assumed to be less understood—the functional and dental health benefits. If they already understood that there was an aesthetic benefit, why allocate so much time to further persuade them? I believed that if I could convince them of the benefits that they weren’t aware of, they would be even more motivated to start treatment. So that’s exactly what I did for years, and not without some measure of success. But I most often did not emotionally connect with them on what they wanted. I did not champion the cause that motivated them to come see me.

After buying my own practice a few years back and feeling more in control of my treatment choices, my mindset started to change. I started to read more and be more invested in continuing education, particularly in my favorite subject—aesthetics. I started to understand how little I knew, and I became motivated try to learn as much as I could. I felt like a student again and am humbled and grateful to still feel that way today.

What I’ve come to realize is that those who arrive at my office seeking improved aesthetics are typically not on a superficial pursuit of vanity; they’re hoping I can help them bring their special and unique beauty to the surface. The majority of patients I encounter don’t desire to look like someone else, they want to look like their best selves. It’s a pursuit that, when not dysmorphic or taken to extremes, is no less healthy than an internal pursuit of what would be considered “inner beauty.” And, man, is it fun and meaningful when you decide to champion that cause for them!

Today in my exams, the benefits of occlusal function and dental health are still always a high priority. These subjects are never discounted or diluted. But every new-patient exam begins and ends with aesthetics. The patient’s positive and unique facial features are always celebrated first. Every time. You think someone across the table from you is going to be bored or lose focus while you celebrate their beauty? Welcome to a very real and instant connection with that person or family that is equally felt on both sides of the table.

This review of their positive and unique facial features obviously includes all dentofacial anatomy that is directly and indirectly influenced by my orthodontic abilities. It also might include things outside of my orthodontic influence, such as eyes, complexion, nose, dimples, cheekbones and smile animation. For many patients, we’re the first professionals to point these things out and propose treatment recommendations that will enhance or diminish their facial appearance for the rest of their lives.

Remember why patients are there: They want to feel better about how they look. Even if they walk out the door and never start treatment with me or anyone else, I have likely spoken a truth to them that they may never hear again. They will remember it. If they take it with them, that’s good enough for me.

So, what if your personality is more reserved? What if informing someone you’ve never met before that they are beautiful doesn’t feel natural to you? Start exercising that muscle immediately! It takes time, but this can be learned and is not strictly innate. (Trust the introvert who writes this!) On an interpersonal level, there is almost nothing more powerful you can bestow on someone than a genuine and heartfelt acknowledgment that they are in some way good. We’re all wired to crave it.

This connection in the exam room is one of my favorite parts of being an orthodontist. It ranks right up there with the patient seeing the full expression of our work and their beauty at the end of treatment.

For me, as my curiosity and passion in aesthetics has grown, so has my love for what we do. We all view aesthetics differently and our individual preferences and biases often vary greatly. I hope that whatever yours are, you keep looking, keep questioning and keep learning, and in doing so continue to champion what is best for your patients.

1. Rinchuse, Daniel J. Orthodontics justified as a profession. AJODO 2002; 121: 93-96
2. Pithon, Matheus Melo. Do dental esthetics have any influence on finding a job. AJODO, 2014; 146: 423-429
3. Pithon, Matheus Melo. Impact of malocclusion on affective/ romantic relationships among young adults. Angle Orthodontist 2016; 86: 638-643

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