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Treatment and Expectations for Dental Students

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     When dental students begin to treat patients, they are eager to implement everything they have learned in didactic courses to provide each patient with an award-winning smile. They want to provide the Cadillac of treatment plans and meet every patient's highest expectations. All crown margins will be silky smooth, there will never be flash on any restoration, the shade match on every composite will be flawless, the gingival architecture between every crown will be ideal, every patient's centric relation will match their centric occlusion, and every patient will have an aesthetic smile.

     With these in mind, students often upsell treatment to try to match patient expectations of a flawless smile rather than portray what realistic outcomes the patient can expect. While all these results are the high standards for which we strive, we all know that achieving a truly perfect result is often more difficult in reality. In addition, how a patient presents to a clinic will largely determine what their optimal treatment can be. 

     On top of these clinical challenges, we must first manage patient expectations. Not every patient presents in the same condition, but it seems like the majority are seeking a “Hollywood” smile. Before sharing treatment options with the patient, it is important to gather all the necessary diagnostic information. Even then, we must assess patient dental IQ and determine if what they are expecting in their dental experience matches what can be accomplished in a school setting. This is often a critical point to determine whether a patient accepts treatment or not.

     One common practice is to set the highest achievable result lower than what can realistically be achieved. If patients are unhappy at this stage, then it will be nearly impossible to meet their expectations and they will be better off treated elsewhere. These are “red-flag” patients. If patients understand that you can only take them to specific results given their current situation, then they are more likely to be accepting of treatment and satisfied with the outcome. These are “green-flag” patients. 

     Only after we know where we can realistically take a patient is it appropriate to present him or her with treatment plans. At this point, it is okay if patients begin to ask questions. For example, if you deliver a treatment plan for full upper and lower dentures and a patient begins to ask about implants and other means of support, it is acceptable to venture down this route of treatment options. However, before committing to treatment, it is important to explain that there are tests and consults, which require a time and financial investment.

     Successfully managing patient expectations is almost as important as the treatment we will eventually deliver. Once patients accept realistic treatment plans, they will not be disappointed when the results they receive are better than what was projected.