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.
References
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